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1.
临床上子宫切除术为妇科常见手术,包括开腹子宫切除术、腹腔镜下子宫切除术和经阴道子宫切除术。临床书写手术名称与ICD手术编码有所区别,并不能完全反应出编码所需的要素。编码时容易错编和漏编。根据ICD-9-CM-3手术分类规则,子宫切除术的手术编码以手术入路、术式、手术切除范围等方面为轴心进行分类,分别为经腹子宫次全切除术68.3、经腹子宫全部切除术68.4、经阴道子宫切除术68.5、经腹根治性子宫切除术68.6和经阴道根治性子宫切除术68.7等术式。实际工作中,编码员应准确掌握手术编码的分类轴心,应结合不同案例分析,阅读手术记录明确了手术的入路、术式、手术切除范围等相关信息,尤其是手术的切除范围、是否伴有临近器官的切除和是否伴有淋巴结的清扫等,从而提高子宫切除术编码的准确性与完整性。 相似文献
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目的 探讨不同时期慢性阻塞性肺疾病(COPD)患者血清诱饵受体3(DcR3)、凋亡抑制蛋白(Survivin)表达水平及临床意义。方法 选取2018年9月—2019年12月本院收治的92名COPD患者为研究对象,其中稳定型COPD 50例,急性加重期COPD 42例;同期本院健康体检者88例为对照组。测定各组研究对象血清DcR3、Survivin水平及肺功能指标。 与对照组[DcR3(106.54±48.35)pg/mL,Survivin(98.85±26.59)pg/mL]比较,稳定期组和急性加重期组血清DcR3[(395.23±123.85)pg/mL,(1 248.81±213.59)pg/mL]、Survivin [(267.54±84.69)pg/mL,(1 233.95±307.26)pg/mL]水平升高;与稳定期组比较,急性加重期组血清DcR3、Survivin水平升高。与对照组比较,稳定期组和急性加重期组FEV1%、FEV1 /FVC、DLCO%水平降低(P<0.001);与稳定期组比较,急性加重期组FEV1%、FEV1 /FVC、DLCO%水平降低(P<0.001)。随着低氧血症严重程度的增加,COPD患者血清DcR3、Survivin水平逐渐增加(P<0.001)。多因素logistics回归分析显示,高水平DcR3、Survivin、IL-12、hs-CRP为COPD病情的危险因素(P<0.001)。DcR3、Survivin与FEV、FEV1 /FVC呈负相关,与IL-12、TNF-α、hs-CRP呈正相关(P<0.001)。 COPD稳定期、急性加重期患者血清DcR3、Survivin表达水平升高,且DcR3、Survivin与COPD病情严重程度呈正相关。 相似文献
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目的研究喉癌肿瘤相关成纤维细胞(CAFs)外泌体表达下调的miRNA-656-3p对喉癌细胞生长和侵袭能力的影响以及丹参酮ⅡA对其调控作用。方法将CAFs外泌体miRNA-656-3p表达上调,制备外泌体上清,检测其对喉癌细胞体外增殖、侵袭能力及细胞周期的影响。检测中药提取物丹参酮ⅡA是否具有类似的上调CAFs外泌体miRNA-656-3p表达的作用,其作用后的CAFs外泌体上清是否具有类似的抑制喉癌增殖和侵袭能力的功效。结果过表达miR-656-3p的CAFs外泌体上清能抑制喉癌细胞的体外增殖和侵袭能力,抑制CCND2的表达,并将喉癌细胞阻滞在G0/G1期。而丹参酮ⅡA也可以上调CAFs外泌体中miR-656-3p的表达水平,其作用后的CAFs外泌体能发挥类似的抑制喉癌细胞体外增殖和侵袭的功效。结论喉癌CAFs外泌体miRNA-656-3p的表达下调促进喉癌细胞的生长和侵袭能力,丹参酮ⅡA可上调CAFs外泌体miR-656-3p的表达,通过后者抑制喉癌细胞的生长和侵袭能力。 相似文献
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Qi Zhang Shuang Wu Qianqian Xiao Chenping Kang Hong Hu Xiaohong Hou Xuetao Wei Weidong Hao 《Journal of applied toxicology : JAT》2022,42(4):588-599
Obesogens are a subset of endocrine disruptor chemicals (EDCs) that cause obesity. The typical EDC 4-nonylphenol (4-NP) has been identified as an obesogen. However, the in vitro effects of 4-NP on adipogenesis remain unclear. In this study, 3T3-L1 preadipocytes and C3H/10T1/2 mesenchymal stem cells (MSCs) were used to investigate the influence of 4-NP on adipogenesis. The differentiation protocols for 3T3-L1 preadipocytes and C3H/10T1/2 MSCs took 8 and 12 days, respectively, beginning at Day 0. In differentiated 3T3-L1 preadipocytes, 20 μM 4-NP decreased cell viability on Days 4 and 8. Exposure to 4-NP inhibited triglyceride (TG) accumulation and adipogenic marker expression on Days 0–8, but the inhibitory effects were weaker on Days 2–8. The protein expression of pSTAT3 or STAT3 decreased on Days 0–8 and 2–8. Conversely, 4-NP promoted TG accumulation and the adipogenic marker expression in C3H/10T1/2 adipocytes. The opposing effects were attributed to physiological differences between the two cell lines. The 3T3-L1 preadipocytes are dependent on mitotic clonal expansion (MCE) to drive differentiation, while C3H/10T1/2MSCs and human preadipocytes are not. Additionally, 4-NP downregulated β-catenin expression in C3H/10T1/2 adipocytes. Accordingly, we hypothesized that 4-NP promotes adipogenesis. The role of the canonical Wnt pathway in the promotion of adipogenesis by 4-NP requires further validation. This study provides new insights into the mechanisms and appropriate risk management of 4-NP. 相似文献
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胃癌作为临床最常见的肿瘤之一,常因确诊疾病较晚而影响治疗效果,胃镜活检后的病理虽然作为确诊的金标准,但是由于此方式过程痛苦,操作复杂,费用较高,且具有侵入性,可能会导致患者拒绝操作而难普及于临床,因此积极找寻胃癌有效的监测指标十分必要。近年来,很多学者研究维生素与胃癌的相关关系,并试图通过摄取某些维生素降低胃癌发生率,延缓病情及改善预后,也有通过检测血清中维生素的水平给早期胃癌的诊断提供帮助。本文就同型半胱氨酸、维生素D、维生素C、维生素E、维生素B12及叶酸在胃癌中的作用机制,及其在血清中水平与胃癌关系的相关研究进展进行简要综述,为临床胃癌诊疗提供新思路。 相似文献
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《Dental materials》2022,38(9):1459-1469
ObjectiveTo evaluate the manufacturing accuracy of zirconia four-unit fixed dental prostheses (FDPs) fabricated by three different additive manufacturing technologies compared with subtractive manufacturing.MethodsA total of 79 zirconia FDPs were produced by three different manufacturing technologies, representing additive (one stereolithography [aSLA] and one material jetting [aMJ] device, two digital light processing [aDLP1/aDLP2] devices) and subtractive manufacturing (two devices [s1/s2]), the latter serving as references. After printing, additively manufactured FDPs were debound and finally sintered. Subsequently, samples were circumferentially digitized and acquired surface areas were split in three Regions Of Interest (ROIs: inner/outer shell, margin). Design and acquired data were compared for accuracy using an inspection software. Statistical evaluation was performed using the root mean square error (RMSE) and nonparametric Kruskal-Wallis method with post hoc Wilcoxon-Mann-Whitney U tests. Bonferroni correction was applied in case of multiple testing.ResultsRegardless the ROI, significant differences were observed between manufacturing technologies (P < 0.001). Subtractive manufacturing was the most accurate with no significant difference regarding the material/device (s1/s2, P > 0.054). Likewise, no statistical difference regarding accurary was found when comparing s2 with aMJ and aSLA in most ROIs (P > 0.085). In general, mean surface deviation was< 50 µm for s1/s2 and aMJ and< 100 µm for aSLA and aDLP2. aDLP1 showed surface deviations> 100 µm and was the least accurate compared to the other additive/subtractive technologies.SignificanceAdditive manufacturing represents a promising set of technologies for the manufacturing of zirconia FDPs, but not yet as accurate as subtractive manufacturing. Methodological impact on accuracy within and in between different additive technologies needs to be further investigated. 相似文献
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