��ͯ����ԭ�ۻ����ٴ��ص��������ù۲�

??Abstract?? Objective To summarize the clinical features of hepatic glycogen storage disease to improve the diagnosis and treatment and decrease the possibility of misdiagnosis. Methods Twelve cases of hepatic glycogen storage disease in Shengjing Hospital from May, 2007 to November, 2013 were analyzed retrospectively and followed up. Results Two cases were misdiagnosed in the 5 final diagnosed cases at first treatment. Liver dysfunction and growth retardation are the main symptoms, 2 cases with low blood glucose and 3 cases with jaundice??4 cases were screened positive result for epinephrine stimulating test. Two time of follow-up confirmed these cases still suffered from hepatomegaly and splenomegaly, liver dysfunction, growth retardation, etc. In suspected diagnosed group,only 1 case was screened positive result for epinephrine stimulating test. Conclusion The clinical manifestations of hepatic glycogen storage disease are multiple. Therefore, physicians should have sufficient recognition for this disease and give a right and prompt diagnosis based on family history, physical examinations and laboratory findings.     

�������Բ������֯ѧ���ͼ������ٰ�����

??Histologic types of benign breast disease and the risk of breast cancer LIU Lu, ZHENG Xin-yu. Department of Breast Surgery, the First Hospital of China Medical University, Shenyang 110001, China
Corresponding author:ZHENG Xin-yu, E-mail: xyzheng126@126.com
Abstract Some histologic types of benign breast disease (BBD) increase the risk of breast cancer. Histologically BBD are classified into nonproliferative and proliferative disease with and without atypia. The risk is higher in women with proliferative disease with atypia followed by those with proliferative disease without atypia. Generally women with nonproliferative disease and without a family history of breast cancer have no elevation in breast cancer risk compared with women of similar age from the general population. However, it is less clear whether histologic entities such as complex sclerosing adenosis, radial scar, and papilloma are associated with increased risk in the absence of atypical hyperplasia.     

���ɺ��ӵ���Բ��δ���뷴��˨��

??Abstract??The patent foramen ovale (PFO) persists during fetal life and approximately 1 of every 4 adults.In recent years??PFO has been implicated in the etiology of cryptogenic stroke secondary to paradoxical embolism??migraine headache??platypneaorthodeoxia syndrome and neurologic decompression illness.This article focuses on the relationship between PFO and PDE??the current research status and treatment of PFO-related syndromes??so as to further understand PFO and PDE??thus proposing theoretical evidence for the treatment of PFO-related syndromes.     

超脉冲CO2点阵激光辅助中药苦参油膏治疗增生性瘢痕的临床疗效观察

目的探讨超脉冲CO₂点阵激光辅助中药苦参油膏治疗增生性瘢痕的临床疗效。方法选取增生性瘢痕患者72例,随机分为对照组和研究组,每组各36例。对照组采用CO₂点阵激光治疗,冷敷冷疗后直接包扎,研究组在此基础上配合中药苦参油膏外敷,观察疗效和不良反应情况,比较两组患者疼痛指数、创面愈合时间、温哥华瘢痕量表(VSS)评分以及治疗后色沉发生率。结果每次治疗后研究组疼痛指数评分及创面愈合时间均低于对照组(P<0.05)。治疗前两组患者VSS评分无统计学差异(P>0.05);治疗后2个月和6个月时,研究组VSS评分均明显小于对照组(P<0.05)。研究组色沉发生率38.88%,明显低于对照组的72.22%,差异有统计学意义(P<0.05)。结论超脉冲CO₂点阵激光辅助中药苦参油膏治疗增生性瘢痕,可明显降低疼痛指数和VSS评分,缩短创面愈合时间,且不良反应较少,值得临床推广应用。     

细胞因子诱导的imDCs鉴定及免疫学功能研究

目的:分析未成熟树突状细胞(immature dendritic cells,imDCs)的免疫学功能,诱导同种异体复合组织移植局部免疫耐受性。方法:采用细胞因子诱导培养黏附法,取大鼠骨髓前体细胞,粒细胞-巨噬细胞集落刺激因子联合白细胞介素-4细胞因子诱导下培养7 d,收集贴壁细胞光学显微镜观察imDCs的形态学特征,用质量分数2%锥虫蓝染色检测活性细胞率;应用流式细胞仪分析imDCs表面标志分子;MTT比色法测定imDCs与同种异体T淋巴细胞混合培养后T淋巴细胞的增殖能力。结果:制备诱导培养的imDCs具有形态不规则、表面粗糙层叠状皱褶、胞质突起短而多、树枝样分叉明显等典型形态特征;活性细胞率高达93%;表面较特异标志分子OX62为(61.08±4.86)%,OX62阳性细胞表达CD80、CD86、组织相容性复合体-Ⅱ表达率分别为(3.56±0.73)%、(5.38±1.09)%、(6.45±0.74)%,均为较低表达;imDCs对同种异体T淋巴细胞基本无刺激增殖能力。结论:用细胞因子诱导培养黏附法取骨髓前体细胞,可较快分选出活性和纯度较高、数量足够的imDCs,为同种异体复合组织移植诱导免疫耐受防止排斥反应的研究奠定良好的基础。     

糖尿病并高血压的药物康复治疗

糖尿病患常伴有高血压。高血压的发生率在糖尿病人群是非糖尿尿病人群的两倍，高血压和糖尿病均被认为是发生大血管和微血管病变的危险因素．高血压控制不良．常常导致肾功能减退，继而肾功能衰竭。当平均动脉压(MAP)保持在92mmHg以下时，肾衰的进程可能会停止，所以抗高血压治疗可以减慢糖尿病肾病的发展。     

拔出部分代偿性气管套管置胃管法在临床中的应用

人体的大脑缺氧超过5min,脑细胞将产生不可逆的损害.当患者自主呼吸暂停或过弱,不能维持必要的每分钟通气量时,则需要机械装置来增加通气量,提供氧疗,改善换气功能,减少呼吸能量消耗.它是支持呼吸、循环功能不全的重要手段.最常用、最直接、最有效的方法便是及时行气管切开并行呼吸机辅助呼吸.     

阿立哌唑致脱发一例

阿立哌唑引起脱发的报道不多，现将具有完整病程记录的1例报告如下     

指动脉皮瓣修复手指深度烧伤——附32例报告

目的:评价指动脉皮瓣修复手指深度烧伤的临床效果。方法:手指深度烧伤伴肌腱及指骨外露患者32例共36指,应用带指动脉、神经蒂顺行岛状皮瓣推进术或指固有动脉逆行岛状皮瓣转移术(包含吻合指神经背侧支指动脉逆行岛状皮瓣转移术)治疗,分别于术后3、6、12个月运用美国手外科学会总主动活动度(TAM)系统评定标准和按英国医学研究会(BMRC)标准,对患者供瓣区及被修复手指的感觉、运动、外观以及生活和工作质量进行评价。结果:术后半个月36指皮瓣全部存活,所有伤指运动功能恢复良好,无明显关节活动受限;长度良好,色泽正常,外观不臃肿,指腹饱满,质地柔软;指固有动脉顺行岛状皮瓣及吻合指固有神经背侧支指动脉逆行岛状皮瓣感觉恢复好;日常生活不受影响且恢复了工作。29例32指获完整随访,其中行带指动脉、神经蒂顺行岛状皮瓣推进术9指的术后3、6、12个月的平均综合评定均为优;指固有动脉逆行岛状皮瓣转移术15指术后3、6、12个月的平均综合评定分别为良、良、优,吻合指神经背侧支指动脉逆行岛状皮瓣转移术8指术后3、6、12个月的平均综合评定分别为良、优、优。结论:该类术式简单,可一次完成,皮瓣外形佳,是目前较为理想的治疗方法,使手指保持良好的功能与形态,供区功能和外形也较好。