振动觉阈值对糖尿病足溃疡风险的预测价值及其危险因素研究

目的探讨振动觉阈值(vibration perception thresholds,VPT)对糖尿病足溃疡风险的预测价值及其危险因素。方法采用美国振动感觉定量检查仪测定60例未发生足溃疡的2型糖尿病患者及30例正常人双足第1跖骨关节头的VPT。结果糖尿病患者的VPT显著高于年龄匹配的正常人(P<0.001)。60例糖尿病患者中VPT升高46例(76.7%),其中低度风险8例(17.4%),中度风险23例(50.0%),高度风险15例(32.6%),有糖尿病周围神经病变(diabetic peripheral polyneuropathy,DPN)症状31例(67.4%),无症状15例(32.6%)。<65岁年龄组,以低中度风险为主,≥65岁年龄组,以高度风险为主,差异有统计学意义(P<0.001)。<5年病程组,以低中度风险为主,≥5年病程组,以高度风险为主,差异有统计学意义(P<0.01)。VPT升高组与正常组比较,前者的年龄较大(P<0.001),病程较长(P<0.005)。二组性别、体重指数(BMI)、空腹血糖(FBS)、糖化血红蛋白(HbA1c)、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白蛋固醇(LDL-C)、糖尿病视网膜病变合并率、心电图缺血性改变合并率、高血压合并率、吸烟率和饮酒率差异无统计学意义(P>0.05)。多元线性回归分析显示,年龄、病程是影响VPT的独立危险因素。结论VPT是一项花费小、简单无创的预测糖尿病足溃疡风险的可靠指标。增龄、病程长可促进糖尿病足溃疡的发生。     

迷你腹腔镜甲状腺切除术

目的 探索迷你腹腔镜甲状腺切除术的可行性、微创性及临床应用价值.方法 对33例甲状腺肿瘤患者行迷你腹腔镜甲状腺肿瘤切除术.结果 手术成功32例,中转开放1例.手术时间28～180min,术中出血量2～120mL.无术后大出血、窒息、声音嘶哑、手足抽搐等严重并发症,术中、术后无死亡病例.结论 迷你腹腔镜甲状腺切除术是安全可行的.手术切口隐蔽,愈合后几乎不留疤痕,创伤小,美容效果好,有望成为腹腔镜甲状腺切除术的主流术式.     

Expression of hypoxia inducible factor-1α and basic fibroblast factor in the tissues of colorectal adenocarcinoma

Objective To observe expression of hypoxia inducible factor-1α(HIF-1α)and basic fibroblast growth factor(BFGF)in the tissues of colorectal adenoearcinoma and analyze the relationship between expression of the two factors and biological behavior of colorectal adenocarcinoma.Methods The samples of colorectal adenocarcinoma(n=60)and para-adenocarcinoma(n=60)were taken from surgical resection patients and normal colorectal tissues (n=20) from patients with irritable bowel syndrome.The expression of HIF-1α and BFGF were detected by immunohistochemical staining (SP method).Results Positive rates of HIF-1αand BFGF in colorectal adenocarcinoma tissues were 61.7% and 65.0%,and positive rates of HIF-1α and BFGF in para-adenocarcinoma tissues were 10.0%and 13.3%(P<0.05,respectively);HIF-1αand BFGF were not detected in normal intestinal mucosa.There was no significant correlation with HIF-1α and BFGF expression in colorectal adenocarcinoma tissues to the sexuality,age,tumor size,tumorposition and differentiation(P>0.05).A significant correlation between expression of the two factors and Dukes stage was observed (P<0.05).Positive rates of HIF-1α and BFGF in colorectal adenocarcinoma tissuesof Dukes A and B stage were 47.2%and 52.7%,respectively.Positive rates of HIF-1α and BFGF in colorectal adenocarcinoma tissues of Dukes C and D stage were 83.3%and 83.3%.respectively.There was a positive correlation between expression of the two factors and carcinogenesis of colorectal adenocarcinoma(r=0.4276.P<0.001).Conclusion The results showed that the enhanced expression of HIF-1 α and BFGF incolorectal adenocarcinoma tissues may be associated with the prognosis of the patients with colorectal adenocarcinoma,and HIF-1α and BFGF may participate synergistically in the carcinogenesis of colorectal adenocarcinoma.     

Expression of hypoxia inducible factor-1α and basic fibroblast factor in the tissues of colorectal adenocarcinoma

Objective To observe expression of hypoxia inducible factor-1α(HIF-1α)and basic fibroblast growth factor(BFGF)in the tissues of colorectal adenoearcinoma and analyze the relationship between expression of the two factors and biological behavior of colorectal adenocarcinoma.Methods The samples of colorectal adenocarcinoma(n=60)and para-adenocarcinoma(n=60)were taken from surgical resection patients and normal colorectal tissues (n=20) from patients with irritable bowel syndrome.The expression of HIF-1α and BFGF were detected by immunohistochemical staining (SP method).Results Positive rates of HIF-1αand BFGF in colorectal adenocarcinoma tissues were 61.7% and 65.0%,and positive rates of HIF-1α and BFGF in para-adenocarcinoma tissues were 10.0%and 13.3%(P<0.05,respectively);HIF-1αand BFGF were not detected in normal intestinal mucosa.There was no significant correlation with HIF-1α and BFGF expression in colorectal adenocarcinoma tissues to the sexuality,age,tumor size,tumorposition and differentiation(P>0.05).A significant correlation between expression of the two factors and Dukes stage was observed (P<0.05).Positive rates of HIF-1α and BFGF in colorectal adenocarcinoma tissuesof Dukes A and B stage were 47.2%and 52.7%,respectively.Positive rates of HIF-1α and BFGF in colorectal adenocarcinoma tissues of Dukes C and D stage were 83.3%and 83.3%.respectively.There was a positive correlation between expression of the two factors and carcinogenesis of colorectal adenocarcinoma(r=0.4276.P<0.001).Conclusion The results showed that the enhanced expression of HIF-1 α and BFGF incolorectal adenocarcinoma tissues may be associated with the prognosis of the patients with colorectal adenocarcinoma,and HIF-1α and BFGF may participate synergistically in the carcinogenesis of colorectal adenocarcinoma.     

Expression of hypoxia inducible factor-1α and basic fibroblast factor in the tissues of colorectal adenocarcinoma

Objective To observe expression of hypoxia inducible factor-1α(HIF-1α)and basic fibroblast growth factor(BFGF)in the tissues of colorectal adenoearcinoma and analyze the relationship between expression of the two factors and biological behavior of colorectal adenocarcinoma.Methods The samples of colorectal adenocarcinoma(n=60)and para-adenocarcinoma(n=60)were taken from surgical resection patients and normal colorectal tissues (n=20) from patients with irritable bowel syndrome.The expression of HIF-1α and BFGF were detected by immunohistochemical staining (SP method).Results Positive rates of HIF-1αand BFGF in colorectal adenocarcinoma tissues were 61.7% and 65.0%,and positive rates of HIF-1α and BFGF in para-adenocarcinoma tissues were 10.0%and 13.3%(P<0.05,respectively);HIF-1αand BFGF were not detected in normal intestinal mucosa.There was no significant correlation with HIF-1α and BFGF expression in colorectal adenocarcinoma tissues to the sexuality,age,tumor size,tumorposition and differentiation(P>0.05).A significant correlation between expression of the two factors and Dukes stage was observed (P<0.05).Positive rates of HIF-1α and BFGF in colorectal adenocarcinoma tissuesof Dukes A and B stage were 47.2%and 52.7%,respectively.Positive rates of HIF-1α and BFGF in colorectal adenocarcinoma tissues of Dukes C and D stage were 83.3%and 83.3%.respectively.There was a positive correlation between expression of the two factors and carcinogenesis of colorectal adenocarcinoma(r=0.4276.P<0.001).Conclusion The results showed that the enhanced expression of HIF-1 α and BFGF incolorectal adenocarcinoma tissues may be associated with the prognosis of the patients with colorectal adenocarcinoma,and HIF-1α and BFGF may participate synergistically in the carcinogenesis of colorectal adenocarcinoma.     

经胸壁入路微型腹腔镜甲状腺切除术并发症防治体会

目的探讨经胸入路微型腹腔镜甲状腺切除术并发症的预防和处理。方法对应用经胸入路微型腹腔镜甲状腺切除术的病人可能出现和已经出现的并发症进行预防和处理。结果经胸入路微型腹腔镜甲状腺切除术共33例，术中大出血、中转开放1例，头晕、呕吐2例，吞咽疼痛3例，一过性声音嘶哑1例，胸前皮肤红肿、淤斑1例。切口过度瘢痕增生1例，术中、后均无死亡病例。结论熟悉甲状腺的解剖结构，熟练细致的腹腔镜操作技术，显露喉返神经，良好的麻醉方式，是预防和减少各种并发症发生的有效途径。     

尿道口处女膜异常所致尿频52例临床分析

对诊断为尿道口处女膜异常的 52例患者行尿道外口成形术并进行随访观察。结果有效率 10 0 % ,尿频症状消失90 .38% ( 47/ 52 ) ,明显减轻 9.61% ( 5/ 52 )。性生活改善 94 .12 % ( 32 / 34 )。认为尿道外口成形术是治疗尿道口处女膜异常的简单有效的方法     

轻度低温,冬眠,机械辅助呼吸求治重型颅脑损伤42例疗效分析

目的：探讨轻度低温，冬眠，呼吸机辅助在重型颅脑损伤的治疗作用。方法：对照组按常规综合治疗，治疗组在常规综合治疗的基础上，应用轻度低温加冬眠及机械辅助呼吸治疗。结果：治疗组昏迷平均时间２４天，病死１５例，病死率，并发症２７例，发生率，中残７例，中残率，重残４例，重残率（９．５％）。对照组昏迷平均时间３２天，病死２４例，病死率（５７．１％），并发症３３例，发生率（７８．６％），中残５例，中残率９１１．     

内镜下高频电凝联合根除幽门螺杆菌治疗隆起糜烂性胃炎的临床研究

目的 探讨应用内镜下高频电凝联合根除幽门螺杆菌(Hp)治疗隆起糜烂性胃炎(EGP)的价值和安全性.方法 将60例EGP患者分成A组(抑酸、保护胃黏膜、根除Hp药物治疗)和B组(抑酸、保护胃黏膜、根除Hp药物+高频电凝治疗同时进行)各30例,比较两种方法 的疗效.结果 A组单纯药物治疗后临床症状缓解(P＜0.05),但隆起病灶数消失不明显,仅有18.57%(47/253)的隆起病灶消失;B组治疗后,临床症状明显缓解(P＜0.05),97.15%(273/281),隆起病灶消失(P＜0.05),与单纯药物治疗组比较差异有统计学意义(P＜0.05).有6例出现轻微上腹胀或上腹隐痛,均在术后5 d内消失.结论 EGP单纯药物治疗疗效欠佳,内镜下高频电凝联合根除Hp治疗EGP不仅疗效确切,而且安全简便.     

右腋下侧切口在体外循环心内直视手术中的临床应用(附63例报告)

目的:探讨经右腋下侧切口径路施行体外循环心内直视手术的手术效果、适应证及美学效果.方法:对63例心脏疾病患者(侧切口组)采用右腋下侧切口径路经第4肋间入胸,施行体外循环心内直视手术,选择59例同期经胸骨正中切口施行体外循环心内直视手术的心脏疾病患者作为对照组,对两组患者的体外循环时间、主动脉阻断时间、呼吸机辅助呼吸时间和术后胸液引流量及术后住院天数进行对比分析.结果:全组术后无死亡,发生并发症4例(6.3%).采用右腋下侧切口径路施行手术患者的体外循环时间、主动脉阻断时间和呼吸机辅助呼吸时间与同期采用胸骨正中切口径路手术患者比较差异无统计学意义(P＞0.05),但术后胸液引流量及术后住院天数较胸骨正中切口径路少(P＜0.05).术后随访45例,随访时间1～12个月,除2例患者术后早期心功能稍差(射血分数＜0.5)和2例室间隔缺损(VSD)患者术后发生轻度残余分流外,其余均恢复良好.结论:经右腋下侧切口径路施行体外循环心内直视手术,有操作简便、易行、安全可靠、术中术后出血少和切口隐蔽、美观等优点,但对严重复杂先天性心脏病和侧支循环丰富的病例、合并大血管疾病及主动脉瓣上狭窄的患者应慎用本术式.