羟考酮注射液对腹腔镜袖状胃切除术患者血流动力学及镇痛效果的影响

目的探讨羟考酮注射液对腹腔镜袖状胃切除术(LSG)患者血流动力学及镇痛效果的影响。方法随机将2017年10月至2019年10月在我院进行LSG的180例患者分为观察组(n=90,羟考酮)与对照组(n=90,芬太尼)。比较两组血流动力学指标、血糖、Cor及E水平及镇痛效果。结果T0、T1、T2时,观察组的MAP、HR均低于对照组(P<0.05)。术后12 h,两组患者血糖、Cor及E水平均较术前升高,但观察组低于对照组(P<0.05)。术后6、12 h,观察组的VAS评分低于对照组(P<0.05)。结论羟考酮应用于LSG患者镇痛效果好,可减轻应激反应,促进患者血流动力学稳定。     

同期多原发肺癌诊断标准更新与分子遗传学特征研究进展

由于高分辨率胸部CT和肺癌早期筛查的普及,同期多原发肺癌(或称同时性多原发肺癌,synchronous multiple primary lung cancer,sMPLC)的检出率逐步提高。sMPLC与肺癌肺内转移的鉴别诊断成为尤其重要的临床问题。借助高通量测序技术刻画sMPLC的分子遗传学特征是目前研究的热点,既能阐释sMPLC的发生发展规律,也可作为临床病理诊断标准的补充和完善。本文对sMPLC诊断标准的更新进行总结,并以克隆性分析领域为例,综述sMPLC分子遗传学特征的研究进展。     

Female breast cancer statistics of 2010 in China: estimates based on data from 145 population-based cancer registries

Background

The aim of the study is to provide incidence and mortality data of female breast cancer at national level of China in 2010.

Methods

A total of 145 population-based cancer registries submitted qualified cancer incidence and mortality data to National Cancer Registration Center of China. Based on the qualified cancer registries’ data, we estimated the overall breast cancer incidence and mortality data of China in 2010 and reported breast cancer statistics by age and geographical area.

Results

The estimated number of female breast cancer cases was about 208 thousand. The crude incidence rate, age-standardized rate by China and World population were 32.43 per 100,000, 25.89 per 100,000 and 24.20 per 100,000, respectively. The incidence rates were higher in urban area than in rural area. And the incidence rates in Eastern area and Middle area were similar and higher that those in Western areas. The estimated number of female breast cancer death in 2010 of China was about 55.5 thousand. The crude, age-standardized mortalities by China population and World population were 8.65 per 100,000, 6.56 per 100,000 and 6.36 per 100,000, respectively. The mortality rates by geographical area had similar pattern to the incidence rates.

Conclusions

Breast cancer is still a major health burden for Chinese women especially in urban area. Prevention strategies such as weight control, high-quality screening and diagnosis may help control the disease.     

灯盏花注射液对老年慢性肾功能衰竭患者血液流变性及肾功能影响的观察

目的：观察灯盏花注射液对老年慢性肾功能衰竭患者的血液流变性及肾功能的影响。方法：根据１９９２年全国肾小球疾病座谈会制订的慢性肾功能衰竭评定标准进行临床分组。肾功能不全失代偿组３４例和尿毒症组１０例，２组患者每日静滴灯盏花注射液２０ｍｌ（含黄酮９００ｍｇ），连用１４日为１个疗程。观察治疗前后血压、胆固醇（ＣＨ）、甘油三酯（ＴＧ）、血粘度、血尿素氮（ＢＵＮ）、血肌酐（ＳＣｒ）等指标的变化，进行治疗前后自身对比。结果：治疗后２组ＢＵＮ、ＳＣｒ均下降，以肾功能不全失代偿组下降显著（Ｐ＜０．０５）；收缩压（ＳＢＰ）和舒张压（ＤＢＰ）均下降，以ＳＢＰ下降极为显著（Ｐ＜０．０１）；高密度脂蛋白（ＨＤＬ）升高显著（Ｐ＜０．０５）；全血粘度、全血低切粘度、纤维蛋白原（Ｆｉ）下降均显著（Ｐ均＜０．０５）；ＣＨ、ＴＧ、血小板最大聚集率（ＰＭＡ）略有下降，但无统计学意义（Ｐ均＞０．０５）。结论：灯盏花注射液对老年慢性肾功能衰竭患者具有降低血粘度及改善肾功能的作用。     

不同中成药治疗缺血性脑卒中急性期的临床疗效对比观察

目的探讨不同中成药治疗缺血性脑卒中急性期的临床有效性。方法将112例患者随机分为对照组与观察组,对照组患者给予川芎嗪注射液治疗,观察组患者给予复方丹参注射液治疗,均采用静脉滴注的给药方式,观察比较不同中成药治疗缺血性脑卒中急性期的临床效果。结果对照组与观察组患者治疗前神经功能缺损评分、血瘀证证候积分、BI评分与FMA评分差异无统计学意义(P0.05),两组患者治疗15、30 d后的神经功能缺损评分、血瘀证积分、BI评分与FMA评分差异均有统计学意义(均P0.05);对照组患者缺血性脑卒中治疗有效率为73.21%,观察组为92.86%,差异有统计学意义(P0.05)。结论采用复方丹参注射液的治疗方案可以显著改善缺血性脑卒中的各项指标,提高治疗缺血性脑卒中的治疗有效率,并且安全、有效。     

Polymorphism of CD14 gene but not the mutation of TLR4 gene is associated with colorectal cancer in Chinese patients

Objectives: Toll‐like receptor 4 and CD14 are components of the lipopolysaccharide receptor complex. Our study aimed to investigate an association between TLR4 Asp299Gly and CD14‐260 polymorphisms in Chinese patients with colorectal cancer. Method: By a method of polymerase chain reaction–based restriction fragment length polymorphism (PCR‐RFLP), we genotyped TLR4 Asp299Gly and CD14‐260 polymorphisms in 110 unrelated patients with colorectal cancer and 160 healthy controls from the Chinese Han population. Results: We found significant differences in CD14 genotypes between healthy controls and patients with colorectal cancer. The frequency of the C/C genotype in healthy controls (15.6%) was significantly lower than in the group of colorectal cancer patients (32%). The frequency of the C/T genotype in healthy controls (48.1%) was significantly higher than that in the group of colorectal cancer patients (31%). No TLR4 Asp299Gly mutation was detected in any patients or healthy controls in the Chinese Han population. Conclusions: These findings indicated that the polymorphism of CD14 but not TLR4 Asp299Gly mutation was associated with Chinese patients with colorectal cancer, and the CD14 gene may contribute to the predisposition to colorectal cancer. Screening for the CD14 C‐260T genotype is likely to be a useful tool for risk assessment or prognostication for colorectal cancer in the Chinese Han population.     

外科手术与介入术治疗糖尿病下肢缺血病变的疗效比较

【目的】比较外科手术与介入术治疗糖尿病下肢缺血病变的临床疗效。【方法】选取2011年6月至2013年6月本院收治的糖尿病下肢缺血病变患者113例,根据 T ASCⅡ分级及治疗方式将其分为四组：T ASCⅡC级30例（C级手术组）、T ASCⅡD级27例（D级手术组）行股‐腘动脉旁路移植术;T ASCⅡC级组29例（C级介入组）、T ASCⅡD级组27例（D级介入组）行支架植入术;观察四组术后1周、3个月、6个月、1年的下肢血管通畅率、踝肱指数（ABI）,记录四组生存率、保肢率、并发症发生率。【结果】术后1周、3个月,手术组与介入组下肢血管通畅率、ABI比较无统计学差异（ P ＞0．05）;术后6个月、1年手术组通畅率、ABI均高于介入组（P ＜0．05）;四组保肢率、生存率比较差异无统计学意义（P ＞0．05）;手术组并发症发生率低于介入组（ P ＜0．05）。【结论】外科手术与介入术治疗糖尿病下肢缺血病变的保肢率、生存率相近,但外科手术的远期疗效优于介入术。