前交叉韧带损伤23例分析

膝关节前交叉韧带损伤因解剖位置特殊,是最易受伤的膝关节韧带,诊断不及时、治疗不当将严重影响或丧失运动和战斗力,晚期可导致严重的膝关节骨关节病。笔者2008年7月～2010年12月收治野战部队军事训练致膝关节前交叉韧带损伤23例,现就其诊断过程进行分析。     

氟哌噻吨美利曲辛在胃食管反流性咳嗽治疗中的作用

目的观察氟哌噻吨美利曲辛在治疗胃食管反流性咳嗽(GERC)中的作用。方法收集2012年10月—2013年11月确诊GERC者73例,将其中焦虑、抑郁患者分为A、B组,无焦虑抑郁患者,定为C组,A组28例,B组24例,C组21例。B组、C组患者进行常规抗反流治疗,A组加用氟哌噻吨美利曲辛片治疗。治疗12周后评估患者GERD-Q量表及咳嗽症状积分变化。结果 3组治疗第4、8、12周后GERD-Q积分、咳嗽症状积分较治疗前均有所下降(P<0.01,P<0.05);治疗第4、8、12周后GERD-Q量表评分、咳嗽症状积分降低程度A、C组均高于B组(P<0.01,P<0.05),A、C组间无统计学差异(P>0.05);A、C组总有效率明显高于B组(P<0.05),A、C组间无统计学差异(P>0.05)。结论埃索美拉唑、莫沙必利联合氟哌噻吨美利曲辛片治疗伴有焦虑、抑郁状态GERC患者,具有价格低廉、疗效确切、服用方便、不良反应少等优点。     

PSA、PSAD、PSAT及f/tPSA与前列腺患者病理分期的相关性研究

目的 研究PSA、PSAD、PSAT及f/tPSA与前列腺癌病理分期的相关性.方法 以本院2013年5月至2015年5月经病理证实的80例前列腺癌患者为研究对象,选择同期60例前列腺增生患者为对照组,所有患者术前均行PSA、PSAD、PSAT、f/tPSA检测,比较两组各项PSA相关指标,并分析上述指标与前列腺癌病理分期的相关性.结果 两组PSA、PSAD、PSAT及f/tPSA比较差异有统计学意义(P＜0.05).不同临床分期前列腺癌患者血清PSA、PSAD、PSAT及f/tPSA值比较差异均有统计学意义(P＜0.05).Spearman等级相关性分析PSA、PSAD、PAST、f/tPSA与前列腺癌临床分期相关(r值分别为0.62、0.45、0.46、0.58,P＜0.05).结论 PSA、PSAD、PSAT及f/tPSA对前列腺癌、前列腺癌临床分期诊断有重要价值.     

Ki67、Survivin在早期宫颈癌中的表达与预后相关性分析

目的探讨Ki67、Survivin在早期宫颈癌组织中的表达,且与术后生存期及淋巴结转移的关系;分析Ki67和Survivin的相关性。方法收集110例手术切除或活检标本,包括正常宫颈组织,宫颈癌组织(按5年存活率及有无淋巴结转移分组),进行免疫组织化学法检测Ki67、Survivin蛋白的表达。结果宫颈癌组织中Ki67的表达率为85%,明显高于正常宫颈组织,Ki67阳性表达与术后生存时间呈负相关(x2=5.7624,P0.05),与淋巴结转移呈正相关(x2=11.4820,P0.01);宫颈癌组织中Survivin表达率为80%,高于正常宫颈组织,Survivin阳性表达与术后生存时间呈负相关(x2=5.2410,P0.05),与淋巴结转移呈正相关(x2=10.0624,P0.01)。结论 Ki67、Survivin可作为反映宫颈癌预后生存期及淋巴结转移程度的指标。     

孕妇血浆中sCD40及其配体与子痫前期发病及肾功能损害的关系

目的 探讨孕妇血浆中可溶性白细胞分化抗原(sCD40)和sCD40配体(sCD40L)水平变化与子痫前期发病及肾功能损害的关系.方法 选择2008年8月-2010年6月在青岛大学医学院附属医院产科分娩的轻度子痫前期孕妇28例(轻度子痫前期组),重度子痫前期孕妇35例(重度子痫前期组);另选同期妊娠结局良好的健康孕妇30例为对照组.比较3组孕妇分娩孕周及血压变化、血小板计数并检测其血常规、C反应蛋白(CRP)、尿常规、24h尿蛋白定量,以及血清尿酸(UA)、肌酐(Cr)、尿素氮(BUN)等生化指标.采用ELISA法检测3组孕妇血浆中sCD40和sCD40L的水平,并对血浆sCD40和sCD40L的水平与各临床指标的相关性进行分析.结果 (1)血常规及l临床指标:重度子痫前期组和轻度子痫前期组孕妇血浆CRP水平(分别为10.8及7.1 mg/L)均明显高于对照组(3.3 mg/L),前后两者分别比较,差异均有统计学意义(P＜0.05);重度子痫前期组高于轻度子痫前期组,两组比较,差异也有统计学意义(P＜0.05).重度子痫前期组孕妇分娩孕周(32.5周)明显低于轻度子痫前期组(37.2周)和对照组(38.6周),分别与对照组比较,差异均有统计学意义(P＜0.01);轻度子痫前期组与对照组比较,差异无统计学意义(P＞0.05).重度子痫前期组孕妇血小板计数(132×109/L)明显低于轻度子痫前期组(212×109/L)和对照组(216×109/L),分别比较,差异有统计学意义(P＜0.01);轻度子痫前期组与对照组比较,差异无统计学意义(P＞0.05).3组孕妇之间血红蛋白水平及白细胞数分别比较,差异均无统计学意义(P＞0.05).(2)血浆sCD40及sCD40L水平:重度子痫前期组、轻度子痫前期组和对照组孕妇血浆sCD40水平分别为133.6、126.5和90.7 ng/L,sCD40L水平分别为12.5、10.4和4.4 ng/L,24h尿蛋白定量分别为4.5、0.8 g和0,UA水平分别为486、289和162 μmol/L,重度子痫前期组以上各指标均明显高于轻度子痫前期组和对照组,差异均有统计学意义(P＜0.01);轻度子痫前期组也明显高于对照组,差异也有统计学意义(P＜0.01).重度子痫前期组孕妇血浆Cr(89 μmol/L)、BUN(5.32 mmol/L)水平高于轻度子痫前期组(分别为66μmol/L及4.49mmol/L)和对照组(分别为57 μmol/L及3.32 mmol/L),分别比较,差异均有统计学意义(P＜0.05);轻度子痫前期组与对照组比较,差异无统计学意义(P＞0.05).(3)相关性分析:轻、重度子痫前期组孕妇血浆sCD40水平与24 h尿蛋白定量呈正相关(r=0.434,P＜0.05),与UA、CRP呈明显正相关(r=0.536、0.528,P＜0.01),与收缩压、舒张压、分娩孕周、Cr、BUN、血小板计数无明显相关(r分别为0.135、0.183、-0.133、0.190、0.167、-0.221,P均＞0.05).轻、重度子痫前期组孕妇血浆sCD40L水平与24 h尿蛋白定量、UA、CRP均呈明显正相关(r分别为0.591、0.445、0.539,P均＜0.01),与收缩压、舒张压、分娩孕周、Cr、BUN、血小板计数无明显相关(r分别为0.178、0.212、-0.292、0.144、0.135、-0.273,P均＞0.05).轻、重度子痫前期组孕妇血浆sCD40L水平与sCD40呈明显正相关(r均为0.707,P＜0.01).对照组孕妇血浆sCD40、sCD40L水平与各项临床指标均无相关性(P＞0.05).结论 子痫前期孕妇血浆中sCD40和sCD40L水平明显升高,可能参与了子痫前期的发病,并导致肾功能损害.sCD40和sCD40L水平变化也与子痫前期的严重程度相关.

Abstract：

Objective To investigate the variance levels of plasma soluble leukocyte differentiation antigens CD40 (sCD40) and soluble CD40 ligand (sCD40L) in preeclamptic patients with renal damage and its relationship. Methods A total of 63 pregnant women attended the Department of Obstetrics, Affiliated Hospital of Qingdao University Medical College between August 2008 and June 2010. In the present study included 28 pregnant women with mild preeclampsia and 35 patients with severe preeclampsia. Thirty matched normotensive pregnant women were enrolled in the study as the control group. Expression of sCD40 and sCD40L were determined by ELISA. At the same time, the blood routine, C reaction protein ( CRP),urine routine, 24 hours urine protein excretion, and serum uric acid (UA), creatinine (Cr), blood urea nitrogen (BUN) were measured. The correlation analysis was performed between the sCD40/sCD40L and the blood biochemical indexes in 3 groups. Results ( 1 ) The median levels of CRP in severe preeclampsia (10. 8 mg/L)and mild preeclampsia group(7. I mg/L)are significantly higher than that of control group (3. 3 mg/L,P ＜ 0. 05 ); The level of CRP in severe preeclampsia group was also higher than that of mild preeclampsia group ( P ＜ 0. 05 ). The median gestational age at delivery in severe preeclampsia ( 32. 5 weeks)was significantly less than that of mild preeclampsia group ( 37. 2 weeks) and normal group ( 38. 6 weeks,P ＜ 0. 05). However no significant differences were observed between mild preeclampsia group and normal group ( P ＞0. 05 ). The platelet count in severe preeclampsia ( 132 × 109/L) was significantly less than those of mild preeclampsia group (212 × 109/L) and normal group ( 216 × 109/L, P ＜ 0. 01 ), but no significant differences were observed in blood platelet amount between mild preeclampsia group and normal group ( P ＞0. 05 ). There was no significant difference in hemoglobin level and white blood cell in three groups ( P ＞0. 05). (2) The sCD40 plasma concentration in severe, mild preeclampsia and normal group was 133.6,126. 5 and 90. 7 ng/L, respectively. The sCD40 L plasma concentrations were 12. 5, 10. 4 and 4. 4 ng/L respectively in the 3 groups. 24 hours urinary protein quantitative was 4. 5 g/d,0. 8 g/d and 0 in the 3 groups respectively. And the UA level was 486 μ mol/L,289 μmol/L and 162 μmol/L. In the above three groups,the monitoring indicators were significantly higher in women with severe preeclampsia group compared with mild preeclampsia and control groups (P ＜ 0. 01 ), and there were also higher in mild preeclampsia group than that in control groups ( P ＜ 0. 01 ). The level of plasma Cr ( 89 μmol/L) and BUN ( 5. 32 mmol/L) in severe preeclampsia group were higher than those of mild preeclampsia group (66 μmol/L and 4. 49mmol/L) and control group ( 57 μmol/L and 3.32 mmol/L, P ＜ 0. 05 ). There was no significant difference between mild preeclampsia group and normal group (P ＞ 0. 05 ). (3) The correlation analysis indicated that the level of sCD40 has a positive correlation with 24 hours urinary protein quantitative( r = 0. 434, P ＜ 0. 05 ),also significant positive correlation( r =0. 536,0. 528 ,P ＜ 0. 01 ) between the level of sCD40 and UA or CRP in women with preeclampsia. There was no significant correlation between the level of sCD40 and systolic blood pressure, diastolic blood pressure, delivery gestational age, Cr, BUN, and platelet count(r =0. 135,0. 183, -0. 133,0. 190,0. 167, -0. 221 ,all P ＞0. 05 ). There were positive correlation between the level of sCD40L and 24 hours urine protein excretion, either UA or CRP( r =0. 591,0. 445,0. 539 ,all P ＜0. 01 ). No significant correlation was found between sCD40 L and systolic blood pressure, diastolic blood pressure,delivery gestational age, Cr, BUN, and platelet count( r =0. 178,0. 212, -0. 292,0. 144,0. 135, -0. 273,all P ＞0. 05). There was significant positive correlation between plasma sCD40 and sCD40L ( r =0. 707 ,P ＜0. 01 ). There was no relationship between the level of sCD40, sCD40L and the blood biochemical indexes in normotensive pregnant women ( P ＞ 0. 05 ). Conclusions The plasma concentrations of sCD40 and sCD40 L are significantly higher in pregnant women with preeclampsia compared with the control, which may be involved in the development of preeclampsia and contribute to the kidney damage. The variance levels of sCD40 and sCD40L may be also related to the severity of preeclampsia.     

中链脂肪酸在头颈肿瘤行颈淋巴结清扫术后合并乳糜漏患者中应用的可行性研究

目的 探讨中链脂肪酸在头颈肿瘤行颈淋巴结清扫术后合并淋巴漏患者中应用的可行性和安全性.方法 选取55例头颈肿瘤行颈淋巴结清扫术后合并乳糜漏患者,对照组25例,实验组30例,分别观察两组患者的营养指标和引流液,统计两组患者的并发症、肠外营养等情况.结果 两组患者的BMI值、白蛋白、前白蛋白水平、肠外营养例次、引流液量、颜...     

无管化经尿道输尿管镜下2μm激光联合第四代EMS系统治疗小儿输尿管囊肿合并结石

目的探讨经尿道输尿管镜下2μm激光联合第四代EMS治疗小儿输尿管囊肿合并结石的可行性。方法对23例接受经尿道输尿管镜下2μm激光低位开窗+碎石清石术治疗的小儿输尿管囊肿合并结石患儿的临床资料进行回顾分析。患儿年龄1～8岁,中位年龄2.5岁。经尿道置入F8/9.8输尿管镜,以2μm激光手术系统行囊肿低位开窗术,再以EMS系统碎石清石。术后不留置输尿管支架管及尿管,观察临床效果。结果全部病例顺利完成手术,术后无明显并发症,如期出院。随访期间未见输尿管囊肿或结石复发。结论经尿道输尿管镜下2μm激光联合第四代EMS系统治疗小儿输尿管囊肿合并结石具有出血少、操作安全简便等优点,无管化方案可进一步减少手术创伤,减轻术后不适感,加快康复进程,是一种安全、可靠的微创手术方法。     

卵圆孔未闭介入封堵术治疗前庭性偏头痛的疗效观察

目的探讨卵圆孔未闭(patent foramen ovale, PFO)介入封堵术治疗前庭性偏头痛(vestibular migraine, VM)的临床效果。方法选取2020年1—9月重庆医科大学附属永川医院收治的40例偏头痛患者,根据是否有≥5次反复发作的中重度前庭症状分为VM组(15例)和非VM组(25例),完善经胸超声心动图右心声学造影(contrast-transthoracicechocardiography, c-TTE)证实存在中量分流以上的PFO。患者均行食管超声引导下PFO介入封堵术治疗,完成术前及术后6个月头痛影响测定-6(headache-impact-test-6, HIT-6)评分、偏头痛积分、视觉模拟评分(visual analogue score,VAS)、汉密尔顿焦虑量表(Hamilton anxiety scale, HAMA)评分、汉密尔顿抑郁量表(Hamilton depression scale, HAMD)评分,VM组患者进行眩晕评定量表(dizziness handicap inventory, DHI)评分,评估PFO介入封堵术对两组疗效...     

CLIC4对胃癌细胞SGC-7901增殖与迁移的影响

目的 探究氯离子通道蛋白4(CLIC4)对胃癌细胞SGC-7901增殖与迁移能力的影响.方法 构建慢病毒载体介导的CLIC4稳定低表达细胞株,Western blot检测CLIC4的表达;克隆形成实验和CCK-8实验检测CLIC4敲低后对胃癌细胞SGC-7901增殖的影响;Western blot检测CLIC4敲低的胃...     

老年患者面部巨大肿物切除术的麻醉与围术期管理

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