腹腔镜胰十二指肠切除术疗效与安全性的单中心回顾性分析

背景与目的:随着腹腔镜技术的发展与普及,腹腔镜胰十二指肠切除术(LPD)也逐渐在临床开展,但由于LPD手术难度大,其效果与安全性方面仍存在一定程度的不确定性.因此,本研究通过对笔者中心实施LPD及同期实施开放胰十二指肠切除术(OPD)患者的临床资料行回顾性分析,进一步评价LPD的近期疗效与安全性.方法:收集2019年2...     

消癌平注射液联合沙利度胺辅助放化疗对中晚期食管癌患者肿瘤标志物、血管内皮生长因子及其受体表达的影响

目的:探讨消癌平注射液联合沙利度胺辅助放化疗对中晚期食管癌患者肿瘤标志物、血管内皮生长因子(VEGF)及其受体表达的影响。方法:选取2012年1月至2016年6月南阳医学高等专科学校第一附属医院收治的中晚期食管癌患者160例为研究对象,入院序号为奇数序号者为对照组,偶数序号者为观察组,每组80例。2组均给予常规化疗,对照组在常规化疗的基础上给予三维适形放疗,观察组在对照组的基础上应用消癌平注射液联合沙利度胺治疗,21 d为1个治疗周期,连续治疗3个周期,并随访2年。观察2组近期及远期疗效;比较2组治疗前后血清中肿瘤标志物、VEGF及其受体表达;统计2组治疗及随访不良反应发生情况。结果:治疗后观察组RR为75. 00%,明显高于对照组的56. 25%(P 0. 05),观察组1年生存率为96. 25%,显著高于对照组的86. 25%(P 0. 05)。治疗后2组吞咽困难、泛吐痰涎、腹痛腹泻及四肢困乏等主要中医证候积分均较治疗前显著下降,且观察组显著低于对照组,差异有统计学意义(P 0. 05)。治疗后2组血清中巨噬细胞炎性蛋白-3α(MIP-3α)、糖类抗原125(CA125)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)及细胞角质蛋白19片段(CYFRA21-1)、VEGF及内皮生长因子受体-1(VEGFR-1)表达均较治疗前显著下降,差异有统计学意义(P 0. 05),且观察组明显低于对照组,差异有统计学意义(P 0. 05)。治疗及随访中观察组呕吐、白细胞下降、放射性食管炎及骨髓抑制的发生率显著低于对照组,差异有统计学意义(P 0. 05)。结论:消癌平注射液联合沙利度胺辅助放化疗可显著降低中晚期食管癌患者血清肿瘤标志物水平,抑制VEGF及其受体表达,改善患者临床症状的同时降低不良反应发生率,提升临床疗效。     

生物化疗、化疗或生物疗法用于治疗恶性黑色素瘤的回顾性分析

背景与目的:近年来恶性黑色素瘤发病率有明显上升趋势,恶性黑色素瘤对单纯放、化疗不甚敏感,然而,它是一种免疫原性较高的肿瘤,联合免疫治疗可以提高疗效,因此,恶性黑色素瘤治疗的合理性在于它的综合治疗.本研究回顾性分析观察Ⅲ、Ⅳ期恶性黑色素瘤患者应用生物化学、生物或化学治疗的近期和远期疗效.方法:分析102例Ⅲ、Ⅳ期恶性黑色素瘤患者化学治疗(达卡巴嗪、顺铂、福莫司汀)、生物治疗(白细胞介素-2、干扰素α-2b、树突状细胞)或生物化疗(上述两者联合续贯)的临床疗效.中位随访时间2年(1至4年).结果:近期疗效:生物化疗组36例,有效率(RR)为69.44%,与生物治疗组(34例,RR29.41%)和化学治疗组(32例,RR 46.89%)相比,差异有显著性(P＜0.05).远期疗效生物化疗组的中位生存时间(MST)为2年9个月,与生物治疗组(MST为2年2个月)和化学治疗组(MST为1年2个月)相比,差异有显著性(P＜0.05).然而,毒副作用在生物化疗明显高于其他两组,但经一般处理,患者均可耐受.结论:恶性黑色素瘤患者经生物化学治疗可明显提高有效率并延长生存时间.     

The changing visual profile of children attending a regional specialist school for the visually impaired in Northern Ireland

AIM: To investigate the changing profile of children attending a special school for visually impaired children over a 30-year period. METHODS: Between 1975 and 2004, 266 children were identified as having been students in the introductory years to secondary education at Jordanstown School. School records and records from the Regional Paediatric Low Vision Clinic at the Royal Victoria Hospital, Belfast were examined to obtain data regarding age, primary ophthalmic diagnosis, visual acuity and any additional impairment. RESULTS: There was no statistically significant change in mean visual acuity of the children entering the secondary school over this period (p > 0.1). Albinism was the most common single condition (20.3%). Notable also was the reduction in incidence of visual impairment following congenital glaucoma and cataract and the corresponding increase in cortical visual impairment (CVI) during this period. CONCLUSION: During the last 30 years medical/surgical treatment has reduced the impact of treatable conditions (e.g. cataract) on visual impairment to the extent that their prevalence within this school has decreased. Consequently, children with non-treatable conditions (e.g. albinism) constitute a larger proportion of the school population. An increase in the proportion of children with CVI and learning disability in the school was noted.     

Treatment with Dehydroepiandrosterone Increases Peripheral Benzodiazepine Receptors of Mitochondria from Cerebral Cortex in d‐Galactose‐Induced Aged Rats

Abstract: The aim of this study was to determine whether dehydroepiandrosterone (DHEA) could regulate the expression of peripheral benzodiazepine receptors of mitochondria in cerebral cortex. The rats were divided into five groups. Those, in the vehicle‐physiological or senescent group, received physiological or d ‐galactose (subcutaneously) once a day. Rats, in the vehicle‐dimethyl sulfoxide‐ or DHEA‐treated senescent group, received 2% of dimethyl sulfoxide or DHEA (intraperitoneally) every other day besides d ‐galactose (subcutaneously) once a day. Rats in the DHEA‐treated normal group received physiological once a day and DHEA every other day. After 8‐week, spatial learning was assessed for 5 days by water maze methods. Following behavioural testing, the cerebral cortex mitochondria were purified for PK11195 binding analysis. When compared to the respective vehicle, d ‐galactose alone induced a significant impairment in water maze performance accompanied by a reduction (30.7%) in peripheral benzodiazepine receptor density of mitochondria, and DHEA displayed a significant enhancement in learning memory accompanied by the elevation (18.3%) of peripheral benzodiazepine receptor density but not affinity in senescent rats. DHEA showed insignificant effects on both learning/memory ability and peripheral benzodiazepine receptors in normal rats when compared to physiological saline. These results suggest that chronic treatment with DHEA enhance cognitive function and increase peripheral benzodiazepine receptor density in cerebral cortex mitochondria in middle‐aged senescent rats.     

ST段抬高型心肌梗死合并心肌桥对直接行经皮冠状动脉介入治疗的影响

目的 观察ST段抬高型心肌梗死(STEMI)梗死相关动脉合并心肌桥对直接行经皮冠状动脉介入(PCI)治疗的影响.方法 将594例STEMI直接行PCI治疗成功的患者分为两组:梗死相关动脉合并心肌桥者46例为肌桥组,梗死相关动脉未合并心肌桥者548例为对照组,比较两组直接行PCI治疗术后即刻冠状动脉造影结果和6个月主要心脏不良事件(死亡、靶血管重建、靶病变重建、非致死性心肌梗死).结果 594例患者术后即刻前向血流TIMI 3级率为92.1%(547/594),其中肌桥组为60.9%(28/46),对照组为94.7%(519/548),两组比较差异有统计学意义(P＜0.01).住院病死率为4.4%(26/594),其中肌桥组为13.0%(6/46),对照组为3.6%(20/548),两组比较差异有统计学意义(P＜0.01).6个月主要心脏不良事件发生率肌桥组为22.5%(9/40),对照组为5.1%(27/528),两组比较差异有统计学意义(P＜0.01).结论 梗死相关动脉合并心肌桥患者直接PCI治疗术后即刻前向血流改善较差,可能是导致住院病死率高和6个月主要心脏不良事件常见的原因之一.     

TQ-2000多通道剂量仪在TBI体内相对剂量测量中的应用

全身照射（TBI）前，各放射治疗部门将针对本单位的设备、机房环境等实际情况，拟定相应的物理照射技术，进行必要的物理参数的测量。CDP仿真人体模型与TQ-2000多通道剂量仪的配合使用，可以快速、准确地测量TBI中体内相对剂量有关数据，为临床治疗提供质量保证。     

大地震中无坚不摧的战斗堡垒

汶川地震发生后，四川大学华西医院作为距离震中最近的、惟一的国家级大型综合性医院，在抗震救灾中，充分发挥国家级部属医院的骨干支撑和引领作用。本文从党的组织领导作用、坚强后盾作用和党员的先锋模范作用等几个方面着手，突出大地震中无坚不摧的战斗堡垒作用。     

Overexpression of CDC25B and LAMC2 mRNA and protein in esophageal squamous cell carcinomas and premalignant lesions in subjects from a high-risk population in China.

Molecular events associated with the initiation and progression of esophageal squamous cell carcinoma (ESCC) remain poorly understood but likely hold the key to effective early detection approaches for this almost invariably fatal cancer. CDC25B and LAMC2 are two promising early detection candidates emerging from new molecular studies of ESCC. To further elucidate the role of these two genes in esophageal carcinogenesis, we did a series of studies to (a) confirm RNA overexpression, (b) establish the prevalence of protein overexpression, (c) relate protein overexpression to survival, and (d) explore their potential as early detection biomarkers. Results of these studies indicated that CDC25B mRNA was overexpressed (>/=2-fold overexpression in tumor compared with normal) in 64% of the 73 ESCC cases evaluated, whereas LAMC2 mRNA was overexpressed in 89% of cases. CDC25B protein expression was categorized as positive in 59% (144 of 243) of ESCC cases on a tumor tissue microarray, and nonnegative LAMC2 patterns of protein expression were observed in 82% (225 of 275) of cases. Multivariate-adjusted proportional hazard regression models showed no association between CDC25B protein expression score and risk of death [hazard ratio (HR) for each unit increase in expression score, 1.00; P = 0.90]; however, several of the LAMC2 protein expression patterns strongly predicted survival. Using the cytoplasmic pattern as the reference (the pattern with the lowest mortality), cases with a diffuse pattern had a 254% increased risk of death (HR, 3.52; P = 0.007), cases with no LAMC2 expression had a 169% increased risk of death (HR, 2.69; P = 0.009), and cases with a peripheral pattern had a 130% greater risk of death (HR, 2.30; P = 0.02). CDC25B protein expression scores in subjects with esophageal biopsies diagnosed as normal (n = 35), dysplastic (n = 23), or ESCC (n = 32) increased significantly with morphologic progression. For LAMC2, all normal and dysplastic patients had a continuous pattern of protein expression, whereas all ESCCs showed alternative, noncontinuous patterns. This series of studies showed that both CDC25B and LAMC2 overexpress RNA and protein in a significant majority of ESCC cases. The strong relation of LAMC2 pattern of protein expression to survival suggests a role in prognosis, whereas the association of CDC25B with morphologic progression indicates a potential role as an early detection marker.     

无髓牙冠内漂白方法的对比研究

目的探讨无髓牙内漂白技术中2种细节操作方法对漂白效果影响。方法选择口腔中前牙和双尖牙区至少2颗变色无髓牙的患者40例,对2颗牙分别采用方法Ⅰ(标准根管治疗后,用光固化玻璃离子封闭根管口,用常温下浸有30%过氧化氢的棉球封闭在髓腔内,3d复诊1次,共封药3次后进行充填治疗)和方法Ⅱ(标准根管预备后,根充前用加热到36℃的30%过氧化氢反复冲洗髓腔,然后做常规根充和充填治疗)治疗。2组均采用同种复合树脂严密充填,1 a后用相同方法观察美观效果和强度效果。结果方法Ⅱ美观效果与强度效果均明显优于方法Ⅰ(P<0.05)。结论漂白变色的无髓牙最好方法是即刻高效的热漂白方法。