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21.
目的 探讨扶正消瘤颗粒对原发性肝癌血清中血管内皮生长因子(Vascular endothelial growth factor,VEGF)和缺氧诱导因子-1α(Hypoxia inducible factor-1α,HIF-1α)表达的影响及临床意义。方法 选择符合纳入标准的原发性肝癌患者66例,按1∶1随机分试验组和对照组。观察治疗过程中两组VEGF、HIF-1α水平的变化及对患者临床疗效指标的影响。结果 (1)在性别、年龄、合并乙型肝炎、Child-Pugh分级、AFP值、临床分期方面,试验组和对照组差异无统计学意义(P > 0.05)。(2)肝癌患者在治疗各时间节点的VEGF和HIF-1α表达水平呈线性正相关(r = 0.829,P < 0.001)。(3)VEGF浓度在经导管动脉化疗栓塞术(Transcatheter arterial chemoembolization,TACE)后3月降至术前水平(P > 0.05),HIF-1α在TACE后3月仍高于术前(P < 0.05)。(4)扶正消瘤颗粒可降低HIF-1α水平,下调VEGF的表达。(5)扶正消瘤颗粒可减少TACE序贯RFA治疗后的不良反应,提高患者的生活质量(P < 0.05)。(6)血清中VEGF水平与生活质量无明显相关性(P > 0.05,r = 0.251),HIF-1α水平与生活质量存在正相关性(P < 0.05,r = 0.450)。结论 扶正消瘤颗粒可明显改善TACE序贯RFA治疗后患者生活质量,降低HIF-1α水平,下调VEGF的表达,抑制肿瘤血管生成。  相似文献   
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Erythema induratum of Bazin (EIB) is a form of tuberculid resulting from hypersensitivity to tuberculosis antigen. EIB occurs most commonly in middle‐aged women and is not typically seen in children. Here, we present a rare case of EIB, presenting as a chronic nodular panniculitis, in a 10‐year‐old Korean boy.  相似文献   
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<正>第5章术前辅助措施在腹疝修补术中的作用通过Medline、PubMed、Cochrane Library以及相关期刊和参考文献进行了系统的文献检索,证据结论:(1)在腹壁疝修补术之前使用A型肉毒素(botulinum toxin type A,BTA)与阿片类镇痛的使用显著减少疼痛。证据级别:3级。(2)(1)应用BTA可使腹壁疝直径减小,腹壁外侧肌厚度显著减少,腹壁外侧肌显著延长。在大多数腹疝患者中,单独  相似文献   
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Clinical Oral Investigations - The aim of this study was the analysis of WNT10A variants in seven families of probands with various forms of tooth agenesis and self-reported family history of...  相似文献   
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Objective

The advantage of arteriovenous fistulas (AVFs) in older patients requiring dialysis is controversial. We reviewed our vascular access experience in patients ≥70 years of age (older group) compared with younger patients.

Methods

We analyzed consecutive patients who underwent access surgery between 2013 and 2016. Primary success (PS) and primary patency (PP) data were analyzed between the older and younger groups before and after propensity score matching of the patients' characteristics and access composition. PS was defined as the achievement of access function that was amenable to two sessions of successful cannulation without early occlusion or maturation failure requiring revision. PP was defined as the time with uninterrupted patency without intervention.

Results

A total of 594 consecutive accesses were created among 563 patients, of whom 119 were allocated into each group after propensity score matching. In the whole cohort, 193 accesses (32.5%) were performed in older patients. AVFs were performed in 130 (67.4%) older patients and 293 (73.1%) younger patients. Regarding AVFs, the PS rate (83.6% in the older group vs 94.3% in the younger group; P = .001) and the overall PP at 6 and 12 months (73.1% and 57.1%, respectively, in the older group vs 86.7% and 77.7%, respectively, in the younger group; P = .009) were lower in the older group than in the younger group. However, no differences were found in the PS and PP rates for arteriovenous grafts between groups. Regarding the AVF location, the PS rate for forearm AVFs was significantly lower in the older group than in the younger group (76% vs 93%; P < .001); however, the PS rate of the upper arm was not different between the groups (94% vs 97%; P = .425). In the patients with PS, the PP rate of AVFs was similar between the two groups. In the older group with forearm AVFs, the median diameter of the radial artery was larger in the patients with PS than in the patients without PS (2.20 mm with PS vs 2.00 mm without PS; P = .008). The propensity score matching results demonstrated similar trends for the whole cohort, with lower PS (P = .042) and PP rates (P = .023) for AVF in the older group.

Conclusions

The outcomes after AVF were poorer in the older group than in the younger group, which was primarily due to unsatisfactory outcomes in patients with forearm AVFs. Thus, stricter criteria, especially regarding the radial artery diameter, should be applied for forearm AVFs in older patients, and additional research is necessary to delineate the risk factors for primary failure.  相似文献   
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