140例胃间质瘤的外科治疗分析

Objective To analyze the outcome of the patients with gastric gastrointestinal stromal tumor (GIST) after surgical treatment and identify the associated risk factors. Methods Clinical data and the tissue slices including immunohistochemistry staining of 140 patients with gastric GIST from January 1990 to December 2008 were retrospectively reviewed. SPSS 16.0 for Windows software package was used for statistical analysis. Results The overall survival rates of 1-, 3-, 5-year were 96.8%,86.7% and 79.3%, respectively. The survival rates of 1-, 3-, 5-year were 98.1%, 90.0% and 85.4% in patients who underwent complete tumor resection. But the survival rates of 1-, 3-, 5-year were 38.1%, 0 and 0 in patients with incomplete tumor resection. The differences were statistically significant (P＜0.05). Gender, preoperative metastasis, tumor size, pathology type, karyokinesis, recurrence and metastasis were associated with survival rates in patients with complete tumor resection by univariate analysis. However, only tumor size, karyokinesis, recurrence and metastasis were associated with survival rates by Cox regression multivariable analysis (P＜0.05). Conclusion Surgery remains the main treatment for gastric GIST. Local complete resection is the principal treatment.     

Height outcome of patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

Objective:To retrospectively investigate the height outcome of patients with congenital adrenal hyperplasia(CAH)due to 21-hydroxylase deficiency(21-OHD).Methods:The 135 CAH patients with 21-OHD diagnosed in our hospital from Jan 1980 to Oct 2006 were retrospectively analyzed.The investigated parameters included final height(FH),FH standard deviation score(FH SDS),target height SDS(TH SDS),difference between TH and FH(TH-FH),FH SDS-TH SDS,the age of onset of sexual development,and the difference between bone age and chronological age(BA-CA)when patients got the FH.Results:Among the 135 patients,female/male=108/27.Mean FH was(156.8±5.4)cm(n=14)and(150.8±6.8)cm(n=76)for males and females,respectively.Mean FH SDS was(-0.6±0.8)(n=13)and(0.2±1.2)(n=54)for males and females,respectively.Sexual development began at(5.2±1.7)years old(y/o)(n=13)and(7.9±3.2)y/o(n=43)in males and females,respectively.Conclusions:The FH of CAH patients with 21-OHD was lower than that of the normal range.Effect of the disease on the height growth in male patients was more severe than that in females.All patients began sexual development much earlier than the normal age-matched group.Male patients began their sexual development even earlier.     

右径小切口房间隔缺损封堵术21例临床分析

目的探讨右径小切口房间隔缺损封堵术的方法与疗效。方法回顾性分析我院2004年7月至2005年5月收治的21例房间隔缺损患者,男性8例,女性13例,年龄1～70岁,中位年龄21岁。房间隔缺损直径8～40mm。全麻下右胸骨旁第4肋间行2～3cm切口,在经食管或胸壁超声引导下,经右心房通过单鞘管置入房间隔缺损封堵器。结果全组21例无手术死亡,使用的封堵器型号为14～46mm,均封堵满意,无残余分流,未影响心脏瓣膜功能。无封堵失败改行体外循环手术者。术中未输血,术后未发生封堵器移位或脱落等严重并发症,术后3～5d出院。复查无残余分流,无严重并发症,效果满意。结论右径小切口封堵房间隔缺损安全、创伤小,有一定推广价值。     

自制三维固定支架与孟和架治疗胫腓骨骨折疗效对比

目的：观察单臂半环式三维固定架与孟和架在胫腓骨骨折治疗中的疗效并就固定架在性能、复位、愈合等方面进行比较。方法：随机选择项目治疗组30例病例和孟和架组（以往）30例在操作难度,骨折复位效果,固定稳定性,骨折愈合时间等方面进行比较结果：项目治疗组解剖复位17例,占57％,近解剖复位13例,占43％;孟和架组解剖复位7例,占23％近解剖复位9例,占30％,以下14例占47％;复位解剖及近解剖均优于孟和架,x^2检验P〈0．01,愈合时间,治疗组2—5个月,平均3．23个月;对照组4-7个月,平均5．64个月。结论：单臂半环三维固定架治疗胫腓骨骨折较孟和架操作简便,复位十分满意,骨折愈合时间短。     

MTA1基因调控人前列腺癌PC-3细胞失巢凋亡的研究

目的:探讨MTA1基因小干扰RNA(siRNA)对前列腺癌细胞PC-3增殖和失巢凋亡的影响。方法:应用MTA1 siRNA转染处理人前列腺癌细胞系PC-3后,采用实时定量PCR和W estern印迹检测MTA1基因mRNA和蛋白水平,采用软琼脂集落培养试验检测锚着不依赖性增殖,采用琼脂糖凝胶电泳和流式细胞术检测癌细胞失巢凋亡。结果:与对照组比较,MTA1基因siRNA转染组MTA1 mRNA和蛋白水平明显下降,且呈浓度依赖性(r=0.935,P=0.0001)。MTA1 siRNA转染组软琼脂集落形成数明显减少,且与浓度相关(r=0.901,P=0.0005)。琼脂糖凝胶电泳和流式细胞术结果显示,MTA1 siRNA转染可诱导前列腺癌细胞失巢凋亡,且与浓度相关(r=0.916,P=0.0003)。结论:MTA1 siRNA可抑制人前列腺癌细胞增殖,诱导失巢凋亡是其机制之一。     

中药藤黄软膏治疗126例皮肤类病变的疗效观察

目的:探讨中药藤黄软膏治疗皮肤类疾病的可行性.方法:采用藤黄中酸性成分配以赋形剂制成5％的软膏用于外敷、外搽癌性溃疡(部分配合针、片剂)、炎性溃疡、皮肤过敏以及无名肿毒等类皮肤创面.结果:藤黄软膏对上述皮肤病变均有优良的功效,疗程短、见效快,无毒副作用,医患皆乐意接受.结论:藤黄软膏是一种简便价廉、安全性大、疗效独特、值得推广应用的一种新剂型.     

应用带锁定加压钢板的动力髋螺钉与防旋型股骨近端髓内钉治疗高龄股骨转子间骨折

目的分析应用带锁定加压钢板的动力髋螺钉（LCP-DHS）与防旋型股骨近端髓内钉（PFNA）内固定治疗股骨转子间骨折的疗效。方法 57例80岁以上高龄股骨转子间骨折患者行内固定治疗,19例采用LCP-DHS,38例采用PFNA。对两种方法的手术时间、术中、术后失血量、术后并发症及髋关节功能进行比较。结果 56例随访4-36（20.4±2.8）个月。LCP-DHS组：手术时间45-80（55±8）min;术中出血量100-220（130±25）ml;术后发生肺部感染1例,并发症发生率5.3%;Harris评分：优11例,良6例,可2例,优良率为89.5%。PFNA组：手术时间50-95（70±14）min;术中出血量80-260（150±35）ml;2例术后发生失血性休克（其中1例死亡）,内固定物松动1例,大转子畸形愈合2例,并发症发生率13.2%;Harris评分：优18例,良13例,可5例,差1例,优良率为83.8%。结论 LCP-DHS是治疗高龄股骨转子间骨折的可靠方法,较PFNA更安全、有效。PFNA钉力臂短,能有效地对抗剪切应力,适用于股骨转子下骨折。     

表达肾癌G250基因和hGM-CSF基因HEK293细胞系的建立

目的 建立稳定表达肾癌G250基因与基因佐剂hGM-CSF基因编码蛋白的的HEK293细胞系。方法 通过脂质体转染的方法,将表达肾癌G250基因与细胞因子GM-CSF基因的双顺反子pIG250-GM真核表达质粒导入HEK293细胞中;经持续G418压力选择和有限稀释法获得稳定转染的细胞系;用免疫组化、ELISA和Western Blot方法,检测目的蛋白在HEK293细胞中的表达。结果 经600 μg/mL的G418压力筛选后,获得了抗性细胞克隆;免疫组织化学方法检测到表达G250的阳性细胞;ELISA方法检测到pIG250-GM转染组细胞培养上清中hGM-CSF的表达与空载体对照组比较,差异有统计学意义（P<0.05）;Western Blotting方法检测到G250蛋白的表达,分子量约54Ku,与预期大小相符。结论 成功建立可稳定表达肾癌G250基因与细胞因子GM-CSF基因的HEK293细胞系,为研究防治肾癌疫苗的免疫应答机制提供了实验基础。     

肺癌介入治疗中体-肺分流的研究(附167例分析)

目的：了解原发性肺癌支气管动脉造影中出现的体肺分流征象及其对ＢＡＩ 疗效的影响。材料与方法：对１６７例原发性肺癌患者在介入治疗前行支气管动脉造影,注射造影剂后１ 、３ 、５ｓ 观察是否提前出现体肺分流。结果：１６７ 例中出现体肺分流者６６ 例,占３９ ．５ ％ ,体肺分流与肺癌的组织类型及肿块大小无明显关系,而与肿块的发生部位有关,中心型肺癌比周围型多。结论：体肺分流发生的形式中以支气管动脉与肺动脉者最多,分流发生的原因是因为肿瘤侵及肺动脉、奇静脉,又与瘤内新生血管相通,分流血管少不影响ＢＡＩ 疗效,多则影响疗效。