腹部推压缓解结肠镜检查后腹胀的效果观察

目的 探讨腹部推压对于结肠镜检查后腹胀的缓解效果.方法 将我院2016年11月28日至2017年1月5日结肠镜检查后的103例患者,采用完全随机分组法分为试验组51例和对照组52例.对照组进行自由行走或变换体位、自主排气以缓解腹胀;试验组在对照组的基础上指导患者自行腹部推压5 min,观察两组患者肠镜检查结束即刻的腹胀程度、结束5 min时的腹胀及其缓解程度.结果 肠镜检查结束时两组患者腹胀程度比较差异无统计学意义(P＞0.05),实施干预5 min后,试验组较对照组腹胀程度减轻,差异有统计学意义(P＜0.01);肠镜检查结束5min时,试验组较对照组腹胀缓解程度明显,差异有统计学意义(Z=-5.839,P＜0.01).结论 结肠镜检查结束时患者自行腹部推压5 min+常规指导处理较单纯常规指导处理能更好缓解患者结肠镜检查后腹胀.     

后路椎弓根螺钉内固定治疗寰枢椎骨折脱位的临床体会

目的：探讨经后路椎弓根螺钉内固定治疗寰枢椎骨折脱位临床疗效。方法选取2011年6月至2013年12月在该院接受治疗的寰枢椎骨折脱位患者19例,经后路切开复位椎弓根螺钉内固定术。术后定期复查X线片了解骨折脱位矫正和后路植骨融合。参照日本骨科学会（JO A ）评分评估神经功能。结果患者植骨全部融合,内固定无松动,无断钉、断棒发生,JO A评分由术前（7．35±2．39）分改善至术后（13．21±2．53）分,差异有统计学意义（ P＜0．05）。结论后路寰枢椎椎弓根螺钉内固定治疗上颈椎损伤疗效满意。     

不同术式对腹透导管移位的影响及其透析效果观察

为探讨不同术式对腹透管移位的影响及其使用效果,将患者随机分成两组：①前置组：将腹透管置入陶氏腔;②后置组：将腹透管置入直肠后。结果发现：后置组导管移位的发生率较前置组明显降低,两组出入液时间、超虑量无显著差异。说明后置式置管方式能有效地减少导管移位,同时有较好的使用效果。     

联合检测ΔNp63、Ki-67和VEGF与膀胱移行细胞癌预后的相关性研究

目的 探讨ΔNp63、Ki-67和血管内皮生长因子(VEGF)在膀胱移行细胞癌(TCCB)中的免疫组化表达及与膀胱癌病理分级、临床病理分期和预后的相关性.方法 用SP法对56例膀胱移行上皮癌病理切片行ΔNp63、Ki-67和VEGF免疫组化染色,将免疫组化染色结果与病理分级、分期和预后进行分析.结果 TCCB中ΔNp63、Ki-67和VEGF阳性表达率明显高于正常膀胱黏膜,在高级别、浸润性癌组织中的阳性表达率明显高于低级别、浅表性癌组织,在复发患者中的阳性表达率显著高于初发组,在膀胱癌的病理分级、临床分期和预后之间表达差异有统计学意义(P<0.05).采用Spearman等级相关性分析,ΔNp63与Ki-67、VEGF呈正相关,差异均有统计学意义(P<0.05).结论 ΔNp63可能通过促进细胞增殖和肿瘤血管生成发挥促癌作用,联合检测ΔNp63、Ki-67和VEGF多项肿瘤标记物可以更好地判断TCCB的预后.     

“双一流”背景下基于SWOT分析的医学高校图书馆特色资源建设探讨

以中医药院校图书馆为例,阐述特色资源内涵,运用SWOT分析法分析“双一流”背景下医学高校图书馆特色资源建设的优势、劣势、机遇和挑战,提出相应建议,包括提升采访馆员素质、制定特色馆藏标准等。     

超声评价外科封堵房间隔缺损

目的　评价经胸小切口外科介入封堵 孔型 ASD的疗效。　方法　术前用经胸及经食道超声心动图(TTE、TEE)筛选合适的病例 6人 ,术中用 TEE指导封堵 ,术后 1周、1月及 3月用 TTE观察封堵器的情况并测量各超声参数。　结果　 6例患者均封堵成功 ,仅 1例呈上下排列的二孔 ASD患者残留少量分流。所有患者术前术后左心大小均无增大 ,术后 3个月右心大小、肺动脉内径及肺动脉压基本恢复正常。　结论　超声心动图在术中监测安置以及术后疗效的评价方面起着非常重要的作用     

Sarcopenia with systemic inflammation can predict survival in patients with hepatocellular carcinoma undergoing curative resection

BackgroundThis study aimed to examine the prognostic significance of sarcopenia combined with systemic inflammation in patients who underwent curative hepatectomy for hepatocellular carcinoma (HCC).MethodsBetween January 2010 and July 2019, we identified 159 patients with HCC who underwent curative hepatectomy at three institutional centers. We retrospectively analyzed clinicopathological outcomes, surgical outcomes, platelet lymphocyte ratio (PLR) as a systemic inflammatory marker, and computed tomography (CT)-assessed sarcopenia at the third lumbar vertebra level (L3).ResultsSarcopenia was noted in 74 (46.5%) of 159 patients and was significantly associated with male sex, low body mass index (BMI), and high PLR. In the multivariate analysis, sarcopenia [hazard ratio (HR): 2.127, P=0.026] and high PLR (HR: 1.971, P=0.038) were associated with a decrease in overall survival (OS) but not in recurrence-free survival (RFS). The combination of sarcopenia and PLR status stratified the 5-year OS into 82.0% (non-sarcopenia and a low PLR), 68.3% (sarcopenia or a high PLR), and 44.4% (sarcopenia and a high PLR) (P=0.001). In the multivariate analysis, “sarcopenia and a high PLR” and “sarcopenia or a high PLR” were revealed to be significant predictors of OS (HR: 4.300, P=0.001 and HR: 2.723, P=0.010, respectively).ConclusionsSarcopenia and high PLR were significantly associated with poor OS. The combination of these two factors may be useful for predicting survival of patients with HCC undergoing curative hepatectomy.     

Application of Alpha1-adrenergic antagonist with extracorporeal shock wave lithotripsy for lower ureteral stone

OBJECTIVE: To evaluate the efficacy of alpha1-adrenergic antagonist in the medical management of lower ureteral stone with extracorporeal shock wave lithotripsy (ESWL). METHODS: A total of 80 patients with stone located in lower ureter were randomly divided into two groups. Group 1 served as control and group 2 received tamsulosin (0.4 mg, once daily) after ESWL. All patients were observed for 2 weeks and asked to compile a diary about renal colic, stone expulsion, use of analgesic drugs, and side effects of medical therapy. RESULTS: During 2 weeks, stones were expulsed in 18 patients (45.0%) of group 1 and in 31 patients (77.5%) of group 2. The expulsion rate between group 1 and group 2 was significantly different (P < 0.01). Eight patients (20.0%) in group 1 and 2 patients (5.0%) in group 2 experienced renal colic relapse within 2 weeks and were administered with analgesics (P < 0.05). No side effect in group 1 was reported, except that 2 patients in group 2 complained of slight dizziness. CONCLUSIONS: Tamsulosin (alpha1-adrenergic antagonist) can improve the stone-free rate of lower ureteral stones after ESWL and reduce the relapse of renal colic. As a safe and effective agent, it can be regarded as an auxiliary clearance method after ESWL for lower ureteral stones.     

小鼠脊髓发育候选基因Wnt7b的初步研究

目的:探讨Wnt7b基因及Wnt信号系统分子对小鼠脊髓发育的作用。方法:基因测序比较A/J和C57BL/6J两种小鼠Wnt7b基因开放阅读框架序列差异;以RT-PCR方法测定Wnt7b基因在两种小鼠组织中的表达差异;免疫组化法测定Frizzled在2种孕14天胎鼠脊髓上的表达和分布。结果:测序结果中发现两种小鼠Wnt7b开放阅读框架序列结构具有差异;在2种小鼠8种组织中,脊髓、肌肉、脾和肾中的Wnt7b基因表达具有明显差异;免疫组化的测定表明,发育14天的胎鼠脊髓上的Frizzled表达强度和分布范围具有显著差异,尤其是A/J小鼠在神经管周围表达明显强于C57BL/6J。结论:基因表达差异和基因结构差异提示,Wnt7b基因与脊髓发育具有一定的关联,应为一脊髓发育候选基因;Frizzled的强表达与脊髓发育的抑制相关,Wnt7b的信号转导途径介导了控制脊髓发育的过程。