结直肠癌肝转移外科治疗的共识与争议

结直肠癌肝转移是导致结直肠癌患者死亡的主要原因。目前,循证医学证据表明手术切除是结直肠癌肝转移患者有效且可能获得长期生存的惟一治疗方式。随着外科技术尤其是微创外科技术的进步,越来越多的患者可从外科手术中获益。化学药物的发展以及贝伐单抗和西妥昔单抗等靶向药物的应用,使不可切除的结直肠癌肝转移转化为可切除,从而使更多患者获得治愈的机会。对于无法根治性切除的患者,外科手术联合射频治疗的方法可延长生存期。多学科合作团队诊治模式的广泛应用,使结直肠癌肝转移的治疗更加精准。     

高血压患者静息心率与血压昼夜节律的相关性

目的探讨原发性高血压患者的静息心率(RHR)与血压昼夜节律的相关性。方法选择210例汉族中年原发性高血压患者,按RHR水平分为3组,RHR1组:RHR<70bpm(53例),RHR2组:70bpm相似文献   

Evaluation of laser-speckle contrast image analysis techniques in the cortical microcirculation of piglets

A new laser speckle-contrast analysis (LASCA) technique based on multi-exposure imaging was employed to simultaneously study pial arteriolar responses with cerebrocortical perfusion changes to various vasodilator (5-10% CO(2) ventilation, bradykinin (1-10 μM), N-methyl-D-aspartate (100 μM)) vasoconstrictor (10-100 μM noradrenaline, 1M KCl), or neutral (2.1% H(2) ventilation) stimuli as well as to asphyxia in the newborn piglet. Anesthetized, ventilated animals (n=20) were fitted with closed cranial windows. Multiple exposure laser-speckle image series (1-100 ms) were obtained using a near infrared diode laser (λ=808 nm). The autocorrelation decay time (τ) of speckle fluctuations was determined over pial arterioles and parenchymal areas to express 1/τ being proportional to blood flow velocity by two different LASCA techniques: our novel multi-exposure or a single exposure (2 and 20 ms) approach. 1/τ values yielded by different LASCA techniques were not significantly different at most points. LASCA easily detected both increases and decreases in cortical blood flow (CoBF). Cortical 1/τ changes to hypercapnia closely matched quantitative CoBF data determined previously, and were also in accordance with increases of pial arteriolar blood flow, calculated from arteriolar flow velocity and cross sectional area changes. In summary, LASCA emerges as an appealing method to simultaneously study microvascular reactivity and cortical perfusion changes in the piglet.     

Pathophysiology of peripheral arterial disease in diabetes mellitus

Peripheral arterial disease (PAD) increases the risk of lower extremity amputation. It is also an independent predictor of cardiovascular and cerebrovascular ischemic events, affecting both the quality and expectancy of life. Many studies have demonstrated that the prevalence of PAD in patients with diabetes mellitus (DM) is higher than in non‐diabetic patients. In diabetic patients, PAD occurs early with rapid progression, and is frequently asymptomatic. Multiple metabolic aberrations in DM, such as advanced glycation end‐products, low‐density lipoprotein cholesterol, and abnormal oxidative stress, have been shown to worsen PAD. However, the role of DM in PAD is not completely understood. The purpose of the present article is to review and discuss the pathophysiology of PAD in DM.     

螺旋CT在上颌前部埋伏阻生牙定位中的临床应用

目的：探索三维CT成像和多层面重建技术（MPR）在骨内埋伏阻生牙中的应用价值。方法：对9例埋伏阻生牙患者，应用螺旋CT的图像处理功能，采用表现阴影成像法和多层面重建技术，获得单纯牙体表面图像和任意平面、任意曲面的断层像。结果：能清晰的显示上颌前部埋伏阻生牙的形态、唇侧或腭侧位置、萌出方向及与邻牙的关系。结论：螺旋CT三维成像和多层面重建技术是一种即能立体展示牙齿表面形态，又能精确判断牙齿位置的影像学技术，可作为骨内埋伏阻生牙外科处理和正畸治疗前的检查手段。     

亚高温热疗对免疫功能的影响

亚高温热疗(MHT)是目前肿瘤治疗领域的研究热点之一.大量离体和在体实验研究表明,39.5℃～41.5℃的加温并不能直接杀伤肿瘤细胞,其抗肿瘤作用是通过提高正常免疫效应细胞活性、诱导免疫效应细胞再分布以及影响某些细胞因子和热激蛋白的表达而达到的,因此具有重要的肿瘤免疫调节作用,是一种安全、有效的辅助性肿瘤治疗手段.     

跟骨骨折CT及3D重建的评价

目的 评价跟骨骨折CT检查及3D重建的价值。方法 CT检查101侧跟骨，3D重建61侧。结果 ①关节外跟骨骨折7侧，关节内骨折44侧。伴后跟距下关节面骨折43侧，按Sanders氏分型为：Ⅰ型14侧，Ⅱ型19侧，Ⅲ型7侧，Ⅳ型3侧。②3D重建跟距下关节面骨折呈斜线形、“Y”字形、倒“Y”字形、不规则形及塌陷或移位形改变。跟骰关节面骨折呈线形、凹陷或粉碎性改变。③采用1mm准直SCT扫描3D重建效果明显优于3mm及5mm者。④SCT及3D重建能较好地显示可塑型跟骨钢板与跟骨间的关系。结论 CT检查及3D重建对判断跟骨骨折的严重程度及术后随访方面有重要价值。     

两种麻醉方式下上腹部手术患者围术期能量代谢和呼吸氧价变化的比较

目的 观察两种麻醉方式下上腹部手术患者围术期能量代谢和呼吸氧价的变化,并探讨其机制。方法选择择期行上腹部手术患者40例,ASAⅡ级,年龄42-61岁,体重42-75kg。随机分为两组,每组20例,Ⅰ组采用硬膜外阻滞复合全身麻醉,Ⅱ组采用全凭静脉复合麻醉。用代谢监测仪分别于麻醉前、麻醉手术中和麻醉清醒后进行代谢测定。结果 两组患者麻醉后手术中的氧耗量(VO2)、二氧化碳产生量(VCO2)、能量消耗(EE)均低于麻醉前,而呼吸商(RQ)高于麻醉前(P<0.05);Ⅰ组患者手术后VO2、VC2、EE、RQ的变化无统计学意义(P>0.05);Ⅱ组患者手术后VO2、VCO2、EE均高于麻醉前(P<0.05),RQ明显低于麻醉前(P<0.05),与Ⅰ组比较,Ⅱ组患者术后VO2、VCO2、EE均升高,RQ降低(P<0.05);Ⅱ组患者呼吸氧价明显高于Ⅰ组患者(P<0.05)。结论 与全凭静脉麻醉比较,硬膜外阻滞复合全麻能够减少术后的能量代谢,降低呼吸氧价。     

小剂量硫酸亚铁治疗妊娠合并缺铁性贫血30例临床分析

目的:观察小剂量硫酸亚铁治疗妊娠合并缺铁性贫血的疗效。方法:选取2006年1月至2007年1月于我院就诊的门诊及住院患者共30例,均给予复方硫酸亚铁颗粒口服治疗,60天后复查血常规、血清铁蛋白。比较治疗前后HB及SF值。结果:治疗后患者的HB及SF均明显增高,P<0.01,有统计学意义。结论:小剂量铁剂治疗妊娠合并缺铁性贫血其临床疗效明显,安全有效。     

重复片段引物PCR用于鲍曼不动杆菌分型研究

目的 运用重复片段引物PCR的分析方法对鲍曼不动杆菌进行分子分型研究。方法 选用肠杆菌科基因间的重复序列（ERIC）为引物进行PCR扩增，对22株鲍曼不动杆菌进行分型研究，并与生物学分型及抗生素耐药结果进行比较。结果 经重复片段引物PCR的方法，分离出6种不同基因型的鲍曼不动杆菌，而生物学分型只有2种，且与抗生素谱较为相关。该方法简便易行，且重复性好，适合于医院感染流行病学研究。