酒石酸罗格列酮联合二甲双胍治疗2型糖尿病的疗效分析

目的评价酒石酸罗格列酮联合二甲双胍治疗2型糖尿病的疗效。方法将80例2型糖尿病患者随机分为实验组和对照组,每组各40例。实验组应用酒石酸罗格列酮联合二甲双胍治疗,对照组应用二甲双胍治疗,两组患者的疗程均是12周。分别观察用药后血糖的变化,比较两组的临床效果。结果两组患者经12周的治疗,FPG、2hPG、HbA1c、Homa-IR均有所下降,实验组治疗后的上述指标明显优于对照组,两组比较组间差异具有统计学意义(P<0.05)。结论酒石酸罗格列酮联合二甲双胍减轻2型糖尿病胰岛素抵抗作用,可以有效降低患者的血糖水平,疗效良好,安全性高。     

血管瘤血管内皮生长因子受体KDR基因异常甲基化的研究

目的通过建立甲基化敏感性高分辨率溶解曲线法（MS-HRM）,检测血管内皮生长因子VEGF受体KDR基因启动子区域在不同时期血管瘤、血管畸形及正常皮肤组织中的甲基化状态,初步探讨基因甲基化在血管瘤形成、增生、退化过程中的作用。方法选取不同时期血管瘤石蜡标本48例、血管畸形石蜡标本15例、正常包皮皮肤组织标本8例,分别提取DNA,经亚硫酸氢盐甲基化修饰、纯化、回收DNA,然后用甲基化敏感性高分辨率溶解曲线法（MS-HRM）,定量检测不同标本中血管内皮生长因子受体KDR甲基化水平。结果48例血管瘤标本共检出32例不同程度KDR基因启动子区域甲基化（66．67％）,其中24例增殖期血管瘤标本中检出21例（87．50％）不同程度甲基化,24例消退期血管瘤标本中检出11例（45．83％）不同程度甲基化,增殖期血管瘤与消退期血管瘤标本中KDR的甲基化程度比较,差异有统计学意义（X^2=9．375,P〈0．05）;15例血管畸形标本中仅检出甲基化程度为0-25％者2例（13．33％）,8例正常包皮皮肤组织中检测到1例甲基化0-5％（12．50％）。与血管瘤相比,差异均有统计学意义（P〈0．05,Fisher’确切概率法）。结论血管瘤中血管内皮生长因子受体KDR基因启动子序列CpG岛存在异常甲基化,血管内皮生长因子受体KDR基因异常甲基化可能与血管瘤增生、退化等有关。     

整合素α6、β-微精浆蛋白基因和染色体8q24区与前列腺癌的关联研究

目的 探讨整合素α6(ITGA6)基因(rs12621278,G)、染色体8q24区(rs10086908,T)和β-微精浆蛋白(MSMB)基因(rs10993994,T)与北京市居民中前列腺癌(PCa)的关联,了解PCa患者基因型和表型的关系.方法 收集112例PCa患者临床、遗传、膳食习惯、嗜好等表型,对PCa患者和91名正常对照者的ITGA6基因(rs12621278,G)、染色体8q24区(rs10086908,T)和MSMB基因(rs10993994,T)进行比较,并进行病例组的基因型-表型分析.结果 2组间相比,MSMB基因rs10993994,T风险等位基因频率差异有统计学意义(病例组56.4%,对照组46.2%;P=0.001,OR=1.97,95%CI为1.28～3.04).8q24区的rs10086908,T(病例组83.5%,对照组79.2%)和ITGA6基因的rs12621278,G(病例组27.2%,对照组27.0%)组间差异无统计学意义(P＞0.05).数量性状分析发现ITGA6风险基因型(G/G)的患者病程为(1.40±0.55)年,显著短于A/G型的(4.38±3.10)年和A/A型的(2.37±1.84)年(P=0.003).结论 MSMB基因变异和PCa易感性之间存在相关性,提示MSMB基因可能与PCa有关联.

Abstract：

Objective To explore the correlation between ITGA6 gene (rs12621278, G), MSMB gene (rs10993994, T), chromosome 8q24 (rs10086908, T) and prostate cancer (PCa) in Beijing residents, and to explore the correlation between genotype and phenotype in PCa patients. Methods PCa patient phenotypes were collected including clinical, genetic, dietary habits, hobbies and blood samples. ITGA6 gene (rs12621278, G), chromosome 8q24 (rs10086908, T) and MSMB gene (rs10993994, T) compared the allele distribution between 112 PCa and 91 healthy control age matched patients. The genotype and phenotype analysis was conducted in the 2 groups. Results Between the case and control groups, only rs10993994, T of MSMB gene (case 56.4%,control 46.2%) was significantly different (P=0.001; OR=1.97, 95%CI:1.28-3.04). The rs10086908, T of 8q24 (case 83.5%, control 79.2%) and rs12621278, G of ITGA6 gene (case 27.2%, control 27.0%) were not significantly associated with PCa in the study sample (P>0.05). Quantitative trait analysis showed that the disease duration of ITGA6 risk genotypes (G/G,1.40±0.55 years) in PCa patients was significantly shorter (P=0.003) than the other genotype carriers (A/G, 4.38±3.10 years; A/A, 2.37±1.84 years). Conclusion The genetic variation in MSMB is possibly associated with PCa susceptibility, suggesting that MSMB genes might be associated with PCa in a Chinese population.     

足背外侧弥漫型腱鞘巨细胞瘤术后复发一例

1病例报告 女性,35 岁.因＂左足背外侧肿块7 年＂入院.患者7 年前无明显诱因发现左足背中部外侧有一约1×1cm 肿物,质软,无疼痛,无红热.2 年前曾于当地卫生院诊断为腱鞘囊肿,行手术切除.术后肿块很快复发,并且肿块生长速度明显加快伴轻度疼痛.遂到我院诊治.体检：左足背中部外侧中部可见1 个6×5cm 肿物,肤色、肤温正常,质软分叶样包块,活动度差,有轻压痛,局部皮肤无破溃,     

2007年贵州省从江县碘缺乏病健康教育效果评价

Objective To evaluate the effect of health education in controlling the iodine deficiency diserders(IDD) in order to provide reference data for the further prevention and control. Methods Each village of 3 towns in Congjiang County was selected in 2007, where the health education lasting for 10 months had been implemented in the school students of 3-6 grade and the villagers. The school students of 3-6 grade and 30 housewives in the villagers were investigated for their IDD control knowledge, the salt consuming conditions as well as the sales of both rough and fine salt at a salt retail site in each village before and after the health education was implemented. Results The awareness rate of the knowledge of IDD control in the students and housewives was 91.4% (581/636) and 78.3% (282/360), respectively after intervention, which significantly increased (χ2= 532.044, 326.117, both P < 0.01) compared with the rate of 28.2% (184/652) and 11.4% (41/360) before intervention. The proportion of consuming fine salt was 91.8%(146/159) and 95.6%(86/90), significantly inereased(χ2= 236.623, 135.350, both P < 0.01) compared with 6.1%(10/163) and 7.8% (7/90) found before intervention. The selling proportion of fine salt at the salt retail site in the village was 60.0%(900/1500), significantly increased(χ2= 824.176, P < 0.01) compared with 10.0%(150/1500) before intervention. Conclusions Health education and promotion is solid foundation for effectively controlling IDD, through which the students and villagers are actively and voluntarily involved in the program and hence have formed good living and hygiene habits, thus expected effect has been obtained.     

地诺前列酮栓促宫颈成熟管理规范对妊娠结局的影响

目的:比较地诺前列酮栓促宫颈成熟管理规范实施前后的妊娠结局,探讨其促宫颈成熟的安全性。方法:回顾分析2012年9月—2014年2月在同济大学附属第一妇婴保健院使用地诺前列酮栓促宫颈成熟并分娩的612例产妇的临床资料,2013年4月起地诺前列酮栓促宫颈成熟管理规范实施,通过比较管理规范实施前后的母婴结局及不良反应发生率,探讨其对妊娠结局的影响。结果:2013年4月管理规范实施前有449例产妇使用地诺前列酮栓促宫颈成熟,管理规范实施后有163例。共413例(67.5%)引产成功,管理规范实施后48 h内、24 h内及12 h内引产成功率均略低于规范实施前,但差异均无统计学意义。总剖宫产率为27.1%,管理规范实施前后剖宫产率差异无统计学意义。2组新生儿Apgar评分及入住重症监护病房率差异均无统计学意义。规范实施后宫缩过频过强以及羊水粪染的发生率较规范实施前显著降低,差异有统计学意义(P<0.05);规范实施前后子宫过度刺激的发生率、绒毛膜羊膜炎可能的发生率差异无统计学意义。2组均无羊水栓塞和会阴严重裂伤并发症的发生。结论:地诺前列酮栓是比较安全有效的促宫颈成熟及引产的方法,管理规范的实施有助于保障母婴安全及减少不良妊娠结局发生。     

永久性膀胱造瘘患者46例护理体会

永久性膀胱造瘘术适用于老年前列腺炎、尿道肿瘤、良性前列腺增生全身情况差不适合手术,及神经源性膀胱所致的尿液排空障碍所引起的尿潴留患者^[1]。膀胱造瘘术后患者易发生尿路感染、造瘘管堵塞、结石形成以及膀胱挛缩等并发症,所以术后的护理对预防并发症的发生,     

适应医疗消费需求 打造军队疗养院品牌

近些年，军队疗养院开展对外服务后，由于特色项目较少，缺乏品牌服务，不能适应社会医疗消费需求而始终没能融入医疗市场竞争的主流。虽然，军队疗养院管理不同于地方医院的企业化经营，但医疗市场激烈竞争的现实和品牌服务的巨大市场效应，已深刻影响着军队疗养院的对外服务工作。因     

冠心病诊断技术和方法进展

冠心病的诊断在病史、体检和化验的基础上,尚需借助辅助性诊断技术和方法,如心电图、心电图运动试验(活动平板或踏车),超声心动图、放射性核素检查及冠状动脉造影。这些技术和方法在冠心病诊断中的价值已有公认的评价。近年来,在上述技术和方法中,主要为超声心动图和放射性核素检查方面的进展,现就此作一简述,并对其作出简短评价。