凝血指标在不同严重程度胆源性急性胰腺炎中的变化

目的探讨不同严重程度胆源性急性胰腺炎患者凝血指标的变化。方法本文为回顾性研究。纳入从2013年01月01日至2017年12月31日在保定市第一中心医院消化内科诊治的胆源性急性胰腺炎患者128例。根据急性生理学与慢性健康状况评分系统Ⅱ进行评分,分为轻度组(A组)、中度及重度组(B组)。收集发病48小时内患者的凝血指标:D-二聚体、血小板计数及凝血酶原活动度。比较在不同严重程度时上述指标的差异。结果 D-二聚体水平B组高于A组(P0.05),凝血酶原活动度B组低于A组(P0.05),血小板计数在两组中的差异无统计学意义(P0.05)。结论 D-二聚体水平随病情加重而升高,凝血酶原活动度水平随病情加重而降低,血小板计数随病情加重无变化。     

药物联合波姆光控制重度外阴阴道假丝酵母菌病症状的疗效观察

目的 探讨局部波姆光理疗对控制重度外阴阴道假丝酵母菌病(VVC)症状的临床疗效.方法 将我院妇科2009年1-12月确诊的重度VVC患者98例按照不同的治疗方法 分成2组:对照组48例,用口服氟康唑和阴道放置硝酸咪康唑栓治疗;理疗组50例,用局部波姆光理疗联合对照组方法 治疗;通过对患者的主观症状和治疗后VVC分别评分进行比较,观察2组方法 的疗效.结果 理疗组患者的临床症状在治疗后4 h就快速缓解,其中瘙痒评分低于治疗前[(1.4±0.3)分与(2.8±0.5)分,P0.05).结论 局部波姆光理疗联合药物治疗重度VVC,不仅可以加强单纯药物治疗的疗效,而且能快速缓解临床急性期的症状.

Abstract：

Objective To evaluate the clinical effect of local POME optical treatmeat in patients with severe vulvovaginal candidiasis (VVC) . Methods Ninety-eight patients, who were diagnosed as severe vulvovaginal candidiasis from January to December 2009 in Beijing Wuzhou Women's Hospital gynecologicalclinic,were enrolled into this study and divided into control and physiotherapy groups randomly. The patients of control group (re =48) were treated with oral Fluconazole and had Miconazde Nitrate suppositories settlement into vagina, while in the physiotherapy group (n =50) the patients accepted local POME optical treatment combined with the same medications as control. The therapeutic effect were evaluated and compared according to the subjective symptoms and VVC scores in both groups. Results The clinical symptoms of physiotherapy group were relieved within 4 hours after the treatment, which were significantly depressed compared to before the treatment (itching score 1.4 ±0.3 vs. 2. 8 ±0. 5,P <0. 05;pain score 1.5 ±0.4 vs. 2. 8 ±0. 3,P <0. 05),while obvious improvements were observed in control group untill 48 hours later (itching score 1. 8 ± 0. 6 vs.2.9 ±0.3,P<0. 05;pain score 1.5 ±0.5 vs. 2. 8 ±0.4,P <0. 05). The VVC scores were significantly lower in physiotherapy group than control after treatment at different timepoints (24 h VVC Score 5. 3 ± 1. 6 vs. 9. 5 ±2. 1,P<0. 05;48 h Score 4. 8 ±1.0 vs. 7.9 ±2. 3,P<0. 05),but no significant difference was observed in the comparison of VVC Scores between two groups 72 h after treatment (P > 0.05). Conclusion Local POME optical treatment combined with drug treatment in severe VVC patients not only has better effect than drug treatment alone,but also relieves clinical symptoms more quickly.     

围术期不同时间应用曲马多对术后镇痛和恶心呕吐的影响

目的 探讨围术期不同时间给予曲马多对术后镇痛和恶心呕吐并发症的影响.方法 选择54例全身麻醉妇科手术患者,按照静脉给予曲马多的时间不同分为手术结束组、手术结束前组、麻醉诱导前组3组.术后3组均安装艾克孚静脉患者自控镇痛泵(PCA),术后随访24 h,记录3组患者的生命体征、镇痛效果和恶心呕吐情况.结果 各时间点3组患者的一般情况和视觉模拟评分之间差异无统计学意义(P＞0.05);麻醉诱导前组8 h内患者的PCA按压次数明显少于其他2组[(0.6±0.8)次比(1.9±1.1)次、(1.6±1.0)次,P＜0.05];术后1 h,手术结束前组恶心呕吐程度最重,手术结束组、麻醉诱导前组与其比较,差异有统计学意义[(1.6±0.9)分比(0.6±0.5)分、(0.5±0.6)分,P＜0.05],术后4、8和12 h,手术结束组的恶心呕吐程度最严重,与其他2组相比,差异有统计学意义(P＜0.05).结论 麻醉诱导前给予曲马多,既可增强术后镇痛的作用,又能降低曲马多术后镇痛恶心呕吐的发生率.

Abstract：

Objective To investigate the analgesic effect and the influence on nausea and vomiting of tramadol during the different periods of perioperation. Methods Fifty-four patients undergoing gynecologic surgery under general anesthesia were randomly divided into three groups according to the time of using tramadol: after operation instantly group, before the end of surgery group and before induction of anesthesia group. All the patients received intravenous patient controlled analgesia(PCA) pump. The vital signs, pain scores and postoperative nausea and vomiting were observed 24 hours after operation. Results There was no significant difference of the vital signs and visual analogue scale (VAS) scores among the three groups( P ＞ 0.05 ). At 8 h after PCA, the number of PCA in before induction of anesthesia group was obviously reduced(P ＜0.05). At 1 h after PCA, the patients in before the end of surgery group experienced the severest nausea and vomiting( P ＜0. 05 ). At 4 h, 8 h and 12 h after PCIA, the patients in after operation instantly group experienced the severest nausea and vomiting ( P ＜ 0.05 ).Conclusion Using tramadol before induction of anesthesia not only has a good analgesic effect, but also decreases the incidence of nausea and vomiting after postoperative analgesia.     

卵巢上皮性癌细胞中E钙黏素基因的甲基化状态及去甲基化的意义

目的 研究卵巢上皮性癌(卵巢癌)细胞中E钙黏素(E-cad)基因启动子区5'二核苷酸胞嘧啶(5'CpG)岛的甲基化状态,观察DNA甲基转移酶抑制剂--5-杂氮脱氧胞苷(5-Aza-CdR)去甲基化后对卵巢癌细胞的生长、侵袭以及E-cad蛋白表达的影响.方法 采用甲基化特异性PCR(MSP)技术检测卵巢癌细胞系ES-2、3AO及SKOV3细胞中E-cad基因启动子区5'CpG岛的甲基化状态.以不同浓度(分别为0.1、110、10.0μmoL/L)的5-Aza-CdR处理卵巢癌细胞后,电镜下观察细胞形态的变化,四甲基偶氮唑蓝(MTT)比色法检测细胞生长情况,蛋白印迹法检测细胞中E-cad蛋白表达的变化,体外侵袭实验检测细胞侵袭能力的变化.结果 MSP技术检测显示,ES-2及SKOV3细胞中E-cad基因启动子区5'CpG岛呈高度甲基化状态和非甲基化状态,3AO细胞中E-cad基因启动子区5'CpG岛仪呈非甲基化状态.经不同浓度(分别为0.1、1.0、10.0 μmol/L)的5-Aza-CdR处理后,ES-2及SKOV3细胞的体积变小,皱缩,核/质比例缩小,核分裂象减少,随着药物浓度的增高,此种趋势逐渐明显;ES-2和SKOV3细胞中E-cad蛋白相对表达水平分别为0.274、0.320、0.398和0.415、0.507、0.638,均明显高于对照细胞(分别为0.131和0.342,P＜0.01);ES-2和SKOV3细胞穿膜细胞数分别为(88.8±2.5)、(60.7±2.4)、(36.1±3.0)个和(88.2±2.1)、(60.5±2.2)、(36.2±3.0)个,均明显低于对照细胞[分别为(121.9±2.3)、(97.6±2.7)个,P＜0.01].结论 启动子区5'CpG岛的高度甲基化是卵巢癌细胞中E-cad基因异常表达的重要机制之一,5-Aza-CdR能通过降低E-cad基因启动子区5'cpG岛的甲基化而恢复其在卵巢癌细胞中的表达,抑制卵巢癌细胞的增殖和侵袭.     

围术期不同时间应用曲马多对术后镇痛和恶心呕吐的影响

Objective To investigate the analgesic effect and the influence on nausea and vomiting of tramadol during the different periods of perioperation. Methods Fifty-four patients undergoing gynecologic surgery under general anesthesia were randomly divided into three groups according to the time of using tramadol: after operation instantly group, before the end of surgery group and before induction of anesthesia group. All the patients received intravenous patient controlled analgesia(PCA) pump. The vital signs, pain scores and postoperative nausea and vomiting were observed 24 hours after operation. Results There was no significant difference of the vital signs and visual analogue scale (VAS) scores among the three groups( P ＞ 0.05 ). At 8 h after PCA, the number of PCA in before induction of anesthesia group was obviously reduced(P ＜0.05). At 1 h after PCA, the patients in before the end of surgery group experienced the severest nausea and vomiting( P ＜0. 05 ). At 4 h, 8 h and 12 h after PCIA, the patients in after operation instantly group experienced the severest nausea and vomiting ( P ＜ 0.05 ).Conclusion Using tramadol before induction of anesthesia not only has a good analgesic effect, but also decreases the incidence of nausea and vomiting after postoperative analgesia.     

脱袖式子宫全切术与常规子宫全切术术式比较

经腹子宫全切术是治疗子宫肌瘤、功能失调性子宫出血等妇科常见疾病的主要常用术式。我院自1997年开始探索经腹“脱袖”式子宫全切手术，现已形成一套较为规范的手术方法，较常见的子宫全切术式有许多明显的优点，现介绍如下。1；临床资料对我院及外院1997年3月一1999年2月期间，子宫肌瘤、功能失调性子宫出血患者采用本法行子宫全切者40例做为研究组。选择常规子宫全切术术式作为对照组，两组从适应征及子宫大小几乎无差异。2手术方法2．1术前准备和麻醉与常规子宫全切术无差别2．2依次打开腹腔，两把弯钳钳夹两侧子宫角部，提起子宫。依次…     

人骨形成蛋白2的基因的克隆和序列分析

目的 克隆人骨形成蛋白2基因全长。方法 以成骨肉瘤细胞总RNA为模板，应用转录酶-多聚酶链反应法克隆人骨形成蛋白2的cDNA全长；将获得的基因插入pGEM—T—Easy载体质粒，并转化至大肠杆菌后挑选阳性克隆，利用限制性内切酶酶切分析鉴定重组质粒。结果 通过质粒酶切分析和序列测定，我们获得的基因为人骨形成蛋白2全长DNA序列。结论 克隆获得人骨形成蛋白2的基因，为其进一步开发利用提供了前提条件。     

双环醇联合异甘草酸镁对BHV感染失代偿期肝硬化患者临床疗效及对肝功能、血清炎性因子、Toll样受体4和谷草转氨酶-血小板比值指数的影响

目的 探讨双环醇联合异甘草酸镁对HBV感染失代偿期肝硬化患者肝功能、血清炎性因子、Toll样受体4及对谷草转氨酶-血小板比值指数的影响。方法 选取2019年1月—2021年12月华北理工大学附属医院和开滦总医院住院的HBV感染失代偿期肝硬化患者134例患者，按照随机数字表法分为随机分为对照组和观察组，每组各67例。对照组给予异甘草酸镁治疗，观察组给予异甘草酸镁和双环醇治疗。观察所有患者肝肾功能、血清炎性因子、Toll样受体4及对谷草转氨酶-血小板比值指数的变化。结果 治疗后ALT、AST、ALP、TBIL、HA、LN、PCIII、CIV、BUN、Cr、阻力指数、IL-6、IL-8、TNF-α、CRP、TLR-4、TGF-β1、APRI水平较治疗前降低，ALB、肾血流量较治疗前升高；差异均有统计学意义。观察组肝肾功能、肝纤维化指标、肝影像学指标、血清炎症因子改善情况优于对照组，差异均有统计学意义。观察组总有效率高于对照组（97.01%vs 86.57%），差异有统计学意义。结论 双环醇联合异甘草酸镁对BHV感染失代偿期肝硬化患者临床疗效显著，可以改善肝肾功能，降低炎症反应，改善谷草转氨酶...     

微波并妇科千金片治疗慢性盆腔炎123例

慢性盆腔炎患者 2 39例 ,年龄 2 5～ 4 5岁 ,平均33.5岁 ;病程 3个月～ 1年。诊断标准 :①自觉下腹坠胀 ,疼痛及腰骶部酸痛 ,劳累或房事后加剧 ;②内诊 ,子宫活动受限、压痛 ,附件增厚 ,或触及边界不清的包块 ;③Ｂ超示子宫后方有液暗区或炎性包块。本组病例均符合以上标准中的 2项。治疗分为两组 ,微波并妇科千金片组 12 3例 (观察组 ) ,单纯口服妇科千金片组 116例 (对照组 ) ,两组患者的年龄、病程及病情等相近 ,具有可比性。采用南京产ＭＴＣ -4型多功能微波手术治疗仪 ,频率 2 4 50ＭＨｚ ,输出功率 4 0～ 50Ｗ ,患者仰卧位 ,选用微波…     

热疗在宫颈癌中的研究进展

肿瘤热疗学近年重新得到关注和研究,随着热生物学的发展,热疗已成为继手术、放疗、化疗及免疫疗法后的又一种治疗肿瘤的新方法.其中,热疗与放疗和/或化疗在晚期宫颈癌综合治疗中的联合应用显示,热疗与放化疗互补,增强对放化疗的敏感性,同时减轻放化疗的不良反应.就热疗对宫颈癌的治疗及研究进展做一.