丹参素对成纤维细胞生物学作用机制的研究

目的　探讨丹参素对成纤维细胞凋亡和前胶原基因表达的影响。　方法　于培养的人皮肤成纤维细胞（2×10     

肠系膜血管病变引起的急腹症八例报告

目的：全面认识肠系膜血管病变引起的急腹症的严重性，提高疗效。方法：对8例临床特点、治疗方法和效果进行了分析比较。结果：6例经手术病理证实，初诊多表现为急腹症，症状和体征不相符，5例误诊，1例术前确诊，2例肠系膜血管供血不足经CT及腹腔动脉造影明确诊断并经药物治疗，7例治愈，1例死亡。结论：该病较少见，症状和体征无特异性，难以做出准确的诊断，B超和CT是较敏感的检查，对诊断有积极的作用。早期切除坏死肠段，包括静脉阻塞的肠系膜部分，术中和术后抗凝治疗是预防复发、降低病死率的重要措施。     

多层螺旋CT双期增强扫描结合仿真内镜成像在膀胱癌术前分期中的诊断价值

目的 探讨多层螺旋CT双期增强扫描结合仿真内镜成像在膀胱癌术前分期中的诊断价值.方法 经纤维膀胱镜或手术病理证实为膀胱癌患者75例.对患者术前螺旋CT双期增强扫描图像和仿真内镜图像进行分析,比较多层螺旋CT分期与病理分期的准确率.结果 75例患者共发现病灶94个.螺旋CT分期:T1 26例、T2a 27例、T2b 13例、T3 12例、T4 16例;病理分期:pT1 28例、pT2a 24例、pT2b 14例、pT3 12例、pT4 16例.螺旋CT双期增强扫描诊断膀胱癌准确率为89.4%(84/94);腔内息肉样病变,仿真内镜诊断敏感性96.6%(84/87);膀胱壁无蒂隆起性病变诊断敏感性为90.9%(10/11).螺旋CT双期增强扫描结合仿真内镜诊断膀胱癌分期准确率为94.5%(91/94),当肿瘤局限于膀胱壁内(≤T2b)时,诊断准确率为91.2%(51/56);肿瘤侵犯膀胱壁外结构时(≥T3),诊断准确率达100.0%(28/28).结论 多层螺旋CT双期增强扫描结合仿真内镜成像对膀胱癌术前临床分期具有重要价值.     

平原人进驻高原后红细胞生成素的变化

目的　探讨红细胞生成素在高原低氧适应机制中的作用。方法　对平原进驻海拔 3 70 0m和气 5 3 80m第 7天及半年的健康青年进行血液促红细胞生成素 (EPO)、血红蛋白 (Hb)及血氧饱和度 (SaO2 )检测 ,并与平原健康青年作对照。结果　进驻高原低氧环境EPO、Hb较平原增高显著 (P <0 .0 5或 0 .0 1 ) ,SaO2 降低非常显著 (P <0 .0 1 )。进驻高原第 7天和半年 ,3 70 0m较 5 3 80mEPO ,Hb降低非常显著 ,SaO2 增高非常显著 (P <0 .0 1 )。进驻 3 70 0m ,第 7天较半年EPO无统计学意义 (P >0 .0 5 ) ,Hb ,SaO2 差异显著 (P <0 .0 5或 0 .0 1 ) ;进驻 5 3 80m ,第 7天较半年EPO ,Hb,SaO2 均有显著性差异 (P <0 .0 5或P <0 .0 1 )。结论　在高原缺氧环境下 ,红细胞生成素调节机制紊乱 ,是导致继发性红细胞增多的一个重要环节。     

Clinical outcomes in pediatric tibial lengthening and deformity correction: a comparison of the Taylor Spatial Frame with the Orthex Hexapod System

PurposeComparison of two hexapod frame systems in paediatric tibial deformity correction; the Taylor Spatial Frame (TSF) and Orthex Hexapod System.MethodsPaediatric patients with congenital and acquired tibial deformities treated with either TSF (between 2014 and 2016) or Orthex (between 2017 and 2019) frames were included in a retrospective comparative study. Outcome measures were healing index, pin infection rate, regenerate quality and density, software residual rate, deformity correction accuracy, strut exchanges and quality of life (QoL).ResultsThe TSF group had 17 patients (18 frames) and the Orthex group had 21 patients (25 frames). The most common indications for tibial deformity correction were fibular hemimelia (14) and septic or traumatic growth arrest (8). The median time in frame was 230 days (TSF) versus 203 days (Orthex) (p= 0.06). The mean lengthening achieved was 54 mm (TSF) and 51 mm (Orthex) (p = 0.41). The healing index was 41 days/cm (TSF) versus 43 days/cm (Orthex) (p = 0.70). Pin site infections occurred more in the TSF cohort (40%) than in the Orthex cohort (18%) (p < 0.001). The regenerate in the Orthex group showed higher density at three months (p = 0.029) and was more homogenous (p = 0.023) at six months after frame application. Strut exchanges were less frequent with the Orthex system (p < 0.0001). QoL measures were similar in both cohorts (p = 0.92).ConclusionsThis is the first study to compare two hexapod designs in paediatric orthopaedics. The Orthex system showed superiority in regenerate quality and a significant reduction in pin site infection rates. Both systems delivered predictable and accurate limb deformity correction.Level of evidenceIII     

The incidence of prostate cancer in a screening population with a serum prostate specific antigen between 2.5 and 4.0 ng/ml: relation to biopsy strategy

PURPOSE: It has recently been suggested that the diagnostic threshold for the prostate specific antigen (PSA) assay be lowered to enhance prostate cancer detection. A 22% incidence of prostate cancer has been reported in men with PSA between 2.5 and 4.0 ng/ml. We designed a study to confirm this observation. MATERIALS AND METHODS: Men who participated in our free early detection program and who had serum PSA between 2.5 and 4.0 ng/ml were asked to undergo prostate biopsy. Of 268 eligible men 151 (56%) agreed to participate in this free trial. All men underwent biopsy using an 11-core multisite directed biopsy scheme. All biopsy cores were color coded for location specificity and examined by 1 pathologist. RESULTS: Cancer was identified in 24.5% (37 of 151) of the men biopsied. The median age of men with cancer was 62 years (range 43 to 74). Conventional systematic sextant biopsies, which accounted for 6 of the 11 cores, detected 73.0% (27 of 37) of the cancers and the alternate site biopsies identified the remaining 10. Gleason score was 6 in 25 men, 3 + 4 in 5, 4 + 3 in 4 and 8 or greater in 3 (median Gleason score 6). There were 14 men who had 1 core positive for cancer, 9 had 2 and 14 had more than 2 (median number of positive cores 2). Of the 14 men with 1 positive core 11 had a less than 3 mm focus of cancer and 8 had only a positive alternate site biopsy. There were 11 cases of abnormal results on digital rectal examination, 5 of which were cancer, and 31 cases of abnormal results on ultrasonography, 13 of which were cancer. Median biological variability in PSA was +/-15% (range 0.4% to 440.0%). CONCLUSIONS: We found a significant incidence of cancer (24.5%, 37 of 51) in men with serum PSA between 2.5 and 4.0 ng/ml. In our study 67.6% of the detected cancers were significant based on the biopsy data. If the PSA threshold is lowered the conventional systematic sextant technique may be preferable to an extended strategy.     

下腔静脉滤器置入与下肢深静脉血栓形成复发的相关性分析

目的探讨下腔静脉滤器(ICVF)置入与下肢深静脉血栓形成(DVT)治疗后复发的关系。方法回顾性分析2002年1月至2009年3月我院的确诊为DVT且符合入选标准的261例患者的临床资料。按照随访结果将患者分为复发组和未复发组,分别对可能引起复发的相关因素,如年龄、性别、分型、是否放置ICVF等11项因素进行对比分析。结果多因素logistic回归法分析放置ICVF,未完成抗凝治疗,分型及未行压力循环袜治疗是下肢DVT治疗后复发的独立危险因素(P0.05),而其他7项因素与DVT复发无统计学意义(P0.05)。结论 ICVF置入是DVT治疗后复发的重要危险因素,使用压力循环袜治疗和规范的抗凝治疗对预防DVT治疗后复发有重要的临床意义。     

新型冠状病毒肺炎患者6例临床特征和影像学表现

目的 总结6例新型冠状病毒肺炎（COVID-19）患者的临床特征和影像学表现，为COVID-19早期确诊和临床干预提供依据。方法 选择上海中医药大学附属第七人民医院2020年1月1日至2020年2月22日严重急性呼吸综合征冠状病毒2（SARS-CoV-2）核酸检测阳性的6例COVID-19患者，回顾性分析流行病学史、临床表现、影像学资料和实验室检查。结果 6例患者均有明确的武汉旅行或居住史，4例患者有发热，3例有咳嗽，2例有流涕、咽痛等上呼吸道症状，2例有头痛、肌肉酸痛等全身症状。6例患者胸部CT检查均可见肺部异常表现，病灶均为双侧分布，下肺病灶多于上肺，主要表现为双侧肺野外带多发磨玻璃影、实变影、“铺路石”征及不同程度纤维化。发病后较晚行胸部CT检查可见肺实变和明显纤维化。结论 COVID-19影像学具有一定的特征性表现，结合患者流行病学史、临床表现和SARS-CoV-2核酸检测能早期诊断。