低剂量电子计算机断层扫描对疑似急性下呼吸道感染老年患者的临床诊断价值及安全性

目的研究低剂量电子计算机断层扫描（CT）对疑似急性下呼吸道感染老年患者的临床诊断价值及其安全性。 方法收集2016年9月至2018年8月广州中医药大学深圳医院（福田）收治的92例疑似急性下呼吸道感染老年患者为研究对象，按随机数字表法分为观察组和对照组，每组各46例。其中对照组患者采用常规剂量CT扫描；观察组患者采用低剂量CT扫描。比较两组患者的诊断效能及辐射剂量，分析低剂量CT对急性下呼吸道感染者的诊断价值。 结果对照组和观察组患者CT检查对急性下呼吸道感染的阳性检出率分别为86.96%和82.61%，差异无统计学意义（χ² = 0.733、P = 0.392）。两组患者CT检查对急性下呼吸道感染诊断的灵敏度、特异度、阳性预测值以及阴性预测值差异均无统计学意义（P均> 0.05）。观察组患者平均辐射剂量为（1.28 ± 0.26）mSv，显著低于对照组[（3.12 ± 0.36）mSv]，差异有统计学意义（t = 28.102、P < 0.001）。 结论低剂量CT对疑似急性下呼吸道感染老年患者诊断价值与常规剂量CT检查相似，且辐射剂量小、安全性高。     

良恶性孤立性肺结节的CT强化效应与鉴别诊断

目的：评估CT增强效应对肺部SPN的诊断与鉴别诊断的价值。方法：73例经手术病理证实的SＰＮ,所有ＳＰＮ的直径均<3cm。采用ＧＥ－ＳＹＴＥＣ２０００型ＣＴ扫描机,在常规平扫发现病灶后,局部作薄层（２－５mm)扫描,增强扫描先采用动态,测注射造影剂后３０,６０,１２０及１８０s的病灶的ＣＴ值。造影剂为非离子型,剂量为１００ml。自动高压注射器注射,速度为２ml/S。结果：７３例中４７例为原发性肺癌,增强ＣＴ值多在２０－５０ＨＵ之间且多为不均质性强化,至于良性病变则多无强化或轻度不均质强化,而结核瘤则可表现为周边强化（５例中有２例）。结论：采用ＣＴ强化效应作为肺部良恶性ＳＰＮ的诊断及鉴别诊断,具有相当大的价值。     

SEPT7基因抑制人胶质瘤细胞系U251MG侵袭的研究

目的 研究SEPT7基因对人胶质瘤细胞系U251MG侵袭的抑制作用及其可能的分子机制.方法 以腺病毒为载体转导SEPT7(rAd5-SEFF7)入U251人脑胶质瘤细胞系;Transwell法和3-D Matrigel法观察U251胶质瘤细胞侵袭能力的变化,划痕实验和2-D Matrigel法观察细胞迁移能力的变化.应用蛋白印记检测MMP2,MMP9,MT1-MMP,TIMP1和TIMP2的表达变化,蛋白印记和免疫荧光检测整合素αvβ3的表达,以及应用激光扫描共聚焦显微镜观察细胞骨架蛋白tubulin-α结构的变化.结果 转染SEPT7后U251MG细胞的侵袭和迁移能力明显受到抑制、细胞MMP2、MMP9、MT1-MMP和整合素αvβ3的表达下调、TIMP1和TIMP2的表达则上调;肿瘤细胞的微管蛋白tubulin-α结构出现了重新分布,发生了扭曲及聚集现象,接近于正常的非肿瘤细胞的tubulin-α结构.结论 SEPT7基因可以抑制胶质瘤细胞的侵袭和迁移能力,其分子机制可能通过逆转MMPs/TIMPs的失衡状态,降低整合素αvβ3的表达,以及改变细胞骨架tubulin-α的结构而实现的.SEPT7可作为基因治疗胶质瘤的重要候选基因.     

颈椎单节段人工间盘置换治疗相关因素的分析及预测

BACKGROUND: There is limited anterior cervical spine space. Incomplete hemostasis or drainage during artificial cervical total disc replacement can incur a series of complications. Preoperative factors can directly affect the amount of bleeding during spine surgery, while there are no publications aiming at cervical artificial disc replacement. OBJECTIVE: To analyze influencing factors on operation time and hemorrhage in patients undergoing single cervical total disc replacement. METHODS: Fifty-six patients with cervical spondylosis who underwent cervical total disc replacement from October 2012 to December 2017 in Department of Spine Surgery, Peking University People’s Hospital, were retrospectively enrolled. Pre- and intra-operative related parameters were measured. Primary outcomes included operation time, intraoperative blood loss and postoperative drainage. The secondary outcomes included demographic data such as sex, male and hypertension;surgery-related information such as operated segment, types of cervical spondylosis and artificial prosthesis;parameters in X-ray plain films such as the motion range and cervical lordosis of C₂-C₇ and index segment, the height of intervertebral disc, MRI classification (Modic classification and Pfirrmann classification) and preoperative functional score. The analysis was performed between primary and secondary outcomes as well as among primary outcomes. RESULTS AND CONCLUSION: (1) The average age of 56 patients (30 males and 26 females) was 48.2±9.8 years;operation time, intraoperative bleeding and postoperative drainage were 73.2±13.4 minutes, 51.8±41.2 mL and 7.8±5.3 mL, respectively. (2) There were no differences both in operation time and intraoperative blood loss in terms of demographics, while the drainage was statistically different in various ages (P=0.030). (3) The operation time of Prestige-LP implantation was statistically shorter than that of Mobi-C and Prodisc-C (P < 0.05). There was a positive correlation between the intermittent on taking (nonsteroidal anti-inflammatory drugs) and intraoperative blood loss (r=0.310, P=0.020). The higher intervertebral disc of the operation segment was, the longer operation time was (P=0.028). (4) There was a significant difference in more intraoperative blood loss with osteoporosis compared to the normal ones (P=0.039);while the rest radiological parameters in X-ray were in no relation to primary outcomes, neither were in MRI degree, Modic change and Pfirrmann classification. (5) There was a positive correlation between operation time and intraoperative blood loss (P=0.010) and postoperative drainage (P=0.001). (6) These indicate that the height of intervertebral space can prolong operation time. Osteoporosis is a risk factor for intraoperative blood loss. The longer the operation time is, the more intraoperative blood loss and postoperative drainage will be. © 2020, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.     

子宫动脉栓塞治疗子宫肌瘤伴月经过多的临床研究

目的:回顾分析24例子宫肌瘤伴月经过多患者入介治疗疗效和子宫动脉栓塞安全性.方法:选择24例子宫肌瘤伴月经过多患者进行子宫肌瘤供血动脉的栓塞.结果:插管栓塞动脉率100%,随访2年.治疗后1月,24例患者月经均明显减少,B超随访,3个月子宫肌瘤体积平均缩小30%.随访2年,其中2例行腹腔镜下子宫肌瘤经阴道摘除术,6例子宫肌瘤消失,16例子宫肌瘤体积平均缩小80%.结论:子宫肌瘤行介入治疗疗效肯定,对粘膜下子宫肌瘤及子宫肌瘤伴月经过多患者尤为适宜.     

中西医结合治疗狼疮性肾炎31例报告

系统性红斑狼疮(SLE)是一种侵犯全身结缔组织的自身免疫性疾病,全身器官特别是肾脏常被累及。SLE 合并肾脏病变的发生率在国外报道为46～80％,我国报道为40～75％,近年来狼疮性肾炎在国外采用激素、免疫抑制剂、抗凝和换血疗法。在我国尚有采用中西医结合的治疗形式。现将本组31例采用中西医结合治疗的 SLE 肾炎临床资料总结如下:     

低剂量CT对儿童腺样体肥大上气道阻塞的客观评价

目的研究低剂量CT三维重建技术在儿童腺样体肥大所致上气道顺应性改变的客观评估中的临床应用价值。方法19例腺样体肥大患儿接受CT低剂量扫描和症状计分表调查,与17例正常儿童的CT低剂量扫描后三维测量指标进行对照。结果腺样体肥大组患儿单位鼻咽腔容积(rNPV)及鼻咽气道最狭窄处面积比值(rNPA)与对照组比较差异均有统计学意义(rNPV值P0.01、rNPA值P0.05);rNPA与症状严重程度呈负相关(r=-0.659,P0.01),rNPV值与症状计分无明显相关(P0.05)。结论低剂量CT三维重建技术可用于腺样体肥大所致儿童上气道阻塞的客观定量评估。在解释测量结果与主观症状关系时rNPA应作为主要参考指标。     

中药消癌平针剂经肝动脉介入治疗转移性肝癌的临床研究

用中药消癌平针剂经肝动脉介入治疗转移性３１例,并与化疗介入２２例作对照,结果：临床总有效率分别为７０．９７％、４０．９１％,两组比较Ｐ〈０．０１。肿瘤的ＰＲ＋ＮＣ分别为６７．７４％,６３．６３％,两组比较Ｐ〉０．０５。治疗平均生存天数为２２６．０７天、１１８．３８天,两组比较Ｐ〈０．０１;ＫＰＳ评分总有效率分别为８０．６５％、５０％,两组比较Ｐ〈０．０５。提示中药消癌平可改善临床症郑州 体征,提高     

RASGRP2在肺腺癌中的表达及对免疫微环境的影响

背景与目的 肺癌是全球发病率和死亡率的居高不下的恶性肿瘤.近年来,随着新型药物的出现和治疗模式的优化,特别是免疫治疗在临床的应用,肺癌患者的预后已经有了一定的改善.但免疫治疗获益的患者仍然有限,因此我们想要寻找新的生物标志物用于预测肺腺癌患者的预后并探索其对免疫微环境的影响.方法 使用癌症基因组图谱(The Cance...     

多层螺旋CT门静脉成像在评估肝硬化门脉侧枝血管中的价值

目的:评价多层螺旋CT门静脉成像显示门静脉高压的价值.材料与方法:30例门脉高压患者进行了螺旋CT门脉成像检查,其中10例患者又进行了门静脉造影检查(间接法).30例患者中全部存在侧枝循环,多数病例有2个或2个以上部位侧枝循环.结果:多层螺旋CT门静脉成像不仅显示了肝内门静脉2～3级分支,还显示了整套门脉侧枝血管系统.在三维门脉像上,脾门静脉曲张29例(占96.7%),其中1例脾静脉因栓子部分闭塞而狭窄,另有1例则完全栓塞血管未显示.胃左静脉曲张28例(占93%),食管或食管旁静脉曲张27例(占90%),胃短静脉(胃后静脉)曲张19例(占63%),胃肾分流血管10例(占33%),腹膜后静脉曲张9例(占30%),脐周静脉曲张伴腹壁静脉曲张6例(占20%).10例患者CT三维门脉像与间接门静脉造影作比较,前者对门静脉及其侧枝循环的显示好于后者.结论:多层螺旋CT门脉成像是门静脉无创性检查的可靠方法,有较高的临床运用价值.