443例胃癌根治术后发生肺部并发症的危险因素

目的 探讨胃癌根治术术后肺部并发症(PPCs)的相关危险因素,为PPCs的个体化防治提供相应的对策。 方法 回顾性分析2019年1月至2021年3月兰州大学第二医院普通外科443例胃癌患者的临床资料,统计患者的临床病理特征,采用二分类Logistic回归分析胃癌根治术PPCs的危险因素。 结果 443例胃癌根治术PPCs的发生率为18.1%(80/443),其中肺部感染的发生率为12.4%(55/443),胸腔积液的发生率为11.7%(52/443),发生PPCs较未发生PPCs住院时间延长。Logistic回归分析显示,年龄≥60岁(OR=0.424、95%CI: 0.241~0.746)、糖尿病史(OR=0.318、95%CI: 0.146~0.693)、每分钟最大通气量(MVV)(%)<85%(OR=0.509、95%CI: 0.297~0.874)、术中失血量≥200 mL(OR=0.496、95%CI: 0.276~0.797)和术后吻合口并发症(OR=4.038、95%CI: 1.250~13.049)是胃癌根治术发生PPCs的独立危险因素。 结论 对于年龄≥60岁、糖尿病史、MVV(%)<85%、术中失血量≥200 mL、术后吻合口并发症的胃癌患者,应注意预防PPCs的发生。     

肺癌细胞外基质的表达与临床病理的关系

目的探讨原发性肺癌层粘蛋白（Ｌａｍｉｎｉｎ,ＬＮ）、纤维连接蛋白（ｆｉｂｒｏｎｅｃｔｉｎ,ＦＮ）和Ⅳ型胶原的表达与临床病理的关系。方法采用免疫组化ＬＳＡＢ法检测１８４例肺癌标本中ＬＮ、ＦＮ和Ⅳ型胶原的表达。结果ＬＮ及Ⅳ型胶原在中、高分化的肺鳞癌中的表达均明显强于低分化组（Ｐ＜００１）,在有无淋巴结转移两组间的表达差异均具显著性（Ｐ＜００５）;肺鳞癌５年以上生存组ＬＮ、Ⅳ型胶原的表达明显高于０５年内死亡组（Ｐ＜００１）,ＦＮ的表达亦有差异（Ｐ＜００５）。肺腺癌的５年以上生存组中ＦＮ、Ⅳ型胶原的表达均强于０５年内死亡组（Ｐ＜００５,００１）。结论ＬＮ和Ⅳ型胶原的表达与肺鳞癌的组织学分级和淋巴结转移有关;ＬＮ、ＦＮ、Ⅳ型胶原的表达均可作为评估肺鳞癌预后的指标,而腺癌的预后仅与ＦＮ、Ⅳ型胶原的表达有关。     

以循证医学的理念观察颈椎综合征的MRI图像

目的鉴于MRI对组织的高分辨性能,利用该图像观察颈椎综合征患者的椎管外组织的病理状况.方法54例患者,其中男30例,女24例,分为2组.观察组44例颈椎综合征患者,对照组10例颈部外伤和三叉神经痛患者.通过常规的MRI矢状位及横轴位颈椎图像,比较两组软组织增生情况.结果与结论在颈椎综合征MRI的颈椎及上段胸椎棘突后侧,均可观察到不同程度的慢性纤维性变化,与对照组比较,有可比性.提示临床上颈椎综合征多与颈肩区筋膜炎、棘突炎相关,属于无菌性炎症,其慢性阶段,局部发生了纤维增生性改变.建议在观察分析此种病症的颈椎骨质及椎间盘改变的同时,宜重视棘突后侧的纤维性变化,有利于病理病因的研究.     

脚压测量用传感器

本文讨论了用于脚压测量的四类压力传感器，电阻式传感器、压电式传感器，光电式传感器，电容式传感器介绍了其结构、原理和特点，并分析了几种典型的测量接口电路。     

Endocarditis with ruptured cerebral aneurysm caused by Cardiobacterium valvarum sp. nov

A fastidious gram-negative bacterium was isolated from the blood of a 37-year-old man who had insidious endocarditis with a sudden rupture of a cerebral aneurysm. Characterization of the organism through phylogenetic and phenotypic analyses revealed a novel species of Cardiobacterium, for which the name Cardiobacterium valvarum sp. nov. is proposed. C. valvarum will supplement the current sole species Cardiobacterium hominis, a known cause of endocarditis. Surgeries and antibiotic treatment cured the patient's infection and associated complications. During cardiac surgery, a congenital bicuspid aortic valve was found to be the predisposing factor for his endocarditis.     

多种金属离子与单宁酸反应媒染微血管的对比研究

目的　镜下观察单宁酸与金属盐溶液中Ca2 + 、Au+ 、Ag+ 、Pb2 + 、Cu2 + 、Al3 + 、U6+ 、K+ 联用显示大脑微血管的效果。方法　用单宁酸媒染固定液灌流大鼠 ,取脑切片 ,入氯化钙、氯化金、硝酸银、硝酸铅、硫酸铜、硫酸铝钾、醋酸双氧铀、高锰酸钾和重铬酸钾等溶液中呈色。结果　单宁酸与Ca2 + 、Cu2 + 、Ag+ 、Al3 + 结合显示血管清晰 ,与Au+ 、U6+ 、Pb2 + 、K+ 联用媒染血管效果欠佳。结论　含Ca2 + 、Cu2 + 、Ag+ 、Al3 + 的金属盐类可替代氯化铁媒染微血管 ,氯化金、醋酸双氧铀、硝酸铅、重铬酸钾和高锰酸钾不宜与单宁酸联用来显示血管     

Brachydactyly type A3 is caused by a novel 13 bp HOXD13 frameshift deletion in a Chinese family

Brachydactyly type A (BDA) is defined as short middle phalanges of the affected digits and is subdivided into four types (BDA1‐4). To date, the molecular cause is unknown. However, there is some evidence that pathogenic variants of HOXD13 could be associated with BDA3 and BDA4. Here, we report a Chinese autosomal dominant BDA3 pedigree with a novel HOXD13 mutation. The affected individuals presented with an obviously shorter fifth middle phalanx. The radial side of the middle phalanx was shorter than the ulnar side, and the terminal phalanx of the fifth finger inclined radially and formed classical clinodactyly. Interestingly, the index finger was normal. The initial diagnosis was BDA3. However, the distal third and fourth middle phalanges were also slightly affected, resulting in mild radial clinodactyly. Both feet showed shortening of the middle phalanges, which were fused to the distal phalanges of the second to the fifth toes, as reported in BDA4. Therefore, this pedigree had combined BDA3 and atypical BDA4. By direct sequencing, a 13 bp deletion within exon 1 of HOXD13 (NM_000523.4: c.708_720del13; NP_000514.2: p.Gly237fs) was identified. The 13 bp deletion resulted in a frameshift and premature termination of HOXD13. This study provides further evidences that variants in HOXD13 cause BDA3‐BDA4 phenotypes.     

新型微波热疗机研制及其临床应用

重点对新型电脑微波热疗机的构成、测温控温方案进行了研究。采用自适应广义预测控制算法对热疗温度进行控制，解决了因更换不同辐射器导致对象特性变化使控制性能降低的问题，从而得到了满意的疗效。文中介绍了该仪器关键的硬件、软件设计，基本的特点和临床应用