小切口胆囊切除术在胆囊疾病诊疗中的临床应用

目的:探讨研究小切口胆囊切除术治疗胆囊疾病的临床疗效并分析其适应证。方法:回顾性分析66例胆囊疾病患者临床资料,随机分为小切口胆囊手术组(A组)和传统开腹胆囊手术组(B组),每组33例。观察两组的总有效率、手术时间、住院时间、术中出血量、并发症以及住院费用。结果:A组与B组相比,其总有效率、手术时间、住院时间、术中出血量、并发症以及住院费用差异有统计学意义(P<0.05)。结论:小切口胆囊切除术在治疗胆囊疾病中有独特的优势,为医生和患者带来了福音,减轻了患者的困扰,是值得推崇的治疗方法。     

农村高血压患者焦虑状况调查分析

目的对农村高血压患者的焦虑状况进行调查分析，并提出有效的防治措施。方法采用Zung氏焦虑自评量表（SAS）评定86例农村原发性高血压患者（研究组）与84例体检血压正常者（对照组）的焦虑状况。结果研究组SAS总粗分与标准分均显著高于对照组（P〈0．05）；研究组有焦虑症者占38．37％，显著高于对照组的11．90％（P〈0．05）。结论农村高血压患者焦虑症的发病较为普遍。应重视其伴发的心理障碍，及时发现和排查其异常的心理状态和行为，在应用心血管药物以外，提供健康教育、心理咨询和心理治疗。     

头孢吡肟与头孢他啶随机对照治疗下呼吸道感染的meta分析

目的比较头孢吡肟与头孢他啶治疗下呼吸道感染的有效性和安全性。方法按照系统评价的要求全面检索了中国数字医院图书馆、万方数据库,对符合纳入标准的9篇文献进行meta分析。结果头孢吡肟组的临床有效率、痊愈率和细菌清除率显著高于头孢他啶组,而不良反应比较无统计学差异。结论细菌感染所致的下呼吸道感染,头孢吡肟的临床疗效优于头孢他啶。     

937人份石家庄地区血小板捐献者基因资料库的建立

目的:建立石家庄地区已知HLA-I(A、B位点)、HPA基因型别机采血小板捐献者基因资料数据库,探讨石家庄地区血小板捐献者HLA-I(A、B位点)和HPA-1~17系统基因多态性分布特点。方法:采用聚合酶链反应-序列特异引物(PCR-SSP)方法石家庄地区937例无血缘关系的血小板捐献者血液样本进行HLA-I类基因A、B位点、HPA-1~17系统基因分型,计算基因频率和基因型频率。结果:937例无血缘关系的血小板捐献者共检出HLA-A位点抗原特异性18种,其中等位基因频率较高(0.05)的特异性依次有A2(0.374 1)、A11(0.166 5)、A24(0.160 7)、A30(0.074 9)、A33(0.065 1)、A1(0.058 2)、A3(0.054 9);检出HLA-B位点抗原特异性40种,频率大于0.05的有8个,依次为B13(0.140 6)、B46(0.077 7)、B61(0.074 9)、B51(0.074 9)、B62(0.068 0)、B35(0.059 9)、B60(0.056 5)、B44(0.050 3),HLA-A-B单体型频率最高的为A2-B13(0.045 9),其次为A2-B46(0.029 9);河北地区汉族人群HPA基因HPA-7~14、HPA-16、HPA-17均为aa纯合子,未检出b等位基因。HPA-1~6、15中杂合度最高的为HPA-15,不配合率为37.45%;其次为HPA-3,不配合率为36.64%;然后为HPA-2,不配合率为6.84%;在HPA-1~6和15中,HPA-4的杂合度最低,不配合率仅为0.22%。结论:初步建立了石家庄地区本地化HLA-A-B和HPA-1~17基因分型库,并进行了基因频率和单体型频率统计,该基因资料库可为患者提供HLA和HPA相容或相合的血小板,减少血小板输注无效的发生。     

人鼻咽癌癌基因及其产物的研究

作者应用外源性DNA转染技术,以人鼻咽癌组DNA,在体外对NIH/3T3细胞进行转染实验。结果观察到在第1、2轮转染中,均获得明显转化灶。并以人Alu顺序为探针,经分子杂交证明1、2轮转化细胞DNA中含有人顺序。以转化细胞注入裸鼠皮下,能诱发形成纤维肉瘤。本实验表明人鼻咽癌DNA中存在具有转化活性的转化基因(癌基因),并已转移至细胞内,发生了明显的恶性转化。作者应用免疫组化技术,观察了Ha-ras基因产物p21蛋白质在人鼻咽癌中的表达。其结果表明,p21在人鼻咽癌中具有阳性表达,其阳性率为90.4％。     

人鼻咽癌癌基因及其产物的研究

Oncogene of nasopharyngeal carcinoma (NPC) by means of external origin DNA transfection experiment and its gene products by immunohistochemical method have been studied. These DNAs were isolated from human primary poorly differentiated NPC tissues and were transfected into NIH/3T3 mouse fibroblasts to induce the foci of the morphologically transformed cells in the culture, while DNAs of normal placenta tissues failed to do so. The DNAs were extracted from the primary and secondary transformed cells to analyse human sequence with human Alu sequence probe. The human sequence has been detected in the DNAs of the primary and secondary transformed foci cells, while none of the human sequence was detected in the DNAs of the control. The results indicated that human transforming sequences had been integrated into transformed cells. The malignant properties of the transformed foci cells were evidenced by tumorigenic experiment of nude mice. The transformed foci cells were inoculated subcutaneously in the nude mice and induced fibrosarcoma in vivo. The tumorigenic rate was 87.5%. It was further demonstrated that DNAs from human NPC possessed carcinogenicity and induced malignant transformation. The primary result revealed that the transforming gene of NPC may be homologue to Ha-ras oncogene. The expression of Ha-ras gene products-p21 has been studied in human NPC tissues. The primary results showed a positive expression of p21 in human NPC tissues by immunohistochemical method. The positive rate was 90.4%.     

MRI及CT对鼻咽癌T分期的不同影响

目的比较80例鼻咽癌患者的CT、MRI资料,探讨MRI及CT对鼻咽癌1992年分期的不同影响.方法回顾性分析80例治疗前短期内同时进行CT及MRI检查并经病理证实为鼻咽低分化鳞癌的患者.比较MRI与CT检查的差异性,并分析由于影像学的差异导致分期不同,及其对治疗的影响.结果 MRI在显示咽旁淋巴结、翼突基底部、岩尖、斜坡、海绵窦上较CT有明显差别,具有一定的优势.根据鼻咽癌1992年分期原则,MRI所划分的中晚期患者较CT明显增多(54/40),47.5%(38/80)的患者发生分期改变.按鼻咽癌分层综合治疗的原则,需要行综合治疗的病例数增加,有利于更多患者17.5%(14/80)进行诱导或同时期化疗.结论 MRI较CT对鼻咽癌T分期的诊断具有优越性,使鼻咽癌分期更加明确,建议在临床推广应用.     

食管癌及癌旁组织中人乳头状瘤病毒DNA的存在状态

DNAs from 24 cases of human esophagus carcinoma and 24 cases of corresponding para-carcinoma tissues were detected by dot hybridization and Southern hybridization techniques using human papillomavirus (HPV) 16 type DNA as probe. The results indicated that the positive rate of the HPV 16 DNA hybridization was 50% (12/24) in esophagus carcinoma tissues, and 37% (9/24) in para-carcinoma tissues. The results of Southern hybridization showed obviously the positive hybridizing band in the zone of 7.2 kb in smear. It implied that HPV 16 DNA was possibly integrated into the tissue's DNA of esophagus carcinoma. In the fetal esophagus tissues as negative control, 3 cases out of 4 showed positive results. The significance has to be further investigated. This experiment has studied the status of HPV 16 type in the tissues of esophagus carcinoma and para-carcinoma at molecular level. This is just a study of the virus etiology of esophagus carcinoma.     

左氧氟沙量不同服法预防骨关节创伤及内固定术后感染的药物经济学比较

目的比较左氧氟沙星1日1次与1日2次用法对预防骨关节创伤及内固定术后感染效果并进行药物经济学分析。方法本院骨科施行骨关节创伤及内固定术患者64例,其中1日1次者30例,1日2次者34例,观察和记录患者一般情况、手术有关情况、不良反应及术后感染情况,计算与感染有关的治疗成本并进行分析。结果两组患者具有可比性,1日2次组出现1例一过性转氨酶轻度升高。1日1次组术后感染分别为发热2例和1例(P>0.05),白细胞记数>9.0×109/L 2例和2例(P>0.05),切口感染3例和4例(P>0.05),其它1例和2例(P>0.05),总感染率4例和4例(P>0.05)。两组用于预防术后感染的相为关费用,1日2次组(680.9元)明显高于1日1次组(409.6元)。结论1日1次组比1日2次组对预防骨关节创伤及内固定术后感染无显著性差异,但费用效果比更好。