莪术微乳凝胶的制备工艺设计与优化

目的:设计与优化莪术微乳凝胶的制备工艺。方法:本实验中莪术微乳凝胶以成型效果及失水率为指标,运用正交设计-效应面优化法以及体外透皮实验等考察处方辅料,优选制备工艺。结果卡波姆水凝胶最佳基质配比为50 mL水,4 mL甘油,1.2 gCMC-Na,失水率测定表明前三天成型效果较好;通过透皮实验选择卡波姆凝胶-980作为载体凝胶;测得莪术微乳凝胶中牻牛儿酮的含量是3.247 mg/g。结论:本制备工艺设计与优化合理、可行。     

具有肝硬化基础的肝内胆管细胞癌的超声造影及增强CT的增强模式分析

目的 探讨在肝硬化基础上的肝内胆管细胞癌的实时超声造影与增强螺旋CT的成像特征.方法 经病理确诊的胆管细胞癌并肝硬化的患者12例(手术切除11例,穿刺1例),11例采用对比脉冲造影技术,1例采用连续脉冲反向谐波造影技术,机械指数<0.2,2.4 mL造影剂SonoVue团注.将超声造影与增强CT的增强模式、术前诊断与病理结果进行对比分析.结果 超声造影动脉相5例(41.7%)为不均匀高增强,3例(25.0%)为均匀高增强,4例(33.3%)为周边环状增强.超声造影3例(25.0%)诊断为肝内胆管细胞癌,9例(75.0%)诊断为肝细胞癌.增强CT动脉期10例(83.3%)为不均匀强化,2例(16.7%)为环状强化.2例(16.7%)诊断为肝内胆管细胞,10例(83.3%)诊断为肝细胞癌.结论 肝硬化基础上的多数肝内胆管细胞癌实时超声造影与增强螺旋CT的增强模式与肝细胞癌类似,影像学鉴别诊断困难.     

微创治疗高血压脑出血200例

目的 探讨微创颅内血肿清除术在治疗高血压脑出血中的应用、疗效,总结经验,从而提高治疗水平.方法 微创颅内血肿清除术使用北京万特福公司生产的YL-1型颅内血肿粉碎穿刺针穿刺;配合血肿腔内注射尿激酶清除颅内血肿.结果 治疗200例,生存173例,死病死27例(13.5%).术后随访6个月,按ADL日常生活能力分级评定Ⅰ级40例,Ⅱ级66例,Ⅲ级41例,Ⅳ级21例,Ⅴ级5例.结论 微创颅内血肿清除术治疗脑出血,简便易行,安全有效,能有效降低病死率和致残率,提高生存质量,适合在拥有CT的各级医院广泛推广、使用.     

转化生长因子β_1基因标签单核苷酸多态性与新疆汉族原发性高血压相关性研究

Objective Essential hypertension (EH) was a complex disease resulted from the interaction of cumulative effect of multiple genetic and environment factors. The relationship between the genetic polymorphisms in the transforming growth factor-β_1 ( TGF-β_1 ), the blood levels and EH have been investigated, but the conclusions were different. Therefore, we investigate the relationship between the tagging single nucleotide polymorphisms (tSNPs) ( rs1800469, rs2241716, rs11466345, rs2241715,rs4803455) in TGF-β_1 gene, blood levels and EH in the Han nationality population in Xinjiang, to clarity the pattern of linkage disequilibrium (LD) and the feature of the structure of haplotype. Methods Based on the case-control study,we selected 732 (365 EH patients,367 controls) Han Chinese population from the Boertonggu countryside of Shawan region in the Xinjiang Uygur Autonomous Region of China by random cluster sampling. After questionnaire and physical examination, we collected blood samples, and the blood levels of TGF-β_1, were quantified using sandwich ELISA. The polymorphisms of TGF-β_1 gene in the study groups were detected with SNaPshot system. The case-control study in a large group was carried out separately for each of the tSNP and followed up by haplotypes analyses to determine the relation between tSNPs of TGF-β_1 gene and EH in the Han population. Results ( 1 ) The frequencies of alleles A, G of rs11466345 of TGF-β_1, gene in EH group and control group were as follows: 69.7%, 30. 3% ,74.4%,25.6%, respectively. It was demonstrated that the G allele of the rs11466345 polymorphism occurred at a significantly higher frequency in EH patients than in healthy controls (30. 3% vs. 25. 6%, P <0. 05). The rs11466345G-allele carriers had a significantly increased risk of EH compared to rs11466345A -allele carrier ( OR = 1. 261 ; P <0. 05). The frequencies of genotypes and alleles of the other tSNPs of TGF-β_1 gene had no difference between EH patients and controls ( P > 0. 05 ). (2) Except the site of rs11466345, the other tSNPs were in strong LD, and no statistical differences were observed in haplotypes distribution in the followup study between case-control groups (P >0. 05). (3) There were no difference of TGF-β_1 levels between the different genotypes and alleles in tSNPs of TGF-β_1 gene ( P > 0. 05 ). Conclusions ( 1 ) These results suggested that TGF-β_1 gene rs11466345 G allele was likely to be a genetic susceptibility factor for EH in the Xinjiang Han population, the other tSNPs perhaps had no association with EH of in the study groups. (2) Except rs11466345, the other tSNPs were in strong LD, and the haplotypes reconsreucted by tSNPs might not be associated with EH in the Han nationality populations. (3) There was no association between the tSNP of TGF-β_1 gene and TGF-β_1 blood levels in the Xinjiang Han nationality population.     

宫腔粘连术后放置避孕环联合口服戊酸雌二醇研究

目的评价宫腔粘连宫腔镜粘连分离术后放置＂O＂型宫内避孕环联合口服戊酸雌二醇治疗宫腔粘连,预防宫腔再粘连及促进子宫内膜生长的效果。方法 25例均有宫腔操作史致宫腔粘连,月经过少甚至闭经（经检查均为子宫性闭经患者,其中17例并不育）。25例均行宫腔镜检查和宫腔粘连分离术后,给予抗生素预防感染3d。手术结束时根据宫深放置相应型号的＂O＂型宫内避孕环,术后第2天开始口服戊酸雌二醇6mg/d,连用3个月后加用黄体酮撤血;定期随诊,治疗结束后复查肝功、动态复查B超了解子宫内膜厚度,观察月经量,月经恢复正常后3～6个月有生育要求者取出宫内避孕环,无生育要求者可继续放置;必要时同时行第2次宫腔镜检查。结果 25例患者术后随访6～36个月,所有患者均无明显的胃肠道副反应,复查肝功正常;12例患者行第2次宫腔镜检查,未见粘连带。有效率达100.00%,月经恢复率96.0%,17例不育患者术后至今有9例妊娠。结论在宫腔镜下行宫腔粘连分离术后,放置宫内避孕环联合口服戊酸雌二醇对治疗宫腔粘连及内膜损伤及预防宫腔再粘连有效,值得推广。     

足部扁平苔藓继发鳞状细胞癌

报告1例足部扁平苔藓继发鳞状细胞癌.患者男,51岁.双足跟、足外侧缘皮损32年,左足跟溃疡1年.足部皮损组织病理活检显示右足界面皮炎(符合扁平苔藓病理改变),左足皮损符合高分化鳞状细胞癌.     

卫生政策科研本体构建研究

在对现有科研本体和本体构建方法进行分析的基础上,利用Protege工具进行开发,选择0WL作为卫生政策科研本体描述语言,阐述了构建过程,初步设计了卫生政策科研本体模型,最后提出了问题和展望。     

V,VI型胫骨平台骨折切开复位内固定术后伤口并发症的临床分析

目的 探讨引起V,VI型胫骨平台骨折切开复位内固定术后伤口并发症的可疑因素.方法 2006年2月～2012年2月32例V,VI型胫骨平台骨折患者行切开复位内固定术,分析年龄、受伤原因、骨折类型、是否吸烟、手术时机、手术时间及止血带使用时间等与术后并发症的关系.结果 32例患者手术后5例（15.64%）出现伤口感染、切口裂开、伤口坏死及慢性骨髓炎等并发症;其中,受伤至手术时间短于7d、手术时间超过2h及止血带使用时间超过1.5h是引起并发症的主要原因（P〈0.05）.结论 骨折后8～14d行手术治疗、缩短手术时间及止血带使用时间,可以降低术后伤口并发症的发生.     

超声评分对乳腺良、恶性结节的临床分析

目的 探讨超声评分对乳腺良、恶性结节的临床效果情况.方法 分析2012年2月～2013年1月本院超声科诊断的乳腺结节患者104例临床资料,分别通过常规超声诊断和超声弹性成像评分进行比较,以术后病理诊断结果作为标准.结果 超声弹性成像评分乳腺良、恶性结节诊断结果明显高于常规超声诊断,P＜0.05,差异均有统计学意义.结论 超声评分对乳腺良、恶性结节的应用,可以提高对乳腺结节的诊断水平,降低良性结节误诊率,提高恶性结节的准确率,值得临床推广应用.     

滋肝补肾法治疗肝肾亏虚型骨质疏松症40例

目的观察滋肝补肾中药法对骨质疏松症（肝肾亏虚型）的临床疗效。方法 2012至2014我科收治的骨质疏松症（肝肾亏虚型）患者80例,随机分为骨痿灵治疗组和骨疏康对照组,每组均为40人,观察时间为8周,疗程结束后评定其疗效。结果骨痿灵可明显改善患者腰背疼痛、腰膝酸软及关节僵硬等症状,其与骨疏康对比疗效相当,并且未出现明显副作用。用药前后骨密度检测对比发现,服药8周时间骨痿灵与骨疏康均可降低骨密度T值,与治疗前相比,差异无显著性,两组间差异也无显著性。结论骨痿灵治疗肝肾亏虚型骨质疏松有效、安全,疗效与骨疏康相当。