前列腺增生症患者尿流动力学检查的临床意义

目的探讨尿流动力学检查在前列腺手术前的应用,对提高术前诊断水平及手术指征、手术方法、手术时机选择的价值。方法回顾分析208例前列腺增生症患者在前列腺手术术前尿流动力学检查的临床资料。结果 208例前列腺增生症患者经尿流动力学检查,180例有不同程度的膀胱出口梗阻,且与其他动力学异常同时存在;180例患者行TURP手术治疗,11例行膀胱造瘘术,17例行药物保守治疗。结论前列腺手术前尿流动力学检查可提供前列腺增生症患者膀胱尿道功能状况,这对于合理选择术式以提高疗效有重要的临床意义。     

A single nucleotide polymorphism in the human BMP-2 gene (109T>G) affects Smad signaling pathway and the predisposition to ossification of posterior longitudinal ligament of spine

Background Although various systemic and local factors such as abnormal carbohydrate or calcium metabolism, aging and hormonal disturbances have been suggested as causes of Ossification of the posterior longitudinal ligament (OPLL), the etiology of OPLL is not fully understood. The purpose of this study was to investigate whether BMP-2 is a candidate gene to modify the susceptibility of OPLL and the mechanism of ossification in signal transduction. Methods A total of 420 OPLL patients and 506 age- and sex-matched controls were studied. The complete coding sequence of the human BMP-2 gene were analysed through PCR and direct sequencing, all the SNPs were detected and genotype. The BMP-2 expression vectors containing positive polymorphism were constructed and transfected to the C3H10T1/2 cell. The expression of BMP-2 and Smad signal pathway in positive cell clones were detected by western blotting. The ALP activity was detected by quantitative detection kits. Results The frequencies for the 109T>G and 570A>T polymorphisms were difference between the case and control group. The “TG’ genotype in 109T>G polymorphism is associated with the occurrence of OPLL, the frequency of the “G” allele is significantly higher in patients with OPLL than in control subjects (P<0.001). The “AT’ genotype in 570A>T polymorphism is associated with the occurrence of OPLL, the frequency of the “T” allele is significantly higher in patients with OPLL than in control subjects (P=0.005). Western blot analysis showed that the expression of P-Smad1/5/8 protein transfected by wild-type or mutant expression vectors were significantly higher than control groups (P<0.05), but there was no statistical difference in each experimental group (P>0.05). The expression of Smad4 protein transfected by wild-type or mutant expression vectors were significantly higher than control groups (P<0.05), the expression of Smad4 protein transfected by pcDNA3.1-BMP2 (109G) and pcDNA3.1-BMP2 (109G, 570T) were significantly higher than the other experimental groups(P<0.05). The ALP activity increase has been detected in pcDNA3.1-BMP2 (109G) and pcDNA3.1-BMP2 (109G, 570T) transfected cells to 4 weeks after stably transfection. The activity ALP results were (30.56±0.46) nmol/minute/mg protein and (29.62±0.68) nmol/minute/mg protein, respectively. There was a statistical difference compared with the other experimental groups (P<0.05). Conclusions The BMP-2 is the predisposing gene of OPLL. The “TG’ genotype in the 109T>G and the “AT’ genotype in the 570A>T polymorphisms are associated with the occurrence of OPLL. In the intracellular signalling transduction, the 109T>G polymorphism in exon-2 of BMP-2 gene is positively associated with the level of Smad4 protein expression and the activity of ALP. Smad mediated signalling pathway plays an important role during the pathological process of OPLL induced by SNPs of BMP-2 gene.     

不同术式治疗胡桃夹综合征继发左精索静脉曲张效果分析

目的探讨不同术式治疗胡桃夹综合征(NCS)继发左精索静脉曲张的临床效果。方法回顾性分析2016-08—2021-08郑州大学第一附属医院泌尿外科行左肾静脉(LRV)外支架固定术的60例NCS继发左精索静脉曲张的青少年患者的临床资料。按不同术式分为3组,各20例。A组行腔镜手术并联合左精索静脉高位结扎术,B组行腔镜手术联合开放左精索静脉高位结扎术,C组不处理左精索静脉曲张。比较3组患者的基线资料及临床效果。结果3组患者的基线资料以及增大腹主动脉与肠系膜上动脉间的夹角、降低血尿及蛋白尿的发生率差异无统计学意义(P>0.05);A组改善精子质量、减小精索静脉内径的效果均明显优于B组、C组,差异均有统计学意义(P<0.05)。结论对于NCS继发左精索静脉曲张患者,腔镜手术、开放手术,以及是否联合左精索静脉高位结扎术,均能增大腹主动脉与肠系膜上动脉间的夹角和降低血尿及降低蛋白尿发生率;但腔镜LRV外支架固定术联合左精索静脉高位结扎术在改善精子质量、减小精索静脉内径、降低精索静脉曲张复发率等方面,具有明显优势。     

肝素酶基因表达与食管癌转移的关系

目的　探讨肝素酶基因表达与食管癌转移的关系。方法　采用逆转录聚合酶链反应技术 ( RT-PCR)检测 5 4例食管癌组织、癌旁组织及正常粘膜中肝素酶基因的表达。结果　有淋巴结转移的食管癌癌组织中肝素酶基因阳性表达率为 90 .5 % ( 19/ 2 1) ,癌旁组织为 6 1.9% ( 13/ 2 1) ,正常粘膜为 0 ( 0 / 2 1)。无淋巴结转移的食管癌癌组织中肝素酶基因阳性表达率为 15 .2 % ( 5 / 33) ,癌旁组织为 6 % ( 2 / 33) ,正常粘膜为 0 ( 0 / 33)。有淋巴结转移的食管癌组织及癌旁组织中肝素酶基因阳性表达率均高于无淋巴结转移者 ,二者相比差异均有显著性 (癌组织 P<0 .0 0 1,癌旁组织 P<0 .0 5 )。结论　肝素酶基因表达可能与食管癌发生转移有关 ,其可能成为预测食管癌转移的指标     

X线下肾结石成分判断及体外冲击波碎石疗效预测

目的 探讨通过X线下观察肾结石的形态及密度判断结石成分及预测ESWL疗效的临床价值. 方法 2010年3月至2011年6月收治肾结石患者358例,男204例,女154例.年龄17 ～58岁,平均39岁.单发结石276例,其中左肾124例,右肾152例;结石位于肾上盏38例、中盏82例、下盏156例.多发结石82例,双肾多发18例,单肾多发54例,其中左肾23例,右肾31例;结石位于上盏7例、中下盏75例.结石直径6 ～18 mm.分析患者术前X线片中结石形态、密度及透视下动态情况,初步判断结石成分,预测ESWL疗效,制定治疗方案.采用红外光结石成分自动分析仪分析结石成分,验正术前判断结果的准确性. 结果 358例患者治疗后获取结石339例,术前X线下判断的肾结石成分与术后红外光结石成分自动分析结果基本相符308例(86.0％),其中二水磷酸氢钙2例,符合2例(100.0％);一水草酸钙14例,符合11例(78.6％);一、二水草酸钙54例,符合45例(83.3％);碳酸磷灰石或草酸钙与碳酸磷灰石混合256例,符合229例(85.9％);六水磷酸镁铵与碳酸磷灰石26例,符合17例(65.4％);尿酸6例,符合4例(66.7％).339例(94.7％) ESWL效果与术前预测结果一致. 结论 通过X线判断结石成分,预测ESWL疗效具有可行性.     

标准大骨瓣减压治疗重度颅脑损伤305例体会

目的：讨论标准大骨瓣减压治疗重度颅脑损伤中的意义。方法：采用标准大骨瓣减压术治疗305例重度颅脑损伤患者，并对有关临床资料进行分析总结。结果：良好47例，中残53例，重残70例，植物生存26例，死亡109例（35．74％）。结论：标准大骨瓣减压治疗重度颅脑损伤，能明显降低患者死亡率。     

不同产地太子参的品质分析

目的测定江苏、安徽、山东、福建、贵州等主产区太子参的多糖和皂苷含量,以此为指标评价其药材质量。方法利用紫外分光光度计采用硫酸-苯酚法测定多糖的含量,香草醛-冰醋酸法测定皂苷含量。结果江苏产区、福建柘荣、贵州施秉、山东临沂、安徽宣城栽培太子参的总多糖含量分别为18.93%~24.47%、22.46%、22.39%、19.27%、23.46%;野生太子参的多糖含量为7.06%~14.37%。江苏产区、福建柘荣、贵州施秉、山东临沂、安徽宣城栽培太子参的总皂苷含量分别为0.111%~0.247%、0.229%、0.218%、0.138%、0.099%;野生太子参的总皂苷含量为0.088~0.164%。结论以多糖和总皂苷的含量为指标,综合考虑两类成分含量高低,初步认为太子参产地中,江苏句容马梗、福建柘荣和贵州施秉为优质太子参的产地。     

应对甲型H1N1流感疫情开展培训的实践与思考

根据2009年甲型H1N1流感防控形势，我院及时开展了防治知识和技能的培训。在培训中把握重点，抓住关键，形式多样，内容丰富，收到了良好效果；同时也体会到加强部门间协作，重视国家有关政策法规的学习，加强住院医师毕业后教育的多学科培训和实践教育都是十分必要的。     

椎间盘内破裂症的微创治疗进展

慢性下腰痛是一种常见症状,椎间盘内破裂症(IDD)是慢性下腰痛的最主要原因。传统的IDD的治疗方案仅仅局限于保守治疗或手术融合。随着这一问题被大家的广泛重视和相关基础研究如生理学、生物化学、生物力学的快速发展,新的治疗方法的出现已经成为一种必然趋势,本文就其微创治疗方法加以综述。     

乙醛脱氢酶2基因多态性与酒精性肝病患者饮酒特点和疾病发生的关系*

目的 分析乙醛脱氢酶2（ALDH2）基因多态性与酒精性肝病（ALD）患者饮酒特点与疾病发生的关系。方法 采用TaqMan荧光定量PCR法,对无血缘关系的296例健康对照者（HC）以及221例ALD患者进行ALDH2基因多态性检测,并分析其与ALD患者饮酒特征和疾病发生的关系。结果 ALDH2在健康人中突变频率为31.1%（92/296）,远高于欧美、非洲等国家（几乎为零）,稍高于亚洲平均水平（22%）;ALDH2*1/*1基因型频率,ALD患者组明显高于健康人[93.7%（207/221） Vs 69.0%（204/296）,OR=6.668,P<0.0001],ALDH2*1等位基因的频率,ALD患者组亦明显高于健康人[96.8%（428/442） Vs 82.9% （491/592）,OR=6.289,P<0.0001];ALDH2*1/*2基因型频率,ALD患者组明显低于健康人[6.3% （14/221） Vs 28.0% （83/296）,OR=0.174,P<0.0001],ALDH2*2/*2基因型频率,ALD患者组亦明显低于健康人[0% （0/221） Vs 3.0% （9/296）,OR=0.13,P<0.05]。ALDH2*2等位基因频率,ALD患者组亦明显低于健康人[3.2% （14/442） Vs 17.1% （101/592）,OR=0.159,P<0.01];ALDH2基因多态性在ALD患者疾病进程的各个阶段分布无明显统计学差异;与ALDH2*1/*1基因型相比,拥有ALDH2*2 携带者基因型饮酒者在较少的总饮酒量情况下即可发生ALD（P均<0.05）。结论 ALDH2*1等位基因是饮酒者发生ALD的重要危险因素,在较多饮酒量和较长时间饮酒的情况下才发生ALD;ALDH2*2等位基因可“保护”机体避免发生ALD,但饮酒者在较少饮酒量和较短饮酒时间的情况下即可发生ALD。