外痔切除缝合内痔结扎术治疗混合痔100例临床观察

目的 提高混合痔手术疗效,缩短愈合时间,减轻患者痛苦.方法 随机将200例混合痔患者分为两组,试验组100例采用外痔切除缝合内痔结扎术,即将内痔结扎,外痔剥离切除后一期缝合切口.对照组100例采用传统Milligan-Morgan术.观察两组切口愈合时间,术后疼痛、水肿、出血等情况.结果 两组病例治愈率均达90%以上,差异无统计学意义.但两组在切口愈合时间、痛苦程度、并发症等方面差异有统计学意义(P<0.05),试验组明显优于对照组.结论 与传统Milligan-Morgan术相比,外痔切除缝合内痔结扎术疗效肯定,愈合时间短,疼痛轻,术后并发症少.     

Patients with Multiple Hepatocellular Carcinomas Within the UCSF Criteria Have Outcomes After Curative Resection Similar to Patients Within the BCLC Early-Stage Criteria

Background

Surgical strategies for the treatment of multiple hepatocellular carcinomas (HCC) remain controversial. This study compared the prognostic power of the University of California, San Francisco (UCSF) criteria with the Barcelona Clinic Liver Cancer (BCLC) early-stage criteria.

Methods

Clinical and survival data of 162 multiple-HCC patients in Child-Pugh class A who underwent curative resection were retrospectively reviewed. Prognostic risk factors were analyzed using univariate and multivariate analyses.

Results

UCSF criteria were shown to independently predict overall and disease-free survival. In patients within the UCSF criteria, 3-year overall and disease-free survivals were significantly better than in those exceeding the UCSF criteria (68 vs. 34?% and 54 vs. 26?%, respectively; both p?p?=?0.506 and 57 vs. 50?%, p?=?0.666, respectively). Tumors within the UCSF criteria were associated with a lower incidence of high-grade tumor (p?=?0.009), microvascular invasion (p?=?0.005), 3-month death (p?=?0.046), prolonged Pringle’s maneuver (p?=?0.005), and surgical margin <0.5?cm (p?Conclusions Multiple HCC patients within the UCSF criteria benefit from curative resection. Expansion of curative treatment is justified.     

Coculture of vascular endothelial cells and adipose-derived stem cells as a source for bone engineering

The interaction between vascular endothelial cells (VECs) and osteoblasts (OBs) is the focus of this recent research. Vascular endothelial cells secrete bone morphogenetic protein, which promotes OB differentiation and stimulates OBs and their precursor cells to secrete vascular endothelial growth factor. Vascular endothelial growth factor is important in angiogenesis and angiopoiesis. Cloning studies have shown that adipose-derived stem cells (ADSCs) have the potential to differentiate into fat, bone, cartilage, and skeletal and smooth muscle cells, among others. Adipose-derived stem cells can express multiple growth factors, including vascular endothelial growth factor and hepatocyte growth factor. Our study examined the influence of coculturing VECs and ADSCs on osteogenic differentiation. Cord blood-derived VECs and ADSCs were isolated from rats and characterized with immunofluorescence staining and morphological observation. Coculture of third-generation ADSCs and VECs was induced for 6 weeks. Cell growth was analyzed using a modified MTT assay. Alkaline phosphatase (ALP) and osteocalcin (OC) was analyzed using immunofluorescence staining. When ADSCs and VECs were cocultured, the absorbance of cells gradually increased, reaching a peak on day 12. The highest absorbance was seen in a coculture system with a ratio of ADSCs and VECs of 1:1. The secretion of ALP and OC gradually increased in these cells and was significantly higher than controls (P < 0.01). Coculturing of ADSCs and VECs at a 1:1 ratio gave the highest secretion of ALP and OC at every time point, and was significantly higher than other groups (P < 0.01). Our results indicated that ADSCs can be induced to osteogenic differentiation by VECs in vitro, suggesting a coculture system of VECs and ADSC as a novel source of cells for bone engineering.     

Putative protein markers in the sera of men with prostatic neoplasms

OBJECTIVE: To describe the preliminary identification of serum proteins that may be diagnostic markers in prostate cancer. PATIENTS AND METHODS: The study included 11 men referred for treatment of localized prostate cancer, 12 with benign prostatic hyperplasia (BPH) and 12 disease-free controls. For serum protein analysis, the protein-chip array surface-enhanced laser desorption/ionization (SELDI) technique was used (Ciphergen Biosystems, Fremont, CA). SELDI combines protein-chip technology with time-of-flight mass spectrometry, and offers the advantages of speed, simplicity and sensitivity. RESULTS: Three protein peaks were identified in the serum of men with prostate cancer and BPH, but not in controls, with relative molecular masses of 15.2, 15.9 and 17.5 kDa. These three proteins were significantly associated with BPH and prostate cancer when compared with controls (P = 0.001, 0.004, and 0.011, respectively, Kruskal-Wallis test). Interestingly, the 17.5 kDa protein was more abundant in five men with stage T1 prostate cancer than in eight with stage T2 (P = 0.016, two tailed Mann-Whitney U-test corrected for ties). CONCLUSIONS: These proteins, particularly the 15.9 kDa one, may be used for the diagnosis or monitoring of prostate cancer and differentiation from BPH, and have the potential for antibody-based chip SELDI-TOF technology. Identified proteins may be targets for immunotherapy.     

不同麻醉药物配伍对高龄危重患者血压、心率的影响

目的探讨不同麻醉药物组合对高龄危重患者麻醉诱导及术中血压(BP)、心率(HR)的影响。方法40例80岁以上ASAⅡ-Ⅲ级老年择期手术患者,随机分为A、B两组(每组20例),A组麻醉诱导及维持采用咪唑安定 芬太尼 异氟醚;B组麻醉诱导及维持采用依托咪酯 七氟醚 氧化亚氮-氧气混合气。观察两组患者麻醉诱导前(T0)、诱导后(T1)、插管时(T2)、切皮时(T3)、切皮后30min(T4)、术毕拔管时(T5)的平均动脉压(MAP)、HR以及脑电双频谱指数(BIS)的变化。结果A组患者诱导后BIS由95±2降为52±4,MAP、HR由110±11mmHg、73±8/min分别降至75±9mmHg、59±4/min;B组患者吸入诱导后BIS值由94±3降至58±3,其MAP、HR分别由103±8mmHg、76±6/min降至87±7mmHg、67±5/min。气管插管时,两组间BIS无差异,而A组MAP、HR较B组明显升高(P<0.01或P<0.05)。结论高龄危重患者手术中应用依托咪酯 七氟醚 氧化亚氮诱导及术中麻醉能维持其BP、HR较为稳定。     

双侧颈动脉体瘤的CT和MRI诊断

目的:探讨双侧颈动脉体瘤CT、MRl影像表现.材料和方法:回顾性分析9例双侧颈动脉体瘤的CT和MRI影像表现及其临床资料.结果:9例双侧颈动脉体瘤影像表现为双侧舌骨水平颈动脉鞘区肿块,平扫呈较均匀的等密度或中等信号,增强扫描肿块明显增强.螺旋CT薄层图像可见肿块周边迂曲扩张的供血动脉(5/6),颈内、外动脉间距增宽.MRI最为特征表现是肿块内或周边迂曲条状的血管流空影(10/13).结论:双侧颈动脉体瘤的CT和MRI表现具有特征性,术前可以做出定性诊断.     

多层CT尿路造影在上尿路梗阻性疾病中的应用价值

目的探讨多层CT尿路造影(MSCTU)在上尿路梗阻性病变中的诊断价值。方法回顾分析103例因上尿路梗阻就诊患者的MSCT和CT尿路造影(CTU)后处理图像资料。结果本组93例上尿路梗阻患者中,结石嵌顿致上尿路梗阻者32例,尿路先天畸形引起上尿路梗阻积水12例,肾盂囊肿或泌尿系肿瘤引起上尿路梗阻者28例,炎性病变、结核致肾盂、输尿管狭窄者14例,非泌尿系肿瘤包埋或压迫上尿路致梗阻积水者7例。结论多层螺旋CT具有快速扫描、图像分辨率优良和强大的图像后处理功能,MSCTU对上尿路梗阻定位、定性诊断具有很高价值。     

抗中性粒细胞胞质抗体和抗酿酒酵母抗体表达在炎症性肠病诊断中的意义

目的 回顾性分析血清核周型抗中性粒细胞胞质抗体(pANCA)和抗酿酒酵母抗体(AScA)的表达在炎症性肠病(IBD)诊断中的意义.方法 间接免疫荧光生物薄片(IIFT)法检测97例IBD患者血清pANCA、ASCA表达,其中86例溃疡性结直肠炎(UC)列入UC组,11例克罗恩病(CD)列入CD组,另设36例结肠镜检查正常者为对照组.结果 pANCA在UC、CD和对照组的阳性率分别为27.9%、0%和0%,UC组显著高于其他两组(P<0.01);ASCA在CD、UC和对照组的阳性率分别为36.4%、4.7%和0%,CD组显著高于其他两组(P<0.01).86例UC患者中,重度UC 23例(26.7%),其中pANCA 6例(26.1%),ASCA 2例(8.7%),pANCA /ASCA 1例(4.4%),轻、中度UC 63例(73.3%),其中pANCA 18例(28.6%).重度与轻、中度UC患者pAN-CA表达情况无显著差异(P>0.05).11例CD患者中,重度CD 4例(36.4%),其中ASCA 3例(75.0%),轻、中度CD 7例(63.6%),其中ASCA 1例(14.3%).重度CD患者ASCA阳性率明显高于轻、中度CD患者(P<0.05).结论 ASCA、pANCA两种血清标志物对诊断UC和CD具有一定临床参考价值.     

Analysis of differences of gene expressions in keloid and normal skin with the aid of cDNA microarray

Background: Microarray analysis is a popular tool to investigate the function of genes that are responsible for the phenotype of the disease. Keloid is a intricate lesion which is probably modulated by interplay of many genes. We ventured to study the differences of gene expressions between keloids and normal skins with the aid of cDNA microarray in order to explore the molecular mechanism underlying keloid formation. Methods: The PCR products of 8400 human genes were spotted on a chip in array. The DNAs were then fixed on the glass plate by a series of treatments. Total RNAs was isolated from freshly excised human keloids and normal skin, and then was purified to mRNA by Oligotex. Both the mRNA from keloids and normal skin was reversely transcribed to cDNAs with the incorporations of fluorescent dUTP, for preparing the hybridization probes. The mixed probes were then hybridized to the cDNA microarray. After highly stringent washing, the cDNA microarray was scanned for the fluorescent signals to display the differences between two kinds of tissues. Results: Among 8400 human genes, there were 402 genes (4.79%) with different expression levels between the keloids and normal skins in all cases, 250were up-regulated (2.98%) and 152 down-regulated (1.81%). Analyses of collagen, fibronectin, proteoglycan,growth factors and apoptosis related molecule gene expression confirmed that our molecular data obtained by cDNA microarray were consistent with published biochemical and clinical observations of keloids. Conclusions: DNA microarray technology is an effective technique in screening for differences in gene expression between keloid and normal skin. Many genes are involved in the formation of keloids. Further analysis of the obtained genes will help understand the molecular mechanism of keloid formation.