腹股沟疝误诊1例

1 病例介绍 患者,男,52岁.因"发现左侧腹股沟可复性包块10年,右侧腹股沟可复性包块1年"入院.查:超力体型,心肺腹(-);站立时,左侧腹股沟区有约4 cm×4 cm×3 cm大小包块,右侧腹股沟区有约6 cm×5 cm×4 cm大小包块,平卧后将包块挤压回腹腔,并压住内环口,嘱咳嗽,包块无突出,有冲击感.入院诊断:"双侧腹股沟斜疝".常规术前检查(未做腹部B超)未发现异常,随后在持硬麻下拟行"双侧腹股疝充填式无张力疝修补术".     

合肥农村小学留守儿童学业成绩和心理感受分析

目的探讨农村小学留守儿童学业成绩和心理感受,为避免留守儿童发展不良问题提供依据。方法采用病例对照方法,研究留守与非留守儿童学业成绩之间的差异性,并通过自设问卷调查留守儿童的心理感受。结果对学生学业成绩方差分析显示,是否留守因素主效应十分显著(F(1,116)=8.60,P=0.001),年级因素主效应无统计学显著意义[F(2,116)=0.65,P=0.53],2个因素交互作用效应无统计学意义[F(2,116)=2.66,P=0.08]。心理感受调查显示,50%以上的留守儿童其父母很少或偶尔与孩子联系;大多数留守儿童父母0.5a或1a回来一次;96.7%的留守儿童很担心或有点担心父母在外出事。结论留守儿童平均学业成绩低于非留守儿童,父母外出打工对孩子心理产生了不良影响。     

脊柱骨折205例手术治疗分析

目的 探讨脊柱损伤的治疗方法,对手术操作要点及相关问题提出见解.方法 本组205例,均采用后入路,在C臂引导下操作,先打入椎弓根螺钉、椎管减压、体位过伸复位、上连接杆并撑开、将骨块回敲,最后椎旁植骨.结果 术后X线复查,椎体的高度、形态及脊柱生理弯曲基本恢复.随访14～36个月,迟发感染4例,螺钉松动7例,断钉6例(14钉),断棒1例,无继发神经损伤及其它并发症.结论 后路椎弓根螺钉内固定操作容易,能充分扩大椎管达到减压目的 ;结合术中脊柱过伸位复位,有利于恢复伤椎高度,获得更好效果.

Abstract：

Objective To discuss the surgical treatment of spinal injury, and provide insights on key points and related issues for operations. Methods Two hundred and five cases of spinal fracture were treated through posterior surgical treatment. Under C-arm X-ray monitoring, surgeries had been operated on pedicle screws insertion, vertebral canal decompression, over-extending reduction position, and placed the connecting rod, knocked in the bone graft and finally transplanted the paraspinal bone. Results After operations , the height and morphology of vertebral bodies and spinal physiological curvature were basically recovered analyzed by X ray examination. The follow-up results (in the average of 14 to 36 months) indicated that there were 4 cases of delayed infection, 7 cases of loosen screw, 6 cases of broken screw (14 screws)and 1 case of broken stick, with no secondary nerve injury or other syndromes. Conclusion The vertebral pedicle screw internal fixation manipulated easily, which could sufficiently enlarge vertebral canal in order to decompression. In addition, during the operation, together with over-extending reduction position is beneficial to regain the height of fractured vertebral bodies.     

胆囊切除术残留病变临床分析

目的:探讨提高胆囊切除术残留病变诊治水平,加强胆囊切除术残留病变的预防。方法:对1997年1月～2007年12月期间行开腹胆囊切除术或胆囊切除、胆总管探查术后9例残留病变的诊断、治疗方法进行回顾性总结。结果:9例残留病变中,残余胆囊管结石3例、残余胆囊伴结石1例行残余胆囊切除术。胆总管残余结石3例行胆总管切开取石"T"管引流术或经"T"管窦道胆道镜取石术。缩窄性乳头炎1例行十二指肠乳头oddi括约肌切开成形术。意外胆囊癌1例行肝楔形切除术。治疗效果良好。结论:提高胆囊切除术残留病变的诊治水平,能使残留病变得到及时诊断、有效的治疗,加强残留病变预防,可尽量避免残留病变的发生。     

Expression and significance of β-catenin and peroxisome proliferator-activated receptor-γ in hepatocellular carcinoma

Objective To investigate the expression and significance of β-catenin and peroxisome prolifera-tot-activated receptor-γ,(PPARγ) in bepatocellular carcinoma. Methods Tissue microarrays were established to detect β-catenin and PPARγ expression in 49 cases of hepatocellular carcinoma,49 cases of adjacent nontumoral liv-er tissue and 6 cases of normal liver tissue. The relationships between PPARγ and β-catenin as well as between PPARγ and clinicopathological parameters were observed. Results The aberrant expression rate of β-catenin was 69.39%,48.98 % and 0 respectively (P=0.001). The positive expression rate of PPARγ was 51.02%,30.61% and 0 respectively (P=0.016). Clinicopathological analysis revealed that the increase of PPARγ expression was not associated with age,tumor size,serum alpha fetoprotein (AFP) levels,tumor embolus of portal vein or inferior vena cava,and HBsAg infection(χ2=0.214,3.201,0.046,3.201,P>0.05 for each),but correlated with differentiation grades(χ2=4.693,P<0.05). Aberrant expression of β-catenin was associated with PPARγ expression(χ2= 5.130,P<0.05). Conclusion Aberrant expression of β-catenin may involve in the liver carcinogenesis. The high expression of PPARγ in hepatocellular carcinoma is significantly correlated with the clinicopathological characteris-tics. Detection of PPARγ is valuable for diagnosing hepatocellular carcinoma,and evaluating malignancy extent and prognosis.     

胶原蛋白海绵与常见纤维素海绵止血材料的理化性质及凝血效果对比研究

目的：对比研究胶原蛋白、羧甲基纤维素钠(CMC-Na)和羟乙基纤维素(HEC)三者的理化性质及凝血效果,寻找适宜人体的止血材料。方法：采用冻干技术制备含有胶原蛋白、CMC-Na和HEC的3种不同海绵止血材料,测定海绵材料的pH值、电导率,对比不同材料在0.9%生理盐水中的溶解状态以及体外凝血时间。结果：在生理盐水温度为37℃下,3种海绵材料的pH值分别为(6.91±0.15)、(6.82±0.06)和(6.94±0.09),均在中性范围内。胶原蛋白海绵和HEC海绵的电导率在37℃下,分别为(2.41±0.56)μS/cm和(3.74±0.14)μS/cm,显著低于CMC-Na海绵的(59.08±4.65)μS/cm,差异有统计学意义(t=18.655,t=15.328;P<0.05)。胶原蛋白海绵在0.9%生理盐水中浸泡40 min时,溶胀后仍能保持完整的结构,但CMC-Na海绵与HEC海绵在浸泡40 min时的结构均发生一定程度的溃散。胶原蛋白海绵凝血时间最快(149 s),HEC海绵与CMC-Na海绵凝血时间分别比其增加了62%和123%,其差异有统计学意义(t=5.376,...     

细胞角蛋白21—1与转移生长因子-β1罗强联合检测诊断良恶性腹水的意义

目的评价细胞角蛋白21—1（CYFRA21—1）与转移生长因子-β1（TGF-β1）联合检测诊断良恶性腹水的意义。方法选取82例腹水患者,采用酶联免疫吸附试验检测其腹水中CYFRA21—1与TGF-β1水平。结果肝癌组患者腹水中CYFRA21-1明显高于结核性腹膜炎和弥漫性腹膜炎患者,差异有统计学意义（P％0．05）;肝癌组患者腹水中TGF-β1明显高于结核性腹膜炎患者,差异有统计学意义（P〈0．05）。结论CYFRA21-1与TGF-β1联合检测对诊断癌性腹水和结核性腹膜炎具有实际临床意义。     

Expression and significance of β-catenin and peroxisome proliferator-activated receptor-γ in hepatocellular carcinoma

Objective To investigate the expression and significance of β-catenin and peroxisome prolifera-tot-activated receptor-γ,(PPARγ) in bepatocellular carcinoma. Methods Tissue microarrays were established to detect β-catenin and PPARγ expression in 49 cases of hepatocellular carcinoma,49 cases of adjacent nontumoral liv-er tissue and 6 cases of normal liver tissue. The relationships between PPARγ and β-catenin as well as between PPARγ and clinicopathological parameters were observed. Results The aberrant expression rate of β-catenin was 69.39%,48.98 % and 0 respectively (P=0.001). The positive expression rate of PPARγ was 51.02%,30.61% and 0 respectively (P=0.016). Clinicopathological analysis revealed that the increase of PPARγ expression was not associated with age,tumor size,serum alpha fetoprotein (AFP) levels,tumor embolus of portal vein or inferior vena cava,and HBsAg infection(χ2=0.214,3.201,0.046,3.201,P>0.05 for each),but correlated with differentiation grades(χ2=4.693,P<0.05). Aberrant expression of β-catenin was associated with PPARγ expression(χ2= 5.130,P<0.05). Conclusion Aberrant expression of β-catenin may involve in the liver carcinogenesis. The high expression of PPARγ in hepatocellular carcinoma is significantly correlated with the clinicopathological characteris-tics. Detection of PPARγ is valuable for diagnosing hepatocellular carcinoma,and evaluating malignancy extent and prognosis.     

老年获得性免疫缺陷综合征住院患者226例临床特征分析

目的 了解老年获得性免疫缺陷综合征(AIDS)住院患者临床特征,为该人群AIDS防治提供更精准的措施.方法 收集2018 年重庆市公共卫生医疗救治中心年龄≥60岁AIDS患者临床资料,回顾性分析人口学、免疫学、病毒学特征及合并机会性感染、慢性基础疾病发生情况.结果 老年AIDS住院患者226例,男女比例5∶1,男性平均...