2型糖尿病患者血清CA199水平与血糖控制水平的相关性

目的:分析2型糖尿病患者血清CA199水平变化与血糖控制水平相关性及临床意义。方法:对120名健康体检正常者(对照组)血清与172例2型糖尿病患者(糖尿病组)血清的CA199、空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)水平进行检测,糖尿病组患者于正规治疗控制血糖后3个月复测各指标水平。结果:糖尿病组血清CA199、FPG、2hPG和HbA1c水平明显高于对照组;糖尿病组血清CA199水平与FPG、2hPG和HbA1c均呈正相关关系(r分别为0.444 3、0.493 9和0.515 0,P<0.01)。正规治疗控制血糖后3个月,糖尿病组血清CA199、FPG、2hPG和HbA1c水平下降,差异有统计学意义(P<0.01)。结论:2型糖尿病患者血清CA199水平明显高于正常人,与患者HbA1c、FPG、2hPG水平呈显著正相关关系。     

区域淋巴结微小转移对非小细胞肺癌长期生存的影响

目的:检测非小细胞肺癌(NSCLC)根治术后常规病理诊断无转移的区域淋巴结中的微小转移,研究微小转移对预后的影响.方法:收集根治术后常规病理证实为T1-4N0-1M0的107例NSCLC的肺门及纵隔淋巴结蜡块,采用Envision二步法检测.结果:NSCLC中微小转移检出率为29.9%.非微小转移病例的1、3、5年生存率及中位生存期较微小转移病例明显延长(均P＜0.05).Cox回归显示KPS评分、CK、T分期及病理分级是影响生存期的独立因素(均P＜0.05).术后放化疗与单纯手术比较术后放化疗组长期生存有优势,但无统计学意义(P＞0.05).结论:NSCLC淋巴结微小转移是影响长期生存的不利因素,放化疗干预有可能延长生存.     

Effect of polylactic acid glue in preventing epidural scar mdhesion after laminectomy in rabbits

Objective： To determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits. Methods： Twenty-four Japanese white rabbits underwent laminectomy （including the attached ligaments） at Lz and Ls. After laminectomy at Ls, polylactic acid glue was sprayed on the dura and nerve roots and this segment was taken as the experimental group. After laminectomy at Lz, nothing was used and this segment was enrolled as the self control group. Four rabbits were killed every two weeks postoperatively till the end of the experiment at 12 weeks. Then the operated spine was observed grossly, histologically and ultrastructurally to check the degree of scar formation, the status of epidural scar adhesion, the absorption of the glue, and the intraceHular structure of fibroblasts. Results： The glue coagulated immediately after spraying and showed excellent hemostatic effect. The glue membrane was easy to be taken away from the dura mater of the samples for 2 weeks and there were no cells in the epidural space in the experimental group. But the dura mater was covered by hematoma in the control group,which formed mild adhesion, with fibroblasts proliferating actively. In the 4th week, some glue shivers remained in the epidural space with fibroblasts increasing a little, and the dura mater was smooth in the experimental group. However, in the control group, the formed scar was fragile and conglutinated with the dura mater diffusely and fibroblasts were much more than those in the experimental group. In the 6th-12th weeks, there was a potential interspace between the scar and the dura mater, and the polylactic acid glue was absorbed completely in the experimental group. Much tough scar was found in the control group, which was very difficult to dissect from the dura mater and the surrounding tissues. From the ultrastructural observation of the fibroblasts, the nucleus became much bigger and the rough endoplasmic reticulum was much more plentiful in the control group than that in the experimental group. Conclusions： Polylactic acid glue can effectively reduce epidural cicatrization and adhesion.     

非小细胞肺癌三维适形大分割放疗疗效观察

非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC)常规放射治疗效果一直不能令人满意,特别是局部晚期病例.三维适形放射治疗 (Three Dimensional Conformal Radiation Therapy,3DCRT)是近年来发展起来的一项新的放射治疗技术,是一种能提高治疗增益比的有效手段,能最大限度地增加肿瘤的局部放射剂量,并减低周围正常组织的放射剂量.1998年12月～2003年7月采用高剂量大分割3DCRT治疗NSCLC44例,效果较满意.     

Ⅳ期NSCLC放疗的回顾与展望

Ⅳ期NSCLC在2DRT时代的姑息减症作用已经肯定,但是研究设计未能很好体现放疗对生存的作用、部分研究结果延长生存的作用未被人们接受。随着3DRT技术的发展、综合治疗理念的广泛应用、对不同转移状态与生存关系的认识,逐渐开展的前瞻性和回顾性研究证实,基于全身治疗联合原发肿瘤3DRT比单纯药物治疗更有利于改善症状和延长生存,尤其对于寡转移的Ⅳ期NSCLC。原发肿瘤剂量与生存密切相关,高剂量放疗可能更有利于延长生存;但仍存在放疗剂量、时机、技术选择等诸多问题,需要更广泛地开展研究。     

线上学习平台对新护士岗前培训的效果

目的探讨线上学习平台对新护士岗前培训效果及满意度的影响。方法内蒙古自治区人民医院于2018年8月开始在新护士岗前培训中采用线上学习平台,以实施前19名为对照组,实施后1年33名为观察组,对照组采用传统的教师课堂授课方式,观察组采用线上学习平台培训方式,培训内容相同。比较两组理论考试成绩、操作考试成绩及培训满意率。结果对照组理论考试成绩和操作考试成绩分别为(82.62±4.96)分和(85.20±6.50)分;观察组理论考试成绩和操作考试成绩分别为(88.49±5.24)分和(92.37±5.84)分;观察组考试成绩和操作考试成绩均明显高于对照组,差异均有统计学意义(P<0.05);观察组培训满意率为100.00%,明显高于对照组的78.95%,差异有统计学意义(P<0.05)。结论新护士岗前培训中采用线上学习平台可有效提升理论和操作考试水平,提高培训满意率,值得推广应用。     

PCR技术在肺癌微转移中的应用现状

肺癌微转移是引起肿瘤复发和转移的重要原因,PCR技术作为目前检测肺癌微转移的一种方法,能及早发现肺癌微转移,因此PCR技术对提高诊断肺癌的准确性、指导肺癌治疗、判断肺癌预后有着重要的作用。本文对近年来PCR技术在肺癌微转移的应用情况进行综述。     

肝门部胆管癌的手术治疗

目的：探讨肝门部胆管癌手术治疗方法和预后。方法：365例肝门部胆管癌患者依据手术治疗时间分为早期治疗组（1995—2000年）和近期治疗组（2001—2007年）,比较2组手术方式和预后。结果：近期治疗组半肝切除率、尾状叶切除率、门静脉切除率及手术切除率、根治性切除率均高于早期治疗组（P〈0.05）,2组并发症发生率和病死率比较差异无统计学意义（P〉0.05）。早期治疗组和近期治疗组1,3,5年生存率分别为30.1%,4.8%,0和53.9%,14.9%,4.3%,后者高于前者（P〈0.05）。结论：联合肝切除、门静脉切除可提高肝门部胆管癌根治性切除率,可改善患者预后。     

黄芪当归合剂联合基础治疗对IgA肾病的疗效观察

IgA肾病是一种常见的原发性肾小球疾病,其临床表现多样,主要表现为血尿,和/或蛋白尿,高血压,可伴有不同程度的肾功能下降,是导致终末期肾病常见的原发性肾小球疾病之一。随着肾脏病理诊断的普遍开展,IgA肾病越来越多地被临床所诊断。