Analysis of 4931 renal biopsy data in central China from 1994 to 2014

The purpose of this study is to investigate the changing spectrum and clinicopathologic correlation of biopsy-proven renal diseases in central China. We retrospectively analyzed data of 4931 patients who underwent renal biopsy in ten hospitals between September 1994 and December 2014. Among them, 81.55% were primary glomerular diseases (GD), and 13.02% were secondary GD. IgA nephropathy (IgAN) was the most common primary GD (43.45%), followed by focal glomerulonephritis (16.79%), mesangial proliferative glomerulonephritis (MsPGN, 14.35%), and membranous nephropathy (MN, 13.28%). IgAN was leading primary GD in patients under 60 years old, while MN was the leading one over 60 years old. The most frequent secondary GD was lupus nephritis (LN) (47.35%). The prevalence of IgAN, MN and minimal change disease was found to increase significantly (p?<?0.001, p?<?0.001, and p?<?0.01, respectively), while that of MsPGN, membranoproliferative glomerulonephritis and LN decreased significantly (p?<?0.001, p?<?0.001, and p?<?0.05, respectively). The main indication for renal biopsy was proteinuria and hematuria (49.03%), followed by nephrotic syndrome (NS, 20.36%). IgAN was the most common cause in patients with proteinuria and hematuria, chronic-progressive kidney injury, hematuria and acute kidney injury; and MN was the leading cause of NS. Primary GD remained the predominant renal disease in central China. IgAN and LN were the most prevalent histopathologic lesions of primary and secondary GD, respectively. The spectrum of biopsy-proven renal disease had a great change in the past two decades. Proteinuria and hematuria was the main indication for renal biopsy.     

全数字化乳腺摄影和彩超对乳腺疾病的诊断效果分析

目的 探讨全数字化乳腺摄影和彩超对乳腺疾病的临床诊断效果.方法 对来笔者医院诊治的40例乳腺疾病患者资料进行分析,患者均行彩色多普勒超声和全数字化乳腺摄影检查,将两种检查结果与病理结果对比,分析两种诊断方法的准确性.结果 本组40例中,29例病理阳性,11例病理阴性;全数字化乳腺摄影检查27例阳性,13例阴性,阳性诊断符合率为93.1％;彩超检查17例阳性,23例阴性,阳性符合率为58.6％,全数字化乳腺摄影阳性诊断符合率高于彩超(P＜0.01).29例年龄＞40岁患者中,病理诊断阳性22例,阴性7例;全数字化乳腺摄影检查阳性符合率为90.9％(20/22),高于彩超检查的阳性符合率(54.5％,12/22) (P＜ 0.01);11例年龄≤40岁患者中,病理诊断8例阳性,3例阴性;全数字化乳腺摄影检查阳性符合率87.5％(7/8),高于彩超检查的阳性符合率(62.5％,5/8),但差异无统计学意义(P＞0.05).结论 全数字化乳腺摄影对乳腺疾病的诊断准确率比彩超高,应作为乳腺疾病的常规诊断方法.但其对于≤40岁患者的诊断准确率不高,需要结合其他方法诊断.     

颈椎弓根钉技术在下颈椎骨折中的临床应用

目的探讨颈椎弓根钉内固定技术在下颈椎骨折中的临床应用方法及效果。方法对24例下颈椎骨折患者,通过术前X线、CT及三维重建检查了解椎弓根的直径、走行方向,并确定进钉点。术中凭手感及C臂斜位透视逐步扩孔,扩孔过程中探查骨孔四壁,确定为骨性,然后置入螺钉。结果经4～20个月的随访,除1例患者术后2.5个月因高位截瘫并发症死亡,1例A级患者无恢复外,其余22例均有1～3级脊髓功能恢复,无内固定失效者。结论下颈椎椎弓根内固定技术是相对安全、可靠的内固定方法,是下颈椎骨折治疗的较理想方法。     

人γ干扰素基因转染成肌细胞在治疗骨骼肌损伤中的应用

目的:构建转人γ干扰素(human interferonγ,hIFNγ)基因的成肌细胞,探讨hIFNγ对小鼠急性钝挫伤骨骼肌修复过程的影响。方法:①应用基因重组技术,将hIFNγ基因克隆到pEGFP-C2真核表达载体中,以酶切和测序方法鉴定重组质粒pEGFP-C2-hIFNγ的正确性;②经脂质体介导转染C2C12成肌细胞,用RT-PCR和Western Blot法检测转基因细胞的hIFNγ表达。③64只7~12周雄性C3H小鼠,制作右侧腓肠肌钝挫伤动物模型,随机分成4组,即A组(注射hIFNγ),B组(注射转hIFNγ的C2C12细胞),C组(注射空白成肌细胞),D组(未干预)。挫伤后第10天,A、B、C组的小鼠,于腓肠肌损伤局部注射不同药物,D组不进行干预以作为自然愈合对照。分别于伤后7、14、28、42天,从各组中随机抽取4只小鼠进行右侧腓肠肌损伤部位取材,以荧光定量PCR和免疫荧光化学染色检测不同时间点波形蛋白(Vimentin)及Ⅱb型肌球蛋白重链(MHC-Ⅱb)的表达。结果:①酶切和测序结果均证实成功构建了hIFNγ真核表达质粒pEGFP-C2-hIFNγ,RT-PCR和Western Blot检测到转染细胞中hIFNγ基因的表达;②干预后各时间点,A、B组小鼠损伤骨骼肌Vimentin表达较C组和D组降低;伤后42天,B组损伤骨骼肌Vimentin表达低于A组,其余时间点A、B两组间无显著差异;③各组MHC-Ⅱb表达无明显差异。结论:①成功制备了含hIFNγ基因的真核表达质粒,转染后获得了高效表达hIFNγ的鼠C2C12成肌细胞;②采用转染hIFNγ的C2C12成肌细胞局部注射,可以抑制骨骼肌纤维化标志产物波形蛋白的表达,与注射外源性IFNγ的作用近似。③局部注射转hIFNγ基因的成肌细胞或外源性IFNγ,未发现对骨骼肌再生标志产物MHC-Ⅱb表达有明显影响。     

Study on changes of partial pressure of brain tissue oxygen and brain temperature in acute phase of severe head injury during mild hypothermia therapy

Ahighdeathrateofseverebraininjurieshasattractedmuchattention .Mildhypothermiatherapyandmonitoringbrainoxygenmetabolismandcerebralbloodflowhavebeendoneinmanyhospitals.Wimaretal1elucidatedthevalueofmonitoringbrainoxygeninseverebraininjuries.Butthemechanismofmildhypothermiaremainsunclear .Zhang2 reportedthatmildhypothermiatherapycouldrecoverthebrainoxygentonormal.Gupta3 usedanesthesiacoolingandobservedduringmildhypothermiathebrainoxygenwasdecreased .Wehavetreated 116patientswithseverebraininjuri…     

Cytokines and growth factors in keratinocytes and sweat glands in chronic venous leg ulcers. An immunohistochemical study

The role of growth factors and cytokines in the impaired healing of chronic leg ulcers remains uncertain. The aim of this study was to determine whether changes in the amount and location of cytokines and growth factors may be associated with impaired healing in chronic leg ulcers. Biopsies from leg ulcers of 21 patients and from normal skin of nine healthy volunteers were examined immunohistochemically for selected growth factors and cytokines. Greater staining intensity was found in keratinocytes at the edges of ulcers compared to normal skin, or skin adjacent to the ulcers. Staining at the ulcer edge was more intense in nonhealing ulcers for only vascular endothelial growth factor and platelet-derived growth factor, whereas staining in the adjacent skin was more intense for all factors in the nonhealing phase. For all factors staining was cytoplasmic, suggesting production in these areas. This study shows up-regulation of the production of cytokines and growth factors in keratinocytes of chronic leg ulcers that is greater when the ulcers are nonhealing.     

CD44v6和组织蛋白酶D表达与食管癌预后的关系

目的　研究CD4 4v6和组织蛋白酶D(cathepsinD ,CD)表达与食管癌生物学行为的关系。方法　应用免疫组化法 ,检测 6 5例食管鳞状细胞癌组织中CD4 4v6和CD表达水平。结果　在食管癌中CD4 4v6和CD表达阳性率分别为 5 8.5 %和 6 4 .6 %。CD4 4v6和CD表达均与肿瘤分级、浸润、淋巴结转移和预后相关。结论　CD4 4v6和CD异常表达与食管癌的病理生物学行为密切相关 ,可作为是预测食管癌转移潜能和评估食管癌预后的客观指标     

急性重症胰腺炎外科治疗临床体会

目的 总结1990年1月－2000年8月期间本科收治的49例急性重症胰腺炎（SAP）,以探讨其合理的治疗方法。方法 非手术治疗14例,均为非胆源性ASP,手术治疗35例,其中胆源性ASP13例。结果 非手术治疗14例,全部治愈,手术治疗35例,治愈31例,死亡4例。并发症及死亡均以ARDS为主。结论 围手术期的基本治疗及并发症的预防是ASP治疗成功的关键,重视早期ASP的非手术治疗。     

二孔技术腹腔镜下阑尾切除术的评价

目的评价二孔技术腹腔镜阑尾切除术(LaparascopicAppendetectomy,LA).方法比较二孔、三孔/四孔LA、开腹阑尾切除术各组的手术时间及术后恢复各项指标及并发症.结果手术时间,二孔LA组(15±3)min较三孔/四孔LA组(27±5)min明显缩短,(P＜0.05),腹壁穿刺孔少,损伤小.二孔LA组与开腹组比较手术时间(15±3VS47±11)min(P＜0.01),术后镇痛剂应用(0/132VS18/100)(P＜0.01),自主下床活动时间(6±2VS48±6)h(P＜0.01),开始进食(8±2VS52±7)h(P＜0.01),住院时间(48±11VS192±17)h(P＜0.01),切口感染率(0/132VS13/100)(P＜0.01),肠梗阻发生率(0/132VS6/100)(P＜0.01).结论二孔技术LA较传统开腹阑尾切除术及三孔/四孔LA有明显优越性.     

成人间充质干细胞体外成骨的初步研究

目的 建立一种分离和培养成人骨髓来源的间充质干细胞（MSCs）的方法,观察成人MSCs体外成骨潜能。方法 用Percoll分离液分离出骨髓中的单个核细胞,并在含10％胎牛血清的低糖DMEM培养液中培养。通过传代培养扩增MSCs。为促进成人MSCs体外成骨性分化,第5传代培养时加入成骨性添加剂,培养第4、12天分别用流式细胞仪分析成人MSCs表面分子的表达,并用碱性磷酸酶组化染色和Von Kossa染色。结果 成人MSCs是骨髓黏附细胞中有相应细胞表面蛋白表达和形态均的一细胞群。成骨性添加剂可作用于传代培养的成人MSCs,表现为培养皿表面有相互连接的结节状聚合体、碱酶染色阳性细胞数量增多、Von Kossa染色可见钙化的基质沉积。结论 所建立的成人MSCs的分离和培养条件可分选出骨髓黏附细胞中一组独特的细胞群,成人MSCs具有体外成骨潜能。