胺碘酮转复肺癌术后室上性心律失常的疗效分析

目的观察肺癌手术后并发室上性心律失常的患者静脉注射胺碘酮的有效性和安全性。方法选择非小细胞肺癌术后并发室上性心律失常的患者43例,给予静脉注射胺碘酮,转复为窦性心律的时间超过24 h后,停用胺碘酮,观察使用胺碘酮转复肺癌手术后并发室上性心律失常的临床疗效。结果43例患者中通过胺碘酮治疗转复为窦性心律有37例（86%）,6例采取直流电复律转复。结论使用胺碘酮转复肺癌手术后并发室上性心律失常是安全有效的。     

64排螺旋CT间接预测心肌缺血的临床应用

目的:探讨64排螺旋CT冠状动脉造影(CTangiography,CTA)诊断冠脉狭窄的程度与单光子发射计算机断层扫描(single photon emission computed tomography,SPECT)心肌灌注显像(myocadiac perfusion imaging,MPI)诊断相关狭窄动脉所支配的心肌血流灌注状况之间的对应关系。方法:112例可疑冠心病的胸痛患者在1周内均行CTA及99mTc-MIBI(甲氧基异丁基异腈)MPI。比较不同狭窄程度的冠脉与相关狭窄动脉所支配的心肌血流灌注之间的关系。结果:分别以冠脉狭窄≥50%及≥70%为诊断心肌缺血的阳性标准。以患者作为比较对象,CTA预测心肌缺血的敏感性、特异性、阳性预测值、阴性预测值分别为88%,52%,74%,74%和76%,86%,90%,70%;以病变血管作为比较,CTA预测心肌缺血的敏感性、特异性、阳性预测值、阴性预测值分别为92%,73%,66%,94%和47%,94%,82%,76%。结论:CTA诊断的冠脉狭窄程度≥70%时与相应的MPI显示心肌缺血之间的一致性较高,而狭窄在50%~70%的患者中两者的结果差异较大。     

后路悬臂梁支撑线缆牵拉复位固定治疗齿状突骨折并寰枢椎脱位

目的 :探讨后路悬臂梁支撑线缆牵拉复位固定治疗齿状突骨折并寰枢椎脱位的临床疗效。方法 :回顾性分析2008年1月至2013年12月收治的12例齿状突骨折并寰枢椎脱位患者的临床资料,其中男8例,女4例;年龄21~53岁,平均37.2岁。11例为新鲜骨折脱位,1例为陈旧性骨折脱位,均为寰枢椎前脱位。依据Grauer改良的Anderson-D′Alonzo分型,ⅡA型3例,ⅡB型5例,ⅡC型3例,ⅢA型1例。所有病例行后路悬臂梁支撑线缆牵拉复位固定治疗。术后分别采用JOA评分和ADI测量对神经功能和寰枢椎脱位复位情况进行评估。结果:所有患者获得随访,时间6个月~2年,平均1年3个月。JOA评分术后1周、6个月及末次随访分别为13.2±1.3、13.5±1.4、14.3±1.5,较术前的8.3±1.4明显改善(P0.05)。术后X线及CT示寰枢椎前脱位均复位满意,术后1周、6个月及末次随访ADI分别为(2.2±0.4)、(2.4±0.6)、(2.3±0.5)mm,均较术前的(5.8±1.2)mm明显改善(P0.05)。内固定螺钉及线缆位置良好,无松动、断裂,寰枢椎后间隙植骨均融合。结论:后路悬臂梁支撑线缆牵拉复位固定治疗齿状突骨折并寰枢椎脱位是一种固定牢固、安全可靠的方法,可获得良好的临床效果。     

CT增强扫描技术在周围型肺癌淋巴结转移的诊断研究

目的探讨CT增强扫描对周围型肺癌淋巴结转移的临床诊断价值。方法选取我院2013年1月-2015年12月入院治疗的周围型肺癌患者69例作为研究对象,均进行CT平扫和CT增强扫描,观察病灶的大小、形态、位置,并结合有无淋巴结转移瘤的特征对其进行分析。结果 69例周围型肺癌患者中发生淋巴结转移的有42例(约占60.8%),其中小细胞淋巴结20例(约占28.9%),腺癌淋巴结16例(约占23.2%),鳞癌淋巴结6例(约占8.7%),而未发生淋巴结转移的有2 7例(约占39.1%),CT增强扫描未检测出病灶的有1例(约占1.5%);周围型肺癌患者中,转移性淋巴结的CT净增强程度略低于非转移性淋巴结,差异具有统计学意义(P0.05);周围型肺癌患者的肺窗与纵隔窗胸部CT图以及动脉期、静脉期和延迟期CT增强扫描图,能清楚地显示病灶大小与位置。结论CT增强扫描具有较高的检出率,提高了对病灶的定性能力,为肺癌的早期发现与治疗提供了科学的理论依据。对于早期症状不明显的周围型肺癌淋巴转移瘤,CT增强扫描应用更为广泛,具有较高的临床价值。     

蓝舌病毒湖北株对小鼠肾癌细胞体内外的杀伤效应

Objective To investigate the anti-tumor effect of Bluetongue virus-HBC3 on murine renal cell carcinoma cell ( Renca) in vitro and in vivo. Methods The renal cells were inoculated with BTVHBC3 at MOI of 1. Observed the cytopathic effects (CPE) by microscopy and the ultra-structural changes by transmission electron. MTT assay was used to comparative analyses of differential survival rates using different Multiplicities of Infection ( MOI) after the renal cells were infected 24,36,48 h. The presence of BTV genome was also detected by agarose gel electrophoresis. The subcutaneous tumor-bearing mice model of renca cells were created up successfully using the BALB/c mice,and the mice was intratumorally injected with BTV-HBC3. Observed the tumor growth, and the pathological and immunohistochemical of the tumor tissue. We also detected the serum IFN-α of the mice. Results Over 90% cytopathic effects (CPE) were readily observed and detected in renca cells infected with BTV 48h postinfection. In electron microscopy (EM), BTV virions could be seen amplified efficiently in renca cells. The survival rate of the renca cell were respectively (44.45 ± 5. 26) % , (30. 47 ± 4. 77)% , ( 20. 34 ± 5. 26 ) % when infected with BTV at MOI of 1 24,36,48 h postinfection. It showed that there was a dose-effect relationship between them. BTV viral genomic ds-RNA fragments could be found in BTV infected Renca cells through gel electrophoresis. The tumor volume reduced dramatically in contrast with the control group. After BTV treatment Subsequent pathological and immunohistochemical analysis also demonstrated its distinct infection restricted in the Rencacells. Conclusion BTV-HBC3 could selectively degradated Renca cells.     

人食管上皮细胞原代培养方法的改良研究

目的探讨适合应用于组织工程食管研究的食管上皮细胞培养方法。方法对比食管上皮细胞在无血清培养基K-SFM及含血清培养基DMEM中的生长情况。结果食管上皮细胞在无血清培养基K-SFM中生长快,细胞形态好,不易被成纤维细胞污染。结论应用无血清培养基K-SFM培养食管上皮细胞,方法简便,适合推广应用。     

增塑剂邻苯二甲酸二丁酯致小鼠睾丸组织的病理学改变

背景：目前国内外研究邻苯二甲酸二丁酯对生殖损害研究对象多为大鼠,且不同时间点下小鼠病理组织学未见,以小鼠为移植对象没有明确移植时间。目的：探讨邻苯二甲酸二丁酯致小鼠睾丸组织病理学改变,并找出其改变最大的时间点,为移植做准备。方法：妊娠balb/c小鼠20只随机分成3组,分别为正常对照组6只,玉米油对照组6只,DBP组8只。自妊娠12～21d,分别经口给予邻苯二甲酸二丁酯和玉米油,分别在小鼠出生后4～8周每间隔1周观察仔代雄小鼠睾丸的组织病理学改变,找到变化最大的时间点。结果与结论：邻苯二甲酸二丁酯组染毒小鼠睾丸出现明显的生理、病理和电镜下的改变。邻苯二甲酸二丁酯可引起雄性仔鼠性分化异常,睾丸生精上皮损害和生精过程障碍,从而对雄性仔鼠生育力产生不利影响,在5,6周小鼠睾丸组织损害最大,可以作为移植变化最大时间进行选择。     

丁苯酞对大鼠骨髓间质干细胞氧化应激损伤的保护机制

目的 研究丁苯酞(dl-3-n-butylphthalide,NBP)对过氧化氢(hydrogen peroxide,H2O2)诱导的大鼠骨髓间质干细胞(rat bone marrow mesenchymal stem cell,rBMSC)氧化应激损伤的保护机制.方法 rBMSC分为对照组、H2O2组以及不同浓度N...     

肾上腺外嗜铬细胞瘤的诊断与治疗

目的 探讨肾上腺外嗜铬细胞瘤(EAP)的诊断和治疗经验.方法 回顾性分析2003年4月至2010年4月收治的37例EAP患者的资料.临床表现为高血压31例,典型的头痛、心悸、多汗"三联征"12例.血浆游离变肾上腺素类物质(MNs)和24 h尿儿茶酚胺(CA)定性诊断的阳性率分别为96.8%(30/31)和86.5%(32/37).超声、CT、MRI和131I-间碘苄胍扫描(131I-MIBG)定位诊断的准确率分别为91.7%(33/36)、97.0%(32/33)、90.0%(9/10)和82.6%(19/23).35例行手术治疗,2例行放射治疗.结果 单发肿瘤32例,其中腹主动脉旁14例、膀胱内7例、下腔静脉旁4例、肾门附近4例、髂血管旁2例、肾上极1例;多发肿瘤5例.完整切除肿瘤30例,行肿瘤切除+右肾切除3例,行膀胱部分切除2例.病理诊断良性24例,恶性11例.术前31例高血压患者中,术后23例血压恢复正常,6例血压降低但仍高于正常,2例血压无明显变化.术后34例随访5个月～7年,肿瘤复发5例,死亡5例.结论 EAP少见,血浆游离MNs和24 h尿CA是重要的定性诊断方法.定位诊断较困难,超声、CT、MRI和131I-MIBG是重要的定位诊断方法.经腹途径切除肿瘤是首选的治疗方法,充分术前准备,术中避免过度挤压肿瘤.对于恶性者术后可辅以131I-MIBG治疗.

Abstract：

Objective To investigate the diagnosis and treatment of extra-adrenal pheochromocytoma(EAP). Methods The clinicsl data of 37 cases of EAP from April 2003 to April 2010 were retrospectively analyzed.Hypertension was observed in 31 cases.The typical triad of headache,palpitation and sweating was observed in 12 cases.The positive rate of plasma-free MNs and 24-hour urinary CA in diagnosing EAP was 96.8%(30/31) and 86.5% (32/37) respectively.The main localization diagnosis included ultrasonography,CT,MRI and 131I-MIBG,with positive rates of 91.7% (33/36),97.0%(32/33),90%(9/10) and 82.6%(19/23) respectively.Two patients underwent radiotherapy, and the remaining 35 cases underwent surgical treatment. Results Among the total of 37 cases,32 cases were single tumor,and five were multiple tumors.The anatomic locations of the single tumors were as follows: 14 wre adjacent to the abdominal aorta,seven in the bladder,four adjacent to the inferior vena cava,four adjacent to the renal hilum,two adjacent to the lilac blood vessel and one in the upper pole of the right kidney.Thirty cases underwent complete tumor resection,three cases underwent tumor resection plus right nephrectomy and two cases underwent partial cystectomy.Twenty-four cases were diagnosed benign and 11 cases were diagnosed malignant by pathological examination.Among 31 cases with preoperative hypertension,postoperative blood pressure returned to normal in 23 patients,blood pressure descended mildly in six cases and blood pressure was still hypertensive in two cases.Thirty-four patients were followed up for five months to seven years,during which five cases had tumor recurrence or metastases and five cases died postoperatively. Conclusions EAP is a rare neuroendocrine tumor and its accurate diagnosis is rather difficult.Plasma-free MNs and 24-hour urinary CA are important qualitative examinations.Ultrasonography,CT,MRI and 131I-MIBG scintigraphy are important methods for the localization of the tumor.Transperitoneal resection of the tumor is the preferred choice of management and adequate perioperative preparation is the key to a successful operation,including bringing down blood pressure,expanding blood volume and correcting arrhythmia.Patients with malignant EAP may be treated with 131I-MIBG after surgical therapy.     

接骨草化学成分研究

目的 分离鉴定侗药接骨草Sambucus chinensis的化学成分。方法 经薄层色谱、硅胶柱色谱、凝胶柱色谱和制备高效液相色谱进行分离纯化,通过理化数据测定、¹H-NMR和¹³C-NMR等谱学技术进行结构鉴定。结果 从接骨草中分离出13个化合物,分别为β-谷甾醇（1）、胡萝卜苷（2）、绿原酸（3）、木犀草素（4）、槲皮素（5）、东莨菪素（6）、落叶松脂醇（7）、α-香树脂醇（8）、山柰酚（9）、单棕榈酸甘油酯（10）、豆甾醇（11）、熊果酸（12）、齐墩果酸（13）。结论 所有化合物均为首次从该植物中得到。