细支气管肺泡癌中CD44v6、survivin和β-Catenin的表达及其与预后的关系

目的： 评价CD44v6、survivin和β-Catenin在细支气管肺泡癌(BAC)的表达及临床意义。方法采用免疫组织化学ElivisionTM两步法检测74例细支气管肺泡癌患者蜡块标本的中CD44v6、survivin和β-Catenin的表达状况,行生存分析研究各因素对BAC预后的预测价值。结果：CD44v6、survivin在Ⅲ期的阳性率明显高于Ⅰ~Ⅱ期患者,有淋巴结转移组的阳性率明显高于无淋巴结转移组（P<0.05）。β-Catenin在低分化组的阳性率明显高于高~中分化组的阳性率（P<0.05）。CD44v6和survivin表达阳性的BAC患者总体生存率低于阴性者（P<0.05）。CD44v6与survivin的表达呈正相关（r＝0.257,P<0.05）。单因素和Cox回归多因素分析均显示CD44v6和survivin的表达、TNM分期、N分期和肿瘤直径均为BAC独立的预后影响因素;分层分析显示CD44v6阳性的有淋巴结转移组BAC患者生存期低于阴性者;CD44v6阳性的Ⅲ期BAC患者生存期低于阴性者（P<0.05）。结论：CD44v6与survivin的表达呈正相关, CD44v6和survivin的表达、临床分期、肿瘤直径和N分期都是BAC预后独立的影响因素。     

新形势 新方针 新发展

新年伊始,万象更新,欣欣向荣.<国际妇产科学杂志>也面临着新的形势,机遇与挑战并存,在科学发展观的指引下,我们开始新的征程.     

小儿颈胸部淋巴管瘤的诊断与治疗(附3例报告)

目的:探讨小儿颈胸部淋巴管瘤的诊断与治疗。方法:3例患者均在全身麻醉下行颈胸联合进路胸骨正中劈开颈胸部淋巴管瘤切除术。结果:所有患者均病理诊断为淋巴管瘤,术后随访未见复发及手术并发症发生。结论:采用颈胸联合进路可以充分暴露瘤体,保证完整切除肿瘤,随访无复发。对于颈胸部的巨大淋巴管瘤,其他治疗手段不推荐采用。     

鼻内镜下改良双径路治疗真菌性上颌窦炎临床疗效分析

鼻内镜下能较好的处理上颌窦非侵袭性真菌病变,我科运用鼻内镜下改良双径路治疗上颌窦真菌性病变取得了较好的疗效,有一定临床推广价值,现报道如下。     

256层CT灌注成像评价兔失神经支配缺血后肢急性期毛细血管床血容量的动态变化

Objective To investigate the capillary blood volume (BV) changes in acute ischemic denervated hindlimb of rabbits and the value of 256-slice detector computed tomography (CT) perfusion imaging in evaluation.Methods A total of 40 healthy, adult white rabbits underwent either right hindlimb femoral artery excision combined femoral nerve denervation (combined modeling group, n = 10), simple femoral artery excision (iachemia group, n = 10), simple femoral nerve denervation (denervation group,n = 10), or simple femoral artery separation (sham-surgery group, n = 10).At 1,7, 14, 21, and 28 days following surgery, CT perfusion scanning (Philips Brilliance 256-row) was performed and CT perfusion images were processed using maximum-slope method with Function CT software on EBW workstation.The ratio of BV (rBV) in muscle tissue between right and left hindlimbs was calculated in each group.At 14 and 28 days, following sacrifice, rabbit bilateral adductor was harvested for immunohistochemical staining.The ratio of microvessei density (rMVD) in muscle tissue between right and left hindlimbs was calculated.The significance of the difference of rBV at each time point was assessed using analysis of variance of factorial design (2 ×2).Pearson correlation analysis was used to study the relationship between rBV and rMVD.Results After surgery, the 1st day rBV of combined modeling group, combined modeling group,denervation group and sham-surgery group is 0.31 ± 0.15 ( n = 6), 0.29 ± 0.12 (n = 6), 0.98 ± 0.08 ( n =6), 0.98 ± 0.07 ( n = 6) respectively.The 7th day following surgery rBV is 1.69 ± 0.45 ( n = 5 ), 1.63 ±0.43(n=6), 0.99 ±0.07(n =6), 1.00 ±0.08(n =6).The 14th day is respectively 1.58 ±0.18(n=5), 1.49 ±0.25(n =6), 0.94 ±0.08(n =6), 1.01 ±0.05(n =6).The 21th day is 1.42 ±0.41 (n=4),1.43 ±0.31(n=4), 0.94 ±0.05(n =5), 1.02 ±0.05(n =5),and the 28th day is 1.00 ±0.25(n=4),0.99 ±0.08(n=4), 0.92 ±0.09(n =5), 1.02 ±0.13(n=5).At each time point with exception of postoperative 28 days(F(A) =0.214,P>0.05), ischemia produced main effects on rBV(F(A) =274.268,30.044,65.787,18.886 ,P < 0.01 ), while simple denervation did not show main effects on each time point.Ischemia and denervation did not yield interaction effects on each time point, rMVD from each group supported above-mentioned changes.The correlation coefficient of rBV to rMVD was r = 0.862 ( P < 0.01 ).Conclusions BV in acute ischemic denervated hindlimb of rabbits shows a dynamic change, and denervation does not obviously influence this process.256-slice detector CT perfusion imaging can be used to noninvasively and semi-quantitatively evaluate the dynamic changes of capillary bed in acute ischemie denervated hindlimb of rabbits.     

胃癌患者术后化疗期间采用药膳辅佐饮食治疗的效果研究

目的:探讨药膳辅助饮食疗法对胃癌术后化疗期间患者饮食营养和生活质量的影响。方法:将110例胃癌术后患者随机分为药膳组50例和对照组60例。对照组给予常规饮食,实验组规律服用特制药膳,观察比较两组患者Visick分级、预后营养指数、Spitzer评分以及血清白蛋白(ALB)和血红蛋白(HB)营养学指标。结果:两组Spitzer评分部分项目可见统计学差异,而Visick分级和Spitzer总分ALB和HB未见显著统计学差异。结论:药膳饮食疗法对提高胃癌患者化疗期间单餐进食量,减低餐后腹胀、烧心发生和增进食欲方面有显著作用,对提高患者生活质量有一定影响。     

全程护理干预对腰穿患者的影响

目的:探讨全程护理干预对腰穿患者的影响。方法:将104例腰穿患者随机分为两组,对照组50例进行常规护理,干预组54例进行全程护理干预。结果:干预组患者恐惧及术后头痛、腰痛、压疮发生率均较对照组低。结论:全程护理干预作用显著,临床上应予高度重视。     

乌拉地尔配伍艾司洛尔在悬雍垂腭咽成形术中的应用

目的探讨乌拉地尔配伍艾司洛尔应用于悬雍垂腭咽成形术的可行性。方法美国麻醉医师协会分级Ⅰ～Ⅱ级阻塞性睡眠呼吸暂停低通气综合征患者80例,随机分为观察组和对照组各40例,2组采用相同的麻醉方法,观察组麻醉后静脉泵入乌拉地尔,根据心率(HR)和平均动脉压(MAP)间断10min静脉注射艾司洛尔,并记录麻醉前、手术开始后1、2h、手术结束后15min2组的HR和MAP,记录术野显露清晰满意度、手术时间、出血量、输液量、苏醒及拔管时间。结果观察组与对照组麻醉前HR和MAP比较差别无统计学意义(P>0.05)。对照组手术1、2h、手术结束15min的HR和MAP与术前比较差别均无统计学意义(P>0.05);观察组手术1、2h、手术结束15min的HR和MAP较术前明显降低(P<0.05),且与对照组同时间点比较明显降低,差别有统计学意义(P<0.05)。观察组术野显露清晰满意度明显优于对照组(P<0.05);观察组手术时间、出血量、输注液体总量、苏醒及拔管时间均少于对照组(P<0.05)。结论乌拉地尔配伍艾司洛尔能有效减少手术出血量,改善术野显露清晰度,使围手术期血压和HR更为平稳。     

UF-100全自动尿沉渣分析仪的临床应用

目的对UF-100全自动尿沉渣分析仪的临床应用进行分析。方法对2009-04-01-2009-04-20住院患者780例送检的晨尿进行全自动尿沉渣分析仪与尿显微镜检查两种不同方法检测。结果全自动分析仪RBC阳性符合率为81.7%,假阳性率为21.7%;WBC阳性符合率为84.9%,假阳性率为10.1%;管型阳性符合率为64.5%,假阳性率为14.5%;上皮细胞的阳性符合率为78.2%,假阳性率为9.8%。结论全自动尿沉渣分析仪和显微镜检查联合应用,可提高尿检的准确率,适应尿沉渣分析标准化的要求。     

贴补法治疗外伤性鼓膜穿孔临床观察

目的观察贴补法治疗外伤性鼓膜穿孔疗效。方法以1%的卡因棉片贴敷于鼓膜穿孔处,7 d更换1次,配合抗生素防止感染,促进穿孔的愈合。结果穿孔部位经1次或多次贴补后92%愈合。结论贴补法治疗外伤性鼓膜穿孔简便易行,成功率高,是一种满意的方法。