血液透析治疗重症急性胰腺炎21例疗效观察

重症急性胰腺炎(原称急性出血坏死性胰腺炎,现已弃用)是一个病情重、来势凶险、并发症多、死亡率高的消化系统重症,死亡率达40%~70%。近几年对它的认识和治疗有所提高,也涌现一些新的药物和治疗方法,死亡率下降致20%~40%。血液透析治疗方法就是一个疗效明显的、显著降低死亡率的、普遍被肯定的治疗方法。现将我们对血液透析治疗重症急性胰腺炎的总结和体会介绍如下。1资料与方法1.1一般资料收集本院2003年1月至2005年3月重症急性胰腺炎病例42例,男性22例,女性20例,年龄20~70岁,胆源性占50%,酒精源性占40.4%,不明原因占9.6%。将42例病人分成…     

新生儿败血症血清瘦素水平分析

目的探讨新生儿败血症时血清瘦素水平的变化及其与炎性因子C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)的相关性.方法检测18例败血症患儿入院时血清瘦素、CRP、TNF-α、IL-6的水平,并与18例健康新生儿血清瘦素水平比较,同时分析患儿血清瘦素水平与CRP、TNF-α、IL-6水平的相关性.结果败血症急性期,患儿的血清瘦素水平显著高于正常对照组,t=6.099,P＜0.001;且与TNF-α水平显著相关,r=0.737,P＜0.001;与IL-6水平之间也存在着相关性,r=0.734,P=0.001;与CRP之间无相关性,r=0.398,P=0.102.结论瘦素可能深入地参与了新生儿的抗感染免疫,瘦素的检测可为新生儿败血症的早期诊断提供一定的参考意义.     

Effect of Electromagnetic Fields on Proliferation and Differentiation of Cultured Mouse Bone Marrow Mesenchymal Stem Cells

Previous clinical observations and animal ex periments showed that EMFs could stimulate newbone formation of the fractures and increase thebone mineral density[1], but the manner in whichEMFs influence the behavior of bone remains poor ly understood. Recent studies[2] found that signaltransduction system plays an important role in thebiological effect of EMFs. Intracellular cAMP wasan important second messenger in signal transduc tion pathway. The cellular proliferation …     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

放疗联合紫杉醇化疗治疗中晚期鼻咽癌的疗效观察

目的观察放疗联合紫杉醇治疗中晚期鼻咽癌患者的疗效。方法分析放疗联合紫杉醇治疗58例中晚期鼻咽癌的局控率、生存率和毒副反应,并与57例单纯放疗相比较。结果综合组和单放组的治疗有效率为87.9%、71.9%,颈部淋巴结有效率91.5%、75.4%,差异均有统计学意义(P<0.05)。综合组的远处转移率低于单放组(P<0.05)。两组1~3年生存率均无统计学意义(P>0.05)。综合组主要不良反应为白细胞下降、胃肠道反应等,经治疗可改善。结论放疗联合紫杉醇可提高中晚期鼻咽癌的近期疗效,毒副反应可耐受,长期疗效有待于临床进一步观察。     

人Survivin蛋白的表达?纯化及初步应用

目的:克隆、表达肿瘤特异性凋亡抑制因子(Survivin),并对其在人肝癌诊断中的意义进行研究。方法:从人白血病细胞系HL60提取总RNA,用RT-PCR方法扩增出Survivin基因片段。将Survivin基因片段插入载体pMD-18T中,测序正确后亚克隆到原核表达载体pGEX-2TK中。IPTG诱导重组质粒pGEX-2TK-Survivin在大肠杆菌BL21中表达N端融合GST的目的蛋白,采用GST蛋白纯化系统进行纯化,经SDS-PAGE分析后,将所得产物用Thrombin裂解后进行Westernblot鉴定。将获得的目的蛋白包板,用ELISA法初步检测了肝癌患者血清中抗Survivin蛋白的表达。结果:克隆了人Survivin基因、表达出相对分子质量约为16.2ku的蛋白并进行了肝癌患者血清的检测应用。结论:成功克隆、表达和纯化了Survivin基因和融合蛋白,为进一步探讨以Survivin为基础的肿瘤诊断和治疗奠定了实验基础。     

Treatment of Thoracolumbar Vertebrate Fracture by Transpedicular Morselized Bone Grafting in Vertebrae for Spinal Fusion and Pedicle Screw Fixation

To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A （n=20） were rein-forced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B （n=50） did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B （group A： 6.4 degree; group B： 5.4 degree）/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B （P=0.0001）. Postoperatively, greater anterior height was achieved in group A than in group B （P〈0.01）. During follow-up study, anterior vertebral height was maintained only in Group A （P〈0.001）. Both group A and group B showed good Denis pain scores （P1 and P2） but group A outdid group B in terms of control of severe and constant pain （P4 and P5）. By Frankel criteria, the changes in neurological functions in group A was better than those of group B （P〈0.001）. It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with th     

上颌窦巨大骨瘤1例

患者女,14岁.发现右面部膨隆1个月,不伴发热、头痛、鼻涕带血,无外伤史.专科检查;右面部膨隆,局部皮肤无红肿压痛,鼻腔无新生物.鼻窦CT示:右上颌窦腔内有一巨大高密度影.     

放射性核素显像在小儿下消化道出血诊断中的应用

应用99mTcO及99mTc-RBC动态显像诊断消化道出血20例，结果阳性18例（美克尔憩室11例，肠重复畸形5例，克隆氏病1例，溃疡性回肠炎1例均被手术证实），阴性2例（肠息肉2例，内窥镜证实）。认为此种检查操作简单，损伤小，安全，灵敏度高，可提示出血部位及原因，对诊断及治疗有极大帮助。