肾血管平滑肌脂肪瘤的诊断与治疗（附36例报告）

报告肾血管平同脂肪瘤３６例，其中随访观察７例，手术治疗２９例，手术治疗包括肾切除１３例，肾部分切除５例，单纯肿瘤剜除１０例，１例双侧病变，左侧行肾切除，右侧行肿瘤剜除，术后全部手术病例均经病理检查证实，文中对临床应用Ｂ超及ＣＴ诊断本病的准确率及重要性进行了分析讨论，认为Ｂ超结合ＣＴ扫描是诊断本病的主要方法，早期明确诊断２是保存正常肾实质功能，降低肾切除率的关键，治疗上应根据不同情况区别对待。     

带蒂筋膜脂肪瓣联合肌腱移植重建手背伸肌腱功能的临床研究

目的：探讨应用带蒂筋膜脂肪瓣联合肌腱移植修复手背部创伤后肌腱缺损的临床应用。方法：2003年4月～2009年12月,行腹部轴型带筋膜及脂肪组织皮瓣修复手背部缺损,二期在脂肪层内行肌腱移植,修复肌腱缺损7例16指。结果：随访6～24个月,根据TAM评定标准,优13指,良1指,中1指,治疗效果满意。结论：应用带蒂筋膜脂肪瓣修复手背部软组织缺损,脂肪层内行肌腱移植,可以很好地防止肌腱粘连的发生。     

发热伴血小板减少综合征一例死因分析

发热伴血小板减少综合征(sfts)是由布尼亚病毒科的一种新型病毒引起的自然疫源性疾病[1].近两年,我国部分地区陆续报告了以发热、胃肠道症状、血小板减少和白细胞减少为主要临床表现的感染性病例,少数患者因多器官衰竭死亡.2009年国家疾病预防控制中心在一份河南患者的样本中分离到一种新病毒,随后通过核酸扩增及电子显微镜形态学分析,确定为布尼亚病毒科白岭病毒属的一种新病毒,命名为sfts布尼亚病毒[2].     

摆型矫治器的改良及临床应用

摆型矫治器不需要患者的配合,可矫治安氏Ⅱ类牙性错(牙合)或上牙弓轻、中度拥挤.目前,针对摆型矫治器进行的改良方法很多.本文就摆型娇治器的改良设计、制作、应用及治疗效果进行了综述.     

欧洲癌症研究与治疗组织风险评分表在非肌层浸润性膀胱尿路上皮癌中的临床应用初探

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.     

欧洲癌症研究与治疗组织风险评分表在非肌层浸润性膀胱尿路上皮癌中的临床应用初探

目的 评价欧洲癌症研究与治疗组织风险评分表(European Organization for Research and Treatment of Cancer risk tables,EORTC风险评分表)用于非肌层浸润性膀胱尿路上皮癌患者预后评估的可行性.方法 回顾性分析2003年1月至2009年2月收治的185例非肌层浸润性膀胱尿路上皮癌患者临床资料,其中Ta128例、T1 57例;G1 87例、G253例、G345例;肿瘤数目为单发、2～7个、≥8个者分别120、36、29例;肿瘤直径＜3 cm者131例、≥3 cm者54例;伴发原位癌者6例.185例均行经尿道膀胱肿瘤电切术,术后均行常规膀胱灌注化疗.采用电话随访方式,随访6～77个月,平均36个月.应用EORTC风险评分表进行预后风险评分,计算各评分组患者的1年复发率和进展率,并与EORTC评分表的预计值进行比较.结果 185例中1年内复发48例(25.9%),1年内出现肿瘤进展者7例(3.8%).根据患者实际情况计算,0、1～4、5～9、10～17分4组患者1年实际复发率分别为10.4%(5/48)、21.5%(14/65)、35.2%(19/54)、55.6%(10/18);0、2～6、7～13、14～23分患者1年实际进展率分别为0(0/43)、1.5%(1/67)、6.7%(4/60)、13.3%(2/15).经x2检验,结果与评分表的预计值差异无统计学意义(P＞0.05);而低危、中危、高危3组患者1年复发率及进展率差异有统计学意义(P＜0.05).结论 EORTC风险评分表可用于非肌层浸润性膀胱尿路上皮癌术后复发和进展风险的短期预测,对长期预测的应用及广泛人群的适用性尚待进一步验证.

Abstract：

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.     

祛湿化瘀方对高脂饮食诱导的小鼠非酒精性脂肪性肝炎的防治作用

目的：观察祛湿化瘀方治疗非酒精性脂肪性肝炎（NASH）的药效。方法：12周龄C57BL／6J雄性小鼠32只．SPF级。随机分为对照饮食组（n=16）和高脂饮食组（n：16）,对照饮食组小鼠给予10％热能来源于脂肪的对照饲料,高脂饮食组小鼠给予60％热能来源于脂肪的高脂饲料。12周末,对照饮食组和高脂饮食组再分,51j随机分为正常组（N,n=8）、正常给祛湿化瘀方组（NQ,n=8）、模型组（M,n=8）、模型给祛湿化瘀方组（Q,n=8）,分别以lml／100g鼠重灌胃给予祛湿化瘀方（生药含量0．93g／m1）和灭菌饮用水,16周末取材,观察各组小鼠体重、肝组织TG、血清ALT、肝组织HE染色、油红O染色等指标的变化。结果：模型组小鼠体重明显增加,肝组织甘油三酯（TG）含量、血清丙氨酸转氨酶（ALT）明显升高,肝脏HE染色见肝细胞明显的肿胀、脂肪变性和炎细胞浸润．油红O染色见肝脏显著脂滴沉着。肝脏脂肪变积分、炎症积分、气球样变积分均显著升高,并达脂肪性肝炎诊断标准。祛湿化瘀方组小鼠肝组织TG、血清ALT较模型组显著下降,同时肝脏病理组织变化改善,病理积分较模型组显著降低。结论：祛湿化瘀方能够有效防治高脂饮食诱导的C57BL／6J小鼠NASH。     

原发性精囊癌1例报道并文献复习

目的探讨原发性精囊癌的诊治方法。方法分析收治的原发性精囊癌1例,结合文献进行复习。结果经CT、MRI及经直肠超声（transrectalultrasound,TRUS）引导下穿刺活检确诊为精囊腺癌,行左侧精囊肿物切除、右侧精囊切除、膀胱与前列腺部分切除及左输尿管膀胱再吻合术,术后恢复良好。现已随访23个月,未见复发转移。结论原发性精囊癌临床罕见,术前诊断较为困难,TRUS引导下穿刺活检可明确诊断,应根据患者个体情况选择不同的根治性切除术。术后定期随访,注意是否复发转移。     

宝石能谱CT去除金属植入物伪影的实验研究

目的探讨宝石能谱CT在去除金属植入物伪影方面的价值。方法含碘对比剂溶液用蒸馏水稀释成8种不同浓度（mg/ml）置于50 ml硬塑料管体模中,将各支硬塑料管嵌入塑料模具及带有金属内固定猪骨的软组织中,分别进行能谱CT及常规扫描,测量不同扫描方式下塑料管体模内试剂的CT值。应用设计资料的非参数设计中的配对设计的秩和检验方法对常规扫描及GSI能谱扫描的8支浓度塑料管内试剂的在植入金属内固定前、后CT值进行统计学分析,并进行两两多重比较。结果在相同KV下,GSI能谱扫描80、100、120、140 Kev下CTGSI后与CTGSI前相比较,P值均大于0.05,差别无统计学意义;常规80、100、120、140 KVP扫描下CT普通后与CT普通前相比较,P值均小于0.05,差别有统计学意义。结论宝石能谱CT明显减少金属植入物伪影。     

3种义齿软衬材料粘结强度的实验研究

目的探讨自凝型丙烯酸酯、热凝型丙烯酸酯和DMG硅橡胶3种义齿软衬材料的粘结强度,为临床选择使用提供理论依据。方法将基托试件制作成长35 mm、截面积25 mm×25 mm的试件36个,用石膏将基托试件两两包埋于牙科型盒内,两粘结面间预留2 mm间隙,然后分别将3种软衬材料注入基托试件两断面预留的间隙内,加压。热凝型丙烯酸酯软衬材料水浴固化,自凝型丙烯酸酯软衬材料和DMG硅橡胶软衬材料常温固化。将试件随机分为A、B、C 3组,每组6个,室温放置24 h后应用万能试验机进行拉伸性能实验。结果自凝型丙烯酸酯、热凝型丙烯酸酯和DMG硅橡胶软衬材料粘结强度比较差异有显著性(F=204.181,q=6.01～26.71,P<0.01)。结论 3种义齿软衬材料的粘结强度均符合临床使用要求,粘结强度热凝型丙烯酸酯软衬材料>自凝型丙烯酸酯软衬材料>DMG硅橡胶软衬材料,临床使用时应根据具体情况进行选择。