喉罩通气在心血管疾病患者心肺复苏中的应用

目的 观察喉罩通气在心血管疾病患者突发呼吸心跳骤停时心肺复苏中的应用效果.方法 将心肺复苏中需要气管插管的80例患者为观察对象,并根据单双号将其分为对照组和观察组各40例,对照组按常规方式气管内插管,观察组首先置入喉罩通气后,再根据病情需要行气管插管,2组其他抢救措施相同.比较2组2 h内,置管时间、一次性插管成功率、通气起效时间及抢救中血气、血生化指标的变化.结果 观察组置管所需时间明显较对照组短,而一次性插管成功的例数明显多于对照组(P<0.05);观察组通气起效的时间较对照组短(P<0.05);复苏开始时2组的SpO2、PCO2等血气指标和乳酸、ALT、BUN等生化指标无明显差别,复苏后,2组的SpO2和pH均升高,而PCO2、乳酸、ALT、BUN和Scr水平均有所下降,观察组上述指标的变化更为明显,2组血糖较复苏前均无明显改变.结论 喉罩通气较气管插管在赢得抢救时间、稳定患者血气方面更具优势,为危重患者的抢救提供了保障.     

冠心病患者血清BNP、VEGF、hs-CRP检测的价值 评估及研究

目的 分析冠心病(CHD)患者血清BNP(B型钠尿肽)、VEGF(血管内皮生长因子)、hs-CRP(高敏C反应蛋白)检测的价值情况.方法 方便择取2014年3月—2017年3月该院收治的270例CHD者为研究对象,另取270名体检者为对照组.后依照CHD者的动脉狭窄程度以及疾病类型,具体分为若干组,分析冠心病以及健康者,UA,SA以及AMI者,不同狭窄程度CHD者的BNP、VEGF、hs-CRP情况以及上述指标水平相关性情况.结果 CHD者的BNP、VEGF、hs-CRP数值分别为(17.25±5.23)ng/L、(332.51±103.65)ng/L、(299.36±91.24)ng/L,对照组为(3.02±0.98)mg/L、(122.58±35.28)ng/L、(36.36±11.27)ng/L.和正常者相比,CHD者的BNP、VEGF、hs-CRP数值显著偏高,组间数据差异有统计学意义(P<0.05).在差异化冠心病类型,狭窄程度方面,冠心病者的以上指标差异有统计学意义(P<0.05).且随着患者疾病加重,BNP、VEGF、hs-CRP指标均呈现出了上升趋势,证实其对于预测CHD者疾病严重程度,有着重要价值.VEGF、hs-CRP与BNP呈现为正相关(r=0.488,0.392).hs-CRP和VEGF为正相关(r=0.395).组间数据差异有统计学意义(P<0.05).结论 和正常群体相比,冠心病患者血清中的BNP、VEGF、hs-CRP指标水平偏高,以上指标和疾病严重程度呈正相关,对其加以检测,能够显示出冠状动脉病变范围和预后情况,值得进一步推广使用.     

单侧唇裂术后继发鼻畸形的解剖学综合整复

目的：矫正单侧唇裂继发鼻畸形。方法：基于对单侧唇裂鼻畸形的病理解剖学研究和对畸形特征的认识，采用延长鼻小柱、纠正鼻小柱和鼻中隔的偏料，解剖显露双侧鼻翼软骨、游离塌陷的鼻翼软骨并悬吊固定在对称位置；同时采用自体耳甲软骨和中隔软骨移植，行鼻翼软骨支架重建。通过前庭粘膜瓣的旋转V-Y推进、纠正鼻前庭皱襞、完成鼻畸形的矫正。结果：自1998年至今，应用此法行76例唇裂鼻畸形矫正，其中63例病例经3-12个月随访、效果满意。结论：本手术方法切口暴露好，可直视下操作，鼻畸形整复效果满意。     

性激素受体及相关生长因子在前列腺基质细胞中的表达

目的：探讨前列腺基质增生的发病机制与性激素以及相关生长因子的关系。方法：应用RT－PCR的方法研究了在人前列腺不同细胞类型中Smoothelin的表达，研究了雄、雌激素受体及相关生长因子在前列腺基质细胞中的表达，以及它们在前列腺基质细胞分化中表达的变化。结果：Smoothelin是前列腺平滑肌细胞特异性的标记蛋白；雄激素受体（AR）、碱性成纤维细胞生长因子（bFGF)、角化细胞生长因子（KGF）主要在前列腺成纤维细胞中表达，而雌激素受体（ER）、转移生长因子β1（TGFβ1）主要在平滑肌细胞中表达。结论：前列腺基质增生与雌激素受体和转移生长因子β1的过度表达密切相关。     

放疗模拟机定位经皮自体骨髓及骨宁注射治疗骨不连及延迟愈合的临床研究

我院于 1998年 8月～ 2 0 0 0年 8月 ,在放疗模拟机定位下 ,经皮自体骨髓及骨宁注射治疗骨不连及骨延迟愈合 14例 ,收到良好效果。1　临床资料本组 14例 ,男 10例 ,女 4例 ;年龄 17～ 5 6岁 ,平均 38岁 ;骨不连部位 :肱骨 2例 ,股骨 2例 ,胫骨 7例 ,尺骨 2例 ,外踝 1例 ,14例为创伤性骨折不愈合 ,其中 10例曾行切开复位内固定术 (8例为开放性骨折 ,2例为骨不连切开植骨内固定术后 ) ,骨不连部位的骨缺损间隙为 2～ 6ｍｍ ,平均为 3 5ｍｍ。2　治疗方法病人置于模拟机平台上 ,先在放疗模拟机下定位 ,然后消毒 ,铺无菌巾 ,局部浸润麻醉后 ,用…     

胫骨平台骨折的治疗进展

胫骨平台骨折是一种常见损伤,常见于轻微创伤后的老年人及遭受高能量创伤的中青年人.但数十年来,胫骨平台骨折的最佳治疗方案一直是争论的焦点,至今仍未有完善的结论.本文就近年来胫骨平台骨折治疗的新进展作一综述.     

腰神经根病致背根神经节受损的实验研究

目的　探讨神经根受压后对背根神经节的影响。　方法　 SD大鼠 50只。参照 Kawakami方法 ,显露左侧 L4～ 6神经根及背根神经节 ,用 4/0肠线于背根神经节头侧端结扎神经根两道打两个结 ,线与神经根相距 3 mm;自身右侧神经根为对照。术后 1、2、4、8和 1 2周 ,分别取 L4～ 6脊髓节段标本 ,依 Gomori法检测抗氟化物酸性磷酸酶 (FRAP)活性 ,并用图像分析。　结果　实验侧术后 4周 ,脊髓后角 FRAP含量开始降低 ,在所观察的 1 2周内 FRAP随时间延长 ,其含量降低 ,与对照侧比较有统计学意义 (P<0 .0 1 )。　结论　腰神经根慢性受压对背根神经节有损害     

抗HLA和抗MICA抗体的表达对移植肾功能和急性排斥反应的预示作用

Objective To investigate the prediction of anti-human leukocyte antigen antibodies (HLA) and anti-major histocompatibility complex class I-related chain A antibodies (MICA) to the development of acute rejection (AR) and kidney allograft function. Methods Forty-one kidney transplant patients were prospectively tested for anti-HLA and anti-MICA. Thirty-seven patients were screened using Luminex/single-antigen beads to determine the HLA and MICA-specific antibody levels at 0,30,90, 180,360,720 and 1080 days post-transplantation. The patients and donors of HLA and MICA allele typing were determined by PCR-SSOP, and donor specific antibody (DSA) and non-donor specific antibody (NDSA) were identified.Simultaneously,their serum creatinine (SCr) levels and clinical data were analyzed. Results Nine patients (21.95 % ,9/41 ) had pre-existing anti-HLA and(or) anti-MICA, including 6 cases of anti-MICA,2 cases of anti-HLA, and one case of anti-MICA and anti-HLA. Nine patients had pre-existing DSA and NDSA. In the 37 patients, 6 patients (16.2% ) developed de novo anti-HLA, and 3 (8.1%) developed de novo antiMICA. In patients positive for de novo anti-HLA, the titer of antibody was gradually increased during the follow-up of three years. Four patients out of 9 patients with pre-existing antibodies were suffered from AR (44.4%); In 6 patients positive for de novo anti-HLA,three cases (50.0%) were suffered from AR; In three patients positive for de novo anti-MICA,no AR occurred (P＜0.05). In two patients positive for DSA of HLAⅡ antibody detected at the third and seventh day after transplantation, the renal grafts were renovecd due to rejection. The Scr levels in patients positive for pre-existing MICA with AR were higher than in those positive for pre-existing MICA without AR at each scheduled time point during the follow-up period (P＜0.05). The Scr levels in patients negative for antibodies pre-transplantation and having AR were higher than in those having no AR at each scheduled time point during the follow-up period (P＜0. 01 ). The Scr levels in patients positive for de novo HLA and MICA and having AR one month following transplantation were higher than in those negative for antibodies and having no AR (P＜0.01 ). Conclusion Pre-existing and de novo anti-HLA were the irnportant factors for the development of AR, but the mismatch of HLA and MICA alleles in donors and patients was primary causes for generation of de novo antibodies.     

直肠类癌的诊断与治疗

Objective To investigate the diagnosis and treatment of rectal carcinoid. Methods Clinical data of 16 patients of rectal carcinoids in our hospital from January 2000 to December 2009 were analyzed retrospectively. Related literatures were reviewed. Results Among the patients included, 11 cases(68.8%)suffered from hypogastralgia, 3 cases(18.8%)bloody stool, 3 cases(18.8%)defecation number increase. All the patients underwent enteroscopy. The average size in diameter of all the tumors was 8.8 mm. 81.3% of the tumors ≤10 mm in diameter. The average distance from tumor to anus was 6.8 cm and 87.5% of the tumors ≤8 cm in distance, Only 25% of all the cases were diagnosed preoperatively, most cases were diagnosed as other diseases and definitely diagnosed by postoperative pathology. 14 cases underwent operation as radical resection of rectal carcinoma, and 2 cases endoscopic removal. There was no operative death and postoperative five-year survival rate is 69.2%. Conclusions Preoperative diagnosis rectal carcinoid is difficult.Misdiagnosis rate is high. The key point of improving diagnosis of this disease is annal digital examination. Enteroscopy and pathology, operation is the first choice to treat rectal carcinoid.     

CR16在特发性无精子症患者睾丸组织中的表达

目的:研究糖皮质激素区域表达基因16(corticosteroids and regional expression 16,CR16)在特发性无精子症患者睾丸组织中的表达,探讨CR16在精子发生中的作用。方法:采用免疫组化法和逆转录-聚合酶链反应(RT-PCR)检测CR16蛋白和CR16 mRNA在48例特发性无精子症患者(病例组)和10例正常生育男性(正常组)睾丸组织中的表达情况。结果:CR16蛋白表达于睾丸生精小管上皮,主要分布在支持细胞与生精细胞连接区,在特发性无精子症患者睾丸组织中的表达显著弱于正常生育男性睾丸组织中的表达。CR16 mRNA在病例组睾丸组织中的表达水平显著低于正常组。结论:特发性无精子症患者睾丸组织中CR16表达水平显著降低,这可能与无精子症相关。