肾癌150例手术治疗方法对疗效的影响分析

[目的]探讨肾癌的临床诊断与手术治疗的方法和效果. [方法]对肾癌150例资料进行回顾性分析.以Kaplan-Meier法评估两种手术方法病人的存活率差异,用Log Rank Test和Generalized Wilcoxon Test分析预后因子对存活率的影响. [结果]诊断以B超、CT、MRI为主.AJCC临床分期:Ⅰ期56.67％ (85/150),Ⅱ期25.33％ (38/150),Ⅲ期11.33％ (17/150),Ⅳ期6.67％ (10/150).Ⅰ组行肾癌根治性切除术54.67％ (82/150),Ⅱ组行肾癌根治性切除加淋巴结清扫45.33％ (68/150).5年累积生存率:Ⅰ组为(77.52±3.46)％,Ⅱ组为(75.65±3.82)％;对数秩检验(Log Rank Test),两组累积生存率差异无统计学意义(x2=1.325,P=0.265), (risk ratio 1.86,95％ CI 0.71～4.53,P=0.254).两组5年累积生存率为75.86％+2.78％,其中pT1 (97.55±1.36)％,pT～pT4 (62.51±2.37)％,pT1与pT3-4比较pT1有更高的5年生存率(O dds ratio 0.264,95％CI0.075～0.972,P=0.038).肿瘤直径小于7 cm对生存率的影响有显著性(risk ratio 0.38,95％ CI 0.16～0.82,P=0.015).[结论]早期发现并早期根治性肾切除手术是肾 癌的主要治疗方法,淋巴结清扫不能明显提高患者生存率.     

双侧上尿路梗阻致肾功能不全200例分析

目的探讨双侧上尿路梗阻引起肾功能不全的诊断和治疗。方法对我院收治的200例双侧上尿路梗阻引起肾功能不全患者的临床资料进行回顾性分析。结果农村患者发病比例为86%,明显高于城镇患者（P〈0.05）。最主要的梗阻原因是尿路结石。用输尿管插管、经皮肾穿刺造瘘和手术方法及早引流,解除梗阻,治愈88.5%,好转11.5%,平均住院26.55 d,血BUN、Cr恢复正常平均22.85 d,术后第7天总体血BUN、Cr分别下降73.35%和57.25%。结论双侧上尿路梗阻引起肾功能不全是泌尿外科的急重症,尽早解除梗阻有利于肾功能的恢复。     

窄谱中波紫外线联合外用药治疗炎性线状疣状表皮痣一例北大核心CSCD

患者女,58岁,右侧臀部及下肢发疹伴瘙痒5年余就诊。5年前患者无明显诱因出现右大腿红色皮疹伴瘙痒,皮损逐渐增多增大变厚变硬,渐延及右臀部、右小腿和足背,瘙痒也日益严重。曾在当地医院就诊,给予外用药间断治疗,     

窄谱中波紫外线联合外用药治疗炎性线状疣状表皮痣一例

【摘要】 目的 评价窄谱中波紫外线(NB-UVB)联合卡泊三醇和卤米松局部序贯疗法治疗炎性线状疣状表皮痣的疗效及不良反应。 方法 分析我科收治的1 例成年后发病炎性线状疣状表皮痣的临床、病理、实验室检查特点及诊疗经过, 并对文献进行复习,以治疗前后的皮损变化评价疗效。结果 患者2周后瘙痒减轻;6周后部分皮损消退、部分皮损变平,痒感消失。无不良反应发生。结论 NB-UVB联合局部序贯疗法（卡泊三醇联合卤米松）可能是治疗ILVEN的一个安全有效的方法。     

CpG ODN刺激的寻常性银屑病中性粒细胞培养上清液对HaCaT细胞增殖的影响

Objective To investigate the role of nentrophils in the pathogenesis of psoriasis vulgaris. Methods Neutrophils were isolated from venous blood samples of 25 patients with psoriasis vulgaris (including 13 cases of active psoriasis and 12 cases of inactive psoriasis) as well as 25 normal human con-trols, and cultured. Then, these neutrophils were grouped and treated with lipopolysaccharide (LPS, 100 g/L),CpG-A (50 mg/L), CpG-B (50 mg/L), and RPMI 1640 culture medium, respectively, for 24 hours followed by the collection of culture supematants. Human keratinocytes (HaCaT) were cultured in the presence of su-pematants of treated or untreated nentrophils for 72 hours followed by the detection of cell proliferation with MTT assay. To determine the role of proinflammatory factors, SOD/CAT and monoclonal antibody to IL-8 and TNF-alpha of 400 u/mL were used to pretreat HaCaT cells 1 hour prior to the stimulation with super-natants of neutrophils. Results Compared with culture medium, the supematant of unstimulated neutrophils from normal controls or patients with inactive psoriasis had no significant effect on the proliferation of HaCaT cells (P ＞ 0.05), but that from patients with active psoriasis markedly promoted the proliferation of HaCaT cells (t = 2.41, P < 0.05). ARe, stimulation by LPS, CpG-A and CpG-B, the supematant of active patient-derived neutrophils significantly promoted the proliferation of HaCaT cells compared with that of normal control-derived nentrophils (t = 3.11, 2.89, 2.29, respectively, all P < 0.05). In comparison with tmstimulated neutrophils, the supematant from LPS- and CpG-A stimulated nentrophiles significantly accelerated the pro-liferation of HaCaT cells. Furthermore, the proliferation of HaCaT cells induced by the supematants of LPS-,CpG-A-, CpG-B-stimulated neutrophils from psoriatic patients was statistically suppressed by the pretreat-ment with the monoclonal antibody to IL-8, TNF-alpha and SOD/CAT (all P < 0.05). Conclusions In patients with psoriasis vulgaris, there is an abnormal secretion of IL-8, TNF-alpha and superoxide by neutrophils in peripheral blood, and these proinflammatory factors could promote the proliferation of HaCaT cells.     

寻常型银屑病患者中性粒细胞分泌炎性因子的研究

目的观察寻常型银屑病患者外周血中性粒细胞是否存在分泌炎性因子的异常,探讨中性粒细胞参与银屑病的机制。方法作中性粒细胞培养,应用酶联免疫吸附法检测脂多糖(LPS)刺激前后中性粒细胞分泌白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的水平,应用细胞色素C还原法检测LPS刺激前后中性粒细胞超氧阴离子(Superox-ide anion)的水平。结果在脂多糖刺激前、后,银屑病患者外周血中性粒细胞分泌的IL-8、TNF-α以及Superoxide anion水平均较正常人显著增高(P<0.05),且进行期患者上述炎性因子的分泌水平显著高于静止期患者(P<0.01)。银屑病患者病情严重程度(PASI评分)与中性粒细胞于脂多糖刺激前、后IL-8、TNF-α及Superoxideanion水平均呈正相关(P<0.05)。结论银屑病患者存在外周血中性粒细胞分泌炎性因子的异常,该种异常可能参与银屑病的发病与病情进展,其中可能有感染因素的介导。     

特发性嗜酸性粒细胞增多综合征1例

1 病历摘要 患者男,27岁.因四肢反复出现丘疹、斑块伴瘙痒2年至我科就诊.2年前患者无明显诱因四肢出现丘疹伴瘙痒,皮损逐渐增多,部分融合为斑块,皮损可缓慢自行消退,遗留淡褐色色素沉着,但不断有新发皮损出现.曾于外院诊断为"湿疹样皮炎",予以糖皮质激素治疗后皮损可消退,但停药后复发.     

侵犯前中颅底鼻咽纤维血管瘤病人的护理

鼻咽纤维血管瘤是发生于鼻咽腔的良性肿瘤,由于其血运极为丰富,常侵犯蝶窦、筛窦、翼腭窝及颞下窝、眼眶、甚至前中颅窝等颅底结构,手术切除十分困难.近年来,由于鼻内镜技术的发展,早期肿瘤全切率大为提高,同时并发症、复发率减少.但是侵犯颅内的晚期肿瘤,各种手术入路创伤巨大且复发率高,相关护理难度大,护理过程复杂.我科在开展了300多例经颅眶入路治疗前中颅底肿瘤的基础上,回顾分析其中16例侵犯前中颅窝的鼻咽纤维血管瘤病人的临床资料.报告如下.     

CpG ODN刺激的寻常性银屑病中性粒细胞培养上清液对HaCaT细胞增殖的影响

Objective To investigate the role of nentrophils in the pathogenesis of psoriasis vulgaris. Methods Neutrophils were isolated from venous blood samples of 25 patients with psoriasis vulgaris (including 13 cases of active psoriasis and 12 cases of inactive psoriasis) as well as 25 normal human con-trols, and cultured. Then, these neutrophils were grouped and treated with lipopolysaccharide (LPS, 100 g/L),CpG-A (50 mg/L), CpG-B (50 mg/L), and RPMI 1640 culture medium, respectively, for 24 hours followed by the collection of culture supematants. Human keratinocytes (HaCaT) were cultured in the presence of su-pematants of treated or untreated nentrophils for 72 hours followed by the detection of cell proliferation with MTT assay. To determine the role of proinflammatory factors, SOD/CAT and monoclonal antibody to IL-8 and TNF-alpha of 400 u/mL were used to pretreat HaCaT cells 1 hour prior to the stimulation with super-natants of neutrophils. Results Compared with culture medium, the supematant of unstimulated neutrophils from normal controls or patients with inactive psoriasis had no significant effect on the proliferation of HaCaT cells (P ＞ 0.05), but that from patients with active psoriasis markedly promoted the proliferation of HaCaT cells (t = 2.41, P < 0.05). ARe, stimulation by LPS, CpG-A and CpG-B, the supematant of active patient-derived neutrophils significantly promoted the proliferation of HaCaT cells compared with that of normal control-derived nentrophils (t = 3.11, 2.89, 2.29, respectively, all P < 0.05). In comparison with tmstimulated neutrophils, the supematant from LPS- and CpG-A stimulated nentrophiles significantly accelerated the pro-liferation of HaCaT cells. Furthermore, the proliferation of HaCaT cells induced by the supematants of LPS-,CpG-A-, CpG-B-stimulated neutrophils from psoriatic patients was statistically suppressed by the pretreat-ment with the monoclonal antibody to IL-8, TNF-alpha and SOD/CAT (all P < 0.05). Conclusions In patients with psoriasis vulgaris, there is an abnormal secretion of IL-8, TNF-alpha and superoxide by neutrophils in peripheral blood, and these proinflammatory factors could promote the proliferation of HaCaT cells.     

CpG ODN刺激的寻常性银屑病中性粒细胞培养上清液对HaCaT细胞增殖的影响

Objective To investigate the role of nentrophils in the pathogenesis of psoriasis vulgaris. Methods Neutrophils were isolated from venous blood samples of 25 patients with psoriasis vulgaris (including 13 cases of active psoriasis and 12 cases of inactive psoriasis) as well as 25 normal human con-trols, and cultured. Then, these neutrophils were grouped and treated with lipopolysaccharide (LPS, 100 g/L),CpG-A (50 mg/L), CpG-B (50 mg/L), and RPMI 1640 culture medium, respectively, for 24 hours followed by the collection of culture supematants. Human keratinocytes (HaCaT) were cultured in the presence of su-pematants of treated or untreated nentrophils for 72 hours followed by the detection of cell proliferation with MTT assay. To determine the role of proinflammatory factors, SOD/CAT and monoclonal antibody to IL-8 and TNF-alpha of 400 u/mL were used to pretreat HaCaT cells 1 hour prior to the stimulation with super-natants of neutrophils. Results Compared with culture medium, the supematant of unstimulated neutrophils from normal controls or patients with inactive psoriasis had no significant effect on the proliferation of HaCaT cells (P ＞ 0.05), but that from patients with active psoriasis markedly promoted the proliferation of HaCaT cells (t = 2.41, P < 0.05). ARe, stimulation by LPS, CpG-A and CpG-B, the supematant of active patient-derived neutrophils significantly promoted the proliferation of HaCaT cells compared with that of normal control-derived nentrophils (t = 3.11, 2.89, 2.29, respectively, all P < 0.05). In comparison with tmstimulated neutrophils, the supematant from LPS- and CpG-A stimulated nentrophiles significantly accelerated the pro-liferation of HaCaT cells. Furthermore, the proliferation of HaCaT cells induced by the supematants of LPS-,CpG-A-, CpG-B-stimulated neutrophils from psoriatic patients was statistically suppressed by the pretreat-ment with the monoclonal antibody to IL-8, TNF-alpha and SOD/CAT (all P < 0.05). Conclusions In patients with psoriasis vulgaris, there is an abnormal secretion of IL-8, TNF-alpha and superoxide by neutrophils in peripheral blood, and these proinflammatory factors could promote the proliferation of HaCaT cells.