经胸手术成功救治Dieulafoy病1例

我科在对上消化道大出血的救治中,曾行开胸手术成功救治1例食管下段Dieulafoy病患者.现报告如下.     

复印机操作工轻度锰中毒1例

复印机操作工轻度锰中毒１例乌兰照日格图唐克成张志忠患者女，２８岁，于１９９６年６月１０日头痛待查入院。患者为汉光优美１１５－Ｅ型复印机操作工。作业工龄４年，每日工作８～１０小时。在一间２０ｍ×２０ｍ×３ｍ的办公室进行复印工作，无任何防护措施。近两个月...     

中西医结合治疗脑卒中后抑郁的临床研究

目的：探讨脑卒中后抑郁应用中西医药物治疗效果。方法：选取2013年4月～2014年12月,我院接收的脑卒中后抑郁患者110例作为探究对象,按照患者进入我院接受治疗的先后顺序进行编号,选择其中的单号为对照组,双号为观察组,对照组和观察组分别有55例,对照组采用盐酸氟西汀片进行治疗,观察组在西药治疗的基础上应用中药进行治疗,对比两组临床治疗有效率以及患者治疗前后的HAMD评分情况。结果：观察组脑卒中后抑郁临床治疗有效率94.55％明显高于对照组的72.73％,差异显著（P＜0.05）;观察组采用中医药治疗后HAMD评分明显优于对照组,差异显著（P＜0.05）。结论：在脑卒中后抑郁临床治疗中应用中西医药物结合治疗能够显著改善临床治疗效果,改善患者抑郁程度,值得在临床推广。     

沉默YAP通过Wnt/β-catenin信号通路影响胃癌BGC823细胞的凋亡

目的 本研究探讨Yes相关蛋白（YAP）对胃癌BGC823细胞凋亡的影响。方法 BGC823细胞中转染YAP小干扰RNA（YAP siRNA1、YAP siRNA2）,用qRT-PCR和蛋白质印迹法分别测定细胞中YAP表达,筛选干扰效果较好的YAP siRNA1做后续实验。MTT测定细胞增殖,平板克隆实验测定克隆形成能力,流式细胞术测定凋亡情况,分光光度法检测Caspase-3、Caspase-9活性,蛋白质印迹法检测β-catenin、c-myc、CyclinD1蛋白水平。用Wnt/β-catenin的激活剂处理下调YAP后的BGC823细胞,按照上述方法测定细胞增殖凋亡和克隆形成能力。结果 YAP siRNA1、YAP siRNA2下调BGC823细胞中YAP的转录和表达,YAP siRNA1对YAP表达的干扰效率较好。敲低YAP后的细胞增殖能力、克隆形成能力降低,细胞凋亡率由（6.32±0.58）%升高至（32.71±2.64）%,Caspase-3、Caspase-9活性升高,β-catenin、c-myc、cyclinD1蛋白表达减少,与正常培养的BGC823细胞相比,差异有统计学意义（P<0.05）。Wnt/β-catenin的激活剂处理可以部分逆转敲低YAP对BGC823细胞的凋亡、增殖、克隆形成能力和细胞中Caspase-3、Caspase-9活性的影响。结论 YAP敲低诱导胃癌细胞凋亡,且作用机制与抑制Wnt/β-catenin通路激活有关。     

四大淮药的药对配伍及临床应用

四大淮药是指淮菊花、淮山药、淮地黄、淮牛膝.一张疗效可靠的处方,用药针对性强,恰中病情,还须立法严谨,用药主次分明,要做到这一点,就必须善于巧妙地配伍.四大淮药在临床中的应用非常广泛,四大淮药配伍对临床医疗用药有着实际性的指导意义.     

TopoⅡ、Ki-67、P53在胃食管结合部腺癌新辅助化疗疗效预测中的意义

目的探讨TopoⅡ、Ki-67和P53在SiewertⅡ型胃食管结合部腺癌中的表达与化疗敏感性之间的关系。方法回顾性分析本院2010年6月~2013年12月行新辅助化疗的胃食管结合部腺癌患者72例。对所有患者均行SOX方案化疗,以RECIST 1.0评价标准评价疗效。用免疫组化方法评价3种蛋白的表达情况,分析各蛋白表达情况及与化疗疗效的关系。结果年龄和病理类型与化疗敏感性无关,本组72例患者中新辅助化疗有效率为48.6%,其中5例达病理完全缓解。3种蛋白的表达情况分别为:TopoⅡ阳性率为73.6%,Ki-67阳性率为59.7%,P53阳性率为33.3%。Ki-67和P53的表达与化疗敏感性有关(P=0.023,P=0.031),但TopoⅡ的表达与化疗敏感性无关(P>0.05)。结论 Ki-67高表达和P53低表达是AGEJ SOX方案新辅助化疗敏感性的影响因素,为AGEJ个体化新辅助化疗方案的选择提供有益的参考。     

甲型H1N1流感34例临床分析

目前，甲型H1N1流感防控形势严峻，故提高早期诊断率，有助于控制疫情的蔓延，有助于减少并发症的发生。我院发热门诊在2009年5～10月诊断甲型H1N1流感34例。现分析报告如下。     

呼和浩特市部分地区重点人群碘营养现状

目的了解全民食用碘盐以来呼和浩特市部分地区孕妇、哺乳妇女、0～4岁婴幼儿碘营养状况。方法尿碘采用过硫酸铵消化一砷铈接触法：盐碘采用GB／T13025．7-1999中直接滴定法。结果孕妇尿碘中位数为220．9Bg／L,哺乳妇女尿碘中位数为207．4gg／L,0～4岁婴幼儿尿碘中位数为191．9Bg／L;居民碘盐覆盖率、碘盐合格、合格碘盐食用率均在95％以上,非碘盐率为0．94％。结论居民碘盐质量总体良好,3种人群碘养状况良好,总体上在一个的适宵水平。     

2007-2008年内蒙古自治区碘缺乏病高危地区病情及碘营养现状调查

目的 了解内蒙古碘缺乏病高危地区是否存在新发地方性克汀病病例,掌握地方性甲状腺肿(简称甲肿)流行现况及综合防治措施落实情况,为制订碘缺乏病的防治策略提供依据.方法 2007-2008年,在内蒙古历史地克病流行严重的松山区、克什克腾旗、喀喇沁旗,扎赉特旗、卓资县,凉城县、清水河县、和林县、东胜区、准格尔旗、伊金霍洛旗等11个旗(县、区),对10岁以下儿童进行新发地克病病例搜索;每个旗(县、区)选择3～5个乡,每个乡选择3～5个村小学,每所小学选择120～200名8～10岁儿童,进行甲状腺检查、智商和尿碘检测;每个乡选择2个村,每个村选择30个居民户,检测家庭主妇尿碘及家中食用盐含碘量情况.结果 11个项目旗(县、区)共搜索出56例疑似新发地克病病例,无确诊病例.触诊法和B超法检查8～10岁甲状腺,甲肿率分别为5.2%(309/5922)、4.3%(252/5922);8～10岁儿童尿碘中位数为241.5μg/L,尿碘为100.0～300.0 μg/L占65.9%(3901/5920).其中9个项目旗(县、区)的尿碘中位数在200.0～300.0μg/L,尿碘<50.0μg/L所占的比例>5%的旗(县、区)为0,<100.0μg/L所占的比例>10%的有1个.家庭主妇的尿碘中位数为225.6μg/L,<50.0μg/L占2.2%(35/1597).<100.0 μg/L所占比例>10%的旗(县、区)有4个.调查的2109户居民中有97.45%(2055/2109)的存食用碘盐,有2.55%(54/2109)的居民食用无碘盐.结论 调查的11个项目旗(县、区)儿童甲肿率降至10%以下,未发现新发克汀病病例,防治成绩显著;儿童和育龄妇女碘营养水平基本适宜;碘盐覆盖率高、销售网络比较健全、价格合理、购买方便,食盐加碘为主消除碘缺乏病防治措施得到有效的落实,儿童的智力得到有效保护.碘缺乏病健康教育仍然是防治工作中的一个薄弱环节,亟待加强.

Abstract：

Objective To investigate new cases of endemic cretinism in high-risk areas of Inner Mongolia, the prevalence of endemic goiter, the implementation of comprehensive measures, and to provide scientific basis for developing control strategies against iodine deficiency disorders (IDD). Methods In 2007 and 2008, a search for new cretin cases was conducted among children under the age of 10 in 11 historical serious epidemic cretinism prevalent areas of Songshan district, Keshiketeng qi, Kalaqin qi, Zhalaite qi, Zhuozi county,Liangcheng county, Qingshuihe county, Helin county, Dongsheng district, Zhungeer qi and Yinjinhuoluo qi. Three to 5 towns were selected in each qi(county, district) and 3 to 5 village primary schools were selected in each town.One hundred and twenty to 200 children aged 8 to 10 were selected in each school to inspect thyroid by B ultrasound and palpation and to test intelligence and urinary iodine. Two villages were selected in each town and 30 households were selected to determine urinary iodine of housewives and salt iodine. Results A total of 56 cases of suspected cases of endemic cretinism were found from the 11 counties but no case was confirmed. The goiter rate of children aged 8 to 10 was 5.2% (309/5922) by palpation and 4.3% (252/5922) by B-ultrasound. The median urinary iodine of children aged 8 to 10 was 241.5 μg/L, and urinary iodine was 100 to 300 μg/L, accounted 65.9%(3901/5920). Median urinary iodine of the 9 Qis(counties, districts) was in the range of 200 and 300μg/L.Higher than 5% of the 11 Qis(counties, districts) with urinary iodine lower than 50 μg/L was zero. Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 1. The median urinary iodine of housewives was 225.6 μg/L, and lower than 50 μg/L accounted for 2.2%(35/1597). Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 4. A total of 2109 households were investigated and 97.45%(2055/2109) of them ate iodized salt and 2.55%(54/2109) of them ate non-iodized salt. Conclusions In the 11 investigated counties, goiter rate of children has decreased to less than 10%, and no new cretin was found. It could be concluded that the fulfillment of prevention and control of IDD is effective. The iodine nutrition of children and women of childbearing age is in an adequate level. The coverage rate of iodized salt has maintained at a higher level, the sales network is sound, the salt price is reasonable and salt is easy to get and the children's intelligence is protected effectively. But, the health education about IDD is still weak, need to be reinforced.