有效的膀胱冲洗治疗泌尿系感染的体会

目的通过比较三种膀胱冲洗的方法治疗尿路感染为临床工作提供一种有效解决尿路感染的方法.方法 将ICU尿路感染患者60例随机分为3组,一组采用生理盐水250ml、庆大霉素8万单位进行膀胱冲洗,2/日;第二组采用生理盐水200ml、庆大霉素8万单位膀胱冲洗,闭管30分钟后,再应用800ml生理盐水反复冲洗2/日;第三组为单纯生理盐水1000ml膀胱冲洗2/日.结果 三组膀胱冲洗前3天比较无显著差异,5天后第一组与第二组尿常规及培养结果比较有显著差异,第二组与第三组无显著差异,不具有统计学意义.结论 有效的膀胱冲洗能够促进患者恢复,减少抗生素应用.     

细针穿刺标本M2型丙酮酸激酶基因检测在甲状腺乳头状癌诊断中的价值

目的 探讨细针穿刺标本M2型丙酮酸激酶基因检测在甲状腺乳头状癌诊断中的价值。方法 对行甲状腺结节细针穿刺检查的120例甲状腺结节患者(125个结节)应用细针穿刺采集标本,采用实时定量聚合酶链反应检测M2型丙酮酸激酶mRNA表达量,采用免疫组化技术检测术后组织中的M2型丙酮酸激酶蛋白表达。结果 本组120例患者共计125个结节,其中良性结节37个,甲状腺乳头状癌88个,甲状腺乳头状癌的M2型丙酮酸激酶mRNA表达量显著高于良性结节(P<0.05)。甲状腺乳头状癌的M2型丙酮酸激酶基因表达量在肿瘤最大直径方面存在显著差异(P<0.05),在年龄、性别、结节数目、BRAFV^600E基因型、淋巴结转移及美国癌症协会分期方面无统计学差异(P>0.05)。M2型丙酮酸激酶基因诊断甲状腺乳头状癌的特异度为95.7%,敏感度为46.9%,准确度为62.8%,阴性预测值为46.4%,阳性预测值为95.8%;联合检测M2型丙酮酸激酶基因、BRAFV^600E基因诊断甲状腺乳头状癌的敏感度、准确度显著高于单独检测M2型丙酮酸激酶基因、BRAFV     

MRI、MSCT对腕关节隐匿性骨折的诊断价值

目的比较磁共振成像(MRI)与多层螺旋CT(MSCT)对腕关节隐匿性骨折的诊断价值。方法回顾性选取2019年1月至2021年3月在我院诊治的83例疑似腕关节隐匿性骨折患者作为研究对象,均行MRI、MSCT检查。分析MRI、MSCT对腕关节隐匿性骨折的诊断结果及其与手术结果的一致性;以手术结果为金标准,比较MRI、MSCT对腕关节隐匿性骨折的诊断效能;比较MRI、MSCT对腕关节隐匿性骨折的检出情况;比较MRI、MSCT对不同部位腕关节隐匿性骨折的诊断准确度。结果手术结果显示,83例患者中有74例确诊为腕关节隐匿性骨折,占89.16%。Kappa检验结果显示,MRI诊断结果与手术结果的一致性极强,Kappa值为0.875;MSCT诊断结果与手术结果的一致性较弱,Kappa值为0.311。以手术结果为金标准,MRI对腕关节隐匿性骨折的诊断准确度、灵敏度、阴性预测值分别为97.59%、98.65%、88.89%,高于MSCT的79.52%、81.08%、30.00%(P<0.05);MRI对腕关节隐匿性骨折的诊断特异度、阳性预测值分别为88.89%、98.65%,与MSCT的66.67%、95.24%比较,差异无统计学意义(P>0.05)。MRI、MSCT诊断腕关节隐匿性骨折的误诊率比较,差异无统计学意义(P>0.05);MRI诊断腕关节隐匿性骨折的符合率高于MSCT,漏诊率低于MSCT(P<0.05)。手术结果显示,74例腕关节隐匿性骨折中,骨折部位为小多角骨4例(5.41%)、腕骨55例(74.32%)、长干骨15例(20.27%);MRI检查结果显示,骨折部位为小多角骨4例、腕骨54例、长干骨15例;MSCT检查结果显示,骨折部位为小多角骨4例、腕骨43例、长干骨13例。MRI、MSCT对小多角骨、腕骨、长干骨骨折的诊断准确度比较,差异无统计学意义(χ^(2)=0.000、1.912、0.065,P=1.000、0.167、0.799)。结论MRI对腕关节隐匿性骨折的诊断准确度、灵敏度、阴性预测值均高于MSCT,与手术结果具有高度一致性。     

Joint detection and clinical analyse of urine β_2-microglobulin,albumin and immunoglobulin G in patients with hyperthyroidism

Objective To evaluate the clinical significance of joint detection of urine β_2-microglobulin(β_2-MG),albumin(Alb)and immunoglobulin G(IgG)in patients with hyperthyroidism Methods Urine β_2-MG,Alb,IgG and serum thyroid hormone free trilute(FT_3),free thyroxin(FT_4)of 45healthy volunteers(as control group)and 120 patients with hyperthyroidism were measured by radioimmunoassay(RIA).Results The urine β_2-MG,Alb and IgG in the hyperthyroidism group(including the primary group(group A)and uncured group(group B))were distinctly higher than those in control group and hyperthyroidism cured group(group C)(t=6.682,P<0.01).It was distinctly higher in hyperthyroidism group B than that in hyperthyroidism group A(t=2.385,P<0.05).And there was no distinct difference between the control group with hyperthyroidism group C in urine β_2-MG,Alb and IgG(t=0.568,P>0.05).There was favorable correlation between the urine β_2-MG,Alb and IgG with serum FT3 and FT4(the related coeflicients were 0.98,0.88,0.93,0.87,0.94,and 0.85 respectively).Conclusion It is important to measure urine β_2-MG together with Alb and IgG in early judgment of the location and degree of kidney injury,as well as the severity of disease in patients with hyperthyroidism.     

通络散预防骨科术后下肢深静脉血栓形成

骨科大手术后易发生下肢深静脉血栓形成（DVT）,影响病人的康复,且有造成肺栓塞（PE）的可能,导致猝死。目前预防治疗多采用低分子肝素皮下注射,虽取得了较好的效果,但可增加术后出血的发生率。尤其对手术需要施行硬膜外麻醉等神经系统周围操作时风险更大。笔者近年来开展中药“通络散”预防骨科大手术后下肢深静脉血栓形成（DVT）的临床研究,并同时将中药防治组、西药防治组以及文献报道未预防组,采用双盲法进行对比观察,现报告如下。     

人肺腺癌PD-L 1的表达及与C D8+T淋巴细胞的相关性

目的 研究人肺腺癌程序性死亡因子配体1(PD-L1)的表达及与肿瘤中CD8+T淋巴细胞的相关性.方法 选取收治的肺腺癌患者80例,取患者手术切除癌组织及癌旁组织标本,Western blot法检测PD-L1表达,采用四色荧光流式细胞仪检测CD8+T淋巴细胞的表达情况,分析其与患者临床病理特征关系,采用Pearson相关...     

99Tcm-二亚乙基三胺五乙酸与99Tcm-奥曲肽眼眶显像在甲状腺相关性眼病中的对比研究

Objective Through a comparative study of 99Tcm-diethylenetriaminepentaacetic acid (99Tcm-DTPA) and 99Tcm-octreotide (99Tcm-OCT) SPECT orbital scan, evaluated the clinic significance of two imaging of estimation activity in thyroid associated ophthalmopathy (TAO). Methods Aeording to the elinnic activity score (CAS), 26 TAO patients were divided into two groups: active group (CAS ≥3) and inactive group (CAS<3), 14 volunteers (control group) participates this study. Orbit scan were completed after intravenously injection with 99Tcm-DTPA 740 MBq and 99Tcm-OCT (every other day). Obtaining the uptake ratio (UR) of two kinds of orbit scans. The statistical analyses included Paired-samples t test analysis of variance and Spearman regression analysis. Results There is no statistically significance between the two methods in UR (t=0.075, P>0.05). There is a statistically significant correlation was found between CAS and the uptake ratios(99Tcm-DTPA: r=0.835, P<0.001; 99Tcm-OCT: r=0.912, P<0.001). Conclusions There is a good uniformity between 99Tcm-DTPA and 99Tcm-OCT orbital scan; 99Tcm-DTPA is a feasible and maybe a new promising estimation method of activity in the patients with TAO.     

心肌细胞肥大中番茄红素对自噬的作用

目的 探讨在血管紧张素Ⅱ（AngⅡ）诱导的心肌肥大中,番茄红素对自噬的影响.方法 原代培养的乳鼠心肌细胞,采用AngⅡ干预建立心肌肥大的模型;用番茄红素和自噬的阻断剂3-甲基腺嘌呤（3MA）干预.在光学显微镜下观察心肌细胞的形态;采用Western blot法检测自噬相关基因6（Atg6）Beclin1及自噬相关基因8（Atg8）LC3蛋白的表达;Real time PCR技术检测心肌细胞肥大标志物心房利钠多肽（ANP）的mRNA表达.结果 在AngⅡ诱导的心肌肥大中[细胞面积（517.19±52.31）;ANP相对含量（17.83±2.07）],番茄红素[细胞面积（355.82±40.45）;ANP相对含量（12.16±1.41）]缓解了心肌细胞面积的增加（F=56.518,P＜0.05）,下调了ANP的mRNA表达水平（F=157.048,P＜ 0.05）.番茄红素增加了心肌肥大时自噬相关基因Beclin1[蛋白相对含量（0.685±0.058）,F=202.873,P＜0.05]和LC3蛋白相对含量[（0.608±0.045）,F=177.114,P＜0.05]蛋白的表达.自噬阻断剂3MA降低了番茄红素对心肌细胞肥大的抑制作用（P＜0.01）.结论 番茄红素可能通过激活自噬来抑制心肌细胞肥大.     

MSCT在大血管疾病检查中的应用

自薄层CT扫描 (MSCT)问世并用于临床以来 ,CT检查无论在图像质量精细程度 ,还是在应用范围和特殊功能方面均已有了划时代的发展和进步。特别是MSCT血管成像 (MSCTA)技术 ,以其准确真实 ,安全无创的特点 ,在大血管疾病的检查中发挥着越来越重要的功能和不可替代的作用。1　MSCT进行大血管检查的优势1.1　范围明显扩大　MSCT管球的一次旋转可采集多层数据 ,加之 ,球管的热容量增大 ,可进行较长时间的扫描。因此 ,允许进行大范围的血管扫描 ,如进行全身动脉血管成像。若采用 3mm层厚 ,螺距为 6 .0 ,4层 /转 ,扫描最大范围可达到 1.8m…     

99Tcm-二亚乙基三胺五乙酸与99Tcm-奥曲肽眼眶显像在甲状腺相关性眼病中的对比研究

Objective Through a comparative study of 99Tcm-diethylenetriaminepentaacetic acid (99Tcm-DTPA) and 99Tcm-octreotide (99Tcm-OCT) SPECT orbital scan, evaluated the clinic significance of two imaging of estimation activity in thyroid associated ophthalmopathy (TAO). Methods Aeording to the elinnic activity score (CAS), 26 TAO patients were divided into two groups: active group (CAS ≥3) and inactive group (CAS<3), 14 volunteers (control group) participates this study. Orbit scan were completed after intravenously injection with 99Tcm-DTPA 740 MBq and 99Tcm-OCT (every other day). Obtaining the uptake ratio (UR) of two kinds of orbit scans. The statistical analyses included Paired-samples t test analysis of variance and Spearman regression analysis. Results There is no statistically significance between the two methods in UR (t=0.075, P>0.05). There is a statistically significant correlation was found between CAS and the uptake ratios(99Tcm-DTPA: r=0.835, P<0.001; 99Tcm-OCT: r=0.912, P<0.001). Conclusions There is a good uniformity between 99Tcm-DTPA and 99Tcm-OCT orbital scan; 99Tcm-DTPA is a feasible and maybe a new promising estimation method of activity in the patients with TAO.