显微手术联合光动力治疗恶性脑胶质瘤

恶性脑胶质瘤是临床最为常见的颅内肿瘤,其生物学特性为侵润生长,边界不清,手术难以全切除,手术后极易复发[1,2],目前主要的治疗方法是手术加其他综合治疗[3].作者自2003年1月至2006年12月应用显微手术联合光动力治疗恶性脑胶质瘤30例取得较为满意的效果,现总结如下.     

腰椎色素性神经鞘瘤1例并文献复习

患者 女,29 岁,腰痛伴双下肢感觉麻木 30 d 余.查体:L3 右侧缘压痛,右大腿感觉减退.实验室检查:白细胞计数10.2×109/L,中性粒细胞百分数79.7％,C反应蛋白131.4 mg/L,结核感染T细胞检测 1.26,糖类抗原 72-411.29 U/mL. CT检查:L3椎体及右附件骨质破坏区内小点状骨质...     

鼻腔平滑肌肉瘤1例及文献复习

目的:探讨鼻腔平滑肌肉瘤(leiomyosarcoma,LMS)的临床病理特征及鉴别诊断.方法:观察1例鼻腔原发LMS的临床表现、组织学特征和免疫组化特点,并复习相关文献.结果:患者,男,62岁,因左鼻塞流涕2月余入院,术后结果显示肿瘤由梭形细胞束组成,细胞核呈卵圆形或短梭形,两端钝圆,部分细胞核仁肥胖,胞浆嗜酸性,染色质粗糙;细胞核异型性明显,核分裂3~5个/10HPF,间质可见粘液变性,部分区域可见坏死.免疫组化显示瘤细胞SMA、Vimentin、Calponin和Desmin均(+).结论:平滑肌肉瘤是鼻及鼻窦部分少见的软组织恶性肿瘤,侵袭性较高,临床预后较差.     

术前CT血管成像在股前外侧穿支皮瓣移植中的临床应用

目的 探讨术前CTA在股前外侧穿支皮瓣移植中的准确性和实用性.方法 15例行股前外侧穿支皮瓣移植患者,术前行CTA检查,分析穿支动脉走行情况,对穿支动脉参数进行测量,选出最适合的穿支用于手术,观察并测量术中穿支相关参数与影像测量进行对照.采用配对t检验对比CTA与术中测量穿支的直径和起始位置距离的差异.结果 15例患者中,1例CTA和术中均未发现符合要求的穿支,后转用腹壁皮瓣移植.14例患者CTA设计的穿支动脉的直径和起始位置(垂直距离和水平距离)影像测量值与术中测量值差异无统计学意义(P＞0.05);穿支类型与术中发现一致,肌间隙型4例,肌皮支型10例.CTA显示穿支的准确性为100％.15例患者的移植皮瓣均存活,供区无坏死.结论 在股前外侧穿支皮瓣移植术中,术前CTA能准确提供穿支动脉的直径、类型和起始位置方面的信息,是一种准确、实用的方法,可提高皮瓣移植手术的成功率和安全性.     

转化生长因子β_1基因标签单核苷酸多态性与新疆汉族原发性高血压相关性研究

Objective Essential hypertension (EH) was a complex disease resulted from the interaction of cumulative effect of multiple genetic and environment factors. The relationship between the genetic polymorphisms in the transforming growth factor-β_1 ( TGF-β_1 ), the blood levels and EH have been investigated, but the conclusions were different. Therefore, we investigate the relationship between the tagging single nucleotide polymorphisms (tSNPs) ( rs1800469, rs2241716, rs11466345, rs2241715,rs4803455) in TGF-β_1 gene, blood levels and EH in the Han nationality population in Xinjiang, to clarity the pattern of linkage disequilibrium (LD) and the feature of the structure of haplotype. Methods Based on the case-control study,we selected 732 (365 EH patients,367 controls) Han Chinese population from the Boertonggu countryside of Shawan region in the Xinjiang Uygur Autonomous Region of China by random cluster sampling. After questionnaire and physical examination, we collected blood samples, and the blood levels of TGF-β_1, were quantified using sandwich ELISA. The polymorphisms of TGF-β_1 gene in the study groups were detected with SNaPshot system. The case-control study in a large group was carried out separately for each of the tSNP and followed up by haplotypes analyses to determine the relation between tSNPs of TGF-β_1 gene and EH in the Han population. Results ( 1 ) The frequencies of alleles A, G of rs11466345 of TGF-β_1, gene in EH group and control group were as follows: 69.7%, 30. 3% ,74.4%,25.6%, respectively. It was demonstrated that the G allele of the rs11466345 polymorphism occurred at a significantly higher frequency in EH patients than in healthy controls (30. 3% vs. 25. 6%, P <0. 05). The rs11466345G-allele carriers had a significantly increased risk of EH compared to rs11466345A -allele carrier ( OR = 1. 261 ; P <0. 05). The frequencies of genotypes and alleles of the other tSNPs of TGF-β_1 gene had no difference between EH patients and controls ( P > 0. 05 ). (2) Except the site of rs11466345, the other tSNPs were in strong LD, and no statistical differences were observed in haplotypes distribution in the followup study between case-control groups (P >0. 05). (3) There were no difference of TGF-β_1 levels between the different genotypes and alleles in tSNPs of TGF-β_1 gene ( P > 0. 05 ). Conclusions ( 1 ) These results suggested that TGF-β_1 gene rs11466345 G allele was likely to be a genetic susceptibility factor for EH in the Xinjiang Han population, the other tSNPs perhaps had no association with EH of in the study groups. (2) Except rs11466345, the other tSNPs were in strong LD, and the haplotypes reconsreucted by tSNPs might not be associated with EH in the Han nationality populations. (3) There was no association between the tSNP of TGF-β_1 gene and TGF-β_1 blood levels in the Xinjiang Han nationality population.     

原发性胃浆细胞瘤1例

病例 男,79岁,因“进食后反复上腹部疼痛1月”来我院就诊.患者平素身体健康,否认有特定疾病史,体格检查上腹部轻压痛,无反跳痛,实验室检查结果均正常.     

儿童支气管黏液表皮样癌1例报道

黏液表皮样癌是肺癌中很少见的一种类型,具有低度恶性的特点。该瘤一般生长缓慢,病程长,预后较好,发病多见于中、青年,儿童少见。现报道1例4岁儿童肺黏液表皮样癌,并结合文献讨论其临床病理学特征及免疫组化表型。     

曲美他嗪联合普伐他汀治疗不稳定型心绞痛的临床观察

目的 观察曲美他嗪联合普伐他汀治疗不稳定型心绞痛（UA）的临床疗效.方法 将102例UA患者随机分为治疗组52例,对照组50例.对照组给予硝酸酯类、β受体阻滞剂等常规治疗及普伐他汀20 mg/d,治疗组在此基础上加用曲美他嗪20 mg,3次/d,睡前口服,连服8 w.疗程结束后观察心绞痛控制情况、动态心电图变化及血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白-胆固醇（HDL-C）、低密度脂蛋白- 胆固醇（LDL-C）变化.结果 疗程结束后,治疗组的心绞痛控制情况优于对照组（P＜0.05 ）,动态心电图ST段最大下降幅度、ST段下降时间、缺血发作次数明显优于对照组（P＜0 .01）,两组间比较血脂变化无明显差异（P＞0.05）.结论曲美他嗪、普伐他汀联合治疗UA效果好,不良反应少.