胆囊后-前三角解剖法在腹腔镜胆囊切除术中的应用

目的:探讨胆囊后—前三角的解剖法在腹腔镜胆囊切除术(Lapardscopic cholecy stectomg,LC)中的合理运用。方法:回顾性分析200例腹腔镜胆囊切除术的临床资料。结果:198例成功手术,其中2例合并其他疾病中转开腹手术,1例行腔镜下胆总管切开取石术。结论:胆囊后—前三角解剖法是一种安全、容易掌握、并发症发生率低的手术方法。     

2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化调查

目的 调查2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化患病情况,探讨水源性高碘与颈动脉粥样硬化发生的关系.方法选择山东省郓城县和巨野县作为高碘病区和对照区,以郓城县的大陈楼村、魏垓村、刘一村和二十里铺村为高碘病村,以巨野县的章西村、毕海南村、夏官屯和祁集村为对照村.利用彩超对40岁以上的高碘病区居民299人和对照区居民323人进行颈动脉粥样硬化检查、诊断和记分.结果大陈楼村、魏垓村、刘一村和二十里铺村4个高碘病村成人颈动脉粥样硬化检出率分别为47.1%(33/70)、62.2%(51/82)、67.5%(52/77)和58.6%(41/70);章西村、毕海南村、夏官屯和祁集村4个对照村成人颈动脉粥样硬化检出率分别为40.7%(35/86)、40.8%(31/76)、38.2%(34/89)和37.5%(27/72).高碘病村和对照村成人颈动脉粥样硬化检出率按年龄标准化后分别为45.81%、58.18%、61.63%、55.34%和34.66%、36.25%、43.01%、41.30%,高碘病村的检出率高于对照村(T=26,P＜0.05).高碘病区299人中,检出阳性163人、阴性136人,0分136人、1～3分120人、4～7分43人;对照区323人中,检出阳性122人、阴性201人,0分201人、1～3分87人、4～7分35人.高碘病区与对照区成人颈动脉粥样硬化阳性检出情况及病变严重程度比较,差异有统计学意义(x2值分别为17.54、18.42,P均＜0.01).结论高碘病区成人动脉粥样硬化检出率增高、病变严重程度增大.

Abstract：

Objective To survey the prevalence rates of adult carotid atherosclerosis in water-sourceoriginated high iodine area in Shandong province in 2008 and discuss the relationship between water-sourceoriginated high iodine and carotid atherosclerosis occurrence. Methods Yuncheng county was chosen as observation area which included Dachenlou, Weigai, Liuyi and Ershilipu villages. Juye county was chosen as control that included Zhangxi, Bihainan, Xiaguan and Qiji villages. Two hundred and ninety-nine participants aged over 40 from water-source-originated high iodine areas and 323 residents aged over 40 from normal iodine areas were investigated.Portable-type B mode color Doppler was performed to examine the carotid artery of all participants. The adult carotid atherosclerosis was diagnosed and graded through the ultrasonograms. Results The prevalence rates of adult carotid atherosclerosis in the 4 water-source-originated high iodine villages of Dachenlou, Weigai, Liuyi and Ershilipu were 47.1% (33/70) ,62.2% (51/82) ,67.5% (52/77) and 58.6% (41/70), respectively and the prevalence rates of adult carotid atherosclerosis in the 4 normal iodine villages of Zhangxi, Bihainan, Xiaguan and Qiji were 40.7%(35/86),40.8% (31/76),38.2% (34/89) and 37.5% (27/72), respectively. The prevalence rates of adult carotid atherosclerosis standardized by age in the 4 high iodine villages and the 4 normal iodine villages were 45.81% ,58.18% ,61.63%,55.34% and 34.66%,36.25%,43.01% ,41.30%, respectively. The prevalence rates were higher in high iodine villages than that in control villages(T = 26, P ＜ 0.05 ). There were 136 people scored "0", 120 people scored "1 -3",43 people scored "4 - 7", and total 299 people. There were 201 people scored "0", 87 people scored "1 - 3", 35 people scored "4 - 7", and total 323 people. The expected prevalence rates and severity of adult carotid atherosclerosis was significantly different between high iodine area and normal iodine area (x2 = 17.54,18.42, all P ＜ 0.01).Conclusion The prevalence rate and severity of adult atherosclerosis in water-source-originatod high iodine area is higher than that in normal iodine area.     

2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化调查

Objective To survey the prevalence rates of adult carotid atherosclerosis in water-sourceoriginated high iodine area in Shandong province in 2008 and discuss the relationship between water-sourceoriginated high iodine and carotid atherosclerosis occurrence. Methods Yuncheng county was chosen as observation area which included Dachenlou, Weigai, Liuyi and Ershilipu villages. Juye county was chosen as control that included Zhangxi, Bihainan, Xiaguan and Qiji villages. Two hundred and ninety-nine participants aged over 40 from water-source-originated high iodine areas and 323 residents aged over 40 from normal iodine areas were investigated.Portable-type B mode color Doppler was performed to examine the carotid artery of all participants. The adult carotid atherosclerosis was diagnosed and graded through the ultrasonograms. Results The prevalence rates of adult carotid atherosclerosis in the 4 water-source-originated high iodine villages of Dachenlou, Weigai, Liuyi and Ershilipu were 47.1% (33/70) ,62.2% (51/82) ,67.5% (52/77) and 58.6% (41/70), respectively and the prevalence rates of adult carotid atherosclerosis in the 4 normal iodine villages of Zhangxi, Bihainan, Xiaguan and Qiji were 40.7%(35/86),40.8% (31/76),38.2% (34/89) and 37.5% (27/72), respectively. The prevalence rates of adult carotid atherosclerosis standardized by age in the 4 high iodine villages and the 4 normal iodine villages were 45.81% ,58.18% ,61.63%,55.34% and 34.66%,36.25%,43.01% ,41.30%, respectively. The prevalence rates were higher in high iodine villages than that in control villages(T = 26, P ＜ 0.05 ). There were 136 people scored "0", 120 people scored "1 -3",43 people scored "4 - 7", and total 299 people. There were 201 people scored "0", 87 people scored "1 - 3", 35 people scored "4 - 7", and total 323 people. The expected prevalence rates and severity of adult carotid atherosclerosis was significantly different between high iodine area and normal iodine area (x2 = 17.54,18.42, all P ＜ 0.01).Conclusion The prevalence rate and severity of adult atherosclerosis in water-source-originatod high iodine area is higher than that in normal iodine area.     

α-玉米赤霉醇对肿瘤坏死因子α诱导的人内皮细胞活性氧产生及其激活信号通路的影响

目的 探讨α-玉米赤霉醇对肿瘤坏死因子α(TNF-α)刺激的人脐静脉内皮细胞中活性氧(ROS)产生及其对激活信号通路的影响.方法 用小分子RNA干扰(siRNA)技术消除人脐静脉内皮细胞的NADPH氧化酶p47phox亚基;用分子探针2,7-DCF测定细胞内ROS的产生量;用RT-PCR测定p47phoxmRNA的表达以及用细胞免疫组化方法测定p47phox蛋白的表达;用Western印迹测定ERK<,2>及核因子(NF)-кB、应激蛋白(SP-1)和活化因子蛋白的表达.结果 TNF-α刺激使细胞内ROS的产生量较对照组高155.4%;α-玉米赤霉醇预处理能够剂量依赖地抑制TNF-α对ROS的诱导效应.TNF-α作用细胞24 h后,p47phox的mRNA表达水平较对照组高212.8%,蛋白的表达也明显高;α-玉米赤霉醇预处理使TNF-α诱导的p47phox mRNA表达水平低63.0%,蛋白表达水平也明显下降.p47phox的siRNA完全阻断TNF-α诱导ROS的产生.α-玉米赤霉醇预处理和p47phox的siRNA均阻断TNF-α对细胞外信号调控激酶的激活和转录因子SP-1的核转位,明显地抑制了NF-кB的核转位.结论 α-玉米赤霉醇能够抑制内皮细胞中TNF-α诱导的ROS的产生及由ROS激活的信号转导通路,主要机制是通过抑制NADPH氧化酶p47phox亚基的表达.     

阑尾类癌16例临床诊治分析

目的探讨阑尾类癌的临床特点及诊治经验。方法对1990年1月~2005年1月收治的16例阑尾类癌病人的临床资料进行回顾性分析。结果16例病人中无1例术前明确诊断,均为术中发现或术后病理确诊。肿瘤直径<1 cm 11例,1~2 cm3例。>2 cm 2例。12例肿瘤浸润深度限于黏膜下或肌层,2例侵及浆膜,2例浸润至阑尾系膜,其中1例伴局部淋巴结转移。采用单纯性阑尾切除术12例。右半结肠切除4例。获随访的13例病人中,11例情况良好,无复发和远处转移,死亡2例,其中1例为非肿瘤性死亡,另1例死于肿瘤转移。结论阑尾类癌术前难以做出明确诊断,手术是主要的治疗手段,手术方式应根据肿瘤大小、部位及浸润深度来决定,化疗效果有待进一步研究。     

依达拉奉联合银杏叶注射液治疗急性脑梗死疗效观察

目的观察依达拉奉联合银杏叶注射液治疗对急性脑梗死患者的疗效。方法将126例急性脑梗死患者随机分为治疗组63例和对照组63例,治疗组采用依达拉奉联合银杏叶注射液静脉滴注治疗,对照组采用银杏叶注射液治疗,2周为1个疗程,观察两组间的疗效差别。结果两组患者疗效间的差别有显著意义(P0.05);两组患者治疗前后2周神经功能缺损评分差别均有显著意义(P0.05)。结论依达拉奉联合银杏叶注射液治疗急性脑梗死效果较单用银杏叶注射液效果明显。     

开放复位治疗跟骨关节内骨折26例

目的:探讨开放复位治疗跟骨关节内骨折的临床价值。方法:对26例29足跟骨关节内骨折患者行开放复位、植入自体髂骨或异体骨钢板内固定植骨手术。结果:26例全部随访,随访时间6～36个月,平均17个月,参照Maryland足部评分系统评价,本组优16例,良5例,可4例,差1例,优良率80.8%。。结论:开放复位植骨内固定是治疗跟骨关节内骨折的有效方法。     

暗娼人群性病艾滋病知识及心理状况调查

目的了解重庆市涪陵区暗娼人群性病艾滋病知识和心理健康状况,为此类人群预防控制艾滋病提供依据。方法于2008年采用面对面方式对在重庆市涪陵区娱乐场所的暗娼进行问卷调查。结果调查对象平均年龄20．1岁,艾滋病知识知晓率为61．4％;86．4％的暗娼人群有性病相关症状,大部分未及时治疗。对暗娼人群进行的心理调查显示,除人际关系敏感因子分外,其余的因子分均显著高于全国常模。结论应根据该人群的心理状况,有针对性地进行艾滋病知识宣传和行为干预。     

手术治疗肺癌伴副癌综合征2例

肺癌副癌综合征往往发生在肺部以外,但其与肺部肿瘤密切相关,行肿瘤切除术后副癌综合征可以很快得以缓解,甚至消失[1]。我院2009年7月至2010年7月,手术治疗伴有副癌综合征的肺癌患者2例,疗效明显,现报告如下。1临床资料病例1,患者男,54岁。全身出现以双上肢为主的红色皮疹5年（图1a）。ECG提示窦性心动过速;UCG提示左房增大,主动脉偏宽;纤维支气管镜检查提示左肺上叶尖后段支气管开口浸润狭窄,组织病理检查提示炎细胞浸润。经术前准备后行左肺上叶切除加纵隔、肺门淋巴结清扫术。术中见左上、     

超声诊断门静脉海绵样变性58例分析

目的：分析门静脉海绵样变性的成因及声像图特征;方法：通过超声扣查58例门静脉海绵样变性患者的声像图表现,分析不同成因的声像图特征;结果：58例中57．0％（33／58）为肝癌门静脉内有癌栓而形成海绵样变性;20．7％（12／58）为肝硬化引起;19．0％（11／58）为门静脉周围脏器晚期肿瘤引起;0．05％（3／58）为先天性的。结论：门静脉海绵性变性的存在清楚的提示有门静脉高压的形成,超声对其的检出具有较高的临床意义,为临床治疗提供了依据。