江苏省≥10岁人群的眩晕流行病学调查研究

目的调查江苏省人群中眩晕的分布情况及相关因素，为制订防治策略提供科学依据。方法采用按容量比例概率抽样（PPS）方法，在江苏省常住人口中抽样，对其中≥10岁的6854人进行眩晕问卷调查、纯音测听和耳科检查。结果本研究实际接受调查6333人，应答率92．4％，男3035人（47．9％），女3298人（52．1％），年龄10～93岁。被调查人群中眩晕的总体患病率为4．1％（标化患病率：全国3．4％，江苏3．6％），眩晕患病率随年龄增加呈上升趋势（P=0．000）。女性眩晕患病率（5．3％）高于男性（2．8％）（P=0．000），城乡之间差异无显著性（农村4．3％。城镇3．8％．P=0．459）。听力减退、中耳炎病史、噪声暴露史是眩晕的危险因素，OR值分别为2．186、2．135、1．609。结论眩晕在江苏省人群中较为常见，其发生与多种因素有关，必须加强这些方面的防治研究。     

嘎日迪-13对局灶性脑缺血大鼠NSE、TNF-α、IL-6表达的影响

目的探讨血清中神经元特异性烯醇化酶(NSE)、炎性因子肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)在大鼠脑缺血损伤后的作用及嘎日迪-13对其影响。方法取雄性SD大鼠360只,将大鼠随机分为脑缺血模型组、假手术组及嘎日迪-13大、中、小剂量(0.24、0.12、0.06 g/kg)组,每组又随机分为缺血1、6、12、24、72、120 h的6个时相组,采用改良Zea Longa线栓法制备大鼠大脑中动脉栓塞(MCAO)模型,ELISA法检测血清中NSE、TNF-α、IL-6水平。结果NSE、TNF-α、IL-6在假手术组表达少;而在模型组脑缺血损伤1 h后开始上升,NSE于12 h达高峰,TNF-α、IL-6在24 h达高峰,之后逐渐下降(P0.01);嘎日迪-13各剂量治疗组能显著降低神经功能评分,NSE、TNF-α、IL-6表达量明显受到抑制(P0.01、0.05)。结论嘎日迪-13对大鼠脑缺血损伤具有明显的保护作用,提示嘎日迪-13可能是通过减轻脑缺血损伤后神经元的损伤,调节炎症因子相互之间的作用,减轻脑组织损伤,从而发挥对脑缺血损伤的治疗作用。     

超微粉碎麻术散治疗无症状高尿酸血症49例临床观察

超微粉碎麻术散由麻黄、苍术、茯苓、萆薄、杜仲、百合、桑枝7味药物经超微粉碎技术加工而成,具有疏通经络,祛除风湿功用。2007年2月至2008年3月,笔者选择了无症状高尿酸血症患者49例,予验方超微粉碎麻术散口服治疗;并与苯溴马隆口服治疗49例对照观察,现报告如下。     

用于颅颌面种植外科的三维立体可视化系统

目的论文对在个人PC机上对颅颌面医学图像的可视化进行研究,开发出用于颅颌面种植外科的CT断层图像三维可视化系统。方法应用3D纹理映射的方法对颅颌面CT断层图像进行三维重建,并得到其XYZ方向上的切面图像。然后利用边缘检测的方法得到眼眶的位置,并在眼眶位置进行扇形切割,得到18幅扇形切割图像。结果该系统可以帮助医生进行手术前的骨质、骨量分析,设计种植手术的过程及模拟、预测手术的种植效果。结论建立的颅颌面种植外科三维可视化系统以其硬件配置合理、软件设计新颖、多维视角、便捷快速精确等为特色。具有较强的应用价值。     

鼻咽癌中国1992、2008分期和国际抗癌联盟2010分期标准的比较研究

目的 比较鼻咽癌中国1992、2008分期和国际抗癌联盟(UICC)2010分期标准之间的一致性,评价它们在预测鼻咽癌放疗疗效中的价值.方法 回顾分析2000-2005年间347例无远处转移的初治鼻咽癌患者临床资料,对每例患者分别用中国1992、2008和UICC2010分期标准进行T、N和临床分期.采用Kappa法分析3种分期标准间各期病例数分布的一致性.采用Kaplan-Meier法分别计算3种分期标准的5年总生存率、局部无复发和无远处转移生存率,并用Logrank检验其差异.结果 中国2008分期和UICC 2010分期标准之间的临床分期、T和N分期的病例构成比例的一致性均优于它们各自与1992分期之间的比较,Kappa值分别为0.700、0.881和0.722.3种分期标准下各临床分期的总生存曲线比较只发现Ⅲ与Ⅳ期间的不同,其中2008分期和UICC2010分期标准下Ⅲ与Ⅳ期间的不同(χ2=4.48,P=0.034和χ2=8.88,P=0.003),而1992分期则相似(χ2=0.40,P=0.526).3种分期标准的局部无复发生存率各T1与T2和T2与T3及T3与T4期间的比较均相似(χ2=1.85、0.53、0.50,P=0.174、0.467、0.479和χ2=1.25、2.10、1.99,P=0.264、0.148、0.159及χ2=0.77、0.60、0.87,P=0.381、0.441、0.350).在3种分期标准的各期无远处转移生存率中,1992分期标准的N0与N1、N1与N2、N2与N3间均相似(χ2=3.71、3.11、2.01,P=0.054、0.078、0.156),2008分期标准的N1与N2、N2与N3间不同(χ2=10.49、5.06,P=0.001、0.024);UICC 2010分期标准中仅N1与N2间不同(χ2=7.73,P=0.005).结论 中国2008分期和UICC2010分期标准对鼻咽癌放疗疗效的预测价值相近,且均优于1992分期.

Abstract：

Objective To compare the agreement among Chinese 1992, 2008 and UICC 2010 staging systems of nasopharyngeal carcinoma (NPC) and evaluate their predictive value of radiotherapeutic prognosis.Methods 347 NPC patients without distant metastasis treated in our hospital from 2000 to 2005 were retrospectively analyzed.Every patient was categorized into T, N, and clinical stage by Chinese 1992, 2008 and UICC 2010 staging systems, respectively.Kappa value was used to evaluate the agreement among three systems.Kaplan-Meier method was used to analyze the 5-year overall survival (OS), local-free survival (LFS) and distant metastasis-free survival (DMFS), the difference between subgroup was tested by Logrank.Results The agreement of clinical stage, T and N stage between Chinese 2008 and UICC 2010 staging system was better than that of them compared to 1992 staging system, Kappa value were 0.700、0.881 and 0.722.The agreement of T stage was better than N and clinical stage among these three staging system.The difference of OS between stageⅢ and stage Ⅳ was significant in Chinese 2008 and UICC 2010 staging system (χ2=4.48,P=0.034;χ2=8.88,P=0.003), and with no different in 1992 staging system (χ2=0.40,P=0.526).There was no significant difference of LFS between T1 and T2,T2 and T3,T3 and T4 in all staging systems (χ2=1.85,0.53,0.50,P=0.174,0.467,0.479;χ2=1.25,2.10,1.99,P=0.264,0.148,0.159;χ2=0.77,0.60,0.87, P=0.381,0.441,0.350).There were no significant differencesin 1992 staging system, while there was significant differences of DMFS between N1 and N2, N2 and N3 in 2008 stage system, N1 and N2 in UICC 2010 stage system.Conclusions The predictive value of Chinese 2008 and UICC 2010 staging system for prognosis were similar, and were better than that of 1992 staging system in NPC.     

皮肤结核一例

患者,女,64岁.颈部斑块结节8年,逐渐增大.患者8年前患乳腺癌,手术切除治疗.曾诊断为毛囊炎、孢子丝菌病、乳腺癌皮肤转移等,给予相应治疗未愈.组织病理学检查:真皮内结核性肉芽肿,结节中央可见干酪样坏死,抗酸染色阳性,PAS染色阴性,真菌培养阴性,PPD(+++).抗结核治疗后皮疹明显消退.     

Function and Significance of Very Low Density Lipoprotein Receptor Subtype Ⅱ

To explore the functions of very low density lipoprotein receptor (VLDL-R) subtype Ⅱ in lipoprotein metabolism and foam cells formation, the recombinant plasmid with the two subtypes cDNA was constructed respectively, the ldl A7 cell lines were transfected and two cell lines expressing VLDL-R were obtained: one stably expressing the VLDLR with the O-linked sugar region (type Ⅰ VLDLR) and the other without the O-linked sugar region (type Ⅱ VLDLR). In the study on binding of VLDLR to their nuclein labeled natural ligands (VLDL and β-VLDL), it was found that surface binding of^125I-VLDL or ^125I-β-VLDL of ldl-A7 cells transfected with type Ⅰ VLDLR recombinant (ldl-A7-VRI) was more higher than that of ldl-A7 cells transfected with type Ⅱ VLDLR recombinant (ldl-A7 VRⅡ). After being incubated with VLDL for different time, the contents of triglyceride and total cholesterol in cells were mensurated, and the formation of foam cells and accumulation of lipid in cells was observed by oil-red O staining. The results showed that the contents of triglyceride and total cholesterol in IdI-A7-VR Ⅰ were much higher than those in ldl-A7-VR Ⅱ, and IdI-A7-VR Ⅰ could transform into foam cells notably. It was suggested that type Ⅰ VLDLR binds with relative higher affinity to VLDL and β-VLDL, and internalizes much more lipoprotein into cells. As a result, we can conclude that type Ⅰ VLDLR plays a more important role in lipoprotein metabolism and foam cells formation than type Ⅱ VLDLR。     

肿瘤患者化疗使用PICC置管的护理

目的:探讨经外周静脉置入中心静脉导管(PICC)对肿瘤化疗患者的临床护理效果。方法:回顾性分析我科医治的60例肿瘤化疗患者,将置中心静脉导管前(静脉留置针)作为对照组,置入中心静脉导管后作为实验组,两组在穿刺点的上方给予药物敷贴等护理干预,观察两组并发症发生的情况。结果:两组静脉炎、药物外渗、导管堵管等有明显差异(P<0.05),具有可比性。结论:经外周静脉置入中心静脉导管(PICC)能够有效预防肿瘤患者化疗过程中静脉炎、药物外渗、导管堵管等并发症,能够有效保护上肢静脉,减轻患者的疼痛,提高患者的生命质量,值得临床应用推广。     

核心稳定性训练法对腰椎退行性疾病患者微创术后效果观察

目的 探讨核心稳定性训练法对经皮内镜下腰椎间盘切除术治疗腰椎退行性疾病患者术后的应用效果.方法 采用便利抽样法选取2019年10月～2019年12月在某院脊柱外科住院且行PELD治疗的60名LDD患者作为研究对象.根据接受康复护理方式的不同,将PELD术后进行核心稳定训练法护理的30名患者作为观察组,将PELD术后进行...     

动脉化静脉皮瓣成活机制的实验研究

目的 直视下观测动脉化静脉皮瓣的血液循环途径,探讨其成活机制。方法 选用15只中国大白兔30只耳朵,设计动脉化静脉皮瓣模型,应用微循环显微镜在不同时间观察皮瓣微循环的血液途径(1h、2h、4h、8h)。结果 皮瓣全部成活。皮瓣组织内毛细管管网是一个“立体”的网状结构;静脉皮瓣早期可见毛细血管床关闭,动脉血在微静脉间快速流动;随毛细血管逐渐开放,动脉血逆流进入微循环,完成循环重建。结论在引流静脉保持通畅的前提下,静脉皮瓣可借助静脉系统重建有效血液循环并保持成活。