海洛因吸毒者血液流变性观察与探讨

吸毒行为不仅危害社会、家庭,且对身体各系统如大脑新陈代谢、免疫及生殖功能等有损害。长期吸食海洛因对人体血液流变性质有何影响呢?本文就66例戒毒者血液流变指标检测情况报告如下。 一般资料 检测对象 治疗组66例,男45人,女21人,年龄16～44岁,均因吸食海洛因成瘾,现正进行戒毒治疗;对照组55例,男35人,女20人,年龄18～42岁,无血液、心、肺、肾等系统疾病的健康人群。 检测项目及方法 检测全血及血浆比粘度(毛细管粘度计法),红细胞压积(Hct,温氏法),纤维蛋白原(Fib,酚试剂显色法),红细胞沉降率(ESR,魏氏长管法),根据检测项目,用肝素、枸…     

经桡动脉途径行冠状动脉介入治疗618例分析

目的:通过对比桡动脉、股动脉2种途径行冠状动脉介入治疗的临床疗效,探讨经桡动脉途径行冠状动脉介入治疗的安全性和有效性。方法:连续入选2003年12月至2009年12月在北京丰台医院心内科行冠状动脉介入治疗的患者1236例,随机分为桡动脉组618例,股动脉组618例,主要观察指标包括:手术成功率、穿刺成功率、血管开通时间、X线透视时间、手术总时间、不同指引导管的使用率、术中不良事件(包括死亡、急性心肌梗死、恶性心律失常、冠状动脉痉挛、夹层及穿孔和闭塞)、术后不良事件(包括死亡、急性心肌梗死、患侧肢体假性动脉瘤及血肿)及总住院时间等。结果:经桡动脉途径行冠状动脉介入治疗术的成功率为95.8%,与股动脉组比较,桡动脉组穿刺成功率、血管开通时间、X线透视时间、手术总时间差异无统计学意义。与股动脉组相比较,桡动脉组术后血肿的发生率、住院时间显著减少。结论:经桡动脉途径行冠状动脉介入治疗术安全有效,并发症少,减少了患者住院时间,但需要熟练掌握手术技巧,术中宜直接选择支撑力较好的指引导管,以提高手术成功率。     

INVESTIGATION OF REGULATORY T CELLS IN PATIENTS WITH NON-SMALL CELL LUNG CANCER

Objective To evaluate the prevalence of CD4 ^＋ CD25^high regulatory T cells （ Treg cells） in the peripheral blood mononuclear cells （PBMC） and tumor-infiltrating lymphocytes （TIL） of patients with non-small cell lung cancer （NSCLC） and to investigate immunosuppression to the progression of cancer. Methods Peripheral blood and tumor tissues were collected from 20 patients with NSCLC at the time of surgery. None of the patients received surgery, radiotherapy, chemotherapy, or other medical interventions before this study. Cancer stages of the patients were Ⅰ-Ⅲ A. Venous blood samples were obtained from 20 health donors. PBMC were isolated from blood samples by differential centrifugation over Ficoll-Hypaque. TILs were isolated from tumors by differential centrifugation over Ficoll-Hypaque and Percoll. Percentage of CD4^＋ CD25^highTr/CD4＋T in PBMC and TIL was assessed by the flow cytometry. Results The percentage of CD4^ ＋ CD25high Tr/ CD4 ^＋T in PBMC [ （4. 87 ± 1.22 ） % ] of NSCLC patients was significantly higher than that in healthy donors [ （ 2.36 ± 0. 72 ） % ] （ P 〈 0.01 ）. The percentage of CD4^＋ CD25^highTr/ CD4^＋ T in PBMC [ （5.40 ± 1.20） % ] of NSCLC patients in stage Ⅱ-Ⅲ A was significantly higher than that in stage Ⅰ [ （3. 87 ± 0. 22 ） % ] （ P 〈 0. 01 ）. The percentage of CD4 ＋ CD25hiShTr/ CD4 ＋ T in TIL[ （ 8. 66 ±0. 76） % ] of NSCLC patients in stage Ⅱ-Ⅲ A was significantly higher than that in stage Ⅰ [ （ 7. 04 ± 0. 80） % ] （ P 〈 0. 01 ）. Conclusion The prevalence of CD4 ^＋ CD25^highTreg cells in PBMC and TIL of NSCLC patients was significantly higher than that in healthy donors. These Treg cells may be preventing appropriate antitumor immune responses. The population of CD4^ ＋ CD25^highTreg cells in PBMC and TILs of NSCLC patients with Ⅱ-Ⅲ A stage was significantly higher than that of NSCLC patients with Ⅰ stage. These Treg cells may facilitate development of tumors.     

省属医学院校住院医师规范化培训模式探索

湖北医药学院充分发挥高校优势,通过开展住院医师规范化培训工作,形成了一整套比较完善的住院医师培训制度.制定模式方案,保证了住院医师培训质量,取得了良好的培训效益,对培养高素质的临床医师起到了重要作用.同时,回顾高等医学院校住院医师规范化培训模式实践,总结在培训管理过程中取得的经验,对其中发现的问题进行探讨,提出解决问题的办法.     

肺包虫囊肿合并肝包虫囊肿的一期手术治疗

包虫病,又称棘球蚴病,是我国西北牧区较常见的寄生虫病,肝、肺为常见的受累器官 [1].新疆医科大学第一附属医院(1957年5月至2008年6月)和新疆维吾尔自治区人民医院(1980年1月至2008年6月)对109例肺包虫囊肿合并肝包虫囊肿患者行一期手术治疗,效果满意,现总结报告如下.     

人胚胎背根神经节雪旺氏细胞的培养

BACKGROUND： Previous studies have used many methods for in vitro Schwann cells （SCs） cultures and purification, such as single cell suspension and cytosine arabinoside. However, it has been difficult to obtain sufficient cellular density, and the procedures have been quite tedious. OBJECTIVE： To investigate the feasibility of culturing high-density SCs using fetal human dorsal root ganglion tissue explants. DESIGN, TIME AND SETTING： Cell culture and irnmunohistochernistry were performed at the Central Laboratory of Kunrning General Hospital of Chinese PLA between March 2001 and October 2008. MATERIALS： Culture media containing 10% fetal bovine serum, as well as 0.2% collagenase and 0.25% trypsin were purchased from Gibco, USA; mouse anti-human S-100 monoclonal antibody and goat anti-mouse IgG labeled with horseradish peroxidase were provided by Beijing Institute of Biological Products, China. METHODS： Primarily cultured SCs were dissociated from dorsal root ganglia of human aborted fetuses at 4 6 months pregnancy. Following removal of the dorsal root ganglion perineurium, the ganglia were dissected into tiny pieces and digested with 0.2% collagenase and 0.25% trypsin （volume ratio 1：1）, then explanted and cultured. SC purification was performed with 5 rnL 10% fetal bovine serum added to the culture media, followed by differential adhesion. MAIN OUTCOME MEASURES： SCs morphology was observed under inverted phase contrast light microscopy. SC purity was evaluated according to percentage of S-100 immunostained cells. RESULTS： SCs were primarily cultured for 5 6 days and then subcultured for 4 5 passages. The highly enriched SC population reached 〉 95% purity and presented with normal morphology. CONCLUSION： A high purity of SCs was obtained with culture methods using human fetal dorsal root ganglion tissue explants.     

纤维支气管镜对纤维素性支气管炎咯血的诊治

为探讨经纤维支气管镜（简称纤支镜）对纤维素性支气管炎咯血的诊断、治疗效果,我院经纤支镜检查,发现管腔内剥离脱落的支气管管型后,用活检钳经活检孔反复钳取管型,并向管腔内注射肾上腺素稀释液、凝血酶。可见,纤维素性支气管炎咯血患者,经纤支镜钳起管腔内剥离的支气管管型做病理检查可以及时诊断病情,镜下应用止血药物治疗,止血迅速。     

胰腺炎病人饮食管理体会

目的 探讨胰腺炎饮食管理的意义.方法 对182例病人饮食管理的回顾性分析.结果 严格饮食管理的2年复发15例,未严格饮食管理的2年内复发34例.结论 胰腺炎有多种因素诱发,严格饮食管理是治疗和预防本病的关键.     

前列腺靶向穿刺联合术中冰冻切片确诊前列腺癌后即刻行根治性前列腺切除术的初步经验

目的探索前列腺靶向穿刺联合术中冰冻切片确诊前列腺癌后即刻行根治性前列腺切除术(RP)的可行性和安全性。方法前瞻性纳入我院2022年3月至7月因前列腺特异性抗原(PSA)异常而怀疑前列腺癌的患者, 纳入标准:年龄≤80岁, 美国东部肿瘤协作组(ECOG)评分≤1分;于穿刺活检前行前列腺MRI和前列腺特异性膜抗原正电子发射计算机断层显像(PSMA PET/CT)检查, 并且MRI和PSMA PET-CT均怀疑前列腺癌, 临床分期为T2-3aN0M0;同意在穿刺确诊前列腺癌后接受RP。入组患者均接受前列腺靶向穿刺(1～2针), 穿刺组织送术中冰冻切片检查。对术中冰冻病理确诊前列腺癌的患者, 即刻行RP。对未诊断前列腺癌的患者, 则继续行经会阴前列腺靶向+系统穿刺活检, 标本送常规病理检查。对患者的基线数据、手术情况、病理结果及随访信息作描述性分析。结果纳入7例患者, 年龄66.7(54～77)岁, PSA 12.668(4.359～22.195)μg/L。PI-RADS评分4分4例, 5分3例, 主要病灶最大径线为1.3(0.5～2.2)cm。PSMA PET/CT评分4分1例, 5分6例,...     

■趾腓侧游离皮瓣结合指压力套修复手指远节指腹缺损

目的 探讨■趾腓侧游离皮瓣结合指压力套修复手指远节指腹缺损的临床疗效。方法 采用■趾腓侧游离皮瓣结合指压力套修复11例手指远节指腹缺损患者。指腹缺损面积2.0 cm×1.0 cm～4.0 cm×1.8 cm。切取皮瓣面积2.2 cm×1.2 cm～4.5 cm×2.2 cm。结果 皮瓣均成活。患者均获得随访,时间3～12个月。末次随访时,指腹皮瓣颜色红润,张力正常,外形饱满,有指螺纹,指腹两点辨别觉9～16 mm,皮瓣与患指皮肤缝合处瘢痕不明显,外形接近正常手指。■趾供区一期缝合,其中2例皮瓣切取宽度>1.5 cm,缝合后张力过大,局部产生张力性水疱,拆除部分缝线后换药愈合,其余患者切口无红肿、破溃,愈合良好,无瘢痕挛缩、关节僵硬等并发症,步行均无异常。结论 采用■趾腓侧游离皮瓣结合指压力套修复手指远节指腹缺损,能重建感觉,很好地恢复患指的外形、功能。