终末期肾病病人伴发肺动脉高压的临床研究

目的:回顾性分析进行血液透析的终末期肾病(ESRD)病人肺动脉压力(PAP)情况,探讨ESRD病人肺动脉高压(PAH)的发生情况及可能的影响因素.方法:选择128例ESRD病人,其中进行血液透析的66例病人作为观察组,无血液透析的62例病人作为对照组,应用超声心动图对病人的PAP进行评估,比较2组病人一般资料、超声心动...     

A Study on High Strength,High Plasticity,Non-Heat Treated Die-Cast Aluminum Alloy

The non-heat-treated, die-cast aluminum alloy samples were prepared meticulously via die-casting technology. The crystal structure, microstructure, and phase composition of the samples were comprehensively studied through electron backscatter diffraction (EBSD), metallographic microscopy, spectrometer, and transmission electron microscopy (TEM). The microhardness and tensile properties of the samples were tested. The die-cast samples were found to have desirable properties by studying the structure and performance of the samples. There were no defects, such as pores, cold partitions, or surface cracks, found. The metallographic structure of the samples was mainly α-Al, and various phases were distributed at the grain boundaries. Before heat treating, α-Al grains were mainly equiaxed with a great number of second phase particles at the grain boundaries. After heat treating, the α-Al grains were massive and coarsened, and the second phase grains were refined and uniformly distributed, compared with those before the heat treating. The EBSD results showed that the grain boundary Si particles were solid solution decomposed after heat treatment. The particles became smaller, and their distribution was more uniform. Transmission electron microscopy found that there were nano-scale Al-Mn, Al-Cu, and Cu phases dispersed in the samples. The average microhardness of the samples before heat treating was 114 HV_0.1, while, after the heat treating, the microhardness reached 121 HV_0.1. The mechanical features of the samples were tremendous, and the obtained die-cast aluminum alloy had non-heat-treatment performance, which was greater than the ordinary die-cast aluminum alloys with a similar composition. The tensile strength of the aluminum alloys reached up to 310 MPa before heat treatment.     

不同剂量米非斯酮用于紧急避孕的临床观察

目的比较米非斯酮10 mg和25 mg用于紧急避孕的有效性,副反应及可接受性.方法将无保护性交后72 h内的198例健康育龄妇女随机分为2组.Ⅰ组198例,口服米非斯酮10 mg;Ⅱ组100例,口服25 mg.于预期下次月经日期的第7天随访,了解避孕效果、副反应及月经的变化.结果 2组紧急避孕的有效率分别为89.28%和89.04%,无统计学差异(P＞0.05);各种副反应发生率较低,均在10%以内,2组相近;2组月经延迟5天以上者的比率分别为8.16%和12%,差异有显著性(P＜0.05).结论 10 mg米非斯酮用于紧急避孕优于25 mg米非斯酮.     

Immunotherapy in combination with chemotherapy for Peutz-Jeghers syndrome with advanced cervical cancer: A case report

BACKGROUND Peutz-Jeghers syndrome(PJS) is a rare autosomal dominant disorder, and female patients may develop gynecologic tumours. The prognosis for such patients is poor and the specific pathogenesis remains uncertain. Therefore, there are currently no uniform treatment options.CASE SUMMARY Herein, we introduce the case of a 45-year-old female who was diagnosed with PJS for 45 years and cervical cancer for 3 years. Postoperative pathological examination showed metastases in the right external i...     

鼻咽癌螺旋断层放疗与固定野静态 调强放疗的剂量学比较

〔摘 要〕 目的：比较鼻咽癌螺旋断层放疗（TOMO）与固定野静态调强放疗（IMRT）的剂量学指标。方法：选择蚌埠 医学院第一附属医院 2018 年 1 月至 2019 年 12 月期间收治的 80 例鼻咽癌患者,按照随机数字法分为两组,各 40 例。观察 组给予 TOMO 处理,对照组给予 IMRT 处理。比较两组靶区剂量、危及器官剂量。结果：观察组患者肿瘤靶区、颈部转移 淋巴结、亚临床病灶及预防照射区 D95 剂量低于对照组,差异具有统计学意义（P ＜ 0.05）。观察组危及脑干、脊髓、视 交叉剂量显著低于对照组,差异具有统计学意义（P ＜ 0.05）。结论：观察组与对照组均能用于临床,但观察组在放疗中 的剂量分布优势更明显,危及器官剂量更低,能更好地保护正常组织。     

特发性视网膜前膜的发病机制及治疗进展

特发性视网膜前膜(iERM)在老年人群中常见,对于症状严重者可能出现视物模糊、视物扭曲、单眼复视和视物变大或变小等症状,严重影响患者的日常生活,因而了解其发病机制和有效治疗具有重要的意义。     

原发性卵巢非霍奇金淋巴瘤1例及相关文献复习

目的:探讨原发性卵巢弥漫性大B细胞淋巴瘤的病因、临床表现、诊断、治疗及预后。方法:报道1例原发性卵巢弥漫性大B细胞淋巴瘤的临床病理资料及术后免疫组化结果,并阅读及复习国内外相关文献。结果:该例患者为（右）卵巢弥漫性大B细胞淋巴瘤,积极治疗后现考虑肿瘤复发。结论:原发性卵巢弥漫性大B细胞淋巴瘤罕见,确诊依赖于术后病理及免疫组化,预后不佳,常采用以手术为主,辅以化疗和放疗的综合治疗。     

结肠癌致肠梗阻的外科治疗（附64例报告）

目的：探讨结肠癌致肠梗阻的外科治疗方法及效果。方法：外科手术治疗结肠癌致肠梗阻64例，其中右半结肠癌并梗阻43例，左半结肠癌并梗阻21例。肿瘤切除一期行肠吻合52例（81．2％）；行肿瘤切除、一期肠吻合、同时行近端结肠预防性造口8例（12．5％），其中4例（6．25％）分别于术后8～12周行造口关闭；4例（6．25％）肿瘤无法切除仅行乙状结肠或横结肠造口。结果：本组64例均治愈。术后出现并发症6例（9．3％），1例为切口感染，3例切口裂开，2例肺部感染，分别采用换药、减张缝合、抗感染等方法治愈。无围手术期死亡。结论：重视结肠癌致肠梗阻的围手术期处理，选择合理的手术方式是提高疗效，减少并发症的重要保证。     

直肠癌患者及健康人群直肠及周围解剖结构的高分辨MRI观察

目的 应用高分辨MRI观察直肠肠壁及其周围解剖细节,为直肠癌的临床诊断和治疗提供解剖参数和依据。 方法 收集60名健康人及20例直肠癌患者的盆腔多序列参数MRI;两位高年资医师行双盲法阅片,对20例直肠癌患者行术前T分期并与术后病理对照,分析准确率;统计分析60名正常人直肠固有筋膜前、后、左、右侧的MRI显示率,以及所有研究对象的骶前筋膜、骶骨筋膜、腹膜返折、直肠侧韧带、下腹下丛的MRI显示率。结果 高分辨MRI可以清楚地显示直肠壁的黏膜层、黏膜下层和固有肌层,直肠癌术前T分期的总准确率为80%（16/20）。健康人直肠固有筋膜前、后、左、右侧的MRI显示率分别为71.7% （43/60）、96.7%（58/60）、90.0%（54/60）和83.3%（56/60）。Denonvillier′s筋膜、骶前筋膜、直肠骶骨筋膜、腹膜返折及下腹下丛的MRI显示率分别为68.8%（55/80）、65.0%（52/80）、87.8%（69/80）、86.3%（69/80）和90.0%（72/80）;直肠侧韧带的显示率较低,左侧为53.8%（43/80）,右侧为47.6%（38/80）。结论 高分辨MRI可以辨识直肠肠壁及其周围解剖细节,帮助直肠癌术前T分期及制定临床治疗方案,判断全直肠系膜切除手术的侧切缘是否浸润,提高微转移癌灶的手术切除率,减少手术并发症。     

认知事件相关诱发电位P300的研究进展

目的 探讨认知事件相关诱发电位（ERP）P300的研究进展。方法 在万方数据、Pubmed等数据库查阅与认知ERP P300研究相关的文献,进行汇总分析。结果 ERP P300反映了大脑认知的加工过程,可对痴呆、脑血管疾病、脑外伤、癫痫、精神疾病等多种疾病进行早期认知减退的检测、认知功能和损害程度的评估以及认知功能的定量分析,具有较广泛的临床应用价值。但P300的临床应用存在没有业内公认的评定标准值、实际检测中影响因素较多等问题,其具体机制及相关问题的解决还有待于进一步更深入地探讨。结论 P300可以检测大脑神经细胞的动态认知过程,具有可靠、有效、客观、无创伤等特点,是其他脑影像技术所不能取代的一种检测方法。未来还需在P300及其亚波的产生定位及临床诊断的统一化标准化等方面做进一步的深入探索和研究。