软通道颅内血肿微创清除术治疗高血压性脑出血后继发性脑损伤的研究

【目的】探讨软通道颅内血肿微创清除术对脑出血继发脑损伤的影响及相关机制。【方法】选择本院首次发病且于起病24 h入院的高血压脑出血患者120例,随机分为三组,每组各40例。对照组采用保守治疗,硬通道组采用硬通道颅内血肿微创清除术治疗,软通道组采用软通道颅内血肿微创清除术治疗。治疗后d7、d14、d28行头颅C T检查及神经功能缺损评分,检测血中及引流脑脊液中白细胞介素‐6（IL‐6）、肿瘤坏死因子‐α（TNF‐α）、丙二醛（MDA）含量,超氧化物歧化酶（SOD）的活性。【结果】与对照组比较,硬通道组和软通道组d7、d14、d28血肿体积明显缩小,d7、d14、d28血肿周围脑水肿体积明显缩小,神经功能缺损评分明显改善（ P ＜0．05）;与硬通道组比较,软通道组d14、d28血肿体积及周围脑水肿体积明显缩小,d7、d14、d28神经功能缺损评分明显改善（ P ＜0．05）,d2、d4、d6引流出脑脊液中IL‐6和TNF‐α含量均明显减低,血SOD活性升高和MDA含量降低（ P ＜0．05）。【结论】采用软通道微创治疗脑出血继发脑损伤患者,能促进血肿吸收、减轻血肿周围损伤、改善神经功能,其机制可能通过减轻脑出血后炎性反应、抑制氧化应激反应来实现。     

嗜酸粒细胞性食管炎临床病理分析

目的探讨疑难食管溃疡性病变——嗜酸粒细胞性食管炎患者临床病理学表现及免疫组化特点。方法对9例术后诊为嗜酸粒细胞性食管炎患者标本进行临床病理学分析,采用HE染色、甲苯胺蓝染色、硫堇染色及免疫组化S-P法染色等。结果9例嗜酸粒细胞性食管炎病变特征均呈溃疡型改变,溃疡及其周围黏膜各层及肉芽组织中,见到未释放型和释放型2种肥大细胞;嗜酸粒细胞集中区也是肥大细胞聚集区。结论本病的发生与变态反应有关,病变过程中可形成溃疡,手术前易误诊为食管癌。     

三算子及血氧功能成像技术联合超声在年轻女性乳腺癌诊断中的应用研究

目的 探讨三算子及血氧功能成像技术联合超声在年轻女性乳腺癌诊断中的应用价值.方法 分析221例年龄≤45岁乳腺肿瘤的三算子及血氧特征,结合病理诊断,与超声对照,得出各自诊断的准确性和联合诊断的准确性.结果 221例患者中发现恶性82例,良性139例,三算子及血氧成像诊断的敏感性90.24%、准确性为89.14%.超声诊断的敏感性85.37%、准确性84.62%,联合两者诊断结果,准确性提高至93.90%. 结论乳腺三算子及血氧功能成像技术在年轻乳腺癌诊断中具有独特优势,与超声结合应用于年轻乳腺癌的筛查,可提高诊断率.     

生莶合剂联合窄谱中波紫外线治疗玫瑰糠疹疗效观察

目的:采用中药煎剂联合紫外线治疗72例玫瑰糠疹患者,探讨其疗效和安全性。方法:治疗组口服生莶合剂,由本院中药制剂室水煎成袋,每次100mL,早晚口服2次,同时采用由德国Waldmann公司生产的UB100L型NB-UVB全身照射,隔日1次,10次为1疗程。对照组:予西替利嗪片10mg每日1次口服,外用0.1%曲安奈德霜(本院自制)。两组均20天为1个疗程,1个疗程后判定疗效。结果:治疗组总有效率88.57%,痊愈率54.28%,均高于对照组,两组差异有统计学意义,未发现明显副作用。结论:生莶合剂联合紫外线治疗玫瑰糠疹,较传统的西医治疗有较好的疗效和安全性,值得总结推广。     

HPLC-DAD同时测定心通口服液中4种成分

目的:建立同时测定心通口服液中葛根素、毛蕊异黄酮葡萄糖苷、柚皮苷及淫羊藿苷含量的方法.方法:采用Kromasil C18色谱柱(4.6 mm×250 mm,5μm),以乙腈-水为流动相,梯度洗脱,流速1 mL·min-1,柱温30℃,检测波长λ1=250 nm(检测葛根素),λ2 =260 nm(检测毛蕊异黄酮葡萄糖苷),λ3=283 nm(检测柚皮苷),λ4=270 nm(检测淫羊藿苷).结果:葛根素、毛蕊异黄酮葡萄糖苷、柚皮苷及淫羊藿苷的线性范围分别为0.441～11.0,0.031 2～0.780,0.186～4.66,0.134～3.47 μg,平均加样回收率分别为98.53％,98.03％,98.64％,99.16％.结论:方法操作简便,快速,重复性好,可作为该产品质量控制的方法.     

单心动周期实时三维超声心动图对房间隔缺损的诊断价值分析

目的探讨单心动周期实时三维超声心动图(sRT-3DE)对房间隔缺损的诊断价值。方法应用西门子SC2000型彩色多普勒超声诊断仪对23例房间隔缺损患者进行常规超声和实时sRT-3DE,重点观察缺损的形态、大小、空间位置及毗邻关系等。结果 sRT-3DE能从多角度观察房间隔缺损的全貌,包括缺损的整体形态、部位、大小、残端及其与周边组织的毗邻关系。结论 sRT-3DE能方便快捷地提供丰富而直观的信息,有助于指导手术者更好地理解房间隔缺损的空间解剖结构,选择合理的治疗方法。     

大直径金属-金属全髋关节置换的早期疗效

背景:髋关节置换后脱位仍然是传统的金属对聚乙烯全髋关节置换的主要并发症之一,大直径金属对金属的全髋关节置换后具有良好的稳定性,适合年轻、活动要求高的患者。目的:验证大直径金属-金属全髋关节置换治疗终末期髋关节疾病的早期疗效。方法:回顾性分析48例(54髋)初次大直径金属-金属全髋关节置换后的早期临床疗效。假体股骨头直径平均为44mm(38～48mm),采用Harris评分和X射线检查评估早期疗效。结果与结论:所有患者都获得18～36个月随访,末次随访Harris评分平均93.6分(91～96分),疗效评价为优。末次随访时髋关节总活动度平均为232.6°(182～257°),置换后髋关节总活动度明显增大。所有患者切口均Ⅰ期临床愈合,无髋部和大腿疼痛、感染、关节脱位、血管、神经损伤等并发症,置换后X射线片示假体位置良好,无松动或下沉。提示大直径金属-金属全髋关节置换治疗终末期髋关节疾病具有早期低磨损、髋关节的活动度好、脱位率低等优点。     

核磁共振多技术扫描在复杂先天性心脏病中的应用研究

目的:探究复杂先天性心脏病一站式1.5T MRI扫描常规应用价值。方法:回顾性分析33例先天性心脏病患儿MRI影像资料,将其分为平扫-电影成像组及平扫-3D成像组,以手术结果为标准,以B超结果为参照,进行准确率分析。结果:在完成核磁共振扫描的31例患儿中,经手术证实,平扫-电影成像组正确诊断率为86.1%,心外结构异常以及心内结构异常的正确诊断率分别为87.3%、84.4%;平扫-3D成像组正确诊断率为91.7%,心内及心外异常结构正确诊断率分别为84.4%与96.8%,分析结果的偏差均在可接受范围内,相关性良好。结论:一站式核磁共振扫描能够明显提高心外大血管异常的正确诊断率,对心外结构异常的诊断比B超更具优势,具有较高的诊断价值。     

Comparative efficacy and safety of palonosetron with the first 5-HT3 receptor antagonists for the chemotherapy-induced nausea and vomiting: a meta-analysis

JIN Y., SUN W., GU D., YANG J., XU Z. & CHEN J. (2013) European Journal of Cancer Care 22 , 41–50 Comparative efficacy and safety of palonosetron with the first 5-HT3 receptor antagonists for the chemotherapy-induced nausea and vomiting: a meta-analysis A number of studies have reported the difference between the 5-HT3 receptor antagonists and palonosetron in preventing the chemotherapy-induced nausea and vomiting (CINV). Through analysing the efficacy and safety in palonosetron-treated patients, it can provide evidence for palonosetron administration. We identified randomised controlled clinical trials comparing palonosetron with the first-generation 5-HT3 receptor antagonists in the prevention of CINV in cancer patients. Nine studies investigated the outcomes in a total of 3463 cases. Compared with the first-generation 5-HT3 receptor antagonists, the cumulative incidences of emesis were significantly reduced in the patients treated with palonosetron (0.25 mg i.v.) on the first day [relative risk (RR) = 1.11, 95% confidence interval (CI): 1.05–1.17], from 2 to 5 days (RR = 1.26, 95% CI: 1.16–1.36) and the overall five days (RR = 1.23, 95% CI: 1.13–1.34). Regarding the drug safety, there was no significant difference between palonosetron-treated group and the first-generation 5-HT3 receptor antagonists-treated group. Results from the analysis suggest that palonosetron is highly effective in preventing nausea and vomiting in the days after administration of moderately or highly emetogenic chemotherapy agents.     

mfat‐1 transgene protects cultured adult neural stem cells against cobalt chloride‐mediated hypoxic injury by activating Nrf2/ARE pathways

Ischemic stroke is a devastating neurological disorder and one of the leading causes of death and serious disability in adults. Adult neural stem cell (NSC) replacement therapy is a promising treatment for both structural and functional neurological recovery. However, for the treatment to work, adult NSCs must be protected against hypoxic‐ischemic damage in the ischemic penumbra. In the present study, we aimed to investigate the neuroprotective effects of the mfat‐1 transgene on cobalt chloride (CoCl₂)‐induced hypoxic‐ischemic injury in cultured adult NSCs as well as its underlying mechanisms. The results show that in the CoCl₂‐induced hypoxic‐ischemic injury model, the mfat‐1 transgene enhanced the viability of adult NSCs and suppressed CoCl₂‐mediated apoptosis of adult NSCs. Additionally, the mfat‐1 transgene promoted the proliferation of NSCs as shown by increased bromodeoxyuridine labeling of adult NSCs. This process was related to the reduction of reactive oxygen species. Quantitative real‐time polymerase chain reaction and Western blot analysis revealed a much higher expression of nuclear factor erythroid 2‐related factor 2 (Nrf2) and its downstream genes (HO‐1, NQO‐1, GCLC). Taken together, our findings show that the mfat‐1 transgene restored the CoCl₂‐inhibited viability and proliferation of NSCs by activating nuclear factor erythroid 2‐related factor 2 (Nrf2)/antioxidant response elements (ARE) signal pathway to inhibit oxidative stress injury. Further investigation of the function of the mfat‐1 transgene in adult protective mechanisms may accelerate the development of adult NSC replacement therapy for ischemic stroke.