下肢浅静脉曲张激光治疗术后复发的临床分析

目的 探讨腔内激光治疗下肢浅静脉曲张术后复发的原因及防治方法.方法 回顾性分析353例(415条肢体)下肢静脉曲张患者的临床资料.结果 38例(40条肢体)患者术后复发,复发率为9.64%.复发原因分别为:18条肢体交通支功能不全,14条肢体大隐静脉主干再通,5条肢体小隐静脉主干未处理,2条肢体深静脉瓣膜功能不全,1条肢体双大隐静脉畸形.38例患者均经再次手术,分别随访1～4年无复发.结论 根据静脉曲张程度和病因采取针对性手术,重视过度扩张大隐静脉的高位结扎和交通支血管的处理是预防术后复发的关键.     

伴门静脉癌栓的原发性肝癌外科治疗：附335例报告

目的：探讨合并门静脉癌栓（PVTT）的肝癌手术治疗的指征与价值。方法：回顾性分析335例伴PVTT肝癌患者临床病理及随访资料,其中273例行手术治疗,包括规则性或非规则性肝切除术（HR）+PVTT清除术（HR组）,62例采用肝动脉化疗栓塞（TACE）治疗（TACE组）。比较两组患者治疗后的生存情况。结果：HR组及TACE组中位生存期分别为4.46个月和5.65个月,差异无统计学意义（P=0.455）;6、12个月生存率分别为30.7%,38.7%与12.1%、19.2%,差异均无统计学意义（均P>0.05）。结论：肝癌合并PVTT不是手术禁忌证,实施HR安全可行,但预后改善不明显,故要遵循个体化标准,慎重选择手术治疗。随着肝癌多学科协作（MDT）治疗及未来精准医学治疗模式的发展,以期能提高其整体治疗水平。

     

The anomalous splenic vein: a case report and review of the literature

The spleen arises from a mesenchymal bulge at the 6-mm stage of development. There are a wide variety of splenic anomalies and variations that range from benign to clinically significant, and this article presents a brief review of splenic embryology and a case report of an anomalous splenic vein that precluded the formation of a Nissen fundoplication.     

CCR1趋化因子受体在人肝癌组织中表达及其临床意义

目的了解CCRl趋化因子受体在人肝癌组织中表达分布情况，探讨其表达水平与临床病理特性的关系。方法采用RT-PCR、免疫组化、Western blot技术检测45例肝癌组织及相应癌旁肝组织CCRl趋化因子受体表达及分布情况，并分析其表达水平与临床病理特性的关系。结果RT-PCR、Western blot在肝癌组织及相应癌旁肝组织中均可以检测到CCR1趋化因子受体mRNA及蛋白，肝癌组织表达水平高于癌旁肝组织。免疫组化显示CCR1趋化因子受体主要表达于肝癌细胞膜。CCR1mRNA表达水平与病人性别、年龄、血清AFP水平、肿瘤大小、分期无明显相关性，而与肿瘤是否有包膜（t=2．305，P〈0．05）、门静脉浸润显著相关（t=3．004，P〈0．01）。无门静脉浸润的肝癌组织中，47．4％免疫组化染色强度为＋＋～＋＋＋，而有门静脉浸润的肝癌组织中，80．8％染色强度为＋＋～＋＋＋，两者比较差异具有显著意义（X^2=5．511，P〈0．05）。结论肝癌细胞表达CCR1趋化因子受体，其表达水平与肝癌侵袭性尤其是门静脉浸润相关，有望成为判断肝癌侵袭性及预后的指标。     

吻合小隐静脉的腓肠神经营养血管逆行皮瓣的临床应用

目的探讨吻合小隐静脉的腓肠神经营养血管逆行皮瓣转移修复下肢软组织缺损的临床效果。方法7例下肢软组织缺损,应用吻合小隐静脉的腓肠神经营养血管逆行皮瓣修复小腿远1/3胫前、足背、足跟、踝部软组织缺损。皮瓣切取面积8 cm×6 cm~18 cm×10 cm。结果7例皮瓣全部成活,随访6~40个月,平均24个月,皮瓣质地优良,外观及功能满意。结论吻合小隐静脉的腓肠神经营养血管逆行皮瓣切取方便,血供丰富且不牺牲主要动脉,静脉血回流通畅,适合修复小腿远1/3胫前、足背、足跟、踝部软组织缺损。     

Bilateral uterine artery ligation via minilaparotomy for heavy menstrual bleeding

Objective

To assess the safety and short-term efficacy of bilateral uterine artery ligation (UAL) via minilaparotomy for the management of heavy menstrual bleeding (HMB).

Methods

A prospective study of 30 women with HMB who underwent UAL. The primary outcome was cumulative treatment failure 12 months after the procedure. Treatment failure was defined as the need for hysterectomy during the follow-up period.

Results

At 12 months, 6 women had undergone hysterectomy for bleeding, for a cumulative failure rate of 20% (95% CI, 9%-38%). The number of bleeding days was significantly reduced by 11.9 ± 1.5 days (P < 0.001) and hemoglobin level significantly increased by 1.3 ± 0.15 g/dL (P < 0.001). Of the 30 women, 24 (80%) were satisfied with the results. No major complications were reported during the procedure or median follow-up period of 13.2 months.

Conclusion

Bilateral UAL is a safe and effective minimally invasive procedure that can provide an alternative treatment for HMB.     

Temporal effect of Guanxin No. 2 on cardiac function, blood viscosity and angiogenesis in rats after long-term occlusion of the left anterior descending coronary artery

AIM: Cardiac infarction is one of the main causes of death in both developing and developed countries over past decades. Currently available approaches for treating patients with this disease are not satisfactory. Traditional Chinese medicines have been increasingly paid attention to. The aim of this study was to characterize the dynamic protective effects of Guanxin No. 2 decoction (GX II) on cardiac dysfunction combined with the blood viscosity and myocardial hypertrophy parameters in myocardial infarction (MI) rats. METHODS: Male Sprague-Dawley rats (180-200 g) were randomly divided into three groups: sham-operated, coronary artery ligation (CAL), and CAL plus GX II (GX II, 10.0 g raw materials/kg/d, bid, p.o.). The experiment was carried out at 4 time points as the 3rd, 7th, 14th, and 28th day after ligation. RESULT: It was found that on the one hand, GX II could significantly improve the heart function, and remarkably decrease infarct size and inhibit ventricular remodeling. On the other hand, GX II showed some unique effects such as angiogenesis which was induced in the left ventricular tissue. This result was consistent with the finding of an augmented vascular endothelial growth factor (VEGF) expression in this area. CONCLUSIONS: The studies demonstrated that GX II exerted extensively beneficial cardioprotective effect on CAL rats, it might stimulate angiogenesis of ischemic region to compensate blood supply to the heart via upregulated VEGF expression.     

肝癌中Ang-2的表达及其临床意义

目的探讨血管生成素2(Ang-2)与肿瘤的血管发生、入侵/转移能力和肝癌(HCC)预后之间的关系。方法采用免疫组织化学的方法检测Ang-2在肝癌、癌旁和正常肝组织中的表达。结果106例患者中,肝癌组织Ang2表达阳性的例数为63例(59.4%),Ang-2表达阳性的患者和表达阴性患者相比,很多方面有统计学差异(P<0.01),包括更低的组织学分期、门静脉侵犯(69.1%)等。Ang-2阳性表达的患者预后较差。结论肝癌Ang-2的表达和HCC的血管新生、入侵、恶性程度及疾病预后有关。     

纵切横缝分段结扎治疗环形混合痔180例临床观察

[目的]探讨治疗环形混合痔的有效方法。[方法]对180例患者采用纵切横缝分段结扎的手术方法。[结果]180例患者均痊愈,总有效率达100%,切口愈合时间15-30 d。随防2-5年,均无肛门狭窄及肛门失禁,肛门功能正常。[结论]纵切横缝分段结扎治疗环形混合痔,疗效高,无并发症及后遗症。     

门脉高压症肝脏门静脉彩色多普勒血流检测及临床意义

目的　探讨门脉高压症肝脏门静脉血流的正确检测,对其变化规律加以分析。方法　 42例病人结合肝功能Child Pugh改良法分级标准分组,对各组病人准确量取门脉主干流速剖面,检测pv、upv、rpv的平均流速、流量及血流方向,并对其结果进行统计学处理。结果　各级别组pv、upv流速、流量及血流方向变化差异显著 (P<0.05 ),而rpv的流速及血流方向变化差异不显著(P>0.05);Vpv与Vupv差异无显著性 (P>0.05 ),Vpv与Vupv,Vupv与Vrpv的变化差异有显著性 (P<0.05 );Qpv的各级别组比较差异显著(P<0.05)。结论　Qpv,Vpv,Vupv在不同级别门脉高压症中变化显著,而Vrpv变化略显迟钝。