肱动脉受压致血栓性闭塞1例报告

正1病例资料患者男,65岁,因"右上肢发凉伴疼痛不适1月"入院。患者1个月前无明显诱因出现右上肢发凉,伴疼痛,呈憋胀痛,无肢体麻木及活动障碍,症状逐渐加重,右手小指指端破溃结痂。查体右上肢皮温低,桡动脉、肱动脉未触及搏动,左侧正常。患者既往体健,无高血压及糖尿病史,每日坚持乒乓球运动10余年,肱二头肌发达,间断拉伤数次。入院后根据病史、查体及发病特点首先考虑上     

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??CXCR4 to clinically distinguish malignant biliary obstruction from benign biliary obstruction LIN Ke-yu??SU Hua-wei. Department of General Surgery??the Second Affiliated Hospital of Harbin Medical University??Harbin 150086??China
Correspongding??SU Hua-wei??E-mail??Shw@medmail.com.cn
Abstract Objective Aim of the study was to investigate the value of bile and serum chemokine receptor-4??CXCR4) for distinguishing malignant biliary obstruction from benign biliary obstruction. Methods Selected 44 cases of obstructive jaundice patients treat in the second affiliated hospital of Harbin medical university in February 2013 to June??including 21 cases of malignant biliary obstruction??23 cases of benign biliary obstruction. Their sera and bile were collected to detect the CXCR4 concentration by using enzyme-linked immunosorbent method, and conventional testing other biochemical indexes: hemoglobin(Hb)??total bilirubin??direct bilirubin??alkaline phosphatase(ALP)??alanine aminotransferase(ALT)??aspartate aminotransferase(AST)??γ-glutamine transferase ammonia(GGT). Do a statistical analysis of the index difference of benign and malignant biliary obstruction patients. Results We can found that age??sex??hemoglobin??ALT??AST??ALP had no significant value between the benign and malignant biliary obstruction (P>0.05). However??r-GT??total bilirubin??serum CXCR4??bile CXCR4 had statistical significance (P<0.05). The result of multiple regression analysis show that the 5 indicators which enriched in the regression analysis??only the bile CXCR4 had relationship with benign and malignant biliary obstruction (OR=1.05??95%CI 1.04~1.06??P<0.05). Conclusion Measurement of biliary CXCR4 may differentiate malignant biliary from benign biliary strictures??and for the clinical differential diagnosis has a reference value.     

干细胞治疗下肢缺血性疾病的Meta分析

目的:采用Meta分析综合评价干细胞治疗下肢缺血性疾病的疗效。方法 :利用计算机检索国内外发表的有关干细胞治疗下肢缺血性疾病的文献,经质量评价后按一定标准纳入文献,应用RevMan 6.0软件进行分析。运用漏斗图、Begg’s回归分析对各研究间进行发表偏倚估计。结果:共纳入16项研究,包括629例研究对象。Meta分析结果显示,干细胞治疗后TcPO2水平升高(WMD=9.27,95%CI:4.53~14.00,P=0.000),ABI水平升高(WMD=0.13,95%CI:0.19~0.18,P=0.000),温度测定水平升高(WMD=2.75,95%CI:1.92~3.75,P=0.000)。3个Meta分析存在异质性,发表偏倚结果显示,漏斗图对称,Begg’s回归分析结果显示无发表偏倚。结论:干细胞治疗下肢缺血性疾病有效,远期安全性仍需大规模循证医学证实。