浅谈乳腺叶状囊肉瘤与乳腺纤维腺瘤超声影像的相关性及临床意义

乳腺纤维腺瘤发病率在乳腺良性肿瘤中居首位,而乳腺叶状囊肉瘤在临床恶性病变中也并不罕见,有的学者报道与乳腺癌之比可达1∶20.国内有些学者认为,叶状囊肉瘤虽然可以由纤维腺瘤经肉瘤变而成,但是也可能开始时就是肉瘤.本文通过对32例经手术病理证实的病例进行回顾分析,以探讨二者超声影像的相关性及临床意义.     

神经导航技术在脊柱固定手术中的应用(附16例报告)

目的探索使用神经导航技术进行脊柱内固定。方法在神经导航辅助下,对16例患者置入70根椎弓根(侧块)螺钉。通过术后X线摄片核实椎弓根螺钉置入的准确性。结果置入的70根椎弓根(侧块)螺钉长度和直径选择合适,其中68根(97·1%)固定位置及方向准确;早期曾有1根穿出至椎体前方(<1mm),未作处理;1根穿出至椎间盘,经翻修后固定情况良好。无神经和血管损伤症状。结论使用神经导航技术,可以前瞻性地判断置入椎弓根(侧块)钉的大小、位置,实时监测置入过程,提高置入的准确性和安全性。术中脊柱影像三维重建及注册配准对神经导航的准确性有较大影响。     

Goldenhar 综合征家系的临床表型和遗传学分析

目的分析1组Goldenhar综合征家系的临床表现及遗传学特征。方法我们随访到1组4代33人的Goldenhar综合征家系，对目前存活的29人进行了临床表型和遗传学的初步分析。结果家系内有Goldenhaar综合征患者5人．临床表现具高度多样性，累及眼、耳、脊柱、颜面、口腔等多个器官和系统的发育不良，在遗传方式上属于常染色体显性遗传。从细胞遗传学水平对家系中成员进行染色体检查，未发现核型异常。结论该Goldenhar综合征家系属常染色体显性遗传，染色体检查未发现核型异常。     

脱乙酰壳聚糖-抗坏血酸盐促进腭裂术后愈合的药效学研究

目的 腭裂手术创口是一类不易愈合的创口，为促进腭裂术后创口愈合速度与质量，减少术后复裂率，在腭裂动物模型上对脱已酰壳聚糖的作用进行药效学研究。方法 选20只Wistar大鼠随机分4组，以两种不同术式的实验组与相应的对照组进行实验。术后1、3、5、7、10天分别进行，)盏床观察和组织病理学观察。结果 实验组1，术后1天创面有缺血，3和5天粘膜颜色基本正常，7和10天拆线后的创口均为一期愈合。对照组1，术后1天创面有缺血，3和5天创缘糜烂，7天减轻，10天拆线创口二期愈合。实验组2与其对照组均有显著差异。组织病理，实验组1和组2重建覆盖上皮较对照组出现的早，实验组2缺损断端有新形成的骨组织连接，新骨周边可见成骨细胞，对照组1，有成纤维连接和炎细胞浸润。对照组2，缺损断处有新形成的软骨细胞，有炎细胞浸润。结论 脱已酰壳聚糖对腭裂术后的愈合有较明显的作用，有深入研究和临床应用的价值。     

Health Behavior Correlates of Depression in a Sample of High School Students

Frequency of symptoms of depression and selected health-related practices and events were measured in a sample of 219 high school students. Students reported numerous symptoms of depression. Relative proportions of boys and girls reporting symptoms of depression were not significantly different. However, girls reported experiencing more severe depression than their male counterparts. Depression correlated significantly with several of the 22 health practices and states of affect examined. Both the determinants and manifestations of depression in adolescent cohorts require in-depth investigation. Possible implications for school health personnel are discussed.     

DNA双链断裂残留损伤与癌细胞辐射敏感性研究

目的 了解不同组织来源癌细胞株和人体肿瘤组织原代细胞的DNA双链断裂损伤修复的个体差异性,探寻预测癌细胞辐射敏感性的生物指标。方法 ⁶⁰Co γ射线照射诱发DNA损伤,脉冲电场凝胶电泳检测DNA双链断裂损伤修复,细胞克隆形成能力法检测细胞辐射敏感性。结果 8个不同组织来源癌细胞株的辐射敏感性有较大的差异(D₀为0.65~2.15 Gy),不同细胞株20 Gy γ射线照射诱发产生的DNA双链断裂原初损伤有一定的差别,但与细胞辐射抗性无相关性。辐射敏感细胞SX-10的DNA双链断裂修复缺陷发生在早期快速修复相,而A2780细胞的修复缺陷是发生在晚期慢速修复相。20 Gy照射修复2 h后DNA双链断裂残留量与细胞辐射敏感性指标D₀或SF₂值有显著的相关性。不同个体患者脑肿瘤组织原代细胞之间,辐射诱发DNA双链断裂的修复反应存在明显差异,修复2 h后残留损伤的个体差异性分布类似于癌细胞株。结论 DNA双链断裂残留损伤与癌细胞辐射抗性有显著相关性,可作生物指标预测肿瘤组织细胞对放射治疗的反应性。     

慢性硬膜下血肿术后并发症原因分析及应对措施

目的探讨慢性硬膜下血肿（chronic subdural hematoma，CSDH）术后并发症的原因及应对措施。方法回顾2000年至2004年手术治疗的85例CSDH患者，并结合有关文献进行相关分析。结果术后血肿复发3例，张力性气颅1例，脑挫裂1例，硬膜外血肿3例，脑脊液漏1例，脑内血肿1例。结论认识CSDH术后并发症的原因，早期采取有效措施，可有效预防并发症。     

肾功能损伤分级系统在成人心脏术后的应用

Objective The aim of this study was to evaluate of adilty of two acute renal failure-specific scoring systenms (the classification by Bellome et al and the AKIN criteria) for predicting hospital mortality after cardiac surgery in adult patients. Methods Between October 1 st 2006 to Decemjber 31 st 2006, 509 adult patients who ungerwent coronary artery bypass grafting (CABG) and/ or valve operation were enrolled in this study. The medical data collection included gender, age, types of operation, perioperative he- modynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed daily according to the classi- ficatinn by Bellomo and the AKIN criteria, respectively. As references, Acure Physiology and Chronic Health Evaluation(APACHE) Ⅱ and Sepsis-related Organ Failure Assessment (SOFA) score were also calculated. Resuits Three hundred and forty-one patients were male (67.0%), and 168 were female (33.0%), mean age was (56.2±12.0) years old. Tnree hundred and nine patieats un- derwent CABG, 182 underwent valve operation and 18 underwent CABG plus valve operation, Mean duration of ventilation support was (20.4±17.7) houra, and the ICU stay was (1.4±1.0) days. Postoperative hospital stay was (13.8±9.1) days. According to the classification by Bellomo., the highest in-hospital mortality was 52.9% in ARFS group. Mahiplicatinn of in-hospital morality rate was abserved (X2 for trend, P<0.01) in 0.4% (non-ARF), 1.2% (stage 1), 12.0% (stal～ 2) and 32.4% (stage 3) of pa- tients based on the AKIN criteria. By applying the area under the receiver operating characteristic ourve, the classification by Bellomo and the AKIN criteria had good discriminative power. Furthering, multivariate logistic regression analysis verified that the Odds Ratio of the AKIN criteria was 5.478 (P =0.028, 95% Confidence Interval 1.027- 24.856), after adjusting for gender and age. Con- clusion Analytical data confinned good discriminative power of both the AKIN criteria and the classification by Bellomo for predicting hospital mortality of adult postoperative patient with ARF.     

前列腺癌组织中性激素受体表达的分析

目的:定性分析雄激素受体(AR)、雌激素受体(ER)、孕激素受体(PR)在良性前列腺增生(BPH)和前列腺癌(PCa)组织中的阳性表达,为激素治疗PCa和预后判断提供一定的依据。方法:采用免疫组化DAKO Envision二步法,分析30例BPH与32例PCa标本中AR、ER、PR的阳性表达情况。结果:AR、ER、PR阳性数BPH组分别为22、10、6例;PCa组分别为18、14、2例,两组差异无显著性。随访30例PCa患者术后的生存期表明:AR表达阳性者平均生存时间为6.41年,AR阴性者为4.28年,两者差异有统计学意义(P<0.05)。结论:BPH和PCa患者在性激素受体表达上的差异无显著意义;PCa患者中AR表达阳性者平均生存时间长于AR阴性者,后者的预后较差,对AR阴性者行激素治疗效果不确定。     

心痛灵喷雾剂抗心肌缺血的实验观察

①目的　观察心痛灵喷雾剂对心肌缺血大鼠的药理作用。②方法　通过结扎大鼠冠状动脉前降支制备大鼠心肌缺血模型 ,观察心痛灵喷雾剂对心肌缺血面积和血清磷酸肌酸激酶 (CK)、乳酸脱氢酶 (LDH)、谷草转氨酶 (GOT)的影响 ;静脉注射垂体后叶素制备大鼠心肌缺血模型 ,观察心痛灵喷雾剂对心电图改变的影响。③结果　心痛灵喷雾剂可减少心肌缺血大鼠心肌梗死面积 ,降低血清CK、LDH、GOT活性 ,并减轻静脉注射垂体后叶素引起的缺血性心电图改变 (tD=1.2 2 3～ 13.890 ,P <0 .0 5、0 .0 1)。④结论　心痛灵喷雾剂具有抗心肌缺血的作用