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。     

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.     

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。     

嗜酸性粒细胞阳离子蛋白测定的影响因素探讨

目的探讨温度、抗凝剂(EDTA-K2)对血嗜酸性粒细胞阳离子蛋白(ECP)水平的影响。方法采用固相双位点酶放大化学发光法,分别对22例健康体检者在两种不同温度(25℃和37℃)的血清标本,以及在相同温度(37℃)下,加抗凝剂和不加抗凝剂的血标本进行ECP水平测定。结果25℃组和37℃组血清ECP水平分别为8.92±6.45μg/L(x±s)和19.87±12.16μg/L(x±s),两组有显著性差异(P<0.01);37℃温度下加抗凝剂和不加抗凝剂血标本的ECP水平分别为5.26±2.60μg/L(x±s)和19.87±12.16μg/L(x±s),两组也有显著性差异(P<0.001)。结论温度和抗凝剂(EDTA-K2)对血标本的ECP水平测定有不同程度的影响。     

登革病毒感染后小鼠细胞免疫功能的动态变化

从登革Ⅱ型病毒感染成年ＢＡＬＢ／ｃ小鼠为模型，观察感染后不同时间机体细胞免疫反应的变化。结果表明：感染后７－１４ｄ免疫功能处于激活状态，表现为腹腔巨噬细胞的吞噬功能和脾淋巴细胞对ＣｏｎＡ的反应及ＩＬ－２产生水平都明显高于对照组，感染２１ｄ后免疫功能则转为抑制状态，上棕免疫反应明显低于对照组，脾中的Ｌ３Ｔ４＾＋细胞亚群的百分比逐渐下降；相反，ＬＹＴ２＾＋细胞亚群的百分比逐渐升高，这种抑制现象可维持到     

261例恶性肿瘤患者血液流变学的检测结果

检测261例恶性肿瘤(肺癌、乳腺癌、胃癌、原发性肝癌、恶性淋巴瘤、食管癌及结直肠癌等)患者的血液流变学水平,并与健康人作了比较。检测结果表明,恶性肿瘤患者的血浆粘度,全血低切粘度及血沉均有明显升高(P<0.05和0.01);而血细胞压积(除乳腺癌外)均低于健康人(P<0.01)。纤维蛋白原水平除恶性淋巴瘤及肠癌外均有明显增高(P<0.05和0.01)。肿瘤复发转移患者仅血浆粘度高于无复发转移者(P<0.01)。作者还对原发性肝癌和肝硬化病人、胃癌和慢性胃炎病人的血液流变学各项指标做了比较分析,结果发现某些指标有明显差异,以血浆粘度变化尤为明显。因此认为血浆粘度对良、恶性的肝、胃疾患可能有一定的鉴别诊断意义。