远离食管癌 这些习惯要不得

根据世界卫生组织发布的癌症数据显示:2018年全世界食管癌患者增加57万例左右。而我国是世界上食管癌的尚发地区之一。通过世界卫生组织发布的癌症地图,按照年龄标准化、性别分类,可以看到中国食管癌的发病率居高不下,且男性多于女性,发病年龄多在40岁以上。     

Risk Factors of Complications after CT-guided Percutaneous Needle Biopsy of Lumps Near Pulmonary Hilum

The factors influencing the incidence of common complications(pneumothorax and pulmonary hemorrhage) of CT-guided percutaneous needle biopsy of lumps near pulmonary hilum were investigated. CT-guided percutaneous needle biopsy of lumps near pulmonary hilum was performed on 48 patients. The complications of pneumothorax and pneumorrhagia as well as the contributing factors were analyzed statistically. The major complications associated with CT-guided needle biopsy included pneumothorax(13 cases, 27.1%) and pulmonary hemorrhage(14 cases, 20.24%). ?2 test revealed that pneumothorax was associated with the lesion size and depth of needle penetration, and pulmonary hemorrhage with the depth of needle penetration and needle retention time with a significant P value. Pneumothorax was observed in 7 cases(17.5%) out of 40 cases with diameter of mass greater than 3 cm, and in 6 cases(60%) out of 10 cases with depth of needle penetration greater than 4 cm. Additionally, pulmonary hemorrhage was identified in 12 cases(41.4%) out of 29 cases with needle retention time longer than 15 min, and pulmonary hemorrhage in 7 cases(70%) out of 10 cases with depth of needle penetration greater than 4 cm. CT-guided percutaneous needle biopsy of lumps near pulmonary hilum is safe and effective. The key factors to prevent the complications include correct evaluation of lesion size, depth of needle penetration and the needle retention time before the operation. Key words: biopsy, CT-guided; hilum; pneumothorax; pulmonary hemorrhage     

青少年鼻咽癌治疗现状

鼻咽癌（NPC）是一种起源于鼻咽部上皮细胞的恶性肿瘤,是青少年人群头颈部最常见的恶性肿瘤之一。青少年鼻咽癌的治疗通常参照成人治疗指南,但是青少年鼻咽癌有其自身的临床特点。对于处于发育阶段的青少年患者来说,治疗的晚期不良反应也不可忽视。寻找适合青少年的治疗方案具有重要意义。本文对青少年鼻咽癌的流行病学、临床特点、治疗现状和有前景的降低治疗强度的策略作一论述,旨在为今后的治疗研究提供思路。     

自制火焰光度计采样小装置

在医院的化验分析设备中,用于人体血液钾、钠含量分析的火焰光度计是使用比较频繁的一种仪器。但由于仪器工作时标本需由操作员一个一个试管地送入,因而操作极不方便。为改变这种状况,我们设计了如图所示的小装置,减轻了劳动强度,提高了工作效率。操作时,把配制好的标本试管按序号插入该装置试管盘后,用手转动试管盘。试管盘上的定位槽在定位片及手的旋转压力作用下使试管盘向下移动,仪器采样吸管就退出     

先天性唇、腭裂修补术的麻醉体会

我院在2003年1月～11月底,共对唇腭裂修补术施行麻醉41例,无1例死亡,现小结如下。1临床资料全组41例,男23例,女18例。唇裂20例,腭裂17例,唇腭裂4例。3岁以下27例,4～6岁9例,7～12岁3例,13岁以上2例。年龄最小70天,最大21岁。手术时间最短35分钟,最长3小时20分钟。麻醉时间最短50分钟,最长5小时20分钟。麻醉方法:病例均采用静吸复合全麻气管插管,其中口腔插管20例,鼻腔插管21例。麻醉用药,单纯唇裂Ⅰ°～Ⅱ°,手术时间相对较短,用氯东利合剂,芬太尼、氯胺酮完成麻醉。腭裂或唇腭裂手术较复杂,手术时间较长,除用以上麻醉药外,还适量吸入安/异…     

胰腺囊性肿瘤15例的诊断与外科治疗

目的探讨胰腺囊性肿瘤的临床诊断策略、手术时机和方法以及并发症的处理。方法选择本院2002年1月～2012年5月共确诊收治胰腺囊性肿瘤患者15例,根据术前辅助检查确定的肿瘤部位、性质、大小采取不同的手术方式,并对患者预后和并发症进行分析。结果术前B超和CT确诊率分别为66.7%和80.0%。经病理确诊黏液性囊腺瘤6例、浆液性囊腺瘤4例、囊腺癌2例、导管内乳头状黏液性肿瘤3例。15例患者均接受手术治疗,且术中无死亡病例,其中3患者接受保留十二指肠的胰头切除术,5例患者接受胰十二指肠切除术,4例患者接受胰腺体尾部切除术,1例患者接受胰腺节段切除术,2例患者接受胰腺全切治疗。术后1例患者出现胃瘫,3例患者发生胰漏,经对症治疗后均或缓解,所有患者均康复出院,且均获随访,随访率100%,时间7个月～8年,平均3.3年,仅1例患者术后19个月复发死亡。结论胰腺囊性肿瘤临床表现不明显,对病理类型术前难以确诊,及时采取手术治疗仍是最为有效的治疗手段,但应遵循个体化的原则,选择合理术式,降低并发症的发生。     

直肠癌不同吻合术对排便功能的影响

目的探讨低位吻合术与超低位吻合术对低位直肠癌患者术后排便功能的影响。方法回顾性本院2008年4月至2012年1月确诊,且行保肛手术治疗的低位直肠癌患者152例的临床资料,按照术中吻合方式分为2组,其中70例患者接受低位吻合术(A组),82例患者接受超低位吻合术纳入B组,并对两组患者术后直肠肛门压力以及肛门排便功能的影响进行比较。结果两组患者术前各项指标差异不显著(P>0.05),术后6个月时,B组在静息压、最大收缩压、最大收缩时间方面显著低于A组(P<0.05),两组术后12个月的总优良率分别为77.1%和62.2%,A组总优良率显著高于B组(P<0.05),术后总满意度分别为82.9%和68.3%,A组总优良率显著高于B组(P<0.05)。结论两种直肠癌吻合术各具特色,其中超低位吻合术术后对排便能力影响较大。     

Correlation between increased circulating endothelial progenitor cells and stage of non-hodgkin lymphoma

This study aims to examine the levels of circulating endothelial progenitor cells (cEPCs) in the peripheral blood of patients with non-Hodgkin lymphoma (NHL) and their correlation with the tumor stage. Forty-one patients with biopsy-proven NHL and 16 healthy individuals were recruited. Peripheral blood mononuclear cells (PBMCs) were isolated by density gradient centrifugation, and cEPCs were characterized by triple staining using antibodies against CD133, CD34 and vascular endothelial growth factor receptor-2 (VEGFR-2, CD309) and quantified by flow cytometry. In NHL patients, the number of cEPCs was significantly greater than in control group (P=0.000). The cEPCs counts in patients with NHL of stage Ⅲ-Ⅳ were significantly greater than in stage Ⅰ-Ⅱ (P=0.010). FACS analysis revealed that the number of cEPCs in NHL patients had no correlation with the gender (P=0.401) or the pathological category (P=0.852). It was suggested that the over-expression of cEPCs in NHL patients may serve as a novel biomarker for disease progression in NHL.     

谷氨酰胺在胃肠肿瘤患者术后的应用进展

谷氨酰胺(glutamine,Gln)是血液循环和组织内游离氨基酸池中含量最丰富的一种氨基酸,既能为氨基酸、蛋白质、核酸的合成提供氮源,又能被氧化释放能量。Gln是一种特殊的营养物质,是一种条件性必需氨基酸,约占全身游离氨基酸的60%,它是血浆中含量最高的氨基酸,正常血浆浓度为0.6~0.9 mmol/L。近年来,随着临床营养领域研究的不断深入,单纯的营养支持已逐步转为免疫营养治疗的概念。Gln能够提     

新型培养体系下小肠类器官模型的构建

目的构建具有损伤再生能力的新型小肠类器官, 体外模拟肠道损伤、再生和修复过程。方法分离6～8周龄、18～24 g无特定病原体动物级C57BL/6小鼠回肠黏膜隐窝结构, 设计ENR、ENR+肿瘤坏死因子-α(TNF-α)和8C培养体系, 分别构建肠道稳态、炎症损伤和损伤再生条件下的小肠类器官并观察形态。通过免疫荧光染色检测类器官包含的细胞类型和空间排布, 以及损伤再生基因凝集素蛋白(Clu)、膜联蛋白A1(Anxa1)、干细胞抗原1(Sca1)和小鼠再生胰岛衍生蛋白3β(Reg3b)的蛋白质表达情况。通过实时荧光定量聚合酶链反应(qRT-PCR)检测Clu、Anxa1、Sca1、Reg3b的mRNA表达情况。统计学方法采用独立样本t检验。结果 8C和ENR培养体系下的小肠类器官均包含肠道干细胞、杯状细胞、潘氏细胞和肠道内分泌细胞, 细胞空间排布与肠上皮基本一致。8C培养体系下的新型小肠类器官的扩增能力较ENR、ENR+TNF-α培养体系下的小肠类器官明显增强, 生长速度更快, 结构更大、更复杂。qRT-PCR结果显示, 8C培养体系下的新型小肠类器官再生基因Clu、Anxa1和Sca1的...