UBD在哈、维、汉三民族食管鳞癌组织中的表达及临床病理学意义

目的 探讨泛素样蛋白D(UBD)在哈萨克族、维吾尔族和汉族3个民族食管鳞癌患者癌及癌旁组织中蛋白和mRNA水平的表达情况,并探究其临床病理学意义.方法 收集2011年1月-2014年12月173例食管鳞癌患者癌和癌旁组织标本(距癌组织＞5 cm的正常食管黏膜组织),其中包含维吾尔族、哈萨克族和汉族.采用免疫组织化学染色...     

学习型医院建设探讨——以安徽省某三级甲等医院为例

学习型医院建设是顺应新医改中“以人为本”的有关要求的举措,具有重大而深远的意义.学习型医院建设与医疗服务水平的提升、患者就医感受的改善、医务人员满意度的提高、医院的健康可持续发展等方面密切相关.该文以安徽省某三级甲等医院学习型医院建设实践为例,分析了学习型医院建设的意义和举措,探索如何将学习型医院建设落到实处.     

新疆不同民族食管癌血浆代谢组学差异分析

Objective To investigate the metabonomic variation between patients with esophageal cancer (EC) and healthy controls, and to analyze the variation between patients with EC. Methods 1H-MR and orthogonal partial least-squares discriminant analysis (OPLS-DA) was performed on 108 plasma specimens from EC patients and 50 health controls, and the metabonomic variation between patients with EC and healthy controls analyzed. Results OPLS-DA analysis might correctly separate all plasma specimens from health controls and patients with EC ,leucine(0. 0043±0. 0006,0. 0040±0. 0006) ,alanine(0. 0039±0. 0007,0. 0033±0. 0006), isoleucine (0. 0067±0. 0010,0. 0063±0. 0009), valine (0. 0037±0. 0005,0. 0035±0. 0006) ,glycopretein(0. 0123±0. 0043,0. 0102±0. 0022), lactate(0. 0342±0. 0113,0. 0258±0. 0085), acetone (0. 0027±0. 0023,0. 0017±0. 0008), acetate (0. 0007±0. 0001,0. 0006±0. 0001),choline(0.0035±0.0006, 0.0029±0.0007), isobutyrate (0.0020±0.0004, 0.0018±0.0003),unsaturated lipid (0. 0072±0. 0013,0. 0059 + 0. 0018), VLDL (0. 1209±0. 0589,0. 0879±0. 0269), LDL (0. 0885±0. 0328,0. 0785±0. 0288), 1-methylhistidine(O. 0005±0. 0001,0. 0004±0. 0005)decreased in EC patient' s plasma with statistical significance (r total>0. 27, P<0. 05), dimethylamine (0. 0004±0. 0001,0. 0005±0. 0001), α-glucose (0. 0079±0. 0013,0. 0081±0. 0016), β-glucose (0. O139±0. 0024,0. 0142±0. 0029) ,citric acid (0. 0044±0. 0008,0. 0106±0. 0058) increase in the EC patient's plasma (r total<-0. 27 ,P<0. 05). There were clear variation between Han and Kazak patients,alanine(0. 0031±0. 0005,0. 0029±0. 0004), glutamine (0. 0010±0. 0001,0. 0009±0. 0001), tyrosine (0. 0009±0. 0001,0. 0008±0. 0001), 1-methylhistidine (0. 0005±O. 0001,0. 0004±0. 0001) increased in the Han patients (r>0. 35, P>0. 05), carnitine (0. 0028±0. 0006) was higher in Kazak patients than in Han patients (0. 0025±0. 0004), which had statistical siginificance (r=-0. 40, P<0. 05). Unsaturated lipid (0. 0059±0. 0018,0. 0047±0. 0011), isoleucine (0. 0062±0. 0011,0.13058±0. 0007), alanine (0.0032±0. 0007, 0. 0028±0. 0004) ,glycoprotein (0. 0096±0. 0019,0. 0086±0. 0011) ,glutamine (0. 0011±0. 0001,0. 01309±0. 0001) ,tyrosine(0. 0009±0. 0001, 0. 0008±0. 0001), 1-methylhistidine (0. 0005±0. 0001, 0. 0004±0. 0001)were increased in Uygnr patients as compared with Kazak patients, having statistical significance (r>0. 33 ,P<0. 05), carnifine (0. 0027±0. 0005) was higher in Kazak patients than in Uygur patients (0.0025±0.0004)(r=-0.36,P<0.05). Conclusion The results indicate that1H-MR spectra of plasma analyzed by OPLS-DA statistical methods might completely separate the EC patients from health controls. The metabonomic approach should be helpful in screening of EC patients.     

高压气体冲击面部致食管严重破裂1例

外伤性胸内食管破裂中 ,高压气体冲击波所致食管破裂非常少见 ,我院 2 0 0 1年 8月 14日收治 1例 ,现报道如下。1　临床资料患者男 ,2 4岁 ,2 0 0 1年 8月 9日因高压气泵栓脱落 ,气体冲击面部致上腹部疼痛、胸闷、气短及呼吸困难 ,在当地医院经 X线检查 ,诊断为右侧液气胸 ,行胸腔闭式引流术 ,第 2天发现引流物内有食物残渣 ,经食道钡餐检查 ,确诊为食管破裂。5 d后转我院。查体 :痛苦面容 ,右胸锁中线第 2肋间置有胸腔闭式引流管 ,引流液为黄白色脓性液 ,咳嗽时有漏气。右下胸叩浊 ,右侧呼吸音减弱 ,胸透示右侧液气胸。血常规 :WBC 8.1×…     

负压吸引对肺手术后康复效果的Meta分析

目的 系统评价肺部手术后胸腔闭式引流系统接用负压吸引的康复效果,为临床提供循证证据.方法 全网检索PubMed、Embase、Web of science、Clinical trail、The Cochrane library、中国生物医学文献数据库、万方数据库、中国知网、维普期刊数据库等.检索时限均为各数据库建库至2...     

食管类癌2例

例 1　女 ,5 2岁。进食梗噎 3月余 ,体重下降 6kg,伴胸骨后疼痛 ,现仅能进半流饮食。查体未见明显阳性体征。上消化道钡餐造影显示食管中段约有 5cm长黏膜破坏 ,可见不规则钡剂充盈缺损。 2 0 0 0年 1月在全麻下行食管肿瘤切除。术中见肿瘤位于主动脉弓下 1cm ,约 5cm× 4cm× 3cm大小 ,肿瘤已侵及食管外膜 ,与纵隔胸膜粘连。切除肿瘤 ,行食管胃左颈部吻合术。术后病理镜下见瘤细胞呈明显一致性、实体巢状排列 ,核呈圆形或椭圆 ,大小相似 ,核分裂相偶见 (图1 )。免疫组化检测NSE (图 2 ) ,EMA ,Ker 。病理诊断为食管类癌 (髓质型 ) ,…     

食管癌及贲门癌伴糖尿病89例的围术期治疗

目的:探讨食管癌及贲门癌伴糖尿病患者围术期治疗的最佳方式。 方法:回顾性分析了 89例食管癌及贲门癌伴糖尿病患者的外科治疗 ,将治疗的重点放在对糖尿病监测和控制上。术前 3d停用口服降糖药 ,改为早、中、晚餐前胰岛素皮下注射 ,术中监测血糖 ,术后禁食水期间 ,每日补充的葡萄糖量不低于 12 5～ 15 0 g,并按糖∶胰岛素为 4～ 5∶ 1的比例给予胰岛素治疗 ,以防发生酮症酸中毒。 结果 :全组治愈 87例 ,死亡 2例。 结论:对于食管癌及贲门癌伴糖尿病患者 ,将血糖控制在 6～ 9mm ol/L,尿糖控制在 (± )时实施手术较为安全。另外应用有效的抗生素预防术后感染也是保证手术成功的重要因素之一。     

浅谈临床医学论文撰写中的技巧与要点

1医学论文的性质和意义医学论文是医疗、科研、教学等人员在实验和调查研究中所取得的结果的总结分析,它是具有一定规范的格式与结构的医学科学研究成果的书面文稿,医学论文作为医疗、科研、教学工作的真实记录,可反映着一个国家和地区、甚至一个医院和医护科研人员的科学研究和临床技术水平。通过发表医学论文的数量、质量和实际应用价值可以判定和评估一个医院的科研、教学、医疗水平的高低,评价一个医师的科研水平和临床能力等。     

新疆不同民族食管癌血浆代谢组学差异分析

Objective To investigate the metabonomic variation between patients with esophageal cancer (EC) and healthy controls, and to analyze the variation between patients with EC. Methods 1H-MR and orthogonal partial least-squares discriminant analysis (OPLS-DA) was performed on 108 plasma specimens from EC patients and 50 health controls, and the metabonomic variation between patients with EC and healthy controls analyzed. Results OPLS-DA analysis might correctly separate all plasma specimens from health controls and patients with EC ,leucine(0. 0043±0. 0006,0. 0040±0. 0006) ,alanine(0. 0039±0. 0007,0. 0033±0. 0006), isoleucine (0. 0067±0. 0010,0. 0063±0. 0009), valine (0. 0037±0. 0005,0. 0035±0. 0006) ,glycopretein(0. 0123±0. 0043,0. 0102±0. 0022), lactate(0. 0342±0. 0113,0. 0258±0. 0085), acetone (0. 0027±0. 0023,0. 0017±0. 0008), acetate (0. 0007±0. 0001,0. 0006±0. 0001),choline(0.0035±0.0006, 0.0029±0.0007), isobutyrate (0.0020±0.0004, 0.0018±0.0003),unsaturated lipid (0. 0072±0. 0013,0. 0059 + 0. 0018), VLDL (0. 1209±0. 0589,0. 0879±0. 0269), LDL (0. 0885±0. 0328,0. 0785±0. 0288), 1-methylhistidine(O. 0005±0. 0001,0. 0004±0. 0005)decreased in EC patient' s plasma with statistical significance (r total>0. 27, P<0. 05), dimethylamine (0. 0004±0. 0001,0. 0005±0. 0001), α-glucose (0. 0079±0. 0013,0. 0081±0. 0016), β-glucose (0. O139±0. 0024,0. 0142±0. 0029) ,citric acid (0. 0044±0. 0008,0. 0106±0. 0058) increase in the EC patient's plasma (r total<-0. 27 ,P<0. 05). There were clear variation between Han and Kazak patients,alanine(0. 0031±0. 0005,0. 0029±0. 0004), glutamine (0. 0010±0. 0001,0. 0009±0. 0001), tyrosine (0. 0009±0. 0001,0. 0008±0. 0001), 1-methylhistidine (0. 0005±O. 0001,0. 0004±0. 0001) increased in the Han patients (r>0. 35, P>0. 05), carnitine (0. 0028±0. 0006) was higher in Kazak patients than in Han patients (0. 0025±0. 0004), which had statistical siginificance (r=-0. 40, P<0. 05). Unsaturated lipid (0. 0059±0. 0018,0. 0047±0. 0011), isoleucine (0. 0062±0. 0011,0.13058±0. 0007), alanine (0.0032±0. 0007, 0. 0028±0. 0004) ,glycoprotein (0. 0096±0. 0019,0. 0086±0. 0011) ,glutamine (0. 0011±0. 0001,0. 01309±0. 0001) ,tyrosine(0. 0009±0. 0001, 0. 0008±0. 0001), 1-methylhistidine (0. 0005±0. 0001, 0. 0004±0. 0001)were increased in Uygnr patients as compared with Kazak patients, having statistical significance (r>0. 33 ,P<0. 05), carnifine (0. 0027±0. 0005) was higher in Kazak patients than in Uygur patients (0.0025±0.0004)(r=-0.36,P<0.05). Conclusion The results indicate that1H-MR spectra of plasma analyzed by OPLS-DA statistical methods might completely separate the EC patients from health controls. The metabonomic approach should be helpful in screening of EC patients.     

青年人食管癌的外科诊治分析

目的:探讨青年人食管癌的特点和外科治疗。方法:回顾性分析手术治疗的50例青年人(≤40岁)食管癌和同期100例(按1:2比例随机抽取)中老年(>40岁)食管癌病人的临床病理资料和手术治疗情况。结果:青年人食管癌病人误诊率高.肿瘤病理分化差,浸润度深,区域淋巴结转移率高,TNM分期Ⅲ、Ⅳ期比例高,术前合并症和术后并发症发生率低。结论:青年人食管癌恶性程度高、易误诊,应早期诊断治疗,采取以手术为主的综合治疗。