全喉切除术中保留甲状软骨膜对手术进程和术后恢复影响的探讨

目的：探讨保留甲状软骨膜对全喉切除手术进程和病人术后恢复情况的影响。方法：在甲状软骨膜下游离甲状软骨并切断其上角。不结扎和切断舌骨下肌群和喉上动脉。保留之甲状软骨膜用以加强修复咽壁黏膜。结果：本组病例较经典全喉切除术手术时间缩短30min以上。手术中出血在100ml以下。患者术后第2d下床活动，第4d开始进食流质。手术创口均一期愈合。结论：全喉切除术中保留甲状软骨膜可有效地简化手术步骤，减少创伤和出血。利用甲状软骨膜加强咽壁黏膜缝合口，进一步减少了咽漏的发生.     

有螺沟渠硬化后钉螺复现原因

目的 目的 了解有螺沟渠硬化后钉螺复现的影响因素, 提出改进措施, 提高沟渠硬化工程的灭螺效果。方法 方法 采用回顾性调查与现场调查相结合的方法, 收集荆门市13个血吸虫病流行区乡 （镇） 实施沟渠硬化灭螺工程和螺情资料, 统计沟渠硬化工程的灭螺效果, 分析钉螺复现的原因。结果 结果 共调查151条硬化沟渠, 71条沟渠钉螺复现, 复现沟渠条数占 47.02%。钉螺面积灭光率为78.79%。钉螺复现的主要原因为上游螺区扩散、 硬化沟渠破损、 工程前未药物灭螺和施工带入钉螺等。结论 结论 单纯硬化有螺沟渠并不能彻底消灭钉螺; 科学规划沟渠硬化工程、 工程前药物灭螺和加强工程后期维护是提高灭螺效果的关键。     

HLA-G对人羊膜间充质细胞免疫调节功能的影响

人类白细胞抗原G(HLA-G)是一种非经典的HLA Ⅰ类抗原,具有抑制炎症反应,协助肿瘤细胞逃逸,促使移植物免疫耐受的作用.人羊膜间充质细胞(HAMC)表达和分泌HLA-G,它能参与HAMC的免疫调节功能,抑制NK、T、B细胞的功能,影响树突状细胞(DC)的活性,为阐述HAMC的免疫抑制机制提供了理论依据.本文主要综述HLA-G的基因及分子结构,HLA-G在HAMC免疫抑制功能中的可能机制及HLA-G与HAMC、NK、DC、T细胞和B细胞的关系.     

迈瑞公司labXpert系统在血细胞分析自动审核中的应用

 目的 探讨迈瑞公司labXpert系统在血细胞分析自动审核中的应用。方法 选择2017年6－7月采用迈瑞公司labXpert(专家系统)软件审核的血常规数据进行分析。主要包括:(1)统计总体自动审核比例;(2)对违反复检规则的样本进行分析,分析违反规则的样本构成;(3)随机分析800例血常规样本周转时间(TAT)平均值、中位数,并将自动审核与传统审核方式进行对比;(4)统计TAT超过30 min的比例,并将该群样本构成进行分析。结果 共统计10 860例血常规标本,自动审核通过率为84.2%;违反复检规则主要样本类型为:未成熟粒细胞报警提示及数目、WBC超范围(WBC<4.0×10⁹/L或>30×10⁹/L)及反应性淋巴细胞报警提示等相关规则。自动审核TAT中位数为20 min, TAT超过30 min比例为20.63%;传统审核TAT中位数为26 min, TAT超过30 min比例为30.25%;自动审核与传统审核比较,差异有统计学意义(P<0.05)。TAT超时的样本中,WBC系异常最多(P<0.05),其次为RBC系异常及PLT系异常。结论 采用专家系统软件对标本进行自动审核,在保证报告质量同时可以提高工作效率,缩短TAT时间,实验室可以采用该软件对异常构成进行分析,有针对性地优化血常规分析流程。     

Clinical significance of vascular endothelial growth factor expression and neovascularization in colorectal carcinoma

AIM: To clarify the association of vascular endothelial growth factor (VEGF) and microvascular density (MVD)expression with the angiogenesis and prognosis of colorectal cancer.METHODS: A total of 97 cases of colorectal carcinomas were examined by immunohistochemical staining (SP method), using anti-VEGF and anti-factor CD34+ monoclonal antibodies. RESULTS: VEGF positive staining was obtained in 68 out of 97 cases (70.1%), and observed mainly in the cytoplasm of tumor cells, and also frequently in stromal cells. VEGF expression was more intense in poorly differentiated adenocarcinoma in comparison with others, but there was no significant correlation between VEGF expression and age,sex and stage. A significant correlation was found between the MVD and grades, and there was no significant relationship between the MVD and age, sex, and stage. The MVD in the VEGF positive group (68 cases) was higher than that in the negative group. Upon multivariate analysis, the significant variables were stage, tumor grade and MVD; VEGF expression was not an independent prognostic factor. CONCLUSION: The expression of VEGF has a significant correlation with MVD; MVD expression has prognostic value but VEGF has not in colon cancer.     

Melatonin attenuates acute pancreatitis-associated lung injury in rats by modulating interleukin 22

AIM:To investigate whether therapeutic treatment with melatonin could protect rats against acute pancreatitis and its associated lung injury.METHODS:Seventy-two male Sprague-Dawley rats were randomly divided into three groups:the sham operation(SO),severe acute pancreatitis(SAP),and melatonin treatment(MT) groups.Acute pancreatitis was induced by infusion of 1 mL/kg of sodium taurocholate(4% solution) into the biliopancreatic duct.Melatonin(50 mg/kg) was administered 30 min before pancreatitis was induced,and the severity of pancreatic and pulmonary injuries was evaluated 1,4 and 8 h after induction.Serum samples were collected to measure amylase activities,and lung tissues were removed to measure levels of mRNAs encoding interleukin 22(IL-22) and T helper cell 22(Th22),as well as levels of IL-22.RESULTS:At each time point,levels of mRNAs encoding IL-22 and Th22 were significantly higher(P 0.001) in the MT group than in the SAP group(0.526 ± 0.143 vs 0.156 ± 0.027,respectively,here and throughout,after 1 h;0.489 ± 0.150 vs 0.113 ± 0.014 after 4 h;0.524 ± 0.168 vs 0.069 ± 0.013 after 8 h,0.378 ± 0.134 vs 0.122 ± 0.015 after 1 h;0.205 ± 0.041 vs 0.076 ± 0.019 after 4 h;0.302 ± 0.108 vs 0.045 ± 0.013 after 8 h,respectively) and significantly lower(P 0.001) in the SAP group than in the SO group(0.156 ± 0.027 vs 1.000 ± 0.010 after 1 h;0.113 ± 0.014 vs 1.041 ± 0.235 after 4 h;0.069 ± 0.013 vs 1.110 ± 0.213 after 8 h,0.122 ± 0.015 vs 1.000 ± 0.188 after 1 h;0.076 ± 0.019 vs 0.899 ± 0.125 after 4 h;0.045 ± 0.013 vs 0.991 ± 0.222 after 8 h,respectively).The mean pathological scores for pancreatic tissues in the MT group were significantly higher(P 0.01) than those for samples in the SO group(1.088 ± 0.187 vs 0.488 ± 0.183 after 1 h;2.450 ± 0.212 vs 0.469 ± 0.242 after 4 h;4.994 ± 0.184 vs 0.513 ± 0.210 after 8 h),but were significantly lower(P 0.01) than those for samples in the SAP group at each time point(1.088 ± 0.187 vs 1.969 ± 0.290 after 1 h;2.450 ± 0.212 vs 3.344 ± 0.386 after 4 h;4.994 ± 0.184 vs 6.981 ± 0.301 after 8 h).The severity of SAP increased significantly(P 0.01) over time in the SAP group(1.088 ± 0.187 vs 2.450 ± 0.212 between 1 h and 4 h after inducing pancreatitis;and 2.450 ± 0.212 vs 4.994 ± 0.184 between 4 and 8 h after inducing pancreatitis).CONCLUSION:Melatonin protects rats against acute pancreatitis-associated lung injury,probably through the upregulation of IL-22 and Th22,which increases the innate immunity of tissue cells and enhances their regeneration.     

3D-DSA技术在诊断颅内动脉瘤中的应用价值

目的:评价3D-DSA技术在颅内动脉瘤诊断中的应用价值。方法:回顾15例蛛网膜下腔出血患者应用传统DSA及3D-DSA进行检查,对比不同方法对动脉瘤的显示情况。结果:所有患者均确诊为颅内动脉瘤,其中常规DSA能确诊12例,3例可疑动脉瘤,常规DSA中只有7例能清楚显示瘤颈形态及载瘤动脉与瘤体的关系。所有病例中3D-DSA均匀清楚显示动脉瘤形态及瘤体与载瘤动脉关系,特别对3例可疑小动脉瘤的显示明显优于常规DSA。结论:3D-DSA技术对颅内动脉瘤病变显示佳,能提高对颅内动脉瘤的诊断水平.     

TACE联合经皮热消融治疗大肝癌的疗效及预后分析

目的 探讨经皮热消融[射频消融(RFA)及微波消融(MWA)]联合经动脉化疗栓塞术(TACE)治疗大肝癌的疗效及预后.方法 2003年5月至2009年5月中山大学附属第一医院TACE联合热消融治疗45例5～10 cm大肝癌患者,肝功能为Child-Pugh A、B级,其中25例行TACE+RFA治疗,20例行TACE+...     

Spontaneous internal carotid artery pseudoaneurysm complicated with ischemic stroke in a young man: A case report and review of literature

BACKGROUNDCarotid artery pseudoaneurysm (PSA) is infrequently encountered in clinical settings. Internal carotid artery (ICA) PSA complicated with ischemic stroke is rare. PSAs are typically caused by iatrogenic injury, trauma, or infection. The underlying mechanisms of spontaneous PSA formation are not well characterized. We report a healthy young man who presented with stroke as a complication of spontaneous PSA of the left ICA.CASE SUMMARYA 30-year-old man working as a ceiling decoration worker was hospitalized due to sudden-onset speech disorder and right lower extremity weakness. Medical history was unremarkable. Brain computed tomography revealed ischemic stroke. Digital subtraction angiography showed a left ICA PSA with mild stenosis. The patient was conservatively managed with oral anticoagulation and antiplatelet therapy. He recovered well and was discharged. The patient was in good condition during follow-up.CONCLUSIONThe occupational history of patient should be taken into consideration while evaluating the etiology of spontaneous ICA PSA in young people with stroke.     

血管腔内修复治疗主动脉夹层15例早中期结果

目的 开展主动脉夹层血管腔内修复术的临床研究.方法 对2001年1月至2006年12月165例行血管腔内修复术的主动脉夹层患者的早中期结果进行回顾性分析.其中男性145例,女性20例;年龄30～82岁,平均52.8岁.Stanford A型夹层36例,B型夹层121例,主动脉溃疡8例.结果 即时手术成功率99.4%(164/165),术后30 d内漏发生率为7.3%(12/165),神经系统并发症发生率为2.5%(4/165).术后30 d病死率为6.1%(10/165),其中急性期夹层病死率为12.8%,哑急性期夹层1.4%,慢性期夹层7.3%.145例(87.9%)患者获得随访,时间6～75个月,平均28.2个月.假腔内完全血栓形成62例(42.8%),部分血栓形成83例(57.2%).随访期间死亡9例(6.2%).本组1、2、5年总体生存率分别为90.9%、89.0%和86.9%.结论 血管腔内修复术治疗主动脉夹层是一种微创、安全且有效的方法,其长期疗效仍有待进一步观察.