目的 探讨传统支气管针吸活检 (cTBNA )与超声支气管镜引导下针吸活检(EBUS-TBNA)对于肺部疾病伴有肺门及纵膈淋巴结肿大患者的诊断价值。方法 2012 年8月—2014年6月对在我院行CT检查提示肺部伴有肺门和/或纵膈淋巴结病变的患者38例, 分别利用cTBNA或EBUS-TBNA检查对肿大的淋巴结行TBNA,对所获得的标本进行相应的细胞学检查。结果 38例病例均经组织病理学诊断后确诊,并经过6个月的随访,其中cTBNA组(n=19)经组织病理明确诊断的包括:1例结核,5例小细胞肺癌,6例腺癌,3例鳞癌,1例大细胞癌,3例慢性炎症,cTBNA细胞学诊断阳性诊断率为63.16%(12/19),cTBNA组细胞学诊断肺癌的敏感度为66.67％(10/15),特异度为100％。EBUS-TBNA组(n=19)组织病理学诊断明确的1例为肺结核,1例为纵隔恶性肿瘤,1例为结节病,1例大细胞癌,1例小细胞癌,7例腺癌,5例鳞癌,2例为慢性炎症,EBUS-TBNA细胞学阳性诊断率为78.94%(15/19)。两种方法在诊断肺门及纵膈淋巴结肿大的疾病中有差异(P<0.05)。EBUS-TBNA组细胞学诊断肺癌的敏感度为86.67％(13/15),特异度为100％。结论 EBUS-TBNA细胞学检查对肺部疾病伴有肺门及纵膈淋巴结肿大的诊断率较cTBNA高,可明显提高检查阳性率,具有重要临床意义。

Objective To evaluate the value of clinical application between cTBNA and EBUS-TBNA in diagnosis of mediastinal and hilar lymph nodes. Methods Between August 2012 and June 2014, 38 in-patients with mediastinal and hilar lymph nodes took conventional transbronchial needle aspiration( cTBNA,n=19) or endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA, n=19), and we were comparing the diagnostic results of two methods. Results 19 patients in the cTBNA group were diagnosed by forceps biopsy,including 1 case of lung cancer and 162 cases of tuberculosis, 5 cases of small cell lung cancer, 6 cases of adenocarcinoma, 3 cases of squamous cell carcinoma, 1 case of large cell carcinoma, 3 cases of chronic inflammation, a cytological diagnosis of TBNA positive in 12 cases (63.16%). In the EBUS-TBNA group (n=19), the patients were diagnosed by accepting forceps biopsy, 1 case of tuberculosis, 1 case of mediastinal malignant tumor, 1 cases of sarcoidosis, 1 cases of large cell carcinoma, 1 case of small cell carcinoma, 7 cases of adenocarcinoma, 5 cases of squamous cell carcinoma, 2 cases of chronic inflammation, EBUS-TBNA cytology positive rate of diagnosis was 14 (73.68%). Two techniques in the diagnosis of mediastinal and hilar lymph nodes have statistically significant(P<0.05). The sensitinty of cytology in the diagnosis of lung caner was 86.67%(13/15),and the specificity was 100%(EBUS-TBNA). Conclusion EBUS-TBNA is an effective tool in the diagnosis of mediastinal and hilar lymph nodes and superior to cTBNA.

目的 观察miR-9在胃癌组织中的表达水平及其与临床病理的相关性。方法 采用实时荧光定量PCR方法分别检测28例胃癌及正常胃组织中miR-9的表达水平,并分析其表达情况与临床病理资料的关系。结果 胃癌组织miR-9的表达水平[0.0078(0.0031~0.0142)]显著低于相应正常胃组织[0.0177(0.0084~0.0311), P<0.05],尤其是伴淋巴结转移者[0.0021(0.0006～0.0685)]miR-9表达水平明显降低。结论 胃癌组织中miR-9低表达,且与胃癌淋巴结转移有关。

Objective To investigate the correlation between the level of miR-9 expression and clinicopathology in gastric carcinoma. Methods The expression of miR-9 in 28 cases of gastric carcinoma tissues and normal gastric tissues were detected by quantitative real-time PCR, and the relationship between the expression and clinicopathology was analyzed. Results The expression of miR-9 expression in gastric carcinoma tissues [0.0078(0.0031~0.0142)] was significantly lower compared with the corresponding normal gastric tissues [0.0177(0.0084~0.0311), P<0.05], especially in lymph node-invasive carcinoma [0.0021(0.0006～0.0685)]. Conclusion miR-9 was down regulated in gastric cancer tissues, which was significantly associated with lymph node metastasis.

目的 探讨功能康复训练与心理干预对全髋关节置换手术患者髋关节功能康复的影响。方法 对2014年3月—2015年12月先后在本院行全髋关节置换手术90例患者,按入院时间分为观察组45例和对照组45例。对照组按全髋关节置换手术功能康复护理要求给予康复护理;观察组在此功能康复护理基础上,同时对患者进行心理评估和相应的心理护理干预;对两组患者在干预前后的心理情况、生活自理能力、髋关节功能和生活质量进行评价。结果 干预前两组患者均有不同程度的焦虑和抑郁反应,不积极的应对方式和自理能力下降;干预后观察组在应对心理反应,降低焦虑和抑郁,主动进行功能锻炼,自理能力和髋关节功能评分均优于对照组。结论 功能康复训练与心理护理干预相结合,对减轻患者心理压力,提高患者心理应对能力、生活自理能力,提高患者生活质量,促进髋关节功能康复有一定的效果。

Objectives To explore the effect of function rehabilitation training and psychological intervention on patients of hip joint function recovery undergoing THA. Methods 90 patients were chosen who were admitted to the hospital from March 2014 to December undergoing THA,2015. These patients were divided into control group and intervention group according to the sequence of admission. The patients in control group were cared by total hip replacement surgery functional rehabilitation; At the same time, the patients in observation group were cared by psychological training. The psychological condition, self-care ability, hip function and quality of life for all patients were evaluated. Results Before the intervention, two groups of patients had some degrees of anxiety and depression, and negative coping style. Their self-care ability were decreased; The response to psychological reaction, reduction for anxiety and depression, initiative exercise, self-care ability and hip function scores of patients in the intervention group were better than that of the control group. Conclusion Combination of rehabilitation training and psychological nursing intervention can relieve the psychological pressure, improve mental health and promote recovery of hip function.

目的 初步探讨黄芩苷防治支气管哮喘的作用机理。方法 用卵蛋白致敏大鼠制备支气管哮喘动物模型,经黄芩苷干预治疗,运用免疫组化法及Western Blot法检测各组大鼠肺组织匀浆中p38 MAPK磷酸化蛋白表达量。结果 两种检测方法均显示,p38 MAPK磷酸化蛋白水平在模型组中有明显的增加,地塞米松组、黄芩苷高剂量组和低剂量组的p38 MAPK磷酸化蛋白水平均低于模型组(P<0.05)。结论 黄芩苷能有效治疗哮喘的作用与抑制哮喘大鼠p38 MAPK信号通路的表达密切相关。

Objective To explore the mechanism of Baicalin in treatment of bronchia asthma. Methods Animal models of bronchia asthma were made in rats sensitized with egg albumen. After the treatment of Baicalin, immunohistochemistry and western-blot methods were used to test expression quantity of phosphorylated p38 protein of lung tissue in all groups of guinea rats. Results Our data confirmed that the level of phosphorylated p38 protein increased significantly in model group, but it decreased in hexadecadrol group, high dose and low dose Baicalin group (P<0.05). Conclusion The effects of Baicalin in asthma model were associated with inhibition of P38 MAPK signal pathways in a dose-dependent manner.

目的 研究鼓室成形术后慢性中耳炎患者的耳鸣变化情况,并探讨患者术后耳鸣变化情况与术后听力提高的相关关系。方法 记录并分析于我科住院治疗的160例慢性中耳炎患者在术前及鼓室成形术术后6个月的听力变化以及耳鸣症状的改变。结果 有60例患者术前伴有耳鸣,术后23例患者耳鸣治愈;27例治疗有效; 10例治疗无效,则术后耳鸣治疗有效率为83.33%。术后可提高两组患者的气导听力,且耳鸣改善明显组较耳鸣改善不良组提高较为显著(t=0.047,0.005,均P＜0.05)。结论 慢性中耳炎患者采用鼓室成形术对耳鸣的治疗有积极影响,术后可提高慢性中耳炎患者的气导听力,进而使耳鸣症状缓解,其中低频气导听力更能缓解耳鸣症状。

目的 探讨注射用黄芪多糖对宫颈癌化疗患者骨髓抑制的影响。方法 选取2012年11月—2015年10月于我院接受治疗的宫颈癌患者110例,随机分为对照组和观察组,每组各55例,两组患者均接受紫杉醇联合顺铂同步放疗,而观察组患者在此基础上接受每日静脉滴注注射用黄芪多糖治疗,连续应用10天。对比分析两组患者的临床疗效以及治疗前后的血象。结果 经过治疗后,观察组的治疗总有效率为61.81%,明显高于对照组的38.18%,差异有统计学意义(P<0.05);两组患者经过放化疗后其白细胞、红细胞和血小板计数均有不同程度的降低,而与对照组相比,观察组患者下降不明显。结论 注射用黄芪多糖可以减轻宫颈癌放化疗所致的骨髓抑制,对骨髓具有一定的保护作用,在临床治疗宫颈癌的过程中值得推广应用。

Objective To explore the clinical effect of astragalus polysaccharides on protecting marrow suppression of cervical carcinoma after chemotherapy. Methods 110 cases of patients with cervical carcinoma treated in our hospital from November 2012 to October 2015 in our hospital were selected and divided into control group and observation group, each group contains 55 cases. Both groups of patients received radiotherapy and chemotherapy of paclitaxel combined with cisplatin, and the observation group additionally received intravenous injection of astragalus polysaccharides for 10 days, to compare the hemogram before and after treatments between two groups. Results After treatments, the total effective rate of the observation group was 61.81%, significantly higher than that of the control group, the difference was statistically significant (P<0.05); The white blood cell, red blood cell and platelet count reduced in two goups after treatment. Compared with the control group, there was no significant decrease in the observation group. Conclusion Astragalus polysaccharides injection may reduce the marrow suppression induced by radiotherapy and chemotherapy in the treatment of cervical cancer, and it has a protective effect on the bone marrow.

目的 探讨胃癌组织中刺猬信号通路(Hedgehog signaling pathway, Hh)中的音猬因子(Sonic hedgehog, Shh)和胶质瘤相关癌基因同源物-1(Glioma-associated oncogene homolog -1, Gli-1)与金属基质蛋白酶-2(Matrix metalloproteinase-2, MMP-2)的表达和临床意义。方法 采用免疫组织化学方法检测40例人胃癌组织、人胃息肉组织和40例正常胃黏膜组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2蛋白的表达。结果 胃癌组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2的阳性表达率分别为62.5%、67.5%、72.5%,高于胃息肉组织(阳性表达率分别为27.5%、37.5%、32.5%)和正常胃黏膜组织(阳性表达率分别为22.5%、17.5%、12.5%)(P<0.05);以上三者的表达与患者性别、年龄、组织学类型无关(P>0.05);而与分化程度、浸润深度、淋巴结转移相关(P<0.05);音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2表达呈正相关。结论 刺猬信号通路可能通过某些机制可上调金属基质蛋白酶-2的表达,从而增强胃癌的侵袭性。联合检测胃癌组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2的表达水平在一定程度上可以作为胃癌预后的客观参考指标。

Objective To investigate the expression and clinical significance of Sonic hedgehog(Shh), Glioma-associated oncogene homolog -1(Gli-1) and Matrix metalloproteinase-2(MMP-2) in gastric cancer.Shh and Gli-1 are the molecules of Hedgehog(Hh) signaling pathway. MMP-2 is the member of matrix metalloproteinase family. Methods The expression of Shh,Gli-1 and MMP-2 proteins was examined by immunohistochemistry in the human gastric cancer tissues and the human gastric polyp and the normal gastric mucosa tissues of 40 cases. Results The positive expression rates of Shh,Gli-1 and MMP-2 in gastric cancer were 62.5%,67.5% and 72.5% respectively, which were significantly higher than those in the gastric polyp tissues (the positive expression rates were 27.5%,37.5% and 32.5% respectively) and normal gastric mucosa tissues (the positive expression rates were 22.5%,17.5% and 12.5% respectively),P<0.05.The expression of Shh,Gli-1 and MMP-2 was not correlated with the sex,age or histological type(P>0.05),but was correlated with depth of invasion,differentiation level and lymphonode metastasis in gastric cancer(P<0.05). The expression of Shh and Gli-1 was positive correlated with MMP-2. Conclusion Hedgehog(Hh)signaling pathway may have great effects on enhancing the invasive ability of gastric cancer by upregulating MMP-2 protein through some unknown mechanisms.The combined detection of the expression level of Shh,Gli-1 and MMP-2 in gastric cancer tissues might be used as an Objective references for assessing the prognosis of gastric cancer.

目的 比较腹腔镜阑尾切除术结合快速康外科(FTS)观念与传统开腹阑尾切除术的疗效差异。方法 回顾分析奉新县人民医院普通外科2001年2月—2003年4月和2010年7月—2013年6月收治的96例阑尾炎患者,随机分为两组,每组各48例,分别为传统开腹手术组(对照组)和腹腔镜阑尾切除术联合FTS组(实验组),检测术前1 d及术后第1 d、第3 d白细胞计数(White blood cell,,WBC)、C-反应蛋白(CRP)、白细胞介素-6(IL-6),同时比较两组术式的手术时间、住院时间、消化功能恢复时间及术后并发症的发生率。结果 实验组与对照组术后第1 d、第3 d外周血WBC、CRP、IL-6均显著高于术前,两组之间相比较差异有统计学意义(P＜0.05);实验组平均手术时间(62±18)min,对照组平均手术时间(55±21)min,两组相比差异无显著性(P＞0.05);实验组平均住院天数为(4.2±1.3)d,对照组平均住院天数为(7.6±1.5)d,两组相比差异有统计学意义(P＜0.05);实验组术后消化功能恢复时间为(23.3±9)h,对照组为(30.5±11)h,两组相比较差异有统计学意义(P＜0.05);实验组未出现术后并发症病例,对照组出现3例切口感染病例,2例粘连性肠梗阻病例,1例盆腔感染病例,两组手术并发症发生情况相比较差异有统计学意义(P＜0.05)。结论 腹腔镜阑尾切除术结合快速康复外科理念,可有效缩短病人住院天数及促进术后恢复,值得临床广泛应用。

Objective To compare laparoscopic appendectomy surgery combined with fast track surgery(FTS)concept and conventional open appendectomy difference in efficacy. Methods To retrospective analysis Fengxin country people's hospital of general surgery from February 2001 to April 2003 and July 2010 to June 2013,a total of 96 cases of appendicitis were randomly divided into two groups,each included 48 cases,namely conventional open appendectomy group(control group)and the laparoscopic appendectomy combined FTS group(experimental group). The changes of white blood cell count(White blood cell,WBC),C-reactive protein(CRP),interleukin-6(IL-6)were detected in the first day before surgery and the 1,3 day after surgery,while the surgical operative time,the length of hospital stay and digestive function recovery, surgical incision pain,and the rate of postoperative complications were compared between the two groups. Results The levels of WBC,CRP, IL-6 at day 1 and day 3 after surgery were significantly higher than before surgery,and there was significant difference between the experimental group and control group(P<0.05). The average operation time of the experimental group and the control group were respectively (62±18)min and (55±21)min,and there was no significant difference(P＞0.05). Meanwhile the average time of hospital stay and digestive function recovery were obviously shorter in the experimental group than in the control group(P＜0.05). There was no postoperative complications in experimental group. There were 3 cases of incision infection and 1 case of intestinal obstruction and 1 pelvic infection in control group. It showed significant difference between the two groups(P<0.05). Conclusion Laparoscopic Appendectomy Surgery combined with fast track surgery,which can effectively shorten patients average time of hospital stay,reduce postoperative complications and promote postoperative recovery. It is worthy in clinical use widely.

目的 氧化苦参碱对视网膜母细胞瘤细胞SM-106凋亡的诱导作用及机制。方法 以不同作用时间(24 h、48 h、72 h)和不同作用浓度(12.5 μl/mL、25 μl/mL、50 μl/mL、100 μl/mL)氧化苦参碱处理视网膜母细胞瘤细胞SM-106,分别采用流式细胞仪及western blot检测视网膜母细胞瘤细胞SM-106细胞凋亡及其凋亡因子(Bax、Bcl-2)蛋白表达。结果 氧化苦参碱可促进SM-106细胞体外凋亡,上调Bax蛋白表达及Bax/Bcl-2蛋白表达比值,下调Bcl-2蛋白表达,并呈现剂量及时间依赖性。结论 氧化苦参碱可诱导视网膜母细胞瘤细胞SM-106凋亡,调控凋亡因子Bax、Bcl-2的表达是其可能作用机制。

Objective To evaluate the apoptosis and its mechanism of retinoblastoma cells SM-106 induced by oxymatrine. Methods Retinoblastoma cells SM-106 were treated with different time(24 h、48 h、72 h)and different concentrations(12.5 μl/mL, 25 μl/mL, 50 μl/mL or 100 μl/mL) of oxymatrine. The apoptosis and protein expression of apoptosis factors (Bax and Bcl-2) were respectively determined by flow cytometry and western blot. Results Oxymatrine significantly promoted the SM-106 cells apoptosis in vitro, raised Bax protein expression and Bax/Bcl-2 protein expression ratio, reduced the Bcl-2 protein expression, and showed the dose and time dependent. Conclusion Oxymatrine is able to induce the apoptosis in retinoblastoma cells SM-106. Regulating apoptosis related gene Bax and Bcl-2 expression may be the mechanism of apoptosis.

目的 回顾分析椎体成形术(PVP)对于治疗骨质疏松性新鲜椎体压缩骨折(OVCF)患者的疗效。方法 收集2011年1月—2012年6月新鲜OVCF患者伤后两周内行PVP术治疗共34例(51个椎体)。于术前1天、术后3天、1个月、3个月、6个月、12个月予VAS、ODI评分,并行X线检查以测量病椎前、中、后缘的高度和病椎cobb角。结果 纳入研究的34个病例中,患者术后各时间点随访中VAS和ODI评分均较术前1天明显改善(P<0.05)。术后各时间点随访中行X线检查时,术后各次随访中椎体前缘、中段、病椎cobb角均较术前有较为明显的矫正(P<0.05)。结论 应用PVP治疗新鲜OVCF疗效满意,可快速缓解疼痛、改善生活质量和矫正病椎后凸畸形。

Objective To study the efficiency and safety of percutaneous Vertebroplasty(PVP) for the fresh osteoporotic vertebral compression fractures(OVCF). Methods 34 patients (30 females and 4 males), mean age 75.8 years old(75.79±9.32, range 60 to 93 years old) hospitalized between January 2011 to June 2012 were reviewed retrospectively in this study. Evaluation at follow-up time point(1 day before PVP, 3rd day, 1st, 3rd, 6th, 12th month after PVP) included the pain score with VAS, mobility improvement with ODI and the measurement of anterior, middle and posterior height of the fractured vertebra, and kyphotic angle of the fractured vertebra with X-ray image. Results For the 34 patients by followed up 1 year, the mean VAS score and ODI decreased significantly after PVP at any follow-up time compared with the 1 day before operation. Anterior and middle body height and the focal kyphotic angle at any follow-up time after PVP was improved statistically significant compared with the preoperative value(P<0.05). Conclusion Percutaneous vertebroplasty results in prompt pain relief, rapid rehabilitation and kyposis reduction, it is a safe and effective procedure for treating fresh osteoporotic vertebral compression fractures.