目的 对乳腺癌中血管内皮生长因子－C(VEGF－C)的表达与淋巴结转移及预后的关系展开研究分析。方法 随机选取我院接收救治的50例乳腺癌患者,采用免疫组化法检测50例患者乳腺癌中VEGF－C的表达情况,研究乳腺癌VEGF－C的表达与淋巴结转移及预后的关系。结果 50例乳腺癌患者中,淋巴结节转移组,VEGF－C阳性23例,阳性率92.0%;未见淋巴结节转移组,VEGF－C阳性10例,阳性率40.0%;淋巴结节转移组VEGF－C阳性表达率高于未见淋巴结节转移组;不同年龄、肿瘤直径以及病理分型的乳腺癌,VEGF－C阳性表达率差异无统计学意义(P均＞0.05);不同临床分期乳腺癌中,I~II期乳腺癌VEGF－C阳性表达率(58.1%)低于III~IV期VEGF－C阳性表达率(84.2%),数据差异有统计学意义(P＜0.05)。结论 早期检测乳腺癌中VEGF－C表达情况,能够为临床早期判定乳腺癌是否转移提供一项可测参考指标,对临床治疗、预后评估可起到一定参考价值。

Objective To make expand research and analysis for breast cancer and vascular endothelial growthfactor-C(VEGF-C)expression and lymph node metastasis and prognosis. Methods 50 cases of breast cancer patients were random collected in our hospital to detect the expression of VEGF-C in patients with breast cancer using immunohistochemical staining,the relationship between breast cancer VEGF-C expression and lymph node metastasis and prognosis. Results In 50 cases of breast cancer,lymph node metastasis group,VEGF-C positive in 23 cases,the positive rate is 92.0%;no lymph node metastasis group,VEGF-C positive in 10 cases,the positive rate is 40.0%;lymph node metastasis group VEGF-C positive expression rate was significantly higher than that no lymph node metastasis group;different age,tumor size and histological type of breast cancer,the VEGF-C positive expression rate difference was not statistically significant(P＞0.05);different clinical stages of breast cancer,I ~ II breast cancer VEGF-C positive expression rate(58.1%)was significantly lower than the III ~ IV of VEGF-C positive expression rate(84.2%),the data were statistically significant differences(P<0.05). Conclusion Early detection of breast cancer in the expression of VEGF-C can determine for early clinical metastasis of breast cancer,can provide a reference index for clinical treatment and prognosis.

目的 观察十一酸睾酮联合左卡尼汀治疗特发性弱精症的疗效。方法 回顾性分析2012年11月—2014年6月在我科诊断为弱精子症的386例患者的临床资料,按标准分成轻(A组)、中(B组)、重(C组)3组。分别给予左卡尼汀、十一酸睾酮联合左卡尼汀治疗,观察两种治疗方法对特发性弱精子症的疗效。结果 A组、B组患者两种治疗方法治疗后精子PR均有升高,差异有统计学意义(P＜0.05),C组患者给予左卡尼汀治疗患者治疗后PR无改善,差异无统计学意义(P＞0.05);十一酸睾酮联合左卡尼汀治疗患者治疗后PR升高,差异有统计学意义(P＜0.05)。A、B、C组患者给予左卡尼汀治疗的有效率分别是47.6%,41.7%,18.9%,总有效率为37.9%;A、B、C组患者给予十一酸睾酮联合左卡尼汀治疗的有效率分别是52.6%,45.5%,34.7%,总有效率为45.5%。A组、B组患者两种治疗方法疗效无差异(P＞0.05);C组患者给予十一酸睾酮联合左卡尼汀组有效率高于给予左卡尼汀组,差异有统计学意义(P＜0.05)。结论 十一酸睾酮联合左卡尼汀治疗特发性弱精子症的疗效优于左卡尼汀单一用药。

Objective To observe the effects of eleven acid testosterone combined with L-carnitine on curing idiopathic asthenospermia. Methods Retrospective analysed the clinical data of 386 patients with asthenospermia patients from November 2012 to June 2014 in our department.According to the standard,the patients were divided into mild A,moderate B,severe C in 3 groups,given L-carnitine treatment and given eleven acid testosterone combined with L-carnitine treatment.We observed effect of the two therapeutic methods for the treatment of idiopathic asthenospermia. Results The sperm PR were increased,In group A and group B patients after treated.The difference was statistically significant(P<0.05).In group C,the patients received the treatment of L-carnitine,the sperm PR has no obvious improvement,There was no significant difference(P>0.05).The patients received the treatment of eleven acid testosterone combined with L-carnitine the sperm PR significantly increased,the difference was statistically significant(P<0.05).The treatment efficiency of A,B,C group received L-carnitine were 47.6%,41.7%,18.9%,the total effective rate was 37.9%.The treatment efficiency of A,B,C group received eleven acid testosterone combined with L-carnitine were 52.6%,45.5%,34.7%,the total effective rate was 45.5%;There was no significant difference in group A and group B(P>0.05).The treatment efficiency in group C received eleven acid testosterone combined with L-carnitine group is obviously higher than that given L-carnitine group,the difference was statistically significant(P<0.05). Conclusion The curative effect of eleven acid testosterone combined with L-carnitine in the treatment of idiopathic asthenospermia is better than that of L-carnitine single drug treatment.

凝血功能障碍是围术期临床关注的重点,评价方式较多,其中血栓弹力图(TEG)可根据凝血过程中血凝块的黏弹性变化所描绘出的图像,反映全血的凝血和纤溶能力,其结果快速准确,被广泛应用围术期凝血功能监测。

Coagulopathy is a key concern around operation period.Thromboelastography (TEG) is in the process of image based on viscoelastic changes of coagulation of blood clots depicted, to reflect the blood coagulation and fibrinolytic capacity. TEG test result is quickly and accurately, therefore it is widely used in the perioperative monitoring of blood coagulation function, blood transfusion guide, hypercoagulation monitoring, prevention of thrombosis.

目的 探寻改良内眦赘皮、重睑组合手术并观察美学效果。方法 选取40例有内眦赘皮、重睑手术需求的患者,分为对照组和观察组,对照组采用传统内眦赘皮、重睑组合手术,观察组采用改良内眦赘皮、重睑组合手术,比较两组患者满意度、美学效果。结果 对照组患者满意度为60. 0%,观察组患者满意度为95. 0%,观察组患者满意度高于对照组(P<0. 05)。观察组美学效果优于对照组(P<0. 05)。结论 改良内眦赘皮、重睑组合手术能够充分矫正内眦赘皮的异常结构,更好暴露泪阜, 能成形鼻眶窝,使鼻根部具有起伏协调之曲线美感,具有较好美学效果的手术方法之一。

目的 探讨锥形纤维桩核与金属铸造桩核在残冠残根修复治疗中的临床效果。方法 65例患者共计69颗残冠残根经完善的根管治疗后采用锥形玻璃纤维桩树脂核和全冠修复,另外32例41颗牙经铸造桩核冠修复,观察疗效对比。结果 所有病例每年复查一次,平均随访期为2年,69颗纤维桩修复患牙未发现牙根折裂,其中66颗全冠与桩核固位稳定,无主诉不适、牙周健康、患者对修复体美学效果与咀嚼功能均感满意。3例失败病例分别为全冠、纤维桩核松动脱落各1颗,有1颗纤维桩折断,成功率为95.6%。金属铸造桩核组41颗患牙失败4例,其中根折2例,均已拔除,牙龈炎伴牙龈及修复体颈缘变色1例,改用纤维桩修复,继发龋1例,成功率为90.2%。结论 纤维桩树脂核具有美学效果好,机械性能好,无腐蚀,耐疲劳,易拆除,不易根折等优点,可替代铸造桩核作为理想的冠、残根桩核修复材料。

目的 探讨优质护理对于提高白内障手术患者术后恢复的影响。方法 选取本院自2014年1月—2014年6月收治的56例实施白内障手术的患者,将患者平均分配为对照组和实验组,对照组实行常规护理服务,观察组实施优质护理服务,建立完善的护理人员工作机制,提高护理人员素质;加强对患者的健康教育和心理护理,及时给患者进行检查。统计两组患者的治疗效果,分析优质护理服务的效果。结果 在术后接受优质护理服务的实验组患者的恢复效果好于对照组患者,术后的不良事件发生率较对照组低,患者的疼痛程度低,二组数据差异具有统计学意义。结论 给白内障术后的患者以优质护理服务能提高护理质量,缩短患者恢复时间,提高患者恢复效果。

目的 探究酒石酸美托洛尔联合辛伐他汀治疗的临床疗效。方法 对我院2013年2月—2014年5月间收治的80例心律失常患者的临床资料进行回顾性分析,将80例患者随机划分为研究组与对照组,两组各40例;对照组40例心律失常患者给予酒石酸美托洛尔治疗,研究组在对照组的治疗基础上给予辛伐他汀治疗,比较研究组患者与对照组患者的临床治疗效果。结果 研究组患者临床治疗总有效率高于对照组,两组差异有统计学意义(P＜0.05);研究组患者室性期前收缩次数、房性期前收缩次数低于对照组,两组差异有统计学意义(P＜0.05);研究组患者与对照组患者不良反应发生例数无统计学意义(P＞0.05)。结论 心律失常行辛伐他汀治疗的临床疗效显著,值得临床推广应用。

目的 本研究通过检测吸入布地奈德治疗支气管哮喘患儿前、后气道重塑、肺功能及外周血TGF-β浓度的变化,探讨布地奈德在哮喘患儿气道重塑早期干预的作用。方法 将2013年1月—2014年10月在我院确诊为支气管哮喘患儿18例,给予规律吸入布地奈德治疗6个月,分别于治疗前、后检测肺功能、外周血TGF-β浓度以及通过高分辨CT(HRCT)测量支气管管壁厚度(T)并计算管壁面积(WA)、支气管管壁厚度与气管外径之比(WT%)、气道壁横截面面积占气道总截面积的的百分比(WA%)。结果 吸入布地奈德治疗治疗6个月后,哮喘患儿WT%、WA%、肺功能以及TGF-β浓度均明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论 规律吸入布地奈德治疗能减轻支气管哮喘患儿早期气道重塑,改善肺功能,可能通过下调细胞因子TGF-β的表达有关。

Objective We detected the changes of Airway remodeling,lung function and peripheral blood concentrations of TGF-β in asthmatic children before and after inhaled budesonide, and explored the role of budesonide in airway remodeling before early intervention in asthmatic children. Methods 32 cases of children were diagnosed asthma in our hospital,and given treatment of inhaled budesonide for 6 months, and to detect lung function,pheral blood TGF-β concentration as well as measuring the bronchial wall thickness (T) and calculate the wall area (WA), the outer diameter of the trachea and bronchial wall thickness ratio (WT%), the cross-sectional area of the airway wall accounted for airway percentage (WA%) of the total cross-sectional area by high-resolution CT (HRCT) before and after treatment. Results After treatment with inhaled budesonide in six months, the asthma WT%, WA%, lung function, and TGF-β concentrations were significantly improved, the differences compared with that before treatment were statistically significant(P<0.05). Conclusion The treatment of inhaled budesonide can alleviate asthmatic airway remodeling in early, improve lung function,possibly related to down the expression TGF-β.

目的 通过比较利伐沙班、依若肝素和非抗凝治疗对全膝关节表面置换术后的疗效,分析全膝关节置换术后抗凝治疗的必要性、有效性及安全性。方法 选取2010年1月—2013年8月我科收治的全膝关节表面置换术的患者154例,按治疗方式分成利伐沙班组(A组)、依若肝素钠组(B组)及非抗凝组(C组)。观察各组术后静脉血栓栓塞发生率;术前及用药后凝血功能指标的变化;术后总失血量、显性失血量、隐性失血量;伤口情况;膝关节功能HSS评分。结果 A组与B组术后无静脉栓塞症发生,C组出现静脉栓塞症3例;A、B、C三组术前与术后凝血功能指标差异均无统计学意义(P>0.05);B组术后显性失血量高于A组(P<0.05);三组患者术前及术后各回访时间点膝关节功能HSS评分差异无统计学意义(P>0.05)。结论 抗凝药物预防全膝关节置换术后静脉血栓栓塞症的效果确切,利伐沙班与依若肝素疗效相当;抗凝治疗不会增加术后失血量及伤口并发症的发生率,且对术后膝关节中期功能恢复无影响。全膝关节表面置换术后使用抗凝治疗效果良好,安全性可。

Objective To compare the influence of anticoagulant therapy on the curative effect after total knee arthroplasty and evaluate the necessity, effectiveness and safety of anticoagulant therapy. Methods 154 patients after total knee arthroplastyfrom January 2010 to August 2013 in our department were divided into the rivaroxaban group (group A), the enoxaparin group (B group) and non anticoagulation group (group C) according to the treatments. It was observed that the postoperative venous thromboembolism incidence; changes of blood coagulation indexes before and after the operation; the total blood loss、dominant blood loss and hidden hemorrhage; the wound; the HSS score of knee function. Results None of postoperative venous thromboembolism occurred in group A and B, three cases of venous thromboembolism in group C;The differences of between preoperative and postoperative coagulation indexes in three groups had no statistical significance (P>0.05); Dominant blood loss in group B was significantly higher than that of group A (P<0.05); No statistical significance in the HSS scores of knee function of three group (P>0.05). Conclusion The effect of anticoagulant drugs on the prevention of venous thromboembolism after total knee arthroplasty is effective, same efficacy in the treatment with rivaroxaban or enoxaparin; anticoagulant therapy does not significantly increase the postoperative blood loss and the incidence of wound complications, does not influence the recovery of postoperative mid-term knee function. The use of anticoagulation therapy after total knee arthroplasty has good effect and be safety.

目的 了解不同类型神经母细胞瘤的生物学特性。方法 在本研究中,对新诊断神经母细胞瘤患者的生物学特点(N-myc基因扩增)与临床特点进行了比较。结果 共49例神经母细胞瘤,起源于腹膜后35例,其他14例。两个组呈现出不同的N-myc基因扩增情况(P<0.05)。结论 不同临床类型的神经母细胞瘤存在有不同的生物学特性发布情况。

Objective To investigate the biological characteristics of neuroblastomas originating from different sites. Methods Fluorescent in situ hybridization (FISH) was employed to detect the status of N-myc amplification in patients with newly diagnosed neuroblastoma originating from different sites from July 2011 to June 2013. Results A total of 49 cases of patients with newly diagnosed neuroblastoma were identified in the study, 35 cases of neuroblastoma originating from retroperitoneal site, 14 cases from other primary sites. There were significant differences in the N-myc amplification between the two groups(P<0.05). Conclusion Patients with neuroblastomas originating from extra-retroperitoneal sites might show a more favorable biological characteristics than from retroperitoneal site.