目的:探討慢性硬膜下血腫的臨床及診療要點。方法:回顧性分析138例慢性硬膜下血腫患者的臨床資料。結果:1例術中大出血死亡,其余137例均治愈出院。術后硬膜下積液2例,腦內血腫5例,張力性氣顱2例,癲癇發作3例,3例復發。結論:頭顱CT平掃是診斷CSDH的首選檢查。對于有癥狀的CSDH患者,應根據血腫的特點,選擇合適的術式,而積極防治手術并發癥是治療CSDH的關鍵。
Objective To investigate the tumor suppressor genes of phlegm DNA in smokers, and analyze the correlation between methylation level of tumor suppressor gene promoter and chronic mucus hypersecretion (CMH). Methods The study recruited the patients who were admitted in the respiratory department during 2013-2016 in this hospital, including 700 cases of urban smokers and 380 cases of rural smokers. Eleven genes commonly silenced by promoter methylation in lung cancer and associated with cancer risk were selected. Methylation specific PCR (MSP) was used in the sputum sample of 700 individuals in the urban smokers cohort. Replication was performed in 380 individuals from the rural smokers cohort. Results CMH was significantly associated with an overall increased number of methylated genes, with SULF2 methylation demonstrating the most consistent association. The association between SULF2 methylation and CMH was significantly increased in males but not in females both in the urban and rural groups (OR=2.73, 95%CI 1.53-4.93, P=0.001; OR=2.96, 95%CI 1.47-5.94, P=0.002, respectively). Furthermore, the association between methylation and CMH was more obvious among 139 male former smokers with persistent CMH compared with current smokers (SULF2, OR=3.64, 95%CI 1.57-8.35, P=0.002). Conclusion These findings demonstrate that especially male former smokers with persistent CMH have markedly increased promoter methylation of lung cancer risk genes and potentially could be at increased risk for lung cancer.
Objectives To analyze the risk factors for cardiovascular disease (CVD) in patients with chronic obstructive pulmonary disease (COPD) of different severities. Methods The study included 50 patients with mild-to-moderate COPD and 50 with severe-to-very severe COPD admitted between January 2014 and January 2016. Comorbidities were recorded on the basis of data obtained from medical charts and clinical evaluations. The Charlson comorbidity index was calculated, and the Hospital Anxiety and Depression Scale (HADS) score was determined in each subject. Results There were more prevalences of smoking, depression and dyslipidemia in the patients with mild-to-moderate COPD than those with severe-to-very severe COPD (all P<0.001). The prevalences of high blood pressure, diabetes mellitus, alcoholism, and chronic heart failure were not different significantly between the two groups. The Charlson comorbidity index and HADS scores were not different between the two groups. Conclusions Comorbidities are fairly common in COPD regardless of its severity. Certain risk factors for CVD, as smoking, dyslipidemia, and depression, appear to be more prevalent in patients with mild-to-moderate COPD.
目的:探討阿魏酸哌嗪對環孢霉素A（CsA）慢性腎毒性的保護作用。方法:按四組分別給予實驗大鼠橄欖油,CsA,CsA加低劑量阿魏酸哌嗪［50 mg/（kg·d）］及CsA加高劑量阿魏酸哌嗪［100 mg/（kg·d）］,四周后取血測血肌酐,計算肌酐清除率,取腎組織測定腎組織和血中的血管緊張素Ⅱ濃度,同時作腎組織病理學檢查。通過免疫組化觀察腎組織內皮素及Ⅲ型膠原表達情況。結果:CsA大鼠腎臟可見明顯損傷,同時肌酐清除率明顯下降,血漿及腎組織血管緊張素Ⅱ含量增高,而且腎組織局部內皮素及Ⅲ型膠原表達明顯增高。給予阿魏酸哌嗪能使腎損傷有所減輕,使血液及腎組織血管緊張素Ⅱ含量減少,內皮素及Ⅲ型膠原表達下降。結論:CsA引起慢性腎毒性可能與血管緊張素Ⅱ、內皮素和Ⅲ型膠原增加有關,同時應用阿魏酸哌嗪可以使血漿及腎臟組織血管緊張素Ⅱ減少,內皮素和Ⅲ型膠原表達下降,因此對腎臟有保護作用,而且這種作用與劑量有相關性。
【摘要】 目的 探討慢性缺氧對大鼠巖神經節神經元酸敏感離子通道（acid-sensing ion channels，ASICs）亞型3（ASIC3）和亞型2a（ASIC2a）表達的影響。 方法 將12只健康成年SD大鼠隨機分為正常組和缺氧組。用免疫組織化學法（PV）觀察正常和慢性缺氧大鼠巖神經節神經元ASIC3和ASIC2a的表達。 結果 給予慢性缺氧刺激后，巖神經節ASIC3陽性表達神經元數目增多（Plt;0.05），灰度值降低（Plt;0.05）；而ASIC2a陽性表達神經元數目和灰度值無明顯變化（Pgt;0.05）。 結論 慢性缺氧可上調大鼠巖神經節神經元ASIC3的表達，而對ASIC2a的表達無明顯影響，提示ASIC3和ASIC2a可能在巖神經節對缺氧的反應中起著不同的作用。【Abstract】 Objective To investigate the effects of chronic hypoxia on expression of acid-sensing ion channels (ASIC) 3 and ASIC2a in neurons of petrosal ganglions of rats. Methods A total of 12 SD rats were randomly assigned to control group and hypoxia group. The expressions of ASIC3 and ASIC2a of the neurons in the petrosal ganglions in the two groups were investigated with the immunohistochemical technique. Results The level of positive ASIC3 expression in the petrosal ganglions was higher in the hypoxia group than that in the control group (Plt;0.05); the difference of positive ASIC2a expression levels between the control group and the hypoxia group was not statistically significant (Pgt;0.05). Conclusion Chronic hypoxia can significantly increase the expression of ASIC3, but not that of ASIC2a, of the neurons in the petrosal ganglions, suggesting their different roles in mediating a cellular response to chronic hypoxia.
目的 比較進展性慢性肝病及重癥肝炎患者原位肝移植(OLT)圍手術期凝血功能的變化。方法 回顧性分析我中心2004年1月至2005年12月期間行OLT治療進展性慢性肝病及重癥肝炎患者各37例的圍手術期血小板(PLT)、凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)及纖維蛋白原(FIB)的變化。結果 2組患者除術前PT、APTT,術后第5 d PLT、FIB和術后第7 d FIB的差異有統計學意義外（plt;0.05），其余時段2組患者的PLT、PT、APTT及FIB 間差異均無統計學意義（Pgt;0.05）, 提示重癥肝炎患者凝血功能損害更為嚴重； OLT術后，2組患者的凝血功能均逐漸恢復正常, 但并非完全同步。結論 進展性慢性肝病與重癥肝炎患者OLT圍手術期凝血功能變化顯著，應注意監測及處理，但術后2組間各指標間比較差異并不明顯。
摘要:目的:探討慢性硬膜下血腫(chronic subdural hematoma, CSDH)鉆孔沖洗引流術后的復發因素。方法：回顧性分析165例CSDH鉆孔沖洗+閉式引流術的治療效果,并結合患者年齡、術后引流量、血腫腔是否有間隔、血腫厚度、引流管安放方向等因素進行相關分析。結果:本組治愈151例,血腫復發14例。〖HTH〗結論〖HTSS〗:患者年齡、術后引流量、血腫腔是否有間隔、血腫厚度、引流管安放方向是影響復發的主要因素。Abstract: Objective: To explore the related factors of recurrence of chronic subdural hematoma after burr hole drainage.Methods:The related aspects that affected the recurrence in 165 cases with chronic subdural hematomas after burr hole drainage were reviewed,and patient’s age,drainage volume,thickness of hematoma, septal hematoma cavity and direction of drain pipe were evaluated.Results:Clinical outcomes were satisfactory.151 patients completely recovered after burr hole drainage,there were 14 patients with hematoma recurrence. Conclusion : Age, drainage volume, thickness of hematoma, septal hematoma cavity and direction of drain pipe would affect the prognosis.
ObjectiveTo summarizes the clinical characteristics of chronic appendicitis in children and discusses the diagnostic methods and the clinical application value of laparoscopic surgery.MethodsThe clinical data and treatment process of 68 children with chronic appendicitis admitted to the First Affiliated Hospital of Anhui Medical University from January 2015 to January 2020 were retrospectively analyzed, and their clinical characteristics and treatment experience were summarized and analyzed.ResultsAccording to different medical histories and symptoms, 68 cases were divided into 3 groups, with 15 patients in the typical symptom group, 28 patients in the appendix abscess group, and 25 patients in the asymptomatic group. All the 25 children in the asymptomatic group underwent barium enema examination, among which 68.0% (17/25) had filling defect in the appendix cavity, 16.0% (4/25) had no obvious appendix visualization, and 68.0% (17/25) had residual barium in the appendix cavity after 72 hours. The incidence of children in the 3 groups was concentrated at school age, but there was no significant difference in the proportion of children in different age groups between the three groups (P>0.05). All cases underwent laparoscopic exploration, 66 cases successfully completed laparoscopic appendectomy, 2 cases transferred to laparotomy, and all recovered satisfactorily. There was no statistically significant difference in the incidence of postoperative complications between the 3 groups (P>0.05).ConclusionsThe clinical manifestations of chronic appendicitis in children are diverse and difficult to diagnose. Barium enema examination (including re-examination after 72 hours) in children with atypical symptoms can help confirm the diagnosis. Chronic appendicitis in children is more common in school-age children, and laparoscopic exploration+appendectomy are the preferred treatment.