目的：探討鼻前庭囊腫的最佳治療方法。方法:在鼻內鏡下輔以鼻竇電動切割器，對32例患者行鼻前庭囊腫揭蓋術。結果:32例均獲治愈，無1例并發癥，隨訪1年以上，均未見囊腫復發和并發癥。結論:鼻內鏡下輔以鼻竇電動切割器行鼻前庭囊腫揭蓋術，具有手術精確、時間短、創傷小、愈合快等微創手術優點，值得推廣。
Objective To study the effects of estrogen and progesterone and their receptors on the development of gallstone (GS) and primary gallbladder carcinoma (PGC), and probe to the relationship between the biological characteristic of PGC and female hormone and their receptors. Methods The study of PGC related to female hormone was reviewed by history document and experimental study in resently. Results The female hormone influenced human body extensively: they acted on not only the target organs, but also the nontarget organs with their receptors. The action was brought about by their receptors expression. The action intensity was dependent on not only the serum level of female hormone but also their corresponding receptors distributing in organs. The carcinogenic mechanism of estrogen was more clear with the discovery of estrogen-regulating-proteins. Conclusion The estrogen play an important role in the onset and development of GS and PGC. Estrogen and progestrone can inhance the patients′ susceptibility to the cholesterol gallstone and become a high risk factor in causing PGC through inducing their corresponding receptors expression in the gallbladder. Evaluating the effects of estrogen-estrogen receptor-estrogen-regulating-protein on biological characteristic of PGC is significant in guiding clinical endocrine treatment.
【摘要】 目的 觀察人類免疫缺陷病毒（HIV）感染后對人體各個系統的影響，為其診斷和治療提供經驗。 方法 回顧性分析2005年1月—2010年6月于華西醫院確診為HIV感染13例患者的臨床表現和相關實驗室指標。 結果 13例HIV感染患者均合并其他感染，以結核病最為常見；除有T淋巴細胞異常外，多數患者可合并出現血液學異常，包括貧血、白細胞和血小板降低；生化異常，包括球蛋白升高、白蛋白降低；HIV感染患者可合并出現風濕病癥狀和免疫學異常。 結論 HIV感染患者臨床表現復雜多樣，可合并出現多種感染和風濕病癥狀，血液學及免疫學異常也比較常見。【Abstract】 Objective To observe the impact of human immunodeficiency virus (HIV) on each system of human body after its infection, in order to provide experiences for diagnosis and treatment of this disease. Methods The clinical manifestations and related laboratory results of 13 inpatients treated in West China Hospital of Sichuan University from January 2005 to June 2010 were reviewed retrospectively. Results The incidence of infection in these patients was 100% with tuberculosis as the most common infection. Apart from the abnormality of T lymphocytes, most patients had a change of hematology and biochemistry, including anemia, depression of leucocytes and platelets, hyperglobulinemia and hypoproteinemia; HIV-infected patients may also presented with rheumatic manifestations or abnormality in the immune system. Conclusion The clinical manifestations of patients with AIDS are complicated. Many kinds of infections and rheumatic manifestations may merge and the change in hematology and immunology is common.
ObjectiveTo evaluate the efficacy and safety of tocilizumab for treating active rheumatoid arthritis (RA).MethodsSeventy-seven patients with active RA who treated from November 2013 to April 2015 in the Outpatient Department of Rheumatology in West China Hospital of Sichuan Universiy with follow-up data were involved. Their clinical data were retrospectively analyzed. Tocilizumab was infused every 4 weeks at a dose of 8 mg/kg and concomitant use of other disease-modifying anti-rheumatic drugs (DMARDs) was allowed. Activity and efficacy were evaluated by Disease Activity Score-28 (DAS28) and European League Against Rheumatism (EULAR) response.ResultAfter the treatment, the DAS28 devreased from the baseline 6.88±1.09 to 4.99±1.53 (4th week), 4.31±1.37 (8th week), 3.74±1.15 (12th week) and 2.66±0.68 (24th week) (P<0.05). The disease activity level assessed by DAS28 was 11.1%, and the low activity was 9.5%, and the values were 10.5%, 32.2% and 66.6%, 16.7% (P<0.05) respectively at the 12th and 24th week. EULAR good/moderate response rates were 17.5%/76.2%, 39.0%/57.4% and 66.7%/33.3% at 8, 12 and 24 weeks. The differences in the decline over time in tender joint count, swollen joint count visual analogue score, Health Assessment Questionnaire score, erythrocyte sedimentation rate and C-reactive protein before and after the treatment were statistically significant (P<0.05). Adverse event was found in 21 cases who were alleviated after the treatment (1 anaphylactic reaction, and the other were mild).ConclusionTocilizumab is safe and effective in treatment of active RA patients.
Objective To investigate the influenceof insulin-like growth factor-I (IGF-I) on biological characteristics of articular chondrocytes cultured in vitro of rabbits. Methods Monolayer articular chondrocytes of 4week old rabbits were cultured in medium with IGF-I, at the concentrations of 3, 10, 30, 100, and300ng/ml. The DNA content in cells and glucuronic acid content in matrix were detected on the 2nd, 4th, 6th days after culture. Results The DNA content in cells and the glucuronic acid content in matrix in articular chondrocytes cultured in medium with IGF-I at concentrations of 3-300ng/ml were all significantly higher than those in control group (P＜0.01), which reached the peak at the concentrations of 30-100mg/ml on the 4th day. Conclusion IGF-I could obviously promote theproliferation of articular chondrocytes in vitro, and there exist time-dependent and dose-dependent effect.
【Abstract】ObjectiveTo inquire into the regulative effect of interferon (IFN) on human leucocyte antigen-DR(HLADR) expression in human colonic cancer cells. MethodsThe expression of HLA-DR in 4 colonic cancer cell lines HCT-8，lovo，SW-480 and Ls-174-T was detected with immunohistochemical SP and ELISA method before and after being stimulated by different doses of α-IFN or γ-IFN. ResultsAll cell lines except lovo cell were HLA-DR positive before stimulation with α-IFN or γ-IFN. HLA-DR expression was enhanced on all of the 4 cell lines after stimulation, and it was correlated with γ-IFN and the dose of γ-IFN. The effect of γ-IFN was more obvious than that of α-IFN. ConclusionIFN can enhance HLA-DR expression in human colonci cancer cells and clinical therapy of IFN for colon cancer has a certain applying prospect.
【Abstract】ObjectiveTo study the relationship between the bacterial spectrum difference of gallbladder mucosa and choledochus bile and clinical prognosis of gallstone pancreatitis. MethodsA synchronic bacterial culture and drug sensitivity test were carried out on 48 patients with gallstone pancreatitis. ResultsThe cases of positive gallbladder mucosa and choledochus bile were 13 (27.1%) and 31 (64.6%) respectively. The cases of double positivity were 12 (25.0%). The cultural strains of gallbladder mucosa and choledochus bile were significantly different. Some strains were only found in choledochus bile，whereas in gallbladder mucosa L-form bacteria predominated.ConclusionThe most common causative strain of gallstone pancreatitis is Bacterium coli. The drug-resistant strain emerges maybe due to bacterium immigration and delitescence in gallbladder mucosa. L-form bacteria should be considered when using antibiotics, because L-form bacteria have close relationship with the prognosis of gallstone pancreatitis.
Abstract： Objective To evaluate different shunting flow in varied conditions in a simulated adult cardiopulmonary bypass (CPB) model under normothermia. Methods We established the pseudo adult patient undergoing CPB at four different shunting states with devices of heartlung machine, heatcooler, an adult membrane oxygenator and arterial filter. In state 1, purge line of the arterial filter was open alone; In state 2, purge line combined with 6.5 mm tubing hemoconcentrator shunting was open; In state 3, purge line combined with 5 mm tubing hemoconcentrator was open; In state 4, purge line combined with blood cardioplegia shunting was open. The flow of preoxygenator and postfilter was recorded with ultrasonic flowmeter, and the pressure of purge line and postarterial filter was also detected. Results At state 1, when the pump flow was invariable, the percentage of the shunting flow increased with the increase of postfilter pressure. However, when the postfilter pressure was constant, the percentage of the shunting flow decreased with the increase of the pump flow. The purge line pressure increased with the increase of the postfilter pressure at a constant pump flow under state 1. The shunting flow of state 2 was the largest among all the four states. The shunting flow of state 3 was similar to that of state 4. All the purge line pressure was lower than the postfiler pressure of the circuit in the four states. Conclusion Under states of different shunting opening, different degrees of blood flow are diverted away from the arterial line. The shunting flow increases at a lower pump flow and a higher postfilter pressure. A flow probe located in the postfilter line may be necessary to monitor realtime arterial flow.
【摘要】 目的 觀察應用不同手術方法矯正麻風麻痹性下瞼外翻的療效。 方法 2006年10月-2009年11月，共收治麻風麻痹性下瞼外翻68例115眼，根據患者下瞼外翻程度和局部專科情況，分別采用顳肌移位+闊筋膜移位懸吊固定術（Johnson法），改良顳肌移位術，下瞼板縮短外眥韌帶懸吊固定術，眼輪匝肌島狀皮瓣，眼輪匝肌懸吊固定術以及絲線懸吊固定術矯正眼瞼外翻。 結果 68例115眼成功率98.9%，手術后由于下瞼外翻導致的各種合并癥明顯好轉。隨訪觀察4～11個月所有患者術后效果良好，無復發。 結論 麻風麻痹性下瞼外翻的手術治療應根據患者的不同情況選擇合適的手術方法，才能達到最佳的矯正效果。【Abstract】Objective To evaluate the clinical effect of different surgical methods to correct lower eyelid paralytic ectropion. Methods From October 2006 to November 2009, 68 cases (115 eyes) with lower eyelid paralytic ectropion induced by leprosy were treated in this department.According to the degree and local circumstance of different patients, some patients underwent temporalis muscle transfer (TMT) with the Johnson’s procedure, some patients underwent modified temporalis muscle transfer, and some patients underwent orbicularis oculi muscle island flap or uplifting the lower eyelids with orbicularis oculi muscle, silk, lateral canthal tendon. Results The achievement rate of 68 cases (115 eyes) was 98.9%.The complications resulted from lower eyelid ectropion were obviously improved.All the patients got good results followed up for 4 months to 11 months after operation and no recurrence was found. Conclusion To achieve the best effect of correcting lower eyelid paralytic ectropion, it is the key point to choose the suitable method according to the level and local circumstance.
Monoclonal gammopathy of renal significance (MGRS) is a group of diseases with different renal damage. It is a new type of renal disease with various types of diseases and complex disease mechanism. In MGRS, due to the clonal proliferation of B lymphoid cells or plasma cells, a large number of monoclonal immunoglobulin (MIg) and/or a large number of free light chain (FLC) appear. Intact MIg can interact with intrinsic cells of glomerulus to change its biology in order to promote the development of renal disease, while monoclonal FLC can potentially alter the function of various cells throughout the nephron. Given the relationship of MIg and monoclonal FLC to MGRS, inhibition of MIg and monoclonal FLC would be a promising approach for the treatment of MGRS. This paper reviews the pathogenesis of MGRS from the sites of renal involvement, including glomerulus, renal tubule-interstitium and renal blood vessel.