摘要:目的: 探討PCNA,VEGF在胃癌組織中的表達關系及其意義。 方法 :免疫組織化學法檢測正常胃和胃癌組織中PCNA和VEGF的表達,并分析其與胃癌臨床病理特征的相關性。 結果 :胃癌組織中PCNA、VEGF的陽性表達率分別為850%、683%,二者在正常胃組織中均為隱性表達。PCNA的表達與腫瘤分期、淋巴結轉移有關(〖WTBX〗P lt;005),而與年齡、性別、腫瘤大小、組織分化程度無關(〖WTBX〗P gt;005);PCNA的表達與腫瘤分期、淋巴結轉移有關(〖WTBX〗P lt;005),而與年齡、性別、腫瘤大小、組織分化程度無關(〖WTBX〗P gt;005)。PCNA和VEGF在胃癌中的表達呈正相關。 結論 :PCNA和VEGF在胃癌組織中的高表達促進了胃癌的發生發展。Abstract: Objective: To study the significance and relationship of expression of proliferating cell nuclear antigen(PCNA) and vascular endothelial growth factor (VEGF) in gastric cancer. Methods : The expression of VEGF and PCNA in normal gastric tissues and gastric cancer tissues were detected by immunohistochemistry (SP),and clinic pathological correlation with gastric cancer was analyzed. Results : The positive exression rates of PCNA and VEGF in gastric cancer were 850%、683%, respectively, while negative expression was shown in normal gastric tissues. It was found that the expressions of PCNA and VEGF were both in significant relation to TNM stages and lymph node metastasis (P lt;005), but in no relation to age, gender, diameter of tumor and tumor cell differentiation (P gt;005). The expressions of PCNA and VEGF were positively correlated with each other. Conclusion : It was indicated that the highlevel expressions of PCNA and VEGF might corporately accelerate the progression of gastric cancer.
ObjectiveTo establish a forecasting model for inpatient cases of pediatric limb fractures and predict the trend of its variation.MethodsAccording to inpatient cases of pediatric limb fractures from January 2013 to December 2018, this paper analyzed its characteristics and established the seasonal auto-regressive integrated moving average (SARIMA) model to make a short-term quantitative forecast.ResultsA total of 4 451 patients, involving 2 861 males and 1 590 females were included. The ratio of males to females was 1.8 to 1, and the average age was 5.655. There was a significant difference in age distribution between males and females (χ2=44.363, P<0.001). The inpatient cases of pediatric limb fractures were recorded monthly, with predominant peak annually, from April to June and September to October, respectively. Using the data of the training set from January 2013 to May 2018, a SARIMA model of SARIMA (0,1,1)(0,1,1)12 model (white noise test, P>0.05) was identified to make short-term forecast for the prediction set from June 2018 to November 2018, with RMSE=8.110, MAPE=9.386, and the relative error between the predicted value and the actual value ranged from 1.61% to 8.06%.ConclusionsCompared with the actual cases, the SARIMA model fits well with good short-term prediction accuracy, and it can help provide reliable data support for a scientific forecast for the inpatient cases of pediatric limb fractures.
目的 全面介紹先天性囊性腺瘤樣畸形(CCAM)其可能的病因，臨床、病理特點及診斷手段，循證探討針對CCAM的治療方法及預后。 方法 對我院2011年11月收治的1例罕見的CCAM患者的臨床資料進行分析，并對相關文獻進行復習。 結果 患者數次誤診后最終診斷為CCAM，予手術治療后痊愈，隨訪1年無復發。 結論 CCAM是一種少見的、非遺傳性的、錯構瘤樣的肺發育異常，為一種良性的肺部畸形，其特點是局部肺終末呼吸性細支氣管過度生長。CCAM多通過產前影像學檢查、活組織檢查或術后病檢診斷。手術為治愈該病的最根本、最重要措施。
目的:觀察比較胃鏡下硬化劑注射聯合藥物治療和單純硬化劑注射治療、藥物治療食管靜脈曲張出血的療效。方法:95例肝硬化并食管靜脈曲張出血患者,分成三組。32例患者給予硬化劑注射聯合藥物治療,31例患者給予硬化劑治療,32例患者給予藥物治療。觀察三組患者急診止血率,近期出血率、遠期再出血率、曲張靜脈消失率、曲張靜脈復發率。 結果: 聯合組、硬化劑組、藥物組急診止血率分別為93.8%.90.3%、68.8%;聯合組、硬化劑組、藥物組近期出血率分別為6.3%、9.7%、46.9%;聯合組、硬化劑組、藥物組曲張靜脈消失率分別為90.6%、83.9%、1.9%;聯合組、硬化組與藥物組急診止血率、近期出血率、曲張靜脈消失率有顯著差異。聯合組、硬化劑組、藥物組遠期出血率分別為9.4%、59.4%、31.3%; 聯合組、硬化劑組、藥物組曲張靜脈復發率分別為18.8%、45.2%、87.5%;聯合組與硬化組、藥物組遠期出血率、曲張靜脈復發率有顯著差異。結論:胃鏡下硬化劑注射聯合藥物治療食管靜脈曲張出血可顯著提高療效。
Objective To improve the knowledge of kartagener syndrome and the understanding of primary ciliary dyskinesia ( PCD) . Methods Three cases of Kartagener syndrome were reported and analyzed on clinical manifestations, symptoms, imaging appearances of chest, and family history. Meanwhile the related literatures were reviewed. Results The three patients deserved special recognition because of recurrent upper and lower respiratory tract infection. Of them, the third case showed mainly the symptoms of nasosinusitis at an early age, and the distinct pulmonary symptoms appeared in his adulthood. Further examination showed that the triad of chronic sinusitis, bronchiectasis, and situs inversus is present in all cases. The parents of the two cases were consanguineous marriaged. Examination of the bronchial mucosal biopsy specimen of the first case under transmission electron microscopy showed cilia with the absence of inner dynein arms. The three cases got improvement after treatment of anti-infection and expectorant. Conclusion For patients with recurring infection in the upper and lower respiratory tract from infancy, the possibility of PCD should be considered no matter whether a situs inversus exists.
【摘要】 目的 探討經鼻胃鏡在食管狹窄擴張和支架置入術中的作用。 方法 2007年10月-2009年3月對28例癌性食管狹窄以及并發食管-氣管瘺的患者行PENTAX（EG-1580K）超細經鼻電子胃鏡檢查，計算插入深度，并進行擴張和支架治療，在胃鏡直視下調節輸送器內支架上端的位置，觀察擴張效果、支架放置成功率、定位的準確性以及并發癥情況。 結果 全部患者均行擴張治療，效果良好，支架一次性放置全部成功，定位準確，自膨滿意，最狹窄處的內徑由（4.8±1.2）mm擴至（12.5±1.5）mm，食管氣管瘺被覆蓋治療效果好，患者的吞咽困難評級由3.25±0.58降至0.94±0.59。 結論 在食管狹窄擴張和支架置入術中應用經鼻超細胃鏡患者依從性好，方法簡便，安全有效。【Abstract】 Objective To explore the role of nasal endoscopy in the esophagostenosis expansion and esophageal stent. Methods PENTAX (EG-1580K) ultrafine nasal endoscopy was used in 28 patients (October 2007-March 2009) with esophageal cancer complicated with esophagostenosis and fistula to check the e-calculated insertion depth, stent expansion and the average diameter expansion. The endoscopy was carried under the direct vision with the location of the top bracket in order to ensure the accurate stent placement, all without X-ray assist. The success rates of stent placement, positioning accuracy, as well as complications were evaluated. Results The expansion treatments were successful in all patients with one-off operation. The narrowest part increased from (4.9±1.6) mm to (12.7±1.5) mm, and the esophageal fistula was covered. The rating of dysphagia decreased from 3.15±0.68 to 0.91±0.49. Conclusion Nasal endoscopy is simple, safe and effective in the treatment of ultrafine expansion for esophagostenosis and stent implantation with good compliance.
ObjectiveTo explorer the risk factors for acute exacerbation in patients with bronchiectasis within one year.MethodsFour hundred and twenty-two patients with non-cystic fibrosis bronchiectasis hospitalized were enrolled in The East Region of the People’s hospital of Sichuan between October 2014 and October 2016. The patients’ clinical data were collected, and follow-up began at the time of discharged. The study endpoint was the first acute exacerbation, all patients were followed-up for one year after discharged. The patients were classified into two groups by the occurrence of acute exacerbation or no occurrence. Logistic regression analysis was used to explore the risk factors for acute exacerbation with bronchiectasis.ResultsThe age, sick time, body mass index (BMI) less than 18.5 kg/m2, smoking index, expectoration, hemoptysis, dyspnea, moist sounds, wheezing sounds, types of imaging, CT scores, lung lesion site, sputum culture, whether infected Pseudomonas aeruginosa, level of serum C-reactive protein (CRP), level of serum PCT, serum albumin, arterial carbon dioxide partial pressure, types of respiratory failure, combined with chronic cor pulmonale differed significantly between the two groups (P<0.05), while gender, history of Infection, smoking, cough, chest pain, fever, clubbed-finger, white blood cell counts, neutrophil counts, erythrocyte sedimentation rate, serum globulins, arterial oxygen partial pressure did not significantly differ (P>0.05). Multivariate Logistic regression analysis found that infection with Pseudomonas aeruginosa, BMI<18.5 kg/m2, high level of serum CRP, high level of arterial carbon dioxide partial pressure (PaCO2), high CT score with bronchiectasis, combination with chronic cor pulmonale were risk factors for acute exacerbation in patients with bronchiectasis (P<0.05).ConclusionsInfection with pseudomonas aeruginosa, BMI < 18.5 kg/m2, high serum CRP level, high arterial blood PaCO2 level, high CT score with bronchiectasis and combination of chronic cor pulmonale are risk factors for acute aggravation within 1 year for patients with bronchiectasis. Doctors can identify these risk factors and intervene early, so as to reduce the acute exacerbation of bronchiectasis.
目的 探討肺郎格罕細胞組織細胞增多癥（pulmonary Langerhans cell histiocytosis, PLCH）的臨床特征、診斷和治療。 方法 回顧性分析1999年-2008年4例病理確診的PLCH。 結果 4例患者均為男性；13～56歲；2例吸煙。臨床特征是活動后氣短、氣胸。胸部CT表現為網格狀、囊狀或結節狀影像。肺活檢病理結果：光學顯微鏡下可見病理性郎格罕細胞，免疫組織化學法檢測發現4例S-100均為陽性，2例CD1a陽性，1例CD68陽性。 結論 PLCH胸部CT表現為網結節或囊性變，病理檢查見病理性郎格罕細胞浸潤細支氣管壁和上皮細胞的間質，免疫組織化學CD1a抗原、S-100蛋白陽性可明確診斷。
Objective To investigate the effect of ultrasonic irradiation time on enhanced green fluorescent protein (EGFP) gene transfection efficiency and local tissue in bone defects using ultrasound-mediated microbubble destruction. Methods Thirty 3-month-old New Zealand rabbits (2.5-3.0 kg in weight) were randomly divided into 5 groups (n=6) and bone defect models were made on the right ulna. At 10 days after modeling, suspension of microbubbles and EGFP plasmids were locally injected (0.3 mL/kg) and then ultrasound was performed on defect at a frequency of 1 MHz, a intensity of 0.5 W/cm2, and a duty ratio of 20% for 1, 2, 3, 4, and 5 minutes respectively (in 1, 2, 3, 4, and 5 minutes groups respectively). The survival condition was observed. Rabbits were sacrificed for gross observation at 7 days after transfer. The gene expression was observed by fluorescence staining. HE staining and transmission electron microscopy were used to observe the local tissue damage. Results The animals all survived. New soft tissue formed in bone defects area at 1 week after transfer, the surrounding muscle tissue was partly filled in it. Green fluorescence expression was observed in all rabbits. The expression was the strongest in 2 minutes group, and was the weakest in 1 minute group. The absorbance (A) value showed significant differences when compared 1 minute and 2 minutes groups with other groups (P<0.05), but no significant difference was found between 3, 4, and 5 minutes groups (P>0.05). Tissue damage was observed in all groups and it was aggravated with the increase of irradiation time. Conclusion EGFP transfection efficiency in bone defect by ultrasound-mediated microbubble destruction is related to irradiation time. EGFP gene can be efficiently transfected without obvious toxicity at 1 MHz, 0.5W/cm2, and duty ratio of 20% for 2 minutes in bone defects of rabbits.
Objective To summarize the etiology and clinical features of Mounier-Kuhn syndrome (MKS) so as to enhance the acknowledgement of MKS. Methods Three cases of MKS were reported and the keywords with " Tracheobronchomegaly”, " Mounier-Kuhn syndrome” were analyzed through the mode of literature retrieval in CNKI, VIP and Pubmed databases. Results There were 214 cases around the world including 14 cases of MKS in China. With unknown etiology and non-specific clinical feature, MKS is characteristic with congenital absence of tracheal or bronchial elastic tissue. MKS is diagnosed with remarkably dilated trachea and bronchus through chest CT or bronchofibroscope, accompanied with genetic defects. The ratio of men to women is 8.5 to 1. There is no radical cure. Symptomatic treatment and surgical treatment when necessary could be available. Conclusions MKS is a rare progressive hereditary disease, irrelevant to smoking and sharing a similar cause with generalized elastolysis, which need pay much attention to the physical examination of skin or elastic tissue. The diagnosis of MKS should be based on not merely airway diameter but also the overall clinical, pathologic, and radiologic profile.