目的 研究三磷酸腺苷二钠氯化镁对宫内窘迫胎鼠心肌组织自由基和病理组织学的影响,探讨三磷酸腺苷二钠氯化镁对宫内窘迫胎鼠心肌组织的保护作用.方法 成年雌性Sprague-Dawley孕鼠15只,随机分为缺血低氧再灌注组(I/R组)、假手术组(Sham组)、三磷酸腺苷二钠氯化镁治疗组(T/M组),每组5只.于妊娠第19天以35 g/L水合氯醛(10 mL/kg)腹腔注射麻醉,应用无损伤动脉钳钳夹双侧子宫、卵巢血管20 min建立缺血低氧宫内窘迫模型.拆除动脉夹恢复血供,并逐层关腹.缺血前30 min,T/M组以三磷酸腺苷二钠氯化镁45 mg/kg腹腔注射,Sham组和I/R组均给予9 g/L氯化钠注射液(45 mg/kg).Sham组只进行开关腹手术,不钳夹子宫卵巢动脉.各组均于手术后24 h计算胎鼠死亡率;每组随机取10只胎鼠心肌组织制备标本,检测心肌组织的丙二醛水平;行苏木精-伊红染色,高倍镜下观察胎鼠心肌组织病理改变.结果 I/R组胎鼠死亡率明显高于Sham组,T/M组胎鼠死亡率较I/R组显著降低,差异有显著性(x 2=12.938,P＜0.05).与Sham组比较,I/R组胎鼠心肌组织丙二醛含量显著增高,T/M组胎鼠心肌组织丙二醛活性显著降低,差异有显著性(F=174.9,P＜0.05).T/M组胎鼠心肌组织病理改变较I/R组轻.结论 三磷酸腺苷二钠氯化镁能够减轻宫内窘迫胎鼠心肌损伤,对缺血低氧心肌有保护作用.
Objective To investigate the causes of hemorrhage after coblation tonsillectomy and adenoidectomy in chil dren.Methods A retrospective analysis was performed for the clinical data of 1 120 children who underwent coblation tonsillectomy with or without adenoidectomy under general anesthesia,and among these children,840 underwent tonsillectomy combined with adenoidectomy and 280 underwent adenoidectomy alone.The incidence rates of primary and secondary hemorrhage after surgery,bleeding site,degree of bleeding,and cause of bleeding were analyzed.Results Of all children,41 (3.7％) experienced postoperative hemorrhage,among whom 9 had primary hemorrhage and 32 had secondary hemorrhage.Four children experienced primary hemorrhage after adenoidectomy;37 children experienced hemorrhage after tonsillectomy,among whom 5 had primary hemorrhage and 32 had secondary hemorrhage.Among the 41 children who experienced postoperative hemorrhage,6 had cry and scream,15 had improper eating habits,7 had postoperative infection and frequent cough,and 9 had no apparent trigger.Conclusion Hemorrhage after coblation tonsillectomy and adenoidectomy in children is associated with surgical technique,improper eating habits,postoperative nursing,postoperative infection,and frequent cough.
Objective To determine the therapeutic efficacy of different hemoperfusion procedures combined with continuous renal replacement therapy (CRRT) in the treatment of acute severe organophosphate poisoning (ASOPP) patients.Methods Sixty-three ASOPP patients admitted to our hospital from December 2014 to February 2017 were divided into control group and strengthened group based on the different hemoperfusion procedures they received.The two groups of patients were given different hemoperfusion procedures combined with CRRT in addition to the conventional treatment,and the clinical outcome was compared between the two groups.Results The total amounts of atropine,penehyclidine hydrochloride,and pralidoxime chloride used,as well as the duration of mechanical ventilation and hospital stay,were significantly reduced in the strengthened group than in the control group (t =2.479-5.618,P ＜ 0.01).After 3 and 5 days of treatment,cholinesterase activity was significantly higher in the strengthened group than in the control group (t =16.315,22.747;P＜0.05).Furthermore,the incidence of complications including intermediate syndrome,rebound,and multiple organ dysfunction syndrome,as well as mortality,were also signifi cantly lower in the strengthened group than in the control group (x2 =4.399 5.611,P＜0.05).Conclusion ASOPP patients treated with the strengthened hemoperfusion procedure have enhanced treatment outcome than those with the conventional hemoperfusion procedure.Therefore,the strengthened hemoperfusion procedure holds promise for clinical application.
Objective To investigate the computed tomography (CT) and magnetic resonance imaging (MRI) findings of primary intraosseous meningothelial meningioma of the fronto-parietal bone.Methods A retrospective analysis was performed on the CT and MRI findings of 6 patients with pathologically confirmed primary intraosseous meningioma of the fronto-parietal bone.And then a comprehensive analysis was performed on the tumors based on the imaging findings,pathological features,and related literature review.Results The pathological examination showed that the tumors of all the 6 cases were meningothelial meningioma WHO Ⅰ;all the lesions were solitary and located in the fronto-parietal bone showing expansive growth.Plain CT scan showed a high and homogeneous density;MRI showed isointensity on T1-weighted and T2-weighted images;contrast-enhanced CTscan showed homogeneous enhancement.The adjacent meninges were pushed,thickening,and obviously enhanced in 5 cases,and dural tail sign was observed in 4 cases.Conclusion Benign primary intraosseous meningothelial meningioma of the fronto-parietal bone shows no specific manifestations in CT and MRI findings,so the final diagnosis should be confirmed by histopathological and immunohistochemical examinations.
Objective To investigate the expression of mediator complex subunit 19 (Med19) in human tongue squamous cell carcinoma (TSCC) tissue and its clinical significance.Methods A total of 50 TSCC tissue samples and corresponding adjacent tissues were collected from the patients who underwent surgical resection in Department of Oral and Maxillofacial Surgery in our hospital from January 2012 to September 2016.Immunohistochemistry and Western blot were used to measure the expression of Med19.In addition,20 normal oral tissue samples were collected as controls and Immunohistochemistry was also performed.Results There was a significant difference in the expression of Med19 protein between TSCC tissue and adjacent tissue or normal oral tissue (x2 =16.82,P ＜0.05).The expression of Med19 protein in TSCC tissue was associated with lymph node metastasis (x2 =9.67,P＜0.05) and was not associated with sex,age,tumor size,degree of tumor differentiation,and clinical stage (P＞0.05).Conclusion The metastasis of TSCC may be closely associated with the abnormal expression of Med19 protein,but its specific mechanism still needs further study.
目的 系统评价免疫相关鸟苷三磷酸酶(IRGM)基因rs10065172位点多态性与结核病发病风险的相关性.方法 通过计算机检索PubMed、万方全文数据库、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普数据库等数据库,查找关于IRGM基因rs10065172位点多态性与结核病发病风险相关性的病例对照研究,检索时限为各个数据库建库至2017年3月.由两名评价员独立对文献进行筛选及数据提取,运用Rev-Man 5.3和Stata 12.0软件进行Meta分析.结果 共纳入文献8篇,9个病例对照研究,包括3 956例结核病病人,4 896例健康对照.Meta分析结果显示,在总体人群合并分析中,IRGM基因rs10065172位点多态性与结核病之间的相关性在隐性基因模型(TT vs TC+CC:OR =0.87,95％CI =0.78～0.97,P=0.01)、共显性基因模型(TT vsCC:OR =0.89,95％CI =0.78～1.01,P=0.08;TT vs TC:OR =0.85,95％CI =0.76～0.96,P=0.007)中有统计学意义.在亚洲人群中,IRGM基因rs10065172位点多态性与结核病之间的相关性在共显性基因模型(TT vs CC:OR=0.80,95％CI=0.67～0.95,P=0.01;TT vs TC:OR =0.80,95％CI =0.68～0.94,P=0.007)、等位基因模型(T vs C:OR =0.91,95％CI=0.84～0.99,P=0.03)、隐性基因模型(TT vs TC+CC:OR =0.80,95％CI =0.69～0.93,P=0.005)中均具有统计学意义.高加索人群及非洲人群因纳入文献较少,未发现IRGM基因多态性与结核病发病风险之间的相关性.结论 在亚洲人群中IRGM基因rs10065172位点多态性与结核病发病风险有相关性,其中野生型等位基因C与结核病发病风险增高相关.
Objective To investigate the influence of intestinal obstruction on the prognosis of rectal cancer patients.Methods The clinical data of 151 rectal cancer patients undergoing radical resection in the Affiliated Hospital of Qingdao University from January 2010 to October 2015 were collected and retrospectively analyzed.Seventy-five rectal cancer patients with intestinal obstruction were enrolled in group A,and 76 rectal cancer patients without intestinal obstruction were enrolled in group B.The Kaplan-Meier method was used to calculate survival rates and further generate survival curves.The log-rank test was used to compare the survival rates.Finally,the COX proportional hazards regression model was used to perform univariate and multivariate prognostic analyses.Results There were significant differences between the two groups in 3-and 5-year overall survival ratio (OSR)(x2 =6.188,P＜0.05) and disease-free survival rate (DFSR) (x2 =3.392,P＜0.05).The univariate COX proportional hazards regression analysis indicated that intestinal obstruction was associated with OSR (RR =2.877,x2 =5.639,P ＜0.05),but not with DFSR (RR =1.909,x2 =3.670,P＞0.05).The multivariate Cox proportional hazards regression analysis revealed that intestinal obstruction was an independent risk factor for OSR (RR =3.290,x2 =4.933,P＜0.05).Conclusion Intestinal obstruction is an independent risk factor for OSR of rectal cancer patients.
目的 探讨Quadrant通道微创椎体间融合术和微创经椎间孔腰椎椎间融合术(MIS-TLIF)治疗腰椎退行性疾病的效果.方法 2015年1月-2017年1月,在我院行手术治疗的腰椎退行性疾病病人90例,随机分为试验组和对照组,各45例.试验组采用22 mm Quadrant通道行微创椎体间融合术,对照组采用MIS-TLIF.观察并比较两组手术时间、术中出血量、术后引流量、切口长度,术后1周、6个月、12个月疼痛视觉模拟(VAS)评分和Oswestry功能障碍指数(ODD评分.结果 试验组术中出血量、术后引流量、切口长度低于对照组,差异有统计学意义(t=1.994～2.317,P＜0.05);两组手术时间比较差异无显著性(P＞0.05).试验组术后1周、6个月VAS评分、ODI评分明显低于对照组,差异有统计学意义(t=2.025～2.251,P＜0.05);术前及术后12个月两组间VAS评分、ODI评分比较差异无统计学意义(P＞0.05).结论 应用Quadrant通道微创椎体间融合术治疗腰椎退行性疾病术后早期减轻病人疼痛、改善腰椎功能效果优于MIS-TLIF,具有较大的临床应用价值.
Objective To determine the type and features of sodium/iodide symporter gene (NIS) mutations in patients with differentiated thyroid cancer (DTC),and to examine the relationship between the genotype and phenotype of these mutations.Methods Genomic DNA was extracted from the thyroid cancer tissues and normal thyroid tissues of 50 DTC patients.Mutations in all exons of the NIS gene were detected by PCR amplification and direct sequencing.Results A mutation (c.1571 C＞T,p.Leu 408=) was identified in exon 10 of the NIS gene in the tumor tissues of two patients;the mutant codon still encoded the same amino acid (leucine) as the wild-type.No mutation was found in normal tissues.There was no significant difference in the frequency of NIS mutations between tumor tissues and normal tissues (P＞0.05).Conclusion NIS mutations may not be associated with DTC in Qingdao,China,and the same-sense mutation detected in this study may not play a major role in iodine uptake in the thyroid.
Objective To investigate the feasibility and optimal negative pressure for closed thoracic drainage combined with low negative pressure in the treatment of primary pneumothorax.Methods Sixty patients with primary pneumothorax who were admitted to our hospital were enrolled as subjects.Those patients received closed thoracic drainage combined with continuous low negative pressure suction immediately after admission.The patients were divided into group A (-0.5 kPa),group B (-1.0 kPa),and group C (-1.5 kPa) based on the value of negative pressure.The duration of moderate to severe chest pain,time to bubble overflow,time to recovery of negative pressure,and retention time of chest tube were observed in the three groups.Results Groups B and C had significantly shorter time to bubble overflow,time to recovery of negative pressure,and time to chest tube extraction than group A (F=3.504-4.068,P＜0.05).There was no significant difference in the duration of chest pain be tween the three groups (P＞0.05).There was no significant difference in any index between group B and group C (all P＞0.05).Conclusion For closed thoracic drainage combined with continuous negative pressure suction,a pressure of 1.0 or-1.5 kPa achieves better treatment outcomes than that of-0.5 kPa and effectively promotes pulmonary reexpansion.
Objective To investigate the pathogenesis,pathological type and other clinical features of salivary gland tumors (SGTs).Methods Clinical data of patients with SGT underwent surgery in our hospital from January 1995 to Decem ber 2014-were collected.Their gender,age,pathological types,and benign and malignant composition ratio,etc.were analyzed.Results In the past 20 years,a total of 2187 patients with SGTs were treated.Ratio of male to female was 1 ∶ 1.01 (1089/1098).Age:10 to 93 years old.The median age was 55,and the most commonly seen age group was 50-59 (22.45％).The ratio of benign and malignant was 2.42 ∶ 1 (1548/639).The top three tumors-pleomorphic adenoma (45.50％),Warthin tumor (18.93％) and adenoid cystic carcinoma (7.86％)-accounted for 72.29％ of all the patients.In patients of over 65 years old,Warthin tumor and pleomorphic adenoma were the top two,and in the malignancy,acinic cell carcinoma (7.61％) and adenoid cystic carcinoma (7.61％) were the most,the ratio of benign to malignant was 2.31 ∶ 1.Conclusion Surgical cases of salivary gland tumors increase year by year,and the proportion of male and female is equal.Among them,the most common type was pleomorphic adenoma,Warthin tumor and adenoid cystic carcinoma,benign tumors accounted for 70％.Warthin tumor was mostly seen in patients over 65,with a higher proportion of malignant.
Objective To investigate the efficacy of different volume catheter thrombolysis in the treatment of acute central deep venous thrombosis (ACDVT) of lower extremity.Methods Eighty patients with ACDVT were evenly randomized to high-volume group and low-volume group.Under filter protection,the infusion catheter was implanted and contact thrombolytic therapy carried out.Continuous infusion of heparin was conducted through indwelling sheath tube in popliteal vein of affected lower limb.In low-volume group,urokinase 100 kU+physiologieal saline 50 mL were given,and in high-volume group,urokinase 100kU+ physiological saline 250 mL were given.Urokinase was sprayed every four hours in both groups through a thrombolytic catheter.In the process of thrombolysis,coagulation function was monitored in both groups.The recanalization rate of external iliac and femoral vein,urokinase dosage and complications between the two groups were compared.Results In high-volume group,the vascular recanalization rate was higher higher than that in the low-volume group and the dosage of urokinase was lower (t =2.33,3.05;P＜0.05).Conclusion The efficacy of high volume urokinase thrombolytic therapy for acute central deep venous thrombosis of lower extremity is significant.
Objective To investigate the expression of E2F-1 and MDM2 in esophageal squamous cell carcinoma (ESCC) tissue and its clinical significance.Methods A total of 49 ESCC tissue samples obtained by surgical resection in Linzhou Tumor Hospital from August 2008 to March 2009 were collected.Normal esophageal tissue samples located more than 5 cm away from the tumor were collected as controls.Immunohistochemistry was used to measure the expression of E2F-1 and MDM2 in ESCC tissue and normal esophageal tissue.Results ESCC tissue samples had significantly higher expression of E2F-1 and MDM2 than normal esophageal tissue samples (x2 =21.598 and 11.004,P ＜0.05).The expression of E2F-1 and MDM2 in ESCC tissue was associated with the presence or absence of lymph node metastasis,degree of tumor differentiation,depth of infiltration,and TNM stage (x2 =4.871-11.002,P＜0.05).In ESCC tissue,the expression of E2F-1 was positively correlated with that of MDM2 (r =0.455,P＜0.05).Conclusion High expression of E2F-1 and MDM2 is associated with the development and progression of ESCC,and there is a synergistic effect between them.
Objective To investigate the effect of long non-coding RNA NEAT1 (lncRNA NEAT1) on hepatoma cell apoptosis.Methods lncRNA NEAT1 expression in cancer tissues before and after transcatheter arterial chemoembolization (TACE),in normal liver LO2 cells,and in hepatoma cell lines (SMMC-7721,Hep3B,Hub7,and HepG2) were measured by quantitative real-time PCR.The lncRNA NEAT1 siRNA was transfected into HepG2 cells using LipofectamineTM 2000 to inhibit lncRNA NEAT1 expression.Cell viability was measured by MTT assay.Caspase-3 activity was measured using the caspase-3 activity kit.Bax and Bcl-2 protein expression was determined by Western blot.Results lncRNA NEAT1 expression was significantly downregulated after TACE treatment (t =6.26,P＜0.05).In addition,lncRNA NEAT1 expression was significantly upregulated in SMMC-7721,Hep3B,Hub7,and HepG2 cells than in normal liver LO2 cells (F =30.02,P＜0.05).Compared with the negative control (NC) group,HepG2 cells treated with lncRNA NEAT1 siRNA had significantly reduced viability (F=15.97,P＜0.05),enhanced caspase-3 activity (F=28.36,P＜0.05),upregulated Bax protein level (F =9.85,P＜0.05),and downregulated Bcl-2 protein level (F=6.73,P＜0.05).Conclusion lncRNA NEAT1 not only inhibits hepatoma cell viability,but it may also be a new biomarker for the development and progression of hepatocellular carcinoma (HCC) and a new target for HCC prevention and treatment.
目的 探讨我国癌症病人弓形虫感染情况及感染风险.方法 检索2017年3月以前公开发表的关于我国癌症病人弓形虫感染风险的病例-对照研究,按照纳入与排除标准筛选文献、提取相关资料,进行Meta分析.结果 最终纳入文献23篇,纳入癌症病人6 196例,对照人群7 852例.Meta分析结果显示,癌症病人弓形虫血清学阳性率为18.1％(95 ％/oCI=14.2～22.1),远高于对照人群的5.8％(95％CI=4.3～7.2);癌症组弓形虫感染风险是对照组的3.19倍(OR =3.19,95％CI=2.63～3.87).结论 癌症病人弓形虫血清学阳性率远高于正常人群,临床上治疗癌症病人时,应留意弓形虫继发感染,给予足够重视.
Objective To investigate the significance of multidisciplinary treatment of brittle diabetes in elderly patients.Methods A total of 19 elderly patients with brittle diabetes who were admitted to our hospital from June 2014 to December 2016 received multidisciplinary diagnosis and treatment,including regular health education about diabetes by medical staffs to strengthen the self-management of diabetic patients;psychological counseling by psychotherapists to relieve mental stress;reasonable and individualized nutrition prescription developed by nutritionists;informing patients of precautions by clinical pharmacists after assessing the risk of drugs;individualized insulin and oral hypoglycemic drugs provided by clinical specialists by monitoring blood glucose level of patients.Results Before treatment,the mean fasting blood glucose (FPG) level and 2 h postprandial plasma glucose (2hPG) level were (9.34±1.7) mmol/L (2.6-17.1 mmol/L) and (15.9 ± 2.9) mmol/L,respectively.The mean glycosylated hemoglobin (HbA1c) level was (9.9±1.1)％.There were no hypoglycemic reaction and hypoglycemic coma occurring during hospitalization.The fluctuations of FPG and 2hPG were reduced significantly.The repeated examination results showed that the urine sugar were (±)-(+) and the urine ketone was negative.The mean length of hospital stay was 14.7 d.Two patients had hypoglycemic reaction during follow-up.After 12 weeks of treatment,the FPG,2hPG,and HbA1c levels were significantly lower than those on admission (t =3.57-6.52,P＜0.05).Conclusion Brittle diabetes in elderly patients can be prevented and controlled by multidisciplinary diagnosis and treatment.
Objective To investigate the distribution of CYP2C19 gene polymorphisms in Uyghur patients with depression and its association with the clinical effect of escitalopram.Methods A total of 36 Uyghur patients with depression were treated with 10-20 mg/d escitalopram for 4 weeks.The Hamilton Depression Scale (HAMD) was used to evaluate clinical outcome at weeks 2 and 4 of treatment,and the Treatment Emergent Symptom Scale (TESS) was used to assess adverse drug reactions.Gene microarray was used to evaluate CYP2C19 gene polymorphisms,and according to the presence or absence of mutant allele,the patients were divided into wild-type group and mutant group.Results Of all 36 Uyghur patients with depression,94.45 ％ were extensive metabolizers and 5.56％ were poor metabolizers.There was a significant difference in response rate after 2 weeks of escitalopram treatment between the wild type group and the mutant group (22.73％ vs 64.29％,x2 =6.218,P＜0.05).After 4 weeks of treatment,there was no significant difference in response rate between the two groups (P＞0.05).Atthe end of week 2,the mutant group had a significantly higher TESS score than the wild-type group (t-2.594,P＜0.05);at the end of week 4,there was no significant difference in TESS score between the two groups (P＞0.05).Conclusion CYP2C19 gene polymor phisms may be associated with the clinical effect and adverse effect of escitalopram.
Objective To explore the effect of carotid artery stenting (CAS) on cognitive function in patients with carotid artery stenosis.Methods Totally 120 patients with carotid artery stenosis were enrolled in this study,including 60 patients who underwent CAS and 60 who received drug treatment.The cognitive function of patients in two groups was measured with Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) before treatment and at 3 days and 6 months after treatment.Results In the CAS group,the scores of knowledge,arithmetic,digit span,digit symbol,and comprehension at 3 days after treatment were significantly lower than those before treatment;the scores of digit symbol and digit span at 6 months after treatment were significantly higher than those before treatment or at 3 days after treatment (F=2.66-3.86,P＜0.05).The score of block pattern in the drug treatment group at 3 days after treatment was significantly higher than that before treatment (F=3.80,P＜0.05).Conclusion Compared with drug treatment,the carotid artery stenosis patients treated by CAS experience temporary cognitive decline in the early stage,but the long-term memory and attention will be improved.
Objective To observe the biomechanical and histological properties of a bone-retinaculum-bone (BRB) autograft.Methods The dorsal aspect of the scapholunate ligament (DSLL) and BRB specimens were harvested from 8 fresh-frozen human cadaveric forearms.The specimens were mounted on a testing machine for biomechanical and histological analyses.The stiffness,maximum force,maximum displacement,maximum stress,and maximum energy of each specimen were calculated.Results The BRB autograft had significantly lower stiffness,maximum force,and maximum energy than the DSLL (t =13.3-14.5,P＜0.05).However,there were no significant differences in the maximum stress or maximum displacement between the BRB autograft and DSLL (P＞0.05).The BRB autograft and DSLL had similar histological properties.Conclusion The BRB autograft may be an appropriatc graft material for scapholunate ligament reconstruction.
Objective To investigate the expressions of Endothelin-1 (ET-1) and E-cadherin,and their correlation,in esophageal squamous cell carcinoma (ESCC).Methods Employing immuno-histochemical technique,expressions of Endothelin-1 and E-cadherin in 58 cases of ESCC tissue and corresponding adjacent normal mucosa were detected.Results In the cancer tissue,expressions of ET-1 and E-cadherin were correlated with invasion depth,peripheral lymph node metastasis,and differentiation degree (Z=6.908-14.973,P＜0.05).The positive expression of ET1 in tissue of ESCC and adjacent normal tissue was 12.07％ (7/58) and 77.59％ (45/58),respectively,and that of E-cadherin was 82.76％ (48/58) and 41.37％ (24/58),respectively,a comparison between the two indicators of the two groups being significant (Z=-7.161,-5.593;P ＜ 0.01).In tissue of ESCC,ET-1 expression was negatively correlated with E-cadherin (r=-0.525,P＜0.01).Conclusion In tissue of esophageal squamous cell cacinoma,the high expression of ET-1 and low expression of E-cadherin are likely to play an opposite regulation on the occurrence and development of ESCC.
