中国实用医刊杂志   部级期刊

摘要：目的 研究人骨髓间充质干细胞(HBMCs)的体外培养和向血管内皮细胞的诱导分化.方法 利用密度梯度离心法将HBMCs从人骨髓中分离出来,体外扩增.将第三代的细胞以含VEGF,bFGF的培养基定向诱导,使其向内皮细胞方向分化.利用免疫细胞化学和流式细胞学检测诱导后的细胞表型.结果 原代未经诱导的骨髓干细胞,培养3周后细胞形态呈梭形,诱导后第7天的细胞呈椭圆形或不规则形,第14天细胞大致呈铺路石样改变.免疫细胞化学显示CD31、CD34、vWF因子呈阳性,流式细胞仪测定CD31、vWF因子阳性率分别为87.5%、82.6%,双阳性率为71.2%.结论 骨髓间充质干细胞在内皮细胞生长因子和碱性成纤维细胞因子的诱导下向血管内皮细胞方向分化. Abstract： Objective To study the culture methods of human bone marrow mesenchymal stem cells(MSCs) and differentiation into vascular endothelial cells in vitro. Methods Bone marrow mesenchymal stem cells were isolated and cultivated by density gradient centrifugation method. Induce the third generation to vascular endothelial cells with vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). Immunophenotypes of cells were detected by flow cytometry techniques and immunocyte chemistry after the transfection. Results After three weeks of primary culture of MSCs, the cell showed on fusiform shape. After 7 days induction, the cell showed on ellipse and irregular shape. After two weeks transfection, the cell exhibited a Cobblestone-like morphology. The cell expressed CD34,CD31,vWF after transfection by immunocyte chemistry. The positive rates of CD31 vWF were 87.5% and 82.6%, and the double positive rate was 71.2%. Conclusions Bone marrow mesenchymal stem cells can differentiate into vascular endothelial cells by treating with vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF).

摘要：目的 观察应用羚羊角滴丸治疗因慢性乙型肝炎而注射干扰素α-2b致发热的疗效.方法 将注射干扰素后发热的52例患者随机分成治疗组27例和对照组25例.治疗组采用口服羚羊角滴丸, 对照组采用对乙酰氨基酚片.结果 治疗组总有效率为88.89%,对照组总有效率为92.00%,两组比较差异无统计学意义(P>0.05).结论 羚羊角滴丸用于治疗注射干扰素所致发热的慢性乙型肝炎患者的退热效果与对乙酰氨基酚相比差异无统计学意义,且无非类固醇类解热镇痛药的不良反应,安全可靠,值得临床应用. Abstract： Objective To study the therapeutic effects of antelope horn dripping pills in the treatment of fever caused by interferon injection for chronic hepatitis B virus infection. Methods Fifty-two adult patients with fever which caused by interferon α-2b injection were randomly divided into treatment group (27 cases) and control group(25 cases).Patients in the treatment group received antelope horn dripping pills and patients in the control group received paracetamol tablets. Results The total effective rates of treatment group and control group were 88.89% and 92.00%,respectiely.There was no significant difference of total effective rates between two groups (P>0.05).Conclusions Antelope horn dripping pill is effective for the treatment of fever which is caused by interferen injection,and is safer because there is no evident side effect combined with it,compared with paracetamol tablets.

摘要：目的 评价研究MSCT多期薄层扫描技术在早期胰腺癌中临床应用诊断价值及其临床意义价值分析.方法 回顾性分析66例行MSCT多期薄层扫描的早期胰腺癌患者并经过手术和病理证实,经MSCT多期薄层扫描比较正常胰腺组织和肿瘤在平扫和多期扫描中的增强变化,依照CT影像学征象诊断胰腺癌并行手术前评估,并与手术结果相比较.结果 早期胰腺癌的直接征象是胰腺内弱强化肿块,间接征象是胰、胆管扩张,胰体尾部萎缩及胰腺轮廓改变. 结论 MSCT多期薄层扫描技术使得胰腺的早期定性诊断和治疗有了明显的改善,是发现早期胰腺癌的最佳扫描方法. Abstract： Objective Appraisement research MSCT expect the scanning technology of thin layer to diagnose value and its clinical meaning in early pancreas cancer. Methods Retrospective analysis 42 patients which was routine MSCT in early stage of many issue scannings of thin layer, pancreas cancer patients confirms via operation and pathology, go through MSCT expect the scanning of thin layer to compare normal pancreas organization and the strengthening change of tumor in being flat to sweep and expect scanning, according to CT the former sign diagnosis pancreas cancer parallel operation assessment of an image, and was compared with operation result appearance. Results In early stage, the direct sign of pancreas cancer was the weak reinforced phyma in pancreas, indirect sign was pancreas, the pipe expansion of gall bladder, pancreas body tail atrophy and pancreas outline change.Conclusions MSCT many issue scannings of thin layer make early stage of pancreas determine the nature to diagnose and treat to have got obvious improvement, it is the best scanning method of discovery early pancreas cancer.

摘要：目的 探讨MRI对鼻咽癌(NPC)放射治疗后的临床价值.方法 109例NPC患者在放疗前、放疗中及放疗后多次行MRI检查,对比分析治疗前后MRI表现的异同,以此评价NPC的放疗效果.所有病例均经病理活检或针吸细胞学检查或随访追踪证实.结果 所有病例中,放疗前44例已发生颅底骨质侵犯;放疗开始1～2周可在放疗局部出现水肿,放疗后1个月局部水肿逐渐消退.65例病灶放疗后逐渐变小至完全消失;27例病灶在放疗过程中逐渐缩小,但放疗后6个月复查MRI示肿块又明显增大,其中12例出现颅底骨质破坏;17例放疗后病灶先是逐渐缩小,后多次复查MRI发现病灶呈团块状改变且形态相对固定,病理证实为纤维化;9例半年后复查MRI发现放射性脑损伤.结论 MRI检查可准确反应NPC放射治疗前后病灶变化情况,定期随访复查对于及时调整治疗方案具有重要参考价值. Abstract： Objective To explore the clinical values of MRI after radiotherapy for nasopharyngeal carcinoma(NPC). Methods One hundred and nine patients with NPC comfirmed by pathological biopsy or cytological smear or follow-up underwent MRI studies before,in the period of and after radiotherapy,and made a comparative analysis about differences of MRI manifestations before and after treatment, to evaluate radiotherapy effect for NPC depending on different appearances of MRI. Results Among all patients, there appeared to show violation of skull base bone in 44 patients before radiotherapy.Local edema appeared 1-2 weeks after radiotherapy started,and edema started to dissipate one month after treatment.The lesions became smaller and smaller,and dissipated in the end in 65 patients.The lesions became smaller and smaller in the period of radiotherapy in 27 patients,but six months later the lesions appeared larger, twelve cases of them were appeared violation of skull base bone.The lesions became smaller and smaller in the beginning,later fibrosis comfirmed by pathology in 17 patie

摘要：患者,女,58岁,因半年前体检发现盆腔肿物,于近期来我院要求手术治疗.患者绝经20余年.30年前因附件肿物扭转行右附件切除术.妇科检查:外阴阴性,阴道通畅,宫颈光滑,子宫萎缩,于盆腔偏左可触及拳头大小的囊性肿物,稍活动,无压痛.辅助检查:宫颈刮片报告未发现瘤细胞.B超示左附件囊性多房伴内实质性乳头状肿物.初步诊断:盆腔肿物性质待查;左侧卵巢肿物.经各种术前准备,于2 d后在腰麻下施剖腹探查术.

摘要：目的 探讨内镜鼻窦手术的治疗方法及效果.方法 对我院2005年1月至2009年12月期间行鼻内镜手术治疗的896例慢性鼻窦炎鼻息肉患者的临床资料进行回顾性分析.结果 术后随访3个月的患者868例,治愈677例(78%),好转152例(17.5%),无效39例(4.5%),总有效率95.5%;术后随访1年以上者376例,治愈248例(65.9%),好转90例(24%),无效38例(10.1%),总有效率89.9%.结论 经鼻内镜手术是治疗慢性鼻窦炎鼻息肉的有效方法,定期的随访及药物治疗有利于提高疗效. Abstract： Objective To study the therapy procedures and the curative effect of endoscopic sinus surgery. Methods Retrospective analysis of clinical data on 896 cases of chronic nasosinusitis who were treated with endoscopic sinus surgery from January 2005 to December 2009 in our hospital was done. Results Eight hundred and sixty-eight cases were followed-up for three months after operation,677 cases(78%)were cured,152 cases(17.5%)were improved, the other 39 cases(4.5%)were not effective,and the total effective rate was 95.5%;376 cases were followed-up for more than one year after operation,248 cases(65.9%)were cured,90 cases(24.0%)were improved,but the other 38 cases(10.1%)were not effective,and the total effective rate was 89.9%. Conclusions The endoscopic sinus surgery is an effective method for chronic sinusitis.The follow-up regularly and reasonable medical treatment are important to improve curative effect.

摘要：目的 探讨血浆输注在小儿危重病症救治中的作用.方法 对经血浆治疗的各种小儿危重病症124例进行分析.结果 83.06%的患儿能在1周内病情稳定,转出PICU;入院后12 h内接受血浆治疗组疗效优于超过12 h接受血浆治疗组(P＜0.01);无不良反应发生.结论 血浆输注治疗小儿危重病症安全有效,可以作为小儿危重病症的基础治疗手段,尽早实施血浆治疗效果更好. Abstract： Objective To explore the role of plasma in treatment of critical disease in children. Methods One hundred and twenty-four examples suffered from critical diseases treated by plasma were analysed. Results Eighty-three percent of 124 cases turn out PICU with stable condition in one week. Children who accept plasma treatment in 12 hours after admission had better curative effect than those accept plasma treatment over 12 hours(P＜0.01). No untoward effect caused by plasma infusion occurred. Conclusions Plasma infusion is safe and effective in treating pediatric critical disease, and can be used as one kind of basic method in pediatric rescue. Plasma treatment effect is better when use it as soon as possible.

摘要：目的 观察腭咽成形术后全麻苏醒期静脉输注小剂量瑞芬太尼的效果和不良反应.方法 60例择期行腭咽成形术病人随机分为两组,丙泊酚、芬太尼和阿曲库铵诱导插管后,术中吸入七氟醚复合静脉输注瑞芬太尼维持麻醉.手术结束后,瑞芬太尼组继续经静脉输注瑞芬太尼,速率为0.05 μg/(kg·min);对照组改为静脉输注生理盐水直至拔管后.观察并记录两组病人全麻苏醒期呛咳反射、呼吸抑制和深度镇静的发生率.结果 瑞芬太尼组28例,对照组29例病人完成本研究.瑞芬太尼组呛咳反射发生率显著低于对照组;呼吸抑制和深度镇静的发生率两组比较差异无统计学意义.结论 0.05 μg/(kg·min)瑞芬太尼静脉输注能减少腭咽成形术后苏醒期呛咳反射的发生,且不增加不良反应. Abstract： Objective To investigate the effect of small dose remifentanil infusion during emergence of anaesthesia after uvulopalatopharyngoplasty (UPPP). Methods Sixty patients scheduled for UPPP were randomly divided into two groups.All patients received propofol,fentanyl and atracurium for induction and intubation.After intubation,sevoflurane inhalation and remifentanil infusion were administered for maintenance of anaesthesia.After operation,remifentanil infusion was continued at a rate of 0.05 μg/(kg·min) in the remifentanil group,while saline was infused in the control group until extubation.The incidence of coughing,respiratory depression and deep sedation were observed and recorded. Results Twenty-eight patients in the remifentanil group and 29 patients in the control group completed the study.The incidence of coughing was significantly lower in the remifentnail group.There was no significant differences in the incidence of respiratory depression or deep sedation between the two groups. Conclusions 0.05 μg/(kg·min) Remifentanil infusion is effective for reducing the incidence of coughing during emergence of anaesthesia after UPPP without increasing incidence

摘要：目的 探讨MRI对半月板桶柄状撕裂的诊断与关节镜下分类的比较研究.方法 分析63例患者65个经关节镜检查证实为半月板桶柄状撕裂的术前MRI的特征性表现,并将5种MRI征象(双后交叉韧带征、半月板翻转征、空领结征、碎块内移征和外周残半月板征)与关节镜下Dandy分型进行比较.结果 MRI桶柄状撕裂诊断符合率89.2%.碎块内移征和空领结征阳性率最高,分别为84.6%和81.5%;双后交叉韧带征(双PCL征)、半月板翻转征(双前角征)、外周残半月板征不如上二者普遍(阳性率分别为43%、21.5%、29.3%).未发现外侧半月板双PCL征;内侧半月板交锁Ⅰ型和Ⅱ型及外侧半月板半长全宽型、全长半宽型与MRI碎块内移征和空领结征有相关性;2例为半月板撕裂Ⅲ级信号,5例为假阴性.结论 5种MRI征象中最少2种(碎块内移征和空领结征阳性率最高)以上出现应高度怀疑为桶柄状撕裂. Abstract： Objective To evaluate the arthroscopic findings of meniscal bucket handle tears and to correlate them with the proposed MR imaging signs of meniscal bucket handle tears suggested in the literature. Methods Sixty-three patients who had a diagnosis of bucket handle tear in arthroscopy were included in our study.Meniscal tears were evaluated in arthroscopy according to Dandy's classification.The MRIs were retrospectively analyzed regarding the following findings:absence of bow tie sign,presence of double posterior cruciate ligament(PCL), fragment within the intercondylar region,flipped meniscus sign, abnormal circumferential meniscus sign. Sensitivity were evaluated for the presence of each individual sign. Results Locked types Ⅰand Ⅱfragment of medial meniscus and half-length,whole-width and whole length-half-width fragement of lateral meniscus in arthroscopy were correlated with fragement within the intercondylar notch and absent bow tie signs in MRI.We didn't find the double PCL sign in any of the patients with a lateral meniscal bucket ha