简介:摘要目的比较3D与2D腹腔镜根治术治疗胃癌的临床效果。方法抽取2018年6月至2020年6月安阳市第二人民医院收治的胃癌患者64例,按照患者入院先后顺序将其分为对照组(32例)和观察组(32例),对照组采用2D腹腔镜根治术治疗,观察组采用3D腹腔镜根治术治疗,比较两组治疗效果。结果观察组患者的手术时间、术中出血量、淋巴结清扫数量、术后排气时间等指标值均优于对照组(P<0.05);观察组患者中出血、感染、吻合口梗阻等不良反应发生率低于对照组(P<0.05);观察组患者的C-反应蛋白、糖类抗原125指标值低于对照组,糖类抗原19-9、癌胚抗原水平高于对照组,两组患者的血清指标值比较差异有统计学意义(P<0.05)。结论在胃癌患者临床中采用3D腹腔镜根治术治疗,患者的手术指标值、血清指标值显著改善,不良反应发生率低。
简介:AbstractBackground:The human brain is the most complex organ in the body, and it is important to have a better understanding of how the protein composition in the brain regions contributes to the pathogenesis of associated neurological disorders.Methods:In this study, a comparative analysis of the frontal and temporal cortex proteomes was conducted by isobaric tags of relative and absolute quantification (iTRAQ) labeling and two-dimensional liquid chromatography-tandem mass spectrometry (2D LC-MS/MS). Brain protein was taken from relatively normal tissue that could not be avoided of damage during emergent surgery of the TBI (traumatic brain injury) patients admitted in Beijing Tiantan Hospital from 2014 to 2017. Eight cases were included. Four frontal lobes and 4 temporal lobes proteome were analyzed and the proteins were quantitated. Gene Ontology (GO), Ingenuity Pathway Analysis (IPA), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were used to analyze the biological function of identified proteins, unchanged proteins, and differentially expressed proteins (DEPs).Results:A total number of 2127 protein groups were identified in the frontal and temporal lobe proteomes. A total of 1709 proteins could be quantitated in both the frontal and temporal cortex. Among 90 DEPs, 14 proteins were screened highly expressed in the temporal cortex, including MAPT, SNCG, ATP5IF1, GAP43, HSPE1, STMN1, NDUFS6, LDHB, SNCB, NDUFA7, MRPS36, EPDR1, CISD1, and RALA. In addition, compared to proteins expressed in the frontal cortex, 14 proteins including EDC4, NIT2, VWF, ASTN1, TGM2, SSB, CLU, HBA1, STOM, CRP, LRG1, SAA2, S100A4, and VTN were a low expression in the temporal cortex. The biological process enrichment showed that unchanged proteins between the frontal and temporal cortex mainly take part in regulated exocytosis, axon guidance, and vesicle-mediated transport. The KEGG pathway analysis showed that unchanged proteins between the frontal and temporal cortex mainly take part in oxidative phosphorylation, carbon metabolism, Huntington's disease, and Parkinson's disease.Conclusions:The majority of proteins are unchanged between the frontal and temporal cortex, and unchanged proteins are closely related to its function. Among DEPs, MATP (tau) is upregulated in the temporal cortex, closely related to Alzheimer's disease (AD), and is one of the targets for the treatment of AD. CLU is downregulated in the temporal cortex which functions as an extracellular chaperone that prevents aggregation of non-native proteins. It was suggested that the temporal lobe may not be the "functional dumb area" of the traditional view, but could be involved in important neural metabolic circuits.
简介:摘要目的观察含有Jumonji结构域的蛋白质2D(JMJD2D)在胃癌组织的表达并探讨其临床意义。方法收集2013年1月至2014年12月期间来自中国科学院大学附属肿瘤医院(浙江省肿瘤医院)手术治疗并经病理诊断证实的133例胃腺癌标本。采用免疫组织化学法检测133例胃癌组织及其配对的癌旁正常组织中JMJD2D的表达,应用SPSS-22统计软件分析其临床意义及与预后的关系,采用比例风险回归模型(proportional hazards model,Cox模型)多因素回归分析JMJD2D蛋白表达及其他病理参数对胃癌患者预后的预测价值。结果胃癌组织中JMJD2D的高表达率为75.9%(101/133),显著高于癌旁正常胃组织(高表达率2.3%,3/133,χ2=64.821,P<0.01),差异有统计学意义。肿瘤组织中JMJD2D高表达与患者幽门螺杆菌感染状态(χ2=22.163,P<0.01)、肿瘤分化程度(χ2=7.022,P<0.05)、浸润深度(χ2=5.061,P<0.05)、淋巴结转移状态(χ2=14.123,P<0.01)、临床TNM分期(χ2=23.194,P<0.01)显著相关,而与患者性别、肿瘤诊断时年龄、肿瘤部位和大小无相关(χ2=0.072、1.451、2.562、1.383,P值均>0.05)。普兰-迈耶(Kaplan-Meier)生存分析显示,JMJD2D高表达的胃癌患者与正常/低表达患者中位生存时间分别为34个月和65个月,两者差异有统计学意义(P<0.05)。比例风险回归模型(proportional hazards model,Cox模型)多因素回归分析表明JMJD2D高表达是胃癌患者独立预后因素[危险比(HR)=2.38,P<0.01]。结论JMJD2D在胃癌组织中高表达,且与胃癌进展及患者预后显著相关。
简介:【摘要】目的:探讨高频彩色多普勒显像(CDFI)对乳腺肿块诊断及定位的临床价值。方法:现随机选取2018年1月-2021年10月期间就诊在我院进行乳腺肿块检查的患者作为本次研究对象,共计纳入30例计30枚结节,所有研究对象均接受了二维超声以及高频CDFI超声检查,并以手术病理诊断结果做为金标准,比较两种检查方式的准确度、特异性以及敏感性,再以良恶性质进行分组,对比良恶肿块的高频CDFI血流阻力指数和血流峰值,以及对比手术视野所见肿块定位以及高频CDFI超声定位。结果:以手术病理诊断结果做为金标准,高频CDFI超声检查的诊断准确度、特异性、敏感性依次为96.67%、100.00%和95.24%,各项指标均高于二维超声检查,(P<0.05)。恶性组血流阻力指数明显高于良性组,(P<0.05),两组血流峰值对比则无明显差异,(P>0.05)。经手术证实所有乳腺肿块的定位均在高频CDFI超声定位范围内。结论:在乳腺肿块的定性、定位方面高频CDFI超声检查具有较高的准确性,能够为临床手术方案的制定提供可靠的超声影像学依据。
简介:摘要目的探讨个性化3D打印定位导板在颅内病变定位和切除术中的应用。方法选择厦门大学附属第一医院神经外科自2021年3月至5月收治的15例手术治疗的颅内占位性病变患者进入研究。所有患者均通过重建颅脑三维影像明确病变体表投影边界并设计、打印个性化定位导板。术前将定位导板贴合于患者皮肤,标记病变位置及边界,并通过神经导航进行定位评估,验证定位导板标记结果的准确性。术中根据显微镜下所见进行病变位置识别,术后复查颅脑CT和MRI评估病变切除效果。结果15例患者的个性化定位导板与皮肤贴合满意,皮肤切口和骨窗设计均满足手术要求,所有手术均一次性完成并成功切除病变组织,术中均未对皮肤切口进行二次扩切调整。术后48 h内复查患者颅脑MRI示11例肿瘤患者病变切除满意(9例全切除,2例次全切除),4例血肿患者术后12 h内复查颅脑CT提示3例血肿清除率为80%以上,1例血肿清除率为70%;所有患者均未出现脑脊液漏、颅内血肿、颅内感染等严重并发症。门诊、电话随访1~3个月,所有患者恢复良好。结论个性化3D打印导板定位方法简单便捷,定位结果准确,可以辅助临床医生更好地进行术前规划,优化手术切口设计,值得在基层医院中推广和应用。
简介:AbstractBackground:Vitamin D deficiency has been reported to be associated with diabetic microvascular complications, but previous studies have only focused on the relationship between vitamin D and specific complications. Therefore, we aimed to explore the relationship between vitamin D level and diabetic microvascular complications in general, including diabetic retinopathy (DR), diabetic nephropathy (DN), and diabetic peripheral neuropathy (DPN).Methods:This was a cross-sectional study of 815 patients with type 2 diabetes mellitus (T2DM). Clinical information and laboratory results were collected from the medical records. The relationship between vitamin D and the three diabetic microvascular complications was investigated.Results:The serum 25-hydroxyvitamin D (25 [OH] D) level of patients with DPN and/or DN was significantly lower than that of T2DM patients without any microvascular complications (P < 0.01). Univariate analysis showed that the 25 (OH) D level was related to DPN and DN, but not DR. After adjustment, the 25 (OH) D level was confirmed to be an independent protective factor for DPN (odds ratio [OR]: 0.968, P = 0.004]) and DN (OR: 0.962, P = 0.006). The prevalence of DPN and DN increased significantly as the serum 25 (OH) D levels decreased. Furthermore, patients with both DPN and DN had the lowest concentration of serum 25 (OH) D (P < 0.001), and the prevalence of macroalbuminuria increased more abruptly than that of microalbuminuria across the 25 (OH) D tertiles. Among the patients with vitamin D insufficiency, those with DPN presented more comorbid macroalbuminuria than those without DPN (15.32% vs. 4.91%; P = 0.001).Conclusions:Vitamin D deficiency is independently associated with higher risk of DPN and DN, but not DR, in T2DM patients. Further, it may be a potential predictor for both the occurrence and severity of DPN and DN.
简介:摘要目的针对心血管介入专业的住院医师规范化培训(规培)学员对心脏超声教学的个性化需求,构建超声数据源的仿生3D打印模型,并探讨其在超声教学及模拟演练方面的应用价值。方法选取在武汉大学人民医院超声影像科接受住院医师规范化培训的心血管内科专业学员60名作为教学对象,随机分为两组,每组30人。实验组采用超声仿生3D打印心脏模型联合以问题为基础的教学方法(problem-based learning,PBL);对照组采用传统多媒体PPT教学联合PBL教学法。教学活动结束后进行理论考试、操作考核和调查问卷,对教学效果进行评价,比较两组的教学效果。应用SPSS 21.0软件进行t检验。结果实验组和对照组理论考试成绩分别为(81.4±8.2)分和(74.8±9.4)分,操作考核成绩分别为(89.1±5.6)分和(71.5±8.8)分,两组差异均有统计学意义(P=0.002、P<0.001)。问卷调查显示实验组在心脏解剖知识的掌握、心脏超声学习体验、学习兴趣、学习效率、对介入心脏病的理解、介入操作技能和总体满意度等方面的反馈均好于对照组,差异有统计学意义(均P<0.05)。结论超声仿生3D打印联合PBL法有助于加强心脏解剖知识的掌握、提升心脏超声的学习体验、提高介入操作技能,教学效果明显,学员满意度高。
简介:摘要目的以三维CT重建(3D-CTR)图像为标准,评价超声判断喉罩置入位置的准确性。方法选择本院行脑血管介入性支架手术患者134例,年龄18~64岁,体重30~100 kg,ASA分级Ⅰ或Ⅱ级。分别于喉罩置入前后进行颈部超声检查,术中进行数字减影血管造影检测获得3D-CTR图像。分析患者颈部超声和3D-CTR图像并进行分级。结果最终125例患者完成本研究。在喉罩垂直位置上,超声分级与3D-CTR分级呈正相关(r=0.742,P<0.05);超声判断喉罩旋转的灵敏度为73.0%(95%CI:62.0%~84.4%)、特异度92.8%(95%CI:86.9%~98.7%)、阳性预测值89.1%(95%CI:80.5%~97.7%)、阴性预测值81.0%(95%CI:72.6%~89.4%)、准确度74.2%(95%CI:65.2%~81.1%)。在喉罩深度分级方面,超声分级与3D-CTR分级呈正相关(r=0.332,P<0.05),超声判断喉罩深度的灵敏度为58.5%(95%CI:46.9%~70.1%)、特异度93.3%(95%CI:87.2%~99.4%)、阳性预测值90.5%(95%CI 82.0%~99.0%)、阴性预测值67.5%(95%CI:57.7%~77.3%)、准确度33.2%(95%CI:16.8%~47.8%)。超声判断喉罩最佳置入位置的阳性预测值61.1%(95%CI:48.6%~73.6%)。结论虽然超声无法测量喉罩尖端入食管的深度,但检测旋转的准确性较高,可以作为临床上检测喉罩位置,尤其是旋转的可靠工具。
简介:摘要目的探讨磁感应式Freehand-3D超声与二维超声测量甲状腺模型体积的准确性。方法使用猪肝制作40个甲状腺模型,用排水法测量得出各模型的体积作为金标准。与金标准对比,比较二维超声、磁感应式Freehand-3D超声测量甲状腺模型体积的准确性。结果二维超声、磁感应式Freehand-3D超声测量法与金标准测量甲状腺模型体积准确性差异无统计学意义(均P>0.05)。各种超声测量法分别与金标准相比,磁感应式Freehand-3D超声测量甲状腺模型体积相关系数最高(r=0.998)。Bland-Altman分析显示磁感应式Freehand-3D超声测量值误差最小,相对误差均值为3.42%,误差范围为-9.57%~12.07%,一致性界限为(-1.253,0.999)。结论与二维超声相比,磁感应式Freehand-3D超声可以更加精准地测量甲状腺模型的体积。
简介:【摘要】目的:分析超声引导与传统解剖定位臂丛神经阻滞麻醉的应用效果。方法:时间2020年7月份到2021年4月份,我院进行上肢手术患者中随机抽取100例为进行分析研究,按随机表法分为比较组和分析组两组,分析组50例,比较组50例,分析组进行超声引导定位臂丛神经阻滞麻醉,比较组进行传统解剖定位臂丛神经阻滞麻醉,对比分析组和比较组两组患者麻醉后不良反应发生情况。结果:分析组50例患者不良反应发生4例,不良反应发生率为8.0%,比较组50例患不良反应发生12例,不良反应发生率为24.0%,分析组不良反应发生率低于比较组,数据组间比较P<0.05结果有统计学意义。结论:超声引导臂丛神经阻滞麻醉效果优于传统解剖定位臂丛神经阻滞麻醉,可以减低患者麻醉后不良反应的发生,建议临床大力推广引用。
简介:摘要自然杀伤细胞2族成员D(natural killer group 2 member D,NKG2D)是由NK细胞表达的一种免疫受体,可识别靶细胞表面上的人类主要组织相容性复合体Ⅰ类多肽相关序列(major histocompatibility complex Class I polypetide-related chain,MIC)A/B。NKG2D与MICA/B的相互作用,在病毒感染和癌症的免疫监视中发挥重要作用。该文通过膜结合型MICB下调、分泌型MICB增多及MICB基因多态性三部分对MICB/NKG2D信号通路在免疫逃逸中的研究进展进行综述。
简介:摘要目的探讨cyclin D2和bcl-2在弥漫大B细胞淋巴瘤(DLBCL)中的表达及其意义。方法收集2015年1月至2020年3月在保定市第一中心医院手术切除的87例DLBCL组织及23例淋巴组织反应性增生(RLH)患者组织,采用免疫组织化学法检测DLBCL和RLH组织中cyclin D2和bcl-2蛋白的表达情况,分析二者表达间的相互关系及与DLBCL患者临床病理特征的关系。结果DLBCL和RLH中cyclin D2蛋白阳性率分别为33.3%(29/87)、2.0%(1/23),bcl-2蛋白阳性率分别为60.9%(54/87)、7.0%(3/23);DLBCL中cyclin D2、bcl-2蛋白阳性率均高于RLH,差异均有统计学意义(χ2=7.566,P=0.006;χ2=17.512,P<0.01)。cyclin D2和bcl-2蛋白表达与DLBCL患者Ann Arbor分期、免疫分型有关(均P<0.05),而与年龄、性别、肿瘤部位、组织类型均无关(均P>0.05)。cyclin D2和bcl-2蛋白在DLBCL中的表达呈正相关(r=1.000,P<0.01)。结论cyclin D2和bcl-2可能与DLBCL的发生、发展相关,两者可能有一定的协同作用。