Objective To investigate the relationship between expression of retinal intercellular adhesion molecule-1 (ICAM-1) and blood-retinal barrier (BRB) rupture and therapeutic effect of intravitreous injection with triamcinolone acetonide (TA) on blood-retinal barrier rupture in rats with diabetes mellitus (DM). Methods Diabetic model of Wistar rats was induced and were divided into normal control group, DM-4-month group and DM-6-month group. Each group was subdivided into immunohistochemcial staining and BRB measurement groups. BRB measurement group was further divided into non-TA treatment group, 1-week-TA treatment group, and 2-week-TA treatment group. The rats were intravitreously injected with 5 mu;l TA. The digested retinal preparation was stained by immunohistochemcial method to observe the expression of retinal ICAM-1 and morphological changes. The mean optic density (A) value of endothelial cells was measured by image-analyzing software to quantify the expression of ICAM-1. BRB changes were measured by content test of retinal Evans blue (EB). Results In the immunohistochemcial staining groups, there was no significant positive expression of ICAM-1 in retinal capillary in control group. Compared with the control, there was significant positive expression of ICAM-1 in DM-4-month group (P＜0.001) with some morphological changes such as irregular width of capillary caliber, and there was enhanced positive expression of ICAM-1 in DM-6-month group (P＜0.001) with aggravated morphological changes and even acellular capillary. In the BRB measurement groups, there was no significant difference of EB content(P＞0.05) among control groups. The EB content in two DM groups significantly increased compared with that in the controls (Plt;0.001), and higher in DM-6-month group than that in DM-4-month group (Plt;0.01). In TA treatment groups, the EB content in all the DM groups significantly decreased (Plt;0.001) but with no significant difference among the groups(P＞0.05). EB content in DM-4-month group after 2-week treatment almost reached to normal value (P＞0.05) while was higher in the rest of TA treatment groups than that in the control group (Plt;0.05). Rectilinear correlation between A value of endothelial cells and the retinal EB content(r=－0.959)was found. Conclusion There is a positive relation between the expression of ICAM-1 and BRB rupture in retina of DM rats, and intravitreous injection with TA can effectively alleviate BRB rupture. (Chin J Ocul Fundus Dis, 2006, 22: 24-27)
【摘要】 目的 探討自制雙孔導線針在腹腔鏡小兒腹股溝疝手術中的應用價值。 方法 回顧性分析2006年4月-2010年6月行腹腔鏡小兒腹股溝疝手術655例患兒的臨床資料。單孔針手術組452例，雙孔針手術組203例，將兩組患兒術中、術后資料進行對比分析。 結果 單孔針組手術時間(17. 7±3. 5) min；術中出血(5. 4±1. 3) mL，住院時間(2. 5±1. 0) d發生腹壁下小血腫15例，術后復發3例；雙孔針組手術時間(8. 2±2. 3) min，術中出血(1. 4±0. 3) mL，住院時間(2. 1±0. 8) d，發生腹壁下小血腫2例，術后復發1例。雙孔針組的手術時間、術中出血、并發癥發生率等均明顯優于雙孔針組(Plt;0. 05)，兩組住院天數、復發率差異均無統計學意義(Pgt;0. 05)。 結論 自制雙孔導線縫扎針在腹腔鏡小兒腹股溝疝手術中應用能夠縮短手術時間，操作安全快捷，創傷更小等優點，值得推廣應用。【Abstract】 Objective To explore the clinical value of self-made diplopore suture needle in laparoscopic herniorrhaphy in children. Methods The clinical data of 655 patients who underwent laparoscopic herniorrhaphy between April 2006 and June 2010 were retrospectively analyzed. The patients were divided into the single-hole needle group (452 patients) and the diplopore needle group (203 patients), and the operative and post-operative data of the two groups were analyzed and compared. Results The operation time in the single-hole needle group was (17.7±3.5) minutes and the bleeding volume during the operation was (5.4±1.3) mL; while 15 patients suffered from small hematoma under the abdominal wall and three recurred. The operation time in the diplopore needle group was (8.2±2.3) minutes with (1.4±0.3) mL blood loss; while two patients suffered from small hematoma under the abdominal wall and one recurred. The patients in the single-hole needle group stayed in the hospital for (2.5±1.0) days, while the patients in diplopore needle group stayed for (1.4±0.3) days. The operation time, bleeding volume, rate of complications in diplopore needle group were significantly less than those in the single-hole needle group (Plt;0.05). The hospital staying days, and the recurrence rate in the two groups didn’t differ much (Pgt;0.05). Conclusion The advantages of self-made diplopore needle in laparoscopic herniorrhaphy in children include short operation time, less trauma, and simple operation; it is worth generalizing and applying.
目的:探討青年人大腸癌臨床表現、病理特點。方法:回顧性分析四川省成都市第五人民醫院普外科1997年7月至2007年12月收治的23例35歲以下青年大腸癌患者臨床資料。結果:23例青年大腸癌患者平均年齡24.5歲,男女比例為2.8∶1;病變部位以直腸多見,組織學分型以低分化腺癌與印戒細胞癌最多;Dukes分期:A期1例,B期3例,C期13例,D期6例。結論:青年大腸癌表現為病理分化程度低、Dukes分期晚,更具進展性。提高認識及早期行腸鏡檢查有助于早期診斷。
目的:分析原發性肝癌手術切除的方法及效果。方法:對手術切除的原發性肝癌112例從腫瘤部位、大小、人肝血流阻斷、切除方式、失血量、手術時間等方面進行分析。結果:手術切除率26.23%,手術死亡率0.89%,5年生存率18.75%,10年生存率僅2例。結論:原發性肝癌患者就診時多數已為中晚期或大肝癌,手術切除后療效較差。提高生存率關鍵是:小肝癌的切除、切除方式、術后TACE、復發再切除及術后生物治療等。
目的 探討熱性驚厥患兒血清電解質和血糖的變化及其臨床意義。 方法 選取2009 年6月－2010 年12月兒科住院的呼吸道感染并發熱性驚厥患兒38例和呼吸道感染無驚厥患兒42例，分別作為觀察組和對照組，測定和比較兩組患兒血清電解質和血糖值。 結果 觀察組血清鈉離子濃度為（133.05 ± 1.74）mmol/L、氯離子濃度為（100.37 ± 1.79）mmol/L；對照組血清鈉離子濃度為（142.19 ± 1.85）mmol/L、氯離子濃度為（104.57 ± 1.55）mmol/L，差異均有統計學意義（P＜0.01）；觀察組和對照組血糖濃度依次為（6.93 ± 0.87）、（5.12 ± 0.55）mmol/L，差異有統計學意義（P＜0.01）。觀察組在治療后的血清鈉離子、氯離子濃度分別為（140.89 ± 2.68）、（103.29 ± 1.94）mmol/L，均高于發生驚厥時的濃度（P＜0.01）；觀察組在治療后的血糖濃度為（5.31 ± 0.68）mmol/L，明顯低于發生驚厥時，差異有統計學意義（P＜0.01）。 結論 嬰幼兒發生熱性驚厥時存在血鈉、血氯水平降低和血糖升高，在熱性驚厥患兒的治療中應糾正血鈉水平和高血糖。Objective To explore the clinical significance of the changes in serum electrolytes and blood glucose in the children with febrile convulsion. Methods Thirty-eight children with respiratory infection combined with febrile convulsion and 42 children with single respiratory infection diagnosed between June 2009 and December 2010 were selected as the observation group and control group, respectively. Serum electrolytes and blood glucose concentration were assayed and compared between the two groups. Results The concentrations of serum sodium and chloride were (133.05 ± 1.74) mmol/L and (100.37 ± 1.79) mmol/L in the observation group, while (142.19 ± 1.85) and (104.57 ± 1.55) mmol/L in the control group; the differences between the two groups were significant (Plt;0.01). The concentrations of blood glucose were (6.93 ± 0.87) mmol/L in the observation group and (5.12 ± 0.55)mmol/L in the control group; the difference was significant (Plt;0.01). After the treatment, the serum concentrations of sodium and chloride were (140.89 ± 2.68) and (103.29 ± 1.94)mmol/L in the observation group, which were higher than those before treatment (Plt;0.01). After treatment, the blood glucose concentration was (5.31 ± 0.68）mmol/L in the observation group, which was lower than that before the treatment (Plt;0.01). Conclusion Hyponatremia, low serum chlorine and hyperglycemia occurre in the febrile convulsion in children, which should be corrected in the treatment of febrile convulsion.