目的 总结我院35岁以下青年人胃癌43例的诊治经验。方法 对43例患者临床特征、诊断及治疗进行回顾性分析。结果 手术40例，根治性切除14例，姑息性切除9例，胃空肠吻合6例，单纯探查11例，切除率57.50%。术后3个月内死亡5例，4～12个月内死亡18例，12～24个月内死亡8例，生存2年以上9例，5年以上3例。误诊26例，误诊率60.46%。结论 青年人胃癌发病率低，恶性程度高，病程短，转移早，早期诊断率低，误诊率高，治疗关键是提高早期诊断率。
目的:分析重型颅脑损伤患者早期进入ICU进行监护和治疗对预后的影响。方法: 将重型颅脑损伤患者根据是否直接进入ICU分为研究组和对照组,评价3月后患者神经功能和死亡率。结果: 与对照组比较,研究组死亡率更低,3月后ADL分级法生存质量良好率也显著更高。结论: 重型颅脑损伤患者早期进入ICU监护和治疗,可降低术后病死率,改善生存质量。
【Abstract】Objective To investigate the recent studies on the biocharacters of keratin family (e.g. genetic mutations and abnormal expressions) and their relationships with the malignant tumors. Methods The literatures of recent years on the biocharacters of keratin family (e.g. genetic mutations and abnormal expressions) and their relationships with the malignant tumors were reviewed. Results Keratin family is a kind of structural proteins in cell which plays an important role in cytomechanics and regulates cell-cycle. The mutations of keratin genes (mRNA) or the overexpression of keratin proteins would interfere with the order of cell-cycle or the integrity of cytomechanics, and lead to some diseases and malignant tumors finally. Conclusion The studies on biocharaters of keratin family (e.g. genetic mutations and abnormal expressions) are helpful in the diagnosis, staging and the evaluation of prognosis of some diseases and cancers, e.g. liver cirrhosis, breast cancer, rectum carcinoma, etc.
Clinically, non-contrastive computed tomography (NCCT) is used to quickly diagnose the type and area of stroke, and the Alberta stroke program early computer tomography score (ASPECTS) is used to guide the next treatment. However, in the early stage of acute ischemic stroke (AIS), it’s difficult to distinguish the mild cerebral infarction on NCCT with the naked eye, and there is no obvious boundary between brain regions, which makes clinical ASPECTS difficult to conduct. The method based on machine learning and deep learning can help physicians quickly and accurately identify cerebral infarction areas, segment brain areas, and operate ASPECTS quantitative scoring, which is of great significance for improving the inconsistency in clinical ASPECTS. This article describes current challenges in the field of AIS ASPECTS, and then summarizes the application of computer-aided technology in ASPECTS from two aspects including machine learning and deep learning. Finally, this article summarizes and prospects the research direction of AIS-assisted assessment, and proposes that the computer-aided system based on multi-modal images is of great value to improve the comprehensiveness and accuracy of AIS assessment, which has the potential to open up a new research field for AIS-assisted assessment.
目的 总结术后早期炎性肠梗阻的临床特点及诊治经验。方法 回顾性分析我院2004年1月至2010年12月期间收治的22例腹部手术后早期炎性肠梗阻患者的临床资料。结果 全组均行保守治疗，均治愈出院。肠梗阻解除时间平均6.5d。2例出院后再次出现慢性肠梗阻，经保守治疗好转。结论 术后早期炎性肠梗阻在腹腔严重感染性疾病术后多见，治疗以保守治疗为主，同时应动态观察腹部症状、体征变化，严防误诊、误治。
Objective To investigate the expression of cell division regulators p16, Rb and cyclin D1 in human early gasric carcinoma tissues and their role in tumor transformation and the correlation among p16, Rb and cyclin D1. MethodsA comparative study was carried out by using immuno-histochemical techniques between the paracarcinomatous intestinal metaplasia of 39 cases of early gatric carcinoma and the non-carcinomatous gastric mucosal intestinal metaplasia tissues of 34 cases.ResultsOver expression of cyclin D1 was determined in 33/39 carcinomatous samples(84.6%) and also in para-carcinomatous intestinal metaplasia tissues. p16 was undetectable in 12 of 39 samples. Interestingly, 15 of 26 Rb positive cancers had no or low p16,while 9 Rb negative cancers showed high levels of p16.Conclusion The over expression of cyclin D1 may be a common molecular abnormality and an early molecular event in early gastric carcinoma. Cyclin D1 over expression and Rb inactivation can co-exist in early gastric carcinoma. However, there is a reciprocity between Rb inactivation and p16 expression in early gastric carcinoma. Thus, abnormality in the negative feedback regulatory pathway of cyclin D1,Rb and p16 may be related to the tumorigenesis in early gastric carcinoma.
Objective To explore the methods of early diagnosis of arteriosclerosis obliterans of lower extremity (ASOLE). Methods The related literatures on ASOLE detection means adopted clinically were reviewed, and their advantages and disadvantages were compared.Results Asymptomatic ASOLE could be discovered by determination of ankle brachial index (ABI) and toe brachial index (TBI), which was a good index for arterial function assessment of lower extremity. Pulse wave velocity (PWV) was more vulnerable and less sensitive than ABI, and therefore more suitable for screening of a large sample. ASI was an index to assess arterial structure and function, and it had a good correlation with PWV. Flow-mediated dilation (FMD) was a measurement evaluating the function of endothelial cell; Pulse wave measurement was simple, sensitive, and its result was reliable. Color Doppler ultrasonography could localizate the lesion and determine the degree of stenosis at the same time. Multiple-slice CT angiography (MSCTA) was more accurate than color Doppler ultrasonography, but its inherent shortcomings, such as nephrotoxicity of contrast agent, was still need to be resolved. 3D-contrast enhancement magnetic resonance angiography (CEMRA) had little nephrotoxicity, but a combination of other imaging methods was necessary. Microcirculation detections required high consistency of the measurement environment, but they were simple, sensitive and noninvasive, and therefore could be used for screening of ASO. Conclusion Publicity and education of highrisk groups, and reasonable selection of all kinds of detection means, are helpful to improve the early diagnosis of ASOLE.