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find Author "姜晓峰" 16 results
  • Evidence- based laboratory medicine and quality control of laboratory

    With the dissemination and popularization of EBM around the world, the evidence-based laboratory medicine has boomed gradually. However, the substantial researches in tbe field are still inadequale now. Based on the facts of hospital laboratory medicine, this article discussed the feasibility that apply the rationale and methods to orient the laboratory quality control.

    Release date:2016-08-25 03:17 Export PDF Favorites Scan
  • 腓骨近端游离移植重建桡骨远端骨巨细胞瘤切除后骨缺损

    【摘 要】 目的 总结桡骨远端骨巨细胞瘤(giant cell tumor,GCT)切除后自体腓骨近端游离移植修复重建方法及效果。 方法 1997 年3 月- 2005 年3 月,对7 例桡骨远端GCT 患者行瘤段切除、自体腓骨近端游离移植修复重建术,其中男2 例,女5 例;年龄31 ~ 55 岁。术前腕关节平均活动度:掌屈37°,背伸30°,桡偏9°,尺偏15°;前臂旋前58°,旋后61°。影像学检查示肿瘤范围为4 cm × 3 cm × 3 cm ~ 8 cm × 6 cm × 4 cm。按改良Campanacci 影像学分级系统对GCT 进行分级,Ⅱ级5 例,Ⅲ级2 例。病理骨折3 例,所有患者桡骨远端骨质破坏均超过50% 。 结果 术后7 例患者均获随访,随访时间6 ~ 48 个月,平均16 个月。未发现肿瘤局部复发和远处转移,术后无感染、骨吸收和骨不愈合。移植腓骨全部成活,骨愈合时间10 ~ 14 周。重建腕关节外观及功能良好,腕关节平均活动度:掌屈40°,背伸36°,桡偏14°,尺偏20°,前臂旋前52°,旋后48°。根据肌肉骨骼肿瘤学会保肢评分标准进行功能评价,本组优3 例,良3 例,可1 例。 结 论 腓骨近端游离移植对桡骨远端肿瘤切除后骨缺损的重建是一良好的选择,远期效果尚待进一步观察。

    Release date:2016-09-01 09:14 Export PDF Favorites Scan
  • 耐万古霉素和利奈唑胺粪肠球菌致肝脓肿1例报道

    Release date:2016-09-08 10:45 Export PDF Favorites Scan
  • Comparative Study Between Single-Incision Laparoscopic Cholecystectomy and Conventional Laparoscopic Cholecystectomy

    目的比较单孔腹腔镜与传统腹腔镜胆囊切除术的临床效果。 方法选取2012年9月至2013年5月期间于我院就诊的胆囊良性疾病患者,分别接受单孔腹腔镜胆囊切除术(单孔腹腔镜组,45例)和传统腹腔镜胆囊切除术(传统腹腔镜组,48例),分别观察并对比2组患者的手术时间、术中出血量、术后(6 h和24 h)疼痛评分、止疼药物的应用率、术后住院时间及患者对切口的满意度。 结果2组患者术前的一般特征差异无统计学意义(P>0.05)。单孔腹腔镜组的手术时间明显长于传统腹腔镜组〔(59.11±14.15)min比(40.21±11.11)min,P=0.00〕,术后6 h疼痛评分及止痛药物应用率均明显低于传统腹腔镜组〔6 h疼痛评分:(3.33±1.41)分比(4.60±1.30)分,P=0.00;止痛药物应用率:6.67%(3/45)比31.25%(15/48),P=0.04〕,术后患者对切口的满意度评分明显高于传统腹腔镜组〔(4.76±6.00)分比(2.60±0.76)分,P=0.02〕。单孔腹腔镜组和传统腹腔镜组的术中出血量、术后24 h疼痛评分及术后住院时间比较差异均无统计学意义〔术中出血量:(14.67±4.80)mL比(13.85±3.85)mL,P=0.36;24 h疼痛评分:(1.60±0.65)分比(1.80±0.70)分,P=0.14;术后住院时间:(3.11±0.77)d比(3.06±0.67)d,P=0.75〕。2组均无并发症发生。 结论单孔腹腔镜较传统腹腔镜胆囊切除术可减轻术后疼痛,美容效果好,且并不增加手术风险。

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  • 十二指肠球后溃疡穿孔5例诊治分析

    目的探讨十二指肠球后溃疡穿孔的诊治方法 方法回顾性分析笔者所在医院2004年12月至2016年10月期间收治的5例十二指肠球后溃疡穿孔患者的临床资料。 结果5例患者均经病史、查体、实验室检查和影像学检查初步诊断为上消化道穿孔,均行急诊剖腹探查术,术中所见证实均为十二指肠球后溃疡穿孔,手术治疗后均治愈出院。 结论消化道穿孔诊断不难,但不易确诊十二指肠球后溃疡穿孔,根据患者条件及穿孔位置合理选择手术方式,术后引流通畅及早期肠内营养是关键。

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  • Diagnosis and Surgical Treatment of Solitary Fibrous Tumour

    目的 探讨孤立性纤维性肿瘤的诊断及外科治疗方法。方法 回顾我院10年来经手术切除并行病理检查确诊为孤立性纤维性肿瘤的病例资料,就其诊断和外科治疗方法进行总结与分析。结果 共16例次患者,肿瘤分别位于胸腔、腹股沟、后腹膜、外阴、颈部、下肢等部位,无明显特异的临床症状。所有病例均行手术完全切除肿瘤,术后经病理学检查和免疫组化染色检查确诊。对患者定期随访,其中2例分别于术后5年和7年肿瘤复发,2例分别随访3年和5年后失访,2例患者分别于随访的第9个月和16个月因全身多发转移死亡,其余患者仍在随访中。结论 孤立性纤维性肿瘤大多数病例表现为局部缓慢生长的无痛性肿块,无明显的临床症状,术前诊断较困难,目前仅能依靠术后免疫组化检查确诊,手术切除是最佳的治疗方法。

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  • Reasons and Preventions of Bleeding after Percutaneous Microwave Ablation for Liver Cancer

    Objective To investigate the reasons and preventions of bleeding after percutaneous microwave ablation for liver cancer. Methods The data of 156 patients with liver cancer between September 2006 and December 2009 treated with percutaneous microwave ablation (226 times) were recorded. The reasons and preventions of bleeding after percutaneous microwave ablation were analyzed. Results Eleven patients (11 times) suffered from bleeding. The rate of bleeding is 4.87% (11/226), including 2 cases of biliary bleeding, 9 cases of intraperitoneal hemorrhage. All patients who suffered from bleeding firstly received medical therapy to control bleeding, 5 cases were successful; in the other 6 cases who failed in medical therapy, 1 case was stopped bleeding with opening procedures, 4 cases received transcatheter embolization to stop bleeding with gelatin sponge, 1 case died due to excessive blood loss. According to Chi-square test result, the bleeding was significantly related with liver cirrhosis, lower platelet count, obvious prolongation of prothrombin time, subcapsular tumor, Child-Pugh B/C grade, and re-ablation (P=0.044, 0.041, 0.028, 0.001, 0.016, 0.016). The multiple variables logistic regression analysis showed that liver cirrhosis, platelet count, prothrombin time, location of tumor, and Child-Pugh grade were the influential factors of bleeding after microwave ablation (OR=5.273, P=0.036; OR=8.534, P=0.043; OR=4.893, P=0.045; OR=7.747, P=0.010; OR=6.882, P=0.015). Conclusions There were some factors were significantly related with the bleeding after percutaneous microwave ablation: liver cirrhosis, abnormal blood clotting function (lower platelet count and prolongation of prothrombin time), tumor located on the surface of liver, and Child-Pugh C grade. When failed to stop bleeding with medical therapy, transcatheter embolization is an effective method to control bleeding.

    Release date:2016-09-08 10:49 Export PDF Favorites Scan
  • Diagnosis and Surgical Treatment for 19 Cases of Pancreatic Cystic Neoplasm

    目的 探讨胰腺囊性肿瘤的诊断及外科治疗方法。方法 对我院2003年4月至2012年4月期间收治的19例胰腺囊性肿瘤患者的临床资料进行回顾性分析。结果 本组19例患者中浆液性囊腺瘤8例,黏液性囊腺瘤5例,导管内乳头状黏液瘤4例,实性假乳头状瘤1例,囊腺癌1例。行B超或CT发现胰腺占位病变。位于胰头部5例,胰体部8例,胰尾部6例。行肿瘤摘除术4例,保留脾脏的胰体尾切除术5例,胰体尾+脾脏切除手术3例,胰十二指肠切除术6例,1例囊腺癌患者因肝脏转移伴腹腔广泛转移、侵犯大血管而肿瘤不能切除仅行胃空肠、胆肠吻合。术后发生胰瘘2例,腹腔感染1例,经保守治疗后康复出院。无围手术期死亡病例。19例患者均进行了随访,随访时间6~80个月,平均45.2个月。1例囊腺癌合并肝脏转移患者于术后7个月死亡,其余良性肿瘤患者均未见复发,最长已存活5年。结论 胰腺囊性肿瘤主要靠影像学检查发现,手术切除是理想的治疗方法,选择合适的术式有助于避免术后并发症的发生和改善预后。

    Release date:2016-09-08 10:23 Export PDF Favorites Scan
  • Diagnosis and Treatment of Hepatocellular Carcinoma with Hypoglycemia

    目的 探讨肝癌合并低血糖的诊断及治疗。方法 对中国医科大学附属第四医院2010年1月至2013年4月期间收治的27例肝癌伴低血糖患者的临床资料进行回顾性分析。结果 27例患者中转移性肝癌2例,原发性肝癌25例;其中伴肝硬变9例。所有患者均给予护肝、补充能量治疗;22例行手术治疗后血糖全部控制在正常或仅轻度升高,5例因肿瘤无法切除而放弃手术治疗,其中1例伴肝硬变肝癌患者2个月后再次低血糖症状发作后死亡。结论 低血糖是肝癌少见的并发症,早期诊断及治疗有助于避免后遗症的发生并改善预后。

    Release date:2016-09-08 10:24 Export PDF Favorites Scan
  • Quantity and Function of CD4+CD25+FOXP3+ Regulatory T Cell Decreased after Operation in Hepatocarcinoma Patients

    ObjectiveThrough the analysis of quantitative and functional changes in peripheral blood CD4+ CD25+FOXP3+ regulatory T cells (Treg) of early HCC patients before and after operation, to discuss the operation effect on the immune function from the aspect of immune suppression. MethodsExtracted the lymphocytes of peripheral blood in HCC patients before and after operation (case group, n=15) and normal people (control group, n=5 cases), and analyze the number and function of Treg by flow cytometer after extracellular (CD4, CD25) and intracellular (FOXP3) staining. ResultsCD4+CD25+ T cells and CD25+FOXP3+ T cells in preoperative peripheral blood in case group were significantly higher than those in control group (12.43±2.57)% vs. (5.56±1.02)%, (5.14±1.4)% vs. (2.18±0.83)%, Plt;0.05). These two cells decreased at 1 week after operation. 〔(10.56±2.13)%, (4.28±1.08)%〕, but there was not statistically significant (Pgt;0.05), they decreased significantly at 2 weeks after operation 〔(7.30±0.89)%, (3.43±0.83)%, Plt;0.05〕. CD8+ T cells and CD4+CD25- T cells in preoperative peripheral blood in case group were significantly lower than those in control group 〔(23.42±1.80)% vs. (29.22±2.26)%, (36.14±1.12)% vs. (43.69±2.78)%, Plt;0.05〕, These two cells decreased significantly at 2 weeks after operation 〔(27.15±1.71)%, (40.30±2.00)%〕. The analysis on the Treg and AFP correlation found that they have low correlation (r=048, Plt;0.05 ). ConclusionsThe hepatectomy can improve the immune response of HCC patient. Treg may have a certain auxiliary significance in the diagnosis, treatment and prognosis of patients with hepatocellular carcinoma.

    Release date:2016-09-08 10:45 Export PDF Favorites Scan
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