目的:探讨股骨近端解剖型钢板治疗股骨粗隆间骨折的临床疗效。方法:自2005年1月至2009年1月,采用切开复位,股骨近端解剖型钢板治疗股骨粗隆间骨折46 例。结果: 术后随访6个月～3年,平均18个月,所有病例均在术后3～55个月获得骨性愈合,髋关节功能根据Harris评分标准进行评定,优32 例,良4 例。结论: 股骨近端解剖型钢板适用于治疗大多数类型的股骨粗隆间骨折,能达到良好的骨折复位和坚强的固定,促进关节早期功能锻炼,骨折愈合率高,是治疗股骨粗隆间骨折的理想选择。
Objective To explore a practical method of culturing discs organ system by observing the changes of the nucleus pulposus after the whole intervertebral discs (including cartilage end-plate, nucleus pulposus, and annulus fibrous)were cultivated. Methods A total of 335 intervertebral discs were taken out completely from 60 healthy SD rats (about150 g) aged 5-6 weeks of clear grade and rinsed by high osmotic sal ine solution containing heparin, then put to the culture plate after being divided into 5 groups randomly. The whole intervertebral discs were cultured with high osmotic (410 mOsmol/ kg) culture medium and changed the medium once every day, then the cell viabil ity (n=15), HE staining (n=15), Safranin O staining (n=15), and immunohistochemistry staining (n=2) were observed at 0, 3, 7, 14, and 21 days; RT-PCR result (n=5) was observed at 0, 3, 7, and 14 days. Results The cell viabil ity was not changed significantly within 14 days (P gt; 0.05) and was significantly lower at 21 days than at other time points (P lt; 0.01). The immunohistochemistry staining results for collagen type II were positive in nucleus pulposus cells at every time point. HE staining showed that the tissue integrity and morphology of the whole intervertebral discs were not changed within 14 days. Safranin O staining showed no significant difference in the matrix grey scale within 14 days (P gt; 0.05) and significant differences between 21 days and 0-14 days (P lt; 0.05). RT-PCR results showed that the mRNA expression of collagen type I increased with time, but the expressions of collagen type II, aggrecan, and decorin decreased, showing significant differences in the mRNA expressions of the matrix protein at each time point (P lt; 0.05). Conclusion High osmotic sal ine solution containing heparin could be used to cultivate the whole intervertebral discs, it is an ideal model for futher studies on physiology and pathology of intervertebral discs.
目的 探讨腹腔镜下胆道镜联合微爆破碎石术仪治疗肝胆管结石的安全性及治疗效果。 方法 回顾分析2008年7月－2012年6月183例胆道结石患者，行腹腔镜下胆道镜联合微爆破碎石仪治疗或单纯经内镜Oddi括约肌切开取石治疗的临床资料。87例患者在术中均应用微爆破碎石仪碎石（微爆破组），96例患者行单纯经内镜Oddi括约肌切开术或经内镜乳头切开术碎石（对照组）。 结果 微爆破组碎石成功率100%，结石取净率85.06%（74/87），微爆破组的碎石时间、平均住院时间、平均住院总费用、并发症发生率均明显低于对照组（P＜0.05）。 结论 腹腔镜下胆道镜联合微爆破碎石术在治疗肝胆管结石病方面，具有微创、安全、经济有效的优点，能降低结石残留率及取石次数，值得临床推广。
ObjectiveTo explore the expression of vascular endothelial growth factor receptor-2(VEGFR-2) protein in esophageal squamous cell carcinoma (ESCC) and to analyze the relationship between VEGFR-2 and prognostic of esophageal cancer in Uygur of Xinjiang. MethodsThe expression of VEGFR-2 protein including 72 patients with ESCC[with 56 males and 16 females at age of 57 (43-79) years] and paracarcinomatous tissues of 28 patients were detected by immunohistochemistry staining (SP) between January 2007 and september 2009 in this hospital. The Kaplan-Meier and Cox proportional hazards analysis were used to analyze the prognosis of ESCC. ResultsThe positive expression rate of VEGFR-2 protein in 72 patients with ESCC was 80.56% (58/72) and 0 in paracarcinomatous tissues. The expression of VEGFR-2 protein in the ESCC was much higher than that in paracarcinomatous tissues with a statistical difference (P<0.05). The expression of VEGFR-2 protein was significantly correlated with depth of invasion, lymph node metastasis, distant metastasis and TNM staging (P<0.05). Tumor size was no correlation with expression of VEGFR-2 protein (P>0.05). Kaplan-Meier survival analysis indicated that five-year survival rate in positive expression of VEGFR-2 was higher than that in the negative group. Lymph node metastasis, TNM staging, and the positive expression of VEGFR-2 protein were independent prognostic factors. ConclusionVEGFR-2 protein is expressed more in ESCC and might be used as the index to predict prognosis and metastasis of esophagedal carcinoma in Uygur.
ObjectiveTo explore the necessity of staple-line reinforcement (SLR) during laparoscopic sleeve gastrectomy (LSG) through evaluating its potential benefit and safety. MethodsA historical cohort study was conducted in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. The consecutive patients underwent LSG for morbid obesity by the same operative team from June 2022 to August 2023 were included, which were assigned into SLR group and un-SLR group according to the SLR or not. Both groups were assessed in terms of the operating time, postoperative hospital stay, total hospital stay, surgical costs, and complications. ResultsA total of 87 patients underwent the LSG from June 2022 to August 2023, all of whom were successfully completed without any conversion to open surgery. Among them, there were 34 cases in the SLR group and 53 cases in the un-SLR group. There were no statistical differences in the age, gender, body mass index, and so on between the two groups (P>0.05). There were no postoperative complications such as gastric leakage, bleeding, or gastrointestinal stenosis, and no perioperative death, as well as no case of reoperation within 30 d after surgery in all patients of the two groups. And there were no statistical differences in the postoperative hospital stay and total hospital stay between the two groups (P>0.05). However, it was found that the operative time was shorter (P<0.05), the surgical costs and total hospital stay costs were also less (P<0.05) in the un-SLR group as compared with the SLR group. ConclusionsBased on the analysis of cases data in this study, there is no added benefit in terms of reducing staple-line leak, bleeding, etc. in adopting SLR during LSG, and the operating time is prolonged and the cost is increased. So the necessity of the SLR or not during LSG needs to be further researched.