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超声电导透皮给药对结肠癌患者术后肠功能恢复的影响研究

目的　观察比较超声电导药物透入治疗对结肠癌患者术后肠道功能恢复的影响。 方法　对2010年10月－2011年10月择期行结肠癌根治术的患者100例，按照手术的先后顺序，分为试验组和对照组各50例，对照组行常规治疗和早期康复锻炼，试验组在行常规治疗和早期常规康复锻炼的基础上使用超声电导药物透入治疗2次/d，每次30 min。观察两组患者术后肠鸣音恢复时间、肛门排气时间、排便时间及术后住院天数。 结果　试验组患者术后首次肛门排气、排便时间早于对照组，术后住院天数短于对照组，差异均有统计学意义（P＜0.05）。 结论　结肠癌患者术后采用超声电导药物透入治疗，可促进患者肠道功能的恢复，加速患者康复。

ULTRASOUND GUIDED CORE-NEEDLE BIOPSY OF NONPALPABLE BREAST LESIONS

目的 评价B超引导下核心针活检术（CNB）对不可触及的乳腺病变（NPBL）的诊断价值。方法 采用18G Tru-cut针结合活检枪对88例患者的96个NPBL行B超引导下CNB，并与切除活检病理结果比较。结果 NPBL大小4～23mm（平均13.1mm）。在CNB中，86个为良性，2个为可疑恶性，6个为恶性，2个取材不良。在切除活检中9个为恶性，87个为良性。CNB可疑恶变的2个NPBL均为恶性，1个恶性NPBL误诊为乳腺腺病，取材不良的2个NPBL均为良性。本组NPBL中恶性病变占9.38%（9/96），B超引导下CNB对NPBL的良恶性诊断正确率为98.94%（93/94），诊断乳腺癌的敏感性为88.89%（8/9），特异性为100%（8/8），良性病变的病理诊断符合率为97.70%（85/87），取材不良为2.08%（2/96）。结论 B超引导下CNB对NPBL的诊断具有较高的敏感性和特异性，结果准确可靠。

先天性心脏病合并肺动脉高压患者肺组织一氧化氮合酶的表达

目的 通过观察先天性心脏病合并肺动脉高压患者肺组织内皮型一氧化氮合酶(eNOS)的表达,了解其肺血管内皮细胞功能有否异常. 方法 32例先天性心脏病患者分为2组,组Ⅰ:合并肺动脉高压患者(n=16);组Ⅱ:未合并肺动脉高压患者(n=16).在心内直视术下,取少许右肺中叶组织,利用免疫组织化学和逆转录-聚合酶链反应(RT-PCR)技术,对eNOS进行半定量分析. 结果 组Ⅱ患者肺血管内皮细胞内eNOS免疫染色比组Ⅰ明显增强(F=93.98,Plt;0.01);组Ⅱ患者肺血管内皮细胞内eNOSmRNA表达比组Ⅰ明显增高(F=58.76,Plt;0.01). 结论 先天性心脏病合并肺动脉高压患者的eNOS表达减少,造成内源性一氧化氮(NO)生成不足,为该类患者吸入NO治疗肺动脉高压提供了理论依据.

颈侧皮下蒂皮瓣修补多发性脑脊液耳漏一例

Comparison between Assay of Immunoblotting Test, ELISA and RIA in Detection for Islet Autoantibodies

目的:评价免疫印迹法检测胰岛自身抗体（GAD-A、ICA、IAA）与酶联免疫法测ICA、GAD-A放射免疫法测IAA结果的一致性。方法:采用免疫印迹法测定81例糖尿病患者胰岛自身抗体,将结果与酶联免疫法测定的GAD-A、ICA,放射免疫法测定IAA结果进行比较。结果:免疫印迹法阳性检出率为:GAD-A 51.8%,ICA 18.5%,IAA 27.1%；酶联免疫法（GAD-A、ICA）、放射免疫法（IAA）阳性检出率:GAD-A 32.1%,ICA 34.5%,IAA 30.8%；上述两组结果进行比较,两组相比ICA和GAD-A有统计学差异（Plt;0.05）,IAA无统计学差异。两组结果一致率比较:GAD-A 50.6%,ICA 64.2%,IAA 69.1%。结论:与临床常用酶联免疫法检测GAD-A、ICA,放射免疫法检测IAA比较,免疫印迹法和酶联免疫法在ICA及GAD-A阳性检出率上的差异有显著性,和放射免疫法在IAA阳性检出率上差异无显著性。

Pay attention to the diagnosis and treatment of fundus complications related to tumor immunotherapy

Cancer immunotherapy refers to the therapeutic effect of controlling or eliminating tumor cells by interfering with the immune system to restore the anti-tumor immune response. Immune checkpoint inhibitor therapy that blocks programmed death -1/programmed cell death ligand-1/cytotoxic T lymphocyte-associated antigen 4 is one of the most commonly used tumor immunotherapies, with good efficacy and wide application. These drugs cause immune-related ocular complications such as uveitis, autoimmune retinopathy, and scleritis, which represent a new etiology of ocular inflammation. The ophthalmologist's grasp of the clinical characteristics of these diseases is helpful for timely diagnosis. At the same time, the ophthalmologist will work closely with the oncologist to make a comprehensive judgment based on the patient's primary tumor, survival prognosis, severity of adverse reactions related to ocular immunotherapy, and visual prognosis, and develop suitable therapeutic strategie, thereby saving the patients' vision and improving the quality of life.

经支气管镜电凝切治疗气管脂肪瘤一例

Bioinformatics analysis of POLD1 gene expression and biological function in non-small cell lung cancer

Objective To detect the expression and clinical significance of POLD1 gene in non-small cell lung cancer (NSCLC) via bioinformatics method. Methods The expression difference of POLD1 in NSCLC tissue and normal lung tissue was investigated by TIMER database. UALCAN database was used to further verify different expression of POLD1 as well as the relationship between POLD1 expression and clinicopathological characteristics of NSCLC. The correlation between POLD1 gene and prognosis of NSCLC patients was detected by GEPIA and TIMER database. cBioPortal database was used to analyze frequencies of POLD1 gene mutation. POLD1-related protein-protein interaction network was constructed by STRING database. The relationship between POLD1 and immune infiltration was based on TISIDB database. Results The expression of POLD1 gene in lung adenocarcinoma and lung squamous cell carcinoma was significantly higher than that in normal lung tissue. In lung adenocarcinoma, patients with lower POLD1 level showed better prognosis. 1.2% of lung adenocarcinoma patients and 1.8% of lung squamous cell carcinoma patients carried mutated POLD1 gene, mainly missense mutations. POLD1 may interact with POLD2, POLD3, POLD4, POLE, RPA1, PCNA, MSH6, MSH2 and FEN1. The biological processes include DNA replication, mismatch repair, etc. Besides, the expression of POLD1 in NSCLC was correlated with the number of different immune cells. Conclusions The POLD1 gene is highly expressed in NSCLC patients, and negatively related with survival prognosis in patients of lung adenocarcinoma. POLD1 gene may be a potential diagnostic target and prognostic marker in NSCLC.

Implications of iCHECK-DH for implementation reports on digital health technologies

To standardize and improve the reporting quality of digital health implementation research, the Geneva Digital Health Hub has developed the guidelines and checklist for reporting digital health implementations (iCHECK-DH). This paper introduces the background of iCHECK-DH and based on practical application experiences, emphasizes the importance of interdisciplinary collaboration. It focuses on economic cost-effectiveness and local policy guidance in the clinical implementation of digital health technologies. This will provide valuable insights for Chinese scholars when writing implementation reports on digital health technologies.

经外周静脉置入中心静脉导管在肠外营养支持治疗胃肠肿瘤患者中的应用现状调查及效果分析

目的探讨经外周静脉置入中心静脉导管（PICC）在营养支持治疗胃肠肿瘤患者中的应用效果并进行分析。 方法2012年2月－4月选取需行肠外营养支持治疗的胃肠肿瘤患者418例为研究对象，进行静脉穿刺次数、穿刺点出血、穿刺周围皮肤红肿、皮温增高、穿刺肢体肿胀的临床观察及分析。 结果所有患者中，自愿选择PICC置管69例，置管期间穿刺点24 h内出血61例（88.4%）、24 h后出血2例（2.9%），周围皮肤发红8例（11.6%），皮温增高4例（5.8%），穿刺肢体肿胀2例（2.9%）；选择静脉留置针349例，置管期间穿刺点24 h内出血4例（1.1%）、24 h后出血18例（5.2%），周围皮肤发红68例（19.5%），皮温增高54例（15.5%），穿刺肢体肿胀62例（17.7%）。 结论早期选择PICC静脉治疗方案，可降低患者静脉治疗中静脉炎、肢体肿胀等并发症及穿刺痛苦，优化管理整体治疗周期静脉治疗费用，是静脉治疗专科护理发展的趋势。