Objective To improve the knowledge of kartagener syndrome and the understanding of primary ciliary dyskinesia ( PCD) . Methods Three cases of Kartagener syndrome were reported and analyzed on clinical manifestations, symptoms, imaging appearances of chest, and family history. Meanwhile the related literatures were reviewed. Results The three patients deserved special recognition because of recurrent upper and lower respiratory tract infection. Of them, the third case showed mainly the symptoms of nasosinusitis at an early age, and the distinct pulmonary symptoms appeared in his adulthood. Further examination showed that the triad of chronic sinusitis, bronchiectasis, and situs inversus is present in all cases. The parents of the two cases were consanguineous marriaged. Examination of the bronchial mucosal biopsy specimen of the first case under transmission electron microscopy showed cilia with the absence of inner dynein arms. The three cases got improvement after treatment of anti-infection and expectorant. Conclusion For patients with recurring infection in the upper and lower respiratory tract from infancy, the possibility of PCD should be considered no matter whether a situs inversus exists.
目的 全面介绍先天性囊性腺瘤样畸形(CCAM)其可能的病因，临床、病理特点及诊断手段，循证探讨针对CCAM的治疗方法及预后。 方法 对我院2011年11月收治的1例罕见的CCAM患者的临床资料进行分析，并对相关文献进行复习。 结果 患者数次误诊后最终诊断为CCAM，予手术治疗后痊愈，随访1年无复发。 结论 CCAM是一种少见的、非遗传性的、错构瘤样的肺发育异常，为一种良性的肺部畸形，其特点是局部肺终末呼吸性细支气管过度生长。CCAM多通过产前影像学检查、活组织检查或术后病检诊断。手术为治愈该病的最根本、最重要措施。
目的:观察比较胃镜下硬化剂注射联合药物治疗和单纯硬化剂注射治疗、药物治疗食管静脉曲张出血的疗效。方法:95例肝硬化并食管静脉曲张出血患者,分成三组。32例患者给予硬化剂注射联合药物治疗,31例患者给予硬化剂治疗,32例患者给予药物治疗。观察三组患者急诊止血率,近期出血率、远期再出血率、曲张静脉消失率、曲张静脉复发率。 结果: 联合组、硬化剂组、药物组急诊止血率分别为93.8%.90.3%、68.8%;联合组、硬化剂组、药物组近期出血率分别为6.3%、9.7%、46.9%;联合组、硬化剂组、药物组曲张静脉消失率分别为90.6%、83.9%、1.9%;联合组、硬化组与药物组急诊止血率、近期出血率、曲张静脉消失率有显著差异。联合组、硬化剂组、药物组远期出血率分别为9.4%、59.4%、31.3%; 联合组、硬化剂组、药物组曲张静脉复发率分别为18.8%、45.2%、87.5%;联合组与硬化组、药物组远期出血率、曲张静脉复发率有显著差异。结论:胃镜下硬化剂注射联合药物治疗食管静脉曲张出血可显著提高疗效。
摘要:目的: 探讨PCNA,VEGF在胃癌组织中的表达关系及其意义。 方法 :免疫组织化学法检测正常胃和胃癌组织中PCNA和VEGF的表达,并分析其与胃癌临床病理特征的相关性。 结果 :胃癌组织中PCNA、VEGF的阳性表达率分别为850%、683%,二者在正常胃组织中均为隐性表达。PCNA的表达与肿瘤分期、淋巴结转移有关(〖WTBX〗P lt;005),而与年龄、性别、肿瘤大小、组织分化程度无关(〖WTBX〗P gt;005);PCNA的表达与肿瘤分期、淋巴结转移有关(〖WTBX〗P lt;005),而与年龄、性别、肿瘤大小、组织分化程度无关(〖WTBX〗P gt;005)。PCNA和VEGF在胃癌中的表达呈正相关。 结论 :PCNA和VEGF在胃癌组织中的高表达促进了胃癌的发生发展。Abstract: Objective: To study the significance and relationship of expression of proliferating cell nuclear antigen(PCNA) and vascular endothelial growth factor (VEGF) in gastric cancer. Methods : The expression of VEGF and PCNA in normal gastric tissues and gastric cancer tissues were detected by immunohistochemistry (SP),and clinic pathological correlation with gastric cancer was analyzed. Results : The positive exression rates of PCNA and VEGF in gastric cancer were 850%、683%, respectively, while negative expression was shown in normal gastric tissues. It was found that the expressions of PCNA and VEGF were both in significant relation to TNM stages and lymph node metastasis (P lt;005), but in no relation to age, gender, diameter of tumor and tumor cell differentiation (P gt;005). The expressions of PCNA and VEGF were positively correlated with each other. Conclusion : It was indicated that the highlevel expressions of PCNA and VEGF might corporately accelerate the progression of gastric cancer.
ObjectiveTo establish a forecasting model for inpatient cases of pediatric limb fractures and predict the trend of its variation.MethodsAccording to inpatient cases of pediatric limb fractures from January 2013 to December 2018, this paper analyzed its characteristics and established the seasonal auto-regressive integrated moving average (SARIMA) model to make a short-term quantitative forecast.ResultsA total of 4 451 patients, involving 2 861 males and 1 590 females were included. The ratio of males to females was 1.8 to 1, and the average age was 5.655. There was a significant difference in age distribution between males and females (χ2=44.363, P<0.001). The inpatient cases of pediatric limb fractures were recorded monthly, with predominant peak annually, from April to June and September to October, respectively. Using the data of the training set from January 2013 to May 2018, a SARIMA model of SARIMA (0,1,1)(0,1,1)12 model (white noise test, P>0.05) was identified to make short-term forecast for the prediction set from June 2018 to November 2018, with RMSE=8.110, MAPE=9.386, and the relative error between the predicted value and the actual value ranged from 1.61% to 8.06%.ConclusionsCompared with the actual cases, the SARIMA model fits well with good short-term prediction accuracy, and it can help provide reliable data support for a scientific forecast for the inpatient cases of pediatric limb fractures.
目的 提高对外源性过敏性肺泡炎的认识。 方法 回顾分析2011年10月报道1例外源性过敏性肺泡炎（过敏性肺炎）患者的诊断及治疗经过，总结其临床特征、诊疗要点及预后评价。 结果 患者数次误诊后最终诊断为外源性过敏性肺泡炎，予脱离变应原及激素治疗后痊愈，随访半年无复发。结论 该病临床表现无特异性，需结合患者病史、临床症状、血清学检查、影像学表现，甚至肺泡灌洗液及肺活检综合判断；脱离变应原为该病治疗的最根本、最重要措施；对于病情严重患者，短期全身性使用糖皮质激素可缩短病程或改善症状。
目的 探讨肺郎格罕细胞组织细胞增多症（pulmonary Langerhans cell histiocytosis, PLCH）的临床特征、诊断和治疗。 方法 回顾性分析1999年-2008年4例病理确诊的PLCH。 结果 4例患者均为男性；13～56岁；2例吸烟。临床特征是活动后气短、气胸。胸部CT表现为网格状、囊状或结节状影像。肺活检病理结果：光学显微镜下可见病理性郎格罕细胞，免疫组织化学法检测发现4例S-100均为阳性，2例CD1a阳性，1例CD68阳性。 结论 PLCH胸部CT表现为网结节或囊性变，病理检查见病理性郎格罕细胞浸润细支气管壁和上皮细胞的间质，免疫组织化学CD1a抗原、S-100蛋白阳性可明确诊断。
【摘要】 目的 探讨经鼻胃镜在食管狭窄扩张和支架置入术中的作用。 方法 2007年10月-2009年3月对28例癌性食管狭窄以及并发食管-气管瘘的患者行PENTAX（EG-1580K）超细经鼻电子胃镜检查，计算插入深度，并进行扩张和支架治疗，在胃镜直视下调节输送器内支架上端的位置，观察扩张效果、支架放置成功率、定位的准确性以及并发症情况。 结果 全部患者均行扩张治疗，效果良好，支架一次性放置全部成功，定位准确，自膨满意，最狭窄处的内径由（4.8±1.2）mm扩至（12.5±1.5）mm，食管气管瘘被覆盖治疗效果好，患者的吞咽困难评级由3.25±0.58降至0.94±0.59。 结论 在食管狭窄扩张和支架置入术中应用经鼻超细胃镜患者依从性好，方法简便，安全有效。【Abstract】 Objective To explore the role of nasal endoscopy in the esophagostenosis expansion and esophageal stent. Methods PENTAX (EG-1580K) ultrafine nasal endoscopy was used in 28 patients (October 2007-March 2009) with esophageal cancer complicated with esophagostenosis and fistula to check the e-calculated insertion depth, stent expansion and the average diameter expansion. The endoscopy was carried under the direct vision with the location of the top bracket in order to ensure the accurate stent placement, all without X-ray assist. The success rates of stent placement, positioning accuracy, as well as complications were evaluated. Results The expansion treatments were successful in all patients with one-off operation. The narrowest part increased from (4.9±1.6) mm to (12.7±1.5) mm, and the esophageal fistula was covered. The rating of dysphagia decreased from 3.15±0.68 to 0.91±0.49. Conclusion Nasal endoscopy is simple, safe and effective in the treatment of ultrafine expansion for esophagostenosis and stent implantation with good compliance.
Objective To investigate the effect of ultrasonic irradiation time on enhanced green fluorescent protein (EGFP) gene transfection efficiency and local tissue in bone defects using ultrasound-mediated microbubble destruction. Methods Thirty 3-month-old New Zealand rabbits (2.5-3.0 kg in weight) were randomly divided into 5 groups (n=6) and bone defect models were made on the right ulna. At 10 days after modeling, suspension of microbubbles and EGFP plasmids were locally injected (0.3 mL/kg) and then ultrasound was performed on defect at a frequency of 1 MHz, a intensity of 0.5 W/cm2, and a duty ratio of 20% for 1, 2, 3, 4, and 5 minutes respectively (in 1, 2, 3, 4, and 5 minutes groups respectively). The survival condition was observed. Rabbits were sacrificed for gross observation at 7 days after transfer. The gene expression was observed by fluorescence staining. HE staining and transmission electron microscopy were used to observe the local tissue damage. Results The animals all survived. New soft tissue formed in bone defects area at 1 week after transfer, the surrounding muscle tissue was partly filled in it. Green fluorescence expression was observed in all rabbits. The expression was the strongest in 2 minutes group, and was the weakest in 1 minute group. The absorbance (A) value showed significant differences when compared 1 minute and 2 minutes groups with other groups (P<0.05), but no significant difference was found between 3, 4, and 5 minutes groups (P>0.05). Tissue damage was observed in all groups and it was aggravated with the increase of irradiation time. Conclusion EGFP transfection efficiency in bone defect by ultrasound-mediated microbubble destruction is related to irradiation time. EGFP gene can be efficiently transfected without obvious toxicity at 1 MHz, 0.5W/cm2, and duty ratio of 20% for 2 minutes in bone defects of rabbits.
Objective To summarize the etiology and clinical features of Mounier-Kuhn syndrome (MKS) so as to enhance the acknowledgement of MKS. Methods Three cases of MKS were reported and the keywords with " Tracheobronchomegaly”, " Mounier-Kuhn syndrome” were analyzed through the mode of literature retrieval in CNKI, VIP and Pubmed databases. Results There were 214 cases around the world including 14 cases of MKS in China. With unknown etiology and non-specific clinical feature, MKS is characteristic with congenital absence of tracheal or bronchial elastic tissue. MKS is diagnosed with remarkably dilated trachea and bronchus through chest CT or bronchofibroscope, accompanied with genetic defects. The ratio of men to women is 8.5 to 1. There is no radical cure. Symptomatic treatment and surgical treatment when necessary could be available. Conclusions MKS is a rare progressive hereditary disease, irrelevant to smoking and sharing a similar cause with generalized elastolysis, which need pay much attention to the physical examination of skin or elastic tissue. The diagnosis of MKS should be based on not merely airway diameter but also the overall clinical, pathologic, and radiologic profile.