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中国实用医刊
中国实用医刊

秦省

半月刊

1674-4756

zgsyyk@163.com

0371-65920096

450003

河南省郑州市经三路七号

中国实用医刊/Journal Chinese Journal of Practical Medicine
查看更多>>1974年1月创刊,中华人民共和国卫生部主管,中华医学会主办。本刊原名《中原医刊》,中国期刊全文数据库全文收录期刊、中国学术期刊综合评价数据库统计刊源期刊、中国核心期刊(遴选)数据库收录期刊、万方数据-数字化期刊群收录期刊。重点报道内、外、妇、儿等学科进展,以及新理论、新成果等。设有论著、临床实践、经验交流、临床研究、药物与临床、综述、误诊分析等栏目。
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    负载槲皮素的间充质干细胞外泌体对小鼠肝纤维化的治疗作用

    褚学宏常青
    1-5页
    查看更多>>摘要:目的 探讨负载槲皮素的间充质干细胞外泌体对小鼠肝纤维化的治疗作用。 方法 实验性研究。于2021年6月选取9只无特定病原体级8周龄雄性C57小鼠(购自郑州大学实验动物中心),以随机数字表法分为正常对照组、模型组和负载槲皮素的外泌体治疗组(以下简称治疗组),每组3只。模型组和治疗组通过饲喂低蛋氨酸低胆碱高脂饲料8周构建小鼠肝纤维化模型,其中治疗组于第6周开始每周通过尾静脉注射负载槲皮素的间充质干细胞外泌体进行治疗。第8周时对三组小鼠进行肝组织病理学检查(肝脏纤维化程度根据Ishak评分系统判定)、肝功能检测[天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和碱性磷酸酶(ALP)],通过免疫组织化学法检测纤维化标志物α-平滑肌肌动蛋白(α-SMA)和Ⅰ型胶原蛋白(colla Ⅰ)在各组肝脏组织中的表达。 结果 肝组织切片苏木精-伊红染色和Masson染色结果显示,正常对照组肝小叶结构完整,肝细胞围绕中央静脉排列整齐,形态正常;模型组肝小叶结构紊乱,脂肪变性,局灶性溶解性坏死,门管区纤维增生;治疗组结缔组织增生较模型组得到明显改善。模型组肝纤维化Ishak评分[(3.40±0.49)分]高于正常对照组[(0.00±0.00)分],治疗组肝纤维化Ishak评分[(2.60±0.49)分]低于模型组(P<0.05)。模型组血清AST、ALT和ALP水平均高于正常对照组,治疗组血清AST、ALT和ALP水平低于模型组(P<0.05)。免疫组织化学法检测结果显示,模型组呈现大范围α-SMA和colla Ⅰ阳性表达,治疗组α-SMA和colla Ⅰ的表达面积较模型组明显减少。 结论 负载槲皮素的间充质干细胞外泌体有缓解小鼠肝纤维化的作用。 Objective To investigate the therapeutic effect of quercetin-loaded mesenchymal stem cell-derived exosomes on hepatic fibrosis in mice. Methods This experimental study, conducted in June 2021, involved nine specific pathogen free 8-week-old male C57 mice (purchased from the Experimental Animal Center of Zhengzhou University). And they were divided into normal control group, model group and quercetin-loaded exosome treatment group (referred to as the treatment group) using a random number table method, with 3 mice in each group. The model group and the treatment group were subjected to an 8-week regimen of a high-fat diet with low methionine and low choline to induce liver fibrosis. Additionally, the treatment group received weekly intravenous administrations of quercetin-loaded mesenchymal stem cell-derived exosomes via the tail vein starting from the 6th week. At the 8th week, liver histopathology examination (evaluation of the degree of liver fibrosis by Ishak scoring system) and liver function tests, including aspartate transaminase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP), were performed on all three groups of mice. The expression levels of collagen Ⅰ(colla Ⅰ) and α-smooth muscle actin (α-SMA), markers of fibrosis, in the liver tissues of each group were detected by immunohistochemistry at the 8th week. Results Hematoxylin-eosin staining and Masson staining of liver tissue sections revealed that the normal control group exhibited intact liver lobule structure, with orderly arranged liver cells around the central vein, displaying normal morphology. The model group manifested disrupted liver lobular structure, steatosis, focal lytic necrosis and portal fibroplasia. The treatment group exhibited a significant amelioration in connective tissue proliferation compared with the model group. The Ishak score for liver fibrosis in the model group (3.40±0.49) was higher than that in the normal control group (0.00±0.00), while the Ishak score for liver fibrosis in the treatment group (2.60±0.49) was lower than that in the model group (P<0.05). The model group had higher levels of serum AST, ALT and ALP compared with the normal control group, while the treatment group had lower levels of serum AST, ALT and ALP compared with the model group (P<0.05). Results of immunohistochemistry showed that the α-SMA and colla Ⅰ expressed positively in most area in the model group compared with the model group, α-SMA- and colla Ⅰ-positively expressed area in the treatment group decreased significantly. Conclusions Quercetin-loaded mesenchymal stem cell-derived exosomes demonstrate a therapeutic effect in alleviating liver fibrosis in mice.

    槲皮素间充质干细胞外泌体肝纤维化

    鼻腔鼻窦NK/T细胞淋巴瘤与弥漫大B细胞淋巴瘤的临床及影像学特征比较

    高旭栋李安赵博李岚...
    6-9页
    查看更多>>摘要:目的 对比分析鼻腔鼻窦NK/T细胞淋巴瘤(NKTCL)和弥漫大B细胞淋巴瘤(DLBCL)的临床及影像学特征。 方法 回顾性分析2019年6月至2023年6月于陕西省人民医院耳鼻咽喉头颈外科进行治疗的40例鼻腔鼻窦NKTCL患者(NKTCL组)与30例鼻腔鼻窦DLBCL患者(DLBCL组)的临床资料。所有研究对象均有完整的临床资料,均接受过影像学检查(CT、磁共振成像及增强扫描等)。比较两组患者的临床特征及影像学特征。 结果 两组患者临床症状相似,均有鼻塞、头闷头痛及眼部症状。两组患者的性别、临床分期、美国东部肿瘤协作组体力状态评分比较,差异未见统计学意义(P>0.05),但NKTCL组年龄小于DLBCL组(P<0.05)。NKTCL组CT平扫可见密度均匀软组织影填充鼻腔,增强扫描可见轻中度不均匀强化;磁共振成像检查T1加权像(T1WI)表现出和肌肉类似的等信号或稍高信号,T2加权像(T2WI)表现为肌肉和鼻腔黏膜之间信号,增强扫描可见轻中度强化。DLBCL组CT平扫示病变以稍高密度软组织影为主,CT增强扫描多为不均匀强化;磁共振成像检查T1WI多为稍高的中等强化信号,T2WI则以稍高信号为主。 结论 鼻腔鼻窦NKTCL、DLBCL的临床表现存在相似性,易导致误诊,临床需结合影像学特征做进一步分析,才能提高鼻腔鼻窦NKTCL、DLBCL诊断的准确度。 Objective To comparatively analyze the clinical and imaging features of sinonasal natural killer/T-cell lymphoma (NKTCL) and diffuse large B-cell lymphoma (DLBCL). Methods The clinical data of 40 patients with sinonasal NKTCL (NKTCL group) and 30 patients with sinonasal DLBCL (DLBCL group) treated in the Department of Otolaryngology, Head and Neck Surgery of Shaanxi Provincial People’s Hospital from June 2019 to June 2023 were retrospectively analyzed. All subjects had complete clinical data and underwent imaging examinations, such as computed tomography (CT), magnetic resonance imaging and contrast-enhanced scans. A comparative analysis of clinical and imaging characteristics were performed between the two groups . Results Both groups presented with similar symptoms, such as nasal congestion, headache, and eye symptoms. There was no statistically significant difference in gender, clinical staging, or Eastern Cooperative Oncology Group performance status score between the two groups (P>0.05) but the NKTCL group had a lower age compared with the DLBCL group (P<0.05). In the NKTCL group, CT scans showed uniformly dense soft tissue shadows filling the nasal cavity, with mild to moderate uneven enhancement in contrast-enhanced scans. T1-weighted images (T1WI) showed signals similar to muscles or slightly higher and T2-weighted images (T2WI) showed signals between muscles and nasal mucosa, with mild to moderate enhancement visible in contrast-enhanced magnetic resonance imaging. In the DLBCL group, CT scans displayed soft tissues mainly with slightly higher density, with predominantly uneven enhancement in contrast-enhanced scans. T1WI demonstrated mostly slightly higher and moderately enhanced signals, while T2WI mainly showed slightly higher signals in magnetic resonance imaging. Conclusions Sinonasal NKTCL and DLBCL share similarities in clinical manifestations, easily leading to misdiagnosis. Further analysis, based on the imaging characteristics, is crucial to improve the accuracy of diagnoses of sinonasal NKTCL and DLBCL.

    鼻腔鼻窦非霍奇金淋巴瘤NK/T细胞淋巴瘤弥漫大B细胞淋巴瘤

    显微镜辅助下经椎板间隙与椎间孔入路手术治疗退行性腰椎管狭窄症的效果比较

    任毅张海鸿李佳佳
    10-13页
    查看更多>>摘要:目的 比较显微镜辅助下经椎板间隙与椎间孔入路手术治疗退行性腰椎管狭窄症的临床效果。 方法 随机对照研究。前瞻性抽取2022年2月至2023年1月于兰州大学第二医院就诊的96例退行性腰椎狭窄症患者为研究对象,按照随机数字表法分为椎板间隙组与椎间孔组,每组48例。两组患者均由同一组医护人员实施手术,椎板间隙组接受显微镜下经椎板间隙入路手术,椎间孔组接受显微镜下经椎间孔入路手术。观察并记录两组手术情况(包括手术时间、术中透视次数、术中出血量及住院时间);比较两组治疗前及术后6个月的腰椎功能[日本骨科协会(JOA)评分表评分]、疼痛情况[数字评定量表(NRS)评分];比较两组治疗效果及围术期并发症发生情况。 结果 椎间孔组手术时间、术中透视次数、术中出血量均多于椎板间隙组(P均<0.05),两组住院时间比较差异未见统计学意义(P>0.05)。术后6个月,两组JOA评分均高于治疗前,NRS评分均低于治疗前(P均<0.05),两组JOA、NRS评分比较差异未见统计学意义(P>0.05)。两组治疗效果以及优良率比较差异未见统计学意义(P>0.05)。两组均未见硬脊膜撕裂、永久性神经根损伤等并发症。 结论 显微镜辅助下经椎板间隙入路手术或经椎间孔入路手术治疗退行性腰椎管狭窄症均有良好的治疗效果及安全性,二者均能有效改善患者腰椎功能,缓解疼痛程度。相较于经椎间孔入路手术,经椎板间隙入路手术时间较短,术中透视次数及术中出血量较少,更具优势。 Objective To compare the effect of microscope-assisted surgery via the interlaminar approach and the foraminal approach in the treatment of degenerative lumbar spinal stenosis. Methods This study was a randomized controlled trail. A total of 96 patients with degenerative lumbar spinal stenosis admitted to Lanzhou University Second Hospital from February 2022 to January 2023 were selected as research subjects prospectively. And they were divided into the laminar space group and the foramen group by random number table method, with 48 cases in each group. Both groups underwent surgery by the same medical team. The laminar space group was treated by microscope-assisted surgery via the interlaminar approach, and the foramen group was treated by microscope-assisted surgery via the foraminal approach. The operation conditions (including operation time, intraoperative fluoroscopy times, intraoperative blood loss, hospital stay) of the two groups were observed and recorded. The lumbar function evaluated by the Japanese Orthopaedic Association (JOA) score and pain degree evaluated by numerical rating scale (NRS) of the two groups were compared before and 6 months after operation. The therapeutic effects and the perioperative complications of the two groups were compared. Results Compared with the laminar space group, the foramen group exhibited a longer operation time, increased intraoperative fluoroscopy times, and higher intraoperative blood loss volume (all P<0.05) there was no significant difference in hospital stay between the two groups (P>0.05). Six months after surgery, the JOA score increased, and the NRS score decreased in both groups (allP<0.05), while there was no significant difference in scores of JOA and NRS between the two groups (P>0.05). There was no significant difference in overall treatment efficacy or excellent and good rate between the two groups (P>0.05). Neither group reported any complications such as dural laceration or permanent nerve root injury. Conclusions Microscope-assisted surgery via the interlaminar approach and the foraminal approach both have ideal effects and safety in the treatment of degenerative lumbar spinal stenosis. They can effectively improve the lumbar function and alleviate pain. However, compared with the foraminal approach, microscope-assisted surgery via the interlaminar approach offers advantages of shorter surgical time, fewer intraoperative fluoroscopy times, and less intraoperative bleeding.

    椎管狭窄退行性显微镜椎板间隙入路椎间孔入路

    经外侧裂入路术治疗高血压基底节区脑出血的效果观察

    白冰杨凤东孙沛文马艳丽...
    14-17页
    查看更多>>摘要:目的 分析经外侧裂入路术治疗高血压基底节区脑出血的效果。 方法 回顾性抽取2022年3月至2023年2月于郑州大学第一附属医院行手术治疗的高血压基底节区脑出血患者72例,按照治疗术式分为对照组(36例)和观察组(36例)。对照组行皮层造瘘术治疗,观察组行经外侧裂入路术治疗。记录并比较两组围术期指标水平、血肿清除率、治疗效果及术后并发症发生情况。 结果 观察组手术时间、术中出血量、后瞳孔恢复时间、住院时间少于对照组(t=3.51、7.09、3.19、2.48, P均<0.05),血肿清除率、总有效率高于对照组(χ2=2.69、6.18,P均<0.05)。观察组术后并发症总发生率低于对照组(χ2=4.18,P=0.041)。 结论 经外侧裂入路术治疗高血压基底节区脑出血的效果良好,血肿清除率高,术中出血量和术后并发症少,且安全性较高。 Objective To analyze the effect of trans-sylvian fissure approach surgery in the treatment of hypertensive basal ganglia hemorrhage. Methods A total of 72 patients with hypertensive basal ganglia hemorrhage who underwent surgery in the First Affiliated Hospital of Zhengzhou University from March 2022 to February 2023 were retrospectively selected, and they were divided into control group (36 cases) and observation group (36 cases) according to the treatment method. The control group was treated by cortical fistulization, and the observation group was treated by trans-sylvian fissure approach surgery. The levels of perioperative indicators, hematoma clearance rate, therapeutic effect, and postoperative complications of the two groups were recorded and compared. Results The operation time, intraoperative blood loss, posterior pupillary recovery time and hospital stay in the observation group were less than those in the control group (t=3.51, 7.09, 3.19, 2.48 all P<0.05). The hematoma clearance rate and total effective rate in the observation group were higher than those in the control group (χ2=2.69, 6.18 all P<0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group (χ2=4.18, P=0.041). Conclusions The trans-sylvian fissure approach surgery has a good effect in the treatment of hypertensive basal ganglia hemorrhage, which has a high hematoma clearance rate, less intraoperative blood loss and less postoperative complications, with high safety.

    基底节区脑出血经外侧裂入路术皮层造瘘术高血压

    血管内机械再通术联合重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死的临床研究

    于广周马文娟
    17-21页
    查看更多>>摘要:目的 探讨血管内机械再通术联合重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死的临床效果。 方法 随机对照研究。抽取2020年10月至2022年5月驻马店市中心医院收治的急性脑梗死患者108例,采用照随机数字表法将其分为对照组和观察组,每组54例。对照组在常规治疗基础上给予重组组织型纤溶酶原激活剂静脉溶栓治疗,观察组患者在常规治疗基础上给予血管内机械再通术联合重组组织型纤溶酶原激活剂静脉溶栓治疗。比较两组患者的临床疗效,比较两组治疗前、治疗后7 d的神经损伤标志物[中枢神经特异性蛋白(S100β)、神经元特异性烯醇化酶(NSE)]、大脑动脉血流动力学指标[颈总动脉血流平均流速(Vmean)、最大流速(Vmax)、血管阻力指数(RI)、搏动指数(PI)],并观察两组治疗后7 d内并发症发生情况。 结果 治疗后7 d,观察组治疗总有效率(92.59%,50/54)高于对照组(77.78%,42/54),P<0.05。治疗后7 d,两组S100β、NSE指标均较同组治疗前降低,且观察组低于对照组(P<0.05)。治疗后,两组患者Vmean、Vmax值均较同组治疗前升高,且观察组高于对照组(P<0.05);两组患者RI、PI指标均较同组治疗前降低,且观察组低于对照组(P<0.05)。两组治疗期间并发症发生率比较,差异未见统计学意义(P>0.05)。 结论 血管内机械再通术联合重组组织型纤溶酶原激活剂静脉溶栓治疗可改善急性脑梗死患者的大脑血流动力学指标,减少神经损伤,提高临床疗效。 Objective To investigate the clinical effect of intravascular mechanical recanalization combined with intravenous thrombolysis with recombinant tissue plasminogen activator in the treatment of acute cerebral infarction. Methods This study was a randomized controlled trial. A total of 108 patients with acute cerebral infarction treated in Zhumadian Central Hospital from October 2020 to May 2022 were selected, and they were divided into control group and observation group by random number table method, with 54 cases in each group. The control group was treated by intravenous thrombolysis with recombinant tissue plasminogen activator on the basis of conventional treatment, and the observation group was treated by intravascular mechanical recanalization combined with intravenous thrombolysis with recombinant tissue plasminogen activator and conventional treatment. The clinical efficacy of two groups were compared. The nerve injury markers, including central nervous specific protein (S100β) and neuron specific enolase (NSE), cerebral artery hemodynamics, including mean velocity (Vmean), maximum velocity (Vmax), vascular resistance index (RI) and pulsatility index (PI) of common carotid artery, were compared between the two groups before treatment and 7 days after treatment. The incidence of complications within 7 days after treatment in both groups were observed. Results After 7 days of treatment, the total effective rate of the observation group (92.59%, 50/54) was higher than that of the control group (77.78%, 42/54), P<0.05. After 7 days of treatment, the levels of S100β and NSE in both groups decreased, compared with preoperative levels in the same group (P<0.05) moreover, the above indicators in the observation group were lower than those in the control group (P<0.05). After treatment, the Vmean and Vmax of both groups were lower than those before treatment, while the Vmean and Vmax of the observation group were higher than those of the control group (P<0.05). The RI and PI in both groups were lower than those before treatment (P<0.05) moreover, the RI and PI in the observation group were lower than those in the control group (P<0.05). There was no statistically significant difference in the incidence of complications between the two groups during the treatment period (P>0.05). Conclusions Intravascular mechanical recanalization combined with intravenous thrombolysis with recombinant tissue plasminogen activator can improve cerebral hemodynamics in patients with acute cerebral infarction, reduce nerve injury, and improve clinical efficacy.

    脑梗死重组组织型纤溶酶原激活剂静脉溶栓血管内机械再通术

    胃大部分切除术与单纯修补术治疗急性胃穿孔的效果比较

    冯淞李连杰罗健威刘小敏...
    22-25页
    查看更多>>摘要:目的 对比分析胃大部分切除术与单纯修补术治疗急性胃穿孔的临床效果。 方法 随机对照研究。抽取2020年3月至2023年3月信阳市中心医院急诊科收治的120例急性胃穿孔患者作为研究对象,根据电脑随机数表法分为对照组与观察组,每组60例。对照组予以胃大部分切除术,观察组予以单纯修补术,比较两组患者的围术期指标、应激反应及安全性。 结果 观察组术中失血量少于对照组,手术操作时间、肛门排气、肠鸣音恢复、术后首次下床及住院时间均短于对照组(P均<0.05);观察组白细胞介素-6、C反应蛋白与降钙素原水平均低于对照组(P均<0.05);观察组并发症发生率(5.00%,3/60)低于对照组(16.67%,10/60),P<0.05。 结论 急性胃穿孔临床治疗中,与胃大部分切除术相比,单纯修补术在改善围术期指标、降低应激反应及提高安全性方面更具优势。 Objective To compare the effect of subtotal gastrectomy and simple repair in the treatment of acute gastric perforation. Methods This study was a randomized controlled trail. A total of 120 patients with acute gastric perforation who were admitted to the Emergency Department of Xinyang Central Hospital from March 2020 to March 2023 were selected, and they were divided into control group and observation group according to the computer random number table method, with 60 cases in each group. The control group was treated by subtotal gastrectomy, and the observation group was treated by simple repair. The perioperative indexes, stress response and safety of the two groups were compared. Results The intraoperative blood loss in the observation group was less, while the operation time, anal exhaust time, bowel sound recovery time, the first ambulation time after surgery and length of hospital stay in the observation group were shorter, compared with the control group (all P<0.05). The levels of interleukin-6, C-reactive protein and procalcitonin in the observation group were all lower than those in the control group (allP<0.05). The incidence of complications in the observation group (5.00%, 3/60) was lower than that in the control group (16.67%, 10/60),P<0.05. Conclusions In the clinical treatment of acute gastric perforation, simple repair has more advantages in improving perioperative indexes, reducing stress response and improving safety, compared with subtotal gastrectomy.

    急性胃穿孔胃大部分切除术单纯修补术应激反应安全性

    外周动静脉同步换血联合间歇蓝光治疗新生儿重度高胆红素血症的效果及对脑电活动的影响

    冯磊董慧茹李晶师淑锋...
    25-28页
    查看更多>>摘要:目的 探究外周动静脉同步换血联合间歇蓝光治疗新生儿重度高胆红素血症的效果及对脑电活动的影响。 方法 随机对照研究。抽取2020年2月至2023年2月郑州大学附属儿童医院收治的高胆红素血症患儿86例,根据蓝光治疗方案分为对照组(46例)和研究组(40例)。两组均接受外周动静脉同步换血,对照组接受持续蓝光治疗,研究组接受间歇蓝光治疗。比较两组治疗前后血清胆红素水平、脑电活动情况及不良反应发生情况。 结果 治疗后,两组患儿血清总胆红素、间接胆红素水平低于治疗前(P<0.05),但两组上述指标水平比较差异未见统计学意义(P>0.05)。治疗后,两组痫性放电者比例与治疗前比较,差异未见统计学意义(P>0.05);治疗后,对照组脑电背景活动异常者比例与治疗前比较,差异未见统计学意义(P>0.05),研究组脑电背景活动重度抑制者比例少于治疗前(χ2=7.21,P=0.007);治疗后,对照组睡眠-觉醒周期成熟者比例高于治疗前(χ2=3.87,P=0.049),研究组睡眠-觉醒周期缺失者比例少于治疗前(χ2=7.21,P=0.007)。两组治疗前及治疗后脑电活动分布情况比较,差异未见统计学意义(P>0.05)。研究组不良反应总发生率(25.00%,10/40)低于对照组(65.22%,30/46),P<0.05。 结论 外周动静脉同步换血联合间歇蓝光治疗新生儿重度高胆红素血症,能有效降低血胆红素水平,改善脑电活动,降低不良反应发生率。 Objective To investigate the efficacy of simultaneous peripheral arteriovenous exchange transfusion combined with intermittent blue light in the treatment of severe hyperbilirubinemia in neonates, and the influence on cerebral electrical activity. Methods This study was a randomized controlled trial.A total of 86 children with hyperbilirubinemia admitted to Children’s Hospital Affiliated of Zhengzhou University from February 2020 to February 2023 were selected, and they were divided into control group (46 cases) and study group (40 cases) according to the blue light treatment plan. The two groups received simultaneous peripheral arteriovenous exchange transfusion the control group received continuous blue light therapy, and the study group received intermittent blue light therapy. The preoperative and postoperative level of serum bilirubin, cerebral electrical activity and incidence of adverse reactions of the two groups were compared. Results After treatment, the levels of serum total bilirubin and indirect bilirubin in the two groups were lower than those before treatment (P<0.05), but there was no significant difference in the levels of the above indexes between the two groups (P>0.05). After treatment, there was no significant difference in comparison of preoperative and postoperative proportion of patients with epileptic discharges in the two groups (P>0.05). After treatment, there was no significant difference in comparison of preoperative and postoperative proportion of patients with abnormal background electroencephalogram activity in the control group (P>0.05). After treatment, the proportion of patients with severe suppression of background electroencephalogram activity in the study group was less than that before treatment (χ2=7.21, P=0.007). After treatment, the proportion of patients with mature sleep-wake cycle in the control group was higher than that before treatment (χ2=3.87, P=0.049), and the proportion of patients with sleep-wake cycle loss in the study group was less than that before treatment (χ2=7.21, P=0.007). There was no significant difference in the distribution of electroencephalogram activity between the two groups before and after treatment (P>0.05). The total incidence of adverse reactions in the study group(25.00%, 10/40) was lower than that in the control group (65.22%, 30/46),P<0.05. Conclusions Simultaneous peripheral arteriovenous exchange transfusion combined with intermittent blue light in the treatment of severe neonatal hyperbilirubinemia can effectively reduce levels of blood bilirubin, improve cerebral electrical activity, and reduce the incidence of adverse reactions.

    高胆红素血症,新生儿外周动静脉同步换血间歇蓝光

    2022年平顶山市肿瘤发病情况的调查分析

    颜欣颖许艺苑马艳丽
    29-33页
    查看更多>>摘要:目的 分析2022年平顶山市肿瘤发病情况,为该地肿瘤防控策略的制定提供参考依据。 方法 横断面研究。整理2022年1月至2022年12月平顶山市疾病预防控制中心收集并质控的10个县区上报的肿瘤登记数据,统计肿瘤发病率、构成比、位次及病死率等数据,分析肿瘤状况。 结果 2022年1月至12月平顶山市常住人口3 978 797人,其中男性2 014 874人,女性1 963 923人。在此期间全市10个县区共上报12 024张卡片,按发病日期共上报8 325张,发病率209.23/10万,其中新华区、卫东区发病率超250.00/10万;按病死日期共上报3 070张,病死率77.16/10万,其中郏县、卫东区肿瘤病死报告相对较高。报告男性肿瘤发病数5 007人,男性粗发病率248.50/10万;报告女性肿瘤发病数3 318人,女性粗发病率为168.95/10万,男性粗发病率为女性粗发病率的1.47倍。65~<75岁年龄段肿瘤发病率较高。2022年平顶山市前十位恶性肿瘤依次为肺癌、肝癌、胃癌、食管癌、直肠癌、胰腺癌和结肠癌、乳腺癌、卵巢癌、宫颈癌、脑及神经系统恶性肿瘤,累计发病7 370人,占全部恶性肿瘤的88.53%。 结论 2022年平顶山市恶性肿瘤发病率和病死率较高,其中肺癌、肝癌、胃癌、食管癌、直肠癌、乳腺癌是重点防控癌种。 Objective To analyze the incidence of tumors in Pingdingshan city in 2022 and provide reference for the formulation of tumor prevention and control strategies in the area. Methods The tumor registration data reported by 10 counties and districts collected and quality controlled by the Pingdingshan City Center for Disease Control and Prevention from January 2022 to December 2022 were analyzed. The incidence of tumors, constituent ratio, rank and case fatality rate were counted to analyze the prevalence of tumor. Results This study was a cross-sectional study. From January to December 2022, the permanent population of Pingdingshan was 3 978 797, including 2 014 874 males and 1 963 923 females. During this period, a total of 12 024 cards were submitted in 10 counties and districts of the city and 8 325 cards were submitted according to the onset date, with an incidence of 209.23/100 000. The incidence of tumors in Xinhua district and Weidong district both exceeded 250.00/100 000. A total of 3 070 cards were submitted according to the date of death, with a case fatality rate of 77.16/100 000, of which the cancer mortality reports in Jiaxian and Weidong districts were relatively high. It was reported that 5 007 tumor cases were in male, with a crude incidence of 248.50/100 000, and 3 318 tumor cases in female, with a crude incidence of 168.95/100 000. The crude incidence of males was 1.47 times higher than that of females. The incidence of tumors in the age group from 65 to less 75 years old was relatively high. In 2022, the top 10 malignant tumors in Pingdingshan were lung cancer, liver cancer, gastric cancer, esophageal cancer, rectal cancer, pancreatic cancer and colon cancer, breast cancer, ovarian cancer, cervical cancer, brain and nervous system malignant tumors, with a cumulative incidence of 7 370 people, accounting for 88.53% of all malignant tumors. Conclusions The incidence and case fatality rate of malignant tumors in Pingdingshan in 2022 are relatively high. Furthermore, lung cancer, liver cancer, gastric cancer, esophageal cancer, rectal cancer, and breast cancer are the specific cancer types which should to be prevented and controlled .

    肿瘤发病率平顶山市

    新辅助化疗联合贝伐珠单抗治疗三阴性乳腺癌的效果及对癌组织PFTK1表达的影响

    车全拴刘小敏
    33-36页
    查看更多>>摘要:目的 探讨新辅助化疗联合抗血管内皮生长因子(VEGF)靶向治疗药物贝伐珠单抗治疗三阴性乳腺癌的效果及对癌组织细胞周期依赖性蛋白激酶1(PETK1)表达的影响。 方法 前瞻性研究。抽取2015年9月至2022年9月临汾市中心医院收治的三阴性乳腺癌患者80例,按照就诊顺序分为治疗组和对照组,每组40例。对照组采用多柔比星+环磷酰胺新辅助化疗方案治疗,治疗组在对照组治疗基础上加用贝伐珠单抗注射液。比较两组患者的治疗效果,比较两组治疗前后血清VEGF水平及病理组织标本中PETK1的表达情况,比较两组患者治疗期间不良反应发生情况。 结果 治疗组治疗总有效率(57.50%,23/40)高于对照组(30.00%,12/40),P<0.05。治疗后,两组血清VEGF-165、VEGF-121、VEGF-145水平均低于治疗前(P均<0.05),且治疗组血清VEGF-165、VEGF-121、VEGF-145水平低于对照组(P<0.05)。治疗前,两组病理组织标本PFTK1阳性表达率比较差异未见统计学意义(P>0.05);治疗后,治疗组复查中PFTK1阳性表达率(32.5%,13/40)低于对照组(57.5%,23/40),P<0.05。两组不良反应发生率比较差异未见统计学意义(P>0.05)。 结论 新辅助化疗联合抗VEGF靶向治疗药物贝伐珠单抗治疗三阴性乳腺癌的疗效较好,其作用机制可能通过抑制PFTK1的表达来降低血管新生因子,发挥抗肿瘤作用。 Objective To investigate the therapeutic effect of neoadjuvant chemotherapy combined with bevacizumab, an anti-vascular endothelial growth factor (anti-VEGF) targeting drug, on triple-negative breast cancer, and its influence on the expression of cyclin-dependent protein kinase 1 (PFTK1). Methods This study was a prospective trail. Eighty patients with triple-negative breast cancer admitted to Linfen Central Hospital from September 2015 to September 2022 were selected, and they were divided into treatment group and control group according to the order of admission, with 40 patients in each group. The control group was treated by adriamycin combined with cyclophosphamide AC neoadjuvant chemotherapy regimen, while the treatment group received bevacizumab injection based on the treatment of the control group. The therapeutic effects of the two groups were compared. The preoperative and postoperative levels of serum VEGF expression, and the expression of PETK1 in pathological tissue samples were compared between the two groups. The incidence of adverse reaction during treatment were compared between the two groups. Results The total effective rate in the treatment group (57.50%, 23/40) was higher than that in the control group (30.00%, 12/40), P<0.05. After treatment, the levels of serum VEGF-165, VEGF-121 and VEGF-145 in both groups were lower than before treatment (allP<0.05), while the levels of serum VEGF-165, VEGF-121 and VEGF-145 in the treatment group were lower than those in the control group (P<0.05). Before treatment, there was no statistically significant difference in the positive expression rate of PFTK1 in pathological tissue samples between the two groups (P>0.05). The positive expression rate of PFTK1 in the follow-up examination of the treatment group (32.5%, 13/40) was lower than that in the control group (57.5%, 23/40) after treatment (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusions Neoadjuvant chemotherapy combined with bevacizumab, an anti-VEGF targeting drug, has a good effect in the treatment of triple-negative breast cancer. The mechanism may be that it can reduce angiogenesis factors by inhibiting the expression of PFTK1 to counteract tumor.

    三阴性乳腺癌细胞周期依赖性蛋白激酶1血管内皮生长因子新辅助化疗

    单侧双通道内镜下减压与全椎板切除减压融合内固定治疗重度腰椎管狭窄症的效果比较

    周昆鹏王鑫鑫张本立李佳佳...
    37-40页
    查看更多>>摘要:目的 比较单侧双通道内镜下减压与全椎板切除减压融合内固定治疗重度腰椎管狭窄症(LSS)的效果。 方法 随机对照研究。抽取2020年1月至2022年12月周口市中心医院收治的重度LSS患者74例,按随机数字表法分为对照组和研究组,每组37例。对照组行全椎板切除减压融合内固定,研究组采用单侧双通道内镜下减压。比较两组围术期指标、腰部和腿部视觉模拟评分法(VAS)评分、腰椎Oswestry功能障碍指数(ODI)及并发症发生率。 结果 研究组术中出血量少于对照组,手术时长、术后首次下地时间、住院时间短于对照组(P<0.05)。术后7 d、6个月,研究组腰部和腿部VAS评分、ODI低于对照组(P<0.05)。研究组并发症发生率(2.70%,1/37)低于对照组(21.62%,8/37),差异有统计学意义(P<0.05)。 结论 与全椎板切除减压融合内固定相比,单侧双通道内镜下减压治疗重度LSS的效果更好,可缩短手术和住院时间,减轻机体创伤,缓解腰部和腿部疼痛症状,改善患者腰椎功能,且治疗安全性较高。 Objective To compare the effects of unilateral biportal endoscopic decompression and total laminectomy with fusion and internal fixation in the treatment of severe lumbar spinal stenosis (LSS). Methods This study was a randomized controlled trail. A total of 74 patients with severe LSS who were treated in Zhoukou Central Hospital from January 2020 to December 2022 were selected, and they were divided into control group and study group by random number table method, with 37 cases in each group. The control group was treated by total laminectomy with fusion and internal fixation, and the study group was treated by unilateral biportal endoscopic decompression. The perioperative indicators, visual analogue scale (VAS) scores of waist and leg, Oswestry dysfunction index (ODI) and incidence of complications were compared between the two groups. Results Compared with the control group, the study group had less intraoperative blood loss, shorter operation time, shorter postoperative first ambulation time and shorter hospital stay (P<0.05). Compared with the control group, the study group had lower VAS scores of waist and leg and lower ODI 7 days and 6 months after operation (P<0.05). The incidence of complications in the study group (2.70%, 1/37) was lower than that in the control group (21.62%, 8/37), and the difference was significant (P<0.05). Conclusions Compared with total laminectomy with fusion and internal fixation, unilateral biportal endoscopic decompression is more effective in the treatment of severe LSS. It can shorten the operation time and hospital stay, reduce body trauma, relieve waist and leg pain, and improve lumbar function, with high safety.

    椎管狭窄腰椎重度单侧双通道内镜下减压全椎板切除减压融合内固定