目的 探讨多层螺旋CT对下颌骨骨折的诊断价值。 方法 对2007年4月-2009年10月下颌骨不同部位骨折的45例患者进行多层螺旋CT轴位扫描,并行多平面、表面遮盖法等三维重建,对下颌骨骨折CT表现特征作回顾性分析。 结果 45例下颌骨骨折中,位于下颌体骨折24例,下颌角骨折5例,下颌升支骨折6例,髁部骨折13例,冠突骨折2例;颞下颌关节脱位中,单侧脱位3例,双侧脱位5例。 结论 多层螺旋CT能准确诊断下颌骨各部位骨折,对诊治方案具有重要价值。
Objective To summarize the current research progress of endoscopic/robotic surgery for breast cancer, so as to provide theoretical basis for surgeons and patients to choose surgical methods. Method The relevant literatures on breast cancer endoscopic/robotic surgery at home and abroad in recent years were summarized and reviewed. Results Endoscopic/robotic surgery for breast cancer had the advantages of low intraoperative bleeding, fewer postoperative complications, fast postoperative recovery, good cosmetic results and high patient satisfaction. Conclusions Endoscopic/robotic surgery is a safe and feasible surgical modality and a complement to traditional open breast surgery.
【Abstract】Objective To investigate the significance of cyclin D1 and p53 protein expression in synchronous breast carcinoma and fibrosarcoma in rats. Methods Immunohistochemical SP methods was used to study the expression of cyclin D1 and p53 in synchronous breast carcinoma and fibrosarcoma induced by DMBA in rats.Results There was no expression of cyclin D1 and p53 in normal breast tissue. In atypical hyperplasia of mammary, there was overexpression of cyclin D1(7/14) and no expression of p53. The overexpression of cyclin D1 and p53 were detected in breast carcinoma (8/18,7/18 respectively) and fibrosarcoma (9/14,5/14 respectively). There was no expression of cyclin D1 and p53 in adjacent sarcoma.The expression of cyclin D1 and p53 protein was associated with histological grading, and showed inverse relation between them. Conclusion There are cyclin D1 and p53 protein overexpression in the synchronous breast carcinoma and fibrosarcoma induced by DMBA in rats. Cyclin D1 may paticipate in the course of the carcinogenesis of breast carcinoma and fibrosarcoma in rats, and p53 protein overexpression may relate to the degree of malignancy of the tumors.
ObjectiveTo compare home blood pressure monitoring (HBPM) versus ambulatory blood pressure monitoring (ABPM) versus office blood pressure monitoring (OBPM) in diagnosis and management of hypertension, and to find the optimal blood pressure measurement and management.MethodsThe following were compared among three BP monitoring, such as cost-effectiveness, prognostic value of target organ damage (TOD), predictive value of the progress in chronic kidney disease (CKD) and blood pressure variety (BPV). ResultsCompared to OBPM, ABPM was the most cost-effective method in the primary diagnosis of hypertension, but HBPM was the optimal method in long-term and self-management in hypertension. In hypertensives, compared to OBPM, HBPM and ABPM, especially HBPM, had a stronger predictive value for cardiovascular events, stroke, end-stage renal dysfunction (ESRD) and all-cause mortality. In hypertensives with renal dysfunction, controlling HBPM and ABPM, especially controlling ABPM, was an effective way to slow the progress in renal dysfunction, to decrease cardiovascular events, and to decrease the need of dialysis. All BPV derived from OBPM, ABPM and HBPM had a predictive significance of cardiovascular events, and HBPM BPV performed the best.ConclusionCompared to OBPM, ABPM is the best method in primary diagnosis of hypertension and BP control in CKD patients, while HBPM is the best method in predicting and in evaluating BPV, as well as in long-term and self-management in hypertension.
Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.
ObjectiveTo explore and analyze the related influencing factors for common intraoperative complications during CT-guided percutaneous radiofrequency ablation of pulmonary tumor. MethodsWe retrospectively analyzed the clinical data of the patients who underwent CT-guided percutaneous radiofrequency ablation of pulmonary tumor in our hospital from December 2018 to December 2019, and analyzed the influencing factors for complications. ResultsA total of 106 patients were enrolled. There were 58 (54.7%) males and 48 (45.3%) females aged 46-81 (68.05±8.05) years. All patients successfully completed the operation. The operation time was 47.67±16.47 min, and the hospital stay time was 2.45±1.35 d. The main intraoperative complications were pneumothorax (16.0%, 17/106) and intrapulmonary hemorrhage (22.6%, 24/106). Univariate analysis showed that the number of pleural punctures had an impact on the occurrence of pneumothorax (P=0.00). The length of the puncture path (P=0.00), ablation range (P=0.03) and ablation time (P=0.00) had an impact on the occurrence of intrapulmonary hemorrhage. Multivariate logistic regression analysis showed that the size of the lesion (OR=17.85, 95%CI 3.41-93.28, P=0.00) and the number of pleural punctures (OR=0.02, 95%CI 0.00-0.11, P=0.00) were independent influencing factors for the occurrence of pneumothorax. The length of the puncture path (OR=15.76, 95%CI 5.34-46.57, P=0.00) was the independent influencing factor for the occurrence of intrapulmonary hemorrhage. ConclusionPercutaneous radiofrequency ablation of pulmonary tumor is safe and with a high success rate, but intraoperative complications are affected by many factors, so the surgeons should be proficient in operating skills to avoid complications.
ObjectiveTo explore the relation between the molecular subtypes and efficacy of neoadjuvant chemotherapy with docetaxel together with epirubicin(TE) in breast cancer. MethodsAccording to the inclusion and exclusion criteria, 239 patients with breast cancer who at least received 3 cycles of TE-based neoadjuvant chemotherapy from May 2011 to December 2012 in this hospital were included. Molecular subtypes were categorized into luminal A, luminal B, human epidermal growth factor receptor 2(HER-2) positive, and triple negative by the immunohistochemical results of estrogen receptor(ER), progesterone receptor(PR), HER-2, and Ki-67 status. The relevant indicators of the different molecular subtypes of breast cancer patients, such as pathological complete response(pCR) rate, age, and menstruation, etc. were analyzed. ResultsThere were 67(28.03%) patients with luminal A, 84(35.15%) luminal B, 21(8.79%) HER-2, and 67(28.03%) triple negative in these 239 patients with breast cancer. The differences of age, menstruation, axillary lymph node status etc. among the four molecular subtypes were not statistically significant(P > 0.05). The pCR rate of triple negative breast cancer(14.93%) was the highest among four subtypes, followed by luminal B(7.14%), HER-2 positive(4.76%) and luminal A(1.49%), there was a significant difference(P=0.027). ConclusionsComparing with luminal A, luminal B, and HER-2 positive breast cancers, triple negative breast cancer is the most sensitive to TE neoadjuvant chemotherapy, and it has the highest pCR rate. Therefore, different treatment should be selected according to molecular subtypes of breast cancer.