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。
【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.
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.
Objective To compare the safety and efficacy of thulium laser wedge resection of the lung under uniportal thoracoscopy with the other two traditional surgical methods (mechanical cutting stapler wedge resection and segmentectomy) in the treatment of small pulmonary nodules.MethodsClinical data of 125 patients with small pulmonary nodules receiving uniportal video-assisted thoracoscopic surgery from December 2017 to December 2018 in our hospital were retrospectively analyzed. Among them, 33 patients had thulium laser wedge resection (a thulium laser group), including 10 males and 23 females, with an average age of 59.21±11.31 years; 48 patients had mechanical stapling pulmonary wedge resection (a mechanical stapling pulmonary wedge resection group), including 17 males and 31 females, with an average age of 57.27±11.30 years; and 44 patients had pulmonary segmentectomy (a pulmonary segmentectomy group), including 21 males and 23 females, with an average age of 63.00±9.68 years. The surgical margin air leakage, operation time, intraoperative blood loss, postoperative hospital stay, drainage days, average daily drainage volume, fever, pain and hospitalization expenses were compared among the three groups. ResultsThe body mass index, gender, smoking history, benign and malignant pathological results, average maximum diameter of lesions and lesion location distribution were not statistically different among the three groups (P>0.05). The average age and the proportion of pleural adhesions in the thulium laser group were not statistically different from those of the other two groups (P>0.05). In the distribution of the number of lesions, the proportion of multiple lesions in the mechanical stapling pulmonary wedge resection group was higher than that of the other two groups, and there was no statistical difference between the other two groups. The intraoperative blood loss in the thulium laser group was less than that of the other two groups (P≤0.05). There was no statistical difference in the classification of surgical margin air leakage or the operation time among the three groups (P>0.05). The proportion of postoperative fever and hospitalization expenses in the thulium laser group were lower or less than those of the other two groups (P<0.05). The length of hospitalization stay and postoperative chest tube placement in the thulium laser group was significantly shorter than that of the pulmonary segmentectomy group (P<0.05), which was not statistically different from the mechanical stapling pulmonary wedge resection group (P>0.05). There was no statistical difference in the average daily drainage volume or the proportion of pain among the three groups (P>0.05). Conclusion The thulium laser wedge resection under uniportal thoracoscopy is a safe, effective and economical method for the treatment of small pulmonary nodules.
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.
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.