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藏红花对慢性高眼压下兔眼视网膜节细胞的保护作用

小切口皮片回植术治疗腋臭

【摘要】　目的　总结彻底根治腋臭的同时保留皮肤完整性，术后不留明显瘢痕的手术方法。　方法　2004年7月-2010年7月对89例腋臭患者进行小切口剪除皮片回植术治疗，超过腋毛外1 cm的梭形范围内作肿胀麻醉，仅在下缘作一1 cm切口，用直尖剪盲视下将皮瓣修剪成全厚皮片，打包后弹性绷带加压包扎。　结果　除早期1例一侧出现部分皮肤坏死、1例一侧皮肤出现皱褶，余全部成活，无患者复发。仅在切口处有一小瘢痕及打包线处点状瘢痕。　结论　腋臭小切口剪除皮片回植术，汗腺清除彻底，外观漂亮。

包扎过紧致整形术后严重医源性损伤二例

Etiology of pleural effusions

Objective To investigate the etiology of pleural effusions. Methods All adult patients with pleural effusions of unknown etiology admitted to this hospital between January 2011 and December 2013 were investigated. The etiological data of these patients with pleural effusion were retrospectively reviewed. Results During the 3-year period, 1 541 patients eventually were included in this study. The most frequent cause of pleural effusions was bacterial infection (38.7%), followed by malignancy (23.7%), congestive heart failure (13.1%), and tuberculosis (10.7%). The etiology of 120 patients (7.8%) remained uncertain. Conclusions The most frequent cause of pleural effusion is bacterial infection, followed by malignancy, cardiac failure, and tuberculosis. These four etiologies account for over 85 percent of all pleural effusions.

The Significance of Serum Colon Cancer-Specific Antigen-2 in Diagnosis of Colorectal Cancer

Objective　To evaluate the significance of serum colon cancer-specific antigen-2 （CCSA-2） in diagnosisof colorectal cancer （CRC）. Methods　By using ELISA method， the serum CCSA-2 was measured from 105 patients with 5 kinds of diseases， including CRC， gastric cancer， inguinal hernia， acute appendicitis， and breast cancer， who weretreated in our hospital from Jul. to Dec. in 2008， and 20 health donors were enrolled in addition. The blood samples were collected on 3 days before surgery， but blood samples from patients with acute appendicitis were collected before emergencysurgery， blood samples of health donors were collected on 1 day before ELISA test. Results　The level of serum CCSA-2 in CRC patients was （99.27±6.25） μg/L， which was significantly higher than those of other patients and health individuals〔（53.58±2.73） μg/L， t=48.29， P=0.000〕. Serum CCSA-2 at a cutoff of 73.96μg/L had a sensitivity of 100% （95% CI：100%-100%） and a specificity of 100% （95% CI：100%-100%） in separating CRC populations from all other indivi-duals by using receiver operator characteristic curve （ROC） analysis. As compared with carcinoembryonic antigen （CEA） and CA19-9， the serum CCSA-2 assay （at a cutoff of 73.96μg/L） was significantly more sensitive than CEA and CA19-9 assay in CRC detection （P＜0.01）. Serum CCSA-2 was not related with patients’ gender （P=0.81）， age （P=0.59）， TNM stage （P=0.85）， Dukes stage （P=0.63）， nuclear grade （P=0.44）， as well as expressions of multidrug resistance associated protein （P=0.33）， P-glycoprotein （P=0.72）， and topoisomeraseⅡ（P=0.95）， but higher in patients with colon cancer than those of patients with rectal cancer （P=0.02）. Conclusion　Serum CCSA-2 may be a useful biomarker in diagnosis of CRC， and it may be only related to tumorigenesis， but is irrelated to tumor progression and chemotherapy.

Effect of Arthroscopy on Diagnosing and Treating Suppurative Arthritis of Knee Joint

Objective To explore the effect of arthroscopy on diagnosing and treating suppurative arthritis of knee joint. Methods The clinical data of 22 patients with suppurative arthritis of knee joint diagnosed between January 2012 and December 2013 were analyzed retrospectively, including 13 males and 9 females with the age of 7-56 years (average 28.5 years). The duration of disease history was from 7 days to 4.5 months with the average of 2.8 months. All of the patients had swelling, pain, and limitation of motion of the knee joint in different degrees. Among them, 20 patients were diagnosed definitely and remaining 2 were osteoarthritis with atypical infections. Patients were investigated by Lysholm questionnaires during the follow-up period. Results All of the 22 patients were followed up for 3-10 months with the average of 8.5 months. The diagnosis was confirmed by pathological and arthroscopic examination after the surgery, and no recurrence was found. Lysholm score ranged from 77 to 99 with the average of 92.8. Only 1 patient had the motion range of 10-40°of the knee joint after several treatment. Conclusion Early arthroscopic treatment for suppurative arthritis of knee joint with continuous postoperati ve lavage and irrigation combined with comprehensive physiotherapy and rehabilitation has the advantages of high efficacy, maximum recovery of knee function, and quick recovery, which should be promoted in the clinical application

烧伤患者血浆凝溶胶蛋白水平及其与预后的关系研究

目的观察烧伤患者血浆凝溶胶蛋白水平及变化规律，探讨凝溶胶蛋白水平与患者预后的关系。 方法采用前瞻性队列研究的方式，选取2010年1月-2013年6月收治的98例烧伤面积≥30%总体表面积患者作为研究对象，分别按照烧伤面积大小、是否出现脓毒症以及脓毒症患者是否死亡分组，比较不同组别患者血浆凝溶胶蛋白水平及变化趋势。 结果伤后7 d患者的血浆凝溶胶蛋白水平处于最低值，与其他时间点比较差异有统计学意义（P＜0.001）。血浆凝溶胶蛋白浓度随着烧伤面积增大而降低（P＜0.001）。脓毒症患者血浆凝溶胶蛋白总体均数水平低于非脓毒症患者，差异有统计学意义（F=1 035.41，P＜0.001）。脓毒症死亡患者血浆凝溶胶蛋白总体均数水平低于存活患者，差异有统计学意义（F=958.69，P＜0.001）；伤后7~21 d的血浆凝溶胶蛋白水平低于伤后3 d及入院当天，差异有统计学意义（P＜0.001）。 结论烧伤可导致患者血浆凝溶胶蛋白水平降低，烧伤面积越大、合并脓毒症患者的血浆凝溶胶蛋白越低。血浆凝溶胶蛋白是反映大面积烧伤患者预后的一项重要监测指标。

改进后的腓肠神经营养血管皮肤筋膜蒂逆行岛状皮瓣应用总结

目的探讨腓肠神经营养血管逆行岛状皮瓣改进前后皮瓣成活情况及静脉回流障碍的差异以及两种方法手术操作的难易程度。 方法回顾性分析2000年1月-2015年12月收治的79例因各种原因行腓肠神经营养血管筋膜蒂逆行岛状皮瓣修复患者的病历资料。根据患者手术方法，将79例患者分为传统手术组（n=44）和改进手术组（n=35）。观察对比两组患者术后的皮瓣成活率及静脉回流障碍的差异。 结果共纳入患者79例，传统手术组和改进手术组分别剔除2例和1例患者。传统手术组皮瓣均出现中、重度静脉回流障碍，而改进手术组静脉回流障碍以轻、中度为主（χ2=13.447，P＜0.001）；且两组患者皮瓣经相应处理后静脉回流障碍均缓解，未出现因静脉回流障碍皮瓣坏死的情况。术后，传统手术组2例皮瓣坏死，成活率95.2%；改进手术组皮瓣全部成活（χ2=70.205，P＜0.001）。 结论改进后的腓肠神经营养血管皮肤筋膜蒂逆行岛状皮瓣无损伤供血动脉血管之虞，术后静脉回流障碍轻，操作简单，术者无需具备显微血管解剖经验，可向基层单位推广。