【摘要】 目的 探索显微眼内窥镜在后段眼内异物取出及玻璃体切除术中的应用。 方法 将2005年7月-2006年3月38例眼内异物患者分为试验组（15例）及对照组（23例）。试验组采用显微眼内窥镜下完成对外伤性视网膜玻璃体病变等的处理及眼内异物的取出；对照组采用显微镜直视下行常规玻璃体切割及眼内异物取出术。 结果 试验组术后角膜透明度及眼压恢复、视力提高及视网膜复位等情况均优于对照组；异物取出情况、手术时间和并发症两组无差异。 结论 在观察困难或异物处于极周边时应用显微眼内窥镜，能够在手术中直接取出眼内各个部位异物，及时发现视网膜裂孔并同时行抗青光眼手术，减少对角膜材料的依赖和对角膜的损伤，为及时、准确和安全地手术提供了条件。【Abstract】 Objective To investigate the application of the intraocular micro-endoscope in extracting intraocular foreign bodies (IOFB) and vitrectomy. Methods A total of 38 patients with IOFB from July 2005 to March 2006 were divided into a trial group (15 patients) and control group (23 patients). The treatment for traumatic retinal vitreous lesions and extraction of IOFB were performed under the intraocular micro-endoscope in the trial group; while the conventional vitrectomy and IOFB extraction were performed under the microscope in the control group. Results The degree of corneal recovery, improvement of intraocular pressure, visual acuity, and retinal reattachment were better in the trial group than that in the control group. There was no difference in removal of IOFB, surgical time and complications between the two groups. Conclusion In patients with intraocular foreign bodies and cloudy cornea or other conditions that made the observation difficult, intraocular micro-endoscope is a useful convenience without relying on donated cornea. The practice made the judge of size, location and the distance more and more accurate through the monitor.
目的 探讨诱导痰、痰、血清中的白介素(IL)-4、-6、-8在慢性支气管炎急性期的浓度阈值，确定其诊断意义，了解三种白介素在三种标本中的不同浓度对诊断慢性支气管炎急性期的意义。 方法 2001年1月-8月对77例慢性反复咳嗽患者按全国慢性支气管炎诊断标准确诊慢性支气管炎急性期48例，非慢性支气管炎29例，进行IL-4、-6、-8的诱导痰、痰、血清检测。采用受试者工作特征曲线(ROC曲线)鉴定三种白介素对三种标本的诊断价值。 结果 ①三种标本的三种白介素的诊断比值比(DOR)均＞3，95%可信区间的下限均＞1。②ROC曲线下面积显示：诱导痰及痰中IL-4、-8之间无差别(P＞0.05)，IL-4和IL-8分别与IL-6之间有统计学意义(P＜0.05)；血清中IL-4、-6、-8检测结果无差异(P＞0.05)。IL-4、-8的诱导痰及痰与血清有统计学意义(P＜0.05)，IL-6的诱导痰、痰、血清之间无差异(P＞0.05)。 结论 诱导痰及痰中的IL-4、-8诊断价值较好，可用于慢性支气管炎急性期的诊断。
Objective Hepatitis B virus X (HBx) protein is involved in the initiation and progression of hepatocellular carcinoma (HCC) by regulating the host protein-coding genes. Herein, we want to explore whether HBx protein can alter the expression of microRNAs (miRNAs) to promote proliferation and transformation in malignant hepatocytesin vitro. Methods MiRNA microarray and quantitative reverse-transcription polymerase chain reactions (qRT-PCRs) were performed to identify miRNAs that were differentially regulated by HBx protein in HCC cells. Protein and mRNA expression analyses, cell cycle and apoptosis analyses, and luciferase reporter assays were performed to delineate the consequences of miR-16 family repression in HepG2 cells. Results HBx protein induced widespread deregulation of miRNAs in HepG2 cells, and the downregulation of the miR-16 family was reproducible in HepG2, SK-HEP-1, and Huh7 cells. CCND1, a target gene of the miR-16 family, was derepressed by HBx protein in HepG2 cells. C-myc mediated the HBx-induced repression of miR-15a/16 in HepG2 cells. Ectopically expressed miR-15a/16 suppressed the proliferation, clonogenicity, and anchorage-independent growth of HBx-expressing HepG2 cells by arresting them in the G1 phase and inducing apoptosis, whereas reduced expression of miR-16 accelerated the growth and cell-cycle progression of HepG2 cells. Conclusions HBx protein altered thein vitro expression of miRNAs in host malignant hepatocytes, particularly downregulating the miR-16 family. Repression of miR-15a/16 is c-myc mediated and is required for the HBx-induced transformation of HepG2 cellsin vitro. Therefore, miR-16 family may serve as a therapeutic target for hepatitis B virus (HBV)-associated HCC.
Objective To explore the risk factors of postoperative portal vein system thrombus (PVST) after laparoscopic splenectomy in treatment of portal hypertension and hypersplenism. Methods Clinical data of 76 patients with portal hypertension and hypersplenism who underwent laparoscopic splenectomy in the Sichuan Provincial People’s Hospital from January 2012 to January 2017 were analyzed. Results There were 31 patients suffered from PVST (PVST group), and other 45 patients enrolled in non-PVST group.There were significant differences on age, diameter of splenic vein, diameter of portal vein, blood flow velocity of portal vein, level of D-dimer, and platelet count between the PVST group and the non-PVST group (P<0.05), but there were no significant difference on gender, Child-Pugh classification, etiology of cirrhosis, operation time, intraoperative blood loss, postoperative complications, and prothrombin time between the two groups (P>0.05). Multivariate logistic regression analysis showed that, patients with age >50 years (RR=1.31, P=0.02), splenic vein diameter >12 mm ( RR=1.29, P<0.01), portal vein diameter >13 mm (RR=1.55, P=0.01), blood flow velocity of portal vein <18 cm/s ( RR=1.47, P<0.01), increases level of D-dimer (RR=2.89, P=0.03), and elevated platelet count (RR=1.82 P=0.02) had higher risk of postoperative PVST than those patients with age ≤50 years, splenic vein diameter ≤12 mm, portal vein diameter ≤13 mm, blood flow velocity of portal vein ≥18 cm/s, normal level of D-dimer and platelet count. Conclusion For patients with portal hypertension and hypersplenism who underwent laparoscopic splenectomy, we should pay more attention to the risk factor, such as D-dimer and so on, to avoid the occurrence of postoperative PVST.
Objective To explore the measures for early diagnosis and treatment of iatrogenic injury in the distal part of common bile duct. Methods The clinical data of 20 patients with iatrogenic injury in the distal part of common bile duct treated in our hospital from 1990 to 2008 were analyzed retrospectively. Results The injuries of 15 cases were found during the operation: 11 cases were treated with 3-stoma (bile duct, pancreas, duodenum)+Oddi sphinctreoplasty (OSP), 1 case with OSP+choledochojejunostomy, 2 cases with the perforated common bile duct suture repair+T tube drainage, 1 case with T tube drainage; All of them were cured after surgery. The other 5 cases were not found during the primary operation, 2 cases in which were cured with several operations, the other 3 were dead from infectious shock. Conclusions Early diagnosis and treatment of iatrogenic injury in the distal part of common bite duct can obtain perfect effects. Different procedures should be performed according to different degrees of the injury. The perfect preoperative imaging examination and intraoperative choledochoscopy before bile duct exploration may reduce the occurrence of the injury.