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Probable benign paroxysmal positional vertigo, spontaneously resolved: Incidence in medical practice, patients’ characteristics and the natural course 预览
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作者 M.G.Alvarez-Morujo de Sande R. Gonzalez-Aguado +7 位作者 G. Guerra-Jimenez E. Domenech-Vadillo H. Galera-Ruiz E. Figuerola-Massana A. Ramos-Macías C. Morales-Angulo A.J. Martín-Mateos E. Domínguez-Duran 《中华耳科学杂志:英文版》 CSCD 2019年第3期111-116,共6页
Background: Probable benign paroxysmal positional vertigo, spontaneously resolved (pBPPVsr), is a variant of benign paroxysmal positional vertigo (BPPV) in which there is no observable nystagmus and no vertigo with an... Background: Probable benign paroxysmal positional vertigo, spontaneously resolved (pBPPVsr), is a variant of benign paroxysmal positional vertigo (BPPV) in which there is no observable nystagmus and no vertigo with any positional maneuver. Objectives: To calculate the incidence pBPPVsr, compare the characteristics of the patients with pBPPVsr and BPPV not spontaneously resolved and describe the spontaneous resolution in the natural course of BPPV. Methods: Multicenter prospective descriptive study. During a one-year period, all patients with suspected BPPV that presented to the Neurotology Units of five participating centers were recruited. The incidence of pBPPVsr was calculated as a percentage of the total number of patients with BPPV. The prevalence of several variables was compared between pBPPVsr and BPPV not spontaneously resolved. The timing of spontaneous resolution was estimated using Kaplan-Meier curves. Results: 457 patients met the inclusion criteria. The incidence of pBPPVsr was 33.5%. It was significantly higher in males, in patients with normal bone mass and in patients who were not taking sulpiride. A rate of 18% of spontaneous resolution after the first month and 51% after the first year was found. This percentage did not change in a significant way after this moment. The curves for males, patients under 50 and patients with normal blood pressure decreased significantly faster. Conclusions: In our serie, BPPV spontaneously resolved in half of the patients with BPPV during the first year. This seemed to occur more commonly in males and could have been hindered by sulpiride intake, osteoporosis, advanced age and high blood pressure. 展开更多
关键词 BENIGN PAROXYSMAL positional VERTIGO PROBABLE BENIGN PAROXYSMAL positional vertigo spontaneously RESOLVED Osteoporosis SULPIRIDE Hypertension
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经膀胱前列腺剜出开放手术与经尿道前列腺等离子电切术治疗良性前列腺增生症的价值比较 预览
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作者 鲁云 《世界复合医学》 2019年第2期44-46,共3页
目的评估经尿道前列腺等离子电切术运用在良性前列腺增生症患者治疗中的临床价值。方法对该医院开展手术治疗的100例良性前列腺增生症患者予以项目研究,将2016年3月—2018年11月作为实验组选择时间,试验组采用经尿道前列腺等离子电切术... 目的评估经尿道前列腺等离子电切术运用在良性前列腺增生症患者治疗中的临床价值。方法对该医院开展手术治疗的100例良性前列腺增生症患者予以项目研究,将2016年3月—2018年11月作为实验组选择时间,试验组采用经尿道前列腺等离子电切术治疗,对照组随机选择2000—2010年间采用传统经膀胱前列腺剜出开放手术治疗患者30例,对比两组临床治疗有效统计率、手术耗时、术中出血量、术后拔尿管天数、住院天数、术后并发症统计率,且分析两组术前和术后最大尿流率、膀胱残余尿量。结果试验组临床治疗有效统计率较97.14%对照组对应数据指标(76.67%)提升,展现数据间差异有统计学意义(χ^2=10.750,P=0.001<0.05);试验组手术耗时(53.60±4.54)min较对照组对应数据指标(44.63±5.80)min提升,试验组术中出血量(33.61±3.60)mL、术后拔尿管天数(4.90±1.21)d、住院天数(8.12±1.30)d较对照组对应数据指标[(103.40±6.87)mL、(7.31±2.10)d、(12.60±2.31)d]下降,展现数据间差异有统计学意义(t=8.310、66.554、7.226、12.337,P=0.000、0.000、0.000、0.000<0.05);试验组术后并发症统计率2.86%较对照组对应数据指标(20.00%)下降,展现数据间差异有统计学意义(χ^2=8.385,P=0.003<0.05);试验组最大尿流率(14.70±3.12)mL/s较对照组对应数据指标(11.63±2.10)mL/s提升,试验组膀胱残余尿量(13.80±1.23)mL较对照组对应数据指标(27.15±2.30)mL下降,展现数据间差异有统计学意义(t=4.925、37.919,P=0.000、0.000<0.05)。结论对良性前列腺增生症患者实行经尿道前列腺等离子电切术治疗获得较优临床疗效,表明临床推广应用优势。 展开更多
关键词 经尿道前列腺等离子电切术 良性 前列腺增生症
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伽玛刀Extend系统分次治疗颅内良性病变初步经验 预览
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作者 孙君昭 张剑宁 +5 位作者 任文庆 贾博 李杰 沈春彩 于新 王亚明 《中国微侵袭神经外科杂志》 CAS 2019年第4期168-171,共4页
目的探讨应用伽玛刀Extend系统分次治疗颅内良性病变的临床效果。方法回顾性分析应用伽玛刀Extend系统治疗13例颅内良性病变的临床资料,其中脑膜瘤7例,垂体瘤5例,海绵窦海绵状血管瘤1例。病变体积1.48~54.26 cm3,平均14.09 cm3。照射方... 目的探讨应用伽玛刀Extend系统分次治疗颅内良性病变的临床效果。方法回顾性分析应用伽玛刀Extend系统治疗13例颅内良性病变的临床资料,其中脑膜瘤7例,垂体瘤5例,海绵窦海绵状血管瘤1例。病变体积1.48~54.26 cm3,平均14.09 cm3。照射方案:10例行2分次治疗,3例行3分次治疗;病变周边剂量16.2~26.2 Gy,平均19.5 Gy;等剂量曲线为45%~50%,平均49.2%。结果随访13例,时间10~24个月,平均18.3个月,MRI检查:病变缩小5例,无明显变化7例,增大1例。12例病变压迫或紧贴视神经、视交叉者,视力提高6例,稳定5例,加重1例。视野缺损改善3例,稳定8例,加重1例。无新发海绵窦神经受损表现。结论 Extend伽玛刀系统分次治疗可用于治疗邻近放射敏感或重要结构的病变以及体积较大、需要重复治疗的病变。 展开更多
关键词 颅内病变 良性 Extend系统 分次伽玛刀 立体定位技术
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Pediatric intrahepatic bile duct adenoma - rare liver tumor: A case report 预览
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作者 Anup Kumar Roy Nrityen Nath Das 《世界胃肠外科杂志:英文版(电子版)》 2019年第11期414-421,共8页
BACKGROUND Intrahepatic bile duct adenoma(BDA)is one of the rarest of the rare benign tumors of the liver in the pediatric age group.It arises from the epithelial lining of intrahepatic bile ducts.The overall incidenc... BACKGROUND Intrahepatic bile duct adenoma(BDA)is one of the rarest of the rare benign tumors of the liver in the pediatric age group.It arises from the epithelial lining of intrahepatic bile ducts.The overall incidence of BDA is 1.3%of all primary benign liver tumors.Few case reports of this rare tumor occurring in adult population are present in the literature and to date,only one pediatric case has been reported worldwide.CASE SUMMARY An 18-month-old male child presented with chief complaints of mass per abdomen for 8 mo.Computerized tomography abdomen revealed a well-defined exophytic solid tumor arising from the posteroinferior margin of the right lobe of the liver with heterogenous enhancement and cystic changes,suggesting a suspicion of hepatoblastoma.Non-anatomical liver resection was done and a tumor of 10 cm×9.5 cm was excised.Histopathology of the specimen was conclusive with the diagnosis of intrahepatic bile duct adenoma,which was further supported by immunohistochemistry panel testing.The post-operative period was uneventful.On follow-up,the child was doing well and had no postoperative complication.CONCLUSION Intrahepatic bile duct adenoma in children is very rare and to date only one case has been reported.This is the second pediatric case of intrahepatic bile duct adenoma in the world.Additionally this is the first ever case of such a large tumor presenting in a child. 展开更多
关键词 Bile duct adenoma Peribiliary gland hamartoma Benign liver tumor Pediatric liver tumor Case report
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倍他米松在良性支气管狭窄介入中的应用价值 预览
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作者 张霞 金星星 +5 位作者 肖梅玲 肖洋 鲁毅 丁敏 谭太蓉 李一诗 《实用临床护理学电子杂志》 2019年第24期2-2,6共2页
目的研究倍他米松在良性支气管狭窄介入中的效果。方法选择我院2016.6-2017.6收治的良性支气管狭窄患者70例,按照随机数字表法分为两组各35例。对照组采用电刀、球囊扩张、冷冻治疗,研究组采用在对照组基础上再加上使用倍他米松,比较两... 目的研究倍他米松在良性支气管狭窄介入中的效果。方法选择我院2016.6-2017.6收治的良性支气管狭窄患者70例,按照随机数字表法分为两组各35例。对照组采用电刀、球囊扩张、冷冻治疗,研究组采用在对照组基础上再加上使用倍他米松,比较两组患者治疗后气促分级、支气管直径等情况。结果研究组气促分级、FEVl、支气管直径、FVC在优于对照组,差异显著,P<0.05。结论通过对良性支气管狭窄介入中实施倍他米松,能够有效改善患者的气促情况,并扩大支气管直径,改善肺功能,值得应用。 展开更多
关键词 倍他米松 良性 支气管狭窄 介入
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Expanding etiology of progressive familial intrahepatic cholestasis 预览
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作者 Sarah AF Henkel Judy H Squires +3 位作者 Mary Ayers Armando Ganoza Patrick Mckiernan James E Squires 《世界肝病学杂志:英文版(电子版)》 2019年第5期450-463,共14页
BACKGROUND Progressive familial intrahepatic cholestasis(PFIC)refers to a disparate group of autosomal recessive disorders that are linked by the inability to appropriately form and excrete bile from hepatocytes,resul... BACKGROUND Progressive familial intrahepatic cholestasis(PFIC)refers to a disparate group of autosomal recessive disorders that are linked by the inability to appropriately form and excrete bile from hepatocytes,resulting in a hepatocellular form of cholestasis.While the diagnosis of such disorders had historically been based on pattern recognition of unremitting cholestasis without other identified molecular or anatomic cause,recent scientific advancements have uncovered multiple specific responsible proteins.The variety of identified defects has resulted in an ever-broadening phenotypic spectrum,ranging from traditional benign recurrent jaundice to progressive cholestasis and end-stage liver disease.AIM To review current data on defects in bile acid homeostasis,explore the expanding knowledge base of genetic based diseases in this field,and report disease characteristics and management.METHODS We conducted a systemic review according to PRISMA guidelines.We performed a Medline/PubMed search in February-March 2019 for relevant articles relating to the understanding,diagnosis,and management of bile acid homeostasis with a focus on the family of diseases collectively known as PFIC.English only articles were accessed in full.The manual search included references of retrieved articles.We extracted data on disease characteristics,associations with other diseases,and treatment.Data was summarized and presented in text,figure,and table format.RESULTS Genetic-based liver disease resulting in the inability to properly form and secrete bile constitute an important cause of morbidity and mortality in children and increasingly in adults.A growing number of PFIC have been described based on an expanded understanding of biliary transport mechanism defects and the development of a common phenotype.CONCLUSION We present a summary of current advances made in a number of areas relevant to both the classically described FIC1(ATP8B1),BSEP(ABCB11),and MDR3(ABCB4)transporter deficiencies,as well as more recently described gene mutati 展开更多
关键词 CHOLESTASIS Progressive FAMILIAL INTRAHEPATIC CHOLESTASIS BENIGN recurrent INTRAHEPATIC CHOLESTASIS INTRAHEPATIC CHOLESTASIS of pregnancy Drug induced CHOLESTASIS BILE acids BILE transport
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二维超声检查、三维超声能量成像技术和超声BI-RADS分级标准在鉴别诊断乳腺肿块良恶性中的应用价值 预览
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作者 肖惠文 《当代医药论丛》 2019年第12期26-28,共3页
目的:分析二维超声检查、三维超声能量成像技术和超声乳腺影像报告-数据系统(BI-RADS)分级标准在鉴别诊断乳腺肿块良恶性中的应用价值。方法:从2015年1月至2017年5月期间在绵竹市人民医院就诊的乳腺肿块患者中选取91例患者作为研究对象... 目的:分析二维超声检查、三维超声能量成像技术和超声乳腺影像报告-数据系统(BI-RADS)分级标准在鉴别诊断乳腺肿块良恶性中的应用价值。方法:从2015年1月至2017年5月期间在绵竹市人民医院就诊的乳腺肿块患者中选取91例患者作为研究对象。这91例患者的病情均经病理检查被确诊。对这91例患者先进行二维超声检查,用超声BI-RADS分级标准对其病情进行分级。再对这91例患者进行三维超声能量成像检查,根据检查结果对其上述病情分级诊断结果进行调整,然后分析用二维超声检查、三维超声能量成像技术和超声BI-RADS分级标准诊断乳腺肿块良恶性的准确性。结果:这91例患者共有115个乳腺肿块病灶,其中有88个良性肿瘤病灶,有27个恶性肿瘤病灶。与用二维超声检查和超声BI-RADS分级标准鉴别诊断乳腺肿块良恶性的准确率相比,用二维超声检查、三维超声能量成像技术和超声BI-RADS分级标准鉴别诊断其良恶性的准确率较高,P<0.05。结论:二维超声检查、三维超声能量成像技术和超声BI-RADS分级标准在鉴别诊断乳腺肿块良恶性中的应用价值较高。 展开更多
关键词 二维超声检查 三维超声能量成像技术 超声BI-RADS分级标准 乳腺肿块 良性 恶性
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经峡部和经侧颈部路径微波消融甲状腺内后象限结节的比较 预览
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作者 赵双双 张政 +5 位作者 王珂珂 尚梦园 吴新财 陈哲铭 杨海珍 陈宝定 《江苏大学学报:医学版》 CAS 2019年第1期67-71,共5页
目的:比较超声引导下经峡部和经侧颈部路径微波消融甲状腺内后象限良性结节的临床效果.方法:回顾性分析超声引导下微波消融甲状腺内后象限良性结节142枚,其中,经峡部组83枚,经侧颈部组59枚,比较两组消融手术的麻醉剂用量、隔离带液体用... 目的:比较超声引导下经峡部和经侧颈部路径微波消融甲状腺内后象限良性结节的临床效果.方法:回顾性分析超声引导下微波消融甲状腺内后象限良性结节142枚,其中,经峡部组83枚,经侧颈部组59枚,比较两组消融手术的麻醉剂用量、隔离带液体用量、治疗时间、术中疼痛评分、术后并发症、术后症状评分、美容评分、治疗成功率及结节体积缩小率等指标.结果:两组患者治疗过程中麻醉剂用量,隔离带液体用量,治疗时间,术中疼痛评分,术后并发症,术后1、3、6、12个月症状评分,美容评分,术后1、3个月结节体积缩小率及治疗成功率等差异均无统计学意义(P >0.05).但经侧颈部组术后6、12个月结节体积缩小率均明显大于经峡部组(P<0.05).结论:对于甲状腺内后象限良性结节可以考虑经侧颈部进针路径进行微波消融治疗. 展开更多
关键词 超声引导 微波消融 甲状腺结节 良性
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Development and validation of a clinical nomogram predicting bladder outlet obstruction via routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms
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作者 Young Ju Lee Jung Keun Lee +6 位作者 Jung Jun Kim Hak Min Lee Jong Jin Oh Sangchul Lee Sang Wook Lee Jeong Hyun Kim Seong Jin Jeong 《亚洲男性学杂志:英文版》 SCIE CAS CSCD 2019年第5期486-492,共7页
We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total o... We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total of 750 eligible patient ≥50 years of age who had previously not responded(International Prostate Symptom Score[IPSS]improvement<4 points)to at least three different kinds of LUTS medications(including a-blocker)for the last 6 months were evaluated as subcohorts for nomogram development(n=570)and for split-sample validation(n=180).BOO was defined as Abrams-Griffiths number^40,or 20-39.9 with a slope of linear passive urethral resistance ratio>2 cmH20 ml^-1 s^-1.A stepwise multivariable logistic regression analysis was conducted to determine the predictors of BOO,and^-coefficients of the final model were selected to create a clinical nomogram.The final multivariable logistic regression model showed that age,IPSS,maximum urinary flow rate,postvoid residual volume,total prostate volume,and transitional zone index were significant for predicting BOO;these candidates were used to develop the final nomogram.The discrimination performance of the nomogram was 88.3%(95%Cl:82.7%-93.0%,P<0.001),and the nomogram was reasonably we 11-fitted to the ideal line of the calibration plot.Independe nt split-sample validation revealed 80.9%(95%Cl:75.5%-84.4%,P<0.001)accuracy.The proposed BOO nomogram based solely on routine clinical parameters was accurate and validated properly.This nomogram may be useful in determining further treatment,primarily focused on prostatic surgery for BOO,without impeding the detection of possible BOO in men with LUTS that is refractory to empirical medications. 展开更多
关键词 BENIGN PROSTATIC HYPERPLASIA bladder outlet OBSTRUCTION lower urinary tract symptoms no mogram URODYNAMICS
超声检查在甲状腺结节患者中的应用价值评价 预览
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作者 刘英 《影像研究与医学应用》 2019年第7期10-11,共2页
目的:分析彩色多普勒超声检查技术鉴别诊断良恶性甲状腺结节的效果。方法:纳入135例2016年7月—2018年10月来院就诊的甲状腺结节患者进行研究,91例良性肿瘤划入研究一组,44例甲状腺癌划入研究二组。对两组患者行超声检查并与病理结果比... 目的:分析彩色多普勒超声检查技术鉴别诊断良恶性甲状腺结节的效果。方法:纳入135例2016年7月—2018年10月来院就诊的甲状腺结节患者进行研究,91例良性肿瘤划入研究一组,44例甲状腺癌划入研究二组。对两组患者行超声检查并与病理结果比较。结果:研究一组诊断准确率为87.91%,与研究二组的86.36%不相上下(P> 0.05);与研究一组比较,研究二组结节纵径与横径比更大,边界形态不规则,低回声以及微钙化患者所占比例更高,且血流阻力指数、舒张末期血流速度均处于较高水平,而收缩期峰值血流速度呈较低水平(P <0.05)。结论:彩色多谱勒超声检查技术在良恶性甲状腺结节鉴别诊断中的应用价值较高,结合超声图像特征以及血流分布特点可提高诊断准确率。 展开更多
关键词 彩色多普勒超声 甲状腺结节 鉴别诊断 良性 恶性
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92例残胃癌的临床病理特征及预后 预览
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作者 刘万鲁 李永柏 王润华 《贵州医科大学学报》 CAS 2019年第8期971-975,979共6页
目的:分析首次胃良、恶性疾病术后残胃癌(GSC)的临床病理特征及预后。方法:收集92例GSC临床资料,良性疾病行远端胃大部切除术后的GSC患者33例为GSC-B组、恶性疾病行远端胃大部切除术后的GSC患者59例为GSC-M组,比较两组患者首次胃手术后... 目的:分析首次胃良、恶性疾病术后残胃癌(GSC)的临床病理特征及预后。方法:收集92例GSC临床资料,良性疾病行远端胃大部切除术后的GSC患者33例为GSC-B组、恶性疾病行远端胃大部切除术后的GSC患者59例为GSC-M组,比较两组患者首次胃手术后诊断GSC间隔时间、首次手术的吻合方式、GSC肿瘤部位、肿瘤大小、肿瘤组织病理分化程度、病理分期(TNM)、治疗方式等临床病理特征,对两组患者进行生存分析并比较生存率。结果:纳入的GSC患者占同期所有胃癌患者的5.90%,两组GSC患者在组织学T分期(P=0.219)、术后淋巴结分期、淋巴结阳性率、术后TNM分期、理分化程度、复发时间、术后远处转移及转移时间、淋巴转移、住院时间比较,差异无统计学意义(P>0.05),GSC-M组5年生存率低于GSC-B组(P<0.05);GSC-B组CA19-9升高患者比例高于GSC-M组(P=0.015);92例GSC患者5年累积生存率为34.3%;GSC-B与GSC-M整体5年累积生存率分别为56.5%及27.3%,两组比较,差异有统计学意义(P=0.029);Cox回归分析结果显示,根治性切除、病理T分期T3/T4、淋巴结阳性及低分化是GSC预后的独立危险因素(P<0.05)。结论:恶性疾病行胃大部切除术后GSC发生的时间早于因良性疾病行胃大部切除术后,预后差,根治性切除、T3/T4、淋巴结转移及低分化是GSC患者预后独立危险因素。 展开更多
关键词 残胃癌 肿瘤 良性 恶性 临床病理特征 预后 累积生存率 手术治疗
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泛发性家族性良性慢性天疱疮
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作者 陆原 李清 李润琪 《临床皮肤科杂志》 CAS CSCD 北大核心 2019年第8期494-497,共4页
报告1例泛发性家族性良性慢性天疱疮。患者男,49岁。反复发作全身瘙痒性皮损30余年,皮损表现为以躯干以及间擦部位为主的泛发性红斑或斑丘疹,以及在红斑或正常皮肤上出现的水疱。皮损组织病理检查示表皮内广泛的棘层松懈,并形成一种倒... 报告1例泛发性家族性良性慢性天疱疮。患者男,49岁。反复发作全身瘙痒性皮损30余年,皮损表现为以躯干以及间擦部位为主的泛发性红斑或斑丘疹,以及在红斑或正常皮肤上出现的水疱。皮损组织病理检查示表皮内广泛的棘层松懈,并形成一种倒塌砖墙样外观。直接免疫荧光检查结果阴性。多处皮损脓液及皮损组织培养为金黄色葡萄球菌。家系调查示该家族13人中共有4人患此病。患者血液中检测到了杂合的ATP2C1基因错义突变。诊断:泛发性家族性良性慢性天疱疹。本病泛发临床上非常少见。 展开更多
关键词 天疱疮 慢性 良性 家族性 泛发性 Hailey-Hailey病
腹腔镜手术治疗良性卵巢肿瘤对机体卵巢功能、免疫功能的影响 预览 被引量:1
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作者 胡先娥 龙凤 《中国继续医学教育》 2019年第5期79-81,共3页
目的分析良性卵巢肿瘤应用腹腔镜手术治疗对患者卵巢功能及免疫功能的影响。方法选择我院2015年5月—2018年5月诊治的60例良性卵巢肿瘤患者,随机分成研究组(30例)和对照组(30例),对照组行开腹手术治疗,研究组予以腹腔镜手术治疗,比较两... 目的分析良性卵巢肿瘤应用腹腔镜手术治疗对患者卵巢功能及免疫功能的影响。方法选择我院2015年5月—2018年5月诊治的60例良性卵巢肿瘤患者,随机分成研究组(30例)和对照组(30例),对照组行开腹手术治疗,研究组予以腹腔镜手术治疗,比较两组治疗效果。结果研究组出血量(91.32±8.87)mL、手术时长(41.03±10.73)min、排气时长(18.82±3.16)h、住院时长(5.93±1.12)d,优于对照组(P<0.05);研究组LH(17.08±1.14)U/L、E2(60.03±3.61)pmmol/L、FSH(20.07±1.63)U/L,优于对照组(P<0.05);研究组IgA(1.95±0.42)g/L、IgE(121.36±28.27)g/L、IgG(13.16±1.87)g/L,优于对照组(P<0.05)。结论腹腔镜手术用于良性卵巢肿瘤治疗中的疗效显著,可减少出血量,减短手术操作时间,对卵巢功能及免疫功能的影响较小。 展开更多
关键词 腹腔镜 良性 卵巢肿瘤 免疫功能 卵巢功能 出血量
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Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report 预览
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作者 Makoto Kobayashi 《世界临床病例杂志》 2019年第11期1323-1329,共7页
BACKGROUND Uncovered stents used for malignant obstructions in the biliary tree, especially in the hilar area, are prone to obstruction by tumor ingrowths. In comparison, however, covered stents may block bile duct br... BACKGROUND Uncovered stents used for malignant obstructions in the biliary tree, especially in the hilar area, are prone to obstruction by tumor ingrowths. In comparison, however, covered stents may block bile duct branches and are at risk of migration. We have developed a multi-hole self-expandable metallic stent (MHSEMS), with a hole in each cell, to prevent the obstruction of bile duct branches. In addition, the holes may prevent migration due to small ingrowths by reducing the tension of the membrane. CASE SUMMARY MHSEMS were placed in five patients with a malignant obstruction and one with post-endoscopic sphincterotomy bleeding. Each MHSEMS was successfully deployed in all cases. Patients showed no complications. Two cases were reviewed. Case 1: A 74-year-old male presented with jaundice and was diagnosed with a sigmoid colon cancer and giant liver metastases in the right liver lobe. A MHSEMS was placed in the left bile duct. The jaundice improved and peroral cholangioscopy was performed. Case 2: A 90-year-old female was admitted to hospital for jaundice and diagnosed with cholangiocarcinoma. A MHSEMS was placed in the left bile duct but after 8 months the stent became obstructed by tumor ingrowth. We treated the patient by ablation therapy. A silicone cover separated the internal bile duct from the surrounding tissue, protecting the latter from thermal injury during treatment by endobiliary ablation of the reobstruction. CONCLUSION A MHSEMS is a new choice of stent for biliary tract diseases. 展开更多
关键词 Multi-hole self-expandable metallic stent Malignant BILIARY STRICTURE Benign BILIARY STRICTURE HILAR BILIARY OBSTRUCTION Distal BILIARY OBSTRUCTION Endobiliary radiofrequency ablation Case report
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Development and validation of a model to determine risk of refractory benign esophageal strictures 预览
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作者 Qing Lu Tian-Tian Lei +5 位作者 Yi-Lan Wang Hai-Lin Yan Bo Lin Lin-Lin Zhu Hong-Sheng Ma Jin-Lin Yang 《世界临床病例杂志》 2019年第13期1623-1633,共11页
BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile,... BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile, the long-term outcomes of RBES remain unclear. The aim of this study was to develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures. And we also explored the long-term outcomes and safety in patients with RBES. AIM To develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures, based on the demographic data and endoscopic findings. METHODS A total of 507 benign esophageal stricture patients treated by dilation alone or in combination with stenting were retrospectively enrolled between January 2009 and February 2018. The primary outcome was to establish a risk-scoring model predicting RBES in benign esophageal strictures. The secondary outcome was to explore the clinical effectiveness and adverse events in patients with RBES. RESULTS In the study, age, etiology, and number and length of strictures were the independent risk factors for the refractory performance of benign esophageal strictures. According to risk factors of benign esophageal strictures, a risk-scoring model for predicting RBES in benign esophageal strictures was established: The risk score ranged from 0 to 8 points, and the risk scores were divided into low risk (0-2 points), intermediate risk (3-5 points), and high risk (6-8 points). The proportions of RBES in the corresponding risk categories were 1.0%, 12.2%, and 76.0%, respectively. Among 507 patients, 57 had RBES (39 males;median age, 60 years). The success rate of dilation treatment (51.2%, 21/41) was higher than that of stent placement (37.5%, 6/16). CONCLUSION In this study, 11.3%(57/507) patients had RBES at our hospital. The risk-scoring model predicting RBES in benign esophageal strictures could predict the longterm outcome of patients with strictures ahead. 展开更多
关键词 REFRACTORY BENIGN ESOPHAGEAL STRICTURES ESOPHAGEAL DILATION ESOPHAGEAL STENTS Long-term outcomes Retrospective analysis
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单光子发射计算机断层成像/CT融合成像技术对脊柱病变良、恶性鉴别诊断准确率分析
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作者 安彩霞 张万春 +3 位作者 耿会霞 龙亚红 李晓敏 马乐 《中国基层医药》 CAS 2019年第13期1553-1556,共4页
目的对单光子发射计算机断层成像(SPECT)/CT融合成像技术在脊柱病变良、恶性鉴别中的应用价值进行分析和讨论。方法70例研究对象均为山西大医院2017年1月至2018年1月接收的脊柱良性以及恶性病变患者,所选患者分别采用SPECT/CT融合成像和... 目的对单光子发射计算机断层成像(SPECT)/CT融合成像技术在脊柱病变良、恶性鉴别中的应用价值进行分析和讨论。方法70例研究对象均为山西大医院2017年1月至2018年1月接收的脊柱良性以及恶性病变患者,所选患者分别采用SPECT/CT融合成像和SPECT检查,对两种诊断结果进行对比。结果经过SPECT诊断之后,总计98处骨转移病灶,其中10处假阳性、60处良性病灶、28处假阴性病灶;经过SPECT/CT融合成像技术之后,总计100处骨转移病灶,其中4处假阳性、59处良性病灶以及37处假阴性病灶;70例脊柱良性以及恶性病变患者中,总计145处病灶,其中95处良性病灶,50处恶性病灶。SPECT/CT融合成像技术特异度、敏感度及准确率分别为95.79%(91/95)、92.00%(46/50)、93.79%( 136/145),均显著高于对照组的 82.11%(78/95).64.00%(32/50).82.76%( 120/145 ),均差异有统计学意义(X^2=9.048、11.422、9578,均P<O.05)。结论在诊断脊柱良性以及恶性病变的过程中,利用SPECT/CT融合成像可以准确的区分良性以及恶性病变,将患者疾病发展状况清楚的反映出来,为日后良好治疗奠定基础。 展开更多
关键词 脊柱病变 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 恶性 良性 融合成像技术 特异度 敏感度 准确率 假阳性
Silicone-covered biodegradable magnesium stent for treating benign esophageal stricture in a rabbit model 预览
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作者 Kai Yang Jun Cao +3 位作者 Tian-Wen Yuan Yue-Qi Zhu Bi Zhou Ying-Sheng Cheng 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第25期3207-3217,共11页
BACKGROUND Stent insertion can effective alleviate the symptoms of benign esophageal strictures(BES).Magnesium alloy stents are a good candidate because of biological safety,but show a poor corrosion resistance and a ... BACKGROUND Stent insertion can effective alleviate the symptoms of benign esophageal strictures(BES).Magnesium alloy stents are a good candidate because of biological safety,but show a poor corrosion resistance and a quick loss of mechanical support in vivo.AIM To test the therapeutic and adverse effects of a silicone-covered magnesium alloy biodegradable esophageal stent.METHODS Fifteen rabbits underwent silicone-covered biodegradable magnesium stent insertion into the benign esophageal stricture under fluoroscopic guidance(stent group).The wall reconstruction and tissue reaction of stenotic esophagus in the stent group were compared with those of six esophageal stricture models(control group).Esophagography was performed at 1,2,and 3 weeks.Four,six,and five rabbits in the stent group and two rabbits in the control groups were euthanized,respectively,at each time point for histological examination.RESULTS All stent insertions were well tolerated.The esophageal diameters at immediately,1,2 and 3 wk were 9.8±0.3 mm,9.7±0.7 mm,9.4±0.8 mm,and 9.2±0.5 mm,respectively(vs 4.9±0.3 mm before stent insertion;P<0.05).Magnesium stents migrated in eight rabbits[one at 1 wk(1/15),three at 2 wk(3/11),and four at 3 wk(4/5)].Esophageal wall remodeling(thinner epithelial and smooth muscle layers)was found significantly thinner in the stent group than in the control group(P<0.05).Esophageal injury and collagen deposition following stent insertion were similar and did not differ compared to rabbits with esophageal stricture and normal rabbits(P>0.05).CONCLUSION Esophageal silicone-covered biodegradable magnesium stent insertion is feasible for BES without causing severe injury or tissue reaction.Our study suggests that insertion of silicone-covered magnesium esophageal stent is a promising approach for treating BES. 展开更多
关键词 BENIGN esophageal STRICTURE BIODEGRADABLE STENT MAGNESIUM SILICONE membrane
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超声造影在乳腺良恶性结节鉴别诊断中应用 预览
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作者 牟泳霖 曹军英 +2 位作者 里子彧 刘聪 于馨 《临床军医杂志》 CAS 2019年第2期114-116,共3页
目的总结乳腺良恶性病灶超声造影的特征。方法回顾性分析自2016年9月至2017年12月在北部战区总医院就诊的87例乳腺肿块患者的超声造影检查结果,观察并记录良恶性病灶的造影特征及时间-强度(TIC)曲线参数。结果恶性病灶患者34例,包括:浸... 目的总结乳腺良恶性病灶超声造影的特征。方法回顾性分析自2016年9月至2017年12月在北部战区总医院就诊的87例乳腺肿块患者的超声造影检查结果,观察并记录良恶性病灶的造影特征及时间-强度(TIC)曲线参数。结果恶性病灶患者34例,包括:浸润性导管癌25例(73.5%),浸润性混合性癌7例(20.6%),导管内原位癌2例(5.9%);良性病灶患者53例,包括:纤维腺瘤45例(84.8%),导管内乳头状瘤2例(3.8%),乳腺腺病3例(5.7%),乳腺炎1例(1.9%),分叶状肿瘤(良)2例(3.8%)。恶性病灶多表现为以高增强为主、不均匀增强、增强后边界均显示不清、造影后肿块明显增大、有穿支血管及造影剂滞留。良性病灶多表现为均匀增强、增强后边界多清晰、大部分造影后无明显增大、无穿支血管显影及造影剂滞留。良、恶性病灶的增强程度、增强方式、增强后边界、增强后病灶大小、穿支血管、造影剂滞留情况比较,差异均有统计学意义(P<0.05)。两组达峰时间及峰值强度比较,差异无统计学意义(P >0.05)。结论乳腺超声造影具有特征表现,是鉴别乳腺良恶性肿块的有效方法。 展开更多
关键词 超声造影 乳腺肿瘤 良性 恶性
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阴道彩色多普勒血流显像血流参数对卵巢肿瘤良恶性鉴别诊断价值研究 预览
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作者 杨林华 冯丹 +2 位作者 程桂静 杨泽萱 周柳英 《临床军医杂志》 CAS 2019年第2期127-130,共4页
目的探讨阴道彩色多普勒血流显像血流参数对卵巢肿瘤良恶性鉴别诊断的价值。方法选取成都市妇女儿童中心医院自2012年1月至2018年1月收治的120例卵巢肿瘤患者为研究对象。根据病理检查结果,将患者分入卵巢良性肿瘤组(A组,n=60)与卵巢癌... 目的探讨阴道彩色多普勒血流显像血流参数对卵巢肿瘤良恶性鉴别诊断的价值。方法选取成都市妇女儿童中心医院自2012年1月至2018年1月收治的120例卵巢肿瘤患者为研究对象。根据病理检查结果,将患者分入卵巢良性肿瘤组(A组,n=60)与卵巢癌组(B组,n=60);再根据肿瘤病理分期,将B组患者分入Ⅰ期组(n=15)、Ⅱ期组(n=17)、Ⅲ期组(n=16)及Ⅳ期组(n=12)。比较A、B两组超声评分,A、B两组及B组中Ⅰ、Ⅱ、Ⅲ、Ⅳ期组患者的阴道彩色多普勒血流显像血流参数;同时分析阴道彩色多普勒血流显像血流参数与肿瘤血管新生、疾病进展之间的关系。结果B组患者超声评分为(7.6±2.2)分,显著高于A组的(3.1±1.3)分,差异有统计学意义(P<0.05)。B组中,Ⅰ、Ⅱ、Ⅲ、Ⅳ期组患者的超声评分分别为(6.1±1.5)分、(7.2±2.0)分、(8.4±2.5)分、(9.4±2.9)分,即随着病理分期的升高,超声评分也随之升高,两两比较,差异均有统计学意义(P<0.05)。B组患者微血管密度、促血管生成素-2阳性表达率、血管内皮生长因子水平均高于A组,而人第10号染色体缺失磷酸酶(PTEN)、人线粒体融合素-2、肿瘤抑癌基因7-L水平均低于A组,差异有统计学意义(P<0.05)。B组中,随着病理分期的升高,患者微血管密度、促血管生成素-2阳性表达率、血管内皮生长因子水平逐渐升高,而PTEN、人线粒体融合素-2、肿瘤抑癌基因7-L水平逐渐降低,两两比较,差异均有统计学意义(P<0.05)。微血管密度、促血管生成素-2阳性表达率、血管内皮生长因子水平均与搏动指数、动脉血管阻力指数呈负相关,与舒张末期流速、峰值流速、平均流速呈正相关(P<0.05);PTEN、人线粒体融合素-2、肿瘤抑癌基因7-L水平均与搏动指数、动脉血管阻力指数呈正相关,与舒张末期流速、峰值流速、平均流速呈负相关(P<0.05)。结论阴道彩色多普勒血流显像血流参数可作为鉴别诊断 展开更多
关键词 阴道彩色多普勒血流显像 血流参数 卵巢 肿瘤 良性 恶性 鉴别诊断
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Toll-like receptor 10 (TLR10) exhibits suppressive effects on inflammation of prostate epithelial cells
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作者 Yu Fan Lu Yang +6 位作者 Qiang Wei Yu Ding Zhuang Tang Ping Tan Tao Lin Duan Guo Shi Qiu 《亚洲男性学杂志:英文版》 SCIE CAS CSCD 2019年第4期393-399,共7页
Prostate inflammation (PI) is closely related to the development and progression of chronic prostatic diseases: benign prostatic hyperplasia and prostate cancer. Toll-like receptor (TLR) 2 has been reported to be asso... Prostate inflammation (PI) is closely related to the development and progression of chronic prostatic diseases: benign prostatic hyperplasia and prostate cancer. Toll-like receptor (TLR) 2 has been reported to be associated with inflammatory diseases, such as infections, autoimmune diseases, and cancers. Meanwhile, TLR10, which can form heterodimers with TLR2, has been considered an orphan receptor without an exact function. The present study therefore aims to examine the effects of TLR2 and TLR10 on PI. Prostate samples and clinical data were obtained from the patients diagnosed with benign prostatic hyperplasia. The inflammatory cell model was established by adding lipopolysaccharide to RWPE-1 cells. Prostate tissues/cells were examined by histological, molecular, and biochemical approaches. Both TLR2 and TLR10 were found to be expressed in prostate tissues and RWPE-1 cells. mRNA/protein expression levels of TLR2 and TLR10 were both positively correlated with prostate tissue inflammatory grades. Lipopolysaccharide-stimulated RWPE-1 cells expressed higher levels of TLR2, TLR10, high mobility group box 1 (HMGB1), phosphonuclear factor kappa-light-chain-enhancer of activated B-cells P65 (phospho-NF-κB P65), interleukin (IL)-6, and IL-8 than control cells. Moreover, HMGB1, phospho-NF-κB P65, IL-6, and IL-8 were down regulated after TLR2 knockdown and upregulated after TLR10 knockdown in RWPE-1 cells. TLR2 stimulation can activate the inflammatory signaling cascade in prostate epithelial cells. Conversely, TLR10 exhibited suppressive effects on inflammation. With antagonistic functions, both TLR2 and TLR10 were invoIved in PI. TLR10 could be a novel target in modulating inflammatory signal transduction of prostate epithelial cells. 展开更多
关键词 benign PROSTATIC HYPERPLASIA INFLAMMATION TOLL-LIKE receptor 2 (TLR2) TLR10
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