目的 研究阿尔茨海默病 (Alzheim er's disease AD )和血管性痴呆 (vascular dementia VaD )的临床特征,寻找鉴别诊断的有效方法。方法 共纳入 112名 AD 患者和 92名 VaD 患者,包括在北京协和医院就诊的门诊痴呆患者和流行病学调查...
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目的 研究阿尔茨海默病 (Alzheim er's disease AD )和血管性痴呆 (vascular dementia VaD )的临床特征,寻找鉴别诊断的有效方法。方法 共纳入 112名 AD 患者和 92名 VaD 患者,包括在北京协和医院就诊的门诊痴呆患者和流行病学调查中的受访痴呆患者,AD 患者均接受过头颅 M RI 检查,VaD 患者都有头颅 M RI 或 CT 检查的资料。按照国际标准诊断痴呆、很可能 AD 和很可能 VaD 。比较 AD 和 VaD 患者在认知功能、行为症状、日常活动能力等方面的差异,确定临床鉴别诊断的有效指标。结果 不同痴呆阶段的 AD 和 VaD 患者有着不同的临床特征,二者之间的鉴别指标随痴呆的进展而变化:轻度 AD 患者延迟记忆明显减退;轻度 VaD 患者计算力障碍更突出。鉴别中度 AD 和 VaD 患者的有效指标是学习能力和注意力。轻中度 AD 在理财和打电话上逊于 VaD 患者,VaD 主要在与肢体活动有关的日常活动中表现退步。中重度 VaD 患者因智能和机体的双重衰退生活自理能力的急剧减退,其 ADL 总分明显高于同阶段 AD 患者 (P <0.05)。重复收敛行为始终是鉴别 AD 和 VaD 患者的有效指标。结论 AD 和 VaD 具有不同的临床特征,二者间的差别是由各自的病变性质、部位和病理生理机制所决定的。
目的探讨抑癌基因蛋白酪氨酸磷酸酶基因（phosphatase and tensin homolog deleted in chromosome 10，PTEN）的突变和基因表达水平变化在口腔鳞状细胞癌发生、发展过程中的作用。方法应用聚合酶链反应（PCR）、基因测序方法检测42例口...
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目的探讨抑癌基因蛋白酪氨酸磷酸酶基因（phosphatase and tensin homolog deleted in chromosome 10，PTEN）的突变和基因表达水平变化在口腔鳞状细胞癌发生、发展过程中的作用。方法应用聚合酶链反应（PCR）、基因测序方法检测42例口腔鳞状细胞癌和癌旁组织中VITEN第3、5、6、8外显子有无突变。应用半定量反转录聚合酶链反应（RT—PCR）方法检测上述病例癌组织及癌旁组织中PTENmRNA的表达。结果发现2例口腔鳞状细胞癌组织中PTEN第5外显子发生点突变。42例口腔鳞状细胞癌和癌旁正常组织中均有PTENmRNA表达，口腔鳞状细胞癌组织中PTENmRNA表达量[PTEN／磷酸甘油醛脱氢酶（glyeeraldehyde phosphate dehydrogenase，GAPDH）]为（0．36±0．12），低于相应癌旁正常组织（0．64±0．09），差异有统计学意义（P〈0．01）。结论PTENmRNA表达水平降低与口腔鳞状细胞癌的发生有一定关系。
OBJECTIVE: To apply fractionated-clamping for repair of thoracoabdominal aortic aneurysm (TAA), and evaluate its effects in decreasing surgical mortality and severe complications, such as renal failure and paraplegia,...
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OBJECTIVE: To apply fractionated-clamping for repair of thoracoabdominal aortic aneurysm (TAA), and evaluate its effects in decreasing surgical mortality and severe complications, such as renal failure and paraplegia, a modified crawford procedure were prospectively evaluated. METHODS: Using modified shunting and cross-clamping techniques, modified Crawford repair in 13 thoracoabdominal aorta patients were performed in the Vascular Division at Peking Union Medical College Hospital. TAA Crawford classification: 1 type I, 2 type II, 2 type III and 3 type IV TAA. Debakey classification: 1 type I, 4 type III (including 2 ruptured aneurysms), and 1 aortic coarctation. RESULTS: Thirteen procedures were performed successfully. One died of ventricular fibrillation just before completing the operation. Surgical mortality rate was 7.7% (1/13). Postoperative complications included 1 acute necrotic pancreatitis, 1 ARDS, 1 paraplegia, 1 acute renal failure, and 2 thoracic cavity bleeding. Total complication rate was 53.8% (7/13). CONCLUSIONS: Fractionated-clamping in thoracoabdominal aortic aneurysm repair is our modified Crawford procedure and aortic bypass. Clinical results demonstrate that our procedure decreased surgical mortality and major complication rate, and also alleviated viscera ischemic injury. Fractionated-clamping in aorta replacement is a practical procedure for TAA repair under general anesthesia at normal temperature.
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