简介:摘要目的探讨9号钢针在改良塞丁格尔技术PICC置管中的应用方法和价值。为长期补液、血管条件差或化疗患者建立无痛、安全、有效的静脉通道,避免反复的静脉穿刺,防止各种药物外渗引起的静脉炎或局部组织坏死。方法回顾性分析192例需长期补液或静脉化疗的患者行PICC置管,并观察其临床效果。其中157例经肘窝外周静脉穿刺,35例行9号钢针引导改良塞丁格尔技术穿刺。结果传统PICC置管一次置管成功率为96%,少数出现并发症。9号钢针引导改良塞丁格尔技术PICC置管的一次性成功率为99%,未有并发症发生。结论PICC导管留置时间长,操作快速、方便,并发症少。而9号钢针引导改良塞丁格尔技术的PICC置管对于血管条件差、长期补液、化疗患者更提供了一条安全、方便的输液途径,并且成功率高,值得在临床上应用。
简介:Objective:Todeterminetheclinicalserumlevelsofcarcinoembryonicantigen(CEA)andcarbohydrateantigen19-9(CA19-9),individuallyandincombination,forthediagnosisof50healthysubjectsand150casesofesophageal,gastric,andcoloncancers.Methods:Thesensitivitiesofthetwomarkerswerecomparedindividuallyandincombination,withspecificitysetat100%.Receiveroperatingcharacteristic(ROC)curveswereplotted.Results:SerumCEAlevelsweresignificantlyhigherincancerpatientsthaninthecontrolgroup.ThesensitivityofCEAwasdetermined:inesophagealcancer,sensitivity=28%,negativepredictivevalue(NPV)=61.72%,andAUC=0.742(SE=0.05),withasignificancelevelofP<0.0001;ingastriccancer,sensitivity=30%,NPV=58.82%,andAUC=0.734(SE=0.05),withasignificancelevelofP<0.0001;incoloncancer,sensitivity=74%,NPV=79.36%,andAUC=0.856(SE=0.04),withasignificancelevelofP<0.0001.ThesensitivityofCA19-9wasalsoevaluated:inesophagealcancer,sensitivity=18%,NPV=54.94%,andAUC=0.573(SE=0.05),withasignificancelevelofP=0.2054.Ingastriccancer,sensitivity=42%,NPV=63.29%,andAUC=0.679(SE=0.05),withasignificancelevelofP<0.0011.Incoloncancer,sensitivity=26%,NPV=57.47%,andAUC=0.580(SE=0.05),withasignificancelevelofP=0.1670.ThefollowingwerethesensitivitiesofCEA/CA19-9combined:inesophagealcancer,sensitivity=42%,NPV=63.29%,SE=0.078(95%CI:0.0159-0.322);gastriccancer,sensitivity=58%,NPV=70.42%,SE=0.072(95%CI:-0.0866-0.198);andcoloncancer,sensitivity=72%,NPV=78.12%,SE=0.070(95%CI:0.137-0.415).Conclusion:CEAexhibitedthehighestsensitivityforcoloncancer,andCA19-9exhibitedthehighestsensitivityforgastriccancer.Combinedanalysisindicatedanincreaseindiagnosticsensitivityinesophagealandgastriccancercomparedwiththatincoloncancer.
简介:摘要目的检测甲状腺肿瘤中半乳糖凝集素-3(Galectin-3)与基质金属蛋白酶-9(MMP-9)的表达,探讨分析甲状腺癌组织中Galectin-3表达与MMP-9的关系和临床意义。方法采用免疫组织化学法对41例甲状腺癌(其中乳头状癌31例,滤泡状癌7例,髓样癌3例),26例甲状腺滤泡性腺瘤,28例结节性甲状腺肿,25例正常甲状腺手术切除标本进行Galcctin-3和MMP-9的检测。结果Galectin-3和MMP-9在良恶性病变之间比较差异有显著统计学意义(P<0.01)。Galectin-3在甲状腺癌伴有、无淋巴结转移之间比较差异无统计学意义(P>0.05),MMP-9在其之间的比较差异有统计学意义(P>0.05)。结论(1)Galectin-3和MMP-9在甲状腺癌中高表达,是甲状腺癌的病理学分子标记物。(2)MMP-9的表达与甲状腺癌淋巴结转移有关,说明MMP-9的表达可能与甲状腺癌的恶性程度有关。