【摘要】 目的 探討慢性丙型肝炎患者干擾素治療前后血清自身抗體的合并狀況。 方法 回顧性分析2005年2月-2008年2月66例慢性丙型肝炎患者應用干擾素治療前后的檢測結果，觀察治療前后自身抗體合并狀況及與干擾素療效的關系。 結果 ①66例慢性丙型肝炎患者中39例自身抗體陽性，陽性率59.1%（39/66），主要為ANA；②自身抗體的產生與年齡相關，而與性別、HCVRNA定量無關；③自身抗體陽性組干擾素應答率66.7% （26/39）明顯高于陰性組40.7%（11/27），二者比較差異有統計學意義；④干擾素治療后，自身抗體陰性組自身抗體檢出率為44.4%（12/27），但滴度均lt;1∶320；治療前抗甲狀腺球蛋白抗體陽性患者會出現較高的甲狀腺功能異常率。 結論 慢性丙型肝炎合并血清自身抗體陽性的患者干擾素應答率高于陰性組，但應注意抗甲狀腺球蛋白抗體，以預測不良反應。【Abstract】 Objective To explore the consolidation of serum autoantibodies in chronic hepatitis C patients treated with interferon. Methods The clinical data of 66 patients with chronic hepatitis C treated with interferon from February 2005 to February 2008 were retrospectively analyzed. The relationship between the consolidation of serum autoantibodies and the effect of interferon was observed. Results ①There were 39 patients with positive autoantibodies; the positive rate was 59.1% (39/66) and ANA was the main antibody. ②The appearance of autoantibodies correlated with the patients′ ages but not with the sexes and CVRNA quantification. ③The interferon response rate in autoantibodies positive group was 66.7% (26/39) which was much higher than that in the negative group; the difference between the two groups was significant. ④After the interferon treatment, the autoantibody detection rate in autoantibody negative group was 44.4%(12/27)and the titer was lower than 1:320; before the treatment, the anti-thyroglobulin antibody-positive patients had a higher rate of thyroid dysfunction. Conclusion The interferon response rate in chronic hepatitis C patients with positive serum autoantibodies is higher than that in the patients with negative serum autoantibodies. Anti-thyroglobulin antibodies should be noted to predict the adverse effects.
ObjectiveTo evaluate the efficacy of video-assisted thoracoscopic sleeve lobectomy in the treatment of central non-small cell lung cancer.MethodsThe clinical data of 105 patients with central non-small cell lung cancer who underwent sleeve lobectomy surgery in the Second Hospital of Shanxi Medical University and Shanxi Cancer Hospital from December 2014 to December 2019 were retrospectively analyzed, including 83 males and 22 females, with an average age of 57.4 (32.6-77.8) years and weight of 62.5 (52.4-79.1) kg. Thirty-five patients received video-assisted thoracoscopic sleeve lobectomy (a group A), and 70 patients received traditional thoracotomy sleeve lobectomy (a group B). The operation time, intraoperative blood loss, number of lymph node dissection, postoperative complication rate, early postoperative mortality, total thoracic drainage volume at 24 hours, time of indwelling chest tube after operation, pain score at 24 hours after operation, postoperative hospital stay, postoperative short-term (1 month, 6 months and 1 year) quality of life score and postoperative 3-year survival rate of two groups were compared.ResultsThere was statistical difference in the operation time (228.1±24.7 min vs. 175.0±23.7 min, P=0.02), postoperative complication rate (28.6% vs. 34.3%, P=0.04), postoperative pain score at 24 h (3.6±3.5 points vs. 5.9±2.0 points, P=0.03) and postoperative indwelling chest tube time (5.0±2.9 d vs. 8.4±2.1 d, P=0.04) between the two groups. There was no statistical difference in the intraoperative blood loss (182.5±36.9 mL vs. 189.8±27.5 mL, P=0.34), number of lymph node dissections (11.1±2.6 vs. 12.3±1.9, P=0.49), early postoperative mortality (2.9% vs. 4.3%, P=0.31), total thoracic drainage volume at 24 h after surgery (346.8±91.1 mL vs. 329.8±101.4 mL, P=0.27), postoperative hospital stay (7.9±4.2 d vs. 8.5±3.4 d, P=0.39) and 3-year postoperative survival rate (68.6% vs. 72.9%, P=0.82) between the two groups.ConclusionVideo-assisted thoracoscopic sleeve lobectomy for the treatment of central non-small cell lung cancer is safe and feasible. Compared with traditional thoracotomy for sleeve lobectomy, fewer postoperative complications occur, body recovers faster and the quality of life is higher within the postoperative 6 months. Besides, the 3-year survival rate can achieve similar oncological prognosis results.
ObjectiveTo explore the correlation between the Barthel index score and other factors with the preoperative occurrence of deep vein thrombosis (DVT) in patients undergoing total hip arthroplasty (THA) revision surgery. MethodsA retrospective analysis was conducted on clinical data from 122 patients who met the inclusion criteria and underwent THA revision surgery between April 2017 and November 2020. Among them, 61 were male and 61 were female, with an age range of 32-85 years (mean, 65.3 years). The reasons for revision included prosthetic joint infection in 7 cases, periprosthetic fracture in 4 cases, prosthetic dislocation in 6 cases, and aseptic loosening in 105 cases. The Barthel index score was 76.4±17.7, with 10 cases classified as level 1, 57 as level 2, 37 as level 3, and 18 as level 4. Univariate analysis was performed on variables such as age, gender, body mass index, Barthel index score, preoperative D-dimer positivity, history of diabetes, hypertension, cancer, cerebral infarction, smoking, and thrombosis in patients with and without preoperative DVT. Furthermore, logistic regression was used to identify risk factors for preoperative DVT in THA revision surgery. The incidence of preoperative DVT was compared among different Barthel index score groups. ResultsPreoperative DVT was detected in 11 patients (9.02%), all of whom had intermuscular venous thrombosis. Among them, 1 had prosthetic joint infection, 1 had periprosthetic fracture, 1 had prosthetic dislocation, and 8 had aseptic loosening. Univariate analysis showed significant differences between the two groups in terms of age, gender, and Barthel index score (P<0.05). logistic regression further revealed that female, age ≥70 years, and Barthel index score<60 were independent risk factors for preoperative DVT in patients undergoing THA revision surgery (P<0.05). The incidence of preoperative DVT in patients with Barthel index scores of levels 1, 2, 3, and 4 were 0 case (0%), 2 cases (3.5%), 3 cases (8.1%), and 6 cases (33.3%), respectively. A significant correlation was found between Barthel index score classification and the incidence of preoperative DVT in patients undergoing THA revision surgery (χ2=10.843, P=0.001). ConclusionIn patients undergoing THA revision surgery, older age, female, and lower Barthel index scores are associated with higher preoperative DVT incidence. For patients with low preoperative Barthel index scores, preoperative thrombosis screening should be emphasized.
