甲状旁腺切除术对甲状旁腺机能亢进性骨病的远期疗效

为了评价甲状旁腺切除术对原发性甲状旁腺机能亢进（ＰＨＰＴ）所致骨病的远期疗效，回顾分析了１６例术后平均５．１（１．０～１０．５）年患者的临床表现、骨结构和骨密度恢复情况，结果表明手术虽能明显改善患者骨病，但在随访终点有１０／１６例（６２．５％）骨病恢复不全，其中骨病重的Ｙ１组比骨病轻的Ｙ２组恢复不全比例更高（Ｐ＜０．０５），１４／１６例血骨钙素（ＢＧＰ）和尿吡啶并啉（Ｐｙｒ）浓度处于中青年对照组范围内，这意味着其成骨与破骨处于平衡状态。这些结果提示：ＰＨ－ＰＴ患者应尽早诊断治疗，术后应对患者密切随访，重视对骨病恢复不全者的后续治疗     

胰十二指肠切除术后住院时间影响因素分析-回顾性研究

Background. Postoperative hospital stay after pancreaticoduodenectomy (PD) was relatively longer than other gastrointestinal operations, The aim of current study was to investigate the risk factors of postoperative hospital stay after PD. Methods. Patients who were performed PD in Cancer Hospital Chinese Academy of Medical Sciences (CHCAMS) between December 2008 and November 2012 were selected for the retrospective study. The clinical and pathological data was collected and analyzed. The primary outcome was postoperative hospital stay. Normal discharge or recovery was defined as postoperative hospital stay no more than 10 days, otherwise it was defined as delayed discharge or recovery (including hospital death). Results. Finally, 152 patients were enrolled in present study. Postoperative hospital stay was 19.7±7.7 (7-57 d). 67 of 152 patients were normal discharge, and 85 of 152 patients were delayed discharge. The overall morbidity of complications was 62.5% (95/152), and the mortality rate was 3.29% (5/152). Multiple factors analysis showed that complication morbidity (adjusted OR=10.40, 95%CI=3.58-30.22), age (adjusted OR=4.09, 95%CI=1.16-14.39), BMI (body mass index) (adjusted OR=4.40, 95%CI=1.19-16.23), surgical procedure (adjusted OR=26.14, 95%CI=4.94-153.19), blood transfusion (adjusted OR=7.68, 95%CI=2.09-28.27) and fluid input (adjusted OR=3.47, 95%CI=1.24-11.57) were significantly associated with delayed discharge. Conclusions. Postoperative complications affects the postoperative hospital discharge. Furthermore, age, BMI, transfused red blood, surgical procedure and input might prolong LOS (length of hospital stay). Studies with more patients were needed in future.     

甲磺酰胺苯乙胺类化合物抗心律失常活性的定量构效关系研究(Ⅰ)

以ＰＯＬＹＧＥＮ软件中的ＣＨＡＲＭｍ程序和集团坐标轮换法，对合成的１２个甲磺酰胺苯乙胺类化合物的结构进行计算机分子模拟。根据所得化合物的能量最低构象，计算了其ＶＤＷ体积、偶极矩、总键能、总键角能、总非正则能以及氮原子电荷等值，并对这些化合物进行ＣＮＤＯ／２法量化计算，这些计算结果作为结构参数分别与１２个化合物抗心律失常活性进行相关分析，以逐步回归法建立了两个相关性较好的方程：ｌｇｌ／ＭＥＣ＝６．９９９１－０．３８４２Ｘ２＋３．６７９６Ｘ５［ｎ＝１２，ｒ＝０．８５５９７５，ｓ＝０．１８９６７２，Ｆ＝１２．３３４６４＞Ｆ１－０．０５（３，９）＝３．８６］；ｌｇｌ／ＭＥＣ＝１４．７０３８－２１３．２６９２Ｘ４－１０．４８２９Ｘ５［ｎ＝１２，ｒ＝０．９３１９１９，ｓ＝０．１３３０４７，Ｆ＝２９．７１３５４＞Ｆ１－０．０１（３，９）＝６．９９］。结果提示，这类化合物的抗心律失常活性与分子中的原子轨道杂化程度和氮原子对分子ＨＯＭＯ和ＬＵ－ＭＯ的贡献有关，可以看出，氮上的取代不同会引起抗心律失常活性的不同     

欧洲刺柏（Juniper）

活性成分与药理作用欧洲刺柏药用部位是其浆果，具有促水排泄、防腐、抗胃肠胀气和抗风湿作用，还可改善胃功能。用作促水排泄药可增加尿量（水丢失），但不增加钠排泄。成分萜品烯-4-醇可增加肾小球滤过率，但刺激肾。欧洲刺柏浆果对单纯疱疹病毒体外显示抗病毒活性，并具抗真菌活性。动物实验显示，欧洲刺柏浆果提取物具有堕胎、抗生育、抗炎、抗胚胎植入、降血压、升血压和降血糖作用。欧洲刺柏浆果油具有兴奋子宫的活性，以及利尿、胃肠道抗菌和刺激作用，该油对平滑肌有阻止解痉作用。     

基于网络药理学探讨独活-羌活-细辛治疗膝骨关节炎的作用机制*

目的 基于网络药理学的方法分析和预测独活-羌活-细辛治疗膝骨关节炎可能的作用机制。方法 利用TCMSP数据库获取独活、羌活、细辛的活性成分及靶点,与CTD、NCBI等数据库获取的膝骨关节炎疾病基因靶点映射,构建药物-活性成分-疾病靶点网络。进行MCODE聚类分析,通过Omicshare云平台和DAVID数据库GO、KEGG通路富集分析。结果 从3味药中共筛选出了36个活性成分及205个靶点,主要有山柰酚、 β-谷甾醇、芝麻脂素、异紫花前胡苷等关键成分,AKT1、ESR1、JUN、CASP3等为关键靶点,核心基因有NOS3、ESR1、COX1、NR1I2,关键的生物进程和通路有类固醇激素反应性、活性氧代谢过程、AGE-RAGE通路和TNF通路。结论 独活-羌活-细辛可能通过多成分、多靶点网络来治疗膝骨关节炎。     

Pleura, pleural cavity, mediastinum, diaphragm

Thoracic primitive neuroectodermal tumor, Long-term effects of thymectomy on the T cellular immunity of myasthenia gravis patients .     

Liver, biliary tract, pancreas, spleen

207577 Pathologic and molecular biologic characteris- tics of hilar cholangiocarcinomas/Li Chenggang(李成 刚,Inst Hepatobil Surg, Gener Hosp PLA, Beijing 100853)…∥Chin J Exp Surg.-2007 ,24(6) .-690 ~ 691 Objective Toinvestigate the pathologic and molec- ular biologic characteristics of hilar cholangiocarcinomas. Methods Sixty-eight patients with hilar cholangio- carcinomas were reviewed,and the pathologic types and incidence of perineural invasionandlymph node metastasis were summariz…     

Liver, biliary tract, pancreas, spleen

Experimental study on bone marrow mononuclear cells on vWF and VEGF expression in ischemic bile duct tissue; Study on molecular mechanism of vasculogenic mimicry in hepatocdlular carcinoma; Study on side population ceils in human hepatocellular carcinoma cell line 97H; Budd-Chiari syndrome associated with hepatocellular carcinoma： a report of 10 cases; Correlation of aPKC-t and E-cadherin expression with invasion and prognosis of extrahepatic cholangioeareinoma……     

Liver,biliary tract,pancreas,spleen

<正>209054 Liver protection of prostaglandin E1in patients after hepatectomy/Hua Yunpeng(华赟鹏,Dept Hepatobil Surg,1st Affil Hosp,Sun Yat-sen Univ,Guang-zhou 510080)…∥Chin J Gen Surg. -2009,24(10). -817～819 Objective To investigate the effect and mechansim of prostaglandin E1(PGE1) to protect liver functions after hepatectomy.     

Liver,biliary tract,pancreas,spleen

<正>209178 Long-term prevention of virus recurrence among recipients with HBV active replication following liver transplantation/Dai Jun(Liver Transplant Center,West Chin Hosp,Sichuan Univ,Chengdu 610041)…∥Chin J Hepatobil Surg.-2009,15(2).-106~109Objective To investigate the long-term prophylactic outcome in recipierts with HBV active replication under LAM or/and HBIG prophylaxis after liver transplantation.Methods The liver biopsy specimens and serum samples were collected during the follow-up.ELISA and chemiluminesent microparticle immunoassay,HBV-DNA fluorescent quantification,immunohistochemisty and HBV-DNA in situ hybridization were performed for analysis.The alteratio of HBV markers in serial biopsy and sera of 55 recipients were investigated retrospectively.Results The mean time of follow-up was 69.14 months.Twelve cases had hepatitis B virus reinfection after transplantation.The accumulated ratio of hepatitis B virus reinfection was 4.8%(2/42)in LAM+HBIG group and 76.9%(10/13) in LAM monoprophylaxis group(P=0.000).The 1-,2-,3-and 4-yr,survival rates in combined prophylaxis group were 100%,97.1%,92.7% and 92.7%,respectively.The 1-,2-,3-and 4-yr survival rates in LAM mono prophylaxis group were 76.9%,69.2%,53.8% and 46.2%,respectively(P=0.000).The rates of hepatitis B virus reinfection in combination prophylaxis group(1-,2-,3-and 4-yr recurrence rates of 2.4%,2.4%,2.4%,and 8.5%,respectively) was markedly lower than those in mono prophylaxis group(1-,2-,3-and 4-yr recurrence rates of 16.1%,41.3%,66.4% and 66.4%,respectively)(P=0.000).Conclusion Currently HBIG combined with LAM is an optimal prophylatic protocol to reduce the hepatitis B virus reifection rate.However,poor compliance of recipients to a prescribed course of prophylaxis as well as viral staus itself is still the main cause of hepatitis B virus reinfection after liver transplantation in China.Compliance education and adjusting the prophylatic protocols according to the viral alteration after liver transplantation may help to fur     

Pleura,pleural cavity,mediastinum,diaphragm

<正>209402 Epidemiological characteristics and care outcome of the elderly patients with severe chest trauma/Kong Lingwen(孔令文,Dept Cardiothorac Surg,Chongqing Inst Accident Emergency Med,Chongqing Emerg Med Center,Chongqing 400014)…∥Chin J Traum.-2009,25(6).-489～492Objective To further improve level of severe chest trauma care in the elderly patients.Methods A retrospective study was done on data of 148 elderly patients(≥65 years)with severe chest trauma(AIS≥3 points)(elderly group)treated in Chongqing Emergency Medical Center from June 1995 to May 2005.A total of 1 669 patients at age less than 65 years and with AIS≥3 points were set as control group in the same research period(control group).Results The main injury mechanism was blunt trauma,which accouted for 83.8%(124/148)in elderly group,higher than 69.3%(1 157/1 669)in control group(P<0.01).The injury causes were mainly traffic accidents,slip and fall from a height,Traffic accidents and slip accounted for 66.2%(98/148)and 14.9%(22/148)respectively,which was significantly higher than 50.6%(845/1 669)and 3.1%(52/1 669)respectively in control group(P<0.01).There was no statistical difference upon ISS,RTS,GCS and prehospital time between both groups(all P value >0.05).The fatality rate and incidence rate of complication in the elerly group were 15.5%(23/148)and 25.7%(38/148),which was significantly higher than 6.5%(108/1 669)and 10.4%(174/1 669)respectively in control group(P<0.01).The fatality rate in elderly group with complications was significantly higher than that in control group(51.7% vs 26.7%)(P<0.01),while those without complications showed no statistical difference between two groups(6.7%∶3.5%)(P<0.05).Conclusion The patient’s age and complications are relative independent factors to estimate the trauma care outcome.Raising risk awareness and strengthening the management of complications and supportive treatments for organ function are keys to improve survival rate of the elderly patients with sever     

Pleura,plural cavity,mediastinum,diaphragm

<正>209550 The management of giant mediastinal lymph node hyperplasia:report of 20 cases/Ye Bo(叶波,Dept Thorac Surg,Cancer Hosp,Chin Acad Med Sci Peking Union Med Col,Beijing 100021)…∥Chin J Thorac Cardio-vasc Surg. -2009,25(4). -248 ～250     

见证 回味 感恩 展望

20年前的金秋,首都医科大学附属北京朝阳医院心脏中心诞生了。满怀豪情壮志的胡大一教授带着先进的技术、全新的理念、科学的管理、年轻的团队来到这里,经过艰苦的创业和科学的管理,打造出了国内首家真正意义上的心脏中心。北京朝阳医院心脏中心的诞生标志着融心脏内科、外科、介入于一体的一种全新的管理和运作模式。