胸腔镜手术中自制改良标本袋的多中心应用研究

目的探讨自制改良标本袋在多中心胸腔镜手术中的应用。 方法用卵圆钳和普通无菌手套制作改良标本袋,对来自5家医院的110例接受全胸腔镜手术的患者随机分为实验组（改良标本袋组）和对照组（普通手套组）,分别统计标本放入标本袋时间和尝试次数,并对结果进行统计分析。 结果放入标本袋的时间实验组为（14.86±5.76）s,而对照组为（123.81±94.65）s,差异有统计学意义（t=-8.600,P<0.05）。尝试次数实验组为1~2次,而对照组为1~4次,差异有统计学意义（U=858.000,P<0.05）。 结论自制改良标本袋较普通手套可以明显缩短胸腔镜手术标本放入标本袋时间和尝试次数,而且不增加成本。     

硒纳米颗粒对类风湿关节炎模型大鼠的治疗效果及抗炎作用机制研究

目的探讨类风湿关节炎(rheumatoid arthritis,RA)模型大鼠应用硒纳米颗粒治疗的效果及可能机制。方法20只雄性SD大鼠,使用Ⅱ型胶原+弗氏完全佐剂制备RA模型,将造模成功19只随机分为RA组10只和硒纳米颗粒组9只。硒纳米颗粒组将硒纳米颗粒6 mg/kg溶于生理盐水灌胃,RA组给予等量生理盐水灌胃,均1次/d,连续3周。灌胃第5、10、15、20天,测量2组足体积,评定关节炎指数,采用Western blot法检测血清谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、环氧化酶-2(cyclooxygenase-2,COX-2)相对表达量,采用ELISA法检测血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)相对表达量;灌胃第21天处死大鼠,取踝关节关节软骨以及软骨下骨行组织病理学检查。结果灌胃第5、10、15、20天,硒纳米颗粒组足体积[(2.28±0.16)、(2.87±0.21)、(2.99±0.25)、(2.51±0.18)mL]较RA组[(2.64±0.19)、(3.79±0.27)、(3.98±0.32)、(3.61±0.28)mL]小(P<0.05),关节炎指数(2.12±0.25、6.31±0.72、6.57±0.80、5.26±0.62)较RA组(2.45±0.36、8.26±0.91、9.03±0.82、7.54±0.73)低(P<0.05),血清IL-6表达吸光度值(1.56±0.03、1.48±0.04、1.51±0.03、1.42±0.04)、TNF-α表达吸光度值(1.52±0.03、1.53±0.05、1.46±0.04、1.41±0.03)、COX-2相对表达量(1.39±0.03、1.35±0.03、1.36±0.04、1.31±0.02)较RA组(IL-6:1.85±0.05、1.88±0.03、1.76±0.04、1.92±0.03;TNF-α:1.79±0.04、1.83±0.03、1.82±0.02、1.86±0.03;COX-2:1.59±0.04、1.67±0.05、1.64±0.04、1.66±0.05)低(P<0.05),GSH-Px相对表达量(0.65±0.03、0.69±0.05、0.67±0.04、0.72±0.06)较RA组(0.43±0.03、0.38±0.02、0.39±0.03、0.32±0.02)高(P<0.05);与RA组比较,硒纳米颗粒组大鼠关节滑膜组织受损较轻,细胞排列较为紧密,炎症细胞浸润明显改善。结论硒纳米颗粒可通过调控血清GSH-Px、COX-2、IL-6、TNF-α表达起抗炎作用,有效改善RA模型大鼠病情。     

Mesonephric adenocarcinoma of the uterine cervix with rare lung metastases: A case report and review of the literature

BACKGROUND Mesonephric adenocarcinoma(MNA)of the female reproductive system is a rare tumor arising from remnants of the mesonephric duct,which is mainly located in the cervix.MNA often occurs in adult women.Due to the rarity of the disease and few reports,the specific clinical features have not been established.CASE SUMMARY We present a case of a cervical MNA in a 48-year-old woman with an incidental intra-operative diagnosis who received postoperative chemotherapy.Rare lung metastases were detected during follow-up.The existing literature is reviewed.CONCLUSION The clinical manifestations,pathological characteristics,diagnosis,treatment,and prognosis of MNA have been summarized through the review of the existing literature and the case in this paper.Due to the rarity of this disease,it is very important for the research of MNA in the future.     

Total endovascular repair of an intraoperative stent-graft deployed in the false lumen of Stanford type A aortic dissection: A case report

BACKGROUND A 46-year-old male underwent ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection in 2016.However,an intraoperative stent-graft was deployed in the false lumen inadvertently.This caused severe iatrogenic thoracic and abdominal aortic dissection,and the dissection involved many visceral arteries.CASE SUMMARY The patient had pain in the chest and back for 1 mo.A computed tomography scan showed that the patient had secondary thoracic and abdominal aortic dissection.The ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection were performed 2 years prior.An intraoperative stent-graft was deployed in the false lumen.Endovascular aneurysm repair was performed to address this intractable situation.An occluder was used to occlude the proximal end of the true lumen,and a covered stent was used to direct blood flow back to the true lumen.A three-dimensional printing technique was used in this operation to guide prefenestration.The computed tomography scan at the 1stmo after surgery showed that the thoracic and abdominal aortic dissection was repaired,with all visceral arteries remaining patent.The patient did not develop renal failure or neurological complications after surgery.CONCLUSION The total endovascular repair for false lumen stent-graft implantation was feasible and minimally invasive.Our procedures provided a new solution for stent-graft deployed in the false lumen,and other departments may be inspired by this case when they need to rescue a disastrous stent implantation.     

Abdominal ventral rectopexy with colectomy for obstructed defecation syndrome: An alternative option for selected patients

BACKGROUNDAbdominal ventral rectopexy (AVR) with colectomy is controversial in the treatment of obstructed defecation syndrome (ODS). Literature data on this technique for ODS are very limited.AIMTo evaluate the safety and efficacy of AVR with colectomy for selected patients with ODS.METHODSConsecutive patients who underwent AVR with colectomy for ODS were identified prospectively from 2016 to 2017 in our department. Patient demographics, perioperative surgical results, and postoperative follow-up outcomes were collected and analyzed. Long-term follow-up was evaluated with standardized questionnaires. The severity of symptoms was assessed by the objective Wexner Constipation Score (WCS) and ODS Score. The quality of life was assessed by the Patients Assessment of Constipation Quality of Life score. Functional outcome was compared pre- and post-operatively for each patient. The primary outcomes were determined by the improvement in symptoms and quality of life. Secondary outcome measures were operating time, postoperative length of stay, morbidity and mortality, improvement of pelvic floor structure, and patient satisfaction.RESULTSFour patients underwent robotic-assisted surgery, and two patients underwent a laparoscopic-assisted procedure. The mean operating time for the robotic approach was 243 min (range 160–300 min), and the mean operating time for the laparoscopic approach was 230 min (range 220-240 min). The mean postoperative length of stay was 8.2 d (range 6-12 d). There was no conversion to open procedure and no postoperative mortality. No urinary retention, wound infection, prolonged ileus, pelvic infection and anastomosis leakage occurred. Six patients were followed up for 36 mo. The WCS, ODS, and Patients Assessment of Constipation Quality of Life score improved significantly postoperatively (P < 0.05). The WCS and ODS scores showed the best remission and stabilization at 6 to 12 mo after surgery. There was no recurrence or novel constipation after surgery. None of the patients used laxative medication.CONCLUSIONRobotic and laparoscopic-assisted ventral rectopexy with colectomy is a safe and effective procedure for selected patients with ODS. However, comprehensive preoperative evaluation and careful patient selection are essential.     

Development of 201 tri- and tetra-nucleotide repeat microsatellites for bighead carp (Aristichthys nobilis)

In this study we developed 201 tri- and tetra-nucleotide repeat microsatellites for bighead carp (Aristichthys nobilis), and 135 of them showed polymorphism. Thirty-seven of polymorphic loci were randomly selected to characterize genetic diversity in a test population with 36 individuals. The number of alleles per locus ranged from 2 to 11 (mean 5.6), and the average observed and expected heterozygosity were 0.53 and 0.61, respectively. Twenty-four of the 37 loci were highly informative (PIC > 0.5) in the test population. Six loci deviated from the Hardy–Weinberg Equilibrium, and no pairs of loci were in linkage disequilibrium after Bonferroni correction. All 201 loci could be successfully amplified in silver carp (Hypophthalmichthys molitrix) with 64 loci being polymorphic, indicating a high universality of these microsatellites across species. These novel polynucleotide microsatellites would be useful tools for further population and conservation genetics studies in bighead carp and its closely-related silver carp.     

2种地龙饮片不同提取法体外抗凝活性对比研究

目的 研究酒制对地龙体外抗凝活性的影响，为地龙临床应用提供科学依据。方法 分别采用传统水提法和仿生酶解提取法对生品地龙、酒制地龙进行提取，以活化部分凝血活酶时间（activated partial thromboplastin time，APTT）、凝血酶原时间（prothrombin time，PT）、凝血酶时间（thrombin time，TT）和抗凝血酶活力为指标进行抗凝活性测定，并采用BCA蛋白测定法测定可溶性蛋白、多肽含量。结果 采用水提取法时，PT和抗凝血酶滴定法均显示酒地龙与生地龙抗凝血活性相当，TT测定结果显示酒地龙抗凝血活性强于生地龙，APTT测定结果则显示地龙具有促凝血活性，且在一定范围内，浓度越高，促凝效果越强，蛋白、多肽含量为酒地龙大于生地龙；采用仿生酶解提取法时，APTT和PT测定结果显示酒地龙的抗凝血活性强于生地龙，并且蛋白、多肽含量测定结果显示酒地龙要多于生地龙，但TT和抗凝血酶滴定法并未比较出生品与酒制品之间的差异。结论 与传统水提法相比，仿生酶解提取法能更多地提取出蛋白多肽类成分，仿生酶解提取液具有更强的抗凝血活性，2种提取法均显示地龙酒制有利于可溶性蛋白、多肽的溶出，能增强体外抗凝血活性。     

Identification of Norovirus as the Top Enteric Viruses Detected in Adult Cases with Acute Gastroenteritis

To elucidate the importance of the norovirus and other enteric viruses, and the difference of the genetic relatedness on norovirus between the outbreak and sporadic cases, a total of 557 stool samples, consisting of 503 sporadic cases and 54 samples of 4 outbreaks were collected and tested for norovirus and other enteric viruses in Beijing, China, July 2007–June 2008. The data showed norovirus, rotavirus, astrovirus, and sapovirus, were detected in 26.6%, 6.1%, 1.8%, and 0.5%, respectively. Norovirus was detected almost throughout the surveillance period, norovirus co-infecting with rotavirus, astrovirus, and sapovirus, respectively, were identified both in outbreak and the sporadic cases. GII.4/2006 was identified as the predominant strain circulating both in outbreak and sporadic cases. The results showed that norovirus was rather the important agent than other enteric viruses affected adults with acute gastroenteritis; no significant genetic relatedness of the dominant strains was found between the outbreak and sporadic cases.