中西医结合干预粘连性肠梗阻腹腔镜松解术后效果分析

简版：目的：观察在常规治疗与护理基础上加用中药热熨和穴位敷贴干预粘连性肠梗阻(ASBO)腹腔镜松解术后患者的效果。方法：将93例ASBO腹腔镜松解术后患者随机分为对照组46例和观察组47例。2组均在腹腔镜松解术后给予常规治疗与护理措施,观察组加用中药热熨腹部和穴位敷贴。连续观察1周。记录2组患者的术后胃肠蠕动恢复时间、下床活动时间、住院时间、胃管拔除时间、首次进食时间、术后并发症情况,评价患者对护理的满意度和依从性。     

乳房假体植入对二重应激下乳腺癌患者心理应激、生存质量的影响

目的探讨乳房假体植入对二重应激下乳腺癌患者心理应激、生存质量的影响。方法选取2021年7月至2022年7月温州医科大学附属第一医院外科收治的乳腺癌患者104例为研究对象, 采用随机对照研究方法, 按照随机数字表法分为对照组(52例)和观察组(52例)。所有患者进行乳腺癌根治术治疗, 观察组患者在乳腺癌根治术的基础上进行乳房假体植入。比较两组患者手术时间、住院时间, 术前与术后3个月心理状态评分, 术后3个月乳房美观恢复效果, 世界卫生组织生活质量评定量表(WHOQOL-100), 以及术后两组患者皮下积液、皮瓣坏死等的发生情况。结果两组患者手术时间差异无统计学意义(P > 0.05), 而观察组患者住院时间为(10.89±2.34)d, 短于对照组的(21.06±3.82)d(t=16.37, P < 0.001);术后3个月, 两组患者焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)、抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)评分均比术前低, 且观察组患者各项评分分别为(39.02±5.21)分、(19.02±2.51)分、(16.03±2.55)分、(41...     

ERCP治疗胆总管结石23例临床研究

目的探讨ERCP治疗胆总管结石相比较于传统手术治疗的优势。方法回顾分析采用ERCP治疗胆总管结石23例的临床资料。结果 23例中21例成功取出结石,2例转外科手术治疗,1例并发胰腺炎,无一例出现肠穿孔、肠道大出血及重症胆管炎等严重并发症,治愈率为91.30%,并发症发生率为4.76%。结论 ERCP相比较传统外科手术,具有创伤小、并发症少、死亡率低、术后恢复快、可重复操作的优点,在条件合适的基层医院也能开展。     

The effects of gossypol on expressions of transforming growth factor-β1, fibronectin and 11β-hydroxysteroid dehydrogenase in nephridial tissue in rats with diabetes mellitus

Objective To observe the effects of gossypol on expressions of transforming growth factor-β1 (TGF-β1), fibronectin (FN) and 11β-hydroxysteroid dehydrogenase (11β-HSD) in nephridial tissue in rats with diabetes mellitus. Methods Thirty male Sprague-Dawley rats were randomly divided into three groups: normal control, type 2 diabetes and gossypol treatment group . After high-fat feeding for 4 weeks, the later two groups were injected with low dosage strepozotocin (30 mg/kg) intraperitoneally to induce type 2 diabetic rat model. The rats in gossypol treated group were given gossypol at the dosage of 15 mg/kg once per day for 4 weeks by gavage. And since the 5th week, the times of gavages had been changed into once per week at the same dosage and lasted to the 12th week . The levels of blood glucose, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-c) were measured. Additionally, the morphological changes of the kidney were studied by light microscopy and transmission electron microscopy respectively. The mRNA expressions of TGF-β1, FN, 11β-HSD and 11β-HSD2 in nephridial tissue were assayed by semi-quantity RT-PCR. The protein expressions of TGF-β1 and FN in nephridial tissue were determined by immunohistochemistry. Results The blood levels of glucose, TC and LDL- c were increased significantly in type 2 diabetic group compared with normal control group(P<0. 01). The volume of glomerulus and the deposition of PAS positive substance in the glomerular interstitium were increased under light microscopy, and the glomerular basal membrane was thicker in type 2 diabetic group than those in normal control group under transmission electron microscopy. The mRNA and protein expressions of TGF-β1 and FN were increased(P<0. 01), and the mRNA expression of 11β-HSD2 was decreased(P<0. 05), while the mRNA expression of 11β-HSD1 was unchanged in type 2 diabetic group compared with normal control group. After the treatment of gossypol, the level of the blood glucose was significantly decreased(P< 0. 01), and the levels of TC, LDL-c showed a trend of decrease but had no statistical differences compared with type 2 diabetic group. The morphology of nephridial tissue was ameliorated in gossypol treatment group. The mRNA and protein expressions of TGF-β1 and FN were decreased(0. 16± 0. 02,0. 22±0. 05 ; 0. 24±0. 06,0. 33±0. 07, P< 0. 05), while the mRNA expressions of 11β-HSD1 and 11β-HSD2 were unchanged compared with type 2 diabetic group. Conclusions Gossypol can relieve the pathologic changes of nephridial tissue, inhibit the expressions of TGF-β1 and FN through decreasing blood glucose of rats with diabetes mellitus.     

小檗碱对2型糖尿病大鼠巨噬细胞ox-LDL、CD36和PPARγ的影响

目的探讨小檗碱对T2DM大鼠脂代谢、腹腔巨噬细胞（PM）及肺泡巨噬细胞（AM）氧化低密度脂蛋白（ox-LDL）、CD36和过氧化物酶体增殖物激活受体γ（PPARγ）表达的影响。方法SD大鼠分为正常对照组、高脂组、糖尿病组、小檗碱治疗组。实验结束后测定各组BG、Ins、血脂,PM及AM内ox-LDL含量、CD36与PPARγ的蛋白与mRNA表达水平。结果与正常对照组比较，糖尿病组BG、Ins、TC、TG、LDL-C显著升高；PM及AM内ox-LDL含量、CD36与PPARγ的蛋白和mRNA表达显著升高。与糖尿病组比较，小檗碱治疗组BG、Ins及LDL-C水平降低，TC、TG显著下降，HDL-C升高，PM及AM内ox-LDL含量下降，CD36的蛋白和mRNA表达降低，PPARγ mRNA表达降低。结论小檗碱降低T2DM大鼠血糖，改善胰岛素抵抗和脂代谢紊乱，其机制可能与降低巨噬细胞内ox-LDL，抑制CD36和PPARγ的表达有关。     

一个中国近端指(趾)骨间关节黏连家系NOG基因新突变鉴定

目的 检测一个中国近端指(趾)骨间关节黏连家系的致病基因突变.方法 收集该家系患者和家系成员的临床资料,采集外周血提取基因组DNA.运用聚合酶链式反应和Sanger测序法筛查先证者的NOG和GDF5基因.确定突变位点后,在家系成员中进行共分离分析并在200名正常对照中筛查该突变.结果 该家系患者中存在NOG基因c.502 T＞C错义突变,该突变导致其编码蛋白Noggin第168位氨基酸由苯丙氨酸变为亮氨酸(p.F168L).在家系正常成员和200名正常对照中未检测到相同突变.该突变在dbSNP、ExAC等数据库中未见报道.在GDF5基因上未发现可疑突变.结论 NOG基因c.502 T＞C错义突变是该家系发病的原因.     

细胞质膜小凹/小凹蛋白1在实验性动脉粥样硬化小鼠血管壁中的表达变化

目的 研究细胞质膜小凹，小凹蛋白1在动脉粥样硬化病变中的表达变化，探索动脉粥样硬化发生过程中细胞胆固醇逆转运障碍的机制。方法采用高脂饲料喂养动脉粥样硬化敏感C57BL／6J小鼠24周，计算机图像分析系统计算动脉粥样硬化病灶面积和主动脉内膜和中膜厚度；电镜观察小凹在主动脉病变区的血管平滑肌细胞表达，Western印迹检测血管壁小凹蛋白1变化情况。结果动脉粥样硬化模型小鼠主动脉病变区的血管平滑肌细胞膜上存在有小凹结构，但排列稀疏，与正常血管平滑肌细胞相比明显减少，泡沫样改变的血管平滑肌细胞未见明显小凹结构的存在。通过Western印迹检测观察到，高脂组血管壁的小凹蛋白1蛋白表达量明显减少，与对照组比较具有显著差异。结论维持细胞内胆固醇平衡的重要结构小凹，小凹蛋白1在动脉粥样硬化病变中明显受损，可能是血管平滑肌细胞胆固醇逆转运障碍重要原因之一。     

精制妇科千金片对生物性大鼠子宫内膜炎的作用

目的 探讨精制妇科千金片对生物性大鼠子宫内膜炎的作用.方法 SD大鼠随机分为正常对照组,模型组,阳性药物金鸡胶囊组,精制妇科千金片高、中、低荆量组.除正常对照组外,其他动物均用大肠埃希茵造成生物性大鼠子宫内膜炎模型.药物治疗20 d后,取子宫做病理学检查,取血观察各组大鼠血液流变学改变;放射免疫法测大鼠血清中血栓素B2（TXB2）和6-酮-前列腺素F1.（6-Keto-PGF1α）的含量,比色法测大鼠血清中丙二醛（MDA）的含量.结果 模型组与正常对照组比较,子宫内膜炎症细胞增生明显,上皮细胞变性坏死,炎症细胞浸润,内膜充血水肿;全血黏度、红细胞压积及血浆黏度均明显升高;TXB2与6-Keto-PGF1α含量均有明显降低;血清中MDA的含量明显升高.给予精制妇科千金片、金鸡胶囊治疗后能显著抑制大鼠子宫内膜炎症细胞增生,促进其病变上皮细胞增生修复;降低全血黏度、红细胞压积及血浆黏度.与正常对照组比较,精制妇科千金片高、中、低剂量组和金鸡胶囊组大鼠血清中6-Keto-PGF1α含量显著升高,MDA含量明显下降.结论 精制妇科千金片对大肠埃希菌所致大鼠慢性子宫内膜炎有治疗作用,该治疗作用可能是通过改善血液流变性,提高炎症后血清中6-Ke-to-PGF1α含量,降低血清中MDA含量实现的.     

喉癌的超声表现1例

患者男 ,6 3岁。因声音嘶哑 ,吞咽疼痛两个月而来院就诊。查体 :体温 ,脉搏 ,血压正常 ,心肺无异常。颈部超声检查 :双叶甲状腺未见异常 ,于甲状软骨及环状软骨的后方探及 3.0 cm× 1.4cm× 1.3cm左右的实性不均质占位 ,边界尚清 ,表面不光滑 ,实质回声偏强不均 ,部分凸出于甲状软骨下方。实质内探及少量的低速动脉血流信号 (图 1)。于右锁骨上窝探及两个大小不等的肿大淋巴结 ,大者 2 .2 cm× 1.3cm。其它部位未探及肿大淋巴结及异常声像。超声诊断 :喉部实性占位 ,考虑喉癌。经手术后病理诊断 :喉鳞状细胞癌图 1　喉癌 (T:喉癌。T前方强…