不同手术时机腹腔镜胆囊切除对老年急性胆囊炎患者术后疗效和康复的影响

目的探究不同手术时机腹腔镜胆囊切除对老年急性胆囊炎患者术后疗效和康复的影响。 方法采用回顾性分析法,选取2013年9月至2017年9月收治的行腹腔镜胆囊切除术的老年急性胆囊炎患者,将发病48h后实施手术的59例患者作为延期组,将发病48 h以内实施手术的59例患者作为早期组。采用SPSS19.0进行数据统计分析,两组术中术后各项指标、CD3^＋、 CD4^＋用( ±s)表示,行独立t检验;两组并发症发生率行χ²检验,P<0.05为差异有统计学意义。 结果早期组手术时间、术中出血量、肛门排气时间、住院时间均短于延期组(P<0.05);早期组术后1 d、 2 d、4 d的CD3^＋、 CD4^＋指标均高于延期组(P<0.05);早期组穿孔、感染、坏疽、腹腔内出血、胆管损伤发生率均低于延期组,差异均有统计学意义(P<0.05)。 结论老年急性胆囊炎患者于病发后48 h内进行腹腔镜胆囊切除术,可有效促进机体康复,提高免疫能力,降低术后严重并发症发生率,值得推广。     

高效液相色谱法测定人血浆中奥氮平的浓度

目的探讨高效液相色谱法测定人血浆中奥氮平浓度的方法及效果。方法抽取临床服用奥氮平患者的静脉血为样本,样本处理后采用Agilent 1260型高效液相色谱仪, G1314B紫外检测器检测,色谱柱为InfinityLab Poroshell 120 SB-C8(150 mm×4.6 mm×2.7μm),流动相为:V(十二烷基硫酸钠,磷酸二氢钠pH 2.5)∶V(乙腈)=1∶1的溶液。检测波长为260 nm,流速1.0 ml/min,柱温35℃。结果血浆中奥氮平的平均回收率为96.61%,测定结果的日内平均相对偏差为6.70%(n=15),日间平均相对偏差为7.60%(n=15)。结论所建立的高效液相色谱法适用于奥氮平临床应用研究中血药浓度的监测。     

PEBP4 enhanced HCC827 cell proliferation and invasion ability and inhibited apoptosis

The purposes of this study were to investigate the effects of phosphatidylethanolamine-binding protein 4 (PEBP4) on the cell growth, proliferation, apoptosis, and invasion of non-small cell lung cancer (NSCLC) cells and to provide evidence for future treatment options for NSCLC. Western blot assays were performed to examine PEBP4 protein expression levels in NSCLC cell lines (HCC827, A549, NCI-H661, NCI-H292, and 95-D) and a normal human bronchial epithelial (HBE) cell line. A PEBP4 shRNA expression vector was constructed and transfected into HCC827 cells. Subsequently, the effects of PEBP4 on the cell viability, cell cycle distribution, apoptosis levels, and invasion properties of HCC827 cells were analyzed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays, flow cytometry analyses, and transwell invasion assays. In addition, the effects of PEBP4 on the expression of proteins including cyclin D1, p53, Bcl-2, MMP-2, and MMP-9 were investigated. PEBP4 was highly expressed in lung cancer cells (HCC827, A549, NCI-H661, NCI-H292, and 95-D), but its expression was low in HBE cells. Cell viability, cell proliferation, and invasion of HCC827 cells in the PEBP4 knockdown group were significantly lower than that in the negative control and blank control groups (p?<?0.05), and there were no significant differences between the negative and blank control groups in terms of cell viability, cell proliferation, apoptosis, and invasion. In HCC827 cells, the expression levels of cyclin D1, Bcl-2, MMP-2, and MMP-9 in the PEBP4 knockdown group were significantly lower (p?<?0.05), and the expression of p53 protein was significantly higher than that in the negative and blank control groups (p?<?0.05). There were no significant differences between the negative and blank control groups in the expression levels of cyclin D1, p53, Bcl-2, MMP-2, and MMP-9. In conclusion, PEBP4 enhanced HCC827 cell proliferation and invasion ability and inhibited apoptosis. Decreased PEBP4 expression may play a role in the reduced invasion ability and increased apoptosis of the human NSCLC cell line HCC827.     

Relationship Between Gastric Cancer Tau Protein Expression and Paclitaxel Sensitivity

The abnormal expression of Tau protein in breast cancer tissue affects paclitaxel sensitivity. The abnormal expression also exists in gastric carcinoma. Therefore, we speculate that the expression levels of Tau protein is closely related to paclitaxel sensitivity in gastric cancer, thus affecting the efficacy of paclitaxel. In this study, we used immunohistochemical methods to detect Tau protein expression levels in 47 cases of gastric cancer specimens. We also used Western blot to detect the level of Tau protein expression in gastric cancer cell lines and to check the efficacy of paclitaxel in vitro application. Findings indicate that Tau protein expression rate can reach as high as (+ +–+ + +) 63.83 % in gastric cancer. Paclitaxel induces inhibition and apoptosis with low expression of Tau protein in gastric cancer cell lines (P?<?0.05). The level of Tau protein expression is significantly correlated with paclitaxel efficacy. If confirmed by further studies, the Tau protein can be another useful marker of gastric cancer, thereby leading to the application of paclitaxel in cancer treatment.     

下肢动脉栓塞30例临床护理研究

目的探讨下肢动脉栓塞取栓术的术后护理体会。方法 2009~2012年共收治下肢动脉栓塞30例患者临床资料进行分析,对护理效果进行分析和总结。结果 30例患者全部存活。3例患者出现下肢神经缺血导致足背屈欠佳,5例患者术后出现单个或多个足趾不同程度坏死,后经截肢治疗后恢复良好。结论通过采取及时的治疗和精心的护理,下肢动脉栓塞患者在取栓术换后可得到良好的恢复。     

国产、进口生长抑素治疗急性胰腺炎的成本-效果分析

目的比较国产、进口生长抑素治疗急性胰腺炎的成本-效果比。方法将患者分为两组,A组用国产生长抑素治疗＋基础治疗;B组用进口生长抑素治疗＋基础治疗。应用药物经济学的成本-效果分析方法,对两组治疗急性胰腺炎的疗效及成本进行评价。结果 1个疗程结束时,国产生长抑素和进口生长抑素的疗效无显著差异（P〉0.05）,有效率分别为85.71%和89.47%,两组腹痛缓解时间、血淀粉酶恢复时间和血白细胞恢复时间差异不明显;A组成本显著低于B组（P〈0.05）,成本-效果比分别为1 066.16和2 901.98,相差1 835.82。两组的不良反应较少且无明显差异。结论应用国产生长抑素治疗急性胰腺炎价格相对低廉,成本-效果比优于进口生长抑素。     

αB-晶状体蛋白在糖尿病视网膜病变患者晶状体上皮细胞中的表达

目的　探究糖尿病视网膜病变（DR）患者晶状体上皮细胞（LEC）中αB-晶状体蛋白的表达及其与DR发生发展的关系。方法　选取东南大学附属中大医院眼科2018年5月至2019年4月收治的年龄相关性白内障和糖尿病并发性白内障患者98例（98眼）,根据血糖及眼底检查将其分为非糖尿病（NDM）组、非糖尿病视网膜病变（NDR）组、非增生型糖尿病视网膜病变（NPDR）组和增生型糖尿病视网膜病变（PDR）组,均进行超声乳化白内障吸除联合人工晶状体植入术,分别收集四组患者晶状体前囊膜,采用免疫荧光染色检测、Western blot检测患者LEC中αB-晶状体蛋白的分布及表达水平。结果　αB-晶状体蛋白在LEC细胞核及细胞质中均有表达。免疫荧光染色结果显示,NDM组、NDR组、NPDR组、PDR组患者LEC中αB-晶状体蛋白的阳性表达率逐渐增高（P<0.001）;与NDM组相比,NPDR组、PDR组患者LEC中αB-晶状体蛋白的阳性表达率均显著升高,差异均有统计学意义（均为P<0.05）;PDR组患者LEC中αB-晶状体蛋白的阳性表达率高于NDR组,差异有统计学意义（P<0.05）;余组间两两比较差异均无统计学意义（均为P>0.05）。Western blot检测结果显示,NDM组、NDR组、NPDR组和PDR组患者LEC中αB-晶状体蛋白的相对表达量分别为2.02±0.83、2.30±0.79、3.94±1.15和 5.69±1.23,四组患者间差异有统计学意义（P<0.01);NDR组患者与NDM组患者LEC中αB-晶状体蛋白相对表达量差异无统计学意义（P>0.05）; NPDR组患者LEC中αB-晶状体蛋白相对表达量均明显高于NDM、NDR组,差异均有统计学意义（均为P<0.05）;而PDR组患者LEC中αB-晶状体蛋白相对表达量均高于其余三组,差异均有统计学意义（均为P<0.05）。结论　LEC中αB-晶状体蛋白的表达水平与DR的发生发展正相关。αB-晶状体蛋白可能通过参与眼内新生血管的形成,对DR的发生发展起促进作用。     

包皮环切结合吻合器的应用治疗包皮过长

目的：探讨使用一次性包皮环切吻合器治疗包茎、包皮过长的临床应用效果。方法：随机将220例包茎、包皮过长患者分成一次性包皮环切吻合器（A组,112）与常规包皮环切（B组,108）两组,比较其优缺点及疗效。结果：A组比B组的手术时间短、出血少、术后不需拆线、术后感染率低、术后创缘整齐,外形美观。结论：应用一次性包皮环切吻合器行包皮环切术,手术简单,并发症少,患者痛苦小,易推广。     

肿瘤科护士健康影响因素与干预措施

从影响肿瘤科护士健康的化学性因素、心理社会因素、物理和生物等因素进行深入分析,并提出干预措施,从而营造和谐、健康、安全的工作环境,确保护理人员的职业安全。