瘘管切除合并内口结扎治疗肛瘘临床疗效分析(附74例报告)

目的观察瘘管切除合并内口结扎治疗肛瘘的临床疗效。方法选择74例内口在肛管齿线附近的肛瘘患者,采用将瘘管完全剥离切除,内口盲端结扎的方法手术的临床资料作回顾性分析。结果 74例患者全部一次性治愈,住院时间为12~23d,完全愈合时间为22~47d。痊愈后肛门外观无缺损、移位等改变,生理功能正常。3例患者早期有少许黏液泄漏,8~10周后症状消失,肛门无失禁。结论采用瘘管切除合并内口结扎的手术方法治疗肛瘘彻底,治愈率高,疗效确切,无肛瘘再次复发。     

艾滋病元素医学食疗中心

笔者自2003年至2006年用元素医学食疗法治疗40余例艾滋病获突破，其中完全治愈两人，一个5岁小女孩、一个是65岁老人。2006年5月40岁中年妇女，在进行Hiv病毒抗体检验开始转阴，病人为生活所迫外出打工终止食疗，于6月份再7欠进行Hiv病毒抗体检验又转变为阳性。笔者于是决定对即将痊愈艾滋病人集中食疗，效果非常有效，建立艾滋病元素医学食疗中心是个好办法。     

正交试验优选益气固脱颗粒醇提工艺研究

摘 要 目的： 优选益气固脱颗粒醇提工艺。方法: 以正交设计的试验方法,对组方中有效成分黄芪甲苷、阿魏酸用HPLC法进行定量分析,选取L₉(3⁴)正交表,考察乙醇浓度、乙醇用量、提取次数、提取时间等工艺参数对益气固脱颗粒提取量的影响。结果:方差分析表明,乙醇浓度与提取次数对浸出物的含量及阿魏酸的提取有显著影响。最佳醇提工艺即加10倍量的70%的乙醇,提取3次,每次1.5 h。结论: 该工艺稳定可行,适于工业生产。     

基于Citespace的动态血压监测研究热点可视化分析

目的 分析近10年动态血压监测应用的研究热点以及现状,为临床研究开展提供相关参考。 方法 检索Web of science核心合集数据库2011~2020年发表的动态血压监测研究文献,通过Citespace软件对已发表文献进行研究机构、作者、国家以及关键词等共现分析,绘制知识图谱。 结果 共纳入3480篇文献,总体呈现逐年上升的趋势。发文量最多的是KAZUOMI KARIO,以77篇排名第一,以及其合作网络较为稳定。发文高产机构排名第一的是米兰比可卡大学,其次为哥伦比亚大学,机构合作网络显示出地理优势。对97个高频关键词进行聚类分析,最终形成8个聚类标签涵盖了ABPM的运用目的以及评价指标。 结论 Citespace软件直观展示了动态血压监测目前研究的热点和成果,为我国的研究提供借鉴和帮助,对ABPM的发展具有积极意义。     

非瓣膜性房颤患者右心耳右心房超声特征与心肌细胞凋亡关系的研究

目的研究非瓣膜性心房纤颤（NV-AF）右心耳（RAA）及右心房超声特征与心房肌细胞凋亡的关系。方法采用经食管超声观察25例NV-AF患者（观察组）和15例窦性心律者（对照组）的RAA及右心房变化,心肌细胞原位末端标记法（TUNEL法）检测RAA的心肌细胞凋亡指数。结果观察组RAA耳充血、排血峰速及速度积分、RAA及右心房射血分数均较对照组显著减小,RAA面积增大,心房肌细胞凋亡指数增高（P〈 0．05）。RAA内自发性超声造影（SEC）现象检出率占16％,RAA及右心房内未发现血栓。对照组未检出SEC或血栓。相关分析显示,心房肌细胞凋亡指数与RAA充流、排血峰速、RAA及右房射血分数呈负相关（P均〈 0．05）,而与RAA及右心房面积呈正相关（P均〈0．05）,与右心室射血分数无相关性（P〉0．05）。结论NV-AF患者的RAA及右心房改变与心房肌细胞凋亡密切相关,心肌细胞凋亡是其病理过程的中间或基础环节之一。     

Adult hippocampal neurogenesis in the context of lipopolysaccharide-induced neuroinflammation: A molecular,cellular and behavioral review

The continuous generation of new neurons occurs in at least two well-defined niches in the adult rodent brain. One of these areas is the subgranular zone of the dentate gyrus (DG) in the hippocampus. While the DG is associated with contextual and spatial learning and memory, hippocampal neurogenesis is necessary for pattern separation. Hippocampal neurogenesis begins with the activation of neural stem cells and culminates with the maturation and functional integration of a portion of the newly generated glutamatergic neurons into the hippocampal circuits. The neurogenic process is continuously modulated by intrinsic factors, one of which is neuroinflammation. The administration of lipopolysaccharide (LPS) has been widely used as a model of neuroinflammation and has yielded a body of evidence for unveiling the detrimental impact of inflammation upon the neurogenic process. This work aims to provide a comprehensive overview of the current knowledge on the effects of the systemic and central administration of LPS upon the different stages of neurogenesis and discuss their effects at the molecular, cellular, and behavioral levels.     

Effect of Dihydrotestosterone on Costimulatory Molecules in a Mouse Model of Graves' Disease

Objective Graves’ disease is the most common autoimmune thyroid disease and its prevalence and clinical manifestations are disparate between females and males. Costimulatory molecules play an essential role in regulating autoimmune responses. The objective of this study was to determine if expression of inhibitory molecules was correlated with treatment by dihydrotestosterone (DHT) in an in vivo BALB/c mouse model of experimental autoimmune Graves’ disease.Methods Female BALB/c mice were immunized three times with thyroid stimulating hormone receptor A-subunit encoded by adenovirus to establish a Graves’ disease model. Three different doses of DHT or a matching placebo were administered by implantation of slow-release pellets a week before the first immunization. Four weeks after the third immunization, the mice were euthanatized, and then the spleen and thymus were removed. Total thyroxine and free thyroxine levels in serum of mice were detected using a radioimmunoassay kit. Real-time polymerase chain reaction was performed to estimate the expression of costimulatory molecules in lymphocytes from the spleen and thymus. Flow cytometry was used to analyze the percentage of CD4⁺ T cells in splenic lymphocytes. Quantitative data were compared with unpaired t-tests. Correlation between two variables was analyzed using Analysis of Variance.Results Treatment with DHT can dramatically reduce total thyroxine and free thyroxine levels. Higher expression of programmed death-1 was found in the spleen of Graves’ disease mice receiving 5 mg of DHT treatment (0.635±0.296 vs. 0.327±0.212; t=2.714, P=0.014), similarly, T-cell immunoglobulin domain and mucin domain 3 (TIM-3) in both the spleen (1.004±0.338 vs. 0.646±0.314; t=2.205, P=0.022) and the thymus (0.263±0.127 vs. 0.120±0.076; t=3.221, P=0.004) also increased after 5 mg of DHT treatment compared with the parallel placebo model mice. Moreover, the percentage of CD4⁺ T cells declined in the splenic lymphocytes of Graves’ disease mice treated with 5 mg of DHT (19.90%±3.985% vs. 24.05%±2.587%; t=2.804, P=0.012). A significant negative association was observed between expression of TIM-3 in the spleen and serum levels of total thyroxine (r=-0.7106, P=0.014) as well as free thyroxine (r=-0.6542, P=0.029).Conclusion This study demonstrates that DHT can ameliorate experimental autoimmune Graves’ disease, which may occur by up-regulating expression of programmed death-1 and TIM-3 and inhibiting development of CD4⁺ T cells.     

老年高血压患者血压节律变化与靶器官损害的关系

目的 探讨老年高血压患者血压节律变化与靶器官损害的关系. 方法 70例老年高血压患者均行24h动态血压检测、颈动脉超声和超声心动图检查,根据24 h动态血压检测结果分为2组:勺形组40例及非勺形组30例,并对2组颈动脉粥样硬化(CAS)、左室肥厚(LVH)及动态血压各参数进行比较. 结果 CAS及LVH检出率非勺形组均高于勺形组(P＜0.01);2组间24 h平均收缩压(24hSBP)及舒张压(24hDBP)、24 h收缩压和舒张压负荷值(24hSBPL、24hDBPL),差异无统计学意义(P＞0.05).勺形组白天平均收缩压(dSBP)及舒张压(dDBP)、白天收缩压和舒张压负荷值(dSBPL、dDBPL)高于非勺形组(P＜0.05).勺形组夜间平均收缩压(nSBP)及舒张压(nDBP)、夜间收缩压和舒张压负荷值(nSBPL、nDBPL)明显低于非勺形组(P＜0.01). 结论 老年高血压患者血压节律变化的消失与靶器官损害关系密切,高血压患者降压治疗的同时还需纠正紊乱的血压昼夜节律.     

IgG4相关系统性疾病的肾脏损害

IgG4相关系统性疾病(IgG4-related systemic disease,IgG4-RSD)是一组最近认识的临床综合征,可累及多个器官,胰腺最常受累,主要表现为血清IgG4升高,受累组织弥漫IgG4阳性浆细胞浸润。本文主要介绍IgG4-RSD累及肾脏时的临床表现、影像学、实验室检查、病理特点及治疗情况。     

腹腔镜腹膜外乙状结肠造口的制作及应用

目的探讨腹腔镜下腹膜外乙状结肠造口的安全性和可行性。方法前瞻性入组2011年7月至2012年7月间南京中医药大学第三附属医院肛肠中心收治的36例行腹腔镜腹会阴联合切除术的低位直肠癌患者,按随机数字表法分为腹膜内造口组和腹膜外造口组,每组18例。术后随访4～16（中位7）月,比较两组患者造口并发症情况。结果腹膜外造口组1例患者因乙状结肠近端拖出后肠壁血供障碍而改行腹膜内造口,故后续的分析中予以剔除。腹膜外造口组手术时间[（25．3±8．5）min]稍长于腹膜内造口组[（14．7±6．4）min],但差异无统计学意义（P〉0．05）。两组各有1例术后早期（4周以内）出现造口缺血,均行造口重建手术;腹膜外造口组术后造口水肿发生率明显高于腹膜内造口组[35．3％（6／17）比0,P〈O．05];两组术后早期总并发症发生率差异无统计学意义[58．8％（10／17）比27．8％（5／18）,P〉O．05]。腹膜外造口组后期（超过4周）未出现并发症;腹膜内造口组出现1例造口脱垂、1例造口狭窄和2例造口旁疝,并发症发生率为22．2％（4／18）,两组比较,差异有统计学意义（P〈0．05）。结论腹腔镜腹膜外乙状结肠造口操作并不比腹膜内造口复杂。且其后期造口并发症明显少于腹膜内造口。