Minilaparotomy for type II and III radical hysterectomy: technique, feasibility, and complications

The objective was to assess the feasibility, the operative and postoperative outcome, and complications in the use of minilaparotomy for type II and III radical hysterectomy (RH) and pelvic lymphadenectomy (PLN) in early-stage cervical/endometrial cancer. A pilot study on 91 consecutive patients submitted to type II and III RH and PLN for early-stage cervical/endometrial cancer was performed between March 2002 and May 2003 in the Division of Gynecologic Oncology (UCSC, Rome). Thirty-two of 91 cases (35.2%) were eligible for minilaparotomy. The mean operative time was 156.7 min, whereas the mean intraoperative estimate of blood loss was 303.7 ml. A mean number of 32.7 pelvic lymph nodes and 6.2 common iliac nodes were removed. Ileus and removal of bladder catheter were on mean postoperative day 2.4 and 3.4, respectively. The mean number of postoperative days spent in the hospital was 3.7. Intra- and postoperative parameters were compared to laparotomy controls and literature data on laparoscopy and Pfannenstiel incision, showing substantially comparable results. Minilaparotomy is acceptable for selected patients undergoing radical abdominal hysterectomy (RAH) and PLN and does not compromise the adequacy of the procedure. It can be considered as an alternative to the classic midline vertical incision or even to the Pfannenstiel incisions and laparoscopy.     

猪喉软骨硫酸软骨素的制备和自由基清除活性

直接用木瓜蛋白酶水解软骨,三氯醋酸除蛋白质,乙醇沉淀干燥得硫酸软骨素粗多糖,经DEAE-Sepharose fast flow离子交换层析分离纯化,高效凝胶渗透色谱和琼脂糖凝胶电泳测定其相对分子质量和纯度,比较硫酸软骨素粗品和纯品的体外自由基清除活性。结果显示硫酸软骨素粗品和纯品提取率分别为31.56±0.46%和19.79±0.78%,后者相对相对分子质量为75 174,粗品的DPPH.和.OH清除活性最强,随着产品纯度的提高,活性降低,而对于O2-.清除活性结果则相反。     

二乙基二硫代氨基甲酸钠对沙土鼠脑缺血再灌注损伤的影响

沙土鼠脑缺血60min后,脑组织氧自由基和MDA含量无明显升高,而Mn-SOD的活性下降。缺血60min再灌注5min时,氧自由基显著升高。再灌注30min时,MDA的生成显著增多,Mn-SOD和Cu,Zn-SOD活性显著降低。缺血前15 min,iv DTC对缺血再灌注脑组织中氧自由基和MDA升高有显著抑制作用,对Mn-SOD活性有显著保护作用,且呈剂量依赖关系。     

大气颗粒物健康效应生物学机制研究进展

大量流行病学研究发现，大气颗粒物的污染水平与心肺系统疾病的超额发病、死亡存在密切关联，但其毒理学机制尚未阐明。本文对近年来大气颗粒物毒理学研究进行综述，包括大气颗粒物对呼吸系统、心血管系统及神经系统的毒性作用，并对氧化应激损伤、细胞钙稳态失衡及激活关键转录因子等分子毒理学机制进行了初步的阐述。     

牛磺酸对应激大鼠心肌损伤的保护机制

以异丙肾上腺素诱导的大鼠应激为模型，研究牛磺酸对心肌及血清中自由基系统与游离脂肪酸含量组成的影响。与对照组比较，结果Ｉｓｏ组心肌中ＦＲ、ＬＰＯ、ＣＫ、ＬＤＨ、Ｃ１６：０、Ｃ１８：０、Ｃ１８：１、ＦＦＡ与Ｃ１８：０／ＦＦＡ值显著升高，ＳＯＤ、Ｃ１８：３、Ｃ２０：４ＰＵＦＡ／ＦＦＡ值显著降低；血清中ＬＰＯ、ＣＫ、Ｃ１６：０、Ｃ１８：１、ＦＦＡ值显著升高，Ｃ１８：３、Ｃ２０：４、ＰＵＦＡ／ＦＦＡ及ＳＯＤ值呈下降趋势，牛磺酸对纠正应激引起的上述变化有显著作用，结果提示牛磺酸可通过减少自由基产生，增加抗氧化酶活性来减少脂质过氧化反应，维持细胞膜完整，影响心肌中ＦＦＡ含量及组成，保护心肌免受应激损伤。     

卡托普利对.OH所致异常血流动力学的保护作用

．ＯＨ生成液０．０５ｍｌ．１００ｇ＾－１经胶静脉注入心脏，可使麻醉大鼠的左心室收缩压力、左心室压力与心率乘积、左心室压力上升最大速率和左心室压力下降最大速率明显下降。     

生姜对超氧阴离子及羟自由基的清除作用

生姜对次黄嘌呤-黄嘌呤氧化酶体系产生的超氧阴离子及紫外线照射H₂O₂体系产生的羟自由基均有显著清除作用。提示生姜对活性氧的清除可能是其重要的药理机制之一。     

Surgical results of performing R4 gastrectomy for gastric cancer located in the upper third of the stomach

Because gastric cancers located in the upper third of the stomach are difficult to detect at an early stage, the surgical results remain poor. We performed R4 gastrectomy as a radical procedure for 25 patients, involving complete resection of the latero-aortic and interaorticovenous lymph modes above and below the left renal vein, in combination with the ordinary R2 or R3 gastrectomy (the R4 group). These patients were compared with 156 others who underwent R2 gastrectomy alone (the R2 group). There were no significant differences in operation time, blood loss, or the incidence of complications between the two groups; however, when the survival rates of the patients with tumors invading beyond the subserosa were compared, the 5-year survival rate was found to be significantly higher in the R4 group than in the R2 group. Furthermore, in patients with para-aortic nodal involvement, a significant survival advantage was observed in the R4 group, as compared with the R2 group. These results suggest that the R4 gastrectomy is a rational approach for patients with advanced gastric cancer located in the upper third of the stomach.     

超氧化物歧化酶对窒息幼兔脑组织的保护作用

将３２只新西兰种幼兔随机分为对照组、室息组、窒息＋ＳＯＤ组。各组均于实验开始后２４小时心脏取血查ＬＰＯ、ＳＯＤ和ＧＳＨ－Ｐｘ、并取脑组织测脑水分含量。窒息组与对照组比较，血清ＬＰＯ、脑水分含量明显增高、（Ｐ均＜０．０１），血中ＳＯＤ、ＧＳＨ－ＰＸ活性明显降低（Ｐ均＜０．０１），窒息组ＬＰＯ与脑水分含量呈正相关关系。室息＋ＳＯＤ组与室息组比较，血清ＬＰＯ、脑水分含量明显减少（Ｐ均＜０．０１），ＧＳＨ－Ｐｘ活性增高（Ｐ＜０．０１）。提示ＯＦＲ参与了窒息所致脑损伤的病理过程，外源性ＳＯＤ可对室息幼兔脑组织起保护作用。     

亚低温配合自由基清除剂治疗脑梗死的临床研究

目的探讨亚低温与自由基清除剂治疗脑梗死的方法和疗效。方法139例脑梗死患者随机分为3组,对照组47例常规治疗;治疗组1:46例采用亚低温治疗;治疗组2:46例给予亚低温配合自由基清除剂治疗。分别评定治疗前后的神经功能缺损评分(NDS)、重要脏器功能指标及预后。结果与对照组相比:亚低温治疗能提高患者治疗有效率(P<0.01),降低NDS(P<0.05)和血乳酸水平(P<0.01),亚低温配合自由基清除剂治疗能显著提高患者治疗有效率(P<0.01),降低NDS(P<0.01)和血乳酸水平(P<0.01),并能显著降低患者肝、肾功能不全和心律失常的发生率(P<0.01 VS对照组);结论亚低温配合自由基清除剂辅助脑梗死的综合治疗可明显改善患者预后、提高患者治疗有效率,降低并发症,值得临床推广。