肠易激综合征血清中降钙素基因相关肽的变化

目的探讨降钙素基因相关肽(CGRP)在肠易激综合征(IBS)中的变化,为进一步探讨其在IBS中的作用提供证据。方法 SPF级大鼠30只,随机分为3组:模型组大鼠以0.85 mL含三硝基苯磺酸(TNBS)的50%乙醇灌肠1次诱发远端结肠炎,对照组仅以等体积的生理盐水灌肠,正常组不作处理。正常饲养30 d后处死。造模前后均以腹部回撤反射(AWR)测定内脏感觉阈值用以评价模型。造模成功后行心脏取血,以ELISA试剂盒测定血清中CGRP浓度。结果 TNBS灌肠法复制模型成功,腹部回撤反射内脏感觉阈值测定模型组造模后内脏感觉阈值较造模前及正常组下降(P<0.05)。模型组血中CGRP浓度较对照组及正常组明显升高(P<0.05),对照组较正常组中CGRP浓度也有升高但差异无统计学意义(P>0.05)。结论模型组血清中CGRP浓度升高,可能在IBS的发生中起着一定作用。     

欧洲癌症研究与治疗组织风险评分表在非肌层浸润性膀胱尿路上皮癌中的临床应用初探

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.     

助力健康中国 寻找“互联网+医疗健康”行业实践者

正近日,由人民日报社指导,人民网、健康时报联合主办的第十一届健康中国(2018年度)论坛在北京举行。原国务委员、十一届全国人大常委会副委员长陈至立,国家卫生健康委员会副主任王贺胜,人民日报社副总编辑卢新宁等相关单位领导及院士专家、医院院长、顶级学者、产业代表、主流媒体等近千人参与本届论坛。卢新宁副总编辑在开幕式致辞中对人民系构建大健康融媒体平台提出期望。她说,健康媒体要努力融入中国乃至世     

后腹腔镜下肾输尿管全切术治疗肾结核的临床分析

目的 探讨后腹腔镜下肾输尿管全切除术治疗肾结核的可行性和安全性.方法 2005-2009年收治肾结核病患者28例.男18例,女10例.年龄26～51岁,平均36岁.左侧16例,右侧12例.术前经尿查抗酸杆菌、IVU、CT、B超及核素肾图等检查明确诊断为单侧无功能或重度受损肾结核,对侧肾功能正常.术前常规给予异烟肼、利福平和乙胺丁醇三联抗结核用药2周～6个月,无活动性肾外结核,红细胞沉降率正常后行后腹腔镜下肾输尿管全切除术.术中以下腔静脉和左侧输尿管为解剖标记寻找肾蒂血管,以患肾脂肪囊外平面作为游离平面.结果 28例手术均获成功,无中转开放病例.手术时间121～258 min,平均170 min;术中出血量70～250 ml,平均110 ml;术后住院5～14 d,平均5.7 d.术中损伤腹膜3例,术后切口感染2例,术后继续抗结核治疗3个月.24例随访6～20个月,平均12.5个月.患者尿路刺激症状消失,尿常规、红细胞沉降率正常,尿查抗酸杆菌阴性,B超复查对侧肾、输尿管及膀胱等未见结核病灶残留.结论 后腹腔镜下肾输尿管切除术治疗肾结核安全可行,术中通过辨认解剖标记结扎肾蒂血管和沿正确的平面游离患肾是手术成功的关键.

Abstract：

Objective To discuss the feasibility and safety of retroperitoneal laparoscopic nephrectomy for treatment of kidney tuberculosis. Methods From March 2005 to February 2009, 28 patients with kidney tuberculosis underwent retroperitoneal laparoscopic nephrectomy. The patients′ data were reviewed and analyzed. Results There were 18 men and tencwomen with an average age of 36 (26-51) in the cohort. Sixteen patients had lesions on the left kidney and 12 on right kidney. All patients had a normal renal function on the contra lateral side. The severely impaired renal function of the lesion side was confirmed before operation. Anti-tuberculosis chemotherapy was administered to patients for two weeks to six months in advance of the surgery. No active lesion of tuberculosis was found and ESR level was normal before operation. All the operations were successfully performed without switching to open surgery. The average operative time was 170 (121-258) minutes, blood loss was 110 (70-250) ml and average postoperative hospital stay was 5.7 (5-14) days. Peritoneum injury was seen in three patients and incision infection in two patients. No severe complications were observed. Anti-tuberculosis chemotherapy was continued for three months. Twenty-four patients were followed-up, and the average follow-up time was 12.5 (6-20) months. All patients recovered without any lesion remaining. Conclusions Retroperitoneal laparoscopic nephrectomy could be a safe and reliable method for the treatment of non-functioning kidney due to tuberculosis.     

短刺小克银汉霉AS 3.153菌株对安非他酮的代谢转化

目的寻找适用体外转化安非他酮的微生物菌株及采用此菌株制备吗啉环羟基化安非他酮纯品的可能性。方法首先采用液相色谱-质谱测定4种小克银汉霉对安非他酮的转化能力,确定菌株,再利用最佳菌株,采用高效液相色谱-多级质谱联用法检测转化液中安非他酮的代谢产物,并针对代谢产物2(M2)的转化进行了培养基初始pH值6水平(分别为6.0,6.5,7.0,7.5,8.0和8.5),底物浓度4水平(分别为0.025,0.05,0.1和0.2g·L-1),转化时间5水平(分别为72,96,120,144和168h)等转化条件的单因素考察,以及采用四因素三水平的正交试验设计对安非他酮进一步优化转化条件。结果根据液相色谱和质谱数据,经短刺小克银汉霉AS3.153转化,安非他酮主要形成单羟基化安非他酮和单羟基化安非他酮的硫酸结合物等3种转化产物,对M2进行分离纯化,根据质谱和核磁共振数据,确证代谢产物M2为吗啉环羟基化安非他酮。M2的最优转化条件为采用短刺小克银汉霉AS3.153培养基、初始pH8.0、底物浓度0.1g·L-1和转化时间168h时转化产率最高。结论短刺小克银汉霉AS3.153对安非他酮的转化与人体代谢结果相同,说明此菌株适宜作为研究人体药物代谢的体外模型,采用此模型及相应的优化转化条件可以制备M2纯品。     

粪菌移植治疗非酒精性脂肪性肝病研究进展

非酒精性脂肪肝病（non-alcoholic fatty liver disease, NAFLD）的发病率在世界范围内呈明显上升趋势,由于目前尚无确切的特效治疗方式,严重影响人类健康。近年来,越来越多的研究表明肠道菌群通过肝-肠轴影响肝功能,肠道菌群失调是NAFLD发病的重要原因。因此,纠正肠道菌群失调,可以预防和减轻NAFLD的发生、发展。粪菌移植（fecal microbiota transplantation, FMT）被认为是纠正肠道菌群失调最有效的方法,但其在NAFLD中的治疗作用还未明确。此外,FMT治疗NAFLD的潜在分子机制也尚未阐明。本文就FMT治疗NAFLD的研究现状进行总结,并发掘其潜在的分子机制,为FMT作为治疗NAFLD的有效手段提供理论支持。     

环形电刀切除术在治疗宫颈病变中的临床应用

作者从21305年1月起应用环形电刀切除术（LEEP）手术治疗117例各种类型宫颈病变，短期观察疗效满意，现报告如下。1资料与方法1．1一般资料选择2005年1月至2006年9月在我院妇科门诊经妇科检查、阴道镜及宫颈活检初步诊断为慢性宫颈炎（包括宫颈息肉）67例，宫颈湿疣8例，各级宫颈上皮瘤样病变（CIN）42例，共计117例。患者年龄21—56岁，平均（37±7．8）岁。     

微创外科治疗肾上腺肿瘤进展

腹腔镜技术是肾上腺肿瘤主要的微刨治疗手段。大部分的肾上腺疾病可以用腹腔镜手术来治疗．在手术失血量、输血率、术后进食时间、术后住院时间和术后恢复工作时间等方面体现了比开放手术突出的优越性。但是对于在恶性肿瘤和嗜铬细胞瘤的治疗，以及如何进一步减少并发症与复发率方面还需继续探讨。     

一次性采血针对小儿股静脉穿刺采血的效果观察

目的 为协助诊治，短时间内完成静脉穿刺采血，提高小儿股静脉穿刺采血的成功率，减少反复穿刺的痛苦，避免对其邻近器官的损伤。方法 选择220例29天～3岁的患儿，做股静脉穿刺采集血标本，观察组110例使用一次性采血针，对照组110例使用一次性注射器，比较两种方法的一次穿刺成功率。结果 一次性采血针组一次性穿刺成功102例，出现淤血或小血肿8例，一次性注射器组一次性穿刺成功86例，出现淤血或小血肿24例。结论 使用一次性采血针进行股静脉穿刺采血成功率高于使用一次性注射器。