盐酸氨溴索治疗小儿支气管肺炎的临床分析

目的分析研究盐酸氨溴索用于小儿支气管肺炎的临床效果。方法将本院2017年12月—2018年12月期间收治的小儿支气管肺炎患儿88例按照随机双盲法均分为对照组和治疗组,予以对照组44例患儿常规治疗,予以治疗组44例患儿常规治疗联合氧气驱动雾化吸入盐酸氨溴索治疗,对两组患儿的临床疗效和临床症状缓解时间进行对比。结果与对照组相比,治疗组患儿咳嗽、咳痰、胸片改善时间及肺部干湿啰音缓解时间均显著短于对照组,组间差异具有统计学意义(P<0.05),治疗组的临床总有效率为95.45%(42/44),明显高于对照组77.27%(34/44),组间差异具有统计学意义(P<0.05)。结论小儿支气管肺炎在临床常规治疗的基础上加用盐酸氨溴索治疗有助于患儿临床症状的缓解,效果明显。     

层面递进法激光腔内剜除高危前列腺增生的治疗体会

目的探讨1 470 nm激光剜除治疗高危前列腺增生的手术技巧及临床效果。 方法回顾分析2018年6月至2018年9月中山大学附属第三医院泌尿外科采用1 470 nm激光治疗共89例高危前列腺增生患者的临床资料，年龄平均（68±3）岁，前列腺体积（57.4±2.6）ml。所有患者均采用"寻找层面，先易后难，剜切结合"的层面递进法思路行激光腔内前列腺剜除术，比较患者术中及术后情况。 结果89例均顺利完成手术，与术前相比，术后3个月患者最大尿流率明显增加，[（6.9±2.1） ml/s vs（19.8±3.6） ml/s]。国际前列腺症状评分显著好转，[（24.6±1.7） vs（8.0±1.2）]。术中无输血、无电切综合征、无直肠和膀胱穿孔病例，无输尿管损伤、大出血、心脑血管意外等严重并发症发生。 结论层面递进法激光剜除技术构想对于高危前列腺增生外科包膜层面的寻找、减少术后并发症有独到优势，且易于掌握，或可为业界同行提供一个新的思路。     

2种取血方式下SD大鼠血常规及生化指标变化的探讨

目的了解成年雌雄SD大鼠在应激与麻醉两种取血方式下,血常规及生化指标变化趋势。方法初离乳SD大鼠400只,雌雄各半,分20批,喂饲30 d后,禁食16 h,不禁水,前10批应激状态下取静脉血,后10批麻醉后取静脉血,进行血常规及生化共14项指标测定,比较两种方式下各项指标的差异。结果 2种取血方式下,雌雄SD大鼠共有10项指标同时出现差异。结论了解雌雄大鼠在应激与麻醉两种状态下血常规及生化指标差异,对其安全性毒理学评价有重要意义。     

Larger regional volume of the thalamus in diarrhea-predominant irritable bowel syndrome: a cross-sectional study

Brain Imaging and Behavior - As a relay center between the cerebral cortex and various subcortical brain areas, the thalamus is repeatedly associated with the dysfunction of brain-gut interaction...     

上皮-间质转化在子宫腺肌病中作用的研究进展

子宫腺肌病(ADS)是子宫内膜腺体及间质侵入子宫肌层导致的以子宫局灶或弥漫性增大为主要改变的良性疾病,其具体发病机制尚不清楚。目前多数研究者认为ADS是基底层内膜细胞增生、侵入到肌层间质的结果。在上皮-间质转化(EMT)过程中,上皮细胞失去细胞极性,细胞间紧密连接和黏附连接减弱,获得了浸润性和游走迁移能力,成为具有间质细胞功能和特性的细胞。EMT在肿瘤形成中赋予细胞迁移、浸润的能力,而ADS发生、发展过程中子宫内膜细胞侵入肌层的生物学行为与之非常相似。已有研究表明EMT在ADS形成中具有重要作用。目前ADS的临床治疗面临较多的挑战,因此阐明ADS的发生机制是寻求临床早期预防、治疗ADS有效方法的关键。     

漏斗胸Nuss矫形术对胸廓的影响及相关因素分析

目的通过CT影像测量了解漏斗胸Nuss矫形术前后胸廓径线的改变情况,探讨并分析Nuss矫形术对胸廓的影响及相关因素。方法对2014年1月至2018年12月郑州大学第一附属医院收治的50例行漏斗胸Nuss矫形术患儿的临床资料进行回顾性分析。50例患儿中男43例,女7例。所有患儿中存在脊柱侧弯6例,胸廓不对称12例,胸骨旋转11例。通过CT影像测量其放置矫形器前及取出矫形器后胸廓各椎体平面最大横内径及该平面胸脊间的距离,通过配对样本t检验比较矫形前后各径线的改变情况,以及通过独立样本t检验分析在不同年龄、性别、矫形时间、漏斗胸对称与否、是否合并脊柱侧弯等情况间的差异性。结果50例患儿均顺利完成矫形器置入术及矫形器拔除术,无明显术中及术后并发症,Nuss矫形后较矫形前相比,胸廓前后径在第8~12胸椎水平均较前增加,第3~5胸椎平面较前减小,胸廓横径在第8~10胸椎平面较前减小;年龄≤10岁、矫形时长≥2年及女性患儿胸廓前后径改变量在多个胸椎平面分别较年龄>10岁、矫形时长<2年及男性患儿大,P<0.05,差异具有统计学意义。结论漏斗胸Nuss矫形后前胸壁凹陷较前明显改善,并且在不同年龄和不同矫形时长间存在差异性,年龄较小及适当增加矫形时间可获得较好的矫形效果,而胸廓横径生长在一定程度上受限。     

CT-guided localization techniques of small pulmonary nodules: a prospective non-randomized controlled study on pulmonary nodule localization needle and methylene blue staining with surgical glue

BackgroundThoracoscopic resection of small pulmonary nodules (SPNs) is challenging. Accurate preoperative computed tomography-guided localization of SPNs is key to successful rection. The aim of the present study was to evaluate the clinical value of a novel localization needle and methylene blue staining combined with surgical glue (MBSG) and to explore the risk factors for post-localization complications.MethodsThis prospective, non-randomized controlled study was conducted on 110 patients who received either MBSG or novel needle localization prior to video-assisted thoracoscopic surgery (VATS) from January 2019 to December 2019 at Shenzhen People’s Hospital. The primary endpoints were the safety and the success rates of the 2 localization techniques. The secondary endpoints were operative time and feasibility.ResultsThe 110 patients were categorized into 2 groups: the MBSG group (n=84) and the pulmonary nodule localization needle group (n=26). The success rate of pre-VATS localization was 100% in both groups. No deaths or serious complications occurred during localization. The rates of pneumothorax, pulmonary hemorrhage, and localization-induced cough were 38.1%, 25%, and 7.14%, respectively, in the MBSG group, and 26.92%, 19.23%, and 0%, respectively, in the pulmonary nodule localization needle group. Differences between the 2 groups were not statistically significant (P>0.05). Total complication rate and the incidence of pain were significantly lower in the pulmonary nodule localization needle group (χ²=4.441 and 4.295, respectively; P<0.05). The difference in operative time between the 2 groups was not statistically significant (P>0.05). Dye diffusion occurred in 2 patients in the MBSG group; however, it had no impact on VATS or on the pathological analysis. Neither displacement nor dislocation was observed in the pulmonary nodule localization needle group. Logistic regression analysis showed that the localization technique was an independent risk factor for total complications (odds ratio: 2.634, 95% confidence interval: 1.022–6.789, P<0.05).ConclusionsBoth techniques can localize SPNs effectively prior to VATS. The pulmonary nodule localization needle technique has a lower incidence of complications.     

重症肌无力相关抗体的研究进展

作为一种累及神经肌肉接头的自身免疫性疾病,重症肌无力(myasthenia gravis,MG)的发病机制与自身免疫性抗体密切相关。关于MG相关抗体,研究最多且最为明确的是乙酰胆碱受体抗体(acetylcholine receptor antibody,AChR-Ab),由于存在AChR-Ab阴性的MG患者,近年来学者们开始热衷于研究AChR-Ab以外的其他抗体,如肌肉特异性酪氨酸激酶抗体、低密度脂蛋白4抗体等,并进行相应治疗方案的探索。该文对MG相关抗体的研究进展进行综述,为今后治疗该病提供临床依据和参考。