护理干预在直肠癌根治术中的应用

目的探讨护理干预对直肠癌根治术患者的护理效果。方法81例患者随机分成观察组（43例）和对照组（38例）,观察组采用有效的护理干预措施,对照组采用传统的护理方法,比较二者护理效果。结果观察组效果明显好于对照组,如在平均住院时间、并发症发生率、患者满意度和疼痛程度等方面的比较两组效果差异有统计学意义（P〈0.01）。结论护理干预可以促进直肠癌根治术患者的康复,降低了并发症的发生率,缩短了平均住院时间,值得临床推广应用。     

肝细胞生长因子在心肌缺血-再灌注损伤中的表达改变及意义

[目的]通过对缺血再灌注心肌细胞内肝细胞生长因子(HGF)mRNA及心肌细胞内MDA和SOD检测,揭示缺血再灌注过程中HGF mRNA表达上调的可能机制及作用。[方法]雄性SD大鼠40只,随机分为假手术组及实验组,每组20只,建立缺血再灌注损伤的模型。对比两组间心肌HGF mRNA、MDA及SOD的含量。[结果]大鼠心电图显示冠脉结扎后ST段明显抬高,打开结扎线后ST段回落,表明心肌缺血再灌注有效。与假手术组SOD(95.311±3.472)U/mL、MDA(18.842±1.166)μmol/g相比,再灌注组心肌细胞SOD活性明显降低(61.257±1.242)U/mL,P<0.01;MDA含量增高至(36.396±0.653)μmol/g,二者相比差异具有显著性意义(P<0.01);心肌HGF mRNA表达,再灌注组与假手术组分别为0.72074±0.00067和0.53668±0.00103,差异有显著性意义(P<0.01)。缺血再灌注过程中,心肌HFG mRNA变化与SOD变化成正相关,与MDA呈负相关。[结论]自由基的损伤性刺激可能是再灌注损伤过程中引起心肌HGF mRNA表达上调的原因之一。     

二茂铁衍生物清除羟自由基的构效关系

采用化学发光法检测并比较了10种二茂铁衍生物清除羟自由基(·OH)活性,用循环伏安法研究了其电化学性质,进而探讨了取代基结构与清除·OH活性间的关系。结果表明,取代基共轭效应、诱导效应和体积都对衍生物清除·OH活性有明显影响。含共轭或吸电子取代基二茂铁衍生物,半波电位(E1/2)较高,清除·OH活性较弱;而含给电子取代基的二茂铁衍生物,E1/2较低,清除·OH活性较强。     

Experimental study on phototoxicity and the photosensitization potential of ketoprofen,suprofen, tiaprofenic acid and benzophenone and the photocross-reactivity in guinea pigs

BACKGROUND: Ketoprofen, suprofen and tiaprofenic acid are arylpropionic anti-inflammatories. Their chemical structures share the same elements as the benzoyl radical and the tiophene ring. We experienced nine cases of ketoprofen photoallergy, seven cases of suprofen photoallergy and three cases of tiaprofenic photoallergy. PURPOSE: To find the key structure of photosensitivity and photocross-reactivity to ketoprofen, suprofen and tiaprofenic acid. METHODS: : Three animals were tested for phototoxicity and six animals for the photosensitization potentials of ketoprofen, suprofen, tiaprofenic acid and benzophenone, and the photocross-reactivity of the above chemicals. Test substances were applied symmetrically on both sides of the animals' backs. The animals were irradiated with 180 mJ/cm2 UVB ((1/2) MED) and 10 J/cm2 UVA on the left side. The reactions were read on days 2, 3 and 4. The photosensitization potentials of ketoprofen, suprofen, tiaprofenic acid and benzophenone were determined using the Adjuvant-Strip method. Six animals were assigned to each test group and to a control group. RESULTS: Ketoprofen, suprofen, tiaprofenic acid and propionic acid showed negative reactions with the phototoxic test. Benzophenone showed phototoxic reactions to 40% acetone (ac.), 20% ac. and 10% ac. Therefore, we used 5% aq. benzophenone with the photosensitization test. Ketoprofen was the strongest photosensitizer (6/6) and showed photocross-reactivities to suprofen (2/6), tiaprofenic acid (3/6) and benzophenone (6/6). Suprofen was a strong photosensitizer (4/6) and showed photocross-reactivities to ketoprofen (1/4) and tiaprofenic acid (2/4), but not to benzophenone. Tiaprofenic acid was also a photosensitizer (2/6) but showed a photocross-reactivity only to benzophenone (2/2). Benzophenone was also the strongest photosensitizer (6/6), but did not photocross-react to the above three chemicals. CONCLUSION: From the test results, it appears that benzoyl radical is the key structure for photosensitivity and the photocross-reactivity of ketoprofen, suprofen and tiaprofenic acid. The whole structure of benzophenone was needed to induce photosensitization of benzophenone. The animals that were photosensitized from the entire structure of benzophenone did not photocross-react to ketoprofen, suprofen or tiaprofenic acid.     

The inhibition of free radical generation by human neutrophils through the synergistic effects of metronidazole with palmitoleic acid: a possible mechanism of action of metronidazole in rosacea and acne

Summary Metronidazole is clinically effective in treating not only rosacea but also acne inflammation. Yet it is generally considered not to be very effective in inhibiting the growth of anaerobic Propionibacterium acnes. We report here our investigation into the synergistic effects of metronidazole and palmitoleic acid on the anaerobic growth of P. acnes as well as on human neutrophil functions, including the generation of reactive oxygen species (ROS). Both metronidazole and palmitoleic acid, when used alone, only slightly inhibited the growth of P. acnes, and no significant decrease in human neutrophil functions, including the generation of ROS, was observed. But metronidazole used in the presence of palmitoleic acid markedly inhibited the anaerobic growth of P. acnes and decreased ROS generation by neutrophils. However, ROS generated in the xanthine-xanthine oxidase system were not affected. Metronidazole was shown to be clinically effective by decreasing neutrophil-generated ROS at the sites of inflammation with the aid of palmitoleic acid, which is generally present in human skin. By inhibiting oxidative tissue injury under in vivo conditions, treatment with metronidazole results in remarkable improvement of rosacea and acne.     

进展期远端胃癌患者腹腔镜根治术后吻合口狭窄发生的影响因素

目的分析进展期远端胃癌(GC)患者腹腔镜根治术后吻合口狭窄发生的影响因素。方法选取行腹腔镜根治术后发生吻合口狭窄的47例进展期远端GC患者,纳为发生组;另选取同期腹腔镜根治术后未发生吻合口狭窄的47例进展期远端GC患者,纳为未发生组。全部患者病历资料、实验室相关检查资料等均完整;设计基线资料填写表,阅读患者基线资料并记录研究所需资料,将可能的影响因素纳入,经单因素、多因素分析找出可能导致进展期远端GC患者腹腔镜根治术后发生吻合口狭窄的影响因素。结果初步比较发生、未发生吻合口狭窄进展期远端GC患者相关基线资料,后经Logistic回归分析结果显示,多层吻合、吻合口水肿、白细胞介素6(IL-6)与肿瘤坏死因子α(TNF-α)过表达均可能是进展期远端GC患者腹腔镜根治术后吻合口狭窄发生的影响因素(OR>1,P<0.05)。结论进展期远端GC患者腹腔镜根治术后吻合口狭窄发生可能与患者多层吻合、吻合口水肿、IL-6与TNF-α过表达有关,临床可据此提出针对性干预方案。     

不同麻醉镇静深度BIS闭环靶控输注对腹腔镜胃癌根治术老年患者围术期Th1/Th2平衡的影响

目的 探讨BIS闭环靶控输注在不同麻醉镇静深度对腹腔镜胃癌根治术老年患者围术期Th1/Th2平衡的影响。方法 对73例择期腹腔镜胃癌根治术的老年患者进行随机数字表法分组,分为BIS闭环靶控输注BIS值55组（H组,36例）和BIS值45组（L组,37例）。分别于手术开始前即刻（T1）、术后2 h（T2）、术后24 h（T3）及72 h（T4）采集静脉血样,流式细胞术微球阵列法测定IL-2、IL-4、IL-6、IL-10、TNF-α和IFN-γ。比较两组患者的手术时间、恢复室停留时间和住院时间。结果 与T1比较,T2、T3、T4时H组IL-6、IL-10浓度明显升高（P<0.05）,T4时H组IL-4和TNF-α明显升高（P<0.05）,T2、T4时H组IL-2、IFN-γ明显升高（P<0.05）,T2、T3、T4时L组IL-6、IL-10浓度明显升高（P<0.05）,T4时L组IL-2明显降低（P<0.05）,T2、T3、T4时H组和L组IFN-γ/IL-6明显降低（P<0.05）;与L组比较,T2时H组IL-6、IL-10明显升高（P<0.05）,H组IFN-γ/IL-6明显降低（P<0.05）,T4时H组IL-2和IL-10明显升高（P<0.05）,两组患者的手术时间、恢复室停留时间、住院时间差异均无统计学意义（P>0.05）。结论 BIS闭环靶控输注的麻醉镇静深度值45比55更有利于维持胃癌根治术老年患者术后Th1/Th2的平衡状态,但是对于改善患者预后不明显。     

子宫颈癌手术治疗质量控制需要注意的几个问题北大核心CSCD

开腹广泛性子宫切除术+盆腔淋巴结切除术±腹主动脉旁淋巴结切除术是早期子宫颈癌手术的标准术式。子宫颈癌手术需重视手术途径、子宫颈周围切除范围、并发症控制、辅助治疗规范化、标本观察和解剖以及围手术期快速康复。     

Sexuality and quality of life after nerve-sparing radical hysterectomy for cervical cancer: A prospective study

ObjectiveNerve-sparing radical hysterectomy (NSRH) decreases the negative postoperative consequences of radical surgery for cervical cancer, such as bladder evacuation disorders, colorectal motility disorders, and sexual dysfunction. The aim of this study was to prospectively assess the sexuality and quality of life in a group of women who underwent NSRH with lymphadenectomy for cervical cancer.Materials and methodsA total of 65 patients with early-stage cervical cancer underwent NSRH between 2014 and 2016. Patient examinations and questionnaire surveys (Female Sexual Function Index questionnaire and European Organization for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-CX24) were conducted, before and one year after the surgery.ResultsAfter the exclusion of 19 sexually inactive women and 10 women who received adjuvant anticancer treatment, 36 sexually active patients treated solely with nerve-sparing surgery were eligible for evaluation. The mean age was 47 years. The average preoperative vaginal length was 9.4 cm, whereas the postoperative length was shortened to 7.1 cm. This study showed no negative impact of NSRH on sexual desire, arousal, satisfaction, orgasm, pain, sexual activity, sexual enjoyment, and sexual worry. The worsening of sexual functioning was recorded during the one-year follow-up. The QLQ-C30 questionnaire confirmed postoperative improvement in global health status and role, emotional, and social functioning.ConclusionOur study showed using standardized questionnaires that NSRH has no negative impact on sexual desire, arousal, satisfaction, orgasm, pain, sexual activity, frequency of sexual intercourse, sexual enjoyment, and sexual worry, while only the worsening of sexual functioning was recorded. Moreover, NSRH did not cause postoperative deterioration in the quality of life parameters.