在腹腔镜下行髂内动脉结扎及置泵10例

目的 探讨腹腔镜髂内动脉结扎及置泵可行性。方法 对10例膀胱癌患者采用经腹腔镜行一侧髂内动脉结扎并植泵，对侧髂内动脉结扎，用于膀胱癌经尿道电切术后的序贯化疗。结果 1例改行开放髂内动脉置泵，9例手术成功。手术时间40～120min，平均65min。出血10～30mL，肠功能恢复6～12h，当日开始灌注化疗药物，术后3d下床活动。带泵2、3a。结论 在腹腔镜下行髂内动脉结扎及置泵具有创伤小、出血少、愈合快等优点，在泌尿外科有很宽广的发展前景。     

直肠瓣过宽导致出口梗阻型便秘的临床治疗

目的探讨直肠瓣过宽导致出口梗阻型便秘的的治疗方法。方法回顾分析出口梗阻型便秘30例患者其中并直肠粘膜内脱垂患者10例。经临床行挂线手术资料。结果治愈率达90％，有效率96％。结论直肠瓣过宽导致的便秘，行直肠瓣挂线手术疗效满意。     

改良结扎法在外伤松动牙中的应用

在临床工作中，经常会遇到前牙外伤患者，因牙齿脱位，松动或移位，需要做松牙固定。常用方法多为复位后，采用牙弓夹板，树脂夹板，八字结扎等固位方法，这些方法存在椅旁工作时间长，操作较为复杂，松动牙移位，患者感觉不舒适等缺点，笔者在工作中采用改良结扎法，取得满意效果。     

Sterilization in Bangladesh: mortality, morbidity, and risk factors

Although surgical sterilization in Bangladesh is common and has been designated as the primary means of helping the country slow its population growth, no reliable information exists regarding the procedure's safety. To define the types and rates of medical complications associated with sterilization, we followed 5042 women and 264 men undergoing sterilization. The problems that increased most markedly after the procedure compared with before included painful urination, shaking chills, fever for at least 2 days, and frequent urination. Most of the postoperative problems could be predicted by the presence of the same problem before the operation. Factor analysis of complaints in those persons who did not have a specific preoperative complaint showed that complaints clustered into three groups: urinary tract symptoms (urinary urgency and frequency), skin problems (bleeding from the incision, sore with pus, and stitches or skin breaking open), and general complaints (weakness and dizziness). The patient's sex, the sponsor and patient load of the sterilization center, and the dose of sedatives administered to women were significantly associated with specific postoperative complaints. Five women died during the study, resulting in a death-to-case rate of 9.9/10,000 procedures tubectomies; four deaths were due to respiratory arrest caused by oversedation.     

2种不同类型自锁托槽对前牙转矩控制的对比研究

摘要：目的比较主动和被动自锁托槽在拔牙病例中对前牙转矩的控制 方法 选取40例拔牙病例,20例应用Empower自锁托槽,20例应用Damon自锁托槽,对治疗前后反应骨性指标的SNA、SNB、ANB、MP-SN和上下前牙倾斜度的牙性指标：UI-SN、U1-PP、U1-NA、L1-NB、L1-MP进行头影测量分析,应用SPSS13.0软件对治疗前后测量的结果进行分析。结果 两组病例治疗前各项测量项目无明显差别;两组病例治疗前后骨性指标无明显改变,而牙性指标UI-SN、U1-PP、U1-NA、L1-NB、L1-MP都有明显减小;Empower组病例治疗后UI-SN、U1-PP、U1-NA测量值较Damon组大,有显著性差异(P<0.05),而Empower组L1-MP治疗后测量值较Damon组小,结果有显著性差异(P<0.05),Empower组L1-NB治疗后测量值较Damon组小,但无明显统计学差别(P>0.05)。结论 主动自锁托槽在拔牙病例中对前牙转矩的控制较被动自锁托槽理想。     

Cardioprotective effects of saponins from Panax japonicus on acute myocardial ischemia against oxidative stress-triggered damage and cardiac cell death in rats

Aim

To study the cardioprotective effects of saponins from Panax japonicus (SPJ) on acute myocardial ischemia injury rats induced by ligating of the left anterior descending branch (LAD), on the basis of this investigation, the possible mechanism of SPJ was elucidated.

Materials and methods

SPJ was identified by high performance liquid chromatography-evaporative light scattering detection. Male Sprague-Dawley rats (200–220 g) were randomly divided into four groups: sham-operated, LAD, LAD + l-SPJ (SPJ, 50 mg/kg/day, orally) and LAD + h-SPJ (SPJ, 100 mg/kg/day, orally). Before operation, the foregoing groups were pretreated with homologous drug once a day for 7 days, respectively. After twelve hours in LAD, the cardioprotective effects of SPJ were evaluated by infarct size, biochemical values, hemodynamic, and histopathological observations and the antioxidative and antiapoptotic relative gene expressions.

Results

SPJ significantly improved heart function and decreased infarct size; remarkably decreased levels of serum lactate dehydrogenase, creatine kinase, xanthine oxide and malondialdehyde content, increased contents of serum total antioxidant capacity, superoxide dismutase (SOD), glutathione peroxidase, catalase; quantitative real-time PCR results showed that SPJ might markedly reverse the down-regulated mRNA expressions of the SOD1, SOD2 and SOD3, ameliorate the increased Bax and caspase-3 mRNA expressions and decreased Bcl-2 mRNA expression and ratios of Bcl-2 to Bax. Histopathological observations provided supportive evidence for biochemical analyses, and with the dose of SPJ increasing, the aforesaid improvement became more and more strong.

Conclusions

The studies demonstrated that in ischemic myocardium, oxidative stress caused the overgeneration and accumulation of reactive oxygen species (ROS), which was central of cardiac ischemic injury. SPJ exerted beneficially cardioprotective effects on myocardial ischemia injury rats, mainly scavenging oxidative stress-triggered overgeneration and accumulation of ROS, alleviating myocardial ischemia injury and cardiac cell death.     

3，4-二-O-甲基-1，2，5，6-四硝酸甘露醇酯对冠状动脉结扎大鼠心肌缺血的保护作用

 目的 研究3,4-二-O-甲基-1,2,5,6-四硝酸甘露醇酯（3,4-di-O-methyl-1,2,5,6-D-mannitol tetranitrate,DMMTN）对冠状动脉结扎所致大鼠急性心肌缺血的保护作用及其作用机制。方法 以结扎左冠状动脉前降支方法建立大鼠急性心肌缺血模型,建立假手术组、心肌梗死模型组、鲁南欣康组、DMMTN低、中、高剂量（15,30,60 mg·kg^-1）组,测定手术后不同时段心电图ST段和T段的抬高;并于手术3 h后硝基四氮唑蓝( NBT) 染色法测定心肌梗死面积;测定血清中肌酸激酶（CK）、乳酸脱氢酶（LDH）、丙二醛（MDA）和超氧化物歧化酶（SOD）。结果 DMMTN能显著缩小心肌梗死面积,抑制术后心电图ST段和T段的抬高;能显著降低CK和LDH的活力,以及MDA的含量,同时能显著提高SOD的活力。结论 DMMTN对冠状动脉结扎所致大鼠急性心肌缺血具有显著的保护作用。     

Reconditioning of self-ligating brackets: A shear bond strength study

Objective:To test the null hypothesis that there is no significant difference in the shear bond strength (SBS) and Adhesive Remnant Index (ARI) scores of new vs reconditioned self-ligating brackets.Materials and Methods:One hundred and twenty permanent extracted bovine teeth were embedded in resin blocks. Three different new and reconditioned self-ligating orthodontic brackets (Smart Clip [3M Unitek]; Quick [Forestadent]; and Damon3MX [Ormco]) were tested. Scanning electron microphotographs of the different new (groups 1, 3, and 5) and reconditioned (groups 2, 4, and 6) bracket bases were taken before starting the experiments. Brackets were then bonded to the teeth using an orthodontic adhesive and were then tested in shear mode using an Instron Universal Testing Machine. ARI scores were then recorded. Statistical analysis was performed to determine significant differences in SBS and ARI Scores.Results:Smart Clip and Damon3MX reconditioned brackets showed significantly lower SBS than did new ones. On the contrary, Quick reconditioned brackets showed significantly higher SBS than did new ones. No significant differences in ARI scores were found after the reconditioning process for the three different brackets tested.Conclusion:The in-office reconditioning procedure alters the SBS of self-ligating brackets, although SBS values still remain clinically acceptable.     

可吸收夹在改良式两孔腹腔镜阑尾切除术中的应用

目的 探讨Lapro-Clip可吸收生物夹在改良式两孔腹腔镜阑尾切除术中的应用价值.方法 2012年3月~2013年6月,对112例急、慢性阑尾炎行两孔腹腔镜阑尾切除术,均用Lapro-Clip可吸收生物夹（12 mm）处理阑尾及其系膜.结果 手术均顺利完成,手术时间18～44 min,（25.6±7.8）min,术中出血〈15 ml,术后仅6例应用镇痛药,无腹腔残余感染、肠漏及肠梗阻等.术后住院2～5 d,（3.9±0.9）d.结论 两孔腹腔镜阑尾切除术中用Lapro-Clip可吸收生物夹处理阑尾及其系膜,操作方便,出血少,创伤小,疼痛轻,恢复快.