TST STARR+：治疗出口梗阻型便秘的一项新术式

直肠前突和直肠内脱垂是引起出口梗阻型便秘（obstructed defecation syndrome,ODS）常见病因。经肛门吻合器直肠部分切除术（stapled transanal rectal resection,STARR）是近年来国际上治疗ODS的最常用术式。常规STARR需要使用两把PPH吻合器,且操作较复杂、学习曲线较长、切除组织容积有限。 Naldini等［1］报道了一种外径为36 mm、吻合腔容积大于35 cm3、钉高4．2 mm且具备4个可视开窗的圆形吻合器,将其应用于ODS和脱垂痔的治疗,疗效显著,并将该技术命名为TST STARR＋。2013年4月至2014年5月,武汉大学中南医院结直肠肛门外科运用该技术治疗ODS患者100例,疗效满意,现报道如下。     

胃间质瘤腹腔内破裂出血一例

正患者,女,21岁,因上腹痛1天急诊入院。体格检查:神清,精神可,轻度贫血貌,心率86次/分,血压108/74mmHg。腹膨隆,腹软,轻压痛无反跳痛,肝脾肋下未及,移动性浊音(-)。超声引导下腹穿抽出不凝血。腹盆腔CT检查提示:胃小弯结节,间质瘤可能;肝胃间隙高密度包块无强化,肿瘤出血可能;腹盆腔积液。见图1。血红蛋白84.00g/L,红细胞2.88×10~(12)/L,红细胞压积     

高表达蛋白hSav1对人胚肾HEK293增殖能力的影响

Objective To elucidate the effects of human Salvador 1 (hSav1 ) on cell proliferation of human embryonic kidney cell line HEK293. Methods The plasmid CFP-N1-hSav1 was constructed and transfected into HEK293 cells with lipofectamine 2000. The transfection efficiency was detected by fluorescent microscopy. The effects of hSav1 on cell proliferation were measured by MTT and BrdU incorporation. Results The transfection efficiency was about 70% -80%. The MTT results showed that the inhibition rate of cell proliferation in transfected group at the 12th, 24th, 36th, and 48th h was 2% , 5% , 15% , and 23% , respectively;while that in the control group was 2% , 3% , 2% , and 2% respectively. The BrdU incorporation revealed that the BrdU incorporation rate in transfected group (12. 9 ±5. 3)% was significantly lower than in control group (27.3±3.8)% (P<0.05). Conclusion hSav1 is a newly identified protein that can cause cell proliferation inhibition in HEK293 cells.     

输入袢与输出袢综合征

输入袢综合征（afferent loop syndrome）主要是指患者行毕Ⅱ式胃大部切除术后因输入袢十二指肠或者临近空肠梗阻引起的一类以呕吐为主要表现的临床症候群。常因为输入袢太长、粘连、成角导致梗阻,根据临床表现分为急性和慢性两型。     

Altemeier手术治疗直肠脱垂

正直肠脱垂是一种相对少见的盆底外科疾病,其发病机制不详,可能与肛提肌分离、乙状结肠冗长、肛门括约肌松弛及直肠骶骨韧带功能降低有关[1]。目前,手术是治疗直肠脱垂的主要手段,已报道的手术方式主要分为经肛门(会阴)入路和经腹入路,术式多达一百多种[1-2]。目前,国外文献报道的手术疗效存在较大差异[2]。国内直肠脱垂病人具有以下特点:(1)大部分直肠脱垂病人病史较长,且并存肛门失禁或者便秘;     

中西医结合治疗卒中后抑郁研究进展

脑卒中是最常见的脑系疾病之一,严重危害人类健康。抑郁是脑卒中后的并发症,发病率较高,达30%~60%,其主要表现为情绪低落、食欲不振、兴致缺乏、急躁易怒、失眠多梦、性欲低下甚至厌世自杀等,提高了中风的致死率和致残率,严重影响了卒中患者病后康复信心及康复疗效。近年来,随着对卒中后抑郁的普遍关注和重视,中医在治疗卒中后抑郁领域方面取得了长足进步。从卒中后抑郁的病因病机、中西医治疗、预防和展望等方面入手,将近十年来中西医结合治疗卒中后抑郁的研究进展做一总结。     

hSav1蛋白高表达对Mst1介导的细胞凋亡的影响

Objective To elucidate the effect of hSavl expression on Mstl-mediated apoptosis in HeLa cells. Methods Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and cotransfected into HeLa cells. Triple immunofluorescent labeling of hSav1, Mst1 and nucleus was performed to determine their subcellular localization. Plasmids pCMV-HA-hSav1 and/or pcDNA/4TO-Flag-Mst1 were transfected into HeLa cells, and 36 hours later cisplatin (50 μmol/L) as a pro-apoptotic agent was added for 14 hours. Cell apoptosis was analyzed by annexin V/PI assay. Results Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and the authenticity of constructs was verified by sequencing. The binding in vitro showed that hSavl could be detect from the anti-Mstl immunoprecipitation complex. The immunofluorescent labeling showed that hSavl and Mstl had the same localization in cells. Overexpressed protein hSavl did not induce a significant cell apoptosis. However, co-expression of hSavl with Mstl resulted in a significant increase of apoptosis above the level seen with Mstl alone (24. 5% ± 2.4% vs. 39.3% ± 4.0%, P < 0. 05). Conclusion Our findings indicate that hSavl is a newly identified protein that interacts with Mst1 and a, augments Mst1-mediated apoptosis.