共查询到20条相似文献,搜索用时 187 毫秒
1.
目的探讨肝细胞生长因子(hepatocyte growth factor,HGF)对移植小肠通透性及细菌易位的作用。方法以Wistar大鼠20只为受体,SD大鼠20只为供体行异位全小肠移植,并以环孢素A(6mg/kg.d)肌注抑制排斥反应。HGF组(n=10)用微量输液泵持续均匀输入HGF(150μg/kg.d),对照组(n=10)输入等量生理盐水,随机选取同批正常Wistar大鼠作为正常基准(n=10)。第7天两组实验动物均分别以乳果糖/甘露醇液2ml(含乳果糖100mg、甘露醇50mg)行移植小肠灌注,采集24h尿液检测乳果糖、甘露醇含量及乳果糖/甘露醇比值;第8天采集移植小肠肠系膜淋巴结及门静脉血行细菌培养,小肠组织学观察。结果对照组尿液中乳果糖含量为0.0931%±0.0085%,乳果糖/甘露醇比值为0.132±0.021,与正常基准0.0150%±0.0020%和0.020±0.005比较,差异均有统计学意义(P〈0.05);HGF组乳果糖含量为0.0396%±0.0090%,乳果糖/甘露醇比值为0.056±0.013,与正常基准比较差异均有统计学意义(P〈0.05),且低于对照组(P〈0.05)。HGF组移植小肠肠系膜淋巴结细菌阳性率为10%,对照组为60%,差异有统计学意义(P〈0.05)。HGF组门静脉血细菌阳性率为10%,对照组为20%,差异无统计学意义(P〉0.05)。两组移植小肠组织学观察仅见少量炎性细胞浸润。结论HGF能够降低同种移植小肠的通透性及细菌易位率,改善小肠黏膜屏障功能。 相似文献
2.
《中国胸心血管外科临床杂志》2016,(6)
目的探讨益生菌联合乳果糖对体外循环心内直视术后胃肠功能及感染发生的影响。方法回顾性分析2013年8月至2014年6月在我院行体外循环辅助的心脏病患者264例的临床资料,男129例、女135例,年龄(53.06±10.97)岁。将264例患者分为两组,其中治疗组121例,男58例、女63例,年龄(53.25±9.27)岁,术后第1天开始使用益生菌联合乳果糖,用至术后第7天;对照组143例,男71例、女72例,年龄(52.29±14.31)岁,未使用益生菌及乳果糖。两组均在术前、术后24 h、72 h及7 d抽血测定降钙素原(PCT)及内毒素(LPS)浓度,记录术后感染、胃肠功能障碍等相关情况。结果治疗组术后72 h的PCT[(1.04±5.39)ng/ml vs.(3.51±4.28)ng/ml,P=0.04)]及LPS[(11.28±4.34)EU/ml vs.(21.59±7.34)EU/ml,P=0.03)]均明显低于对照组,治疗组术后7天的PCT[(0.17±2.79)ng/ml vs.(1.98±4.62)ng/ml,P=0.04]及LPS[(6.74±6.38)EU/ml vs.(15.96±4.61)EU/ml,P=0.01)]均明显低于对照组;治疗组术后ICU停留时间[(43.25±14.36)h vs.(63.47±24.46)h,P=0.01]及术后住院时间[(15.07±4.52)d vs.(21.08±6.49)d,P=0.02]明显短于对照组;治疗组术后感染率为1.65%,胃肠功能障碍为2.48%,死亡率1.65%,对照组分别为5.59%,6.99%和2.10%(P=0.00,P=0.12)。结论体外循环心内直视术后早期使用益生菌联合乳果糖可能降低机体炎症反应,改善胃肠功能,降低感染发生率。 相似文献
3.
《中华男科学杂志》2016,(10)
目的:探讨口服通淋散治疗良性前列腺增生(BPH)的有效性和安全性。方法:根据随机对照原则将100例BPH患者分为治疗组50例和对照组50例,治疗组口服通淋散,对照组口服盐酸特拉唑嗪,治疗3个月后观察国际前列腺症状评分(IPSS)、生活质量评分(Qo L)、前列腺体积、残余尿量、血尿常规、肝肾功能各指标的变化。结果:两组患者年龄[(48.19±10.85)岁vs(48.27±11.87)岁]、治疗前IPSS评分[(22.24±7.33)分vs(21.40±8.24)分]、Qo L评分[4(2~6)分vs 4(2~6)分]、前列腺长度[45(30~65)mm vs 45(39~65)mm]与宽度[35(21~54)mm vs 36(26~57)mm]及残余尿量[10(5~100)ml vs 10(10~100)ml]均无统计学差异(P均0.05)。治疗后治疗组患者IPSS评分[(11.60±6.49)分]明显降低,与对照组[(15.38±7.34)分]相比具有统计学差异(P=0.008);Qo L评分[对照组(3(1~6)分,治疗组(2(0~5)分]亦明显降低,具有统计学差异(P=0.01)。两组患者治疗后前列腺长度[47(38~67)mm vs 47.5(38~67)mm]与宽度[36(26~57)mm vs 36.5(31~57)mm]及残余尿量[10(8~100)ml vs 10(8~70)ml]未见统计学差异(P0.05)。根据尼莫地平法对两组患者进行疗效评价,治疗组患者显效率(40%)明显高于对照组(8%),具有统计学差异(P0.01);治疗组患者总有效率(82%)也显著高于对照组(64%),具有统计学差异(P=0.043)。结论:通淋散在治疗BPH方面能够有效改善患者因BPH导致的排尿困难等症状,进而改善了患者生活质量,并可恢复老年人的前列腺功能。 相似文献
4.
目的:比较单孔法与双孔法胸腔镜下肺大疱切除术治疗自发性气胸的疗效。方法:收集2014年1月至2016年1月收治的96例自发性气胸患者,随机分为单孔组与双孔组,每组48例,比较两组临床指标、术后复发率及术后不同时间点的疼痛评分。结果:切口长度[(2.24±0.28)cm vs.(4.53±0.34)cm,P=0.021]、术后胸腔引流量(120 ml vs.320 ml,P=0.008)、术后引流管留置时间[(2.76±0.63)d vs.(4.62±1.24)d,P=0.037]及术后第3天[(2.63±0.62)vs.(4.83±0.71),P=0.006]、3个月[(1.22±0.45)vs.(2.14±0.52),P=0.016]疼痛评分单孔组显著低于双孔组。结论:单孔法胸腔镜肺大疱切除术治疗自发性气胸的疗效与双孔法相当,在技术上是安全、可行的,而且创伤更小,术后疼痛更轻,康复更快,更具优势。 相似文献
5.
冠心病合并左室功能不全患者的非体外循环与体外循环下冠状动脉旁路移植术早期结果分析 总被引:1,自引:0,他引:1
目的 比较非体外循环和体外循环下行单纯冠状动脉旁路移植术对冠状动脉粥样硬化性心脏病(冠心病)合并左室功能不全患者的早期疗效. 方法 1996年11月~2007年12月,对98例冠心病合并左室功能不全患者在非体外循环(off-pump coronary artery bypass,OPCAB,n=41)或体外循环(cardiopulmonary bypass,CPB,n=57)下行单纯冠状动脉旁路移植术,2组性别、年龄、体重指数、心功能等级、既往病史及手术移植血管种类差异无显著性.比较2组手术的情况及术后早期心功能变化的情况. 结果 2组术后2周、3个月左室射血分数(LVEF)、左室舒张末径(LVEDD)均显著改善(P<0.05).与CPB组相比,OPCAB组移植血管数目少[(2.6±0.5)支vs(3.0±0.4)支,t=-3.589,P=0.001],手术时间短[(4.43±0.80)h vs (5.35±1.24)h,t=-4.192,P=0.000],术后住院日短(Z=-4.030,P=0.000),呼吸机辅助呼吸时间短(Z=-1.985,P=0.047),术后较少应用血管活性药物[23例(56.1%) vs 44例 (77.2%), χ2=4.907,P=0.027],并发症少[0/41(0%)vs 6/57(10.5%),P=0.039],术后3个月随访LVEF[(50.42±9.00)% vs (46.09±9.10)%,t=2.037,P=0.045]和LVEDD[(53.2±5.4) mm vs (56.4±7.2) mm,t=-2.056,P=0.043]更理想. 结论 对冠心病合并左室功能不全患者,单纯的心肌再血管化是一个确切、有效的治疗方法;对该疾病具有相同手术适应证的患者,非体外循环组的早期疗效优于体外循环组. 相似文献
6.
《中国微创外科杂志》2016,(1)
目的探讨2型糖尿病GK大鼠不同小肠段注射葡萄糖对血糖的影响。方法将24只GK大鼠随机分为A、B、C三组,每组8只。测各大鼠体重及尾部静脉血空腹血糖。手术探查小肠全长,将其分为三等分,用7号丝线结扎每段肠管的两端,保留正常的肠系膜血液循环。A组向近侧段小肠腔内注射葡萄糖,B组向中间段小肠腔内注射葡萄糖,C组向远侧段小肠腔内注射葡萄糖,注射量均为1 mg/kg,生理盐水稀释至1 ml。分别测定注射葡萄糖后2、15、45、75、120 min尾部静脉血血糖。结果手术过程中5只大鼠死亡(A、B组各2只,C组1只),手术存活率79.2%(19/24)。空腹血糖3组差异无显著性[(12.97±3.12)、(12.11±3.80)及(12.61±3.25)mmol/L,F=0.099,P=0.906]。注射葡萄糖后,A、B、C组血糖均升高。2 min血糖A组[(15.57±3.14)mmol/L]和C组[(14.21±2.74)mmol/L]明显高于B组[(11.67±0.23)mmol/L](P=0.008、0.011),A、C组差异无显著性(P=0.778)。15 min血糖A组[(21.23±3.16)mmol/L]C组[(16.95±0.29)mmol/L]B组[(14.06±3.00)mmol/L](P=0.006、0.049)。45 min血糖A组[(25.66±1.53)mmol/L]C组[(17.63±1.46)mmol/L]B组[(13.24±0.66)mmol/L](P=0.000、0.000)。75、120 min血糖3组差异无显著性(P0.05)。结论采用分段结扎肠管注射葡萄糖的方法观察到2型糖尿病GK大鼠各段小肠均表现出对血糖控制能力差,不同小肠部位控制血糖升高的能力具有差异,短时间内中段小肠对血糖控制效果最好,远段小肠次之,近段小肠控制效果最差。 相似文献
7.
目的:比较直线切割吻合器与圆形吻合器在腹腔镜辅助远端胃癌根治术Roux-en-Y吻合中的安全性与卫生经济学的差异。方法:回顾分析2017年8月至2019年2月192例接受腹腔镜辅助远端胃癌根治术并Roux-en-Y式吻合患者的临床资料。根据胃肠吻合所用吻合器材类型,将患者分为直线切割吻合器组(A组,n=40,20.8%)与圆形吻合器组(B组,n=152,79.2%)。比较两组手术安全性、术后消化道功能恢复及卫生经济学的差异。结果:A组术中出血量[(59.75±38.397)mL vs.(63.29±67.792)mL,(P=0.752)]、手术时间[(249.28±65.72)min vs.(255.03±62.67)min,P=0.609]、淋巴结清扫数量[(30.68±11.74)枚vs.(32.43±12.61)枚,P=0.429]、Ⅱ度及以上并发症发生率[7.5%(3/40)vs.7.9%(12/152),P=0.934]、手术耗材费用(中位数:30758元vs.32749元,P=0.064)及住院费用(中位数:70759元vs.70851元,P=0.527)与B组差异无统计学意义。A组术后首次排气时间[(3.46±0.767)d vs.(3.98±1.190)d,P=0.013]、首次进流食时间[(4.32±1.029)d vs.(4.91±0.996)d,P=0.020]、拔除腹腔引流管时间[(6.00±0.882)d vs.(6.56±1.764)d,P=0.008]均短于B组,差异均有统计学意义。结论:腹腔镜辅助远端胃癌根治术Roux-en-Y吻合中使用直线切割吻合器或圆形吻合器行消化道重建均是安全、可行的,使用直线切割吻合器术后首次排气时间、首次进流食时间更短,在术后胃肠道功能恢复方面存在优势。 相似文献
8.
《中国胸心血管外科临床杂志》2020,(1)
目的探讨无管化电视辅助胸腔镜手术(VATS)技术治疗自发性气胸的安全性、可行性及优越性。方法回顾性分析2017年2月至2018年7月我院治疗的38例原发性自发性气胸患者的临床资料。18例行tubeless肺大疱切除手术(Tubeless组),男11例、女7例,年龄(14.3±1.5)岁;20例行传统胸腔镜下肺大疱切除手术(对照组),男12例、女8例,年龄(14.5±1.7)岁。比较两组临床效果。结果 38例均在单孔胸腔镜下顺利完成手术,无中转开胸及二次手术。Tubeless组无中转插管,手术时间[(67.3±13.3)min vs.(81.4±13.4)min,P=0.002]、术前麻醉时间[(14.2±2.6)min vs.(18.5±2.6)min,P=0.000]、术后麻醉复苏时间[(17.1±2.6)min vs.(26.5±5.0)min,P=0.000]、术后疼痛视觉模拟评分(2.3±0.9 vs. 5.2±1.0,P=0.000)、术后下床活动时间[(1.3±0.4)d vs.(2.9±0.6)d,P=0.000]、术后住院时间[(2.9±0.8)d vs.(5.6±1.3)d,P=0.000]、住院费用[(3.5±0.6)万元vs.(5.9±1.0)万元,P=0.000]均优于对照组。两组患者术中出血量[(73.2±4.6)mL vs.(73.9±4.1)mL]、术后肺复张时间[(29.3±2.4)h vs.(29.7±2.5)h]差异均无统计学意义(P0.05)。结论与传统胸腔镜下肺大疱切除手术相比,无管化VATS技术治疗自发性气胸安全可靠,患者疼痛轻,恢复快,符合加速康复外科理念,值得临床推广。 相似文献
9.
目的探讨表皮生长因子(EGF)对大鼠移植小肠黏膜结构的保护作用。方法近交系Wistar(RT1k)大鼠行异位全小肠移植后第2天开始给予完全胃肠外营养(TPN)至第10天,对照组(10只)行常规TPN支持,EGF组(10只)行常规TPN支持的同时加用重组人(rh)EGF 200μg·kg~(-1)·d~(-1),观察移植小肠黏膜的形态学变化(参数:绒毛高度、绒毛宽度、隐窝深度、黏膜厚度及绒毛表面积)和肠上皮细胞超微结构变化及肠黏膜蛋白质和DNA含量改变。结果移植前,肠黏膜形态学参数变化两组间差异无统计学意义(P>0.05)。移植并TPN后,对照组各项参数明显低于移植前(P<0.05),而EGF组各参数与移植前比较变化不明显(P>0.05)。EGF组移植肠绒毛高度为(284.47±31.58)μm,绒毛宽度为(99.37±11.57)μm,隐窝深度为(98.78±10.83)μm,黏膜厚度为(389.56±31.72)μm,绒毛表面积为(0.089±0.009)mm~2;明显高于对照组的(176.45±14.62)μm、(74.2±16.85)μm、(74.45±8.34)μm、(259.38±24.65)μm和(0.041±0.005)mm~2,P均<0.01。EGF组移植肠黏膜蛋白质含量[(84.65±8.32)mg/g wet wt]也明显高于对照组的[(53.73±11.45)mg/g wet wt,(P<0.05)]而与基准值[(92.64±10.52)mg/g wet wt]接近;DNA含量[(0.86±0.10)mg/g wet wt]也显著高于对照组[(0.51±0.06)mg/g wet wt,(P<0.01)]。EGF组移植肠上皮细胞超微结构基本保持完好,而对照组则出现明显线粒体肿胀,嵴短小紊乱和微绒毛萎缩。结论EGF能较好保护大鼠移植小肠黏膜结构,维持移植肠上皮细胞超微结构的完整。 相似文献
10.
《中国实用外科杂志》2017,(3)
目的观察加速康复外科(ERAS)理念在胃癌根治术中应用的安全性及可行性。方法回顾性分析广东省人民医院普外科胃肠专业组2015年7月至2016年1月收治的57例行D2根治手术的胃癌病人临床资料,根据围手术期是否应用ERAS理念处理分为ERAS组(21例)及传统组(36例)。结果 ERAS组与传统组相比,肛门排气时间提前[(2.95±1.36)d vs.(4.44±1.95)d,P=0.003],腹腔引流管留置数量及时间减少[(0.95±0.50)根vs.(2.03±0.45)根,P=0.000]、[(5.05±3.64)d vs.(8.69±5.40)d,P=0.008],术后经口进食时间提前[(1.71±2.39)d vs.(5.39±2.54)d,P=0.000],术后下床活动时间提前[(2.14±1.42)d vs.(3.47±1.80)d,P=0.005],术后住院时间缩短[(6.48±3.40)d vs.(10.56±6.54)d,P=0.010],住院费用减少[(68 270.57±13 277.11)元vs.(81 068.18±27187.35)元,P=0.021],术后疼痛减轻,两组病人术后6、12、24及48 h数字疼痛评分逐渐减少(P=0.001,0.000,0.000,0.000);两组术后并发症发生率为9.5%vs.11.1%(P=1.000),两组病人无围手术期死亡病例,术后1个月内均无再入院病例。结论胃癌根治术病人应用ERAS理念可以促进术后胃肠功能恢复,减轻术后疼痛,缩短住院时间,减轻经济负担。ERAS理念应用于胃癌根治术安全可行。 相似文献
11.
【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。 相似文献
12.
13.
O'Rourke RW Kay T Scholz MH Diggs B Jobe BA Lewinsohn DM Bakke AC 《Obesity surgery》2005,15(10):1463-1468
Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral
blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear
cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster
differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference
12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations
in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data
suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for
further study into obesity's effects on the immune system. 相似文献
14.
目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况,为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养,分为4组:I:Adv-hBMP-2转染组;Ⅱ:Adv—β—gal转染组;Ⅲ:未转染组;Ⅳ:地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达,其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal,该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。 相似文献
15.
16.
Parvez Sheikh 《The Indian journal of surgery》2012,74(3):217-220
Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies. 相似文献
17.
18.
《Archivos de bronconeumologia》2020,56(9):559-563
IntroductionSmoking-attributable mortality (SAM) is a valuable indicator that can be used to characterize the course and health burden of the smoking epidemic. The aim of this paper was to estimate SAM in Spain in 2016 in the population aged 35 and over, using the best available evidence.MethodsA smoking prevalence-dependent analysis based on the estimation of population-attributable fractions was performed. Smoking prevalence (never, former, and current smokers) was calculated from a combination of the Spanish Health Survey (2016) and the European Health Survey (2014); the relative risk of death among current and former smokers was taken from the follow-up of various cohorts; and mortality rates were obtained from National Center for Statistics data. SAM estimates are presented globally, and by sex, age groups, and major disease categories: cancer, cardiometabolic diseases and respiratory diseases.ResultsIn 2016, 56,124 deaths were attributed to tobacco consumption, 84% in men (47,000), and 50% in the population aged over 74 (27,795). Overall, 50% of SAM was due to cancer (28,281), 65% of which was lung cancer. One in 4 attributable deaths (13,849) occurred before the age of 65.ConclusionsOne in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of SAM clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease. 相似文献
19.
Purpose
Minimally invasive surgery has evolved into single-incision laparoscopic surgery (SILS) in the recent years. Few reports have addressed the practicality of SILS in children. Our current experience with regard to feasibility and effectiveness of SILS in children is presented.Methods
A retrospective review of the operative database for patients operated on using SILS in our department from March 2009 to July 2010 was performed. Data regarding the type of the procedure, age, sex, operative performance, hospital stay, and complications were collected.Main Results
Among 43 patients, cholecystectomy was performed in 11; appendectomy, in 10; unroofing for ovarian cysts, in 5; unroofing for splenic cysts, in 4; oophorectomy, in 6 (ovarian torsion, 2; teratoma, 4); ovary-preserving teratoma excision, in 1; splenectomy, in 1; gonadectomy, in 3; and varicocelectomy, in 2. There were no conversions to standard laparoscopic or open techniques. The only postoperative complication was a wound infection that occurred after an appendectomy.Conclusion
Although currently more expensive, SILS can be performed in children in almost every pediatric surgical procedure that can be accomplished with conventional laparoscopic techniques. The most significant contribution of SILS procedure is cosmesis. Postoperative pain and length of hospital stay were not improved. 相似文献20.
MicroRNAs(miRNAs or miRs) are small approximately 22 nucleotide RNA species that are believed to regulate diverse metabolic and physiological processes.In the recent past,several reports have surfaced that demonstrate the role of miRNAs in various biological processes and numerous disease states.For a disease as complex as diabetes,the emergence of miRNAs as key regulators leading to the disease phenotype has added a novel dimension to the area of diabetes research.On the other hand,the liver,a metabolic hub,contributes in a major way towards maintaining normal glucose levels in the body as it can both stimulate and inhibit hepatic glucose output.This equilibrium is frequently disturbed in diabetes and hence,the liver assumes special significance considering the correlation between altered hepatic physiology and diabetes.While the understanding of the mechanisms behind this altered hepatic behavior is not yet completely understood,recent reports on the status and role of miRNAs in the diabetic liver have further added to the complexities of the knowledge of hepatic pathophysiology in diabetes.Here,we bring together the various miRNAs that play a role in the altered hepatic behavior during diabetes. 相似文献