经脐单孔腹腔镜胆囊切除术11例的整体护理

目的总结整体护理在经脐单孔腹腔镜胆囊切除术围手术期的应用。方法分析11例经脐单孔腹腔镜胆囊切除术患者的临床资料。结果本组患者对新技术的接受性、依从性提高,能接受和配合护士的指导与护理。结论通过系统的整体护理是经脐单孔腹腔镜胆囊切除术患者手术成功的重要保证。     

经脐单孔法腹腔镜胆囊切除术89例围手术期的护理

目的探讨经脐单孔法腹腔镜胆囊切除术患者的围手术期护理。方法 2009-03-2009-12为89例患有胆囊结石及胆囊息肉进行经脐单孔法腹腔镜胆囊切除术的患者,通过周密的术前准备,密切的术后观察及完善的术后指导,为患者的康复提供安全有效的护理。结果 89例患者手术及围手术期护理均顺利完成,无手术并发症。结论完善的围手术期护理措施可以为经脐单孔腹腔镜下胆囊切除术提供有效的保障。     

手术室舒适护理在经脐单孔腹腔镜胆囊切除术中的应用

目的 总结和探讨经脐单孔腹腔镜胆囊切除术患者手术过程中舒适护理的措施.方法 对14例在本院入院接受经脐单孔腹腔镜胆囊切除术的患者,手术室护理人员采取针对性的舒适护理措施.结果 14例手术均顺利完成,患者能积极主动配合治疗,心理和生理方面均有明显改善,术后随访患者对手术满意度较高.结论 手术室护理人员对经脐单孔腹腔镜胆囊...     

经脐单孔腹腔镜肾切除术:首例经验与体会

目的 汇报国内首例经脐单孔腹腔镜肾切除术的经验与体会,并探讨其可行性.方法 1例左肾萎缩无功能合并同侧肾结石患者行单孔腹腔镜肾切除术.在脐部做-4cm切口,经脐建立腹腔镜单孔4通道操作通道,维持气腹并完成肾切除手术.结果 手术时间为126 min,手术顺利完成,切除左侧肾脏同时取出结石,术后未放置引流管,无出血等并发症发生,术后第3天患者顺利出院,脐部几乎无明显手术瘢痕.结论 经脐单孔腹腔镜肾切除术安全可行,较传统多孔腹腔镜更加微创美容.     

经脐单孔法腹腔镜胆囊切除术的手术配合

目的 探讨经脐单孔法腹腔镜胆囊切除术的手术护理配合要点.方法 对5例30岁以下术经脐单孔法腹腔镜胆囊切除术的手术护理配合步骤进行回顾性总结.结果 5例经脐单孔法腹腔镜胆囊切除术均顺利完成手术,术后随访切口甲级愈合,恢复好,无一例并发症发生.结论 认真做好术前访视主心理护理,正确准备手术器械和特殊用品,熟悉仪器性能,密切配合手术操作是手术成功的有效保证.经脐单孔法腹腔镜胆囊切除术满足了患者更微创、更美观、术后痛苦更少的心理需求,受到患者的欢迎.     

经脐单孔腹腔镜胆囊切除术前超声评估价值

目的 探讨超声检查在经脐单孔腹腔镜胆囊切除术前评估中的应用价值.方法 回顾性分析行经脐单孔腹腔镜胆囊切除术90例结石性胆囊炎患者的超声声像图资料.结果 术前超声示单发结石26例,多发结石64例;90患者均符合经脐单孔腹腔镜胆囊切除术手术适应证,82例完成经脐单孔腹腔镜胆囊切除术,8例中转行多孔腹腔镜胆囊切除术.结论 超声检查在经脐单孔腹腔镜胆囊切除术术前评估中有重要指导意义.     

尿道途径辅助下经脐单孔腹腔镜根治性全膀胱切除术25例护理配合

目的:探讨尿道途径辅助下经脐单孔腹腔镜根治性全膀胱切除术的护理配合效果。方法:对25例膀胱癌患者在尿道途径辅助下采用经脐单孔腹腔镜根治性全膀胱切除术,总结护理配合方法。结果:手术配合顺利,手术均在尿道途径辅助下于单孔腹腔镜下完成,手术时间245~530(367.0±6.7)min、出血量80~500(247.0±6.9)ml、住院时间9~83(22.0±7.8)d,无围术期死亡病例。结论:尿道途径辅助下经脐单孔腹腔镜根治性全膀胱切除术安全可行,该手术方法能有效减少器械间的相互干扰,降低手术难度及风险,充分的术前准备,准确熟练的护理配合,是保证手术顺利进行的关键。     

经脐单孔腹腔镜下脾脏切除术患者二例的护理

目的探讨经脐单孔腹腔镜下脾脏切除术患者的护理方法。方法回顾性分析2011年5月在南方医科大学珠江医院肝胆二科行经脐单孔腹腔镜下脾脏切除术患者2例的临床资料,并总结其护理方法。结果2例患者均顺利完成手术,无加孔或中转开腹,术后第5天均康复出院,1个月后随访无并发症。结论脐单孔腹腔镜下脾脏切除术具有创伤小、恢复快、美容效果好等优点,是值得临床推广的手术。     

两种腹腔镜胆囊切除术后疼痛情况比较及护理

目的:比较经脐单孔腹腔镜胆囊切除术与常规腹腔镜胆囊切除术患者的术后疼痛情况。方法:将65例择期行腹腔镜胆囊切除术患者随机分为观察组32例和对照组33例,对照组采用常规腹腔镜胆囊切除术和常规手术护理,观察组采用经脐单孔腹腔镜胆囊切除术和围术期护理,比较两组患者术后疼痛评分。结果:观察组术后0.5、4、8、12、24 h疼痛评分低于对照组(P0.05)。结论:经脐单孔腹腔镜胆囊切除术患者术后疼痛轻。     

经脐单孔腹腔镜胆囊切除术3O例的护理

目的探讨经脐单孔腹腔镜胆囊切除术的护理方法。方法使用常规腹腔镜器械对30例患者进行经脐腹腔镜胆囊切除术。结果30例患者手术均获成功,无并发症发生,伤口愈合良好,除脐部外,腹壁无手术瘢痕。结论经脐单孔腹腔镜手术创伤比普通腹腔镜手术更小,因此患者术后疼痛更轻,恢复更快,护理方法简单。     

Blood group genotyping for Jk(a)/Jk(b), Fy(a)/Fy(b), S/s, K/k, Kp(a)/Kp(b), Js(a)/Js(b), Co(a)/Co(b), and Lu(a)/Lu(b) with microarray beads

BACKGROUND: Traditionally, blood group typing has been performed with serologic techniques, the classical method being the hemagglutination test. Serotyping, however, may present important limitations such as scarce availability of rare antisera, typing of recently transfused patients, and those with a positive direct antiglobulin test. Consequently, serologic tests are being complemented with molecular methods. The aim of this study was to develop a low-cost, high-throughput method for large-scale genotyping of red blood cells (RBCs). STUDY DESIGN AND METHODS: Single-nucleotide polymorphisms associated with some clinically important blood group antigens, as well as with certain rare blood antigens, were evaluated: Jk(a)/Jk(b), Fy(a)/Fy(b), S/s, K/k, Kp(a)/Kp(b), Js(a)/Js(b), Co(a)/Co(b), and Lu(a)/Lu(b). Polymerase chain reaction (PCR)-amplified targets were detected by direct hybridization to microspheres coupled to allele-specific oligonucleotides. Cutoff values for each genotype were established with phenotyped and/or genotyped samples. RESULTS: The method was validated with a blind panel of 92 blood donor samples. The results were fully concordant with those provided by hemagglutination assays and/or sequence-specific primer (SSP)-PCR. The method was subsequently evaluated with approximately 800 blood donor and patient samples. CONCLUSION: This study presents a flexible, quick, and economical method for complete genotyping of large donor cohorts for RBC alleles.     

Diurnal variation in lipoprotein-associated phospholipase A(2) (Lp-PLA(2))

ObjectivesThe aim of our study was to determine the diurnal variation of lipoprotein-associated phospholipase A₂ (Lp-PLA₂), an arterial-specific inflammatory enzyme implicated in the formation of vulnerable, rupture-prone plaque that can identify individuals at high risk for cardiovascular disease. Presently, the diurnal variation of Lp-PLA₂ is not known.Design and MethodsTen men and 8 women (age range: 22–76 years) had a blood sample taken every 4 h over a 24-hour time period. Samples were analyzed for both Lp-PLA₂ mass and activity.ResultsThe mean coefficient of variation (CV) for Lp-PLA₂ mass was 5.9% (ranges from 2.5 to 9.4%) for the 18 subjects. Similarly, the mean CV for Lp-PLA₂ activity was 3.7% (ranges from 1.2 to 6.8%). There were no significant correlations between CV and any of the subject characteristics.ConclusionsThe diurnal variation of Lp-PLA₂ mass and activity is similar to that of well accepted lipoprotein risk factors. With the relatively low diurnal variability, there does not appear to be a need to make sure serial measurements of Lp-PLA₂ mass and activity are taken at the same time of the day.     

Glinide(s), sulfonylurea(s)

Diabetic macroangiopathy has already developed before diagnosis of diabetes mellitus. Postprandial hyperglycemia has been known as a risk factor for diabetic macroangiopathy and may be more powerful than fasting hyperglycemia. To intervene in hyperglycemia, insulin secretagogues, glinides which selectively stimulate early meal-induced insulin secretion and improve postprandial hyperglycemia, and sulfonylureas which enhance total daily insulin secretion and improve fasting hyperglycemia, have been prescribed as major oral antidiabetic agents. Few evidences that amelioration of glycemic control with insulin secretagogues lower the risk of cardiovascular diseases have been reported. But current studies have shown that intervention in postprandial hyperglycemia with drugs including glinides decreased thickness of carotid IMT as a surrogate marker of atherosclerosis. Results from on-going large scale intervention study with glinides may clarify whether amelioration of hyperglycemia lower the risk of atherosclerotic events.     

Alpha(4)beta(7)/alpha(4)beta(1) dual integrin antagonists block alpha(4)beta(7)-dependent adhesion under shear flow

The alpha(4) integrin, alpha(4)beta(7), plays an important role in recruiting circulating lymphocytes to the gastrointestinal tract, where its ligand mucosal addressin cell adhesion molecule-1 (MAdCAM-1) is preferentially expressed on high endothelial venules (HEVs). Dual antagonists of alpha(4)beta(1) and alpha(4)beta(7), N-(2,6-dichlorobenzoyl)-(L)-4-(2',6'-bis-methoxyphenyl)phenylalanine (TR14035) and N-(N-[(3,5-dichlorobenzene)sulfonyl]-2-(R)-methylpropyl)-(D)-phenylalanine (compound 1), were tested for their ability to block the binding of alpha(4)beta(7)-expressing cells to soluble ligand in suspension and under in vitro and in vivo shear flow. Compound 1 and TR14035 blocked the binding of human alpha(4)beta(7) to an (125)I-MAdCAM-Ig fusion protein with IC(50) values of 2.93 and 0.75 nM, respectively. Both compounds inhibited binding of soluble ligands to alpha(4)beta(1) or alpha(4)beta(7) on cells of human or rodent origin with similar potency. Under shear flow in vitro, TR14035 and compound 1 blocked binding of human alpha(4)beta(7)-expressing RPMI-8866 cells or murine mesenteric lymph node lymphocytes to MAdCAM-Ig with IC(50) values of 0.1 and 1 microM, respectively. Intravital microscopy was used to quantitate alpha(4)-dependent adhesion of fluorescent murine lymphocytes in Peyer's patch HEVs. When cells were prestimulated with 2 mM Mn(2+) to activate alpha(4)beta(7) binding to ligand, anti-alpha(4) monoclonal antibody (mAb) [10 mg/kg (mpk) i.v.] blocked adhesion by 95%, and anti-beta(1) mAb did not block adhesion, demonstrating that this interaction was dependent on alpha(4)beta(7). TR14035 blocked adhesion to HEVs [ED(50) of 0.01-0.1 mpk i.v.], and compound 1 blocked adhesion by 47% at 10 mpk i.v. Thus, alpha(4)beta(7)/alpha(4)beta(1) antagonists blocked alpha(4)beta(7)-dependent adhesion of lymphocytes to HEVs under both in vitro and in vivo shear flow.     

电视辅助胸腔镜外科

１概述 电视辅助胸腔镜外科（Ｖｉｄｅｏ—ａｓｓｉｓｔｅｄ ＴｈｏｒａｃｉｃＳｕｒｇｅｒｙ,ＶＡＴＳ）是内镜外科在设备和手术器械不断发展的基础上产生的“微侵入”外科技术。如腹腔镜技术在外科的应用一样,９０年代以来,ＶＡＴＳ在胸外科领域也得到蓬勃发展。 ＶＡＴＳ的出现改变了胸腔内镜技术的面貌。早在１９１０年,瑞士内科医师Ｊａｃｏｂｅｕｓ首先把膀胱镜技术移植到胸腔内,用于诊断胸膜病灶以及应用到治疗肺结核的胸膜粘连术和肺萎陷疗法。开辟了内镜诊断、治疗胸部疾病的先例［１］。以后,在２０世纪三四十年代,逐渐发…