腹腔镜超低位直肠癌保肛手术应用价值分析

目的探讨腹腔镜超低位直肠癌保肛手术的临床应用效果及安全性。方法选取本院2015年10月～2018年10月收治的258例直肠癌患者作为研究对象,按照随机数表法将其分为观察组和对照组,每组各129例。对照组患者采用传统开腹保肛手术治疗,观察组患者给予腹腔镜超低位直肠癌保肛手术治疗。比较两组患者的各项手术指标、近期疗效和术后随访3个月不良反应发生情况。结果观察组患者近期有效率为96.90%,显著高于对照组的83.72%(P0.05);观察组患者的手术时间、术中出血量、引流量和胃肠道功能恢复时间均明显少于对照组,切口长度明显小于对照组(P0.05);观察组患者不良反应发生率为11.63%,明显低于对照组的28.68%,差异具有统计学意义(P0.05)。结论直肠癌患者采用腹腔镜超低位直肠癌保肛手术治疗效果好,术后不良反应少,有利于患者的恢复和预后,值得临床推广应用。     

传统开腹手术与腹腔镜手术治疗卵巢囊肿临床疗效对比研究

目的 观察对比开腹手术与腹腔镜手术治疗卵巢囊肿的各自临床效果.方法 将243例卵巢囊肿患者随机分为治疗组128例和对照组115例.对照组给予开腹手术治疗,治疗组给予腹腔镜手术治疗,观察两组患者的手术时间、术中出血量、并发症及住院时间,同时对患者随访观察3年.结果 治疗组术中出血量少于对照组,术后并发症发生率低于对照组,住院时间短于对照组,差异均有统计学意义(P＜0.05);治疗组手术时间短于对照组,但差异无统计学意义(P＞0.05).结论 腹腔镜手术治疗卵巢囊肿其临床疗效较为显著,大大减少了手术伤口及术中的出血量,同时也降低了对卵巢功能的损害,避免了永久性的服药,值得临床推广应用.     

腹腔镜与传统开腹手术治疗直肠癌的安全性及远期疗效比较

目的 探讨腹腔镜辅助治疗直肠癌手术与传统开腹方法的安全性及远期疗效的差异.方法 回顾性分析从2010年1月到2013年1月本院收治的直肠癌根治患者297例.根据患者手术时自愿选择的手术方式将其分为腹腔镜组和开腹组,其中腹腔镜组129例,开腹组168例.手术后随访检查,比较两组手术的基本情况(手术时间、术中出血量、住院时间)、安全性(淋巴结清扫数量)和1年、3年的远期疗效(局部复发率、远端转移率、生存率、无瘤生存率).结果 腹腔镜手术较传统开腹手术的术中出血量少、住院时间短(P＜0.05);手术时间和淋巴结清扫数量方面差别无统计学意义(P＞0.05).远期疗效中两组患者的复发率、转移率、生存率、无瘤生存率差别均无统计学意义(P＞0.05).结论 腹腔镜直肠癌根治手术在近期效果上较传统开腹手术有优势,而远期疗效上又能达到与开腹手术相同的疗效,不会增加直肠癌的复发率和转移率,值得推广.     

腹腔镜联合肛门内镜行低位直肠癌根治术的疗效分析

目的探讨腹腔镜联合肛门内镜治疗低位直肠癌患者的临床疗效。方法回顾性分析重庆市急救医疗中心结直肠外科2013年4月至2017年10月收治的64例低位直肠癌患者的临床资料,按照手术方法的不同分为对照组和观察组,每组32例。对照组患者行腹腔镜全直肠系膜切除术治疗,观察组患者行肛门内镜联合腹腔镜全直肠系膜切除术治疗。比较2组患者的手术时间、腹壁切口长度、术中出血量、术后首次排气时间、首次下床活动时间、住院时间等相关指标,比较2组患者肺部感染、造口出血、切口漏等并发症发生情况及术后2年复发转移率,同时比较术前及术后1个月2组患者胃泌素、胃动素等胃肠指标水平,比较术后6个月及12个月2组患者的肛门功能Wexner评分。结果观察组与对照组患者的手术时间、术后首次排气时间、首次下床活动时间、住院时间比较差异无统计学意义(P0.05),观察组患者腹壁切口长度及术中出血量均短/少于对照组(P 0.05)。观察组患者并发症总发生率低于对照组(P 0.05)。术后1个月观察组患者血清胃泌素、胃动素水平高于对照组(P 0.05)。术后6个月观察组患者Wexner评分低于对照组(P 0.05),但术后12个月2组患者Wexner评分比较差异无统计学意义(P 0.05)。术后2年2组患者复发转移率比较差异无统计学意义(P0.05)。结论腹腔镜联合肛门内镜治疗低位直肠癌的疗效及术后2年内复发转移情况与腹腔镜全直肠系膜切除术相当,但其术后并发症发生率更低,对患者胃肠功能及肛门功能影响更小。     

腹腔镜与开腹手术治疗上消化道穿孔的临床效果比较

目的：比较腹腔镜与开腹手术治疗上消化道穿孔的临床疗效。方法回顾性分析我院2010年6月~2013年12月收治的经腹腔镜手术及开腹手术治疗的上消化道穿孔患者各40例,比较两组患者手术时间、术中出血量、术后排气时间、住院时间。结果腹腔镜组患者手术时间、术中出血量、术后排气时间、住院时间上均少于开腹手术组,经统计学分析组间差异有统计学意义(<0.05)。结论腹腔镜手术治疗上消化道穿孔的临床疗效优于开腹手术组,值得临床进一步推广使用。     

不同手术入路在腹腔镜直肠癌前切除低位吻合术中的应用

目的研究经不同手术入路行保留左结肠动脉的腹腔镜直肠癌前切除低位吻合术的效果。方法回顾性分析我科2016年1月至2017年12月收治的80例行腹腔镜直肠癌前切除低位吻合术患者的临床资料,并按手术入路的不同分组,其中40例患者术中采取头侧中间入路,设为改良组;另外40例患者术中采取传统中间入路,设为传统组。比较2组患者手术时间、术中出血量、住院时间、术后并发症、左结肠后间隙打开时间、肠系膜下动脉周围淋巴结清扫时间、第253组淋巴结清扫数目、肿瘤下切缘距离、术后排气时间及远期预后情况,对比两种手术入路方式的临床效果。结果在手术时间、住院时间、术中出血量、肿瘤下切缘距离及术后排气时间方面,2组患者比较差异无统计学意义(P>0.05);而在肠系膜下动脉周围淋巴结清扫时间及第253组淋巴结清扫数目上,改良组优于传统组,差异有统计学意义(P<0.05);在术后并发症方面,改良组发生7例(17.50%),传统组发生8例(20.00%),2组比较差异无统计学意义(P>0.05)。结论采取头侧中间入路腹腔镜下直肠癌前切除低位吻合术治疗直肠癌患者,可有效缩短肠系膜下动脉周围淋巴结清扫时间,在第253组淋巴结清扫上较传统中间入路更具优势。     

腹腔镜和开腹手术治疗化脓性阑尾炎的对比研究

目的探讨腹腔镜阑尾切除术治疗化脓性阑尾炎的临床应用价值。方法回顾分析113例化脓性阑尾炎的手术治疗病例,其中行腹腔镜阑尾切除术61例（LA组）,行开腹阑尾切除术52例（OA组）。比较两组的手术时间、术中出血量、术后肛门排气时间、术后疼痛程度、术后住院时间、切口感染率和住院费用。结果 LA组中有4例中转开腹。LA组的住院费用和术中出血量高于OA组（P〈0.05）,术后疼痛程度和切口感染率较OA组低（P〈0.05）。两组患者在手术时间、术后住院时间和术后肛门排气时间的差异无统计学意义（P〉0.05）。结论腹腔镜和开腹手术治疗化脓性阑尾炎各有优势,临床工作中应根据患者具体病情和医师的手术经验合理选用。     

腹腔镜下宫颈癌根治术与传统开腹手术的对比研究

目的 对比研究腹腔镜下宫颈癌根治术和传统开腹宫颈癌根治术的临床疗效、安全性、术后生活质量等。方法 选择湖南省肿瘤医院妇瘤科2014年5月~2016年12月因宫颈癌行手术的患者200例,根据手术方式分为两组,各100例。开腹组采用传统开腹手术,腹腔镜组采用腹腔镜下宫颈癌根治术治疗,对比两组患者的手术情况、并发症、术后恢复情况以及FACT-G评分。结果 腹腔镜组前50例手术时间为（280.0±32.5）min,长于开腹组的（190.0±23.2）min,差异具有统计学意义（P＜0.05）,但腹腔镜组中按照时间顺序后50例手术时间为（200.0±22.6）min,与开腹组相比,差异无统计学意义（P＞0.05）。腹腔镜组中出血量（125.3±48.2）ml,少于开腹组的（230.0±70.2）ml,统计学意义显著（P＜0.01）。腹腔镜组中淋巴结清扫数目多于开腹组,差异具有统计学意义（P＜0.05）。腹腔镜组术中损伤、切口愈合不良、淋巴囊肿发生率与开腹组比较,差异无统计学意义（P＞0.05）。腹腔镜组尿潴留发生率为35.00%,高于开腹组的12.00%,差异具有统计学意义（P＜0.05）。腹腔镜组术后48 h疼痛评分、肛门排气时间、术后住院日及术后FACT-G评分均优于开腹组,差异具有统计学意义（P＜0.05）。结论 腹腔镜手术治疗宫颈癌疗效确切,具有创伤小、恢复快、术后生活质量高等优点。     

腹腔镜与传统开腹手术治疗直肠癌疗效的比较

目的:通过传统开腹手术对照,研究腹腔镜治疗胃癌的效果。方法:2013年5月至2015年5月我院86例直肠癌患者随机分成腹腔镜组和传统开腹组,分别进行腹腔镜和传统开腹手术治疗。观察手术时间、出血量、切除肠管长度、清扫淋巴结数量、术后胃肠功能恢复时间、住院时间和并发症。结果:腹腔镜组术中出血量少于传统开腹组,而腹腔镜组手术时间明显长于传统开腹组;腹腔镜组的胃肠道功能恢复时间和术后住院时间短于传统开腹组;腹腔镜组和传统开腹组的术后并发症分别为14.0%和23.3%(P0.05)。腹腔镜组和传统开腹组淋巴结清除数目和肠管切除长度没有显著性差别。结论:腹腔镜直肠根治术治疗直肠癌的疗效确切,与传统手术方式相比,术后并发症及恢复等方面有明显的优势。     

腹腔镜手术与开腹手术治疗输卵管妊娠的临床效果观察

目的：观察分析在输卵管妊娠治疗中腹腔镜手术与开腹手术的临床效果。方法回顾性分析60例输卵管妊娠患者临床资料,随机分为研究组(30例)和对照组(30例),研究组采用腹腔镜手术治疗,对照组采用开腹手术治疗,对比观察两组患者临床效果。结果研究组手术时间、术中出血量、术后排气时间、术后并发症、住院时间均优于对照组,具有统计学差异意义(P<0.05)。结论采用腹腔镜手术治疗输卵管妊娠临床效果显著,能有效缩短手术时间,减少术中出血量,降低术后并发症发生率,效果优于开腹手术,是治疗输卵管妊娠的理想方法。     

Rates of oxygen consumption and of anaerobic glycolysis in renal cortex and medulla of adult and new-born rats and guinea-pigs

1. Rates of oxygen uptake and of anaerobic glycolysis were estimated in slices from the renal cortex and medulla (a) of adult rats and guinea-pigs, (b) of new-born (1-, 5- and 21-day-old) rats and of guinea-pigs of 1, 12, 21, 24 and 120 hr age.2. In the adult rat, Q(O2) values for the cortex were 12.55 +/- 0.20 (22) and for the medulla: 8.56 +/- 0.17 (22) mul./hr.mg dry weight, while in the new-born rat (24 hr old) they were 10.99 +/- 0.46 (12) and 9.33 +/- 0.18 (9) mul./hr.mg dry weight respectively.3. Values for Q(CO2) (N2) (anaerobic glycolysis) in the 14 hr old new-born rat were in the renal cortex 9.65 +/- 0.35 (5) and in the medulla 7.39 +/- 0.43 (5) mul./hr.mg dry weight; while in the adult they were 2.25 +/- 0.08 (16) and 5.76 +/- 0.14 (16) mul./hr.mg dry weight, respectively.4. In the adult guinea-pig values for Q(CO2) (N2) were of the same order as in the adult rat, though the rate of O(2) uptake was for the cortex 8.12 +/- 0.22 (12) and for the medulla 5.02 +/- 0.23 (11) mul./hr.mg dry weight.5. Though the Q(O2) values in the renal cortex and medulla were smaller in the 1 hr old new-born guinea-pig, they were already increasing in the 12 hr old neonate.6. The results are discussed in the light of enzyme changes occurring during the process of maturation of the nephron as indicated by histochemical observations.     

Timing and intensity of early fevers and the development of allergies and asthma

BACKGROUND: Early childhood fevers appear to protect against later allergies and asthma. What is not known is the time in which fevers exert this effect and whether the degree of temperature increase is important. OBJECTIVE: We sought to examine the relationship between the time and degree of early fevers and later allergies and asthma. METHODS: Eight hundred thirty-five children from southeast Michigan were enrolled at birth. Clinic records from their first 2 years were abstracted for episodes of fever. At age 6 to 7 years, children underwent allergy testing. We examined fevers occurring within 6-month intervals in the first 2 years of life and outcomes at age 6 to 7 years. The primary outcome measures were allergic sensitization, asthma, asthma with allergic sensitization, and asthma without allergic sensitization. RESULTS: In the unadjusted analysis each episode of fever between 7 and 12 months of age was associated with a lower odds of allergic sensitization (odds ratio [OR], 0.71; 95% CI, 0.54-0.93) and asthma with allergic sensitization (OR, 0.43; 95% CI, 0.21-0.90) at age 6 to 7 years. Likewise, every 1 degrees C increase in the maximum temperature between 7 and 12 months was associated with a lower odds of allergic sensitization (OR, 0.77; 95% CI, 0.61-0.96) and asthma with allergic sensitization (OR, 0.62; 95% CI, 0.40-0.94). After adjusting for potential confounders, each episode of fever between 7 and 12 months was associated with a lower likelihood of asthma with allergic sensitization (adjusted OR, 0.33; 95% CI, 0.11-0.94) at age 6 to 7 years. CONCLUSIONS: Both the timing and intensity of childhood fevers appear to be important factors in the development of allergies and asthma.     

Modes of reinforcement and gender and culture of experimenter and subject: effects of "alien" and external reinforcement for Japanese and American men and women

In this study, we examined external and "alien" reinforcement (ER and AR. respectively) as a factor in social learning, and studied the combined effects of culture and reinforcement mode. A female (Experiment 1) and a male (Experiment 2) experimenters conducted experimental sessions. Both men and women, who grew up in the same culture as the experimenter, participated and performed the experimental task. A three-way interaction effect of experimenter gender, culture, and reinforcement mode was found on task performance. And the effect was more pronounced for a Japanese experimenter. A female and a male experimenters conducted Experiments 3 and 4, respectively; however participants this time were men and women who grew up in different cultures than the experimenter. Results indicated that the pattern of the subject gender and reinforcement mode interaction effect, when the experimenter was Japanese with American subjects, was exactly opposite to that when the experimenter was American. These experiments showed that AR was as effective for social learning as ER, and that the cultural backgrounds of experimenter and subject influenced AR and ER effectiveness.     

纳米水平分子成像与诊疗一体化研究进展与挑战

分子成像能以非侵入性的方式重现活体细胞的生理功能和生物学过程,提高疾病的早期和特异性诊断水平。纳米颗粒/材料具有物理性质可控性高、易于表面修饰、血液循环时间长和可功能化等优点,在疾病诊断与治疗中显示出巨大潜力。但如何阐明纳米材料多功能间的内在联系、解决其代谢及安全性等关键机制难题、实现纳米颗粒/材料多功能性到临床多功能...