Risk factors for wound infection after cholecystectomy.

BACKGROUND AND PURPOSE: Surgical site infection (SSI) after cholecystectomy is a common problem. The aim of this study was to identify the possible risk factors for the development of SSI. METHODS: 545 consecutive patients who received open (125) or laparoscopic (420) cholecystectomy due to gallbladder disease during the years 1998 to 2000 were included in the study. Potential risk factors including clinical features, biochemical data, and operative types were analyzed by univariate and multivariate analysis. RESULTS: The overall incidence of SSI was 4.4% (24/545). The wound complication rate was significantly lower in the laparoscopic group than in the open group (1.4% vs 14.4%, respectively). Factors associated with SSI found by univariate analysis (p < 0.05) included age, gender, acute cholecystitis, white blood cell count, serum albumin, blood glucose and bilirubin level, type of surgery, operative time and positive bile culture. Stepwise logistic regression analysis showed that abnormal blood glucose [odds ratio (OR), 4.7; 95% confidence interval (CI), 1.6 to 13.5], positive bile culture (OR, 3.5; 95% CI, 1.2 to 10.4), and open cholecystectomy (OR, 4.3; 95% CI, 1.3 to 13.6) were the most significant predictors of SSI. CONCLUSION: Poor control of diabetes mellitus before surgery, positive bile culture and open cholecystectomy significantly increased the rate of SSI. These findings indicate that better control of diabetes mellitus, and appropriate selection of surgical procedure and antibiotic regimen in the management of high-risk patients may reduce the incidence of postoperative SSI.     

拉米夫定对不同中医证型的慢性乙型肝炎疗效辨析

拉米夫定是一种有效的抗乙肝病毒药物,它对病毒的逆转录酶有明显的抑制作用,可抑制乙肝病毒的复制,降低血液和肝脏中的病毒数量,改善肝脏生化功能和组织学病变,从而提高患者生存质量。为进一步提高拉米夫定治疗慢性乙型肝炎的疗效,本文收集统计了近4年的80例相关病例,从中医辨证的角度,分析应用拉米夫定治疗不同证型的慢性乙型肝炎的疗效。现报告如下。1临床资料1·1一般资料收集本院肝炎科门诊慢性乙型肝炎患者80名,其中男性47名,女性33名,年龄17~64岁,平均35岁。诊断标准依据2000年全国传染病与寄生虫病学会和肝病学会修订的病毒性肝炎诊…     

Neuroprotective strategies in parkinson’s disease: protection against progressive nigral damage induced by free radicals

Brain undergoes neurodegeneration when excess free radicals overwhelm antioxidative defense systems during senescence, head trauma and/or neurotoxic insults. A site-specific accumulation of ferrous citrate-iron complexes in the substantia nigra dopaminergic neurons could lead to exaggerated dopamine turnover, dopamine auto-oxidation, free radical generation, and oxidant stress. Eventually, this iron-catalyzed dopamine auto-oxidation results in the accumulation of neuromelanin, a progressive loss of nigral neurons, and the development of Parkinson's disease when brain dopamine depletion is greater than 80%. Emerging evidence indicates that free radicals such as hydroxyl radicals ((.-)OH) and nitric oxide ((.-)NO) may play opposite role in cell and animal models of parkinsonism. (.-)OH is a cytotoxic oxidant whereas oNO is an atypical neuroprotective antioxidant. (.-)NO and S-nitrosoglutathione (GSNO) protect nigral neurons against oxidative stress caused by 1-methyl-4-phenylpyridinium (MPP(+)), dopamine, ferrous citrate, hemoglobin, sodium nitroprusside and peroxynitrite. MPP(+), the toxic metabolite of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), increases the nigral uptake of iron complexes and dopamine overflow leading to the generation of (.-)OH, protein oxidation, lipid peroxidation, and associated retrograde degeneration. In addition to GSNO, MPP(+)-induced oxidative neurotoxicity can be prevented by antioxidants including selegiline, 7-nitroindazole, 17beta-estradiol, melatonin, alpha-phenyl-tert-butylnitrone and U78517F. Similar to selegiline, 7-nitroindazole is a MAO-B inhibitor, which blocks the bio-activation of MPTP and oxidative stress. Freshly prepared but not light exposed, (.-)NO-exhausted GSNO is about 100 times more potent than the classic antioxidant glutathione. Via S-nitrosylation, GSNO also inhibits proteolysis and cytotoxicity caused by caspases and HIV-1 protease. Furthermore, in addition to protection against serum deprivation stress, the induction of neuronal NOS1 in human cells increases tolerance to MPP(+)-induced neuro-toxicity since newly synthesized (.-)NO prevents apoptosis possibly through up-regulation of bcl-2 and down regulation of p66(shc). In conclusion, reactive oxygen species are unavoidable by-products of iron-catalyzed dopamine auto-oxidation, which can initiate lipid peroxidation, protein oxidation, DNA damage, and nigral loss, all of which can be prevented by endogenous and exogenous (.-)NO. Natural and man-made antioxidants can be employed as part of preventative or neuroprotective treatments in Parkinson's disease and perhaps dementia complexes as well. For achieving neuroprotection and neuro-rescue in early clinical parkinsonian stages, a cocktail therapy of multiple neuroprotective agents may be more effective than the current treatment with extremely high doses of a single antioxidative agent.     

不同提取方法制备石菖蒲挥发性成分的GC-MS比较研究

目的:比较不同提取方法制备的石菖蒲挥发油中的挥发性化学成分。方法:采用传统的水蒸气蒸馏提取挥发油,超临界流体萃取挥发油和顶空进样直接采集挥发性成分3种方法,对石菖蒲中的挥发性成分进行GC-MS分析。结果:顶空进样技术鉴定出44种挥发性化学成分;水蒸气蒸馏法可鉴定出23种挥发性化学成分;超临界流体萃取可鉴定出25种化合物,经GC-MS分析,水蒸气蒸馏法与粉末顶空进样有14种化合物相同,超临界流体萃取与粉末顶空进样有8种化合物相同,相对含量均有一定的差异。结论:顶空进样技术分析石菖蒲中挥发性成分更简单、快速、无溶剂残留并节省药材。     

人参15个组织器官中皂苷量与6种人参皂苷生物合成基因表达的相关性研究

以四年生红果期吉林人参的15个组织器官为材料,利用HPLC和香草醛-硫酸比色法分别测定15个组织器官中6种单体皂苷(人参皂苷Rg₁,Re,Rb₁,Rc,Rb₂,Rd)和总皂苷含量;同时,利用实时荧光定量PCR测定15个组织器官中法尼基焦磷酸合成酶(farnesyl pyrophosphate synthase,FPS)、鲨烯合成酶(squalene synthase,SQS)、鲨烯环氧酶(squalene epoxidase,SQE)、氧化鲨烯环化酶(oxidized squalene cyclase,OSC)、β-香树脂合成酶(β-amyrin synthase,β-AS)和细胞色素P450超家族(cytochrome P450 family,P450)基因的相对表达量。研究试图通过相关性分析,获得吉林人参15个组织器官中人参皂苷含量与生物合成途径相关酶基因表达量之间相关关系。结果表明,6种单体皂苷含量之间具有线性正相关的协同增减趋势,而单体皂苷含量与总皂苷含量之间具有相关性极显著(P<0.01)的正相关关系;总皂苷含量与人参中SQS,OSC,β-AS,SQE,P450,FPS基因之间的相关性极显著(P<0.01),单体皂苷含量与6种酶基因之间相关性各不相同。说明这6种参与人参皂苷生物合成酶基因调控人参总皂苷与单体皂苷的生物合成,它们在人参不同组织器官中的表达呈现协同增减趋势,并以集群协调表达的方式来调控人参皂苷生物合成。     

Antioxidative and in vitro hepatoprotective activity of Bupleurum kaoi leaf infusion

The roots of Bupleurus spp. have been used in traditional Chinese herbal medicine for curing liver diseases. Although bioactive saikosaponins have been detected in the leaves as well as in the roots, the aerial parts of the plants are discarded as waste. In the present study, a leaf infusion of B. kaoi Liu, Chao et Chuang, an indigenous Bupleurus species in Taiwan, was prepared and the antioxidant properties and in vitro hepatoprotective activity were demonstrated. The results show that the leaf infusion exerted DPPH free radical scavenging activity, inhibitory capacity on superoxide anion formation and superoxide anion scavenging activity. The hepatotoxicity of acetaminophen (APAP) and carbon tetrachloride (CCl4) on the rat liver cells were also decreased by the leaf infusion.     

Effect of irisin on endometrial receptivity of rats with polycystic ovary syndrome

Abstract

To investigate the influence of irisin on endometrial receptivity of rats with polycystic ovarian syndrome (PCOS). PCOS rats were randomly divided into PCOS group and irisin group, and normal rats were used as control group. The PCOS group and control group were injected intraperitoneally with normal saline while the irisin group with recombinant irisin. The serum and uterus were obtained. Detect serum sex hormones, including Testosterone (T), Estradiol (E₂), Progesterone (P), and glucose, insulin levels. Observe endometrial morphology by hematoxylin-eosin staining. Then evaluate the expression of leukemia inhibitory factor (LIF) and integrin αvβ3 in endometrium using ELISA, immunohistochemistry and Real-time PCR. (1) Levels of serum T, glucose and insulin in PCOS group were significantly higher than those in control and irisin group. (2) For the endometrial morphology, levels of equivalent diameter, area of uterine glands and gland cavity and endometrial average thickness were lower in PCOS group than those in control and irisin group. (3) LIF and integrin αvβ3 mRNA were basically consistent with protein expression. Levels of LIF and integrin αvβ3 were decreased in PCOS group when compared with control and irisin group. Irisin may improve endometrial receptivity by promoting expression of LIF and integrin αvβ3.     

坤泰胶囊联合黄体酮对围绝经期功能失调性子宫出血患者性激素水平的影响

目的 探讨坤泰胶囊联合黄体酮对围绝经期功能失调性子宫出血患者性激素水平的影响。方法 126例围绝经期功能失调性子宫出血患者随机分为两组各63例,对照组采用黄体酮治疗,观察组采用坤泰胶囊联合黄体酮治疗,比较两组治疗前后的肾阴虚证症状评分及性激素水平。结果 治疗3个月后,观察组的盗汗、失眠、腰膝酸软、耳鸣、五心烦热评分均显著低于对照组（P <0.05）。治疗3个月后,观察组的血清FSH、 LH水平均显著低于对照组,E2水平显著高于对照组（P <0.05）。结论 坤泰胶囊联合黄体酮可有效改善围绝经期功能失调性子宫出血患者的肾阴虚证症状,调节患者的性激素水平。     

局部注射曲安奈德联合左甲状腺素钠治疗桥本甲状腺炎的效果

目的 探讨局部注射曲安奈德联合左甲状腺素钠治疗桥本甲状腺炎的效果。方法 选取2018年5月至2020年5月辽阳市中心医院新城医院收治的120例桥本甲状腺炎患者作为研究对象,采用随机数字表法将其分为对照组与观察组,每组各60例。对照组患者给予左甲状腺素钠治疗,观察组患者在对照组的基础上加用局部注射曲安奈德治疗。比较两组患者连续治疗12周后的疗效、甲状腺指标、血清内脂素、细胞因子表达水平及不良反应发生情况。结果 观察组患者的临床总有效率高于对照组,差异有统计学意义（P<0.05）。观察组患者治疗后的促甲状腺激素（TSH）、甲状腺球蛋白抗体（TGAb）、甲状腺微粒体抗体（TMAb）、血清内脂素、重组分化蛋白簇195(CD195)及重组分化蛋白簇30(CD30)均低于对照组,血清游离三碘甲状腺原氨酸（FT3）及血清游离甲状腺素（FT4）高于对照组,差异有统计学意义（P<0.05）。两组患者不良反应总发生率比较,差异无统计学意义（P>0.05）。结论 在左甲状腺素钠治疗桥本甲状腺炎的基础上加用局部注射曲安奈德可更好地缓解临床症状及体征,调节甲状腺相关指标,改善血清内脂素及细胞因...