单孔胸腔镜右肺上叶袖式切除术两例

<正>临床资料患者1,男,52岁,因反复咳嗽,低热6个月入院。有吸烟史,既往史和体格检查无特殊。气管镜检查显示右肺上叶前段新生物阻塞伴黏膜水肿;病理活检未能明确诊断。胸部CT检查发现右肺上叶前段支气管完全阻塞,前段肺组织不张实变(图1 A,图1 B),恶性肿瘤不能除外。肺功能检查:第1秒用力呼气容积(forced expiratory volume in 1 second,FEV1)3.16 L(占预计值91.0%),最大通气量     

不插管单孔胸腔镜右肺中叶袖式切除术一例

目的评估不插管单孔胸腔镜肺叶袖式切除术的安全性及可行性。 方法对所在科室首例监护麻醉下不插管右肺中叶袖式切除术的成功案例进行报道并对此类手术进行文献回顾。 结果不插管单孔胸腔镜右肺中下叶袖式切除术成功,患者恢复良好。 结论不插管单孔胸腔镜肺叶袖式切除术是一种更微创的支气管重建手术,具有进一步开展的价值。     

胸心外科预防性抗生素合理应用

普通胸外科手术多属二类切口手术,是使用预防性抗生素的指征;多数心脏手术虽为一类切口手术,感染率较低,因需要体外循环,植入人造物,手术时间长,感染后果严重,归入预防性抗生素使用范畴.     

甲基苯丙胺对大鼠小胶质细胞的损伤及炎性相关基因表达的影响

目的：观察甲基苯丙胺(methamphetamine,Meth)对原代小胶质细胞的损伤及炎性相关基因表达的影响。方法：原代培养SD胎鼠小胶质细胞,利用MTT和原位末端转移酶标记技术(TUNEL)分别检测Meth引起小胶质细胞活力和凋亡的变化。采用实时荧光定量聚合酶链反应法(real-time PCR)观察Meth对小胶质细胞炎性相关因子mRNA表达的影响。ELISA及试剂盒法检测Meth作用后小胶质细胞白介素(interleukin,IL)-6、肿瘤坏死因子(tumor necrosis factor,TNF)-α、诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)的分泌改变。结果：MTT实验显示,Meth降低小胶质细胞活力,呈浓度依赖性,浓度为200 μmol/L时与对照组比较,差异有统计学意义(P＜0.01)。TUNEL实验结果显示200 μmol/L Meth可引起细胞凋亡,与对照组比较,差异有统计学意义(P＜0.05)。q-PCR结果显示Meth作用于小胶质细胞24 h可降低IL-24、一氧化氮合酶3(nitric oxide synthase 3,NOS3)表达水平,上调Peli3、Sigma受体1(Sigma receptor 1,Sig1-R)、IL-1β、IL-6、Toll样受体4(Toll like receptor 4,TLR4)的表达水平,差异有统计学意义(P＜0.05)。此外,蛋白水平亦发现,Meth可促进IL-6和TNF-α的分泌。结论：Meth可降低小胶质细胞活力,诱导小胶质细胞凋亡,并引起IL-1β、IL-1R、IL-6、TLR4等炎性因子mRNA表达变化,促进IL-6和TNF-α的分泌,进而可能损伤中枢神经系统,产生神经毒性。     

抗apoAl、B和Lp（α）混合单抗与单一单抗包被的比较

抗ａｐｏＡｌ、Ｂ和Ｌｐ（α）混合单抗与单一单抗包被的比较赵满仓，刘菊林，李健斋，蒋雷（空军石家庄医院检验科，石家庄０５００８１）（卫生部北京老年医学研究所，北京１００７３０）：ａＰｏＡ１、Ｂ、ＬＰ（ａ）分别为高密度脂蛋白（ＨＤＬ）、低密度脂蛋白（ＬＤ...     

胆囊癌原位移植模型的建立及探讨

目的 阐释裸鼠胆囊癌原位移植模型的优缺点,同时讨论胆囊癌动物模型的发展方向.方法 创建裸鼠胆囊癌原位移植模型,以成瘤率,淋巴结、腹水、肝肺转移等为指标,对原位移植瘤模型进行评价.结果 原位移植瘤模型在成瘤率、淋巴结移位、腹水、肝肺转移、微淋巴管密度方面具备优势.结论 胆囊癌原位移植瘤模型具有更高自发转移率,其生物学特性和人胆囊癌更为接近,是胆囊癌生物学研究的重点方向之一.     

胰岛素干预对糖尿病大鼠骨折愈合及骨痂内细胞因子的影响

BACKGROUND: Fracture healing in diabetic patients is usually unsatisfactory because of hormones and metabolic disorder, and an eventual multiple organ dysfunction resulting from high blood glucose. OBJECTIVE: To dynamically observe the changes of cytokines during the fracture healing process in diabetic rats before and after insulin treatment. METHODS:A total of 120 Sprague-Dawley rats were included in this study. Of them, 90 rats intravenously injected with 5% tetraoxypyrimidine to induce rat models of diabetes were randomized into insulin treatment and diabetes groups, respectively. The remaining 30 rats were intravenously injected with equal volume of saline and selected as control group. The next day, blood glucose was determined. Healing at 1, 4, and 8 weeks after fracture were observed by the X-ray film. Biomechanical strength of the injured right tibia was measured at 4, 6, and 8 weeks after modeling. Cytokines in the osteotylus were determined by immunohistochemical staining and in situ hybridization technique. RESULTS AND CONCLUSION: The X-ray films showed that the speed of fracture healing in the diabetes group was slower than insulin treatment and control groups. Biomechanical strength of the osteotylus in the diabetes group was significantly decreased compared with the insulin treatment and control groups. However, there were no significant differences in above-mentioned parameters between the control and insulin treatment groups. Bone morphogenetic protein 2, basic fibroblast growth factor, transforming growth factor-beta, and vascular endothelial growth factor were widely expressed in the osteotylus and their expressions in diabetes group were significantly lower and slower than those in the control and insulin treatment groups. There was no statistical difference between control and insulin treatment groups. These results indicate that osteotylus formation speed, biomechanical strength, and growth factor expressions at the fracture site in diabetes rats were decreased compared with normal rats. Insulin treatment can enhance cytokine levels at the fracture site, thereby promoting the osteoblast proliferation and fracture healing. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

斜外侧腰椎椎间融合术与经椎间孔腰椎椎间融合术治疗腰椎不稳的临床比较

目的 比较斜外侧腰椎椎间融合术(Oblique lateral interbody fusion,OLIF)与经椎间孔腰椎椎间融合术(Transfo-raminal lumbar interbody fusion,TLIF)治疗腰椎不稳的临床疗效.方法 回顾性分析自2018-10-2020-10采用OLIF与TLIF治...     

急性双肺多发性微血栓栓塞抢救成功一例

患者男,58岁。因反复咯血3个月入院。入院时患者胸痛、咯血,血为鲜红色（10~20 ml/d）,无发热、咳脓痰、呼吸困难等症状。查体：气管居中,双肺呼吸音清晰,右背下部份可闻及湿啰音,肺部叩诊左右对称无浊音。     

国内首例机器人辅助双孔胸腔镜下全隆突重建术

本文报道2021年10月同济大学附属上海肺科医院胸外科应用达芬奇机器人手术治疗主气管与右主支气管腔内占位患者1例。手术方法采用经右侧胸壁双孔入路,切除隆突及右主支气管内肿物的同时完成全隆突重建。手术进展顺利,总手术时间约2h,术中出血量约50ml,术后正常麻醉复苏后拔出气管插管,并于术后第6d拔除胸腔引流管,痊愈出院。