妇产科腹腔镜治疗输卵管梗阻性不孕症的疗效观察

目的:探讨腹腔镜手术治疗输卵管梗阻性不孕症的临床疗效。方法:60例输卵管梗阻性不孕症患者接受腹腔镜手术治疗同时行美蓝染液试验,使其输卵管恢复通畅并恢复其生育能力。结果:60例输卵管梗阻性不孕患者总通畅率为40.00%,术后再次美蓝通液证实输卵管总通畅率为70.00%,两者比较差异具有统计学意义(P<0.05)。60例病例全部获得成功随访,共妊娠23例,妊娠率38.33%,其中1例为异位妊娠,有14例已足月分娩。结论:腹腔镜下治疗输卵管梗阻性不育孕症是安全、简便和有效的方法,值得推广应用。     

柯萨奇B组病毒感染与小儿哮喘发作关系的探讨

目的　探讨柯萨奇 Ｂ 组病毒（ Ｃ Ｖ Ｂ） 感染与哮喘发作的关系。方法　观察急性发作期哮喘患儿１０２ 例、上呼吸道感染１８２ 例、非感染性疾病患儿７１ 例、健康儿童３０ 例。采用 Ｅ Ｌ Ｉ Ｓ Ａ 法测定静脉血 Ｃ Ｖ Ｂ 抗原（ Ｃ Ｖ Ｂ－ Ａｇ）和 Ｉｇ Ｍ 抗体（ Ｃ Ｖ Ｂ－ Ｉｇ Ｍ） 、免疫组化法测定 Ｔ 细胞亚群和［３ Ｈ］ － Ｔｄ Ｒ 标记法测定 Ｎ Ｋ 细胞活性。结果　①哮喘患儿 Ｃ Ｖ Ｂ 感染率为５７８ ％ （５９／１０２） ;②哮喘患儿 Ｃ Ｄ８ 显著升高; Ｃ Ｄ３ 、 Ｃ Ｄ４／ Ｃ Ｄ８ 及 Ｎ Ｋ 细胞活性均明显下降（ Ｐ ＜００１） ;而 Ｃ Ｖ Ｂ 阳性哮喘患儿 Ｎ Ｋ 细胞活性又低于非 Ｃ Ｖ Ｂ 阳性哮喘儿（ Ｐ ＜ ００５） , Ｃ Ｄ８ 明显高于非 Ｃ Ｖ Ｂ 阳性哮喘儿（ Ｐ ＜ ００１） 。结论　 Ｃ Ｖ Ｂ 感染与哮喘发作有密切关系。     

儿童无创通气的局限性及气管插管介入时机选择

近年来,无创通气在儿童呼吸支持领域有了较快发展。无创通气无需气管插管,操作简便,对部分呼吸道疾病有较为满意的疗效。但是,无创通气不能完全替代有创机械通气。在有些疾病无创通气不仅有着较高的失败率,而且会因气管插管的延误导致病情恶化,增加患儿的病死率。在行无创通气之前需评估患儿是否适宜进行无创通气治疗。对于进行无创通气治疗的患儿需严密监护,动态观察生理指标和监测数据的变化,掌握好气管插管的时机,以免造成有创机械通气治疗的延误。     

Resistin induces insulin resistance, but does not affect glucose output in rat-derived hepatocytes

AIM: The aim of the present study was to observe the effects of resistin on insulin sensitivity and glucose output in rat-derived hepatocytes. METHODS: The rat hepatoma cell line H4IIE was cultured and stimulated with resistin; supernant glucose and glycogen content were detected. The insulin receptor substrate (IRS)-1 and IRS-2, protein kinase B/Akt, glycogen synthase kinase-3beta(GSK-3 beta), the suppressor of cytokine signaling 3 (SOCS-3) protein content, as well as the phosphorylation status were assessed by Western blotting. Specific antisense oligodeoxynucleotides directed against SOCS-3 were used to knockdown SOCS-3. RESULTS: Resistin induced insulin resistance, but did not affect glucose output in rat hepatoma cell line H4IIE. Resistin attenuated multiple effects of insulin, including insulin-stimulated glycogen synthesis and phosphorylation of IRS, protein kinase B/Akt, as well as GSK-3beta. Resistin treatment markedly induced the gene and protein expression of SOCS-3, a known inhibitor of insulin signaling. Furthermore, a specific antisense oligodeoxynucleotide directed against SOCS-3 treatment prevented resistin from antagonizing insulin action. CONCLUSION: The major function of resistin on liver is to induce insulin resistance. SOCS-3 induction may contribute to the resistin-mediated inhibition of insulin signaling in H4IIE hepatocytes.     

丹红注射液中迷迭香酸、紫草酸、丹酚酸B在大鼠血浆中的浓度测定

目的:建立测定大鼠血浆中丹红注射液中迷迭香酸、紫草酸、丹酚酸B浓度的方法。方法:采用HPLC法,色谱柱为Diamonsil C18柱(250 mm×4.6 mm5,μm);流动相为乙腈-0.4%的磷酸水,梯度洗脱;流速为1.0 mL.min-1;检测波长为288 nm。结果:迷迭香酸在4.0～100.0μg.mL-1浓度范围内线性关系良好(r=0.9925);回收率在85.0%～101.4%之间,日内、日间RSD<8%;紫草酸在4.0～100.0μg.mL-1浓度范围内线性关系良好(r=0.991 1);回收率在84.4%～93.9%之间,日内、日间RSD<9%;丹酚酸B在2.0～200.0μg.mL-1浓度范围内线性关系良好(r=0.998 6);回收率在80.0%～97.4%之间,日内、日间RSD<5%。结论:本文所建立的方法灵敏度好、准确率高,可用于丹红注射液中迷迭香酸、紫草酸、丹酚酸B的药代动力学研究。     

离子色谱直接提取法测定天花粉中二氧化硫的含量

目的：建立离子色谱直接提取法测定天花粉中二氧化硫（SO2）含量的实验方法。方法采用氢氧化钾溶液（25 mmol/L）直接提取,色谱柱为AS11-HC色谱柱（4 mm×250 mm,9.0μm）;柱温20℃;淋洗液：氢氧化钾溶液（20 mmol/L）;淋洗液流速1.00 mL/min;电导检测法,电导池温度20℃通过分离度实验、精密度实验、重复性实验检测并计算分离度、亚硫酸根峰面积和天花粉中SO2含量及亚硫酸根峰面积与进样量的关系。结果亚硫酸根色谱峰与其他相邻色谱峰间有较好的分离度,峰面积变化不大,亚硫酸根平均含量为每克天花粉含SO20.1977 mg、RSD为0.6%。亚硫酸根标准溶液进样量在1.16～29.1μg（即当进样体积为100μL时,被测定溶液浓度为11.6～291.2μg/mL）与亚硫酸根色谱峰的峰面积有良好的线性关系,平均回收率为99.2%,最低定量限以被测定溶液计算为0.00138μg/mL。结论离子色谱法操作简便、准确、快速,适用于天花粉中SO2的定量检测。     

超前镇痛对食管癌手术后应激反应的影响

目的 研究超前镇痛在食管癌手术中镇痛的效果及对术后应激反应的影响.方法 30例食管癌手术病人随机分为超前镇痛组和常规镇痛组,超前镇痛组在切皮前20min硬膜外腔注入0.1mg/mL吗啡 盐酸昂丹司琼8mg 0.15%罗哌卡因混合液15mL,并接镇痛泵(PCEA)(40μg/mL吗啡 盐酸昂丹司琼8mg 0.15%罗哌卡因混合液100mL)持续硬膜外泵入,持续至术后;常规镇痛组术前及术中硬膜外不给予药物,术毕从硬膜外腔导管注入与超前镇痛组配方相同药物,并接PCEA持续硬膜外泵入.于拔管后、拔管后6、12、24和48h各时点对患者进行视觉模拟评分(VAS);采用放射免疫法测定麻醉前、术后90min、术后24h、术后48h血浆胰岛素(Ins)、皮质醇(Cor)以及促肾上腺皮质激素(ACTH).结果 拔管后6.12、24和48h常规镇痛组VAS评分明显高于超前镇痛组.Ins值术后24、48h时点两组均明显高于麻醉前(P<0.05); Cor、ACTH值常规镇痛组明显高于麻醉前,超前镇痛组麻醉后各时点也明显高于麻醉前(P<0.05),组间比较术后24、48h时点两组有显著性差异(P<0.05).结论 超前镇痛用于食管癌手术镇痛明显优于常规镇痛方法,能较好地缓解其术后各种应激反应.     

能谱CT多参数成像评估胆结石成分的应用价值

目的 探究能谱CT多参数成像评估胆固醇结石和非胆固醇结石的应用价值.方法 收集125枚胆结石置入猪肝模型中行CT能谱模式扫描,并重建普通螺旋CT图像,测量所有胆结石单能量40 keV、100 keV时的CT值(HU40 keV、HU100 keV)、有效原子序数(Eff-Z)和普通螺旋CT值(HU120 kVp lik...     

The impact of alfentanil supplementation on the sedation of bronchoscopy: A meta-analysis of randomized controlled trials

Background:The efficacy of alfentanil supplementation for the sedation of bronchoscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of alfentanil supplementation on the sedation during bronchoscopy.Methods:We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through December 2019 for randomized controlled trials (RCTs) assessing the effect of alfentanil supplementation versus placebo for the sedation during bronchoscopy. This meta-analysis is performed using the random-effect model.Results:Five RCTs are included in the meta-analysis. Overall, compared with control group for bronchoscopy, alfentanyl supplementation is associated with significantly reduced coughing scores (Std. MD = –0.55; 95% CI = –0.96 to –0.14; P = 0.009) and dose of propofol (Std. MD = –0.34; 95% CI = –0.64 to –0.04; P = 0.03), but reveals the increase in hypoxemia (RR = 1.56; 95% CI = 1.17 to 2.08; P = 0.002).Conclusions:Alfentanyl supplementation benefits to reduce coughing scores and dose of propofol for bronchoscopy, but increases the incidence of hypoxemia. The use of alfentanyl supplementation for bronchoscopy should be with caution.     

组织因子研究进展

组织因子(凝血因子Ⅲ)是一个KD的跨膜糖蛋白,参与外源性凝血途径的启动因子, 一直是研究的热点.随着研究的深入,对其有更多深度和广度的发展.本文就其主要作用及机理、病理生理、抑制剂等方面的最研究进展作一综述.