腹腔镜下应用高频电外科工作站行全子宫切除术的护理配合

对40例子宫疾病患者在腹腔镜下行全子宫切除术,术中使用高频电外科工作站的百克钳,无需游离子宫动脉,无需结扎和传统电凝;产生永久性血管闭合,止血效果理想,减少了术中对患者的损伤,缩短手术时间,提高了工作效率。提出手术室护士熟悉手术步骤,掌握高频电外科工作站及百克钳的正确使用,是手术顺利进行的保证。     

The dynamic changes of plasma neuropeptide y and neurotensin and their role in regulating cerebral hemodynamics in neonatal hypoxic-ischemic encephalopathy

Hypoxic-ischemic encephalopathy (HIE) is a common cause of neonatal encephalopathy and is one of the most important causes of neonatal death and disabilities, especially those infants with moderate to severe encephalopathy. However, the pathogenesis of HIE still remains unclear. The purpose of this study was to explore the dynamic changes in plasma neuropeptide Y (NPY) and neurotensin (NT) as well as their role in regulating cerebral hemodynamics in HIE patients. The plasma levels of NPY and NT in the umbilical artery and peripheral blood on the first, third, and seventh days after birth in 40 term infants with HIE and 40 healthy controls were measured using radioimmunoassay. On the first day of life, the blood samples were collected immediately when ultrasound examinations were finished. The ultrasound transducer was placed on the temporal fontanelle to detect the hemodynamic parameters of the middle cerebral artery, including peak systolic flow velocity, end-diastolic flow velocity, time-average mean velocity, pulsatility index, and resistance index (RI) in both groups were measured by pulse Doppler ultrasound in the first day after birth. The relationship between RI and NPY or NT was analyzed by linear regression analysis. NPY levels in umbilical blood ([mean +/- standard deviation] 615.5 +/- 130.7 ng/L) and first-day peripheral blood (355.9 +/- 57.4 ng/L) in neonates with HIE were significantly higher than those in normal newborns' blood (199.1 +/- 63.2 and 214.4 +/- 58.0 ng/L, respectively; P < 0.01). NPY levels in HIE neonates then declined to control levels on the third day after birth ( P > 0.05). However, the levels of plasma NT in umbilical blood and peripheral blood were much higher in the HIE group than those in normal newborns during the first week ( P < 0.01). The results of Doppler ultrasound examinations showed that cerebral blood flow velocity significantly decreased, whereas RI increased markedly in HIE patients compared with healthy controls ( P < 0.01). Linear regression analysis revealed that the RI was positively correlated with NPY levels ( R = 0.614; P < 0.01) and negatively correlated with NT levels ( R = -0.579; P < 0.01). The results of this study showed that there was a significant increase in plasma NPY and NT levels in HIE patients and this was strongly related to the severity of HIE, and the hemodynamic parameter RI was significantly correlated with NPY and NT. Therefore, we believe that the dynamic changes in plasma NPY or NT levels participate in the mechanisms of HIE by regulating cerebral hemodynamic changes after neonatal asphyxia occurs.     

Enhanced immune response to foot-and-mouth disease vaccine by oral administration of ginseng stem-leaf saponins

Vaccination is an important approach to the control of foot-and-mouth disease (FMD). This study evaluated the effect of oral administration of ginseng stem–leaf saponins (GSLS) on the immune response to FMD vaccine and the gut mucosal immunity in mice. In experiment 1, mice were orally administered GSLS or not treated as a control. The animals were then immunized twice with FMD vaccine. Blood was sampled weekly within five weeks after the boost immunization for measurement of serum IgG and the isotypes. In experiment 2, mice were orally administrated GSLS or not treated as a control. After that, splenocytes were prepared from sacrificed mice for lymphocyte proliferation assay and intestinal tissues were sampled for immunohistochemistry and histological examination. The results showed that oral administration of GSLS significantly enhanced serum IgG and the isotype responses to FMD vaccine as well as the number of intestinal intraepithelial lymphocytes (IELs) and immunoglobulin A (IgA)+?cells. Therefore, GSLS may be a potent oral adjuvant and deserve further study to improve vaccination in susceptible animals.     

基于脑电图的不同频率磁刺激内关穴脑网络分析

磁刺激和电刺激在离子水平的作用机制是相似的。相比之下,磁刺激技术具有无痛、可刺激深部组织等优点。不同的刺激参数会产生不同的机体效应,同时所引发的神经调控机制也不同。采用不同频率(0.5和3 Hz)的脉冲磁场刺激内关穴,采集刺激前、后的32导脑电信号,计算各通道脑电信号之间的相关系数。针对正、负相关系数的不同分布特点,采用不同的阈值,分别对正、负相关系数矩阵进行二值化处理。以脑电通道作为所构建脑功能网络的节点,构建并分析不同状态下的脑功能网络,探讨频率参数对磁刺激内关穴脑功能区活动的影响。结果发现,0.5和3 Hz磁刺激内关穴后较刺激前,大脑额叶、颞叶和中央区内部以及脑区之间的正相关呈现增加的趋势。同时,0.5 Hz磁刺激内关穴后,额叶与枕叶以及颞叶与枕叶之间的大尺度连接增强,且具有负相关特性。这一研究结果为磁刺激频率的选取提供一定的依据。     

新型下胫腓联合弹性钩钢板与传统下胫腓钩内固定治疗下胫腓联合损伤的临床疗效比较

目的 探讨自行设计的一种新型下胫腓联合弹性钩钢板(ESHP)与传统下胫腓钩(OSH)内固定治疗下胫腓联合损伤的临床疗效。方法 选择2011年2月—2012年2月解放军第175医院(厦门大学附属东南医院)全军骨科中心收治的51例下胫腓联合损伤的患者进行前瞻性对照研究,对入院日期为奇数的27例患者采用ESHP治疗(ESHP组)、为偶数的24例患者采用OSH治疗(OSH组),比较两组患者的手术时间、术中出血量、手术切口长度、住院时间,术后1年按Baird-Jackson评分系统进行疗效评定,比较两组患者优良率。结果 51例患者均顺利完成手术,ESHP组术中出血量(22.5±5.6)mL,少于OSH组的(28.5±6.0)mL,差异有统计学意义(t=-5.593,P＜0.05);而手术时间、切口长度、住院时间差异均无统计学意义(t值分别为-1.571、0.539、-0.476,P值均＞0. 05)。患者均获随访,随访12～36个月,平均26.5个月。随访期间骨折均一期愈合,未发生感染、骨不连、骨折畸形愈合及内固定断裂等并发症。ESHP组和OSH组患者均于术后8个月～1年取除踝关节骨折钢板及下胫腓联合内固定物,取除术后均未出现下胫腓联合再分离及固定失效等并发症。术后1年按Baird-Jackson评分系统进行疗效评定,ESHP组优23例、良4例,优良率100%(27/27);OSH组优13例、良10例、差1例,优良率96%(23/24)。ESHP组优良率高于OSH组,差异有统计学意义(Z=2.429,P<0.01)。结论 相比传统OSH,ESHP更符合下胫腓关节的微动生理特点,在促进下胫腓联合韧带的修复及踝关节术后功能恢复方面有明显优势。     

RNA-binding protein is involved in aggregation of light neurofilament protein and is implicated in the pathogenesis of motor neuron degeneration

Abnormal protein aggregation is emerging as a common theme in the pathogenesis of neurodegenerative disease. Our previous studies have shown that overexpression of untranslated light neurofilament (NF-L) RNA causes motor neuron degeneration in transgenic mice, leads to accumulation of ubiquitinated aggregates in degenerating cultured motor neurons and triggers aggregation of NF-L protein and co-aggregation of mutant SOD1 protein in neuronal cells. Here, we report that p190RhoGEF, an RNA-binding protein that binds to a destabilizing element in NF-L mRNA, is involved in aggregation of NF-L protein and is implicated in the pathogenesis of motor neuron degeneration. We show that p190RhoGEF co-aggregates with unassembled NF-L protein and that co-aggregation is associated with down-regulation of parent NF-L mRNA in neuronal cells. Co-expression of NF-M increases NF assembly and reduces RNA-triggered aggregation as well as loss of solubility of NF-L protein. siRNA-induced down-regulation of p190RhoGEF not only reduces aggregation and promotes assembly of NF-L and NF-M, but also causes reversal of aggregation and recovery of NF assembly in transfected cells. Examination of transgenic models of motor neuron disease shows that prominent aggregates of p190RhoGEF and NF-L and down-regulation of NF-L expression occur in degenerating motor neurons of mice expressing untranslated NF-L RNA or a G93A mutant SOD1 transgene. Moreover, aggregates of p190RhoGEF and NF-L appear as early pathological changes in presymptomatic G93A mutant SOD1 transgenic mice. Together, the findings indicate that p190RhoGEF is involved in aggregation of NF-L protein and support a working hypothesis that aggregation of p190RhoGEF and NF-L is an upstream event triggering neurotoxicity in motor neuron disease.     

组织工程心脏瓣膜研究进展

目前组织工程心脏瓣膜研究已在支架的选材、种子细胞的选择、种子细胞的种植与瓣膜构建方法三个方面取得进展，并已构建出三种代表性组织工程心脏瓣膜。对它们各自的特点进行综述。