胆囊颈部结石嵌顿无或伴急性胆囊炎的免钛夹腹腔镜胆囊切除术

目的探讨用可吸收缝线结扎胆囊管和胆囊血管行免钛夹腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）治疗胆囊颈部结石嵌顿无或伴急性胆囊炎的安全性及可行性。方法 2008年12月～2010年7月53例胆囊颈部结石嵌顿无或伴急性胆囊炎全麻下行三孔法LC,采用分离钳、电凝钩、吸引器显露胆囊,对胆囊肿大、张力高的病人采用胆囊底、体部穿刺、打孔减压,保持胆囊颈部完整,根据胆囊三角情况采用顺行或逆行方式切除胆囊。解剖出胆囊管和胆囊动脉,用分离钳将长约10 cm的可吸收线（强生公司Vicryl 31 mm 1/2c）送入腹腔,腹腔内打结结扎胆囊管及胆囊血管的近端,远端不结扎用电凝钩电凝直接离断。根据术中情况术后放置或不放腹腔引流管。结果 53例手术全部成功,无中转开腹,未使用超声刀、钛夹及其他种类夹子。49例顺行胆囊切除,4例逆行胆囊切除,所有病例均未行胆囊颈部切开取石。手术时间30～70min,平均42 min;术中出血量15～200 ml,平均24 ml。18例放置腹腔引流1,～6 d拔出腹腔引流管,平均1.8 d。术后住院3～7 d,平均3.5 d。53例随访1～18个月,平均7.6月,无胆管损伤、出血、胆漏和腹腔感染等并发症。结论 LC中用可吸收缝线代替钛夹或其他夹子及超声刀处理胆囊管及胆囊血管治疗胆囊颈部结石嵌顿安全、可行。     

Transcranial focused ultrasound stimulation reduces vasogenic edema after middle cerebral artery occlusion in mice

Blood-brain barrier(BBB)disruption underlies the vasogenic edema and neuronal cell death induced by acute ischemic stroke.Reducing this disruption has therapeutic potential.Transcranial focused ultrasound stimulation has shown neuromodulatory and neuroprotective effects in various brain diseases including ischemic stroke.Ultrasound stimulation can reduce inflammation and promote angiogenesis and neural circuit remodeling.However,its effect on the BBB in the acute phase of ischemic stroke is unknown.In this study of mice subjected to middle cerebral artery occlusion for 90 minutes,low-intensity low-frequency(0.5 MHz)transcranial focused ultrasound stimulation was applied 2,4,and 8 hours after occlusion.Ultrasound stimulation reduced edema volume,improved neurobehavioral outcomes,improved BBB integrity(enhanced tight junction protein ZO-1 expression and reduced IgG leakage),and reduced secretion of the inflammatory factors tumor necrosis factor-αand activation of matrix metalloproteinase-9 in the ischemic brain.Our results show that low-intensity ultrasound stimulation attenuated BBB disruption and edema formation,which suggests it may have therapeutic use in ischemic brain disease as a protector of BBB integrity.     

Impact of matrine on inflammation related factors in rat intestinal microvascular endothelial cells

Ethnopharmacological relevance

Matrine (MT) is a main active ingredient of Sophora flavescens roots, which is used in Traditional Chinese Medicine (TCM) for the treatment of inflammations like enteritis, hepatitis and atopic dermatitis.

Aims of the study

Aim of the study is to gain insight into the effects of MT on nitric oxide (NO) release, intracellular NO production, and endothelial nitric oxide synthase (eNOS) level in second generation rat intestinal microvascular endothelial cells (RIMECs). Moreover, the effects of MT on soluble intercellular adhesion molecule-1 (sICAM-1), interleukin-6 (IL-6) and interleukin-8 (IL-8) production induced by lipopolysaccharide (LPS) in these cells were evaluated.

Material and Methods

Isolated and identified RIMECs cultures were exposed to different concentrations of matrine, and changes in extra- and intracellular NO concentrations were measured in dependance of time by Griess reaction or DAF-FM diacetate. Obtained cell cultures were solitude treated with lypopolysaccharide (LPS) or combined with MT to observe impacts on sICAM-1, IL-6 and IL-8 concentration in culture supernatants by ELISA.

Results

Matrine dose-dependently increased the concentration of NO in culture supernatant of RIMECs. Exposure of MT resulted in a steady intracellular NO increase pattern under different concentrations with different values and has an increasing effect on eNOS concentration at a long time exposure. Additionally, matrine reduced the increasing effect of LPS on the production of IL-6, IL-8, and sICAM-1 in RIMECs.

Conclusion

These results show that matrine may serve as a protective agent against tissue damage in inflammation by improving NO-dependent vasomotion and inhibiting inflammatory cytokines induced by LPS.     

利窍益智汤治疗轻度认知障碍32例临床研究

目的 观察利窍益智汤治疗轻度认知障碍(MCI)的疗效.方法 将32例MCI患者采用自拟利窍益智汤治疗(治疗组),与30例MCI患者采用西药吡拉西坦治疗(对照组)进行比较,观察两组治疗后记忆功能和认知功能疗效,以及相关量表积分的比较.结果 两组MCI患者的认知功能、记忆功能及行为能力的积分均可以明显改善(P<0.01),且在行为能力积分方面治疗组优于对照组(P＜0.05).对MCI患者的记忆及认知功能的作用两组差异无统计学意义(P＞0.05).结论 利窍益智汤对痰浊蒙窍、脾肾两虚证MCI有确切的疗效.     

颈后路经皮大通道全内镜椎板减压术治疗单节段脊髓型颈椎病的临床效果观察

目的:探讨颈后路经皮大通道全内镜椎板减压术治疗单节段脊髓型颈椎病的临床效果。方法:回顾性分析2017年2月—2019年3月河北医科大学第三医院脊柱外科、河北工程大学附属医院脊柱外科行后路经皮大通道全内镜椎板减压术治疗的17例单节段脊髓型颈椎病患者的临床资料,其中男11例、女6例,年龄42～81(57.1±8.7)岁。记...     

Abrogation of USP7 is an alternative strategy to downregulate PD-L1 and sensitize gastric cancer cells to T cells killing

Targeting immune checkpoints such as programmed cell death protein 1(PD-1)and pro-grammed death ligand-1(PD-L1)have been approved for treating melanoma,gastric ...     

甲状腺结节发生率及相关因素分析

目的 调查分析黑龙江省城市和农村健康人群甲状腺结节的发生率及相关因素。方法 采用分层整群随机抽样的横断面调查方法,随机入户问卷调查,一般体格检查并行甲状腺超声检查,收集血液及尿液标本;甲状腺结节发生率以超声检出结节者为准。结果 黑龙江省城市和农村甲状腺结节发生率分别是27.77%和18.18%（χ²=33.991,P<0.01）;女性高于男性,随着患者年龄增加,甲状腺结节发生率显著增加（P<0.01）。另外,甲状腺结节患者的尿碘量、TSH水平、TPOAb阳性率、TgAb阳性率、收缩压、空腹血糖、甘油三酯、胆固醇、低密度脂蛋白和高密度脂蛋白显著高于正常人群,而糖化血红蛋白则显著下降（P<0.05）。Logistic多因素分析发现,地域分布、性别、年龄、胆固醇水平和糖化血红蛋白是影响甲状腺结节发生率的独立危险因素（P<0.05）,其中黑龙江地域分布对甲状腺结节发生率的影响属首次发现。结论 黑龙江地区城市人群甲状腺结节发生率明显高于农村人群,女性又高于男性,随着年龄的增加其发生率也显著增加,其中地域分布、性别、年龄、胆固醇和糖化血红蛋白水平是影响甲状腺结节发生率的独立危险因素。     

HPLC法测定甘草中甘草酸的含量

目的:为丰富《中国药典》中草药质量控制的内容,建立一套完整的甘草酸测定方法。方法:运用高效液相色谱法对甘草中的甘草酸进行测定,比较不同的提取剂,不同的流动相对甘草酸测定的影响。采用ODS柱(15cm×4.6mm),检测波长为254nm,流速0.8mL/min。结果:氨水对甘草酸具有很好的提取效果,同时,以甲醇作流动相,分离效果最佳。结论:HPLC法试剂用量少,简便、快捷、准确,运用HPLC对甘草中的甘草酸进行质量控制的结果是可信的,令人满意的,可作为一种常规分析方法。