胫骨平台骨折辅助关节镜治疗的有效性分析

目的探讨胫骨平台骨折合并半月板损伤的治疗及有效性。方法收集2016年11月-2018年8月50例胫骨平台骨折合并半月板损伤患者,随机分组。常规开放手术组采取常规开放手术方案,关节镜下微创手术治疗组实施关节镜下微创手术。分析膝关节功能恢复时间、入院到出院时间;治疗前后患者HSS膝关节功能评分、VAS膝关节疼痛程度;骨筋膜室综合征等并发症。结果关节镜下微创手术治疗组HSS膝关节功能评分、VAS膝关节疼痛程度、膝关节功能恢复时间、入院到出院时间、关节感染等并发症和常规开放手术组比较有优势,P0.05。结论胫骨平台骨折合并半月板损伤患者实施关节镜下微创手术效果确切,可有效缩短膝关节功能恢复时间、入院到出院时间,改善患者的膝关节功能,并减少并发症的发生,效果肯定。     

微粒子活性炭对腹腔镜结直肠癌手术淋巴结清扫的指引作用

目的：探讨微粒子活性炭在腹腔镜结直肠癌手术中指引清除淋巴结的临床意义。方法：随机将2005年10月至2007年12月我院收治的70例结直肠癌病例分为：标记组35例,患者术前经肠镜在肿瘤周围局部注射微粒子活性炭后行腹腔镜结直肠癌根治术,对照组35例,仅行常规腹腔镜结直肠癌根治术。切除标本中的淋巴结由外科医师仔细检查剖出、计数并做病理检查。结果：腹腔镜术中被微粒子活性炭黑染的肠系膜淋巴结清晰可见;标记组平均每例清除淋巴结（27.03±2.770）枚,对照组为（15.09±1.522）枚（P〈0.001）;淋巴结转移病例中,标记组平均每例清除转移淋巴结（9.08±1.782）枚,对照组（5.00±1.00）枚（P〈0.001）;标记组平均每例清除小转移淋巴结（3.83±1.528）枚,对照组（1.62±0.961）枚（P〈0.001）。结论：术前注射微粒子活性炭在腹腔镜结直肠癌手术中对淋巴结清扫有指引作用,不仅淋巴结清除总数明显增多,而且可清除更多和更小的转移淋巴结,提高了根治程度。     

切口保护开创器在腹腔镜结直肠手术中的应用

目的探讨切口保护开创器在腹腔镜结直肠癌切除术中的临床应用效果。方法32例结直肠癌在行腹腔镜手术时辅助小切口使用切口保护开创器。逐层切开辅助小切口进入腹腔后,首先将切口保护开创器的固定环经小切口放入腹腔内,固定环自动张开恢复为圆形,然后连续翻转牵拉环同时卷绕硅胶薄膜套管使其绷紧,直到切口保护开创器固定在辅助小切口周围。结果辅助切口下手术视野整体显露良好,无须助手牵拉手术切口。辅助切口长度4.0~6.5cm,平均4.5cm。术后32例辅助切口均一期愈合,无切口感染。住院时间7~16d,平均8d。32例随访3~12个月,无辅助手术切口和操作孔肿瘤种植转移。结论切口保护开创器使用简单,对切口提供良好保护;手术切口能够自动敞开,无需助手用拉钩牵拉;优化了腹腔镜结直肠手术肠管取出和离断步骤,具有良好的开发应用前景。     

Ⅱ、Ⅲ期乳腺癌术后三种放疗方式对肺损伤的研究

目的:通过对Ⅱ、Ⅲ期乳腺癌根治或改良根治术后胸壁、锁骨上区放射治疗后评价三种放射治疗方法对放射性肺损伤发生率。方法:对156例Ⅱ、Ⅲ期乳腺癌患者,根据放射治疗方式不同,分为常规放疗组(A组)全程电子线照射50Gy/25f;常规+调强放疗组(B组)电子线照射32Gy/16f,调强照射18Gy/9f;常规+适形放疗组(C组)电子线照射32Gy/16f,适形照射18Gy/9f。结果:三种放疗方式照射胸壁、锁骨上区,放射性肺损伤、远处转移情况比较差异有统计学意义(P<0.05)。常规放疗组与常规加调强放疗组比较,放射性肺损伤比较差异有统计学意义(P<0.05)。其余两组两两比较,比较差异均无统计学意义(P>0.05)。结论:三种放疗方式照射胸壁、锁骨上区后,常规+调强放疗组能减少放射性肺损伤,较好的控制远处转移发生率。     

急性肠系膜血管缺血性疾病的早期诊治探讨

目的探讨急性肠系膜血管缺血性疾病的早期诊断和治疗方法。方法 回顾性总结１９６５～１９９９年急性肠系膜血管缺血性疾病的３９例临床资料。分析其诊断和治疗方法。结果 器质性心脏病、动脉硬化、血栓等病史伴有与腹部体征不相符的剧烈腹痛，应首先考虑肠系膜血管缺血。结论 选择性动脉造影和给药是早期诊断、治疗最有价值的方法。血Ｄ－Ｄｉｍｅｒ是实验室检查血栓形成的敏感指标。及早应用抗凝、溶栓和罂粟硷等药物是避免手术治疗和预防术后复发的有效方法。     

缺血预处理对大鼠肝脏缺血再灌注损伤的保护作用

目的：探讨缺血预处理（ＩＰＣ）对肝脏缺血再灌注损伤的保护作用及其机理。方法：采用大鼠部分肝脏原位缺血再灌注损伤模型,随机分成：（１）下沉对照组,不作肝门阻断。（２）再灌注对照组;进行４５ｍｉｎ的肝门阻断及６０ｍｉｎ的再灌注;（３）预处理组：４５ｍｉｎ的肝门阻断前先进行５ｍｉｎ肝脏缺血及５ｍｉｎdisplay structure     

Alpha-熊果苷激活凋亡信号通路对人急性T细胞白血病细胞TIB-152异常增殖的调节作用

目的:本文旨在探究alpha-熊果苷对人急性T细胞白血病细胞TIB-152增殖和凋亡的影响及其分子机制。方法:TIB-152细胞分为4组:TIB-152 (对照组); alpha-熊果苷(10、20、50μmol/L)组。CCK-8检测细胞增殖。流式细胞术分析细胞凋亡。蛋白印迹检测B细胞淋巴瘤2(Bcl-2),Bcl-2相关蛋白X(Bax),Cleaved caspase-3和Cleaved caspase-9表达。结果:低浓度(50μmol/L)的alpha-熊果苷对TIB-152没有明显的细胞毒性,高浓度(50μmol/L)的alpha-熊果苷会对TIB-152产生细胞毒性。50μmol/L的alpha-熊果苷组细胞增殖倍数明显低于对照组(P0. 01)。与对照组相比,50μmol/L的alpha-熊果苷组细胞凋亡率显著升高(P0. 01)。而且,50μmol/L的alpha-熊果苷组Bax/Bcl-2比值显著高于对照组(P0. 01)。同时,50μmol/L的alpha-熊果苷组Cleaved caspase-3和Cleaved caspase-9表达也显著高于对照组(P0. 01)。结论:Alpha-熊果苷可激活凋亡信号通路抑制人急性T细胞白血病细胞TIB-152细胞增殖,促进细胞凋亡。     

模拟调强技术照射鼻咽低分化鳞癌细胞的生物效应机制研究

Objective To study the altered radiobiological effect of simulative intensity-modulated radiotherapy (SIMR) in cultured human nasopharyngeal carcinoma (NPC) cells and the related mechanism. Methods Single cell suspension of exponentially growing CNE-2 cells, a poor differentiated NPC cell line, was seeded and cultured for 12 hours, then the cells were irradiated in two different models by 6 MV X-ray beams at 3 Gy/min. In single fraction irradiation (SFR) model, cells were irradiated a single fraction of 0, 2, 4, 6 or 8 Gy within 0 to 3 minutes. In S1MR model, cells were irradiated 0, 2, 4, 6 or 8 Gy in 5 frac-tions with interval of 8.0-8.5 minutes between. Clonogenic assay was performed to determine the radiosen-sitivity. Cellular apoptosis was measured by flow cytometry. RT-PCR was used to detect mRNA expressions of Bax and Bcl-2, Respectively. Results Compared with SFR group, the survival fraction in SIMR group was higher at all the dose levels. The values of α, β, D0 and Dq were higher in SIMR group than in SFR group. At dose levels of 2 Gy, 4 Gy and 6 Gy, The early and late apoptotic cells in SIMR group were lower than in SFR group (21.20%: 15.89%, F=18.51, P=0.020;13.00%: 10.20, F=15.67, P=0.040).The mRNA expression of Bax was upregulated in a dose-dependent manner in the both groups. Compared with SFR group, the mRNA expression of Bax in SIMR group was lower at all the dose levels (Mean value of 76.75% : 62.50%, F =36.57, P =0.000). Bcl-2 mRNA expression at every dose level had no significant difference between the two groups (Mean value of 29.25% : 29.75%, F=0.74, P=0.800). Conclusions Prolonged delivery time in SIMR model can decrease the radiobiological effects.     

模拟调强技术照射鼻咽低分化鳞癌细胞的生物效应机制研究

Objective To study the altered radiobiological effect of simulative intensity-modulated radiotherapy (SIMR) in cultured human nasopharyngeal carcinoma (NPC) cells and the related mechanism. Methods Single cell suspension of exponentially growing CNE-2 cells, a poor differentiated NPC cell line, was seeded and cultured for 12 hours, then the cells were irradiated in two different models by 6 MV X-ray beams at 3 Gy/min. In single fraction irradiation (SFR) model, cells were irradiated a single fraction of 0, 2, 4, 6 or 8 Gy within 0 to 3 minutes. In S1MR model, cells were irradiated 0, 2, 4, 6 or 8 Gy in 5 frac-tions with interval of 8.0-8.5 minutes between. Clonogenic assay was performed to determine the radiosen-sitivity. Cellular apoptosis was measured by flow cytometry. RT-PCR was used to detect mRNA expressions of Bax and Bcl-2, Respectively. Results Compared with SFR group, the survival fraction in SIMR group was higher at all the dose levels. The values of α, β, D0 and Dq were higher in SIMR group than in SFR group. At dose levels of 2 Gy, 4 Gy and 6 Gy, The early and late apoptotic cells in SIMR group were lower than in SFR group (21.20%: 15.89%, F=18.51, P=0.020;13.00%: 10.20, F=15.67, P=0.040).The mRNA expression of Bax was upregulated in a dose-dependent manner in the both groups. Compared with SFR group, the mRNA expression of Bax in SIMR group was lower at all the dose levels (Mean value of 76.75% : 62.50%, F =36.57, P =0.000). Bcl-2 mRNA expression at every dose level had no significant difference between the two groups (Mean value of 29.25% : 29.75%, F=0.74, P=0.800). Conclusions Prolonged delivery time in SIMR model can decrease the radiobiological effects.