An Antireflux Anastomosis Following Esophagectomy: A Randomized Controlled Trial

Background  

Reflux of duodeno-gastric fluid is a significant problem after esophagectomy with gastric conduit reconstruction. Symptoms may be severe and impact considerably upon the quality of life. Previous studies have suggested that a fundoplication type anastomosis may limit post-esophagectomy reflux.     

Preoperative biliary drainage before resection in obstructive jaundice

BACKGROUND: Surgery for patients with malignant obstructive jaundice carries high morbidity and mortality rates. Preoperative biliary drainage (PBD) has been used in an attempt to improve the outcome in these patients. AIM: To review the evidence in the literature on whether PBD improves postoperative morbidity and mortality in obstructive jaundice patients. MEHOD: Using Medline a literature search was performed for papers published in English from January 1980 to October 2000, using the text words 'obstructive jaundice', 'preoperative', 'drainage' and 'stent'. All retrieved papers which reported experimental or clinical observations relevant to the study aim were carefully analysed and the findings are summarised in this review. RESULTS AND CONCLUSION: There is no evidence in the literature to support the view that routine PBD improves postoperative morbidity and mortality in patients with obstructive jaundice undergoing resection. PBD has its own complications that cancel out its benefits. However, PBD could be beneficial in patients presenting with sepsis, coagulation abnormalities or malnutrition.     

改良性治疗法联合西地那非治疗勃起功能障碍维吾尔族患者2505例回顾性分析

目的:性治疗法目前尚未普及,本研究旨在评价性治疗法联合西地那非治疗勃起功能障碍(ED)的疗效。方法:根据治疗方法的不同将在本院治疗随访过的3130例维吾尔族ED患者分成2组。对照组625例,单纯口服西地那非3个月;试验组2505例,采用性治疗法联合西地那非治疗3个月。采用国际勃起功能问卷表(IIEF-5)在各组治疗前、后进行疗效评估,并随访12个月。结果:对照组治疗前、后及在6个月、12个月随访的IIEF-5评分分别为12.80±3.76、18.10±2.61、17.35±2.73和16.64±2.63;试验组治疗前、后及在6个月、12个月随访的IIEF-5评分分别为12.73±3.52、19.06±4.07、19.86±2.42和20.47±2.38。两组治疗前后IIEF-5评分自身对比差异均有显著性(P<0.05)。组间比较,试验组较对照组6个月和12个月随访IIEF-5评分均有显著性差异(P<0.05)。结论:性治疗法联合西地那非治疗ED的效果优于单纯西地那非治疗,并在12个月的随访中稳定性良好。     

Fungal endophytes from higher plants: a prolific source of phytochemicals and other bioactive natural products

Bioactive natural products from endophytic fungi, isolated from higher plants, are attracting considerable attention from natural product chemists and biologists alike as indicated by the steady increase of publications devoted to this topic during recent years (113 research articles on secondary metabolites from endophytic fungi in the period of 2008–2009, 69 in 2006–2007, 36 in 2004–2005, 14 in 2002–2003, and 18 in 2000–2001). This overview will highlight the chemical potential of endophytic fungi with focus on the detection of pharmaceutically valuable plant constituents, e.g. paclitaxel, camptothecin and podophyllotoxin, as products of fungal biosynthesis. In addition, it will cover new bioactive metabolites reported in recent years (2008–2009) from fungal endophytes of terrestrial and mangrove plants. The presented compounds are selected based on their antimicrobial, antiparasitic, cytotoxic as well as neuroprotective activities. Furthermore, possible factors influencing natural product production in endophytes cultivated in vitro and hence the success of bioprospecting from endophytes are likewise discussed in this review.     

寰椎椎弓根螺钉置钉技巧探讨

[目的]探讨寰椎椎弓根螺钉固定治疗寰枢椎不稳的置钉技巧。[方法]总结2000年10月～2008年9月应用寰椎椎弓根螺钉技术治疗寰枢椎不稳患者66例,置钉132枚。术中在直视下依据手感行寰椎椎弓根螺钉置钉,复位固定。[结果]本组66例132枚螺钉均成功置入,复位固定满意。术中未发现脊髓、神经根、椎动脉等损伤。术后患者症状及神经脊髓功能均有不同程度恢复。96枚螺钉术后行CT检查,其中91枚位置良好(94.89%)。全部病例内固定无松动、断裂,植骨均融合。[结论]术前影像学测量,术中显露寰椎后弓、直视下依据手感置钉、X线确定进钉方向,是安全置钉的技巧。     

豚鼠耳蜗基底膜振动的测试方法

 目的  探索豚鼠耳蜗基底膜振动测试的方法。方法  用戊巴比妥钠腹腔注射麻醉豚鼠后,腹侧切口,逐层切开皮肤,分离肌肉,可见听泡位于豚鼠下颌骨内侧深面,钝性分离听泡表面的肌肉组织,暴露听泡,用电钻将听泡打开,可见螺旋形耳蜗结构,辨认基底膜所在的部位。用电钻在需要开孔的骨壁上轻磨一个环形的凹陷,待足够薄弱的时候用尖头的刀片挑开骨片。用具有微细尖端的不锈钢针蘸取少量反光微珠,放置在基底膜上。然后用激光多普勒测振仪(laser doppler vibrometer,LDV)测量基底膜在外耳道纯音激励下的振动。结果   用该方法测量了豚鼠耳蜗基底膜在不同频率声波激励下的响应曲线。结论   该方法可进行豚鼠耳蜗基底膜振动的离体实验,但活体的振动测试尚需进一步的探索。     

中孕期非整倍体染色体异常血清学筛查不同方案比较

目的：对中孕期非整倍体染色体异常血清学筛查不同方案的检出率进行探讨。方法选取513名2009年9月~2013年3月在攀枝花市妇幼保健院产科进行常规产前筛查的孕妇血清样本,分别采用化学发光法和时间分辨荧光免疫法对孕妇血清进行二联、三联、四联检查,比较阳性率及假阳性率。结果二联化学发光法检测唐氏综合征(DS)高危假阳性率为9.10豫,三联为7.36豫,四联为6.28豫,假阳性率呈递减趋势(字2=5.119,P约0.05);二联化学发光法筛查18-三体高危假阳性率(0.63豫)低于三联(0.82豫),差异有统计学意义(字2=4.776,P约0.05)。三联时间分辨荧光免疫法筛查DS、18-三体假阳性率(4.01豫、0.34豫)较二联(8.93豫、0.61豫)均明显降低(字2=6.992、4.776,P约0.05)。二联化学发光法检测DS、18-三体假阳性率分别为9.10豫、0.63豫,时间分辨荧光免疫法则分别为8.93豫、0.61豫,两种检测方法比较,差异无统计学意义(字2=1.787、0.000,P跃0.05);而三联时间荧光分辨法检测DS、18-三体假阳性率(4.01豫、0.34豫)均低于三联化学发光法(7.36豫、0.82豫),差异有统计学意义(字2=5.382、4.783,P约0.05)。结论化学发光法的检测系统发现筛查效率二联、三联及四联方案呈递增趋势。时间分辨荧光免疫法检测系统发现筛查效率三联高于二联方案,时间荧光分辨法三联筛查优于化学发光法。     

The effect of arachidonic acid and its metabolites on acid production in isolated human parietal cells

The effect of arachidonic acid and its metabolites on the histamine-stimulated acid production in human isolated parietal cells provenient from endoscopic biopsies was examined. 14C-aminopyrine (14C-AP) accumulation in the parietal cells was used for evaluation of acid production. Histamine dose-dependently increased AP uptake. Histamine stimulation (taken as 100% at 10(-5) M) was significantly inhibited by prostaglandin (PG) E2 to 66 +/- 7% at 10(-8) M, 42 +/- 8% at 10(-6) M, and 13 +/- 10% at 10(-4) M (mean +/- SEM, n = 10). PGF2 alpha, PGD2, and PGI2 showed significant inhibitory effects only at very high concentrations (10(-5)-10(-4) M). Leukotriene (LT) B4 and LTC4 were without effect. The basal acid production (taken as 0%) was lowered significantly by 10(-6) M arachidonic acid to -20 +/- 7.4% (p less than 0.02, n = 10), and the histamine-stimulated (10(-6) M) acid production from 100% to 64 +/- 7.2% (p less than 0.001, n = 10). Aspirin (10(-3) M) increased basal (45 +/- 9.6%, p less than 0.001, n = 10) and histamine-stimulated (10(-6) M) acid production (164 +/- 16.3%, p less than 0.001). It is concluded that PGE2, the major product from arachidonic acid metabolism in the human gastric mucosa, is a significant inhibitor of the histamine-stimulated human parietal cell and may, in humans, play a role as a local physiologic inhibitor of acid secretion.     

纳米羟基磷灰石/硫酸钙复合人工骨顺铂缓释系统注射液的制备与研究

目的研制可注射α-CSH-nano-HA/PHBV-PEG顺铂释药系统,为骨转移瘤提供新型的局部药物缓释系统。方法α-CSH-nano-HA/PHBV-PEG载顺铂制成可注射用α-CSH-nano-HA/PHBV-PEG cis-platinum缓释微球,研究其结构、释药特性、可注射性以及力学性能。结果(1)第1、3、5、7天缓释微球的释药浓度分别为97.5、90.7、83.2、68.5μg/mL,第7天后趋于稳定。(2)可注射α-CSH-nano-HA/PHBV-PEG顺铂释药系统在液固比为0.7时可注射性强,与此同时缓释药系统随着液固比的增大凝固时间延长。结论α-CSH-nano-HA/PHBVPEG顺铂释药系统具有良好的注射性能和缓释作用。