大鼠面神经切断和切断修复后面神经核内鞘脂激活蛋白原的变化

BACKGROUND： Studies have demonstrated that damaged facial nerves synthesize prosaposin to promote repair of facial neurons. OBJECTIVE： To observe time-course changes of prosaposin expression in the facial nerve nucleus of Sprague Dawley rats following facial nerve transection and repair. DESIGN, TIME AND SETTING： A randomized control neuropathological animal experiment was performed in Chongqing Medical University between March 2007 and September 2008. MATERIALS： A total of 48 adult, male, Sprague Dawley rats were selected and randomly divided into transection and transection ＋ end-to-end anastomosis groups （n =24）. Rabbit anti-rat prosaposin antibody, instant SABC immunohistochemical kit, and antibody dilution solution were purchased from Wuhan Uscn Science Co., Ltd., China. METHODS： In the transection group, the nerve trunk of the distal retroauricular branch of the left facial nerves was ligated in Sprague Dawley rats, and a 5-mm nerve trunk at the distal end of the ligation site was removed. In the transection ＋ end-to-end anastomosis group, epineurial anastomosis was performed immediately following transection of the left facial nerves. The right facial nerves in the two groups served as the normal control group. MAIN OUTCOME MEASURES： The number of prosaposin-positive neurons, as welt as intensity of immunostaining in facial nerve nucleus, following transection and end-to-end anastomosis were determined by immunohistochemistry at 1, 3, 7, 14, 21, and 35 days after injury. RESULTS： Transection group： transection of facial nerves resulted in increased number of prosaposin-positive neurons and immunoreactivity intensity in the facial nucleus on day 1. These values significantly increased by day 3. Expression was greater than in the control side. The peak of the reduction was reached at 7 days post-surgery. Transection ＋ end-to-end anastomosis group： the number of prosaposin-positive neurons and immunoreactivity intensity was reduced in the facial nerve nucleus following immediate end-to-end anastomosis on day 7 post-surgery. These values began to gradually increase by day 14 post-anastomosis. By day 35 post-anastomosis, the number of prosaposin-positive neurons in the operated side recovered to normal levels. The number of prosaposin-positive neurons, as well as immunoreactivity intensity, was significantly greater in the facial nerve nucleus, compared with the transection group on days 14, 21, and 35 post-surgery （P 〈 0.05）. The rhythmic whisking of vibrissa recovered, and recovery time was consistent with increased numbers of prosaposin-positive neurons. CONCLUSION： Within 7 days after injury, prosaposin expression in the facial nerve nucleus exhibited an initial increase, followed by a decrease, and was not affected by facial nerve repair. Following facial nerve damage, neural anastomosis was shown to increase prosaposin expression in the facial nerve nucleus after 14 days. Recovery of prosaposin occurred simultaneously with reinnervation.     

肺部结节性病灶X线数字成像的实验与临床研究

目的：探讨X线数字成像及后处理对肺部结节性病灶的诊断价值。材料和方法：使用SiemensPolystar·FluorospotHX线数字成像和处理系统分别对12个用Philips肺部Phantom叠加肥皂制作之不同大小及形态之结节模型以及30例不同病理之肺部结节性病灶，进行摄片及图像后处理，分别作0％～100％边缘增强。结果：经对12个不同肺部结节模型及30例肺部结节性病灶的原始图像与后处理图像比较研究后发现，所有图像都明显地提高了质量，并以15％～60％的边缘增强为好；所有结节模型及结节性病灶之内部及表面结构比原始图像显示更好。结论：胸部平片是诊断肺部结节性病灶的首选方法，用数字成像及边缘增强等后处理后能显示直径更小的病灶（≥0．2cm），能更好地显示病灶的内部及表面结构，对病灶的检出及良恶性病变的鉴别诊断有很大帮助。     

Video-assisted thoracoscopic surgery segmentectomy by non-intubated or intubated anesthesia: a comparative analysis of short-term outcome

Background

The aim of this study was to reveal the short-term outcomes of video-assisted thoracoscopic surgery (VATS) segmentectomy without tracheal intubation compared with intubated general anesthesia with one-lung ventilation (OLV).

Methods

We performed a retrospective review of our institutional database of consecutive 140 patients undergoing VATS anatomical segmentectomy from July 2011 to June 2015. Among them, 48 patients were treated without tracheal intubation using a combination of thoracic epidural anesthesia (TEA), intrathoracic vagal blockade, and sedation (non-intubated group). The other 92 patients were treated with intubated general anesthesia (intubated group). Safety and feasibility was evaluated by comparing the perioperative profiles and short-term outcomes of these two groups.

Results

Two groups had comparable surgical durations, intraoperative blood loss, postoperative chest tube drainage volume, and numbers of dissected lymph nodes (P>0.05). Patients who underwent non-intubated segmentectomy had higher peak end-tidal carbon dioxide (EtCO₂) during operation (44.81 vs. 33.15 mmHg, P<0.001), less white blood cell changes before and after surgery (△WBC) (6.08×10⁹ vs. 7.75×10⁹, P=0.004), earlier resumption of oral intake (6.76 vs. 17.58 hours, P<0.001), shorter duration of postoperative chest tube drainage (2.25 vs. 3.16 days, P=0.047), less cost of anesthesia (¥5,757.19 vs. ¥7,401.85, P<0.001), and a trend toward shorter postoperative hospital stay (6.04 vs. 7.83 days, P=0.057). One patient (2.1%) in the non-intubated group required conversion to intubated OLV since a significant mediastinal movement. In the intubated group, there was one patient (1.1%) required conversion to thoracotomy due to uncontrolled bleeding. The incidence difference of postoperative complications between groups was not significant (P=0.248). There was no in-hospital death in either group.

Conclusions

Compared with intubated general anesthesia, non-intubated thoracoscopic segmentectomy is a safe, technically feasible and economical alternative with comparable short-term outcomes. Patients underwent non-intubated thoracoscopic segmentectomy could gain a prompt recovery.     

人前列腺LRIG1蛋白三维结构同源模建及其小分子激动剂的虚拟筛选

目的 LRIG1(tandem leucine-rich repeat sand immunoglobulin-like domains 1,LRIG1)是新近发现的抑癌基因,在前列腺癌中表达下降,通过对人前列腺LRIG1蛋白的三维结构进行同源模建,虚拟筛选出LRIG1的功能蛋白,试图为前列腺癌新靶点治疗提供新思路.方法 以LRIG1的同源蛋白LRRC4 C蛋白的晶体结构(PDB号3 ZYJ)为模型,通过MODELLER软件搭建LRIG1蛋白的三维空间结构;采用柔性对接的虚拟筛选技术,以荷兰SPECS公司的202490个化合物进行对接和打分,挑选出排名靠前的10个小分子化合物;通过AMBER软件分别进行20 ns的分子动力学模拟,并分析这10个小分子的结合模式、 动力学轨迹的RMSD、RMSF、 结合口袋的氢键以及它们的结合能量.结果 10个小分子化合物都具有一致的结合模式,而且都具有激活LRIG1活性的潜在能力.结论 发现与人LRIG1具有潜在特异结合能力的激动剂,可以为前列腺癌治疗新靶点的确立及开发具有药理活性的先导化合物提供理论依据.     

Comparative tests on methods for automatic mapping of land cover dynamics from multi-year images

Most land use/land cover (LULC) mapping methods require us to collect ground reference data at the time when the remotely sensed data are acquired. However, the high cost of the data collection limits the production of annual LULC maps in a short time span. In this study, in order to reduce the mapping cost and improve the timeliness of the map products, several simple and effective methods were tested and compared with same-year mapping (SY), including cross-year mapping (CY), multiple-indices automatic classification (MI), and spectral transfer (ST) and index transfer (IT). For the study years of 2001–2016, SY yields accuracies higher than 93%, the mean CY accuracy is about 83%, and the MI accuracy reaches 88%. Both the overall accuracies (above 90%) and the detailed accuracy indicators of the ST and IT are higher than those of CY and MI, and very close to the SY accuracy. It can, therefore, be stated that the methods are able to map urban LULC variations automatically, withsatisfactory performance.     

BosniakⅠ型肾囊性病变发生癌变的诊治经验(附5例报告)

目的:总结BosniakⅠ型肾囊性占位病变发生癌变的诊治经验。方法:回顾性分析5例BosniakⅠ型肾囊性恶性病变的B超、CT、病理特征、治疗方法和随访结果:男3例,女2例;年龄42～72岁,平均54岁。患侧腰酸1例,体检发现4例。囊腔直径5.5～8.0cm。术前B超及CT均诊断为肾囊肿。结果:5例均行腹腔镜下肾囊肿去顶术,术后病理检查诊断为透明细胞癌,再次行根治性肾切除术。5例随访6～33个月,4例无瘤存活,1例因心血管疾病死亡。结论:重视BosniakⅠ型肾囊性病变的影像学和病理学特征,术中行冷冻切片病理检查是提高BosniakⅠ型囊性肾癌诊治水平的关键。     

牙哈凝析气田产层段内高渗透条带储层分布特征及对开发的影响

目的 观察复方聚乙二醇电解质散溶液不同口服速度对肠道清洁的效果.方法 将180例行结肠镜检查的患者按随机数字表分成A、B、C组,每组60例.服药方法：将2包复方聚乙二醇电解质散用2 000 ml温开水冲调后,A组在1 h内服完,B组在2 h内服完,C组在3 h内服完.观察患者服药后不良反应发生情况,在肠镜检查时进行肠道清洁质量总体评分.结果 A组肠道清洁质量总体评分优于B组、C组,P＜0.01;肠道准备质量：右侧结肠清洁度A组与B、C组比较有统计学意义（P＜0.01）,中间结肠清洁度3组组间比较无统计学意义,左侧结肠清洁度A组与B、C组比较有统计学意义（P＜0.05）.A组5例出现腹胀、呕吐;B组3例患者出现腹胀,没有呕吐;C组无明显不良反应发生.结论 1 h内服完复方聚乙二醇电解质散药液,肠道清洁效果最好.     

品管圈活动在手术室院内感染控制中的应用

目的：探讨品管圈活动在手术室院内感染控制中的应用效果。方法于2013年8-11月在手术室组建立品管圈,选定主题,在现状分析的前提下,确立目标,拟定并实施相应的对策,比较实施前后快速手消毒剂使用不规范行为的发生情况,并采用自制的问卷对本次品管圈所产生的无形结果进行评价。结果实施品管圈活动后,每8天平均不规范例数为（21．6±12．52）次,与实施前（56．8±28．42）次相比,差异有统计学意义（t＝2．534,P＜0．05）;品管圈实施后圈成员解决问题能力得分由（2．0±0．69）分提升至（3．8±0．50）分;责任心得分由（2．0±0．75）分提升至（4．2±0．75）分;沟通协调能力由（2．4±0．69）分提升至（4．4±0．45）分;自信心由（2．6±0．82）分提升至（4．6±0．27）分;团队凝聚力得分由（2．6±1．63）分提升至（4．5±0．37）分;组员积极性由（1．8±0．58）分提升至（4．6±0．14）分;品管手法得分由（1．2±0．81）分提升至（5．0±0．00）分;科室和谐度由（2．2±0．94）分提升至（4．6±0．36）分,实施前后比较差异均具有统计学意义（t值分别为6．667,7．142,7．657,7．352,3．676,14．896,14．918,7．556;P＜0．01）。结论品管圈活动在手术室控制院内感染控制中的应用效果显著,值得推广。     

糖尿病患者急性心肌梗死的临床特点

目的　分析糖尿病患者急性心肌梗死的临床特点及临床治疗经验。方法　取糖尿病和非糖尿病各 5 2例合并急性心肌梗死的病人 ,对比分析其临床症状、体征 ,以及并发症等表现。结果　糖尿病组病死率为非糖尿病组的 2 .5 7倍 ,糖尿病组发生心肌梗死时以无痛型为多 ,并发症中心力衰竭、心律失常、猝死等明显高于非糖尿病组。结论　对糖尿病人应严格控制血糖 ,合并心肌梗死时须给予充分的重视和及时处理。     

Chinese multi-institutional registry (CMIR) for resected non-small cell lung cancer: survival analysis of 5,853 cases

Background

Concerns on surgical treatment of non-small cell lung cancer (NSCLC) have been increasing recent years. However, the significance of previous studies based on single center or regional experience in China was impaired by small sample size. Here we described a Chinese Multi-institutional Registry (CMIR) to address this disadvantage and proposed a further collaboration project.

Methods

Information of patients diagnosed with stage I to III NSCLC who underwent radical resection between 2001 and 2008 in seven institutions from the People’s Republic of China was collected using a blinded standardized data form. Survival outcomes were calculated by Kaplan-Meier curves and Life-table method.

Results

A total of 5,853 patients who met the inclusion criteria were entered into the database. The average age was 58.9±10.7 years. Males (59.5%) and adenmocarcinoma (53.0%) represented the majority of all cases. Lobectomy (87.9%) was the major operation type in practice. The 5-year overall survival rates were 81.9% for stage IA, 71.6% for IB, 55.0% for IIA, 45.2% for IIB, 34.9% for IIIA and 23.3% for IIIB (P<0.001).

Conclusions

This is the first and the largest clinical database for resected NSCLC in China with optimal data quality. Future collaboration to expand and share this database nationwide is warranted.KEYWORDS : Non-small cell lung cancer (NSCLC), resected, overall survival, database