机器人辅助腹腔镜下膀胱癌根治术后早期并发症及其危险因素

目的：探索机器人辅助腹腔镜下膀胱癌根治术后早期并发症发生的危险因素,为预防术后早期并发症 提供参考。方法：选择2016年1月至2018年1月在中南大学湘雅二医院和湘雅三医院行机器人辅助腹腔镜下膀胱癌 根治术(robot-assisted laparoscopic radical cystectomy,RARC)的膀胱癌患者90例,收集患者基本信息、术前检查及术 后90 d内随访资料。对术后早期并发症的危险因素行单因素和多因素logistic回归分析。结果：术后总体并发症发 生率为48.9%(44/90),其中Clavien分级1级9例,2级17例,3级4例,4级12例,5级2例。术后90 d内并发症以急性肾 功能损伤(22.2%)、肠梗阻(16.7%)、尿路感染(14.4%)、淋巴漏(10.0%)最为常见。术后90 d内死亡2例(2.2%)。术前 BMI(OR=1.16,95% CI：1.02~1.32)、术后30 min内血肌酐值(OR=1.02,95% CI：1.00~1.03)和pT分期(OR=1.67,95% CI：1.05~2.68)为RARC术后早期并发症的危险因素。结论：RARC术后早期并发症发生率较高,术前血液透析,纠正 贫血,术中保护肾功能,快速康复治疗等有助于预防术后早期并发症的发生。     

外固定器结合可吸收缝线治疗桡骨远端骨折

目的探讨外固定架结合可吸收缝线治疗桡骨远端粉碎性骨折的临床疗效。方法 2006年9月至2008年5月,运用万向式骨外固定器结合可吸收线治疗桡骨远端不稳定骨折42例,男性26例,女性16例,并对关节功能按Dienst标准进行评定。结果 42例均获随访,时间6~18个月（平均10个月）,骨折均骨性愈合,愈合时间6~8周。关节功能评定：优23例,良14例,可5例。结论万向式外固定架结合可吸收线治疗桡骨远端粉碎性骨折操作简单、固定可靠、疗效满意。     

医学物理学实验教学模式改革实践

为了使各种类型学生在物理学实验课程中得到有关动手能力培养、物理知识增加、思维模式转换等,本文设计了两个与医学专业有联系的新型物理学实验.通过语音和脉搏这两个与人体信息相关的物理学实验,增加学生的研究兴趣,引导学生主动思考.调查结果显示,这种类型的物理学实验得到不同专业学生的普遍认可和欢迎.     

Production of chitosan from endolichenic fungi isolated from mangrove environment and its antagonistic activity

Objective

To screen the chitosan producing ability of endolichenic fungi and its antibacterial activity.

Methods

Lichen collected from mangroves was screened for endophytes and the chitosan producing ability of endolichenic fungi by submerged fermentation was also determined. Antibacterial activity was carried out against different pathogens.

Results

Totally 4 different groups of fungi were isolated from the lichen Roccella montagnei. Among the four genera, Aspergillus niger (A. niger) is potential to produce chitosan (1.3 g/L) on the twelfth day of incubation. Glucose plays an important role in the productivity of chitosan and the yield was maximum at 10% (1.93 g/L). Antibacterial activity revealed that Vibrio cholerae was sensitive to chitosan followed by Escherichia coli.

Conclusions

In conclusion, our findings suggest that A. niger is a potential candidate to produce more chitosan than the other strains and glucose plays an important role in the production of chitosan which proves to have a good antibacterial activity.     

Dilated biliary tract: evaluation with MR cholangiography with a T2- weighted contrast-enhanced fast sequence

A heavily T2-weighted gradient-echo sequence was used for magnetic resonance (MR) imaging of the biliary system in five healthy volunteers and 13 patients with obstructive jaundice. Images were obtained in the sagittal and coronal planes during sequential breath-hold intervals and were post-processed by using a maximum-intensity projection algorithm. The extrahepatic and intrahepatic bile ducts were well visualized in 11 patients. The level of obstruction and the grade of dilatation were depicted with MR cholangiography. However, the cause of obstruction could be determined with MR cholangiography in only eight cases. The part of the biliary system below the obstruction could not be visualized with MR cholangiography. In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. Possible causes for this phenomenon are the limited spatial resolution of MR imaging, partial volume effects, or flow within the bile ducts. MR cholangiography may be a useful adjunctive tool for noninvasive evaluation of patients with obstructive jaundice. However, further technical advances are necessary to improve image quality.     

Ethnic variation in childhood lung function may relate to preventable nutritional deficiency

This study aimed to define the differences in lung function between British Caucasian and rural eastern Indian children, and to test the hypothesis that nutrition could account for such ethnic variation. To exclude confounders, a rural Indian setting was identified and children were screened for respiratory illness before lung function and nutritional characteristics were measured. Regression equations for this population have already been published. In this study, the lung function differences between rural eastern Indian ( n = 391) and mean predicted lung function for Caucasian children were characterized, matched for height and sex. In addition, stepwise multiple regression models were fitted to investigate the relative associations of lung function differences with body mass index (BMI), occipitofrontal circumference and age. Although the largest differences in the forced expiratory volume in 1 s (FEV 1 ) [girls 28.7 (27.3-30.1), boys 23.4 (22.2-24.6)] and forced vital capacity [girls 27.9 (26.4-29.4), boys 30.7 (29.6-31.9)] [values as mean difference in % predicted (95% confidence intervals)] ever reported between two populations were observed, differences in peak expiratory flow rate (PEFR) were small. BMI was strongly associated with inter-racial differences for FEV 1 for both sexes (boys β= -0.227, girls β= -0.353, p ≤0.001) and PEFR for girls ( β= -0.200, p ≤0.05) ( β= standardized coefficient).

Conclusion: Preventable nutritional factors may play a causal role in determining the FEV 1 differences between rural Indian and Caucasian children. As peak FEV 1 in youth influences respiratory morbidity in later life, it is important to define specific nutrient 1 deficiencies that may relate to poor FEV growth in these children.     

关节镜手术治疗踝关节骨折后创伤性关节炎17例

目的 观察关节镜手术治疗踝关节骨折后创伤性关节炎的近期效果.方法 2007年12月～2009年4月我院对17例踝关节骨折术后创伤性关节炎进行踝关节镜手术治疗,并运用关节镜观察踝关节病变情况.结果 术中踝关节镜下见慢性滑膜炎性增生17例,胫骨下端前缘骨赘6例,距骨颈部骨赘4例,距骨关节软骨损伤11例,胫骨关节软骨损伤4例,游离体2例.术后48 h 5例有关节疼痛、轻度肿胀,1周后好转,余无明显关节疼痛.16例随访12～25个月,平均18.2个月.根据Baird等踝关节评分系统评定疗效,优4例,良10例,可2例,优良率87.5%.结论 踝关节镜手术治疗踝关节骨折后创伤性关节炎近期效果满意.