左半结肠癌急性梗阻一期切除吻合的安全保证——彻底快速而无污染的肠减压术(英文)

目的研究一种彻底快速而毫不污染手术野的术中肠减压方法,以便提高手术的安全性。方法游离系膜后,钳夹下将拟切除肠段的下端先切断,将其近侧断端置入并固定于粘附在手术床边的塑料袋中;松开肠钳,肠内容物自由流入袋内;双手交替推挤膨胀的肠段,由近而远,由小肠向大肠,直至大、小肠的内容物彻底排空。钳夹下切断上端,移除切下的肠段和充满粪便的塑料袋。结果使用本法行肠减压术,一期切除急性梗阻的左结肠癌31例,均未发生吻合口漏,创口一期愈合。另有6例肝段切除同时切除未作肠道准备的结肠癌亦取得同样结果。同法亦用于各种急性小肠梗阻,均未造成腹腔污染。结论本法可推荐为术中肠减压的首选方法。     

小儿双清颗粒治疗小儿急性上呼吸道感染表里俱热证304例临床观察

目的观察小儿双清颗粒治疗小儿急性上呼吸道感染表里俱热证的疗效和安全性。方法收集急性上呼吸道感染表里俱热证患儿420例,随机分为试验组315例,对照组105例。治疗组给予小儿双清颗粒,对照组给予小儿热速清颗粒,两组均1岁以内每次1g,1～3岁每次2g,4+～6岁每次3g,6岁以上每次4g,每天3次。治疗3天后比较两组疾病疗效、中医证候疗效、单项中医症状疗效、体温完全恢复正常所需时间,并观察治疗过程中的不良反应。结果疾病疗效总有效率试验组为83.23%、对照组为60.95%;中医证候疗效总有效率试验组为94.41%、对照组为74.29%,两组比较差异均有统计学意义(P<0.05);两组各单项中医症状有效率试验组均明显高于对照组(P<0.05)。试验组体温完全恢复正常所需时间明显短于对照组(P<0.05)。两组均未发现明显不良反应。结论小儿双清颗粒治疗急性上呼吸道感染表里俱热证患儿疗效确切,临床应用安全。     

子宫内膜异位症与抗碳酸酐酶抗体的关系

目的 :探讨抗碳酸酐酶Ⅰ、Ⅱ抗体与子宫内膜异位症的关系。方法 :应用酶联免疫吸附 (ELISA)法分别检测内异症 32例、其他妇科疾病 (妇科组 ) 2 0例及正常妇女 12例血清抗碳酸酐酶抗体水平。结果 :(1)内异症患者血清抗碳酸酐酶Ⅰ、Ⅱ抗体阳性率(87.5 %、5 3.1% )高于妇科组 (2 5 %、15 % ) ,两组差异有显著性 (P <0 .0 1) ;(2 )内异症患者血清抗碳酸酐酶Ⅰ、Ⅱ抗体阳性率明显高于正常妇女组 (0 %、0 % ) ,两组差异有显著性 (P<0 .0 1) ;(3)妇科组及正常妇女组血清抗碳酸酐酶Ⅰ、Ⅱ抗体阳性率较低 ,两组差异无显著性 (P >0 .0 5 )。结论 :检测抗碳酸酐酶抗体对诊断子宫内膜异位症及探讨其发病机制有重要价值     

“培土生金”法在新型冠状病毒肺炎疫情中对慢性阻塞性肺疾病的作用

目前,新型冠状病毒肺炎(简称"新冠肺炎")在我国已经得到阶段性地控制,但在世界范围,患者仍不断增加,且仍有不少境外输入病例不断进入国内。因此,现阶段对新冠肺炎疫情防控仍处于关键时期。慢性阻塞性肺疾病(COPD)是我国中老年人常见的呼吸系统疾病,患者常存在肺脾气虚的证候表现,加之免疫力、抵抗力较低,是新冠肺炎的易感人群。COPD与新冠肺炎同属呼吸系统疾病,二者在病因上具有一定的相似性,且具有相同的病变脏腑。二者在发病过程中,都会产生"湿、毒、热"的病理因素,影响肺、脾与大肠等脏腑的生理功能,致使其在病机上具有相关性,且贯穿疾病的始终。脾胃的盛衰是治疗新冠肺炎进退的关键。培土生金法有健脾益肺,化湿祛毒的含义,可以同时调节肺、脾、大肠三个脏腑,改善相关脏腑的功能,达到肺肠同治、肺脾同调的作用。因此培土生金法不仅是治疗COPD的常用方法,也可以作为本次新冠肺炎"湿、毒、热"病理因素的治疗方法。参苓白术散是培土生金法的代表方剂,有益气健脾化湿的功效,契合本次新冠肺炎"湿毒疫邪"的主要病机,对COPD患者具有扶正祛邪,增加免疫力的作用。同时也可以采用培土生金法选取相应穴位艾灸,加强对新冠肺炎的预防。因此,培土生金法可作为疫情期间COPD患者预防新冠肺炎的治疗方法。     

基于无尺度网络法的4 116 张胃癌中医处方研究

本研究借助临床科研信息共享系统,使用无尺度网络挖掘方法,分析了江苏省中医院门诊994 例胃癌患者中医治疗的4 116 张处方,以图示化直观展示了核心药物及配伍,揭示出该院胃癌的中医治疗处方用药特点。该方法具有较高的可信度,对于中医处方的研究具有一定的意义和价值。     

血清RBP4、visfatin、RIPK1水平在冠心病伴颈动脉粥样硬化患者中的表达及临床意义

目的 探究血清视黄醇结合蛋白4(RBP4)、内脏脂肪素(visfatin)、受体相互作用蛋白激酶1(RIPK1)水平在冠心病伴颈动脉粥样硬化(CAS)患者中的表达及临床意义。方法 选取2020年2月至2021年2月于该院就诊的163例冠心病患者作为研究对象,按是否伴CAS分为冠心病组79例和冠心病伴CAS组84例。同期选取72例于该院进行体检的体检健康者作为健康组,检测上述研究对象血清RBP4、visfatin、RIPK1水平并分析其与冠心病伴CAS组的相关性。结果 与健康组、冠心病组相比,冠心病伴CAS组血清RBP4、visfatin、RIPK1水平较高,差异有统计学意义(P<0.05)。与中度、轻度冠心病伴CAS患者相比,重度冠心病伴CAS患者血清RBP4、visfatin、RIPK1水平较高,差异有统计学意义(P<0.05);Pearson相关性分析显示,RBP4、Gensini评分呈正相关(r=0.429,P=0.001);RBP4、Gensini评分呈正相关(r=0.486,P=0.001);visfatin、Gensini评分呈正相关(r=0.630,P=0.0...     

Isolated splenic metastasis of endometrial cancer 12 years after treatment: A case report and literature review

Rationale:The spleen is an uncommon metastatic organ for malignant solid tumors because of its special anatomy and microenvironment. Isolated splenic metastasis of endometrial cancer is an extremely rare clinical event, with only 17 cases reported in literature.Patient concerns:We report the case of a 58-year-old woman with abdominal distension and nausea for 7 months who had undergone surgery and chemotherapy for endometrioid adenocarcinoma 12 years previously. A space-occupying lesion in the upper pole of the spleen was observed on an abdominal ultrasound.Diagnosis:The spleen was resected, and splenic metastasis of endometrial adenocarcinoma was histologically confirmed.Interventions:Splenectomy was performed, and no lymph nodes or other metastases were observed. The patient received postoperative chemotherapy with 6 cycles of docetaxel and carboplatin.Outcomes:The patient recovered well 11 months postoperatively, with no evidence of recurrence or metastatic disease.Lesson:Since the time interval between the diagnosis of primary endometrial cancer and splenic metastasis may be very long, it may be necessary to monitor the recurrence of endometrial cancer after primary treatment.     

Comparison of the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma: a retrospective cohort study

BackgroundThere is lack of studies on sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma (HCC). This study was to explore the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib failure in HCC patients.MethodsThis study was a retrospective, real-world study that included 50 HCC patients who received sequential regrafinib after sorafenib and lenvatinib failure. The safety and prognosis of two groups were compared.ResultsThe incidence of all grade and III/IV adverse events were 68% and 24%. According to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 and modified (m) RECIST standards, the objective response rates (ORRs) after receiving regorafenib were 14.0% and 22.0%, respectively. The disease control rates (DCRs) were 62.0% and 60.0%, respectively. Based on different first-line targeted drugs, 50 patients were divided into sorafenib (n=22) and lenvatinib group (n=28). There was no differences between two groups except age and bilirubin. And there was no differences in other treatments before or after regorafenib. The baseline between two groups was basically same and had good comparability. There was no difference in incidence of all grade and III/IV adverse events, ORR and DCR between two groups (P>0.05). On long-term prognosis, total overall survival (TOS) in sorafenib and lenvatinib group were 23.0 (95% CI: 15.1–30.9) vs. 29.7 (95% CI: 21.4–38.1) months. The difference was statistically significant (P=0.041). Besides, regorafenib overall survival (ROS) in sorafenib and lenvatinib group were 11.7 (95% CI: 7.1–16.3) vs. 15.9 (95% CI: 8.3–23.5) months. The difference was statistically significant ( P=0.045). The regorafenib progression-free survival (RPFS) was 5.6 (95% CI: 1.9–9.2) vs. 8.0 (95% CI: 5.1–10.9) months in sorafenib and lenvatinib group, respectively, and difference was not statistically significant (P=0.380).ConclusionsRegorafenib is an effective drug for second-line treatment of HCC, with fewer severe adverse events, ORR and DCR was 14–22% and 62–60%, respectively. Both TOS and ROS in lenvatinib group were better than those in sorafenib group. For HCC patients whose first-line targeted drug is lenvatinib, it is safe and effective to accept regorafenib after disease progresses.     

靶向MMP-9的siRNA抑制人类SGC7901胃腺癌细胞侵袭和迁移的研究

目的:探讨基质金属蛋白酶(MMP-9)siRNA对胃腺痛细胞系SGC7901中MMP-9表达的影响以及siRNA干扰后对SGC7901细胞侵袭和迁移的抑制作用.方法:设计合成针对MMP-9的siRNA,采用oligofectamine转染SGC7901胃腺癌细胞,分别采用实时定量聚合酶链反应(realtime PCR)和蛋白印迹法分别检测转染细胞后MMP-9mRNA及蛋白的表达.Matrgel 3D生长实验和Transwell实验检测细胞侵袭情况,Matrgel 2D生长实验和划痕实验检测细胞迁移情况.结果:realtime PCR和蛋白印迹法显示转染MMP-9 siRNA后细胞中MMP-9 mRNA和蛋白的表达较空白组和对照组明显降低.RNA干扰MMP-9基因后SGC7901细胞的侵袭和迁移能力也有明显下降.结论:靶向MMP-9的siRNA不仅能特异性的降低MMP-9 mRNA及蛋白的表达,且能抑制人SGC7901胃腺癌细胞的侵袭和迁移.     

Identification of trace organic pollutants in freshwater sources in Eastern China and estimation of their associated human health risks

Concentrations of polycyclic aromatic hydrocarbons (PAHs) and organochlorine pesticides (OCPs) in ten water samples (four pairs of tap water with source water and two additional tap water) were analyzed and a US EPA algorithm was used to estimate their associated human health risks. Organochlorine pesticides were found in most samples analyzed. Concentrations of total PAHs ranged from 4.8 to 84.4 and 0.7 to 53.8 ng/l, for source and tap water, respectively. Carcinogenic and noncarcinogenic risk assessments were employed for various trace organic pollutants in the tap water. The results indicated that carcinogenic risk for male and female lifetime of tap water from XuZh (XZ) city was higher than the others. XZ located in the northern part of Jiangsu province, which takes ground water as the water source. Children were more vulnerable to the carcinogenic chemicals than adults. Carcinogenic risks for male children (0–14 years old) in XZ were the highest, reaching 3.68 × 10⁻⁶. Contribution analysis showed that dibenz[a,h]anthracene contributed most to the carcinogenic risk in XZ city, and α-HCH, β-HCH and γ-HCH posed the most carcinogenic risk in tap water from GoHu (GH) in Eastern Taihu Lake. Additionally, noncarcinogenic risks posed by the detected chemicals to local people were negligible. Risk alleviation strategies should be adopted, taking into account the results of these health risk assessments.