胸腹腔镜联合手术对食管癌患者炎症及创伤应激的影响

目的 探究胸腹腔镜联合手术对食管癌患者炎症及创伤应激的影响.方法 将60例食管癌患者按手术方式不同分为观察组及对照组,每组30例.对照组采用传统开胸手术治疗,观察组采用胸腹腔镜联合手术治疗,比较两组患者炎症指标、创伤应激指标、免疫功能指标、手术相关指标水平.结果 术后,两组患者白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、皮质醇(Cor)、去甲肾上腺素(NE)水平均上升,且观察组患者IL-6、IL-8、TNF-α、CRP、Cor、NE水平均低于对照组,差异均有统计学意义(P﹤0.05).术后,两组患者CD4+、CD8+、CD4+/CD8+及自然杀伤(NK)细胞均下降,且观察组患者CD4+、CD4+/CD8+及NK细胞均高于对照组,差异均有统计学意义(P﹤0.05).观察组患者术中出血量少于对照组,手术时间、住院时间、肠道功能恢复时间均短于对照组,差异均有统计学意义(P﹤0.05).结论 食管癌患者采用胸腹腔镜联合手术治疗可降低机械性刺激引发的炎性反应及创伤应激反应,同时对机体免疫功能的影响较小,促进机体恢复,临床应用价值较高.     

关于《护理学基础》双语教学的实践与探讨

目的提高护生护理专业英语水平，以增强其竞争力。方法根据《护理学基础》课程内容特点，确立了关键词、定义双语注解、部分护理技术双语授课及部分护理技术“全英”授课的3种双语教学形式，教学过程以课前指导预习—授课—课后跟踪反馈的方法来实施。通过成绩分析，问卷调查及教师研讨进行了系列的教学效果评价。结果85％学生认同开展双语教学的必要性及前景性；72．6％学生认为对提高英语的运用能力有帮助。80％以上学生赞同所采用的独特的双语教学方法。同时在教材的选择，教师的培训方面也获得探索性经验。结论在《护理学基础》中实施双语教学有助于促进护生的专业英语水平。     

Delta大通道内镜辅助下后路椎管减压椎间植骨融合术治疗退变性腰椎疾病的临床疗效

【摘要】 目的：探讨Delta大通道内镜辅助下后路椎管减压椎间植骨融合术治疗退变性腰椎疾病的效果。方法：回顾性分析2021年9月~2022年9月我院收治的80例退变性腰椎疾病患者的病历资料,根据患者治疗方式分为观察组（38例,男17例,女21例,年龄61.0±4.9岁）和对照组（42例,男20例,女22例,年龄60.5±5.4岁）,观察组患者采取Delta大通道内镜下Endo-PLIF治疗,对照组采取开放后路腰椎椎间融合术治疗,记录两组患者术中出血量、术后引流量、手术时间、手术切口长度、住院时间,比较患者并发症发生情况。于术前、术后1周、1个月、3个月、6个月使用视觉模拟量表（visual analogue scale,VAS）评分评估患者腰痛情况,并采用Oswestry功能障碍指数（Oswestry disability index,ODI）评估患者腰椎功能;使用改良Macnab标准对患者进行疗效评估。根据患者术后1年随访时的腰椎影像学复查结果,使用Bridwell椎间融合标准对患者手术节段融合情况进行评估。结果：观察组患者的术中出血量及术后引流量分别低于对照组（88.46±10.98mL vs 112.99±12.01mL、159.73±18.42mL vs 201.36±23.06mL,P<0.05）,手术切口及住院时间分别短于对照组（1.54±0.36cm vs 5.43±1.01cm、6.79±1.22d vs 8.03±1.43d,P<0.05）,手术时间长于对照组（162.33±19.57min vs 126.87±23.15min,P<0.05）。80例患者术后均获随访,随访时间15~40个月（19.0±6.3个月）。观察组患者术后1周、术后1个月的VAS评分分别为2.46±0.51分、1.21±0.38分,ODI分别为（17.84±4.15）%、（10.69±1.88）%,均低于对照组[VAS评分分别为3.68±0.62分、2.01±0.41分,ODI分别为（21.33±3.48）%、（12.33±2.17）%,均P<0.05],两组患者术后3个月、术后6个月的VAS评分比较无统计学差异（P>0.05）。观察组治疗优良率为92.11%,与对照组的85.71%比较无统计学意义（P=0.487）。两组患者融合分级比较,差异无统计学意义（Z=0.487,P=0.624）。观察组术后并发症发生率为5.26%,与对照组的9.52%比较无统计学差异（P=0.678）。结论：Delta大通道内镜辅助下后路椎管减压椎间植骨融合术治疗退变性腰椎疾病效果良好,可以减少术中出血量,缩短手术切口和住院时间,更快改善患者术后短期内疼痛、腰椎功能,安全性较好。     

高效液相色谱法测定氟尿嘧啶在人体内的血药浓度

目的:建立血清中氟尿嘧啶浓度的HPLC测定方法。方法:血清经处理后,采用Nova-Pak C_(18)柱,流动相为甲醇-0.3％乙酸溶度(2:98),检测波长266 nm。结果:氟尿嘧啶浓度在0.226～36.16μg·ml~(-1)范围内与峰面积呈良好的线性关系,血清中药物最低检测浓度为0.028 25 μg·ml~(-1);高中低3种浓度的日内 RSD(n=5)分别为2.2％,2.4％和3.5％,方法回收率为99.8％,107.5％和91.7％。结论:本方法灵敏度高,操作简便易行,结果准确可靠,能满足氟尿嘧啶血药浓度的测定。     

拜新同联合血府逐瘀汤对稳定性心绞痛的疗效观察

目的观察拜新同联合血府逐瘀汤对稳定型心绞痛的临床疗效。方法将我院135例于2008年3月～2009年5月收治的稳定性心绞痛患者随机分为两组,拜新同联合血府逐瘀汤组(治疗组,n=68)和单纯拜新同组(对照组,n=67),治疗期28天,观察两组疗效。结果治疗组的总有效率为94.1%,对照组的总有效率为74.6%,治疗组显著优于对照组(P<0.05)。心电图总有效率分别为64.7%和53.7%,差异有显著性。结论拜新同联合血府逐瘀汤可显著提高稳定性心绞痛的临床疗效。     

胃大部切除术后食管癌的外科治疗

目的：探讨胃切除术后食管癌的外科手术治疗。方法：通过我科的39例手术,结合文献分析胃大部切除术后食管癌手术切除重建的各种术式方法及优缺点。结果：上段食管癌切除应以横结肠代食管重建为佳,中下段食管癌以残胃代食管重建最理想,也可以用空肠代食管重建。结论：胃大部切除术后食管癌是可以通过手术再根治的,食管的重建以残胃最接近生理及解剖学,术式简单,安全,易行。     

Proteomic analysis of liver cancer cells treated with 5‐Aza‐2′‐deoxycytidine (AZA)

5‐Aza‐2′‐deoxycytidine (AZA) is a potent inhibitor of DNA methylation that exhibits anti‐tumor activity in a variety of tumor cells via reactivation of tumor suppressor genes. However, few studies have been done on the biological and clinical significance of AZA in human hepatocellular carcinoma. To identify potential genes that may be aberrantly methylated and confer growth advantage to neoplastic cells and to better understand the molecular mechanism(s) underlying AZA anti‐tumor activity, a proteomics approach was used to annotate global gene expression changes of HepG2 cell line pre‐ and post‐treatment with AZA. A total of 56 differentially expressed proteins were identified by 2D gel analysis, 48 of which were up‐regulated while the remaining 8 were down regulated. Among the identified proteins, eight of these showed marked changed proteins, including seven up‐regulated proteins: glutathione S‐transferase P, protein DJ‐1, peroxiredoxin‐2, UMP‐CMP kinase, cytochrome c‐type heme lyase, enhancer of rudimentary homolog, profilin‐1, and one down‐regulated protein, heat‐shock protein β?1. The possible implication of these proteins in hepatocarcinogenesis is discussed. We tested two up‐regulated proteins, glutathione S‐transferase P and peroxiredoxin‐2, using RT‐PCR and their expression was consistent with the results obtained in the protein level. Both of these genes were methylated when methylation‐specific PCR was used against their promoter regions. Following treatment with AZA, the gene promoter regions were found to be unmethylated, concomitant with overexpression of the proteins compared to HepG2 cells without treatment. These data provide useful information in evaluating the therapeutic potential of AZA for the treatment of HCC. Drug Dev Res 69, 2009. © 2009 Wiley‐Liss, Inc.     

Novel genetic biomarkers for susceptibility to oral submucous fibrosis: cytochrome P450 3A

Oral submucous fibrosis (OSF) is a chronic and insidious oral mucosal disease, which always carries high risk of transition to oral cancer. Mainly based on genetic predisposition in pharmacokinetics for toxic substances of betel quid, there are obviously variable responses to betel quid among chewers. But the key genes resulting in interindividual variability in OSF development are still obscure. The cytochrome P450 3A (CYP 3A) gene family plays major roles in the oxidative metabolism of active endogenous and xenobiotic substrates, which is generally found polymorphic with variant alleles in different individuals and regarded as a major determinant of the interindividual variability in chemicals pharmacokinetics. Based on the specific property of CYP 3A, we consider this polymorphically expressed genotype could be a predictor of OSF susceptibility. Betel-quid chewers with lower level of CYP 3A expression might be more susceptible to toxicity of betel quid, resulting in higher risk of OSF lesion. Meanwhile, individuals at genetically high risk of OSF could be screened according to the genetic polymorphisms in some exclusive regions of the CYP 3A genes. By analyzing the polymorphisms of CYP 3A genes, we could differentiate interindividual variability for pharmacokinetics of betel-quid chewers, and then guide OSF therapy.