全腔镜手术与传统手术治疗早期分化型甲状腺癌的临床比较

目的：探讨腔镜下治疗早期分化型甲状腺癌可行性及临床应用价值。 方法：回顾性分析2010年1月—2013年6月收治的75例早期分化型甲状腺癌患者临床资料,其中15例患者行全腔镜甲状腺切除术（腔镜手术组）,60例患者行传统手术（传统手术组）,所有患者均至少行患侧腺叶及峡部切除加中央区淋巴结清扫。比较两组的主要各项临床指标及术后美容效果。 结果：15例腔镜手术患者均获得成功,无中转开放手术病例,无术后大量出血患者。腔镜手术组手术时间略长于传统手术组,但差异无统计学意义（P=0.059）;两组均无术后低钙血症及声音嘶哑并发症,两组术中出血量、术后引流量、住院天数、中央淋巴结清扫数差异均无统计学意义（均P>0.05）。两组患者术后随访6~36个月,均无复发病例,腔镜手术组患者的手术瘢痕小且隐蔽,美容效果明显好于传统手术组。 结论：腔镜下治疗早期分化型甲状腺癌是安全可行,有良好美容效果。     

甲状腺疾病、糖尿病相关骨质疏松的病因研究进展

骨质疏松症是临床的常见病和多发病,并严重影响着人们的健康和生活质量,而糖尿病和甲状腺疾病都是继发性骨质疏松的主要病因。了解这两种疾病相关骨质疏松的病因对骨质疏松的治疗和预防有重要意义。本文主要对内分泌代谢病中的甲状腺疾病及糖尿病引起骨质疏松的病因进行了阐述。     

血红蛋白最佳聚合工艺匹配条件的研究

目的 探讨以戊二醛为交联剂的血红蛋白类氧载体（HBOCs）的聚合工艺匹配条件的优化研究,进一步降低终产品的平均分子质量和超大分子含量,提高聚合血红蛋白的有效转化率.方法 在前期对人胎盘血红蛋白与戊二醛交联的单因素影响水平的研究基础上,选取戊二醛的加样速度、血红蛋白的质量浓度和戊二醛与血红蛋白的摩尔比3个因素做正交试验以优化血红蛋白聚合工艺的匹配条件.结果 戊二醛与血红蛋白的摩尔比对聚合血红蛋白分子质量分布的影响最大,其次是血红蛋白的质量浓度,最后为戊二醛的加样速度.对平均分子质量的影响分析,不同的戊二醛与血红蛋白摩尔比条件下的平均分子质量间的差异均具有统计学意义（P＜0.05）,而不同的血红蛋白质量浓度和戊二醛的加样速度条件下的平均分子质量间的差异均无统计学意义（P＞0.05）;对有效转化率的影响分析,不同的戊二醛与血红蛋白摩尔比和不同的血红蛋白质量浓度条件下的有效转化率间的差异均具有统计学意义（P＜0.05）,不同的戊二醛加样速度条件下的有效转化率间的差异均无统计学意义（P＞0.05）;对超大分子含量的影响分析,不同的戊二醛与血红蛋白摩尔比条件下的超大分子含量间的差异均具有统计学意义（P＜0.05）,不同血红蛋白的质量浓度和戊二醛的加样速度条件下超大分子含量间的差异均无统计学意义（P＞0.05）.结论 通过以上实验分析,优化确定了血红蛋白聚合工艺的最佳匹配条件.     

Enhanced Photo-Fenton Activity of SnO2/α-Fe2O3 Composites Prepared by a Two-Step Solvothermal Method

The x-SnO₂/α-Fe₂O₃ (x = 0.04, 0.07, and 0.1) heterogeneous composites were successfully prepared via a two-step solvothermal method. These composites were systematically characterized by the X-ray diffraction technique, field emission scanning electron microscopy, an energy dispersive spectrometer, X-ray photoelectron spectroscopy and a UV–visible spectrometer. It was found that SnO₂ nanoparticles were uniformly decorated on the surface of α-Fe₂O₃ particles in these heterogeneous composites. A comparative study of methylene blue (MB) photodegradation by α-Fe₂O₃ and x-SnO₂/α-Fe₂O₃ composites was carried out. All x-SnO₂/α-Fe₂O₃ composites showed higher MB photodegradation efficiency than α-Fe₂O₃. When x = 0.07, the MB photodegradation efficiency can reach 97% in 60 min. Meanwhile, the first-order kinetic studies demonstrated that the optimal rate constant of 0.07-SnO₂/α-Fe₂O₃ composite was 0.0537 min⁻¹, while that of pure α-Fe₂O₃ was only 0.0191 min⁻¹. The catalytic mechanism of MB photodegradation by SnO₂/α-Fe₂O₃ was examined. The SnO₂ can act as a sink and help the effective transfer of photo-generated electrons for decomposing hydrogen peroxide (H₂O₂) into active radicals. This work can provide a new insight into the catalytic mechanism of the photo-Fenton process.     

宫颈微偏腺癌六例伴五例卵巢转移的临床病理学分析

目的:探讨宫颈微偏腺癌（minimal deviation adenocarcinoma of cervix,MDA）伴卵巢转移临床病理特征。方法:收集四川省肿瘤医院2014年1月至2019年12月确诊MDA 6例伴卵巢转移5例,总结其临床病理特点及HER2表达状况,并结合文献复习。结果:6例患者年龄33~71岁,中位...     

黄蜡果植物鉴定、化学成分与药理作用研究进展

黄蜡果（Stauntonia brachyanthera Hand.-Mazz.）是木通科野木瓜属植物,在侗医药中具有多种药用价值,其全草均可入药。藤茎具有清热利尿、通经活络、镇痛排脓、通乳等作用,与木通功效相似,民间有将黄蜡果藤茎代替木通入药的用法。该植物主要从黄蜡果的果、花、叶和藤茎进行鉴定。经过查阅文献对黄蜡果的化学成分进行分类,主要含有三萜、黄酮、苯乙醇苷、苯丙素类等成分。目前对黄蜡果的药理活性主要集中在镇痛、抗炎、抗痛风、抗氧化、保肝、利尿等方面进行了研究。     

住院医师规范化培训中中医病案内涵缺失问题及对策

目的 通过补充中医病案内涵,提高住院医师规范化培训质量.方法 随机抽取80份由中医标准化培训医师撰写的中医档案,参照中医病历书写的基本规则,逐项进行检查和分析.结果 住院中医病案普遍存在的问题是中医病案内涵不完整、不完善,主要表现在四诊记录、辨证依据、三级查房记录等方面.结论 通过调查,实施一系列提高住院医师规范化培训...     

Structure-Based Discovery of N-Sulfonylpiperidine-3-Carboxamides as Novel Capsid Assembly Modulators for Potent Inhibition of HBV Replication

As a key element during HBV replication, a nucleocapsid is considered a promising target for the treatment of chronic hepatitis B. The present study aimed to identify small molecules as novel capsid assembly modulators with antiviral activity. Structure-based virtual screening of an integrated compound library led to the identification of several types of HBV inhibitors. Among these inhibitors, N-sulfonylpiperidine-3-carboxamides (SPCs) potently reduced the amount of secreted HBV DNA. Through structure–activity relationship studies, we identified an SPC derivative, namely, C-39, which exhibited the highest antiviral activity without causing cytotoxicity. Mechanism studies showed that C-39 dose-dependently inhibited the formation of HBV capsid, synthesis of cccDNA, e antigen (HBeAg), viral pregenomic RNA (pgRNA), and HBV DNA levels, thereby restraining HBV replication. In summary, SPCs represent a new class of capsid assembly modulators. Further optimization of SPCs is expected to obtain new antiviral drugs against HBV infection.     

Dyspnea induced by hemidiaphragmatic paralysis after ultrasound-guided supraclavicular brachial plexus block in a morbidly obese patient

Rationale:Hemidiaphragmatic paralysis (HDP) is a frequent complication of the brachial plexus block, caused by unintentional blockade of ipsilateral phrenic nerve. HDP did not rise enough alarm and attention to most anesthesiologists, because most patients with no coexisting comorbid diseases are asymptomatic and able to tolerate it. However, it may cause severe respiratory complication for patients with preexisting compromised cardiorespiratory function.Patient concerns:A 67-year-old woman with morbidly obesity was planned to receive opening reduction and internal fixation of right humeral shaft fracture under regional anesthesia considering less respiratory and cardiovascular system interference compared with general anesthesia.Diagnoses:After ultrasound guided supraclavicular brachial plexus block, the patient developed severe hypoxia and hypercapnia.Unintentional block of phrenic nerve and diaphragm paralysis was diagnosed by diaphragm ultrasound, which was considered as the main reason of severe hypoxia.Interventions:It led to a conversion from regional anesthesia to general anesthesia with endotracheal intubation for patient''s safety and smooth operation.Outcomes:The unintentional phrenic nerve block leads to a prolonged ventilation time, length of stay in intensive care unit and length of stay in hospital.Lessons:This case report highlights the risk of diaphragm paralysis in morbidly obese patients. Though new diaphragm sparing brachial plexus block (BPB) methods were developed intended to reduce the risk of HDP, no approaches could absolutely spare phrenic nerve involvement. Therefore, clinicians should always consider the risk of HDP associated with BPBs. For each individual, a detailed preoperative evaluation and sufficient preparation are paramount to avoid serious complications.