同期两镜或三镜下留置输尿管导管胆管引流207例

目的总结运用同期两镜或三镜术中留置输尿管导管胆管引流的治疗经验。方法从1992年10月-2014年8月,我们运用同期两镜或三镜术中留置输尿管导管胆管引流的手术方式,即腹腔镜术中经胆囊管残端输尿管导管胆管引流术（LUD）,对207例患者进行治疗。结果 181例胆管引流获得成功（87.4%）。输尿管导管插管失败12例（5.8%）,其中中转为鼻胆管引流7例,T管引流2例,放弃胆管引流3例。输尿管导管打折或堵塞导致无任何液体流出2例（1.0%）。输尿管导管早期滑脱导致胆汁性腹膜炎2例（1.0%）,再次腹腔镜下放置输尿管导管及腹腔引流管1例和放置T管及腹腔引流管1例而治愈。术后胆漏4例（1.9%）,经腹腔引流管引流自愈。乳头切开术后发生轻症胰腺炎3例（1.4%）。术后经输尿管导管胆管造影无残石,胆管切口一期缝合术后有轻度狭窄影像2例未处理,乳头区狭窄影像1例未处理。无其他严重并发症,无死亡。结论只要选择合适的病例,同期两镜或三镜术中留置输尿管导管胆管引流是可行、有效和安全的。     

腹腔镜下经腹顺行推进法T管双导管捆绑支撑引流术45例

目的探讨在腹腔镜胆总管切开胆管镜探查取石术中采用腹腔镜下经腹顺行推进法T管双导管(T形管＋2根裁剪后的鼻胆管导管)捆绑支撑引流术(LCTBS)联合治疗胆囊结石、胆总管结石、合并的十二指肠乳头部梗阻或狭窄的应用体会。 方法回顾性分析2001年4月至2018年6月期间符合入选标准的45例患者的临床资料。 结果本组45例患者行胆囊切除术、行胆总管切开胆管镜取石术,必要时行冲击波碎石术。预先行逐级导管乳头扩张术、后行T形管＋双导管支撑引流术86.7% (39/45),行逐级导管联合球囊导管乳头扩张术、T形管＋双导管支撑引流术4.4% (2/45),行乳头扩张术失败而改为内镜乳头切开术、T形管＋双导管支撑引流术6.7% (3/45),双导管支撑引流放置失败而改为T管引流术2.2% (1/45)。无残余结石。胆漏1例(2.2%)。经T管瘘道拔除双导管支撑引流管无失败病例。术后无肠穿孔和胆管穿孔,无大出血,无重症胰腺炎,无非计划再次手术病例,无死亡病例。手术并发症发生率为2.2%(1/45)。 结论从本文有限病例进行初步研究发现,只要病例选择合适,LCTBS治疗胆囊结石、胆总管结石、合并十二指肠乳头部梗阻或狭窄是可行、有效和安全的。     

前后路联合手术治疗髋臼双柱骨折疗效分析

目的:探讨前后路联合手术治疗髋臼双柱骨折的效果并分析影响疗效的相关因素。方法:2007年8月至2009年7月收治髋臼双柱骨折患者19例,男13例,女6例;年龄27～52岁,平均39.6岁。高位双柱骨折11例,低位双柱骨折8例,双柱骨折累及骶髂关节1例。受伤至手术时间4～11 d,平均5.8 d。患者均采用前后联合入路手术,重建钢板和螺钉内固定。结果:除1例死亡外本组全部获随访,随访时间12～18个月,平均13.6个月。关节功能根据Harris评分标准,术后功能优9例,良7例,可2例。结论:经前后路联合切开复位内固定治疗髋臼双柱骨折疗效满意。     

锁定加压钢板治疗骨盆骨折的初步体会

目的探讨锁定加压钢板在骨盆骨折中的应用。方法应用锁定加压钢板治疗8例骨盆后环损伤患者,其中男4例,女4例;年龄24-57岁,平均39岁。致伤原因:全部为车祸伤。按照Tile分型:B1型3例,B2型2例,C1型2例,C2型1例。结果8例患者获9个月到2年的随访。手术时间1.5小时到2个小时。术中无输血。术后一例患者出现褥疮,切口均一期愈合。下肢运动、感觉均正常,无神经损伤表现。结论锁定加压钢板治疗骨盆骨折,尤其对后环的固定具安全、微创、稳定的优势。     

4—硒硫酸酯多糖对人肝癌细胞Bel／7402DNA RNA及蛋白质合成的影响

目的 研究4－硒硫酸酯多糖体外给药对人肝癌细胞Bel/7402DNA.RNA及蛋白质的抑制作用。方法 肿瘤细胞与不同浓度的药物培养24h后,用同位素掺入实验,观察药物对肿瘤细胞DNA、RNA及蛋白质合成的影响。结果 4－硒硫酸酯多糖可抑制肿瘤细胞DNA、RNA及蛋白质合成。结论 4－硒硫酸酯多糖对瘤细胞生长的抑制作用,可能与抑制瘤细胞DNA、RNA及蛋白质合成有关。     

功能性消化不良患者胃排空功能与症状分型的关系

目的　通过 99m Tc植酸钠固体餐检测胃排空 ,了解功能性消化不良 (functional dyspepsia,FD)患者各临床亚型胃运动的情况 .方法　 99m Tc植酸钠标记固体餐 ,对 30例 FD患者 (其中溃疡样型 10例 ,动力障碍型 10例 ,非特异型 10例 )及 10名健康对照者进行了核素检测分析 .结果　运动障碍样型及非特异型 FD患者胃半排空时间延迟 (87± 2 8min,89± 2 6 min vs6 1± 9min,P<0 .0 5 ) ,2 h胃排空率明显减少(6 3.0± 11.5 % ,5 7.7± 15 .5 % vs87.0± 10 .3% ,P<0 .0 1) ,而溃疡样型 FD与正常人比无差异 (P>0 .0 5 ) .结论　胃排空延迟在运动障碍样型及非特异型 FD病因中占重要地位 ,FD三个临床亚型之间发病机制既相同又略有不同 ;FD患者中有症状与胃排空之间存在不一致现象 ,所以核素胃排空检查在 FD胃运动功能的判定及指导治疗上有重要意义 .     

A carbonised sieve-like corn straw cellulose–graphene oxide composite for organophosphorus pesticide removal

The development of efficient adsorbents for the removal of organophosphorus pesticides from water is a major challenge. In this work, we prepared an activated carbon derived from sieve-like cellulose/graphene oxide composites (ACCE/G) for the removal of several organophosphorus pesticides. We employed corn straw to produce a sieve-like cellulose–graphene oxide composite (CCE/G); then, by treating CCE/G with potassium hydroxide at high temperatures, the efficient adsorbent ACCE/G was prepared. The adsorption capacity of ACCE/G is higher than those of other sorbents, including a multi-wall carbon nanotube, graphitised carbon black, activated carbon, C18, and primary secondary amine adsorbent. The ACCE/G structure has been fully characterised via scanning electron microscopy, Fourier-transform infrared spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction and Brunauer–Emmett–Teller analysis. The maximum adsorption capacity of ACCE/G is 152.5 mg g⁻¹ for chlorpyrifos. The mechanism, the thermodynamic properties, and the kinetics of the adsorption process have been investigated as well. Our findings demonstrate that the adsorption mechanism depends on the electron-donating abilities of the S and P atoms. Moreover, the Langmuir model gives the best fit for the isotherm data, and the adsorption efficiency of the ACCE/G is still over 80% after eight times of recycling, making ACCE/G a valuable candidate for the removal of OPPs.

Synthesizing a reusable adsorbent from waste corn straw is a sustainable way to utilize secondary resources and purify water.     

Combined spectroscopy methods and molecular simulations for the binding properties of trametinib to human serum albumin

Trametinib is a novel anticancer drug for treating metastatic cutaneous melanoma. The present study probed into the binding of trametinib to human serum albumin (HSA) through spectroscopy methods and molecular simulations. Trametinib could quench the fluorescence of HSA through static quenching which could be probed via fluorescence spectroscopy and time-resolved fluorescence. Thermodynamic parameters and docking results indicated that hydrogen bonds and van der Waals forces play crucial roles in this binding process, which exerts almost no effect on the HSA conformation under synchronous fluorescence, three-dimensional fluorescence, circular dichroism spectra, and molecular dynamics simulations. Site marker displacement experiments and molecular docking reveal that trametinib primarily binds to Sudlow site I of HSA. In addition, the trametinib–HSA interaction was hardly influenced by varying amino acid (glutamine, alanine, glycine, and valine) concentrations. This study can provide useful information for the pharmacokinetic properties of trametinib.

Probing the binding properties of trametinib to human serum albumin.