经脐单部位腹腔镜治疗罕见儿童疝体会

目的探索经脐单部位腹腔镜手术在罕见儿童疝的临床应用。 方法回顾性分析2014年10月至2017年10月山西省儿童医院11例罕见疝患儿行腹腔镜手术的临床资料。其中男性患儿7例，女性患儿4例，年龄1～12岁。其中腹股沟滑疝5例，腹股沟直疝5例及股疝1例。 结果本组患儿均经脐单部位完成，手术时间20～39 min，无中转开放手术，均术后第2天出院。术后无切口感染、阴囊血肿发生。 结论经脐单部位腹腔镜手术治疗罕见小儿疝安全、微创、恢复快，值得推广应用。     

海洋生物医用材料的临床应用和安全性评价

目的： 对海洋生物医用材料在医疗领域的应用情况和海洋生物材料来源医疗器械的安全性评价趋势进行分析，为推进该材料的临床转化提供参考。方法： 归纳海洋生物医用材料的分类和应用，介绍该材料的安全性评价的程序要点，探讨其安全性评价中面临的挑战。结果与结论： 常用的海洋生物医用材料主要为多糖和蛋白质，在创伤修复和组织工程领域应用广泛。海洋生物医用材料具有生物活性和良好的生物相容性，对此类材料的安全性评价应根据材料特性和预期用途，科学制定评价程序和选择检验方法。     

针刀松解联合丹参注射液关节腔注射治疗骨性关节炎模型兔

文题释义： 针刀疗法：用一个完整的语言来概括应该是一种介于手术方法和非手术疗法之间的闭合性松解术。针刀疗法是将东方中医学的基本理论和西方医学的手术解剖基本理论融为一体，针刀疗法其操作的特点是在治疗部位刺入深部到病变处进行轻松的切割、剥离等不同的刺激，以达到止痛祛病的目的。 丹参注射液：其化学成分主要是水溶性酚酸类化合物，通过多种靶标起到促进血液循环和祛瘀的作用。动物研究表明，丹参注射液可通过抑制IκBα磷酸化来抑制NF-κB信号通路的激活。保护软骨下骨及软骨细胞，有效防治骨关节炎。 背景：丹参注射液与针刀松解术都是临床中治疗骨关节炎很常用的技术，目前缺乏对2种治疗方法联合使用的研究。 目的：对比单独使用针刀松解术、单独使用丹参注射液与两种方法联合使用治疗兔模型骨关节炎的效果。 方法：实验方案经黑龙江中医药大学动物实验伦理委员会批准。50只新西兰白兔分为5组：空白对照组；模型组；丹参注射液组；针刀组；针刀联合丹参注射液组。除空白对照组外，其他4组兔均制备膝关节骨关节炎模型。造模成功后，对针刀组兔内外侧支持带、内外侧膝眼，膝关节上方髌上囊、股四头肌各肌肌腹，膝关节内侧股薄肌肌腹及止点、收肌肌群肌腹及止点和胫骨平台附近部位进行针刀松解；空白对照组及模型组兔关节腔注射生理盐水0.3 mL；丹参注射液组兔关节腔每次注射0.3 mL丹参注射液；针刀联合丹参注射液组：每周进行1次针刀治疗同针刀组，每次针刀干预之后，关节腔注0.3 mL丹参注射液。上述干预每周1次，持续5周。对各组兔膝关节软骨进行大体观察及病理切片组织学观察，ELISA 检测关节液白细胞介素1、肿瘤坏死因子α水平。 结果与结论：①大体观察：模型组膝关节磨损较为严重，针刀组、丹参注射液组、针刀联合丹参注射液组膝关节轻度磨损；②病理切片评分：丹参注射液组评分略高于针刀组和针刀联合丹参注射液组差异无显著性意义；③ELISA 检测结果：针刀联合丹参注射液组白细胞介素1、肿瘤坏死因子α水平显著低于或针刀组或丹参注射液组(P < 0.05)；④结果说明，在兔膝关节骨关节炎模型中降低白细胞介素1、肿瘤坏死因子α水平方面，针刀松解术结合丹参注射液关节腔注射治优于单独使用针刀或单独使用丹参注射液关节腔注射。ORCID: 0000-0003-4119-633X(刘广宇) 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程     

萨提亚团体干预模式在老年肺癌根治术后患者中的应用

目的探讨萨提亚团体干预模式在老年肺癌根治术后患者中的应用效果。方法采用便利抽样法,选择2017年6月—2018年6月郑州大学第一附属医院收治的老年肺癌根治术患者82例为研究对象。随机分为观察组和对照组,每组各41例。对照组术后接受常规护理,观察组采用萨提亚团体干预模式。干预前后采用社会回避与苦恼量表(SADS)、Rosenberg自尊量表(RSES)和欧洲癌症研究所癌症患者生命质量测定量表(EORTC QLQ-C30)比较干预效果。结果干预后观察组患者SADS评分低于对照组,RSES评分高于对照组,差异均有统计学意义(P<0.05)。干预后观察组患者躯体功能、角色功能、情绪功能、社会功能、疲乏感、恶心呕吐、疼痛、呼吸困难、睡眠障碍、食欲丧失、便秘、腹泻、经济困难及整体生活质量评分均高于对照组,差异有统计学意义(P<0.05)。结论萨提亚团体干预模式用于老年肺癌根治术患者,有助于提高患者自尊,纠正不良情绪,改善生活质量,值得推广应用。     

Primary Conservative Therapy for Symptomatic Isolated Mesenteric Artery Dissection with Severely Compressed True Lumen or Large Dissecting Aneurysm

PurposeTo investigate the safety and effectiveness of primary conservative therapy for patients with symptomatic isolated mesenteric artery dissection (IMAD) with a severely compressed true lumen and/or a large dissecting aneurysm.Materials and MethodsA total of 35 consecutive patients (all men; median age, 53 y) with symptomatic IMAD with a severely compressed true lumen and/or a large dissecting aneurysm but without intestinal necrosis or arterial rupture who were treated with primary conservative therapy between November 2018 and February 2020 were assessed. A severely compressed true lumen was defined as luminal stenosis > 70%. A large dissecting aneurysm was defined as dissecting aneurysm diameter ≥ 1.5 times larger than the normal mesenteric artery diameter.ResultsThere was a strong positive relationship among abdominal pain, degree of luminal stenosis, and length of dissection (R = 0.811; P < .001). Conservative treatment was successful in all patients. Abdominal pain was eliminated within 4.7 d ± 4.8 (range, 2–31 d) in all patients, within 3.6 d ± 1.2 (range, 2–6) in the 31 patients with minor or moderate abdominal pain, and within 13.3 d ± 11.9 (range, 6–31 d) in the 4 patients with severe abdominal pain. Complete or partial remodeling of the mesenteric artery was achieved in 6 (17.1%) and 29 (82.9%) patients, respectively, during 8.6 mo ± 4.3 of follow-up.ConclusionsPrimary conservative therapy can be used safely and effectively in patients with symptomatic IMAD with a severely compressed true lumen and/or a large dissecting aneurysm but without intestinal necrosis or arterial rupture.     

Clinical study of transcatheter occlusion in treating ventricular septal defect combined with right coronary cusp bulge

Background: Perimembranous ventricular septal defect combined with right coronary cusp bulge generally should be treated with surgical thoracotomy, owing to the potential aortic regurgitation. However, the minimally invasive method of transcatheter closure has always attracted the attention of cardiologists and patients. The present study aimed to apply transcatheter occlusion in treating ventricular septal defect with right coronary cusp bulge and further evaluate the clinical effect through follow-up.Materials and methods: A total of 40 children diagnosed as having a ventricular septal defect with right coronary cusp bulge, examined using transthoracic echocardiography and cardiovascular angiography, were enrolled in this study. The ventricular septal defects were closed by placing occluders through transcatheter occlusion treatment. During the operation process, the children underwent angiography and transthoracic echocardiography examinations to check the position of the occlude and the extent of aortic regurgitation. The influence of occlusion on the conduction system was evaluated using a surface electrocardiogram. The children were followed up after their procedures.Results: All 40 patients were immediately and successfully occluded. Three patients with filament residual shunts were observed during the operations. No major surgical complications occurred during the perioperative period. During the follow-up period, the positions of all the occluders were good, the residual shunts in the three patients disappeared, and no new or aggravated aortic regurgitation occurred. Electrocardiogram did not reveal any atrioventricular blocks. Only one patient suffered from an incomplete right bundle branch block.Conclusions: Children diagnosed with ventricular septal defect combined with right coronary cusp bulge could be considered for transcatheter occlusion. With appropriate indications and methods, the effect may be favorable.     

Synergistic effects of ischemic preconditioning and immediate post‐conditioning in the protection against ischemia/reperfusion injury in rabbit submandibular glands

Submandibular gland autotransplantation is an effective approach for treating severe keratoconjunctivitis sicca. However, ischemia/reperfusion (I/R) injury, which inevitably occurs during transplantation, is involved in the hypofunction and structural damage that occur early after transplantation. Therefore, it is critical to identify effective strategies to ameliorate I/R injury in submandibular glands. In this study, we investigated the ability of immediate post‐conditioning combined with ischemic preconditioning to attenuate I/R injury. We observed that after I/R injury, the level of reactive oxygen species was increased, inflammatory response was strengthened, and severe apoptosis had occurred. In addition, the salivary flow rate was greatly decreased. However, the pathogenesis of I/R injury was significantly ameliorated by ischemia post‐conditioning or ischemia preconditioning treatments. In addition, the combination of ischemia preconditioning and post‐conditioning achieved synergistic protective effects against I/R injury compared with ischemia preconditioning or ischemia post‐conditioning alone. The secretion function was restored in the combination group. Furthermore, the combination treatment involved the same mechanisms of ischemia preconditioning or ischemia post‐conditioning, including suppression of the inflammatory reaction and neutrophil accumulation, attenuation of oxidation stress, and inhibition of apoptosis. In conclusion, the combination of ischemia preconditioning and ischemia post‐conditioning treatment is a simple and effective approach for treating I/R injury in submandibular glands.     

NOISE INDUCED HEARING LOSS IN CHINA:A POTENTIALLY COSTLY PUB-LIC HEALTH LSSUE

Hearing loss and tinnitus are among the most common consequences of long term noise exposure and re-main an under-addressed heath issue in most developing nations including China. The rapid industrializa-tion and life style changes in China increase the concern over noise exposure and noise induced hearing loss (NIHL). Research on NIHL in China is limited. The current paper reviews studies published in English and Chinese language literatures regarding noise exposure and NIHL in China. Their implication on the Chi-nese population is discussed. The possible utility of a research model such as the Dangerous Decibels? as a means to increase understanding of the scope of NIHL among the Chinese population, to educate the gener-al public in China (especially the young) about NIHL and its prevention, and to study effects of language and cultural factors on international information dissemination and behavioral interventions is proposed.