The association between caudal block and urethroplasty complications of distal tubularized incised plate repair: experience from a South China National Children’s Medical Center

BackgroundThe effect of caudal block (CB) on the incidence of urethroplasty complications in hypospadias repair remains controversial. The evidence is conflicting, and some confounding bias issues need to be addressed. We sought to study a more homogenous group of distal hypospadias patients undergoing primary tubularized incised plate (TIP) repair by a senior pediatric urology surgeon in the past 2 years to examine the relationship between urethroplasty complications and the use of CB.MethodsWe reviewed our database to identify consecutive patients who had undergone hypospadias repairs by a senior director surgeon at our Center between January 2018 and November 2020. To be eligible to participate in the study, patients had to meet the following inclusion criteria: (I) have distal hypospadias; (II) have undergone a primary TIP repair; and (III) have attended follow-up appointments for a minimum period of 6 months. The primary outcome was the development of urethroplasty complications during the follow-up period. The principal variable of interest was whether or not CB was used perioperatively. The patients were categorized into a CB group (general anesthesia combined with CB) or a control group (general anesthesia only). Other potential risk factors were analyzed, including patient age at operation, patient weight, glans width, and the length of the urethral plate defect.ResultsThirty (12.2%) of the distal patients developed postoperative surgical complications. The postoperative surgical complication rates were similar between the different anesthesia groups. Weight, the length of the urethral plate length, and glans width did not contribute to the risk. Age was the only independent risk factor for postoperative surgical complications, and the complication rates increased in older patients.ConclusionsOur data from consecutive TIP repairs in distal hypospadias patients indicated no association between the use of CB anesthesia and the postoperative urethroplasty complication rate. Patients who were older in age when they underwent surgery had a higher risk of complications.     

LAK细胞体外杀伤直肠腺癌细胞的扫描电镜观察

应用扫描电镜观察体外LAK细胞与直肠腺癌细胞相互作用时的形态学变化。结果表明:LAK细胞与HR8348细胞均具有主动互相趋向运动,效靶细胞借其细胞突起及微绒毛相互接触。LAK细胞及肿瘤细胞的细胞突起及微绒毛由早期的平面接触逐渐发展为犬牙交错状结合。效靶细胞紧密结合后,靶细胞鼓泡,细胞膜出现环形穿孔。互相接触,结合的微绒毛及细胞突起在靶细胞的溶解过程中起到一个物理微桥的作用。LAK细胞分泌的杀伤物质通过微桥介导靶细胞的溶解。效靶细胞互相结合的微绒毛间形成关闭小室,它可能与维持局部杀伤物质浓度有关。     

神经移植端侧缝合颈5/7神经根与上干桥接治疗产瘫

目的：探讨一种不影响残存神经自行恢复的产瘫臂丛神经修复新方法。方法：将上干损伤部位行松解,不切除神经瘤,将其近端的颈5或颈7神经根和神经瘤远端的臂丛上干的神经束膜切开窗口,取颈丛皮支或前臂外侧皮神经前成多段（一般每段长约2．0－2．5cm）,两端分别与颈5神经根和上干的神经束膜行端侧缝合,结果：8例患儿经术后1－11年（平均3年）的随访,4例的三角肌和肱二头肌骨力达4级和4^-级,4例达3例。3例后期进行了肩关节松解和旋前圆肌肌腱切断,结论：该方法既提供了可使损伤近端颈5神经根的新生纤维生长至上干的神经通道,又未阻断神经瘤内残存神经纤维的自行恢复,是治疗产瘫特别是Tassin2型的新术式。     

渤海鱼类和头足类异尖科线虫幼虫感染情况调查

[目的 ]调查渤海鱼类和头足类异尖科线虫幼虫感染情况 .[方法 ]对渤海 2 5种鱼 2 90尾和 3种头足类 10 8尾进行剖检 .[结果 ]发现 19种鱼 15 6尾和 1种头足类 8尾感染异尖科线虫幼虫 6种 ,计73 2 7条 .从 15种鱼 (N =191)中的 12 1尾 ( 63 4 % )和一种头足类 (N =5 4 )中的 8尾 ( 14 8% )体内检出简单异尖线虫幼虫 5 992条 ,占总数的 81 8% ,4种鱼是本幼虫的新发现宿主 .其余 13 3 5条幼虫中 ,15 4( 2 1% )条为鲔蛔线虫B型幼虫 ,采自 4种鱼 2 3尾 ;10 13 ( 13 8% )条为鲔蛔线虫C型幼虫 ,采自 13种鱼79尾 ;164( 2 2 % )条为宫脂线虫中国V型幼虫 ,采自 4种 2 0尾鱼 ;2种鱼感染针蛔虫幼虫 3条 ;仅发现 1条伪新地蛔虫幼虫 .     

丙肝宁对动物实验性肝损伤的保护作用

目的 研究中药复方丙肝宁的保肝作用。方法 采用Ｄ－Ｇａｌ造成大鼠的急性肝损伤模型和ＣＣＩ４所致慢性肝损伤模型。结果 丙肝宁２个剂量组对Ｄ－Ｇａｌ造成大鼠的急性肝损僵模型和ＣＣＩ４所致慢性肝损伤模型的血清酶活性均具有明显的抑制作用（Ｐ〈０．０５,Ｐ〈０．０１）,病理检查结果表明,丙肝宁２个剂量组对Ｄ－Ｇａｌ造成大鼠的急性肝损伤模型和ＣＣＩ４所致慢笥肝损伤模型的肝脏病理形态的改变具有明显的改善作用。结     

经皮腔内冠状动脉成形术对心脏自主神经活动的影响

目的：观察经皮腔内冠状动脉成形术（ＰＴＣＡ）后心率变异（ＨＲＶ）的变化,探讨ＰＴＣＡ和ＨＲＶ的影响。方法：ＰＴＣＡ患者１２０例,２４ｈ动态心电图（ＤＣＧ）记录ＰＴＣＡ术前１周、术后１周、术后６个月的心电信息并进行ＨＲＶ分析。结果：ＰＴＣＡ术后６个月ＨＲＶ指标中的２４ＲＲ间期标准差（ＳＤＮＮ（和高频段的功率谱密度（ＨＦＰ）较术前明显增高（Ｐ分别不小于０．０５及０．０１）;ＰＴＣＡ术后冠状动脉再狭窄患     

硝酸酯类与钙拮抗剂预防高压氧诱发脑血栓形成的比较

目的:比较硝酸酯类及钙拮抗剂对高压氧诱发脑血栓形成的预防作用.方法:以年龄≥60岁、高血压病、高脂血症、原有脑梗死(或脑出血)、高粘血症和糖尿病为危险因子,将192例行高压氧(HBO)治疗的病人分为3组:①硝酸酯类组34例;②钙拮抗剂组49例;③未特殊用药组109例,在不同危险因子簇集水平上分析药物的预防作用.结果:簇集3个及3个以下危险因子者无一例发生脑血栓形成,在簇集4个及4个以上危险因子的水平上,硝酸酯类药物有良好的预防作用,而钙拮抗剂组中有33.3%发病,二者有显著性差异(P＜0.05).结论:硝酸酯类药物有显著的预防作用,而钙拮抗剂无此作用.     

血管迷走性晕厥的直立倾斜试验及药物疗效观察

对７４例不明原因晕厥患者进行直立倾斜试验。方法：采用自制手动式直立倾斜试验台,对阳性 病例选用氨酰心安或倍它乐克治疗,原有或经β－受体阻滞剂后发生心动过缓者同服６５４－２或改用氨茶碱,用药６ ｄ 后重复试验。结果：诱发出晕厥者４２例（５６．７６％）,其中心脏抑制型４例（９．５２％）,血管抑制型６例（１４．２８％）,混合 型３２例（７６．１９％）,阳性组发作时最低血压为零,最低心率４０次／ｍｉｎ,心电图主要改变为交界性逸搏心律,发作时 症状为晕厥、心悸、恶心、发汗,经平卧位后,上述改变均可恢复,无任何并发症。经氨酰心安治疗的１１例中９例转 阴,倍它乐克１４例中１１例阴转,氨茶碱３例中无１例阴转。结论：①直立倾斜试验既是诊断血管迷走性晕厥的简 便有效的措施,也是判断药物疗效的可靠方法。②β－受体阻滞剂氨酰心安、倍它乐克是治疗血管迷走性晕厥的有效 药物。     

猴开角青光眼模型的制作

用氩激光激射恒河猴眼功能小梁网制作开角青光眼模型。取６ 只猴１２ 只眼用于模型制作。激射部位是小梁网的后半部即功能小梁网区, 相邻两激射点的烧灼斑相连接,范围是３６０°。两周后重复激射, 共３ 至５ 次。激光参数是：光斑直径５０ μｍ , 能量８００ ｍ Ｗ, 时间０．５～１．０ ｓ。每次激射前及最后一次激射之后平均３８ ｄ （２１～９７ ｄ） 进行眼压测量, 眼底杯盘比值测量及房角观察。有４ 只猴８ 只眼激射后眼压持续升高, 眼底杯盘比值增大, 激射后房角仍为宽角。实验表明猴开角青光眼模型的制作是成功的