高分辨CT诊断恶性弥漫性肺间质疾病的价值

目的：探讨高分辨CT（HRCT）诊断恶性弥漫性肺间质疾病的价值,加深对恶性弥漫性肺疾患HRCT表现的认识,从而提高肺间质疾病的诊断、鉴别诊断水平。方法：复习文献并回顾分析5例肺淋巴管癌病临床病例及其HRCT特点。结果：肺淋巴管癌病是恶性肿瘤致弥漫性肺间质病变最常见疾病,其HRCT特点：小叶间隔不均匀增厚,不均一的支气管血管束结节状增厚,胸膜不规则增厚,纵隔淋巴结肿大等,区别于良性肺间质病变HRCT改变。结论：HRCT作为常规的CT的一种补充,近年在肺部疾病影像学诊断中受到广泛重视,因其能清晰显示肺组织的细微结构,故可用于弥漫性肺疾病的诊断和鉴别诊断。     

中药四性的生物热动力学研究（Ⅱ）参叶和参花药性的微量量热学比较

目的 从生物物时化学的角度,阐明中药四性（寒、热、温、凉）的客观真实性。方法 利用微量量热法,测定了大肠杆菌在不同条件下的生长热谱曲线,得到了相应的生物热动力学参数和生长速率常数（K）、抑制率（I）、半抑制率（IC50）、热焓（△H）。根据生物热动力学通用数值,结合本草文献报道,综合分析了参叶和参花药性的差异所在。结果 参叶和参花抑制细菌生长的热谱曲线,其形状基本相同,随着药物浓度的加大,代谢过程的停滞期延长,生长代谢峰后移;其移力学参数势焓（△H）存在较稳定的差异--参叶降低了细菌生长代谢过程中热量的释放,而参花增加了细菌生长代谢过程中热量的释放。结论 微量量热法可作为刻划中药药性的一个新的有效手段,亦可作为中药活性筛选的新工具。     

鼻咽癌患者心理社会因素多变量分析

目的 :探讨心理社会因素对鼻咽癌患者影响的作用规律和早期识别方法 ,为早期发现、早期诊断和早期治疗服务。方法 :通过 1∶1配对临床流行病学调查方法收集资料建立数据库文件 ,在PTMMX 2 0 0 0型微机上完成配对Logistic回归和判别分析。结果 :在α =0 .0 5水准 ,发现X2 (嗜烟习惯 )、X8(家用燃料种类 )、X12 (爱生闷气 )、X13(病后情绪低落恐惧 )和X15(病后得不到亲人关照和心理满足 )计 5个差异有显著性的变量 (P <0 .0 5 )进入方程 :LogitP=ai- 66.7362X15+ 91.386 6X13 - 3.7985X12 - 4.0 142X8- 5 .6 0 6 3X2 ;在此基础上建立了鼻咽癌和非鼻咽癌判别诊断模型。判别诊断与临床诊断总的符合率高达 93 .33% ,其中对鼻咽癌和非鼻咽癌判别符合率分别为 95 .0 0 %和 91.6 7% ,总的误判率为 6 .6 7%。结论 :所建数学模型具有一定临床意义 ,从是否患肿瘤角度提出的健康模式假设 ,尚待进一步研究。     

Leptin对人成骨细胞增殖和功能的影响

目的 观察瘦素（leptin)对人成骨细胞增殖和功能的影响。方法 培养人成骨细胞,并观察其形态及功能变化。采用MTT比色法检测不同浓度的Leptin对人成骨细胞增殖的影响,同时观察不同浓度Letptin条件下骨钙素浓度的变化,并用细胞总蛋白较正。结果 体外培养的人成骨细胞大多呈长梭型,碱性磷酸酶组织化学染色、骨钙素免疫荧光组织化学染色阳性,培养液中加入β-甘油磷酸及L－抗坏血酸后钙茜素红染色阳性,在加入不同浓度Leptin后1、2、3天,人成骨细胞增殖无显著变化。Leptin可刺激骨钙素分泌,呈浓度依赖性（P＜0．05）,但无时间依赖性（P＞0．05）。结论 Leptin对人成骨细胞增殖无影响,但可刺激人成骨细胞功能。     

人参皂甙Rg1对缺氧豚鼠心肌细胞游离钙浓度降低作用的研究

目的探讨人参皂甙(ginsentosides,Gin)单体Rgl及维拉帕米(verapamil,Ver)对豚鼠心肌细胞内游离钙浓度([Ca2+]i)变化的影响.方法采用离体豚鼠心脏Langendorff法灌注,胶原酶Ⅰ型分离心肌细胞,用荧光指示剂方法(Fura-2/AM)标记心肌([Ca2+]i)变化.将心肌细胞悬液分为3组对照组、Rgl组和Ver组.观察缺氧后心肌[Ca2+]i的变化.结果(1)正常氧状态心肌[Ca2+]i均值为(125.4±10.3)nmol/L(n=20).(2)缺氧状态下,心肌[Ca2+]i增加与缺氧时间(程度)直线相关,相关系数r为0.98左右.(3)Rgl对缺氧后心肌[Ca2+]i增加明显延缓.结论Rgl在缺氧条件下,使心肌[Ca2+]i明显下降,从而阻止心肌细胞内钙超载,其作用与Ver相似,我们认为Rgl具有心肌细胞的保护作用.     

周围神经端侧缝合与神经移植的实验研究

目的　比较周围神经端侧缝合与神经移植的效果。方法　选用体重 2 0 0～ 30 0gWistar大白鼠 ,左侧后肢腓总神经与胫神经端侧缝合 ,右侧腓总神经采用神经移植修复。结果　 3个月后运动神经传导速度分别为2 9.6 8± 5 .34m/s、 30 .87± 6 .0m/s(P >0 .0 5 ) ,潜伏期 2 .1± 0 .1ms ,2 .0± 0 .1ms(P >0 .0 5 ) ,波幅 12 .5± 0 .6mV、13.9± 0 .5mV(P >0 .0 5 ) ,组织切片中 ,两组均可见大量神经纤维和髓鞘 ,有髓神经纤维计数分别为 75 7.2± 2 2 .31、775± 2 1.87(P >0 .0 5 )。结论　①正常神经发出侧芽能通过端侧缝合口长入远端神经 ,使变性神经再神经化 ;②周围神经端侧缝合能取得与神经移植相近的结果。     

Research trends of prostatitis over past 20 years: A bibliometric analysis

In the past two decades, thousands of documents in the field of prostatitis have been published. This bibliometric analysis aimed to assess the characteristics, hotspots and frontiers trend of global scientific output on prostatitis. With the trend of moderate growth, altogether 2,423 papers were reviewed. The leading role of the United States in global prostatitis research was obvious, while China had developed rapidly in recent years. Queen's University and JOURNAL OF UROLOGY were the most prolific affiliation and journal respectively. Nickel, J. C made the greatest contribution to the field of prostatitis. Five hotspots have been confirmed: (a) male infertility associated with prostatitis and the molecular mechanisms; (b) diagnosis and treatment of prostatitis; (c) inflammation, pain and bladder irritation symptoms; (d) relationship between chronic prostatitis/chronic pelvic pain syndrome, benign prostatic hyperplasia and prostate cancer; (e) epidemiology, complications of prostatitis and improvement of acupuncture. This bibliometric analysis reveals that the international cooperation was becoming more and more close. Hotspot analysis shows that the molecular mechanism of prostatitis will be a hotspot in the future, mainly focussing on inflammatory immunity and oxidative stress.     

Comparison of renal function after open radical cystectomy,extracorporeal robot assisted radical cystectomy,and intracorporeal robot assisted radical cystectomy

PurposeRenal function outcomes following robot-assisted radical cystectomy (RARC) have not been well established. We sought to compare long-term renal function outcomes between open radical cystectomy, RARC with extracorporeal urinary diversion and intracorporeal urinary diversion at a high volume institution.Materials and MethodsWe retrospectively reviewed our institutional bladder cancer database for patients who underwent RC from 2010 to 2019 with pre-operative estimated glomerular filtration rate (eGFR) > 45 ml/min/1.73m². Changes in renal function were assessed through locally weighted scatter plot smoothing and comparison of median eGFR between surgical groups. Chronic Kidney Disease Stage 3B was defined as eGFR < 45 ml/min/1.73m². Renal function decline was defined as a ≥10 ml/min/1.73m² drop in eGFR. Kaplan Meier method with log-rank was used to compare CKD 3B-free survival and renal function decline. Cox Proportional Hazards model was used to identify predictors of CKD 3B.ResultsSix hundred and forty four patients were included with median follow-up of 32 months (IQR 12–56). Preoperative characteristics were similar among the groups with no differences in median pre-operative eGFR (ORC: 74.6, extracorporeal urinary diversion: 74.3, intracorporeal urinary diversion: 71.6 ml/min/1.73m², P = 0.15). Median postoperative eGFR on follow up was not different between groups (P = 0.56). 33% of patients developed CKD 3B. There were no differences in CKD 3B-free survival by surgical approach (P = 0.23) or urinary diversion (P = 0.09). 64% of patients experienced renal function decline with a median time of 2.4 years (P 0.23). Predictors of CKD were pathologic T3 disease or greater (HR: 1.77, P = 0.01), ureteroenteric anastomotic stricture (HR: 2.80, P < 0.001), preoperative CKD Stage 2 (HR: 1.81, P =0.02), and preoperative CKD Stage 3A (HR: 5.56, P < 0.001).ConclusionRenal function decline is common after RC. Tumor stage, pre-operative eGFR, and ureteral stricture development, not surgical approach, influence renal function decline.     

The anterior versus posterior approach for the treatment of ossification of the posterior longitudinal ligament in the cervical spine: A systematic review and meta-analysis

Study Design: Systematic review and meta-analysis.Objective: To compare the effectiveness and safety between anterior and posterior approach, and determine the best surgical methods for the treatment of ossification of the posterior longitudinal ligament (OPLL) in the cervical spine.Methods: We searched the Cochrane Library, PubMed, CNKI and Wanfang Med Data databases from January 2007 to March 2018. Japanese Orthopaedic Association (JOA) scores, cervical lordosis, functional recovery rates, excellent and good outcomes of the surgical approaches, and complication and reoperation rates were analyzed. RevMan 5.3 was utilized for data analysis.Results: Eleven studies were included in the meta-analysis. By comparing the anterior and posterior approaches for the treatment of OPLL in the cervical spine, statistically significant differences were found in the preoperative initial JOA, the postoperative final JOA scores, functional recovery rates, complication rates, excellent and good outcomes of the surgical approaches and reoperation rates. However, no statistically significant difference in the occurrence of the preoperative and postoperative cervical lordosis was noted.Conclusion: The anterior approach is superior to the posterior approach in terms of the postoperative final JOA score, functional recovery rate, and clinical outcomes. Although the complication and reoperation rates of the anterior approach are higher than those of the posterior approach. We recommend the anterior approach for the treatment of OPLL when patients with occupying ratio ≥ 60%. In addition, high-quality studies with long-term follow-up and large sample size are also needed.     

腹腔镜右半结肠癌切除术后消化道重建的研究现状及前景

腹腔镜右半结肠癌切除术后腹腔内吻合正逐渐成为结直肠手术领域中的热点。研究者发现:腹腔内吻合与腹腔外吻合比较,前者在促进病人术后恢复,降低术后并发症发生率等方面有潜在优势。且腹腔内吻合较腹腔外吻合病人术后胃肠功能恢复更快、术后疼痛评分更低。但对于腹腔内吻合的并发症发生率,尤其是重要指标吻合口漏的比较,尚缺乏足够证据。而手术技术不统一、吻合口漏定义不明确是目前研究的主要困难。多项高质量的前瞻性随机对照试验目前正在进行中,对于腹腔镜右半结肠癌切除术的客观评价仍需要更高级别的循证医学证据验证。笔者综合分析国内外研究进展,系统阐述腹腔镜右半结肠癌切除术后消化道重建的研究现状及前景,旨在为我国结直肠外科临床研究探索新方向。