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21.
Objective: Two major changes have occurred in inguinal hernia repair during the last two decades: (i) the use of tension‐free mesh repair; and (ii) the application of laparoscopic technique for repair. The aims of the present study were to study: (i) how inguinal hernia repair was carried out; and (ii) the outcome of inguinal hernia repair in Hospital Authority (HA) hospitals. Methodology: This was a retrospective analysis on 8311 elective inguinal hernia repairs performed in 16 HA hospitals from January 2001 to December 2003. The mean age was 63.9 ± 14.2 years, and the male to female ratio was 22.0 : 1.0. Among these, 869 (10.5%) repairs were performed with the laparoscopic approach and 7442 (89.5%) repairs with the open approach. The proportion of laparoscopic hernia repair increased from 8.7% to 12.6%. Results: For open repair, 39% of cases were carried out with regional anaesthesia, 32% with general anaesthesia and 29% with local anaesthesia (LA). Furthermore, mesh repair was used in 88% of the patients. For laparosocpic repair, 98.4% of cases were carried out under general anaesthesia, and all patients had mesh repair using the totally extraperitoneal approach. A significantly higher proportion of bilateral repair and recurrent hernia repair was performed with the laparoscopic approach (P = 0.000). For primary unilateral repair, there was no significant difference in the postoperative length of stay (LOS) and the total LOS between the laparoscopic and the open surgery groups. No difference in LOS was found in recurrent hernia repair between the two groups. With respect to bilateral repair, both the preoperative LOS (P = 0.036) and total LOS (P = 0.039) were shorter in the laparoscopic group. Furthermore, a significantly higher proportion of day‐surgery patients was observed in the laparoscopic group than the open surgery group (21.3%vs 16.9%, P = 0.001). Nevertheless, when only the results of 2003 were analyzed, the postoperative LOS (P = 0.000) and total LOS (P = 0.000) were significantly shorter in the laparoscopic group than the open surgery group. The LOS parameters were significantly shorter in the open surgery LA subgroup compared with the non‐LA subgroup (P = 0.000), and they were not different from those in the laparoscopic group. Conclusions: The open mesh repair is the predominant approach for inguinal hernia repair in HA hospitals. The originally described local anaesthetic approach was under utilized, although it resulted in good outcome. The use of laparoscopic hernia repair is increasing and a learning curve was recently observed with improved outcome.  相似文献   
22.
Systemic anticancer therapy for hepatocellular carcinoma (HCC) is limited by intrinsic drug resistance and accompanying liver dysfunction. However, recent advances in molecular targeted therapy (MTT) have shed light on the treatment of advanced HCC. A recent randomized, placebo-controlled trial demonstrated that sorafenib, a multi-target tyrosine kinase inhibitor, prolonged overall survival and time-to-progression in patients with advanced HCC. This breakthrough highlights the potential of MTT targeting hepatocarcinogenic pathways, such as the Raf/MAPK/ERK pathway, angiogenic pathways and the EGFR signaling pathway. This review discusses the current status and the potential of developing novel MTTs for advanced HCC.  相似文献   
23.
Although studies exist using both male and female rats, there are virtually no studies that compare male and female bladder function. In this initial study, in-vivo and in-vitro urinary bladder function was investigated in two age groups of male and female rats (sexually immature and sexually mature). These studies compare in-vivo micturition behavior (water intake, urine output, frequency and volume per micturition); and in-vitro whole bladder function (bladder volume/pressure relationships, the ability of the in-vitro bladders to generate pressure and empty in response to bethanechol and field stimulation). The results can be summarized as follows: 1) The 24 hour water intake, urine output, and volume per micturition for the mature male rats was significantly greater than that of the mature females with no significant differences among the immature females, mature females, or immature males. 2) There were no significant differences in the frequency of micturition between the 4 groups. 3) Although the average plateau pressures (cystometrograms) of the immature and mature female bladders were greater than that of the immature and mature male bladders, the compliance was similar for all groups. 4) The maximum pressure response of the mature female bladder was significantly greater than pressures generated by bladders in the other three groups; there were no age or sex related differences in the bethanechol log ED50 values. 5) There were no age or sex-related differences in the bethanechol log ED50 values or maximal expulsion responses. 6) Field stimulated bladders from mature animals generated significantly greater intravesical pressures than bladders from immature animals, but, there were no significant differences in maximal pressures attained between mature male and female bladders nor between immature male and female bladders. In conclusion, micturition behavior, and the maximal pressure response to bethanechol changed dramatically with sexual maturity. These results are consistent with the idea that estrogen and other hormones may have a marked influence on bladder function and micturition behavior.  相似文献   
24.
胃癌D17S261和D17S799位点二核苷酸重复序列不稳定性的意义   总被引:2,自引:2,他引:0  
目的研究二核苷酸重复序列不稳定性〔DRSI〕在胃癌发生中的作用及其临床意义.方法采用PCR方法检测了D17S261和D17S799位点二核苷酸重复序列不稳定性.结果胃癌总DRSI发生率为34%(17/50),其中高中分化腺癌DRSI阳性率(667%,10/15)显著高于低分化癌(194%,6/31,P<001);肠型胃癌DRSI阳性率(556%,10/18)显著高于胃型胃癌(20%,6/30,P<005),DRSI与胃癌部位、大小、浸润、分期、淋巴结转移无显著相关.结论DRSI在胃癌的发生中可能起重要作用.  相似文献   
25.
通过丙烯酸和丙烯酸正丁酯溶液共聚合,得到丙烯酸-丙烯酸正丁酯共聚物,该树脂与环氧氯丙烷反应后再与PET树脂切片继续反应,可使PET树脂切片表面形成聚丙烯酸酯自膨润型吸油网络结构,将表面具有聚丙烯酸酯自身膨润型吸油网络结构的PET树脂切片(简称为留香剂)在油溶性香精中浸泡,香精就被吸附在留香剂表面,即得到芳香PET树脂母粒。用SEM观察了母粒的表面结构形态。  相似文献   
26.
合成了水杨酸铜络合物并分析了其组成,提纯了Tween-20,-40,-60,-80,并测定了它们在pH7.4的磷酸缓冲液中的CMC。用Cyt.c还原法分别测定了水杨酸铜络合物在不同介质中的SOD样活性。详细研究了表面活性剂与水杨酸铜络合物协同清除O-2的作用。观察到在胶束体系中水杨酸铜络合物的SOD样活性明显高于缓冲液体系无表面活性剂时的SOD样活性,表面活性剂本身也具有清除O-2的功能。抗红细胞膜脂质过氧化实验也得到类似结果。这可用胶束催化解释。水杨酸铜-Tween体系可能是一种潜在的抗炎药物。  相似文献   
27.
应用脉冲多普勒超声心动图对30例使用1,6-二磷酸果糖的肺炎心衰患儿进行心室舒缩功能指标的观测,并以20例常规治疗的心衰患儿及20例正常儿为对照组,评价1,6-二磷酸果糖的疗效。结果表明,1,6-二磷酸果糖能明显改善PEP、PEP/ET、PEP/R-R、FVI和SV等心室收缩功能指标及PFVE、E/A、PFVA等心室舒张功能指标,使心功能恢复正常。1,6-二磷酸果糖对肺炎心衰引起的心肌缺血、缺氧有保护作用。  相似文献   
28.
抗病毒药利巴韦林(ribavirin)被临床用于抗严重急性呼吸综合征(SARS)病毒,利巴韦林与激素联用对SARS的疗效肯定,但亦有一定不良反应。本文对其临床使用方法、疗效、不良反应及注意事项等作一综述。  相似文献   
29.
蕲蛇酶减轻大鼠局灶性脑缺血再灌注损伤的实验研究(Ⅱ)   总被引:2,自引:0,他引:2  
目的 从病理形态学观察蕲蛇酶对大鼠局灶性脑缺血再灌注损伤的保护作用并探讨其机制。方法 采用线栓法制备大鼠大脑中动脉栓塞后再灌注模型,光镜及电镜观察缺血3h恢复血流再灌24h后脑组织形态学变化。TTC染色观察脑梗死面积,免疫组织化学方法检测脑组织碱性成纤维细胞生长因子(bFGF)的表达。用药组分别在缺血即刻或再灌即刻静脉给予不同剂量的蕲蛇酶,观察比较模型组和蕲蛇酶所有给药组之间上述指标的变化。结果 缺血即刻给蕲蛇酶4U/kg组较再灌即刻给蕲蛇酶同剂量组显著减小梗死灶(P〈0.001),减轻脑组织病理改变,并使脑组织中bFGF蛋白表达明显增多。结论 蕲蛇酶对脑缺血再灌注损伤的神经保护作用可能与脑组织中bFGF表达增高有关;提示该药早期使用更为有效。  相似文献   
30.
Few studies used paired kidneys for comparison between tacrolimus and cyclosporine in renal transplantation. Most of the published data used whole blood trough levels for drug monitoring. However, the use of limited sampling strategy and abbreviated formula to estimate the 12-h area under concentration-time curve (AUC(0-12)) allowed better prediction of drug exposure. Sixty-six first cadaveric renal transplant recipients receiving paired kidneys were randomized to receive either tacrolimus-based (n = 33) or cyclosporine microemulsion (Neoral)-based therapies (n = 33). Abbreviated AUC(0-12) was used for drug monitoring and dose titration. Mean follow-up duration was 2.8 +/- 2 years. The patient and graft survival were comparable. Fewer incidence of acute rejection was observed in tacrolimus group (15% vs. 27.3%) though the difference was not significant (P = 0.23). The absolute value and the rate of decline of creatinine clearance were both significantly better in tacrolimus-treated patients. Prevalence of hypertension, post-transplant diabetes mellitus, infection, and malignancy were similar in both groups. Prevalence of hypercholesterolemia (11/33 vs. 4/33) and gum hypertrophy (6/33 vs. 1/33) was more common in cyclosporine-treated patients (P = 0.04 in both parameters). This was the first prospective, randomized study with paired kidney analysis showing the renal function was significantly better in tacrolimus-treated patients than in cyclosporine-treated patients.  相似文献   
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