腹腔镜胃底折叠术联合胃大弯折叠术治疗肥胖合并胃食管反流的护理

[目的]探讨腹腔镜胃底折叠术联合胃大弯折叠术治疗肥胖合并胃食管反流的护理。[方法]回顾分析2014年12月—2016年12月接受腹腔镜胃底折叠术联合胃大弯折叠术治疗10例肥胖合并胃食管反流病人的临床护理资料。[结果]10例病人均顺利完成腹腔镜胃底折叠术+胃大弯折叠+食管裂孔疝修补术+肠粘连松解术,术后住院5～7d。术后10例病人均未出现严重并发症,均达到减重效果。[结论]胃底折叠术联合胃大弯折叠术是治疗肥胖合并胃食管反流病或食管裂孔疝的新手术方法,做好充分的术前准备、心理护理是保证手术顺利进行的前提;术后加强并发症的观察与护理、正确的体位、合理的饮食、药物治疗和各种管道的精心护理是保证手术疗效的重要措施。实施随访护理、体重管理是提高手术成功率、达到减重效果的关键。     

乳腺癌干细胞放疗反应性和耐受机制的研究

Objective To discuss the response of breast cancer stem cells to radiation and its resistant mechanism. Methods Single breast cancer stem cells were isolated from the human breast adenocarcinoma cell line, MCF-7, and suspension-cultured into mammary cell microspheres in vitro. The radiosensitivity of these breast cancer stem cells were evaluated using a colony formation assay. Real-time polymerase chain reaction (PCR) was used to detect the expression levels of the following genes before and after radiation in the breast cancer stem cells, along with non-stem cells of the breast cancer cell line: ATM, p53, Her-2, Ku70/Ku80 and Survivin. Results The average survival fraction (SF2) of the suspensioncultured MCF-7 cells after 2 Gy of radiation was 0. 49, while the average SF2 of MCF-7 cells cultured as a monolayer was 0. 27 (P<0.01). Compared to the MCF-7 cells grown in a monolayer, the suspension-cultured MCF-7 cells had higher expression levels of ATM, p53, Her-2, Ku70/Ku80 and Survivin; The expression of ATM, p53, Her-2, Ku70/Ku80 and Survivin was 5. 29±1. 36,1. 37±0. 73,2.10±0. 57,4. 69±1. 45,and 1. 80±1.29 fold, respectively. Conclusion Breast cancer stem cells have stronger anti-radiation capabilities than breast cancer non-stem cells. The stronger DNA repair capacity is an important resistant mechanism about radiotherapy of breast cancer stem cells.     

剑突下小切口非胸腔镜辅助Nuss手术治疗小儿漏斗胸

目的:探讨剑突下小切口非胸腔镜辅助Nuss手术治疗小儿漏斗胸的手术方法和治疗经验。方法:16例漏斗胸患儿采用剑突下小切口非胸腔镜辅助Nuss手术治疗,全部为对称型。结果:16例均顺利完成手术,手术时间36~70min;术中平均出血10 mL左右,无严重并发症发生,术后6~8 d出院。术后近期疗效评价:优12例,良4例。所有病例进行随访,复查胸部X线片,1例因钢板移位致胸骨轻度凹陷。结论:剑突下小切口非胸腔镜辅助Nuss手术具有创伤小、方法简单且要领易于掌握等优点,特别适合于胸腔镜技术不太成熟的基层医院开展。     

活血化瘀法治疗寻常型银屑病气血郁滞证45例

目的观察活血化瘀法治疗寻常型银屑病气血郁滞证的临床疗效。方法将90例患者随机分两组,各45例,治疗组用活血化瘀法治疗,对照组用复方青黛胶囊治疗。结果临床治疗率治疗组为86.67%,对照组为60%,两组比较有统计学意义（P〈0.05）。结论活血化瘀法治疗寻常型银屑病气血郁滞证有良好疗效。     

黄芪炮制工艺优化及不同炮制品成分比较

目的:优化黄芪蜜炙、盐炙、醋炙工艺,并比较不同炮制品水溶出物溶出率、黄芪甲苷含量差异。方法:采用均匀设计试验,以加辅料(蜜、盐、醋)倍数、浸泡时间、炒制时间、炒制温度为考察因素,以水溶出物溶出率、黄芪甲苷含量的综合评分为指标,优选炮制工艺;采用香草醛-硫酸比色法测定黄芪甲苷含量。结果:蜜炙、盐炙、醋炙最优工艺为加蜜、盐、醋倍数分别为1:7、1:1、1:1(均为V/V),炒制时间分别为13、5、5min,炒制温度分别为70、240、70℃,浸泡时间均为0.5h;盐炙黄芪水溶出物溶出率高于醋炙品,且有显著性差异(P<0.01),而3种炮制方法下黄芪甲苷含量差异不明显。结论:所选工艺稳定、可靠;不同炮制方法对水溶出物有显著性影响。     

不同术式治疗早期非小细胞肺癌的临床疗效

目的：比较电视辅助胸腔镜手术（VATS）及传统开胸手术（TOS）治疗早期非小细胞肺癌的临床疗效。方法：收集2006年1月-2009年6月期间行VATS治疗非小细胞肺癌患者28例（VATS组）及同期行TOS治疗非小细胞肺癌患者25例（TOS组）,比较两组在手术时间、术中出血量、术后疼痛及胸管引流时间、住院时间、1年后复发、转移、死亡率的差异。结果：VATS组手术时间、胸管引流时间及引流量较TOS组无明显差异（P〉0．05）;与TOS组相比,VATS组术后疼痛明显减轻、围手术期出血量明显减少,术后住院时间明显低于TOS组（P〈0．05）。术后1年两组间复发转移率及死亡率无差异（P〉0．05）。结论：全胸腔镜下肺叶切除具有创伤小疼痛小、术后恢复快等优点,是治疗早期非小细胞肺癌较好的方法。     

血浆N末端脑钠肽在心力衰竭诊断中的价值

心力衰竭是心血管疾病最主要的死亡原因之一,其主要表现症状是呼吸困难,在临床工作中与肺源性及其他原因所致的呼吸困难很难进行鉴别,以至于患者不能得到及时有效的治疗。近年来国内外多项研究表明血浆N末端脑钠钛(NT-ProBNP)浓度可作为心力衰竭的诊断、治疗评估     

乳腺癌干细胞放疗反应性和耐受机制的研究

Objective To discuss the response of breast cancer stem cells to radiation and its resistant mechanism. Methods Single breast cancer stem cells were isolated from the human breast adenocarcinoma cell line, MCF-7, and suspension-cultured into mammary cell microspheres in vitro. The radiosensitivity of these breast cancer stem cells were evaluated using a colony formation assay. Real-time polymerase chain reaction (PCR) was used to detect the expression levels of the following genes before and after radiation in the breast cancer stem cells, along with non-stem cells of the breast cancer cell line: ATM, p53, Her-2, Ku70/Ku80 and Survivin. Results The average survival fraction (SF2) of the suspensioncultured MCF-7 cells after 2 Gy of radiation was 0. 49, while the average SF2 of MCF-7 cells cultured as a monolayer was 0. 27 (P<0.01). Compared to the MCF-7 cells grown in a monolayer, the suspension-cultured MCF-7 cells had higher expression levels of ATM, p53, Her-2, Ku70/Ku80 and Survivin; The expression of ATM, p53, Her-2, Ku70/Ku80 and Survivin was 5. 29±1. 36,1. 37±0. 73,2.10±0. 57,4. 69±1. 45,and 1. 80±1.29 fold, respectively. Conclusion Breast cancer stem cells have stronger anti-radiation capabilities than breast cancer non-stem cells. The stronger DNA repair capacity is an important resistant mechanism about radiotherapy of breast cancer stem cells.