中老年男性血清催乳素水平与良性前列腺增生的关系

目的　探讨中老年男性血清催乳素 (PRL)和睾酮 (T)的变化 ,研究PRL与良性前列腺增生的关系。　方法　将 84例健康中老年男性分为 4个年龄组 ,测定血清PRL和T水平 ,分析不同年龄组的数值变化。采用B超测定其中 38例的前列腺体积 ,与PRL进行相关性分析。　结果　 5 0、6 0、70和 80岁年龄组的T水平分别为 (2 5 .92± 2 .5 4)、(2 1.0 0± 1.92 )、(18.37± 2 .49)和 (14.75±2 .38)nmol/L ,不同年龄组之间T水平比较 ,差别有显著性意义 (F =3.44 ,P <0 .0 5 ) ;PRL水平分别为 (1.11± 0 .16 )、(0 .96± 0 .2 0 )、(0 .99± 0 .18)和 (0 .91± 0 .2 9)nmol/L ,组间比较差别无显著性意义(F =0 .12 ,P >0 .0 5 ) ;PRL水平与前列腺体积无显著相关性 (r =0 .2 5 ,P >0 .0 5 )。　结论　PRL通过雄激素在前列腺的生长过程中产生作用 ,但中老年男性雄激素水平不断降低 ,削弱了PRL在前列腺增生中的作用。     

经腹食管下段胃底切除术治疗门静脉高压症的临床研究

目的 研究经腹食管下段胃底切除术治疗门静脉高压症的临床效果。方法 采用择期经腹食管下段胃底切除术治疗门静脉高压症18例。患者均为肝炎后肝硬化伴有比较严重的食管胃底静脉曲线及1次以上出血史。结果 全部病例均获随访,平均随访46个月。随访中无食管曲张静脉复发出血,无手术近期死亡,效果满意。结论 经腹食管下段胃底切除术能较好地为患者耐受,复发出血率低,止血确切,是治疗门静脉高压症比较理想的一种手术方法。     

血卟啉甲醚声动力疗法诱导体外C6胶质瘤细胞凋亡作用

Objective To study apoptotic effect and mechanisms of sonodynamic therapy (SDT) with hematoporphyrin monomethyl ether (HMME) on C6 glioma cells in vitro. Methods Time of ultrasound irradiation was optimized by methyl thiazol tetrazolium (MTT) . Apoptotic rate( AR) generation of reactive oxygen species (ROS) ,mitochondrial membrane potential (MMP) were detected by flow cytometry ,and expressions of apoptosis proteins were measured by Western blotting after SDT treatment. Results 60 s is the optimal time irradiation by MTT when the ultrasound frequency was maintained in 1 mHz and the average intensity was kept in 1. 0 W/cm2. To compare with the control,HMME and ultrasound group,treatment of C6 glioma cells with SDT resulted in the occurrence of apoptosis(34. 7 ±1.9)% .which was associated with the production of ROS ( 36. 4 ± 3. 1) % and loss of MMP (44. 9 ± 3. 4) %. The results showed that significantly increased expression in bax,Caspase-9 ,-3 , decreased in bcl-2 after SDT treatment. The results also showed apparent release of cytochome c in the SDT group versus to the other three groups. Conclusion Our results suggested that SDT mediated by HMME could induce apoptosis in C6 glioma cells.The mitochondrial signal pathway may play a pivotal role in the apoptosis.     

伊马替尼治疗慢性移植物抗宿主病2例临床分析

目的探讨伊马替尼治疗异基因造血干细胞移植(allo-HSCT)后慢性移植物抗宿主病(GVHD)伴嗜酸性粒细胞增多的疗效及嗜酸性粒细胞增多与慢性GVHD的关系。方法回顾性分析2例白血病患者allo-HSCT术后慢性GVHD的诊治经过并结合文献复习讨论。结果 2例患者分别于移植后5个月和76d出现口腔溃疡、皮肤瘙痒、皮疹、胆红素水平增高和转氨酶水平增高,伴有嗜酸性粒细胞增多,诊断为局限型慢性GVHD,激素治疗不佳,加用伊马替尼后症状缓解,嗜酸性粒细胞数降至正常,无不良反应。结论伊马替尼治疗慢性移植物抗宿主病安全、有效,嗜酸性粒细胞增多可能与GVHD有一定的关系。     

Alport综合征诊断与治疗研究进展

Alpon综合征是一种以进行性肾功能减退和肾小球基底膜结构异常伴有神经性耳聋和眼部病变为临床特征的遗传性肾病.编码Ⅳ型胶原α3、α4、α5链的基因突变与这一疾病有关.肾小球基底膜的超微结构变化与肾和皮肤基底膜的Ⅳ型胶原链的频繁的异常表达是Alport综合征诊断关键.动物模型提供了宝贵的工具来提供各种实验数据,并评估潜在的治疗方案的好处.本文将上述研究进展简要综述.     

压力和容量通气模式对肥胖患者腹腔镜手术中呼吸功能的影响

Objective To investigate the effects of pressure -controlled ventilation (PCV) and volume -controlled ventilation (VCV) on obese patients undergoing gynecologic laparoscopic surgery by evaluating hemodynamics and respiratory parameters, and arterial oxygenation. Methods Forty obese patients undergoing gynecological laparoscopic surgery were randomly divided into PCV and VCV group (n=20). Patients were all implemented into the program of total intravenous anesthesia, and ventilated with different modes.End-tidal carbon dioxide partial pressure (PETCO2) was maintained between(35-45 ) mm Hg. Arterial blood was collected respectively to analyze blood gas at 5 min before anesthesia (T0), 5 min before the start of pneumoperitoneum (T1),30 min after the start of pneumoperitoneum(T2), 5 min after the end of pneumoperitoneum(T3) and at extubation(T4). Meanwhile, parameters of hemodynamics and respiratory mechanics were monitored and calculated. Results 1 、At T1,T2 and T3, PaO2 and OI (460±78,453±83,463±95)were significantly higher in PCV group (P<0.05), A-aDO2(74±25,80±30,82±26) and RI (0.32±0.08,0.33±0. 10,0.34±0.13 ) was significantly lower (P<0.05) in PCV group. 2. Compared with T0, PaCO2 at T2,T3,T4 in both groups increased significantly and PH decreased significantly (P<0.05); Compared with VCV group, PCV group had no significant difference at each time point. 3. Compared with VCV group, Ppeak(27.8±1.6)in PCV group at T2 was significantly lower(P<0.05). Conclusion The ventilation/perfusion ratio was improved and gas exchange was promoted in obese patients undergoing gynecologic laparoscopic surgery with PCV model.     

氨基胍对梗阻性黄疸大鼠治疗作用的实验研究

目的 探讨诱导型一氧化氮合酶(iNOS)抑制剂氨基胍(AG)对梗阻性黄疸大鼠的治疗作用及作用机制.方法 雄性Wistar大鼠40只,随机分为正常对照组、假手术组、黄疸组、氨基胍治疗组4组,每组10只.通过测定治疗前后肝功、血胆红素、内毒素、乳酸、肝组织丙二醛水平,以及通过对肝脏、小肠的形态学分析来探讨氨基胍对梗阻性黄疽大鼠的治疗作用.结果 血浆内毒素和血清乳酸、肝组织丙二醛随着胆道梗阻时间的延长逐步升高,并伴随着肝脏小肠病理形态学的改变.氨基胍治疗组各项指标显著低于对照组,并能改善肝组织及小肠病理形态.结论 氨基胍(AG)可通过减轻脂质过氧化与内毒素血症发挥保护肝脏及小肠的作用,为治疗梗阻性黄疸患者提供了一种新的思路和方法.

Abstract：

Objective To evaluate the therapeutic effect and mechanism of specific inducible nitric oxide synthase(iNOS)aminoguanidine(AG)in rats with obstructive jaundice.Methods Forty male Wistar rats were divided randomly into four groups: normal control group, sham operation group, obstructive jaundice group and aminoguanidine therapeutic group.Each group had 10 rats.We assayed levels of liver function,hemobilirubin, endotoxin,lactic acid and malondialdehyde before and after therapy, and we also analyzed pathology of the liver and small intestine.Then we could explore the therapeutic effect of AG in rats with obstructive jaundice.Results The levels of endotoxin,lactic acid and malondialdehyde in blood increased progressively along with the pathological changes of the liver and small intestine.Each of the AG group parameters was significantly lower, and the pathological changes of liver and small intestine were improved.Conclusion AG could protect liver and small intestine by attenuating lipid peroxidative and endotoxemia,and provide a new way to cure obstructive jaundice.     

免钉合腹腔镜下350例完全腹膜外无张力疝修补术的应用

目的探讨腹腔镜下完全腹膜外疝修补术(totally extroperitoneal in-guinal hernia repair,TEP)应用的合理性。方法回顾性分析2002年11月至2009年7月行腹腔镜下完全腹膜外疝修补术共350例(356例次)患者的临床资料,总结术后并发症、复发率的发生情况。结果本组术后并发症发生率10.1%(36/356),复发率0.84%(3/356),平均手术时间60 min,术后平均住院时间3.5 d。结论TEP经由腹膜前间隙进入腹股沟区,采用补片覆盖耻骨肌孔,符合力学原理,不仅具有微创优势,而且比开放式无张力疝修补更具合理性。     

柱状经腹会阴切除术治疗直肠癌15例

目的 介绍直肠癌柱状经腹会阴切除术(cylindrical abdominoperineal resection,CAPR)的应用体会.方法 2009-2010年采用柱状经腹会阴直肠癌切除术治疗低位直肠癌15例.采用Holm等描述的手术方法.按TME技术要求游离直肠系膜,向下游离至肛提肌的起点处,结肠造口,关闭腹部切口.将患者置于俯卧位,实施扩大的会阴部切除,沿外括约肌、耻骨直肠肌、肛提肌外表面游离至肛提肌的盆壁起始处,即腹部向下游离的终点下方,后方自尾骨骶骨连接处切开,进入骶前,由背侧至腹侧,将肛提肌自起始处离断.结果 柱状经腹会阴切除术切除更多远端直肠周围组织,15例均无直肠穿孔,会阴切口均Ⅰ期愈合,1例发生会阴血肿,1例发生盆底腹膜疝,1例发生下肢深静脉血栓形成;术后平均随访6个月,1例发生盆腔腹膜后淋巴结转移,1例发生肝肺转移.结论 柱状经腹会阴切除术可以切除更多的低位直肠癌周组织,有利于减少术中穿孔发生率和环周切缘阳性率,进一步降低术后局部复发率.     

法尼酯X受体激动剂GW4064对人胆管癌细胞株QBC939生长的影响

目的:研究法尼酯X受体(FXR)激动剂GW4064对人胆管癌细胞株QBC939增殖和凋亡的影响,并检测QBC939细胞株中FXR基因表达的改变。方法:用浓度为0.5、1.0和5.0μmol/L的法尼酯X受体(FXR)激动剂GW4064刺激人胆管癌细胞株QBC939,用四甲基偶氮唑蓝(MTT)比色法检测24、48 h后细胞活力的变化,以流式细胞仪技术检测药物刺激48 h后肿瘤细胞凋亡的变化,并以RT-PCR检测QBC939细胞株中FXR mRNA表达的改变。结果:浓度为1.0、5.0μmol/L的GW4064在作用24 h后即能显著抑制胆管癌细胞生长(P0.05);在药物作用48 h后,所有浓度的GW4064均能对肿瘤细胞生长起明显的抑制作用(P0.05)。流式细胞仪检测细胞凋亡的结果显示,药物刺激48 h后,对照组凋亡细胞占细胞总数的3.38%,加入0.5μmol/L浓度GW4064的细胞凋亡率为10.02%;而加入1.0和5.0μmol/L浓度的GW4064后,细胞凋亡率明显升高至23.74%和42.11%。RT-PCR结果显示,所有浓度的GW4064于刺激48 h后,QBC939细胞株中FXR基因表达增加,与对照组相比均有统计学差异(P0.05)。结论:GW4064能通过特异性激动FXR有效抑制胆管癌细胞株QBC939的细胞活力,并促进其凋亡,这一过程可能与其上调FXR的表达有关。