高胆汁酸血症对肝脏能量代谢的影响

目的：探讨高胆汁酸血症单一因素对肝脏能量代谢的影响。方法：经Wistar大鼠颈内静脉持续给阳外源性胆汁酸,升高其外周血清中胆汁酸浓度,模拟阻塞性黄疸患者外周血清中胆汁酸的变化规律。观察腹腕动脉酮体比值及肝组织能荷变化,时间一周。结果：随外周血清中胆法 酸浓度的升高,腹腔动脉血酮体比值,肝组织能荷均呈进行性下降,结论：高胆汁酸血症时肝脏能量代谢受损,表明在阻塞性黄疸患者肝功能损害中高胆汁酸血症起了重要作用。     

NO-cGMP通路对下丘脑钙激活钾通道的调控研究

目的研究一氧化氮（ＮＯ）对ＳＤ乳鼠下丘脑神经元钙激活钾（ＫＣａ）通道的作用及其机制。方法采用内面向外 式及细胞贴附式膜片钳技术比较浴槽液中加入１００μmol/L硝普钠（ＳＮＰ）前后动物下丘及神经元ＫＣａ通道动力学 的改变。结果细胞贴附式时浴槽液中加入１００μmol/L ＳＮＰ,通道开放概率由（７．３±１．５）％升高至（４０．２±６．５）％,开放时 间由（７．１２±１．４１） ｍｓ增大至（１５．３４±３．４５） ｍｓ,开放频率由（１１．３±３．５）Ｈz升高为（２６．６±４．２） Ｈz（ｎ＝１０, Ｐ＜０．０５）。结论 ＮＯ－cＧＭＰ通路可显著提高通道的开放概率,这种增强作用是通过延长通道开放时间及增加开放频率实现的,它的 病理或生理作用还有待于进一步研究。     

Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis of randomized controlled trials

The benefit of transurethral laser prostatectomy over open simple prostatectomy (OSP) is controversial in aged symptomatic benign prostatic hyperplasia (BPH) patients with large volume prostates, and the aim of this study is to compare the safety and efficiency of these two methods. Meta-analysis was applied using the Review Manager V5.3 software and the retrieved randomized controlled clinical trials (RCTs) comparing transurethral laser prostatectomy with OSP were analyzed for the treatment of large volume prostates from 2000 to 2019 in PubMed, Web of Science, Cochrane, and EMBASE datasets. Five RCTs assessing transurethral laser prostatectomy versus OSP were considered suitable for this meta-analysis, which included a total of 448 patients, with 232 patients undergoing laser and 216 patients undergoing OSP. Compared with OSP, although transurethral laser prostatectomy required a longer operative time (weighted mean difference (WMD) 27.49 mins; 95% confidence interval (CI) 16.54–38.44; P?<?0.00001) and obtained a less resected prostate weight (WMD ??11.72 g; 95% CI ??21.75 to ??1.70; P?=?0.02), patients undergoing laser prostatectomy benefited from significantly less hemoglobin decline (??0.97 g/dL; 95% CI ??1.31 to ??0.64; P?<?0.00001), shorter time of catheterization (WMD ??3.67 days; 95% CI ??5.60 to ??1.75; P?=?0.0002), shorter length of hospital stay (WMD ??4.75 days; 95% CI ??6.57 to ??2.93; P?<?0.00001), and less blood transfusion (odds ratio 0.10; 95% CI 0.03 to 0.35; P?=?0.0003). During postoperative follow-up, no significant difference was observed between the two groups in IPSS, QoL, Q_max, and PVR. Both transurethral laser prostatectomy and OSP are safe and effective for large prostates that require prostate resection. Taking into account of less blood loss, shorter catheterization time and hospital stay, and less blood transfusion, transurethral laser prostatectomy may be a better treatment for patients with large prostates.

     

Safety and efficacy of thulium laser resection of bladder tumors versus transurethral resection of bladder tumors: a systematic review and meta-analysis

Lasers in Medical Science - The thulium laser resection of bladder tumor (TmLRBT) is widely used in the treatment of non-muscle-invasive bladder cancer (NMIBC), and we conduct this study to compare...     

基于“药辅合一”理念的Pickering乳技术提升儿科用药羚珠散中石菖蒲挥发油热稳定性的研究

目的 在“药辅合一”理念下导入Pickering乳技术,提升儿科用药羚珠散中石菖蒲挥发油的稳定性。方法 对羚珠散各饮片粉末进行初步表征,确定稳定剂。通过成乳量、包油量和乳剂形态筛选出最佳稳定剂质量浓度、油水比和制备方法。并使用近红外光谱（nearinfraredspectroscopy,NIRS）分析石菖蒲油在Pickering乳中的包裹状态。比较不同时间下各组别挥发油的保有量、丙二醛和过氧化物的含量。再通过GC-MS分析其中成分的变化趋势。结果 筛选出珍珠粉作为Pickering乳的稳定剂,珍珠粉质量浓度为65 mg/mL,油水比9∶11为最优成乳条件,高压均质法为最优的制备方法,NIRS分析可知石菖蒲挥发油被珍珠粉包裹,Pickering乳液中没有形成新的化学键。对比各组在不同时间段下石菖蒲油的保有率和其中丙二醛和过氧化物含量,可知40℃放置1、3、8 h的Pickering乳剂相比于石菖蒲挥发油组有更高的保有率和更低的氧化程度。GC-MS分析结果表明,相比于石菖蒲挥发油组,Pickering乳组挥发性成分的稳定性显著提高。结论 在“药辅合一”理念下Pickering乳可用于含油固...     

不停跳冠状动脉旁路移植术中应用MostCare/PRAM监测系统进行血流动力学监测的临床研究

目的探究Most Care/PRAM系统监测下不停跳冠状动脉旁路移植术(OPCABG)患者术中血流动力学变化情况和预后分析。方法纳入2016年10月至2017年1月安贞医院89例OPCABG患者,其中男53例、女36例,年龄(60.50±8.40)岁。记录术中血流动力学变化情况。按是否发生心肌梗死、低心排血量等严重循环不良事件,分为平稳组和严重循环不良事件组,进行相关分析。结果手术全程监测完整血流动力学数据患者65例,开胸前和关胸后被动抬高试验的每搏量(SV)升高均值分别为23.00%±3.20%和29.40%±3.70%。麻醉、开胸、应用肝素时、搭桥中、应用鱼精蛋白时、关胸和术毕7个时间段,SV明显下降,外周血管阻力指数(SVRI)持续显著增加,最大压力梯度(d P/d T)和心脏循环效率(CCE)在麻醉后明显下降,搭桥时下降到最低,其后逐渐升高;每搏量变异率(SVV)和脉压变异率(PPV)在麻醉后下降,开胸后一直升高。89例患者发生严重循环不良事件共9例,其中4例死亡。严重循环不良事件组术中基础SVRI、SVV和PPV均显著高于平稳组(P<0.05),CCE、d P/d T和SV差异无统计学意义(P>0.05)。术中基础SVRI、CCE、d P/d T、SVV、PPV和SV均值与预后指标均无明显相关性。结论OPCABG术中易出现血流动力学的改变,因此,OPCABG术中宜应用Most Care/PRAM仪进行血流动力学监测,并及时纠正血流动力学异常。     

Systematic review of outcomes and meta-analysis of risk factors for prognosis after liver resection for hepatocellular carcinoma without cirrhosis

Long-term overall survival (OS) after liver resection for non-cirrhotic hepatocellular carcinoma (NCHCC) has been reported recently. The aim of this study was to review outcomes systematically and analyze risk factors for survival after surgical resection for HCC without cirrhosis. A literature search was performed of the PubMed and Embase databases for papers published between January 1995 and October 2012, which focused on hepatic resection for HCC without underlying cirrhosis. Cochrane systematic review methodology was used for this review. Outcomes were OS, operative mortality and disease-free survival (DFS). Pooled hazard ratios (HR) were calculated using the random effects model for parameters considered as potential prognostic factors. Totally, 26 retrospective case series were eligible for inclusion. The 1-, 3- and 5-year OS rate after surgical resection of NCHCC ranged from 62% to 100%, 46.3%–78.0%, and 30%–64%, respectively. The corresponding DFS rates ranged from 48.7% to 84%, 31.0%–66.0%, and 24.0%–58.0%, respectively. Five variables were related to poor survival: multiple tumors (HR 1.68, 95%CI 1.25–2.11); larger tumor size (HR 2.66, 95%CI 1.69–3.63); non-clear resection margin (R0 resection) (HR 3.52, 95%CI 1.63–5.42); poor tumor stage (HR 2.61, 95%CI 1.64–3.58); and invasion of the lymphatic vessels (HR 4.85, 95%CI 2.67–7.02). In sum, hepatic resection provides excellent OS rates for patients with NCHCC, and results have tended to improve recently. Risk factors for poor prognosis comprise multiple tumors, lager tumor size, non-R0 resection and invasion of the lymphatic vessels.     

丹皮酚对增生性瘢痕成纤维细胞的抑制作用

目的探讨丹皮酚对增生性瘢痕成纤维细胞的抑制作用。方法自2018年9月至2020年6月北部战区总医院烧伤整形科提取原代增生性瘢痕成纤维细胞后,将细胞平分为4组,分别采用0μmol/L(对照组)、50μmol/L、100μmol/L的丹皮酚及10μmol/L的5-氟尿嘧啶(5-Fu)处理;CCK-8实验检测细胞处理后第0、3、5、7天的增殖情况。处理3 d后通过ELISA实验检测增生性成纤维细胞中活性氧基团或分子、丙二醛和超氧化物歧化酶的含量;Western blot实验检测丹皮酚对于细胞中TGF-β1、Ⅰ和Ⅲ型胶原的表达情况。结果50、100μmol/L的丹皮酚和10μmol/L的5-FU分别作用于细胞3 d后与对照组相比,对于细胞增殖的抑制率分别为(32.63±3.06)%、(46.41±4.41)%和(45.32±9.26)%,组间比较差异显著,具有统计学意义(P<0.05)。丹皮酚能够显著下调增生性成纤维细胞中ROS和MDA的表达情况,上调SOD的含量,降低TGF-β1、Ⅰ和Ⅲ型胶原的表达。结论丹皮酚能够抑制增生性瘢痕成纤维细胞的生长、减轻氧化应激损伤,下调TGF-β1和胶原的表达。     

Enforcing Imprecise Constraints on Generative Adversarial Networks for Emulating Physical Systems

Generative adversarial networks (GANs) were initially proposed to generate images by learning from a large number of samples. Recently, GANs have been used to emulate complex physical systems such as turbulent flows. However, a critical question must be answered before GANs can be considered trusted emulators for physical systems: do GANs-generated samples conform to the various physical constraints? These include both deterministic constraints (e.g., conservation laws) and statistical constraints (e.g., energy spectrum of turbulent flows). The latter have been studied in a companion paper (Wu et al., Enforcing statistical constraints in generative adversarial networks for modeling chaotic dynamical systems. Journal of Computational Physics. 406, 109209, 2020). In the present work, we enforce deterministic yet imprecise constraints on GANs by incorporating them into the loss function of the generator. We evaluate the performance of physics-constrained GANs on two representative tasks with geometrical constraints (generating points on circles) and differential constraints (generating divergence-free flow velocity fields), respectively. In both cases, the constrained GANs produced samples that conform to the underlying constraints rather accurately, even though the constraints are only enforced up to a specified interval. More importantly, the imposed constraints significantly accelerate the convergence and improve the robustness in the training, indicating that they serve as a physics-based regularization. These improvements are noteworthy, as the convergence and robustness are two well-known obstacles in the training of GANs.