完全腹腔镜下与开腹胰十二指肠切除术治疗壶腹周围肿瘤近期疗效比较

目的探讨完全腹腔镜下胰十二指肠切除术(TLPD)与开腹胰十二指肠切除术(OPD)治疗壶腹周围肿瘤的近期疗效。方法回顾性分析山西医科大学第一医院2016年6月至2019年3月收治的50例壶腹周围肿瘤患者的临床资料,根据手术方式不同分为TLPD组(22例)及OPD组(28例),比较两组患者围术期及术后各项指标情况。结果两组患者均顺利完成手术,TLPD组手术时间[(665±213)min]长于OPD组[(447±215)min],差异有统计学意义(t=-0.356,P=0.001);TLPD组术中出血量[100 ml(50~325 ml)]少于OPD组[300 ml(100~500 ml)],差异有统计学意义(Z=-2.230,P=0.026)。TLPD组与OPD组术中输血者比例、淋巴结清扫数量、切除肿瘤长径、术后禁饮食时间、术后拔管时间、术后住院时间及术后并发症发生率比较,差异均无统计学意义(均P>0.05)。结论TLPD与OPD治疗壶腹周围肿瘤临床近期疗效相近,TLPD手术时间较OPD长,但可有效控制术中出血量。     

脊髓背侧损伤大鼠排尿上行传导通路的改变

目的采用生物素葡聚糖胺(BDA)示踪技术观察大鼠脊髓背侧损伤后排尿上行传导通路的改变。方法采用清洁级雌性SD大鼠30只,随机分为实验对照组和脊髓背侧损伤17 g/2 cm、17 g/5 cm及17 g/10cm,3个小组,使用该院自行设计的实验装置在T12~L1水平制备背侧脊髓损伤动物模型,对照组大鼠仅暴露脊髓,但不损伤脊髓。术后第1天,所有大鼠开腹,BDA注射于膀胱壁。BDA注射2周后取出脊髓组织,行BDA染色并观察其变化。结果神经示踪后BDA免疫组化阳性的神经元呈棕褐色深染。BDA阳性的神经元细胞主要分布在脊髓灰质。通过观察脊髓组织内BDA的变化情况,发现脊髓损伤后损伤部位以上脊髓组织内BDA阳性的神经元细胞数目较对照组减少;随着脊髓损伤程度的加重,神经元细胞染色程度减弱。并且在脊髓损伤组中,损伤部位以上出现一侧深染者,向上走行过程中观察到另一侧相应位置也出现明显BDA染色阳性的区域。结论 BDA示踪技术在神经传导的研究中有较好的应用价值。神经示踪结果提示外伤性脊髓损伤后膀胱尿道与排尿中枢间神经通路的传导发生了减弱,并且膀胱尿道与排尿中枢间神经通路在传导过程中存在神经支配向对侧交叉传导的情况。     

前列腺源性ETS因子在哮喘及鼻黏膜炎性疾病中的研究进展

含SAM尖端结构域的E26转化特异性因子(SPDEF)是ETS转录因子家族的最新成员之一, SPDEF又称为前列腺源性ETS因子(PDEF),首次发现其在前列腺癌中高度表达,参与肿瘤细胞的增殖分化、迁移凋亡和血管形成。近年来研究发现SPDEF与杯状细胞增生和分化密切相关,是调控呼吸道黏液高分泌的核心因子。对SPDEF调控黏液高分泌的机制及其在呼吸道慢性炎性疾病中的研究进展做一综述,以期为呼吸道黏液高分泌疾病的发病机制和诊治提供新思路。     

Correlation of macrophage migration inhibitory factor gene polymorphism with the risk of early-stage cervical cancer and lymphatic metastasis

Associations of functional single nucleotide polymorphisms in MIF-173G/C with early stage cervical cancer were investigated in a hospital-based case-control study on 250 patients with cervical cancer prior to surgery (including 49 cases with and 201 cases without lymphatic metastasis) and 147 healthy controls. The polymorphism was assessed using restriction fragment length polymorphism polymerase chain reaction, and the MIF serum concentration was examined using the enzyme-linked immunosorbent assay to analyze the correlation between the polymorphism and the MIF serum concentration. Carriers of the variant C allele in MIF-173 were at a significantly higher risk of cervical cancer compared to carriers of the wild-type allele (aOR=1.508; 95% CI, 1.128-2.016, p=0.05). The GC and CC genotypes may be the causative factors for cervical cancer (aOR=1.851; 95% CI, 1.132-3.027, p=0.013). Individuals with the GC+CC genotype and C allele at the MIF-173G/C site were at a significantly higher risk of cervical cancer and lymphatic metastasis. The risk of lymphatic metastasis in early stage cervical cancer was increased more than 1.6 times in patients with the CC and GC genotypes compared with those with the GG genotype. The genotype distribution and allele frequency of MIF-173G/C were statistically significant in the well-, moderately and poorly differentiated groups (P<0.05). Compared to the GG genotype and G allele, patients with GC and CC genotypes and C allele exhibited a lower degree of differentiation and a higher degree of malignancy. A significant difference was observed in MIF serum concentrations among the various subgroups (P<0.05). The early cervical cancer, lymphatic metastasis and poorly differentiated groups exhibited higher MIF levels in serum. Moreover, patients with the CC genotype exhibited higher MIF serum concentration, which could increase the risk of early stage cervical cancer and lymphatic metastasis. The results presented in this study provide the first evidence that the genetic polymorphism MIF-173 is associated with cervical cancer in humans. Detection of MIF serum concentration and genotyping may be used as biomarkers for early diagnosis and therapy for cervical cancer.     

尿动力学在前列腺增生诊疗中的策略及其理论支撑

BPH患者的梗阻性和刺激性下尿路症状多种多样，缺乏特异性。尿动力学检鹰对BPH患者确定膀胱出口梗阻部位及程度、评估逼尿肌功能状态、预测手术疗效和并发症、术后评价疗效及分析并发症的原因均有重要的应用价值，对于合理选择BPH治疗策略的参考作用不可替代。     

重症患者肠内肠外营养支持治疗疗效分析

目的：对比重症患者肠内肠外营养支持疗效。方法回顾性分析该院2011年9月—2014年10月收治的危重患者66例。根据纳入对象营养方式不同分为肠内营养组36例和肠外营养组30例。肠内营养组男性26例,女性10例;肠外营养组男性21例,女性9例。比较两组患者治疗前后Hb、TP、ALB、TLC。结果肠内营养组Hb、TP、ALB、TLC均较肠外营养组高,两组数据差异有统计学意义（P＜0.05）。结论正确合理地应用肠内营养支持治疗可改善重症患者营养状况和免疫功能。     

概述美国的药学服务实践流程变迁

摘 要 目的： 概述美国的药学服务实践流程变迁,为我国开展药学服务工作提供借鉴。方法: 查阅文献,对美国医院药学相关学会组织提出的药学服务实践流程进行总结、分析。结果与结论:美国药学从业者联合委员会提出的以患者为中心的药学服务完整总结了其实践流程,包括采集-评估-计划-实施-随访等步骤,强调与团队的沟通、合作、资源共享,适合任何工作环境对患者提供的药学服务。     

Evaluation of adalimumab biosimilar candidate (HS016) in Chinese patients with active ankylosing spondylitis based on a health survey: sub-analysis of a phase 3 study

Clinical Rheumatology - The equivalence of the biosimilar HS016 to adalimumab (Humira) for the treatment of active ankylosing spondylitis (AS) patients has been previously validated. The aim was to...