两种肺癌术式对比应用研究

目的探讨常规肺癌手术的最佳胸部切口方式。方法对自2006年1月～2007年1月期间农垦三亚医院肺癌手术患者112例的临床资料进行回顾性分析，根据手术切口分为前外侧切口（A）组与后外侧切口（B）组，比较两组术式的手术效果。结果A组病人平均开胸时间（12．1±3．8）min，平均关胸时问（19．5±2．2）min，分剐较B组缩短约8min和7min（P〈0.05）；A组病人术后病人疼痛VAS评分5．5±3．1，明显低于B组病人（P〈0．05）；A组病人术侧肩关节乃至上肢活动基本不受影响，B组病人术后肩关节活动受阻明显。而手术时间、术中出血、术后胸腔引流量、伤口感染、术后住院时间等方面两者无明显差别（P〉0．05）。结论胸部前外侧切口在常规的肺癌手术中较传统的后外侧切口优越，是一种比较理想的入路方式，是微创手术概念的延伸。     

桐花树化学成分研究

目的研究桐花树的化学成分。方法采用硅胶柱色谱法分离纯化,薄层色谱及波谱法进行结构鉴定。结果从桐花树树皮的乙醇提取物的醋酸乙酯萃取部位分得6个化合物,其结构鉴定为16α,28-dihydroxyl-3-oxo-12-oleanene(Ⅰ)、5-O-methylembelin(Ⅱ)、豆甾醇(Ⅲ)、α-菠甾醇(Ⅳ)、岩藻甾醇(Ⅴ)、棕榈酸(Ⅵ)。结论化合物Ⅰ为新三萜化合物,命名为桐花树素(aegicornin),Ⅲ~Ⅵ均为首次从该植物中分离得到。     

桐花树化学成分研究

目的研究桐花树的化学成分。方法采用硅胶柱色谱法分离纯化,薄层色谱及波谱法进行结构鉴定。结果从桐花树树皮的乙醇提取物的醋酸乙酯萃取部位分得6个化合物,其结构鉴定为16α,28-dihydroxyl-3-oxo-12-oleanene(Ⅰ)、5-O-methylembelin(Ⅱ)、豆甾醇(Ⅲ)、α-菠甾醇(Ⅳ)、岩藻甾醇(Ⅴ)、棕榈酸(Ⅵ)。结论化合物Ⅰ为新三萜化合物,命名为桐花树素(aegicornin),Ⅲ~Ⅵ均为首次从该植物中分离得到。     

中心静脉导管置管引流结核性胸腔积液的临床应用

目的探讨中心静脉导管置管引流结核性胸腔积液的方法及疗效。方法回顾总结2002年2月～2008年8月95例中心静脉导管置管引流结核性胸腔积液的病例，分析病种、方法、疗效。结果穿刺成功率100％，引流积液完全消失率98．7％。结论中心静脉置管引流结核性胸腔积液是治疗结核性胸腔积液微创、安全、可靠、有效的方法。     

Contrast Transthoracic Echocardiography Using 50% Glucose as a Contrast Agent for Screening of a Patent Foramen Ovale

A patent foramen ovale (PFO) is considered a risk factor for neurologic events. The goal of the study described here was to assess the feasibility, advantages, diagnostic sensitivity and accuracy of contrast transthoracic echocardiography examination (cTTE) using 50% glucose as a contrast agent in comparison with the use of agitated saline as contrast to screen for PFO. In our study, we found that the peak time, effective duration and duration of microbubbles produced by 50% glucose were all longer than those produced by the physiologic saline. The sensitivities for detection of PFO with cTTE using physiologic saline and 50% glucose as contrast were 83% (20/24) and 100% (24/24), respectively. TEE suggested a PFO in 24 patients in two groups. Use of 50% glucose as a contrast agent in cTTE examination enables ultrasound technicians to easily observe the right-to-left shunt across the PFO. However, the sensitivities for detection of PFO with cTTE using 50% glucose did not statistically significantly differ from those for physiologic saline.     

循证医学与早孕终止妊娠方法的选择

目的通过分析对比早孕终止妊娠的不同方法，探讨其方法选择，为临床咨询提供详实的方案。方法收集本院2008年自愿选用药物流产1013例，自愿选用无痛人流2424例，对比流产时出血量、术后流血及腹痛天数，并对两组用药方案进行研讨。结果药物流产组流产时出血量、流产后阴道流血天数及24h内的腹痛程度均大于无痛人流组，差异有显著性（P〈0．05）。结论尽管无痛人流的预后明显优于药物流产，但实施难度大，且风险也大，并基于约40％的人群选用药物流产，提示不同方法有不同的适应症。医生应按循证医学原则，充分提供咨询并与早孕妇共同确定流产方式，尽可能减少流产者的心身伤害和经济负担。     

Are fatty acids and fatty acid binding proteins novel biomarkers for cryoablation efficiency?

PurposeCryoablation is a recommended, modern and well-tolerated method of treating atrial fibrillation (AF). The study evaluates plasma biomarkers related to AF and the effectiveness of its treatment – cryoablation. Heart- and adipocyte-type fatty acid binding proteins (H-FABP and A-FABP, respectively) as well as fatty acids (FAs) were assessed in patients that underwent cryoballoon ablation (CBA) for AF.Patients and methodsConcentrations of plasma FABPs and FAs were measured in 33 AF patients on admission and 24 ?h after CBA (enzyme-linked immunoassay and gas liquid chromatography, respectively). The control group consisted of 20 volunteers.ResultsWe showed that plasma H-FABP and A-FABP concentrations were significantly higher in the patients with AF than in the control group (1135 ?pg/mL vs 836 ?pg/mL, and 34.29 ?ng/mL vs 15.14 ?ng/mL, respectively; p ?< ?0.05). After CBA, H-FABP plasma concentration increased even further (1574 ?pg/mL vs 1135 ?pg/mL; p ?< ?0.05) and FAs levels decreased concomitantly. AF recurred in 8 patients (24.25%) after 3 months and in 13 patients (39.4%) after 6 months. Initially higher concentration of oleic acid (680.24 ?± ?189.768 vs 567.04 ?± ?70.002; p ?< ?0.05) correlated substantially with lower AF relapse rate in 6 months follow-up.ConclusionsThe patients with AF showed increased concentration of H-FABP, whereas CBA triggered further elevation of H-FABP with a simultaneous decline in the total plasma FAs concentration. H-FABP and A-FABP could not be confirmed as new biomarkers of cryoablation efficiency, but this requires further investigation due to the limitations of the study.     

Greater Curvature Plication with Duodenal–Jejunal Bypass: a Novel Metabolic Surgery for Type 2 Diabetes Mellitus

Objective

The study investigated the use of great curvature plication with duodenal–jejunal bypass (GCP-DJB) in a type 2 diabetic with obesity rat model.

Methods

Twenty-two Sprague-Dawley rats were given a high fat and sugar diet with subsequent intraperitoneal injection of a small dosage of streptozotocin (30 mg/kg) and randomly assigned to either GCP-DJB (n?=?12) or Sham surgery (n?=?10). Body weight, peripheral blood glucose, and fasting serum insulin were assayed, and insulin resistance index (IRI) was calculated, before and at 1, 2, 4, and 8 weeks after surgery.

Results

No differences were found in the preoperative characteristics of the two groups (P?>?0.05). At week 1, the body weights decreased significantly, but there was no significant difference between the two groups (P?>?0.05).The fasting blood glucose was significantly lower in the GCP-DJB than in the Sham group (P?<?0.05), serum insulin levels were higher (P?<?0.05), and IRI began to decline (P?<?0.05). From 2 to 8 weeks, the body weight of Sham group gradually recovered and continued to rise, while the GCP-DJB group remained at a relatively lower state. Compared to the Sham group, the body weight, fasting blood glucose as well as IRI of GCP-DJB rats had significantly decreased (P?<?0.05). But, the fasting insulin concentrations had significantly increased (P?<?0.05).

Conclusion

This novel GCP-DJB procedure established a stable animal model for the study of metabolic surgery to treat type 2 diabetes mellitus (T2DM).

     

抑制miR-133b通过靶向FOXP3对PD大鼠调节性T淋巴细胞、炎性反应和神经元凋亡的影响

目的探究抑制微小RNA(microRNA,miR)-133b通过靶向叉头盒蛋白3(forkhead box protein 3,FOXP3)对帕金森病(Parkinson’s disease,PD)大鼠调节性T细胞(regulatory T cells,Treg)的影响。方法 32只PD模型大鼠随机分为PD组和PD+miR-133b antagomir组(n=16),健康大鼠16只作为对照组。尾静脉注射miR-133b antagomir(300μg)来抑制miR-133b的水平。检测和比较各组大鼠神经功能、黑质损伤、细胞凋亡、炎性反应、Treg细胞水平、miR-133b、FOXP3 mRNA和蛋白表达水平;通过双荧光素酶报告验证miR-133b和FOXP3的靶向关系。结果 PD组的逃避潜伏期、旋转速率、细胞凋亡情况、IL-6、miR-133b水平显著高于对照组,穿越次数、IL-10、FOXP3 mRNA和蛋白表达量显著低于对照组(P<0.05)。PD+miR-133b antagomir组的逃避潜伏期、旋转速率、细胞凋亡情况、IL-6、miR-133b水平显著低于PD组,穿越次...     

循证护理在气管切开术后患者呼吸道管理中的应用

目的：探讨循证护理在气管切开患者呼吸道管理中的应用。方法：选择本院气管切开患者40例并实施常规护理为对照组,40例患者运用循证护理管理模式进行护理干预为观察组。结果：观察组肺部感染的发生率明显低于对照组。结论：运用循证护理可减少人工气道患者肺部并发症,提高护理质量。