腹腔镜手术与开腹手术治疗异位妊娠比较研究

目的：探讨腹腔镜手术治疗与开腹手术治疗异位妊娠的临床疗效对比。方法：选择近5年来腹腔镜与开腹手术治疗66例异位妊娠病例,根据实施手术的方式把患者分为观察组36例,和对照组30例,进行全方位比照分析情况分析。结果：腹腔镜组术后自主排尿时间、术后住院时间患者康复时间,均明显短于开腹组,差异常显著性（P〈0.001）。腹腔镜组手术时间也短于开腹组（P〈0.05）。结论：腹腔镜手术治疗异位妊娠手术安全,具有手术时间短,创伤小,术后恢复快,住院时间短等优点,值得推广。     

Subcutaneous Tissue Mechanical Behavior is Linear and Viscoelastic Under Uniaxial Tension

Subcutaneous tissue is part of a bodywide network of “loose” connective tissue including interstitial connective tissues separating muscles and surrounding all nerves and blood vessels. Despite its ubiquitous presence in the body and its potential importance in a variety of therapies utilizing mechanical stretch, as well as normal movement and exercise, very little is known about loose connective tissue's biomechanical behavior. This study aimed to determine elastic and viscoelastic mechanical properties of ex-vivo rat subcutaneous tissue in uniaxial tension with incremental stress relaxation experiments. The elastic response of the tissue was linear, with instantaneous and equilibrium tensile moduli of 4.77 kPa and 2.75 kPa, respectively. Using a 5 parameter Maxwell solid model, material parameters μ₁ = 0.95 ± 0.24 Ns/m and μ₂ = 8.49 ± 2.42 Ns/m defined coefficients of viscosity related to time constants τ_1M = 3.83 ± 0.15 sec and τ_2M = 30.15 ± 3.16 sec, respectively. Using a continuous relaxation function, parameters C = 0.25 ± 0.12, τ_1C = 1.86 ± 0.34 sec, and τ_2C = 110.40 ± 25.59 sec defined the magnitude and frequency limits of the relaxation spectrum. This study provides baseline information for the stress-strain behaviors of subcutaneous connective tissue. Our results underscore the differences in mechanical behaviors between loose and high-load bearing connective tissues and suggest that loose connective tissues may function to transmit mechanical signals to and from the abundant fibroblasts, immune, vascular, and neural cells present within these tissues.     

结直肠损伤

近年来结直肠损伤的救治水平有了明显进步,但仍存在并发症发生率高、腹膜外结直肠损伤漏诊率高、转流造口手术率高等问题。本文介绍了结直肠损伤的2种分类方法:穿透伤和钝性伤,毁损伤和非毁损伤。在分析结直肠损伤漏诊有关因素的基础上,提出了诊断策略和剖腹术中探查要点,全面阐述了结肠和腹膜内段直肠、腹膜外段直肠的手术策略和手术方式。     

腹腔镜手术治疗妇产科疾病临床观察

目的 通过分析腹腔镜手术在治疗妇产科疾病中的临床应用,探讨手术治疗效果.方法 对本院行腹腔镜手术治疗疾病的121例妇科患者临床资料进行回顾性分析.结果 腹腔镜手术在妇产科中疾病的治疗中应用广泛,患者术后恢复比较快,同时疼痛创伤比较小,操作过程简单易行.结论 行腹腔镜手术治疗妇产科疾病效果显著,能够减轻病人的痛苦,有出血少、恢复快、简便易行等优点,是妇产科手术的首选.     

Commercially available bone graft substitutes: the impact of origin and processing on graft functionality

Abstract

Development of effective and cost-efficient bone tissue engineering grafts has been the key area of research for regenerative medicine, yet an ideal grafting material has remained elusive due in large part to the highly dynamic nature of bone. A wide array of materials, both natural and synthetic, have been implemented as potential candidates for commercially available products, yet the gold standard for grafting material still remains autogenous bone. We review currently commercially available bone graft materials and relevant graft characteristics that impact the effectiveness of tissue repair, emphasizing the advantages and disadvantages of materials based on composition and origin. Examined materials were selected through a web-based search for readily accessible and clinically applicable graft materials. Grafts were then categorized according to material source to examine advantages and disadvantages associated with allogenic, xenogeneic, synthetic materials. Lastly, the application of bioactive molecules onto these basal grafts is explored to illustrate the enhancement and regulative capacity of these additives on traditional osteobiologic materials.     

局麻单孔腹腔镜双极电凝与经腹近端抽芯包埋两种输卵管绝育术对生殖激素近期影响的对比观察

目的:比较观察局麻单孔腹腔镜双极电凝输卵管绝育术与经腹近端抽芯包埋输卵管绝育术对卵巢功能的影响。方法:在贵州省内14个县随机抽取2014年10月~2015年10月行上述两种输卵管绝育术妇女各100例,测定卵巢基础激素(FSH、LH和E2)。结果:共133例研究对象进入观察,其中腹腔镜输卵管绝育术组82名,年龄28.84±4.02岁;开腹输卵管绝育术组51名,年龄27.61±4.20岁。两组术后1个月的卵巢基础性激素平均水平无统计学改变;术后1个月基础FSH≥10U/L、基础FSH/LH升高2的比例开腹组明显高于腹腔镜组。结论:腹腔镜输卵管绝育术近期对卵巢功能的影响小于开腹输卵管绝育术。     

Papel de los nuevos agentes inmunosupresores en el cáncer cutáneo no melanoma en pacientes trasplantados renales

IntroductionNonmelanoma skin cancer (NMSC) is the most common malignancy in patients who have received a solid organ transplant. Multiple factors are involved in the onset of posttransplant NMSC.ObjectivesTo analyze the relationship between new immunosuppressive drugs and the onset of NMSC in renal transplant recipients.MethodThis was a combined retrospective and prospective observational study in which we studied 289 patients who received a kidney transplant between January 1996 and December 2010 at Hospital Universitario Doctor Peset in Valencia, Spain.ResultsSeventy-three patients (25.2%) developed 162 NMSCs over a median follow-up of 72 months. There were no statistically significant differences in the onset of NMSC on comparing different induction therapy strategies involving monoclonal and polyclonal antibodies. NMSCs occurred less frequently in patients treated with mammalian target of rapamycin (mTOR) inhibitors than in those treated with other immunosuppressive regimens, although the differences were not statistically significant. Three of 5 patients with recurrent NMSC who were switched from calcineurin inhibitors to mTOR inhibitors developed additional NMSCs despite the change.ConclusionsInduction therapy with monoclonal and polyclonal antibodies in renal transplant recipients is not associated with an increased risk of NMSC. While mTOR inhibitors are associated with a lower risk of posttransplant NMSC, it remains to be determined whether a switch to these drugs is useful in the management of patients who develop multiple NMSCs.     

Ultrastructural immunocytochemistry suggests that periderm granules in embryonic chick epidermis contain beta-defensins

The capability to express an innate antimicrobial action through the production of beta-defensins in the skin of chick embryos has been studied by immunocytochemistry. The immunolabeling of periderm granules present in the initial embryonic epidermis of the chick is obtained with a lizard anti-defensin antibody (Ac-BD-15) that recognizes a homologous peptide in the chick beta-defensin 9. Similar granules, termed honeycomb granules, are also stored in some basophilic granulocytes of adult and hatchling chicks, but did not show immunoreactivity to the antibody. It is unclear whether this morphology indicates different organelles, content or lack of available antigens due to organelle packaging. The remarkable ultrastructural similarity between periderm granules and the honeycomb granules present in basophil granulocytes further indicates that embryonic keratinocytes can synthesize antimicrobial peptides together with corneous proteins. These peptides may participate in the formation of an epidermal microbial barrier during ontogenesis or protect the embryo in case of damage to the amniotic-periderm barrier. These transient organelles, apart from the early keratinization of the epidermis that forms the initial barrier before hatching may also contribute to the formation of an efficient anti-microbial barrier against the penetration of microbes during embryonic life until hatching when the adaptive immunity system is still immature.     

长效抗菌敷料在肠造口所致周围皮肤瘙痒患者中的应用效果

目的 探讨长效抗菌敷料在肠造口所致造口周围皮肤瘙痒患者中的应用效果。 方法 选取2013年1月-2016年12月行肠造口手术并发造口周围皮肤瘙痒的直肠癌患者167例。采用随机数字表法将其分成实验组和对照组。实验组采用长效抗菌敷料(洁悠神)进行治疗,对照组使用皮炎平乳膏进行治疗。 结果 治疗第1、2周,2组患者肠造口周围皮肤瘙痒复发率比较,差异无统计学意义(P>0.05);第3、4周,实验组肠造口周围皮肤瘙痒复发率低于对照组(χ²=14.056,P<0.001; χ²=15.465,P<0.001)。实验组舒适度和生活质量均高于对照组。 结论 长效抗菌敷料可以治疗由肠造口所致造口周围皮肤瘙痒,降低患者瘙痒感和瘙痒复发率,提高造口患者舒适度,从而改善造口患者生活质量。