肛瘘经括约肌间瘘管结扎后肛门功能恢复的相关影响因素分析

目的 探讨肛瘘经括约肌间瘘管结扎后肛门功能的恢复情况及其影响因素。方法 采取病例对照研究方法,选取海口市中医医院2019年1月—2022年8月收治的172例肛瘘患者作为研究对象。统计分析患者手术前后肛门功能恢复情况,根据患者术后3个月的肛门功能恢复情况将其分为良好组140例、不良组32例。比较两组患者的手术指标、术后并发症及基线资料,采用多因素一般Logistic回归分析影响手术后肛门功能恢复的相关因素。结果 良好组手术后创面愈合更早（P <0.05）,疼痛持续时间更短（P <0.05）,总体平均住院总时间短于不良组（P <0.05）。良好组与不良组术后1、2、3个月的Wexner量表评分比较,采用重复测量设计的方差分析,结果 ①不同时间点的Wexner量表评分有差异（P <0.05）;②两组的Wexner量表评分有差别（P <0.05）,良好组Wexner量表评分较不良组低,肛门功能恢复较好。③两组的Wexner量表评分变化趋势有差异（P <0.05）。良好组患者的病程、瘘管长度、Parks分型、术后切口感染率、二次手术率（再次实施清创手术）、治疗依从性（术后用药是否遵从医嘱）、术后机械性刺激率（术后各种外因刺激肛门）与不良组比较,差异均有统计学意义（P <0.05）。多因素一般Logistic回归分析结果显示,肛瘘患者病程［O^R =1.842（95% CI：1.105,3.073）］、瘘管长度［O^R =1.788（95% CI：1.137,2.812）］、术后切口感染［O^R =1.694（95% CI：1.081,2.653）］、再次手术［O^R =1.347（95% CI：1.018,1.783）］、治疗依从性［O^R =1.493（95% CI：1.058,2.108）］是肛瘘患者括约肌间瘘管结扎后肛门功能恢复不良的影响因素（P <0.05）。结论 肛瘘患者经括约肌间瘘管结扎后肛门功能大部分恢复良好,但是肛瘘患者病程较长、瘘管长度较长、出现术后切口感染、术后再次手术、治疗依从性差可能会增大患者术后肛门功能恢复不良的风险。     

Technique and early clinical results of endoscopic variceal ligation (EVL)

Summary Endoscopic variceal ligation (EVL) is a new technique designed to be used instead of sclerotherapy. Small elastic O rings ligate varices resulting in their strangulation and eradication. During a 12-month period, EVL was employed in 53 consecutive patients, of whom 36 (68%) had alcoholic cirrhosis 17 were Child-Pugh class A, 22 class B, and 14 class C. Varices were graded from I to IV and repeat treatments were given at 1–2 week intervals until the varices were eliminated. At follow-up ranging from 6–18 months (mean 11.5), 217 EVL treatment sessions had been performed. Of the 13 patients (24%) who died during the study, 11 died during the index hospitalization. Active bleeding was controlled in 19 of 21 patients (90%). Of 40 survivors 13 patients (33%) had 1–2 (mean 1.4) recurrent variceal bleeds while 34 patients had repeat EVL treatment. Elimination of distal varices was achieved in 26 and 7 had reduction of varices from grade III–IV to grade I–II or less. Eradication required a mean of 4.4 EVL sessions in Child's A and B patients and 7.0 sessions in Child's C patients (P<0.025). No significant treatment-related complications were observed. EVL appears to control active bleeding, is associated with a low incidence of non-bleeding complications, and may be used as an alternative to sclerotherapy.     

两微孔法腹腔镜下精索静脉曲张高位结扎53例

目的总结二微孔法腹腔镜下精索内静脉高位结扎的临床经验。方法二微孔法行腹腔镜下精索内静脉高位结扎术53例，其中左侧曲张39例，双侧陆张14例。结果患者手术均获成功，无并发症发生，平均手术时间30min，术后平均住院3d。结论二微孔法行腹腔镜下精索内静脉高位结扎术是一种可选的术式，患者痛苦小，损伤轻，恢复快，更具有美容、微创的治疗效果，操作难度不大。     

Relationship between parameters of lipid peroxidation during obstructive jaundice and after bile flow restoration

Restoration of bile flow after 9-day cholestasis in rat liver normalized the content of lipid peroxidation products. The removal of the cholestatic factor after 12-day cholestasis was not followed by recovery of these parameters. We showed that measurement of serum concentration of lipid peroxidation products in patients with cholelithiasis during the preoperative period holds promise for selection of the optimum time for surgical treatment and prediction of the risk of postoperative complications. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 145, No. 1, pp. 39–42, January, 2008     

Mucosal bromodomain-containing protein 4 mediates aeroallergen-induced inflammation and remodeling

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Desmin as an immunochemical marker of human decidual cells and its expression in menstrual fluid

The expression of intermediate filament proteins in human endometrial tissue was examined. Desmin was selectively expressed in decidualized stroma, as demonstrated by SDS-PAGE analysis and positive response with a monoclonal antibody specific for desmin in ELISA and in western blot analysis. The same monoclonal antibody specifically stained human decidual cells in decidualized endometrium (secretory endometrium) in formalin-fixed paraffin-embedded sections prepared from diagnostic curettage samples. Desmin was also detected in menstrual fluid. Therefore, desmin might serve as a biochemical and histochemical marker of human decidualized endometrium.     

The exclusion among the Ustilago viruses — A dsRNA restriction modification system?

Summary Specific exclusion relations are know among the three Ustilago maydis viruses that are associated with the cytoplasmically transmitted killer phemomenon. Of the three viruses P1, P4 and P6, only P1, and P4 cancoexist in one host cell. Mutual exclusion occurs between P1 and P6 and P4 unilaterally excludes P6. The exclusion relations were originally defined among the wild-type viruses. Those relations can be modified by two specific segments that are a part of the P4 dsRNA genome and were also found in some sensitive strains that contained part of the viral genome. Also, deletion of the dsRNA segment that is assumed to encode the toxin information permits the formation of hybrid genomes that otherwise cannot be formed. The data is interpreted in terms of a dsRNA restriction modification system in which the killer toxin or a toxin-linked function acts as the restriction factor and segments H3 and H4 or H4 alone contain the necessary information for the modification of certain sites on the M and L segments of the P1 and P4 viruses but not on the P6 segments.     

Sarcomeric determinants of striated muscle relaxation kinetics

Ca²⁺ is the primary regulator of force generation by cross-bridges in striated muscle activation and relaxation. Relaxation is as necessary as contraction and, while the kinetics of Ca²⁺-induced force development have been investigated extensively, those of force relaxation have been both studied and understood less well. Knowledge of the molecular mechanisms underlying relaxation kinetics is of special importance for understanding diastolic function and dysfunction of the heart. A number of experimental models, from whole muscle organs and intact muscle fibres down to single myofibrils, have been used to explore the cascade of kinetic events leading to mechanical relaxation. By using isolated myofibrils and fast solution switching techniques we can distinguish the sarcomeric mechanisms of relaxation from those of myoplasmic Ca²⁺ removal. There is strong evidence that cross-bridge mechanics and kinetics are major determinants of the time course of striated muscle relaxation whilst thin filament inactivation kinetics and cooperative activation of thin filament by cycling, force-generating cross-bridges do not significantly limit the relaxation rate. Results in myofibrils can be explained well by a simple two-state model of the cross-bridge cycle in which the apparent rate of the force generating transition is modulated by fast, Ca²⁺-dependent equilibration between off- and on-states of actin. Inter-sarcomere dynamics during the final rapid phase of full force relaxation are responsible for deviations from this simple model.     

Structural and functional analysis of a new desmin variant causing desmin‐related myopathy

Desmin‐related myopathy is a familial or sporadic disease characterized by skeletal muscle weakness and cardiomyopathy as well as the presence of intracytoplasmic aggregates of desmin‐reactive material in the muscle cells. Previously, two kinds of deletions and eight missense mutations have been identified in the desmin gene and proven to be responsible for the disorder. The present study was conducted to determine structural and functional defects in a pathogenic desmin variant that caused a disabling disorder in an isolated case presenting with distal and proximal limb muscle weakness and cardiomyopathy. We identified a novel heterozygous Q389P desmin mutation located at the C‐terminal part of the rod domain as the causative mutation in this case. Transfection of desmin cDNA containing the patient’s mutation into C2.7, MCF7, and SW13 cells demonstrated that the Q389P mutant is incapable of constructing a functional intermediate filament network and has a dominant negative effect on filament formation. We conclude that Q389P mutation is the molecular event leading to the development of desmin‐related myopathy. Hum Mutat 18:388–396, 2001. © 2001 Wiley‐Liss, Inc.     

Comparison of three models of neuropathic pain in mice using a new method to assess cold allodynia: The double plate technique

The recent identification of receptors sensitive to cold stimuli increased the significance of using mice to study cold allodynia, one of the important features of neuropathic pain. However, commonly used techniques (simple cold plate and acetone technique) may be inappropriate to study cold allodynia in mice because of problems of interpretation. We have developed a new method for assessing aversion to a cold non-noxious stimulus. It consists of calculating the time that mice spend on a non-noxious cold plate during their explorative behavior versus a thermoneutral one. We used three different models of neuropathic pain: chronic constriction injury of the sciatic nerve (CCI), partial sciatic nerve ligation (PSL) and chronic constriction of the saphenous nerve (CCS) with their respective sham groups and naive animals to assess the double plate in comparison to the acetone drop technique. All operated mice displayed cold allodynia with both methods. The response to acetone and the time spent on the cold plate were correlated (r = −0.93) and we also showed that the CCI mice were more sensitive to cold. Pharmacological validation of this technique showed that CCI induced cold allodynia was alleviated by gabapentin. In conclusion, the double plate technique provides a new, relevant method for assessing cold allodynia in mice. The advantages and drawbacks with the other techniques are discussed.