Esophageal Calibration with Soft Orogasrtric Tube During Laparoscopic Nissen Fundoplication may Reduce Postoperative Transient Dysphagia

Gastroesophageal reflux is the most common benign disorder of the esophagus and laparoscopic Nissen fundoplication has become the standard surgical treatment for its treatment. In our area, where the use of bougie calibration is debatable, postoperative dysphagia is encountered often after this surgery although it is usually not permanent. The aim of this study was to investigate the effect of using a soft silicone tube 39 F in diameter for esophageal calibration during laparoscopic Nissen fundoplication on the incidence of postoperative dysphagia. We divided cases scheduled to undergo laparoscopic Nissen fundoplication between January 2009 and November 2010 into two groups, each consisting 25 patients. Esophageal calibration with a 39 F silicone orogastric tube was used for the first group while there was no operative calibration in the second group. The surgical duration was recorded; the presence and severity of the postoperative dysphagia was calculated by using a dysphagia severity scoring system during the 1-year postoperative follow-up. The dysphagia severity scores were significantly lower in group 1 than group 2 on the postoperative second day and at the end of the first week and first month. We did not find a significant difference at the end of the 6-month and first year. There was also no significant difference regarding surgery duration. The use of a soft orogastric tube 39 F in diameter for esophagus calibration during laparoscopic Nissen fundoplication has significantly decreased the incidence of postoperative transient dysphagia without affecting the duration of surgery. Although dysphagia gradually resolves in the majority of patients, a safe and easy calibration method for its prevention is worth developing, and we believe that the use of our method in larger series could be beneficial.     

The effect of nadroparine on coagulation mechanisms: ultrastructural analysis.

Low molecular weight heparins are widely used in the prophylaxis and treatment of thrombotic disorders. The effect of low molecular weight heparins on coagulation was examined ultrastructurally in an animal model. A test and a control group was formed, each consisting of five rabbits. Nadroparine (225 Institute of Chaoy Unit/kg twice daily) was applied to the test group for 10 days. The control group received 1 ml saline solution subcutaneously. Blood and vascular tissue samples collected at the end of the 10th day were evaluated under a JEM 100 B electron microscope. Platelet degranulation and agglutination was observed in the control group. Fibrin materials were detected in the cytoplasms and surroundings of degranulated platelets. Erythrocyte accumulation was remarkable on the vascular endothelium with intact coagulation periods. In the test group, outer membranes of platelets, hyalomere, and granular structures in the granulomeres were detected to be nearly intact. There were rare erythrocytes in the large vascular lumens. The aggregation phase had occurred but no agglutination was detected. Nadroparine seems to preserve consistency of lipoprotein membranes of platelets and granular structures containing enzymes, which contribute to the coagulation mechanisms.     

大学生健康概念认知的调查研究

随着教育改革的深化,健康教育日益成为高校素质教育的热点课题。现代健康理念建立在“生物-心理-社会医学模式”之上,1978年WHO在《阿拉木图宣言》中指出:“健康不仅是没有疾病或不虚弱,而且是身体的、精神的健康和社会适应的完美状态。”[1]依据这一健康观的指导,笔者认为高校健康教育机构应该从机体健康、心理健康、行为与社会适应性健康几方面对学生的健康观和保健能力进行培养。为了解目前大学生对“健康”的理解和认识水平,进一步为高校有针对性的健康教育实践提供依据,笔者在广州市两所综合大学对学生的健康概念认知情况进行调查。1…     

Spatial dispersion modeling of 90Sr by point cumulative semivariogram at Keban Dam Lake, Turkey.

Spatial analysis of (90)Sr artificial radionuclide in consequence of global fallout and Chernobyl nuclear accident has been carried out by using the point cumulative semivariogram (PCSV) technique based on 40 surface water station measurements in Keban Dam Lake during March, April, and May 2006. This technique is a convenient tool in obtaining the regional variability features around each sampling point, which yields the structural effects also in the vicinity of the same point. It presents the regional effect of all the other sites within the study area on the site concerned. In order to see to change of (90)Sr, the five models are constituted. Additionally, it provides a measure of cumulative similarity of the regional variable, (90)Sr, around any measurement site and hence it is possible to draw regional similarity maps at any desired distance around each station. In this paper, such similarity maps are also drawn for a set of distances. (90)Sr activities in lake that distance approximately 4.5 km from stations show the maximum similarity.     

Effect of N-acetylcysteine on blood and tissue lipid peroxidation in lipopolysaccharide-induced obstructive jaundice.

In obstructive jaundice, free radical production is increased and antioxidative activity is reduced. N-Acetylcysteine (NAC) has a beneficial effect with anti-inflammatory and antioxidant activity, acting as a free radical scavenger. NAC inhibits inducible nitric oxide synthase, suppresses cytokine expression/release, and inhibits adhesion molecule expression and nuclear factor kappa B. The aim of this study was to investigate the effects of NAC on liver/renal tissue and serum lipid peroxidation in lipopolysaccharide (LPS)-induced obstructive jaundice. We randomized 60 rats into 6 groups: group 1, Sham; group 2, obstructive jaundice (OJ) induced after bile-duct ligation; group 3, OJ + NAC (100 mg kg- 1 subcutaneously); group 4, OJ + LPS (10 mg kg-1); group 5, OJ + NAC + LPS; and group 6, OJ + LPS + NAC. For each group, the biochemical markers of lipid peroxidation and the antioxidant products were measured in serum and liver/renal tissue after sacrifice. Almost all lipid peroxidation products levels were increased and antioxidant products levels were decreased in groups who received LPS (groups 4, 5, and 6), but the effect was less remarkable when NAC was administered before LPS (group 5). The same trend was seen for groups with OJ +/- LPS who did not received NAC or received it after induced toxemia (groups 2, 4, and 6) as compared to groups 1 and 3. Moreover, in the case of OJ + LPS, rats treated with NAC before LPS (group 5) had lower lipid peroxidation products levels and higher antioxidant products levels as compared to those who did not received NAC (group 4). This phenomenon was not reproducible with NAC administered after LPS (group 6). Thus, results of this study showed that NAC prevents the deleterious effects of LPS in obstructive jaundice by reducing lipid peroxidation in serum and liver/renal tissue if administered before LPS. Nonetheless, NAC failed to prevent the lipid peroxidation in the case of established endotoxemia in obstructive jaundice.     

Role of insulin like growth factor-I in repair response in immature cartilage

OBJECTIVE: The purpose of this study was to investigate the effects of exogenous local Insulin like growth factor-I (IGF-I) on the repair of full-thickness articular cartilage defects in immature rabbits. DESIGN: Thirty-six skeletally immature New Zealand rabbits between 6 and 8 weeks old were used. A single defect, 3.5-mm-wide by 4-mm-deep full-thickness articular cartilage defect in the medial femoral condyle, was created. The defect was either filled with a collagen sponge or with a collagen sponge impregnated with 5 mug of recombinant IGF-I. The animals were sacrificed at 4, 8 or 12 weeks, and the repair tissue was examined macroscopically and histologically. Repair tissue was also examined immunohistochemically for the presence of type-I collagen, type-II collagen and PCNA at all weeks. RESULTS: Newly formed tissue in all of the defects in the IGF-I group had the gross, histological and histochemical appearance of a smooth, intact hyaline articular cartilage. The average total scores on the histological grading scale were significantly better (p<0.05) for the defects treated with recombinant IGF-I at all time points. Immunostaining with an antibody against type-II collagen showed the diffuse presence of the repair cartilage in the IGF-I treated defects. The control groups demonstrated minimum staining with type-II collagen antibody. CONCLUSIONS: These findings suggest that repair of full-thickness immature cartilage defects can be enhanced by recombinant IGF-I.     

急慢性肾功能衰竭常见血清酶的变化及其临床意义

目的探讨急慢性肾衰患者体内常见血清酶含量的变化及两者的差异性。方法急性肾衰（ＡＲＦ）和慢性肾衰（ＣＲＦ）患者及正常健康人３组各３０例,采用全自动生化分析仪检测血清中碱性磷酸酶（ＡＣＰ）,淀粉酶（ＡＭＹ）,肌酸激酶（ＣＫ）、乳酸脱氢酶（ＬＤＨ）及α一羟丁酸脱氢酶（ＨＢＤＨ）。结果（１）与正常健康人比较,急慢性肾衰患者血清ＡＭＹ、ＬＤＨ、ＨＢＤＨ均显著升高（Ｐ＜０．０１）,ＣＫ次之（Ｐ＜０．０５）;血清ＡＬＰ在ＣＲＦ组明显升高（Ｐ＜０．０５）,而ＡＲＦ组无显著差异（Ｐ＞０．０５）。（２）与ＣＲＦ组比较,ＡＲＦ组血清ＬＤＨ、ＨＢＤＨ明显升高（Ｐ＜０．０１）,而ＡＭＹ、ＡＬＰ明显降低（Ｐ＜０．０１、Ｐ＜０．０５）;血清ＣＫ两组比较无显著差异（Ｐ＞０．０５）。结论血清ＡＬＰ、ＡＭＹ、ＬＤＨ和ＨＢＤＨ变化有助于临床上鉴别急、慢性肾衰。     

肌纤维转化生长因子- β信号激活与急性肌损伤炎症反应的相关性研究

目的:探讨肢体创伤后急性肌损伤炎症反应过程中肌纤维自身转化生长因子- β(TGF- β)信号对肌内炎症的影响。 方法:取野生C57BL/6小鼠（野生小鼠组）、肌纤维条件性TGF- β受体Ⅱ敲除小鼠（敲除小鼠组)各16只。肌毒素腓肠肌内注射诱导小鼠急性肌损伤。比较两组小鼠在注...     

Brachial plexus injury during open heart surgery--controlled prospective study

BACKGROUND: Postoperative brachial plexus injury is often reported because the brachial plexus is stretched by sternotomy and the use of sternal retractors during open heart surgery. In many studies, brachial plexus injuries have been demonstrated by postoperative electrophysiological studies in susceptible patients. In this study, we estimated the incidence, severity, and type of brachial plexus injuries by routine preoperative and postoperative electrophysiological studies of patients undergoing open heart surgery. METHODS: Patients undergoing coronary artery bypass grafting (CABG) surgery (Group 1), heart valve surgery (Group 2), or peripheral vascular surgery (Group 3) were included in the investigation. Electrophysiological studies of both upper extremities were performed five days before and three weeks after the operation. RESULTS: Peripheral nerve problems were found preoperatively in 23 of the 112 patients (21 %). These problems persisted, but similar findings were obtained postoperatively from the left upper extremities of six of the 42 CABG (14 %) and two of the 24 heart valve (8 %) patients who had had normal preoperative evaluations. The patients with injured nerves were older and had undergone longer operation times. There were no differences between the patients with injured nerves and the others with respect to mammary artery harvesting or other operative variables. CONCLUSIONS: There are no reports in the literature of routine preoperative and postoperative electrophysiological studies in large patient groups to evaluate brachial plexus injury during open heart surgery. It is known that heart surgery sometimes causes partial brachial plexus injury, especially in the lower trunk. However, these peripheral nerve problems are usually not considered clinically important and are not investigated. Patients undergoing open heart surgery must be closely followed up for peripheral nerve injury during the postoperative period.