Comparison of Laparoscopic-Assisted Operations and Laparotomy Operations for the Treatment of Hirschsprung Disease: Evidence From a Meta-Analysis

The purpose of this meta-analysis is to compare the relative merits among laparoscopic-assisted operations and laparotomy operations for patients with Hirschsprung disease.PubMed, Web of Science, and Wanfang databases were searched for the related articles. We analyzed dichotomous variables by estimating odds ratios (ORs) with their 95% confidence intervals (CIs) and continuous variables using the weighted mean difference (WMD) with the 95% CI. The random-effects model (REM) was used to combine the results. The outcome measures included operating time (OT), estimated blood loss (EBL), length of hospital stay (LOHS), mean first bowel movement (MFBM), and number of complications.Sixteen articles were included in the meta-analysis. These studies involved a total of 774 patients, 396 of whom underwent laparoscopic-assisted operations and 378 of whom underwent laparotomy operations. The EBL (WMD = −1.48, 95% CI = −1.82, −1.13), LOHS (WMD = −0.67, 95% CI = −0.86, −0.49), MFBM (WMD = −0.83, 95% CI = −1.05, −0.61), and number of complications (OR = 0.60, 95% CI = 0.40, 0.89) were significantly lower in laparoscopic-assisted operations than in laparotomy operations. The OT (WMD = 0.12, 95% CI = −0.05, 0.28) showed no significant differences between laparoscopic-assisted operations and laparotomy operations.Compared with laparotomy operations, laparoscopic-assisted operations are generally safer and more reliable for patients with Hirschsprung disease.     

肥胖患者胰升糖素水平变化及其对空腹血糖的影响

目的　探讨肥胖患者胰升糖素的变化特点及其对血糖的影响。方法　将 82例患者根据体重指数分为 3组 :A组 (BMI <2 4,n =2 3 )、B组 (2 4≤BMI <2 7,n =2 7)、C组 (BMI≥ 2 7,n =3 2 ) ,分别测定胰升糖素、胰岛素、空腹血糖 ,采用单因素方差分析法与Spearman等级相关性分析法进行分析。结果　 3组胰升糖素分别为 (15 6.3± 5 8.6)、(186.7± 67.5 )、(2 2 2 .2± 88.4)ng·L-1,C组与A组比较有显著性差异 (P <0 .0 1) ;3组胰岛素分别为 (15 .4± 4.7)mIU·L-1、(2 0 .6± 9.6)mIU·L-1、(2 2 .3± 10 .6)mIU·L-1,B组、C组与A组比较差异有显著意义 (P <0 .0 5、P <0 .0 1) ;B、C两组胰升糖素与空腹血糖呈正相关。结论　肥胖患者胰岛素、胰升糖素一致性增高 ,胰升糖素的增高是空腹血糖增高的重要因素。     

40例痔患者的辨证施护体会

目的：总结了痔患者的辨证施护体会，为临床护理工作提供参考。方法：回顾分析了自2001年以来收治的40例痔患者的临床资料。护理诊断及相应措施。结果：本组40例患者，痊愈者28例，好转者10例，病情稳定出院者2例。结论：树立以病人为中心的整体观。实施相应的辨证护理，贯彻以预防为主的方针，可提高痔的治愈率。     

Design and evaluation of a controlled-release theophylline tablet. Preliminary communication

A 300 mg controlled-release theophylline formulation was developed as a tablet prepared by wet granulation using the acrylic resins Eudragit S 100R and Eudragit RSPMR. The tablet was compared with a marketed controlled-release capsule using in vivo and in vitro tests. The in vitro dissolution of theophylline from the tablets followed an apparent zero order kinetics. The in vivo comparison was performed in a cross over fashion in four healthy volunteers who received one tablet or capsule every 12 hours during seven days. The results showed no statistically significant differences in AUC, tmax and in plasma theophylline concentrations at the different times. Nevertheless, concentrations were lower after the administration of the tablets than when the volunteers received the capsules. On the other hand, the apparent elimination half lives obtained after the tablets were longer than with the capsules. An excessive retardation in the release of theophylline from the tablet could be responsible for this fact.     

Comparison of survival among patients with breast cancer treated at First Teaching Hospital,Changchun, China,and Saint-Sacrement hospital,Quebec, Canada

The aim of this study was to compare the survival of 116 patients with breast cancer initially treated at the First Teaching Hospital (FTH) of Norman Bethune University of Medical Sciences located in Changchun, China, from 1986 to 1991 with the survival of 886 patients seen in the “Hipital du Saint-Sacrement” (HSS) located in Quebec City, Canada, from 1987 to 1992. The clinical data were collected from the hospital records at FTH. The vital status for Chinese patients was obtained from letters of follow-up or the records of local police offices. The list of patients treated at HSS and the data for each woman were extracted from computerized data banks. The major variables studied included age at diagnosis, tumor size at pathology (cm), number of lymph nodes involved, breast surgery and adjuvant treatments of breast cancer (chemotherapy, radiotherapy, immuno-therapy). Age at diagnosis was substantially lower among patients with breast cancer seen at FTH compared to those treated at HSS (x) ₁ ² =60.95,P<0.0001). The average age at diagnosis for Chinese women was about 10 years less than that for Canadian women. Patients in the two hospitals differed with respect to tumor size at pathology (x ₂ ² =6.67,P=0.036). The proportion of patients with tumor size larger than 2.0 cm was larger at FTH (48.3%) than at HSS (41.1%). The mean tumor size at pathology was 3.0 cm (standard deviation =2.1 cm) for patients treated at FTH, but 2.6 cm (standard deviation=1.8 cm) for women treated at HSS (P=0.07). The proportion of women with lymph node involvement was greater at FTH (61.1 % than that at HSS (37.3%) (x ₁ ² =16.51,P<0.0001). Surgical treatment of breast cancer varied considerably. In Changchun, radical mastectomy was frequent for any stage of breast cancer patients, but partial mastectomy was never performed. The situation was reversed in Quebec. The five year observed survival was 74.2% (standard error, 0.05) among breast cancer patients seen at FTH compared to 76.0% (standard error, 0.02) among women treated at HSS. After adjustments of confounding factors, there were no significant difference in five year observed survival between the patients treated at the two hospitals (P=0.42).     

Modulation of the immunological response of guinea pig mast cells by carbon monoxide.

Challenge of guinea pig mast cells with antigen under aerobic conditions induced the expected release of histamine and led to a significant increase in intracellular calcium ([Ca2+]i) and cyclic adenosine monophosphate (cAMP) levels. Prior exposure to CO decreased the immunological histamine release. This effect was accompanied by a decrease in the levels of [Ca2+]i and by an increase in the cyclic guanosine monophosphate (cGMP) levels. The exposure of mast cells to nitrogen (N2) did not modify the release of histamine. The CO-mediated inhibition of the immunological release of histamine was reversed by the soluble guanylate cyclase inhibitor (1 H-[1.2,4]oxadiazolo[4,3-a]quinoxalin-1-one, ODQ) and by oxyhaemoglobin (HbO2). Incubation of mast cells for 4 h with hemin, a heme oxygenase (HO) inducer, resulted in an increase in HO activity, measured as bilirubin production. Hemin abated the immunological release of histamine, in similar fashion to exogenous CO, and increased the cGMP levels. These effects were reversed by ODQ and HbO2. It is proposed that CO from an exogenous or endogenous source stimulates guanylyl cyclase and causes cGMP formation which then induces calcium to be sequestrated so that the [Ca2+]i concentration falls and histamine release is inhibited.     

冠状动脉损伤修复中Ⅲ型胶原的表达及其与血管平滑肌细胞增生的关系

目的;探讨血管损伤修复中Ⅲ型胶原的分泌规律及其与血管平滑肌细胞（ＶＳＭＣ）增生的关系,方法：２６只犬冠状动脉植入过大钽丝支架建立再狭窄模型,分别于术后７天,１４天和２８天处死动物,用透射电镜及免疫组化染色观察新生内膜中Ⅲ型胶原分泌和ＶＳＭＣ特征,并用图像处理技术对Ⅲ型胶原的染色密度作定量分析,结果：支架植入后７天以ＶＳＭＣ移行增生为主,１４天时ＶＳＭＣ增生达高峰并有较多胶原分泌,２８天时ＶＳＭＣ由     

微细药物表面包覆技术在制剂中的应用

新型药物开发制备过程中，需要对药物颗粒进行粒子设计，通过多层微胶囊化而得到复合包覆药物颗粒。药物包覆、微胶囊制备方法很多，可分为化学法、物理化学法、物理法。本文着重介绍了制备复合多层包覆药物颗粒的几种物理机械方法：复合杂化系统，高速椭圆转子混合法、喷流床包覆法。简要分析了该技术用于中药现代化加工的可能性。     

中药超微粉碎后对其性能的影响研究

本文详细地阐述超微粉碎技术的特点，中药超微粉碎后对生物体吸收、药物用量、药物工业加工和提取等方面的影响，以及中药超微粉碎存在的问题，最后阐明了中药超微粉碎的广阔前景。