芍倍注射液辅助痔上黏膜错位套扎术治疗中重度痔疮临床观察

目的:评价芍倍注射液辅助痔上黏膜环形错位套扎吻合术(EPH)治疗中重度痔疮的临床疗效。方法:将我院收治的72例中重度(Ⅲ~Ⅳ)痔患者随机分为两组,治疗组39例行芍倍注射液辅助EPH治疗,对照组33例行EPH治疗。观察比较两组患者手术时间、术后并发症及治愈率的差异。结果:治疗组与对照组的手术时间分别为(15±5)min和(13±4)min,差异无统计学意义(t=1.74,P>0.05);治愈率分别为治愈率为97.4%和96.7%,差异亦无统计学意义(t=0.71,P>0.05)。治疗组和对照组出血量分别为(10±3)m L和(14±2)m L,差异有统计学意义(t=5.90,P<0.05);治疗组无并发症发生,对照组有6例出现并发症,二者比较差异有统计学意义(P=0.013)。结论:芍倍注射液辅助EPH是治疗中重度痔疮的一种安全有效方法,具有操作简单,费用低,术后恢复快,并发症少及可重复操作等优点,值得临床推广。     

全系膜切除术和双吻合技术在低位直肠癌保肛术中的应用

目的探讨全直肠系膜切除（TME）联合双吻合器（DST）在低位直肠癌手术中的应用效果。方法回顾性分析2007年至2008年133例直肠癌应用全直肠系膜切除联合双吻合器行低位直肠前切除的临床资料。结果本组术后出现吻合口漏8例（6%）,吻合口狭窄4例（3%）,直肠阴道瘘2例（1.5%）,吻合口出血3例（2.3%）,经对症治疗后治愈,死亡3例（2.3%）。结论全直肠系膜切除联合双吻合器的应用可有效保留肛门功能,是治疗低位直肠癌的有效方法。     

肛周脓肿长期误诊1例

<正>1病历介绍患者,女,16岁,因发热并肛周不适7个月于2011年3月5日入院。患者于2010年7月无明显诱因间断出现发热症状,最高至39℃。伴有大便次数增多,无肛门疼痛,无脓血便。前往当地医院查体无明显异常,查血常规WBC 30×109L-1,当地医院考虑肺部疾病。给予联合使用抗生素及降温对症治疗(具体不详),持续输液2周,患者体温下降,仍有低烧症状,大便次数恢复正常,复查血常规示WBC 10×109 L-1。     

Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

内皮祖细胞在创伤后多器官功能障碍中的变化及意义

Objective To investigate characteristics of changes in bone marrow endothelial progenitor cells (EPCs) and implications on multiple organ dysfunction syndrome (MODS) as a result of trauma.Methods Eighteen mini-pigs were randomized into two groups: MODS group (n=9) and control group (n=9).The animal models of MODS were reproduced by "two-hit" injury with hemorrhagic shock and lipopolysaccharide (LPS) injection.Bone marrow and peripheral blood of them were collected at five time points: normal condition (T1), before injection of LPS (T2), and 0 (T3), 24 (T4) and 48 hours (T5) after injection of LPS.Erythrocytic lysate was added to the samples, and the number of leucocytes in every sample was counted.The rate of EPCs in each sample was determined by flow cytometry.Number of EPCs in bone marrow and peripheral blood were calculated, and the results were analyzed statistically.Results The number of EPCs (×106/L) in bone marrow of control group at T1-5 was 7.64±0.68,7.32±0.55, 7.58±1.13, 7.77±0.70, and 7.88±0.84, respectively, and in peripheral blood control group was 3.54±0.26,4.06±0.64, 3.74±0.55, 3.61±0.37, and 3.98±0.63, respectively.The number of EPCs (×106/L) in bone marrow in the experimental group was 7.45 ± 1.55, 6.58 ± 0.80, 11.27 ± 1.20, 10.88±1.15, and 8.36 ± 2.88, respectively.The number of EPCa (× 106/L) in peripheral blood in the experimental group was 3.21±0.48, 8.71±2.04, 5.98±0.77, 1.27±0.91, and 2.14±0.96, respectively.The number of EPCs in bone marrow of experimental group was larger than that of control group at T3, T4, T5.The number of EPCs in the experimental group in peripheral blood was larger than that of control group at T2, T3, T4, T5.The number of EPCs in bone marrow was larger than that in peripheral blood at every time point (all P＜0.05).Conclusion The number of EPCs in peripheral blood elevates sharply in the earlier period, then plummetes quickly during MODS after a trauma.While the number of EPCs in bone marrow descends mildly at first, then rises obviously.Along with the aggravation of MODS, a declination of EPCs in bone marrow emerges.The change in bone marrow EPCs plays an important role in recovery of MODS.     

应用膨化聚四氟乙烯补片行开放式腹壁大切口疝修补术的临床分析

目的探讨腹壁大切口疝治疗经验。方法对我院采用补片行开放式腹壁大切口疝修补术的211例病人临床资料进行回顾性分析。结果手术平均时间为80 min(45~190 min),术中出血为15~90 ml,平均35.6 ml；术中无血管和内脏损伤等并发症。术后3~7 d(平均4.9 d)下床活动；平均住院时间为6.3 d(2~16 d)。1例病人由于网膜出血进行了急诊二次手术。2例病人由于皮下出血,于手术后2~6 h 进行了伤口修整术。211例 病 人 长 期 随 访 (60~178个月),有6例病人(2.8%)出现疝复发,所有病例无慢性疼痛。结论应用膨化聚四氟乙烯补片行开放式腹壁大切口疝修补术是一种安全、可靠的方法,复发率低。     

Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

一期根治术治疗肛周脓肿300例

2005-2009年，我科采用一期根治术治疗肛周脓肿300例，疗效满意，总结报道如下。