肝段或肝叶切除术对肝内胆管结石再次手术效果的影响

目的对比不同术式对肝内胆管结石再次手术效果，探讨肝段或肝叶切除术的优势。 方法回顾性分析2011年8月至2014年8月收治的79例肝内胆管结石再次手术患者资料，依据术式不同分为肝段(叶)切除术组(甲组，n＝38)和非肝段(叶)切除术组(乙组，n＝41)两组。应用SPSS 19.0软件对所有临床数据进行统计学分析，手术相关指标等以( ±s)的形式表示，组间比较采用独立t检验；术后并发症发生情况及预后情况等计数资料以例(%)的形式表示，采用χ²检验；P<0.05差异有统计学意义。 结果两组患者术中出血量、手术时间及术后住院时间相比，差异无统计学意义(P>0.05)；甲组患者的术后并发症发生率5.3%(2/38)显著低于乙组22.0%(9/41)(P<0.05)；甲组残留结石发生率、症状复发率2.6%(1/38)、 0(0/41)均显著低于乙组17.1%(7/41)、 12.2%(5/41)(P<0.05)，差异有统计学意义(P<0.05)；但两组患者的病死率2.6%(1/38)和0(0/41)相比，差异无统计学意义(P>0.05)。 结论肝段(叶)切除术能够有效改善肝内胆管结石再次手术效果，值得推广。     

马齿苋“成分-活性-中药功效-疾病”研究进展及关联分析

马齿苋是一种药食同源品,具有清热解毒、凉血止血、止痢的功效,为常见中药,作为药物安全性高。马齿苋具有多种活性成分及药理作用,为了充分开发利用马齿苋,加快马齿苋研究的现代化进程,综述马齿苋的研究进展并在此基础上对于其"成分-活性-中药功效-疾病"进行关联分析,为马齿苋的现代化研究提供思路。     

Additional bedtime H2‐receptor antagonist for the control of nocturnal gastric acid breakthrough: A Cochrane systematic review

OBJECTIVES: To assess the effectiveness and safety of additional bedtime H₂‐receptor antagonists (H₂RAs) in suppressing nocturnal gastric acid breakthrough (NAB) via a systematic review. METHODS: Eligible trials were identified by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library Issue 2, 2004), MEDLINE (January 1966–June 2004), EMBASE (January 1980–June 2004) and CINAHL (January 1982–June 2004). Additional hand‐searching was conducted on the proceedings of correlated conferences, eight important Chinese journals and references of all included trials. All randomized controlled trials evaluating H₂RAs for the control of NAB were eligible for inclusion. The systematic review was conducted using methods recommended by The Cochrane Collaboration. RESULTS: Only two randomized crossover studies, comprising 32 participants, met the inclusion criteria. Because the design, dosage and duration of the treatments were different between the studies, it was not possible to conduct meta‐analysis. There were no consistent conclusions found between the two included studies in evaluating H₂RAs for the control of NAB. CONCLUSIONS: No implications for practice at this stage can be concluded. Appropriately designed large‐scale randomized controlled trials with long‐term follow up are needed to determine the effects of additional bedtime H₂RAs in suppressing NAB.     

超顺磁性氧化铁标记大鼠骨髓基质细胞经门静脉移植MRI活体示踪的研究

目的观察1．5T场强MRI联合动物专用线圈是否可以活体示踪经门静脉移植的纳米级超顺磁性氧化铁颗粒标记的骨髓基质细胞（bone marrow stromal cells BMSCs），为介人性门静脉骨髓基质细胞移植治疗终末期肝脏疾病的研究提供进一步的依据。方法供体大鼠5只，梯度密度离心分离BMSCs，纳米级超顺磁性氧化铁颗粒和脂质体转染BMSCs，体外经普鲁士蓝染色和HE染色确定细胞标记率。受体大鼠15只，分为5组，分别为对照组和纳米级超顺磁性氧化铁颗粒标记的骨髓基质细胞经门静脉移植人正常大鼠肝脏后2h、3d、7d及2周组。1．5T场强MRI联合动物专用线圈行T1W、T2W和T2＊序列扫描，观察肝脏信号改变情况，与对照组比较，并且与组织切片对照。结果纳米级超顺磁性氧化铁颗粒和脂质体转染BMSCs，细胞标记率〉95％。经门静脉移植人正常大鼠肝脏后，T2＊序列扫描显示经标记的BMSCs在肝内显示弥漫性的结节性低信号影，移植后2h到2周均可见到细胞在受体肝脏内存在，组织学切片显示信号缺失部位与铁颗粒标记细胞相一致。结论纳米级超顺磁性铁氧体颗粒标记的大鼠BMSCs经门静脉移植后可以通过1、5T场强行MRI活体示踪，为临床干细胞移植的应用提供可行的示踪方法。