血红素抑制内皮细胞损伤的形态学观察

目的 探讨血红素对人脐静脉内皮细胞氧化应激损伤的保护作用。方法 将培养的人脐静脉内皮细胞进行分组：对照组、损伤组、血红素组。观察各组细胞在光、电镜下形态学的改变。结果 在光镜下，血红素组细胞的生长状态明显优于损伤组；在电镜下，损伤组细胞核固缩，而血红素组细胞核幼稚，核仁明显。结论 在人脐静脉内皮细胞中，血红素对过氧化氢所造成的氧化应激损伤有明显的保护作用。     

脐血液动力学指标在围产儿预后预测中的意义

目的：探讨脐血流阻力指标(S／D、PI、RI)在正常与高危妊娠中的变化及其与围产儿预后的关系。方法：1998年3月至1999年3月住院的正常与高危产妇共计110例,均于产前1周内行多普勒超声检查,并统计相关临床资料。结果：高危妊娠时脐血流阻力指数较正常时明显升高,各组中S／D值超过警戒值(2.20)及危险值(2.66)者围产儿预后不良发生率较S／D值正常者显著升高。结论：彩色多普勒超声测定脐血流阻力指数是一种简便、无创、有效的围产期监测手段,以S／D值2.20为警戒线;S／D值2.66为危险线可能更有助于胎儿缺氧的早期诊断,确保围产儿安全。     

耻骨上辅助经脐单孔腹腔镜上尿路全切除术（附8例报告）

目的：探讨耻骨上辅助经脐单孔腹腔镜（SA—LESS）上尿路全切除术的可行性、有效性和技术要点。方法：对2例肾盂癌,2例输尿管癌,1例肾盂癌合并输尿管癌,2例肾结核,1例巨输尿管症并积脓、肾萎缩患者施行SA—LESS上尿路全切除术。患者全麻,取健侧70°卧位,于脐缘内侧置人两个Trocar,自患侧耻骨联合上方置人一个Trocar,分别置入远端可弯曲腹腔镜及操作器械。先游离患侧输尿管下段,予Hem—0—lok夹闭;向上游离肾脏并离断。肾动静脉,切除肾脏;向下行袖套状切除输尿管末端周围膀胱壁,缝合膀胱切口;标本装袋,延长耻骨上切口取出。结果：8例手术均顺利完成。中位手术时间165（115～220）min,术中中位失血量140（50～200）ml。均未输血,术中未出现肠管、实质性器官和大血管损伤等并发症。均于术后第1天下床活动,第2～3天拔除腹腔和盆腔引流管,第6～7天拔除导尿管（肿瘤患者行膀胱灌注后）,第8天出院。结论：SA-LESS上尿路全切除术安全可行,术后恢复快,住院时间短,美容优势明显,值得临床应用。     

Anthropometric Determinations of Umbilical Position in Iraqi Adults

Introduction  Umbilicus is an important surface landmark on the anterior abdominal wall in addition to its aesthetic and psychological effect. Objectives  The objective of the study is to determine the position of umbilicus in Iraqi adults to provide a guide for the neoumbilicus in abdominoplasty. Subjects and Methods  This is an observational study performed on 100 volunteers with no abdominal wall abnormality. Measurements included weight, height, body mass index (BMI), distance from xiphoid to umbilicus, distance from xiphoid process to pubic symphysis, distance from xiphoid process to both anterior superior iliac spine (ASIS), distance from pubic symphysis to umbilicus and from pubic symphysis to xiphisternum, distance of umbilicus to both ASIS, and distance of umbilicus to interspinous line and to inter-anterior hypochondrium line. Results  The study included 100 volunteers, with 50% male and 50% female whose age ranges between 18 to 60 years. The results were a follows: distance from xiphoid process to umbilicus and distance from xiphoid process to pubic symphysis were 18.03 ± 3.25 cm and 32.21 ± 4.64 cm, respectively; distances from xiphoid process to right ASIS and left ASIS were 25.95 ± 5.72 cm and 25.84 ± 6.02 cm, respectively; distance from pubic symphysis to umbilicus was 17.66 ± 3.12 cm; distance of umbilicus to interspinous line was 9.25 ± 1.84 cm. The distance from umbilicus to inter anterior hypochondrium line was 9.905 ± 2.19 cm. Conclusion  These measurements can determine the neoumbilicus position, reduce practical mistakes, and improve postsurgical outcomes.     

Primary umbilical adenomyotic lesion presenting as cyclical periumbilical swelling

A 5-cm umbilical endometriotic lesion associated with a nodule of the posterior aspect of the cervix was discovered in a 32-year-old woman who was consulting for primary infertility. Histological examination of these lesions confirmed smooth muscle hyperplasia that was infiltrated by numerous endometrial glands (adenomyosis).     

穴位埋线、耳压、敷脐治疗顽固性高血压临床疗效观察

评价穴住埋线、耳压、敷脐疗法治疗顽固性高血压临床疗效。方法：90例患者随机分为3组：西药组、外治组和综合组,每组30例,西药组服用双氢克尿噻片、硝苯地平缓释片、马来酸依那普利片;外治组采用穴位埋线、耳压、敷脐治疗;综合组为西药与外治法联用,观察治疗4周。结果：降压疗效综合组总有效率70％,与西药组43．3％、外治组40％相比有显著性差异（P〈0．05）.结论：穴位埋线、耳压、敷脐疗法配合西药可以有效地治疗顽固性高血压。     

Laparoendoscopic single-site cholecystectomy: A randomized controlled study

Abstract

This study reports the initial experience with laparoendoscopic single-site (LESS) cholecystectomy and compares it with laparoscopic cholecystectomy (LC) through a randomized controlled trial. Sixty selective patients diagnosed with cholelithiasis or polyp lesion of the gallbladder (PLG) were randomly divided into two groups undergoing either LESS cholecystectomy or LC separately. The clinical data about operations and recovery of the two groups were compared. In the LESS group 28 of 30 patients underwent LESS cholecystectomy successfully and the remaining two (6.7%) were converted to standard laparoscopic surgery. LC was successfully performed in all patients in the control group. Mean operative time of LESS cholecystectomy group and LC group was 55.6 ± 25.7 versus 42.7 ± 18.6 (p < 0.05). Mean postoperative hospital stay was 3.7 ± 1.3 versus 3.8 ± 0.8 days (p < 0.05). Mean pain index was 2.8 ± 0.6 versus 3.7 ± 1.1 (p < 0.05). A questionnaire revealed that the mean scores of satisfaction with the operation were 8.9 ± 0.7 versus 8.1 ± 1.5 (p < 0.05). LESS cholecystectomy is safe, feasible, minimally invasive, and cosmetic. It is a reasonable alternative to selective patients with uncomplicated cholelithiasis and PLG. But larger controlled studies are still needed.     

Urodynamic study of enhanced continent mechanism using tapered ileum as continent urinary reservoir

Objective To investigate the effect of extramural support from the pouch and abdominal wall to enhance the continent mechanism of tapered ileum. Methods A total of 24 patients underwent a procedure in which an ileal segment was tapered into an efferent tube, of which a part was placed between the back surface of the rectus muscle and the ileal pouch wall. The internal orifice of the tapered ileum was anastomosed to the ileal pouch and its external orifice was anastomosed to the umbilicus. A urodynamic study of the efferent tubes and pouch was done 1.5 to 3 months and 6 to 24 months postoperatively. Results One patient died of heart disease 55 days postoperatively, while 22 of the remaining 23 were completely continent day and night. At 1.5 to 3 months, the urodynamic study of the efferent tubes demonstrated that the maximum closure pressure with a full pouch was 46-124 cmH20 （91.26±15.71 cmH20）and with an empty pouch was 34-84 cmH20 （67±10.60 cmH20）. The difference in mean maximum closure pressure in the full and empty pouches was statistically significant (t=-11.78 and P=0.00001). At 6 to 24 months, a second urodynamic study was performed on 18 cases, demonstrating a reservoir capacity of 420 to 750 ml (481.67±78.83 ml). Reservoir pressure was 6 to 9 cmH(2)O (7.17±1.17 cmH20) when the pouch was filled to 50 ml, and 16 to 35 cmH(2)O (24.12±5.61 cmH20) when it was filled to maximum capacity. There was no contractive wave during the filling in any patient. Maximum closure pressure in the efferent tube was 80 to 194 cm H(2)O (98.89±26.34 cmH20) when the pouch was filled with saline, and 64 to 128 cmH(2)O (74.78±14.54 cmH20) when the pouch was empty. The difference in mean maximum closure pressure in the full and empty pouches was statistically significant (t=-7.58 and P=0.00003). Conclusions This study indicates that the continent mechanism of tapered ileum may be greatly enhanced by extramural support from the abdominal and pouch walls.     

应用重组内皮抑素腺相关病毒抑制内皮细胞趋化运动

【目的】检测重组内皮抑素腺相关病毒(rAAV-Endostatin)感染膀胱癌细胞后内皮抑素的分泌及其对内皮细胞趋化运动的抑制作用,为rAAV-Endostatin抑制膀胱癌血管生成基因治疗提供依据。【方法】以rAAV-Endostatin感染膀胱癌EJ细胞,24 h后ELISA法测定上清液中内皮抑素浓度;以该上清液为条件介质,Tran-swell法检测其对血管内皮细胞趋化运动的抑制作用。【结果】rAAV-Endostatin转染EJ细胞后上清液中内皮抑素浓度为54.09 ng/ml,经Transwell检验,该上清液对血管内皮细胞趋化运动的抑制率为37.45%。【结论】rAAV-Endostatin是介导内皮抑素基因治疗的有效载体,为膀胱癌的原位基因治疗奠定了基础。