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find Author "郑建伟" 9 results
  • Problem-Based Learning of Clinical Hepatocellular Carcinoma Teaching Method Under Network Environment

    Objectives To train postgraduate medical students the ability of effectively using network resources and independently studying, and to explore new model of clinical liver cancer teaching. Methods The teaching model of problembased learning (PBL) to clinical liver cancer teaching was applied. Results The teaching model of PBL changed graduate student the status of passive acceptance to active participation. The teaching process was full of livingness, and the teaching quality was improved.Conclusion The teaching model of PBL can break through the limitations of passive acceptance of book knowledge in traditional teaching model and improve the ability to handle the comprehensive clinical knowledge of liver cancer, which provides a new model to the teaching of liver cancer to graduate medical students in clinic.

    Release date:2016-09-08 10:54 Export PDF Favorites Scan
  • Diagnosis and Treatment of Afferent Loop Obstruction after Billroth-ⅡSubtotal Gastrectomy

    目的探讨Billroth-Ⅱ胃大部切除术后输入袢梗阻的诊断和手术方式。 方法本组共17例输入袢梗阻患者,对17例患者的手术史、临床表现及影像学资料进行总结分析。 结果典型的输入袢梗阻表现为上腹胀痛、上腹部触及张力较高且有压痛的囊性包块,腹部CT检查见腹主动脉与肠系膜上动脉之间横向走行的扩张肠管。17例患者均再次行剖腹探查术,术中见输入袢扩张,5例行Braun吻合术,12例行Roux-en-Y吻合术。术后无严重合并症,无围手术期死亡,患者均恢复顺利,梗阻症状消失。术后随访1~4年(平均2.5年),经X线胃肠钡餐检查见吻合口钡剂通过顺利,无狭窄;胃镜检查未见胆汁反流。 结论严格遵守正确的手术操作常规是预防输入袢梗阻的关键;经腹部CT诊断明确后,应尽早再手术;Braun吻合术及Roux-en-Y吻合术为胃大部切除术后输入袢梗阻较理想的术式。

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  • Expression of Caspase-3 in Targeted Therapy with Magnetic Nanoparticle in Cholangiocarcinoma Xenograft of Nude Mice

    Objective To investigate the expression of caspase-3 in xenograft that was treated with targeted therapy with magnetic nanoparticles in nude mice. Methods QBC939 cell lines were injected into nude mice subcutaneously to establish the model of human cholangiocarcinoma xenograft. After two weeks of tumor inoculation, the animal models were divided randomly into 4 groups: group A received placebo (sodium chloride), group B were treated with magnetic nanoparticles (250 mg/kg), group C were treated with magnetic nanoparticles (150 mg /kg) combined with inner-stent, group D with magnetic nanoparticles (250 mg /kg) combined with inner-stent (the inner-stent was used to generate the magnetic targeting effect). The 21th day after treatment, expression of caspase-3 in tumor cells of each groups were measured with histochemical method and RT-PCR. Results The quantity of caspase-3 in tumor cells that were treated with magnetic nanoparticles (250 mg/kg) combined with inner-stent was the most (P<0.05), and the quantity of caspase-3 in cells of group C was significantly more than that of the other two groups (P<0.05). While the quantity of caspase-3 in group B was more than that of the control group(P<0.05). Conclusion The use of magnetic nanoparticles combined with inner-stent may increase the expression of caspase-3, and the expression is dose-dependent with magnetic nanoparticles.

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  • 卵黄管未闭、内疝形成导致肠梗阻1例报告

    患者,男,27岁,因腹痛、腹胀,停止从肛门排便、排气2天伴恶心、呕吐入院。查体: 体温37.0℃,急性痛苦病容,心、肺无异常发现; 腹平坦,未见肠型及蠕动波,未扪及肿块,脐周有轻压痛及局部肌紧张,但无反跳痛、移动性浊音及震水音,肠鸣音1~2次/min,偶有高调肠鸣音,未闻及气过水声。腹部X线透视示一组小肠可见巨大液平面。诊断: 高位肠梗阻。入院后经禁食、持续胃肠减压、补液、抗炎及对症治疗24小时,但症状仍逐渐加重。体温37.8℃,上腹部膨隆,叩诊呈鼓音,腹透示左上腹有4个巨大液平面。遂在全麻下行急诊剖腹探查术。术中见腹腔内有约400 ml淡红色清亮渗液,有约1 m长的空肠及系膜呈“W”形顺时针疝入由未闭之卵黄管形成的“C”形回肠憩室疝环(约300°),造成肠管完全性闭绊性梗阻。该段肠管壁水肿、瘀血,呈暗红色,有散在瘀斑,肠腔扩张显著,肠管蠕动明显减弱。行肠减压术,待该肠段松弛后,在距腹壁约3.0 cm处将卵黄管盲端切断,缝扎断端,从根部切断憩室,全层加浆肌层缝合修补回肠侧壁,检查可通过一指后,于肠管修补处近端约10 cm处放置菌形造瘘管。再次检查梗阻部位,见肠管蠕动良好,血运显著改善。温盐水反复冲洗腹腔,于盆腔置血浆引流管。术后诊断: ①高位肠梗阻; ②内疝; ③卵黄管未致回肠憩室。术后行抗感染、止血、对症及支持治疗,痊愈出院。

    Release date:2016-08-28 04:47 Export PDF Favorites Scan
  • 胰床U形管引流术在高原地区重症胰腺炎中的应用

    Release date:2016-08-28 04:49 Export PDF Favorites Scan
  • 冠心病术后胸骨钢丝断裂误诊为心绞痛一例

    Release date:2016-08-30 06:16 Export PDF Favorites Scan
  • 奥曲肽治疗胆瘘7例报告

    Release date:2016-08-28 05:30 Export PDF Favorites Scan
  • 心脏手术体外循环中心包血回输对凝血系统功能的影响

    摘要:  目的 探讨心脏手术体外循环(CPB) 中心包血回输对凝血系统功能的影响及作用。 方法 将24 例行二尖瓣置换术患者随机分为心包血回输组和心包血不回输组, 每组12 例。分别于术前5min、肝素化后10min、CPB30min 和CPB 结束时采集体循环血; CPB 结束时同时采集心包血。用酶联免疫吸附分析(ELISA ) 法检测组织因子(TF)、D-二聚体(D-D) 的血浆含量。 结果 两组体循环D-D 和TF 在CPB 30min、CPB 结束时分别较本组术前明显增高(P lt; 0. 05)。心包血不回输组体循环D-D 和TF 在CPB30min、CPB 结束时较心包血回输组明显降低, 两组比较差异有统计学意义(P lt; 0. 01)。两组心包血D-D 和TF 较同时循环血中D-D 和TF 明显升高(P lt; 0. 05) , 全血激活凝血时间(ACT) 缩短。 结论 直视心脏手术CPB 中心包血可激活凝血系统, TF 通过外源性凝血途径激活凝血系统。

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • Effect of CDM3 on the co-culture of human induced pluripotent stem cells with matrigel-coated polycaprolactone to make cardiac patch

    ObjectiveTo provide experimental data and theoretical support for further studying the maturity of cardiac patches in other in vitro experiments and the safety in other in vivo animal experiments, through standard chemically defined and small molecule-based induction protocol (CDM3) for promoting the differentiation of human induced pluripotent stem cells (hiPSCs) into myocardium, and preliminarily preparing cardiac patches. MethodsAfter resuscitation, culture and identification of hiPSCs, they were inoculated on the matrigel-coated polycaprolactone (PCL). After 24 hours, the cell growth was observed by DAPI fluorescence under a fluorescence microscope, and the stemness of hiPSCs was identified by OCT4 fluorescence. After fixation, electron microscope scanning was performed to observe the cell morphology on the surface of the patch. On the 1st, 3rd, 5th, and 7th days of culture, the cell viability was determined by CCK-8 method, and the growth curve was drawn to observe the cell growth and proliferation. After co-cultured with matrigel-coated PCL for 24 hours, hiPSCs were divided into a control group and a CDM3 group, and continued to culture for 6 days. On the 8th day, the cell growth was observed by DAPI fluorescence under a fluorescence microscope, and hiPSCs stemness was identified by OCT4 fluorescence, and cTnT and α-actin for cardiomyocyte marker identification. ResultsImmunofluorescence of hiPSCs co-cultured with matrigel-coated PCL for 24 hours showed that OCT4 emitted green fluorescence, and hiPSCs remained stemness on matrigel-coated PCL scaffolds. DAPI emitted blue fluorescence: cells grew clonally with uniform cell morphology. Scanning electron microscope showed that hiPSCs adhered and grew on matrigel-coated PCL, the cell outline was clearly visible, and the morphology was normal. The cell viability assay by CCK-8 method showed that hiPSCs proliferated and grew on PCL scaffolds coated with matrigel. After 6 days of culture in the control group and the CDM3 group, immunofluorescence showed that the hiPSCs in the control group highly expressed the stem cell stemness marker OCT4, but did not express the cardiac markers cTnT and α-actin. The CDM3 group obviously expressed the cardiac markers cTnT and α-actin, but did not express the stem cell stemness marker OCT4. ConclusionhiPSCs can proliferate and grow on matrigel-coated PCL. Under the influence of CDM3, hiPSCs can be differentiated into cardiomyocyte-like cells, and the preliminary preparation of cardiac patch can provide a better treatment method for further clinical treatment of cardiac infarction.

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