目的 探讨全胸腔镜下Box Lesion双极射频消融术治疗单纯性房颤的围手术期护理方法与要点。方法 对2011年5月－2011年9月拟行全胸腔镜下Box Lesion双极射频消融（双侧肺静脉+左心房后壁隔离）治疗的6例心房纤颤患者，术前做好心理疏通及各项手术准备；术后采取各项对症措施加强呼吸道、心律、引流、疼痛等监测与护理。 结果 6例患者均在术后即刻转复为窦性心律，无死亡，无并发症发生，术后7 d均顺利出院。出院后4周复查均为窦性心律。 结论 全胸腔镜下行Box-lesion双极射频房颤术是治疗单纯性房颤的有效手段，严密的观察及精心护理是手术顺利施行和疾患治愈的重要因素。
【摘要】 目的 研究双侧迷走神经切断对肺缺血再灌注引起的氧化应激反应的影响。 方法 将24只健康雄性新西兰大白兔随机分为:假手术组（S组）、缺血再灌注组（IR组）、双侧迷走神经切断合并缺血再灌注组（NIR组）。缺血前和再灌注末抽取动脉血进行血气分析，观察动脉血氧分压PaO2及肺泡动脉氧分压差（A-aDO2）的变化。再灌注末取肺组织检测肺的湿干重比值（W/D）和氧化应激指标，包括丙二醛（MDA）、超氧化物歧化酶（SOD）及过氧化氢酶（CAT）。 结果 与S组比较，缺血再灌注明显降低了PaO2，增加了A-aDO2和W/D值，增加了肺组织MDA含量并降低了SOD、CAT活性；双侧迷走神经切断进一步降低了SOD活性。 结论 切断实验兔的双侧迷走神经，降低了肺组织抗氧化酶-超氧化物歧化酶的活性，提示迷走神经在降低肺缺血再灌注引起的氧化应激反应中发挥了重要的调节作用。【Abstract】 Objective To evaluate the effect of bilateral vagal nerves transection on lung ischemia-reperfusion induced oxidative stress. Methods A total of 24 New Zealand male rabbits were randomly divided into 3 groups: sham group (S group), ischemia-reperfusion group (IR group), and bilateral vagal nerves transection with ischemia-reperfusion group (NIR group). Before ischemia and at the end of reperfusion, arterial blood samples were collected for blood gas analysis. Arterial partial pressure of oxygen (PaO2) and alveolo-arterial oxygen tension difference (A-aDO2) were detected. At the end of reperfusion, lung tissues were obtained to measure wet/dry weight ratio (W/D). Evaluation of oxidative stress indicators, including content of lung malondialdehyde (MDA), superoxide dismutase enzyme (SOD) and catalase (CAT) activities was also performed. Results Compared with the S group, lung ischemia-reperfusion significantly decreased the PaO2, elevated A-aDO2 and lung W/D weight ratio. At the same time, MDA level in the lung tissue was elevated and SOD and CAT activities were decreased. After bilateral vagal nerves transection, SOD activity was further decreased. Conclusion Transection of bilateral vagal nerves reduced the activity of antioxidant enzyme, especially superoxide dismutase in lung tissue, suggesting that the integrity of the vagal nerves plays an important regulatory role in ischemia-reperfusion mediated oxidative stress in the lung.
Objective To evaluate the safety and efficacy of procedure for prolapse and hemorrhoids （PPH） combined with Shaobei injection in treatment for obstructed defecation syndrome （ODS） caused by rectocele. Methods Seventy-two female patients with rectocele from December 2009 to January 2011 in this hospital were divided into PPH combined with Shaobei injection group （36 cases） and only PPH group （36 cases）. The Longo ODS score was performed on week one，month one，month three，and month six after operation，respectively；pain was evaluated， complications such as urine retention，postoperative bleeding，and anal function were observed；hospital stay and recovery work time were recorded in two groups. Results All patients were followed up for 6 months，there were no significant differences in complications，hospital stay，and the Longo ODS score on week one and month one after operation between two groups （P＞0.05）. But the Longo ODS score of the PPH combined with Shaobei injection group on month three and month six after operation were significantly lower than those of the only PPH group （P＜0.05）. Conclusion PPH combined with Shaobei injection has a better efficacy as compared with only PPH，and at least as safe as only PPH.
In order to accurately localize the image coordinates and serial numbers of intraoperative subdural matrix electrodes, a matrix electrode localization algorithm for image processing is proposed in this paper. Firstly, by using point-by-point extended electrode location algorithm, the electrode is expanded point-by-point vertically and horizontally, and the initial coordinates and serial numbers of each electrode are determined. Secondly, the single electrode coordinate region extraction algorithm is used to determine the best coordinates of each electrode, so that the image coordinates and serial numbers of all electrodes are determined point-by-point. The results show that the positioning accuracy of electrode serial number is 100%, and the electrode coordinate positioning error is less than 2 mm. The algorithms in this paper can accurately localize the image coordinates and the serial numbers of a matrix electrode arranged in an arc, which could aid drawing of cortical function mapping, and achieve precise positioning of brain functional areas, so that it can be widely used in neuroscience research and clinical application based on electrocorticogram analysis.
ObjectiveTo explore the therapeutic effect and safety of irreversible electroporation (IRE) ablation technique on esophageal cancer.MethodsAn ECM830 electroporator was used for IRE treatment on esophageal cancer cells EC109 and KYSE30. According to the different electric field intensity, five groups were assigned: a control group, a 500 V/cm group, a 1000 V/cm group, a 1500 V/cm group, and a 2 000 V/cm group. After 24 h, methyl thiazolyltetrazolium (MTT) was used to detect the cell proliferation of each group. Western blotting was performed to evaluate the expression of apoptosis proteins in cells before or after IRE treatment. Eight healthy BALB/c nude mice were equally divided into two groups: a control group (n=4) and an IRE group (n=4). EC109 was used to establish subcutaneous transplantation tumors and subsequently the mice in the IRE group were treated with flat electrode. The weight and volume of tumors were measured after 14 days. Ten healthy New Zealand white rabbits were equally divided into two groups: a control group (n=5) and an IRE group (n=5). After exposing the abdominal cavity, the abdominal esophagus of the IRE group was treated with flat electrode. Seven days later, the esophagus was extracted for HE and Masson staining.ResultsWhen the electric field intensity was low (500 V/cm), there was no change in esophageal cancer cells proliferation after IRE treatment compared to the control group (EC109: P=0.385, KYSE30: P=0.600). With the increase of electric field intensity, the influence of IRE on the proliferation of esophageal cancer cell gradually increased. When it reached 2 000 V/cm, there was basically no cell viability after IRE treatment (P<0.001). The results of Western blotting showed that the expression of cleaved caspase-3 increased after IRE treatment (P<0.01). Animal experiments indicated that the weight and volume of tumors in nude mice reduced (P<0.05) and the growth of tumors was slowed down after IRE treatment. In addition, the parenchymal cells of rabbit esophagus were largely damaged, while interstitial tissues such as fibers were well preserved.ConclusionIRE ablation has the potential to inhibit the proliferation of esophageal cancer cell and slow down the tumor growth.What’s more, it is safe for the esophagus.
ObjectiveTo investigate the level of serum long non-coding RNA antisense non-coding RNA INK4 locus (LncRNA ANRIL) in patients with ulcerative colitis (UC), and to analyze the diagnostic value of serum LncRNA ANRIL level in UC. MethodsA total of 143 UC patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from February 2015 to November 2019 were retrospectively analyzed, and 145 healthy people with normal physical examination in the First Affiliated Hospital of Henan University of Science and Technology were selected as the control group. The relationship between serum LncRNA ANRIL level and PCT/IL-17 level was analyzed, the serum levels of LncRNA ANRIL, PCT, and IL-17 were compared between the two groups, and their diagnostic value for UC was explored.ResultsThe disease degree of 143 UC patients: 41 cases were mild, 59 cases were moderate, and 43 cases were severe; endoscopic grade: 38 cases were grade Ⅰ, 65 cases were grade Ⅱ, and 40 cases were grade Ⅲ. Compared with the control group, the serum levels of LncRNA ANRIL, PCT, and IL-17 were increased in the UC group (P<0.05); the levels of serum LncRNA ANRIL, PCT, and IL-17 in the UC group increased gradually with the increase of disease severity and endoscopic grade (P<0.05). The serum levels of LncRNA ANRIL were positively correlated with the levels of PCT and IL-17 in the UC patients (r=0.596, P<0.001; r=0.492, P<0.001). The area under the curve (AUC) of serum LncRNA ANRIL level in the diagnosis of UC was 0.851, the cut-off value was 1.29, the sensitivity and specificity were 75.5% and 83.4%, respectively. The AUC of serum LncRNA ANRIL combined with PCT in the diagnosis of UC was 0.898, the corresponding sensitivity and specificity were 81.8% and 87.6%, respectively. The sensitivity and diagnostic value of combination of LncRNA ANRIL and PCT were higher than that of serum LncRNA ANRIL alone (Z=2.102, P=0.036). ConclusionsThe serum level of LncRNA ANRIL in UC patients is increased, which has a certain diagnostic value, and it combines with PCT can better predict UC.
【Abstract】 Objective To evaluate the cl inical effect of excising the radial head, repairing or reconstructing themedial collateral l igament (MCL) in treating comminuted fracture of the radial head accompanying by MCL injury. Methods From September 2000 to April 2006, 18 patients with comminuted fractures of radial head accompanying by MCL injury were treated by excision of the radial head, repair or reconstruction of the MCL. Of them, there were 12 males and 6 females,aged 21 to 57 years. Injury was caused by high fall ing in 10 cases and by traffic accidents in 8 cases. According to Mason classifications,13 fractures were of type Ⅲ and 5 of type Ⅳ . Fifteen cases of fresh fractures were operated within 2 weeks, 3 cases of old fractures at 4, 6, and 14 months after injury respectively. Four cases underwent MCL repair and 14 cases underwent MCL reconstruction. Results All the 18 cases were followed up 1-5 years (mean 3 years ). According to Broberg and Morrey scoring system, 4 patients were rated as excellent, 12 as good, 1 as fair, and 1 as poor. The excellent and good rate was 88.9%.Three patients had l ight pain of elbow, 1 patient had moderate pain and the other 14 had no pain. The range of elbow motion was from 110 to 140°(mean 130°). The pronation averaged 75° (35-85°). The supination averaged 80° (65-89°). Compared with normal l imbs, the grip strength decreased by 3% to 28% (mean 15%); the extension strength decreased by 8% to 39% (mean 30%); the flexion strength decreased by 7% to 29% (mean 18%); the pronation strength decreased by 7% to 31% (mean 20%);the supination strength decreased by 15% to 45% (mean 25%). The X-ray films showed that carrying angle increased by 0 to 11°(mean 5° ) under two-newton-meter valgus torque. There were significant differences between injured l imbs and normal l imbs (P lt; 0.05). Conclusion The MCL was the primary valgus stabil izer of the elbow. If the radial head replacement could not becarried out, the repair or reconstruction of the medial collateral l igament was effective.
【摘要】 目的 研究大剂量辣椒素对兔肺P物质和降钙素基因相关肽(CGRP)的影响。方法 将16只成年健康雄性新西兰大白兔随机分为两组:载体组(A)、大剂量辣椒素组(B)。两组动物取样前7 d和前6 d分别于颈部皮下注射等量的载体或者辣椒素(20 mg/mL)。大剂量戊巴比妥钠静脉麻醉处死动物后立即切取左肺下叶,称重,匀浆,离心后取上清液置于-80℃冰箱保存待测P物质和CGRP。结果 A组肺组织中P物质的浓度高于B组(Plt;0.05),而CGRP的浓度两组差异无统计学意义(P＞0.05)。结论 大剂量辣椒素(100 mg/kg)不能完全耗竭兔肺初级感觉神经纤维的神经肽类物质。
Objective To present the concept and explore the diagnosis and treatment strategies of secondary appendicitis. To summarize the clinical features of secondary appendicitis caused by different related factors. Methods The clinical data of 660 patients with a presumptive diagnosis of acute appendicitis between November 2003 and November 2008 in The First Affiliated Hospital of Harbin Medical University were collected and analyzed retrospectively. Five hundred and ninetyfour patients with primary appendicitis (primary appendicitis group), and 66 patients with secondary appendicitis (secondary appendicitis group). Clinical parameters such as fever， nausea or vomit, abdominal pain, abdominal distension, change of defecation habits or characters, tenderness in the right lower abdominal quadrant, acute abdomen, abdominal mass, and WBC were compared between two groups. Results Biopsies of appendectomy were taken in all and the results showed inflammation. The pathogenic factors and cases of primary appendicitis: bacterial infection in 171 cases (25.91%), appendix cavity blocked by fecalith in 386 cases (58.48%), appendix cavity stricture in 33 cases (5.00%), and appendix deformity in 4 cases (0.61%). Sixty-six patients resulted from secondary appendicitis: colon carcinoma in 7 cases (1.06%) receiving laparocolectomy including 5 ascending colon and 2 transverse colon; gynecological disease in 20 cases (3.03%), 7 cases of right ovarian cyst accompanying adnexal torsion receiving oophorocystectomy combining with appendectomy, 5 right rupture of corpus luteum of ovary receiving right ovariectomy combining with appendectomy, 4 acute pelvic inflammation and pelvic abscess receiving transvaginal drainage of pelvic abscess combining with appendectomy, 4 extra-uterine pregnancy receiving right ovariectomy and salpingectomy combining with appendectomy; 9 cases (1.36%) of hernia, all to be right oblique hernia, receiving herniorrhaphy combining with appendectomy; Intestinal tuberculosis in 6 cases (0.91%), 4 cases receiving appendectomy, 1 case for resection of ileocecum, and 1 case for right hemicolectomy; parasitic disease in 24 cases (3.64%), all to receive appendectomy. There were significant differences in nausea or vomit, abdominal pain, abdominal distension, changes of defecation habit or character, tenderness in the right lower abdominal quadrant, abdominal mass, and WBC between two groups (Plt;0.05). There was no significant difference in fever or acute abdomen between two groups (Pgt;0.05). InclusionsAppendicitis could be secondary to many diseases. We must attach importance to the diagnosis of secondary appendicitis so that to decrease or avoid the appearance of missed diagnosis and misdiagnosed in the clinical.
ObjectiveTo detect expressions of cell programmed death ligand 1 (PD-L1) and adenosine 2a receptor (A2aR) proteins in colorectal cancer tissues and investigate its relationship with clinicopathologic features of patients with colorectal cancer.MethodsThe colorectal cancer tissues and corresponding paracancerous tissues of 106 patients with colorectal cancer were collected, the patients underwent surgery in the Affiliated Hospital of Xuzhou Medical University from August 2013 to August 2015. The immunohistochemical staining was used to detect the expressions of A2aR and PD-L1 proteins.ResultsThe positive rates of A2aR and PD-L1 protein expression in the colorectal cancer tissues were significantly higher than those in the corresponding paracancerous tissues, respectively [A2aR: 74 (69.8%) versus 35 (33.0%), χ2=28.721, P<0.001; PD-L1: 57 (53.8%) versus 28 (26.4%), χ2=16.516, P<0.001], which in the colorectal cancer tissues were correlated with the Broders grading (A2aR: χ2=9.198, P=0.010; PD-L1: χ2=8.354, P=0.015), T staging (A2aR: χ2=6.737, P=0.009; PD-L1: χ2=6.437, P=0.011), and TNM staging (A2aR: χ2=4.884, P=0.027; PD-L1: χ2=8.246, P=0.004) and were not correlated with the gender, age, tumor portion, lymph node metastasis and CA19-9 (P>0.05), but the positive rates of A2aR protein expression were correlated with the tumor diameter (χ2=4.386, P=0.036) and CEA positive (χ2=6.315, P=0.012), and the positive rates of PD-L1 protein expression were not correlated with them (P>0.05). The expression of PD-L1 protein was positively correlated with the expression of A2aR in the colorectal cancer tissues (rs=0.237, P=0.027).ConclusionPD-L1 and A2aR protein expressions are higher in colorectal cancer tissues, it is provided that both of them might play an important role in promoting occurrence and development of colorectal cancer.