腹腔镜疝手术的临床应用

目的总结应用腹腔镜技术治疗腹股沟疝及切口疝的手术抉择、临床效果及并发症.方法回顾性分析2004年10月至2009年12月期间对腹股沟疝和切口疝行腹腔镜手术71例患者的临床资料,其中腹腔镜小儿腹股沟斜疝疝囊高位结扎43例(51侧),TAPP25例(31侧),腹腔镜切口疝修补术3例.结果无一例中转开放手术.平均手术时间34.5 min,术中出血量5 ml,术后并发症发生率为11%(5/71),其中血清肿2例,阴囊气肿4例,腹股沟区血肿2例,术后平均住院时间2.8 d,术后随访1~12个月均未出现疝复发、慢性神经性疼痛、异物感、补片及切口感染等.结论腹腔镜疝手术安全性良好、复发率低、术后疼痛轻、并发症少及术后住院时间短;对于疝开放手术术后复发、双侧疝、复合疝等是首选术式,并可避免隐匿疝的遗漏.参4.     

甲氨喋啶联合米非司酮及中药治疗输卵管妊娠的疗效观察

近年来输卵管妊娠发病率居高不下,且多发生于年轻女性.随着检测手段的提高,其早期诊断率也明显提高.如何选择经济、简便、对患者损伤小的治疗方式成为临床医务工作者探讨的方向.通过我院对2002年1月～2005年1月的异位妊娠挑选60例采用甲氨喋啶、米非司酮及中药联合保守治疗.结果60例异位妊娠患者中,保守成功53例,成功率88.33%,血β—HCG降至正常需12±30d,盆腔包块消失需28～42d,月经恢复约需30～40d,月经后输卵管通液术发现全部通畅(除1例未复诊外),毒副反应不大.得出甲氨喋啶、米非司酮配伍中药治疗疗效肯定,值得推广的结论.     

内镜超声联合经肛门内镜微创手术治疗直肠肿瘤29例体会

目的:总结内镜超声联合经肛门内镜微创手术(transanal endoscopic microsurgery,TEM)治疗经验,探讨其在直肠肿瘤中的治疗效果.方法:回顾分析我院2009年7月-2011年9月29例内镜超声联合经肛门内镜微创手术治疗直肠肿瘤患者临床资料,其中为直肠腺瘤12例,早期直肠癌和腺瘤癌变10例,直肠炎性息肉及直肠间质瘤等粘膜下结节共7例.距肛缘为5～15 cm.术后平均随访5～17月.结果:29例全部成功完成TEM术式,其中2例术后病理证实为T2期直肠癌1,例进一步扩大手术行TME,另1例拒绝进一步手术而放弃.肠壁全层切除17例,粘膜下及部分肌层切除12例.所有标本切缘均为阴性.手术时间35～130 min,平均时间70 min;术中失血2～20 mL,平均失血7 mL.术后并发出血2例,泌尿系感染1例.术后住院日3～8 d,平均住院日5 d;术后随访5～17月,除1例外未发现肿瘤复发及转移.结论:内镜超声联合TEM治疗直肠肿瘤具有定位准确、手术创伤小、出血少、恢复快等优点,是直肠肿瘤局部切除理想的方法,但须严格掌握适应症.图3,参10.     

30例10 kg以下心脏直视手术护理配合体会

目的:总结30例10 kg以下患儿心脏直视手术的护理经验,增强巡回护士、器械护士在患儿体重10 kg以下心脏直视手术的配合意识以及协助手术医师提高手术成功率,共同促进患儿术后顺利康复.方法:收集2010年10月-2013年4月该小组(巡回及器械护士)参与我院胸心外科运用体外循环进行30例先天性心脏病手术资料,并从中对护理配合要点及体会进行总结分析.结果:30例患儿手术过程顺利,1例患儿在术后第三天死亡,死亡原因为肺部感染(术后尸检证实).讨论:术前精心访视、宣教、心理疏导,术中积极主动配合,术后平稳转运是手术顺利完成及术后患儿健康恢复的关键.     

黄河源区退化高寒草地土壤种子库:种子萌发的数量和动态

对青藏高原黄河源区不同退化程度高寒草地的土壤种子库土样用土壤分析筛进行浓缩,并以萌发法分析土壤种子库萌发种子数量和动态.结果表明,孔径0.25~2 mm的土壤分析筛分离土样中萌发种子可达萌发种子总量的85%~97%,而小于0.25 mm的土样中未发现种子.因此,用0.25 mm孔径大小的土壤筛对高寒草地土壤种子库土样进行大规模浓缩是一种方便、可靠的方法.4种不同退化程度高寒草地(A:未退化草甸;B:轻度退化草甸;C:中度退化草甸;D:重度退化草甸)的土壤种子库在实验室条件下萌发的种子数量分别为:A 1 194~3 744粒/m2,平均2 421.3粒/m2;B 5 376~1 0912粒/m2,平均7 786.7粒/m2;C 2 304~1 3216粒/m2,平均8 695.5粒/m2;D 4 768~12 352粒/m2,平均8 125.9粒/m2.除样地A外,其它3个样地的可萌发种子数量差异不大.单子叶植物种子在培养到d 10左右开始萌发,双子叶植物在5~7 d内开始萌发,前者3 wk后基本不再萌发,后者5 wk左右停止萌发.4个样地土壤种子库种子萌发主要集中在第2~3周,并表现出近似单峰型格局.图1表3参39     

油松毛虫感染白僵菌后体内蛋白质、酯酶和多酚氧化酶的变化

采用分光光度法测定了油松毛虫(Dendrolimus tabulaeformisTsai et Liu)3~5龄幼虫被病原物白僵菌(Beau-veria bassiana)感染后,其体内蛋白质的含量和多酚氧化酶活性的变化;结果表明,被白僵菌感染后1~8d,虫体内蛋白质含量持续下降,而未感染的则变化不大;多酚氧化酶(PPO)的活性呈现出先升高后下降的趋势.利用聚丙烯酰胺凝胶电泳技术,分析了染菌后1~7d幼虫体内酯酶同工酶的变化;结果显示,染菌后的3、4龄幼虫体内酯酶同工酶酶谱与对照相比,酶带数量变化较大,未染菌的为3条酶带,感染病菌后变为1条和2条.与其相比,5龄幼虫染菌后酯酶同工酶的酶带数量没有变化,只是酯酶的活性及含量比对照有明显减弱趋势.图2表5参16     

油松毛虫感染白僵菌后超氧化物歧化酶和过氧化氢酶的变化

采用分光光度法测定了3~5龄油松毛虫(DendrolimustabulaeformisTsaietLiu)幼虫被白僵菌(Beauveriabassi ana)感染后保护酶的活性.结果表明: 3~5龄油松毛虫被白僵菌感染后1 ~8d,体内超氧化物歧化酶(SOD)活性显著高于同期未感染的幼虫,并呈现出先升高后下降的变化趋势,而同期未感染的幼虫变化不大;过氧化氢酶(CAT)的活性也呈现出先升后降的趋势.利用聚丙烯酰胺凝胶电泳技术,分析了感染后1~8d幼虫体内SOD同工酶与CAT同工酶的变化.结果显示:SOD同工酶带宽与酶带亮暗变化显著;CAT同工酶酶谱有所差异,酶带数由感染初期的一条变为后期的两条带,而且带宽值与酶带亮暗变化显著. 图3表2参16     

颅内动脉瘤夹闭术围手术期的护理

目的:探讨颅内动脉瘤夹闭术围手术期的护理要点.方法:对我科2011年1月～2012年5月收治的100例动脉瘤夹闭术患者进行细致的围手术期护理,严密观察病情,术前预防动脉瘤再破裂出血,积极做好术前准备,术后做好引流管、并发症及康复等护理.结果:100例动脉瘤夹闭术患者,80例无任何并发症治愈出院,15例出现一侧肢体偏瘫,经术后康复治疗,随访3～6个月均恢复,5例死亡.结论:精心细致的围手术期护理,可有效提高手术成功率及治愈率,改善患者术后生活质量.     

南昌市道路尘PM2.5中重金属分布特征及健康风险评价

为了解南昌市道路尘PM_(2.5)中重金属元素的分布特征和健康风险,利用颗粒物再悬浮采样器采集了道路尘中的PM_(2.5)样品,用电感耦合等离子体质谱仪和原子荧光光谱仪测定了样品中11种重金属元素的含量.结果表明,道路尘PM_(2.5)中Mn、Zn、Cr、Cu、Pb、V、As、Ni、Co、Cd和Hg的平均含量分别为1014、208.17、106.47、102.40、62.12、39.59、28.93、24.07、7.86、0.58、0.53 mg·kg~(-1),除V和Co外均大于南昌市土壤元素背景值,整体上次干道和支路的金属含量会高于主干道重金属的含量,比国内外其他城市相对要低.地累积指数结果显示,Cd、Hg、Cu、Mn和Zn处于偏中度污染,As和Pb属于轻度污染,其余元素处于无污染水平.日均暴露剂量表明,Mn在儿童的非致癌日均暴露剂量最高(摄食:2.83×10~(-3) mg·(kg·d)~(-1),呼吸吸入:2.50×10~(-7) mg·(kg·d)~(-1),皮肤接触:6.87×10~(-6) mg·(kg·d)~(-1)),经口摄食是人体暴露的主要途径,Cr的终身暴露剂量最高(儿童:8.63×10~(-9) mg·(kg·d)~(-1),成年男性:9.12×10~(-9) mg·(kg·d)~(-1),成年女性:8.12×10~(-9) mg·(kg·d)~(-1)).11种重金属对儿童、成年女性和成年男性的非致癌风险值之和分别为0.58,0.19和0.17,小于可接受风险值1.0,As、Cr、Mn是主要贡献元素;5种致癌元素(Cr、As、Co、Ni和Cd)经呼吸途径对人体的总致癌风险值均小于可接受水平10~(-6),成年男性(4.29×10~(-7))略高于儿童(4.06×10~(-7))和成年女性(3.82×10~(-7)),Cr和As是主要贡献元素.     

不同温度下四川马尔康岷江柏种子的发芽特征

通过对不同温度下岷江柏(CupressuschengianaS. Y. Hu)种子的发芽特征研究,分析了种子的发芽周期和最适发芽温度,以及温度对种子发芽的影响,并讨论了岷江柏的发芽特征与环境温度的关系.结果表明,种子发芽周期为20d,其中0~5d为准备期, 5~15d为对数期.种子发芽温度为5~30℃,适宜发芽温度为10~25℃, 5℃和30℃均不利于种子发芽.在贮藏过程中,贮藏开始阶段10℃不利于种子发芽, 10~25℃贮藏4~10mo后的发芽率没有差异.种子最适发芽温度在2003年1月、4月、7月和10月分别为25℃、10℃、15℃和25℃.在不同温度下,种子发芽率没有差异,而种子发芽势和达到50 %发芽的天数有显著差异.岷江柏种子的发芽周期和最适发芽温度,以及贮藏过程中的发芽特征与环境温度有着密切的关系,这是它对自然环境的一种适应表现. 图3表2参30     

Nitrogen retention in urban lawns and forests

Lawns are a dominant cover type in urban ecosystems, and there is concern about their impacts on water quality. However, recent watershed-level studies suggest that these pervious areas might be net sinks, rather than sources, for nitrogen (N) in the urban environment. A 15N pulse-labeling experiment was performed on lawn and forest plots in the Baltimore (Maryland, U.S.A.) metropolitan area to test the hypothesis that lawns are a net sink for atmospheric-N deposition and to compare and contrast mechanisms of N retention in these vegetation types. A pulse of 15N-NO3-, simulating a precipitation event, was followed through mineral soils, roots, Oi-layer/thatch, aboveground biomass, microbial biomass, inorganic N, and evolved N2 gas over a one-year period. The 15N label was undetectable in gaseous samples, but enrichment of other pools was high. Gross rates of production and consumption of NO3- and NH4+ were measured to assess differences in internal N cycling under lawns and forests. Rates of N retention were similar during the first five days of the experiment, with lawns showing higher N retention than forests after 10, 70, and 365 days. Lawns had larger pools of available NO3- and NH4+; however, gross rates of mineralization and nitrification were also higher, leading to no net differences in NO3- and NH4+ turnover times between the two systems. Levels of 15N remained steady in forest mineral soils from day 70 to 365 (at 23% of applied 15N), but continued to accumulate in lawn mineral soils over this same time period, increasing from 20% to 33% of applied 15N. The dominant sink for N in lawn plots changed over time. Immobilization in mineral soils dominated immediately (one day) after tracer application (42% of recovered 15N); plant biomass dominated the short term (10 days; 51%); thatch and mineral-soil pools together dominated the medium term (70 days; 28% and 36%, respectively); and the mineral-soil pool alone dominated long-term retention (one year; 70% of recovered 15N). These findings illustrate the mechanisms whereby urban and suburban lawns under low to moderate management intensities are an important sink for atmospheric-N deposition.     

术后早期急性炎性肠梗阻的观察及护理

目的探讨术后早期急性炎性肠梗阻（EPII）的临床表现、治疗方法及护理．方法回顾性分析86例EPII的临床表现、治疗及护方法．结果EPII发生在术后4-21d,肠蠕动一度恢复,继而又出现呕吐,腹胀,腹痛等肠梗阻表现,大部分病例非手术治愈,仅少部分手术治疗．结论EPII以非手术治疗为主,积极的心理干预及护理有助于疾病康复．表2,参14．     

Effect of fomesafen on glutathione S-transferase and cellulase activity and DNA damage in the earthworm (Eisenia fetida)

Biochemical responses and DNA damage of earthworm (Eisenia fetida) exposed to various concentrations of fomesafen (0, 10, 100, and 500 μg kg^?1) for 3, 7, 14, 21, and 28 days were investigated in vivo. Glutathione S-transferase (GST) activity was significantly stimulated upon treatment with 500 μg kg^?1 fomesafen for 21 days, while the cellulase activity was markedly inhibited after 14 days of treatment. On day 28, the activities of GST and cellulase had recovered to the level similar to that of controls. Low or mild DNA damage in earthworm was induced within 14 days of exposure, and the damage was reduced or disappeared with the extension of exposure.     

红壤丘陵区LAI与土壤侵蚀分布特征的关系

叶面积指数(LAI)是常用的一个用于描述植被覆盖的方面指数,土壤侵蚀的分布又与植被的覆盖状况息息相关,这就意味着LAI与土壤侵蚀有一定的相关性,目前有关这二者的相关性研究还鲜有文献报道。基于这此,本研究首先利用2000年的遥感影像(TM)解释出该年度的土壤侵蚀强度图,再利用该遥感影像通过图像的代数运算得出该地区的NDVI栅格图,通过实测该县不同典型植被条件的LAI值,得出实测的LAI与图像NDVI值之间的函数关系式,由图像的代数运算把NDVI图转换成LAI图,即实现了遥感图像的实测LAI纠正。在GIS软件的帮助下,通过将LAI栅格图与土壤侵蚀强度图的空间叠加分析,得到不同LAI条件下的土壤侵蚀分布。结果表明,LAI与土壤侵蚀的分布表现为:大致以LAI=2为分界线,当LAI<2时,土壤侵蚀并未随LAI的增加而迅速减少,LAI>2时,土壤侵蚀的分布随植被指数的增加而减少,当LAI=2左右时,土壤侵蚀的面积最大。这种情况对于轻度、中度及强度土壤侵蚀的影响是类似的,都呈类正态分布的曲线形式,但在曲线的两侧土壤侵蚀类型是有本质区别的,在曲线的左侧土壤侵蚀类型的分布是中度和强度为主,而在曲线右侧则以轻度为主。表明LAI这个指标与土壤侵蚀有很好的相关性,可以用于土壤侵蚀方面的相关研究工作。     

雨雪冰冻灾害后粤北森林各林型凋落物动态

为了考察中国亚热带不同森林类型对雨雪冰冻灾害的响应模式,以粤北天井山3种代表性的林型—针叶林、阔叶林和混交林为对象,于不同森林类型中比较受损森林与未受损森林在凋落物年产量、成分及月际动态方面的差异,从而在凋落物水平上反映不同森林类型在雨雪冰冻灾害后的早期恢复力。研究结果表明,灾后针叶林、阔叶林和混交林的年凋落量分别为0.52、3.21、1.37 t.hm-2,比未受损的同种森林类型年凋落量显著减少,减少程度分别为87.89%、53.46%、76.78%。由此可以看出阔叶林的植被恢复情况最好,说明在凋落物水平上,其灾后恢复的早期阶段恢复力最强。在凋落物成分方面,灾后各森林类型叶凋落物所占比例显著增加,枝凋落物所占比例则显著减少。受损针叶林和阔叶林的凋落物月动态与未受损森林基本一致,但其波动幅度较小;在混交林中,受损和未受损森林其凋落量的季节动态模式则表现出不一致性且为不规则型。根据研究结果,建议在亚热带地区优先考虑种植阔叶林以促进受损森林在类似雨雪冰冻灾害的极端天气后的恢复。     

Effect of pine mistletoe on radial growth of Crimean pine (Pinus nigra) in Turkey

In this study, the influence of infection by pine mistletoe (Viscum album L. subsp. austriacum (Wiesb.) Volmann) on the radial growth of crimean pine (Pinus nigra Amold) in Turkey was investigated. We built local residual tree-ring-width chronologies using dendrochronogical techniques. Tree ring chronologies of uninfected (control) crimean pine were used to estimate potential radial growth characteristics in the "infected" crimean pine (light, moderate and severe infection groups). In 2005, increment cores were collected from 26 infected and 19 control dominant or co-dominant trees and annual radial growth indices from 1930-2005 were calculated for each infection group in a 14 point sampling. We compared radial growth in the uninfected trees with mean regional chronology. We found a strong decrease in radial growth in during the 1998-2005 period. The periodic average radial growth reduction (in %) from 1998 to 2005, respectively, were 0 for control, 26 for light, 39 for moderate and 63 for severe infection groups. It can be especially concluded that a severe degree of pine mistletoe attack has a negative effect on radial growth of the infected crimean pine trees.     

水分胁迫对短葶山麦冬生长和总皂苷量的影响

以盆栽的短葶山麦冬为材料,采用称重控制浇水的方法,设置对照(CK)、轻度胁迫(W1)、中度胁迫(W2)、重度胁迫(W3)4个处理[土壤含水量分别为土壤田间持水量(FC)的80%、65%、50%和35%],研究不同程度土壤水分胁迫对短葶山麦冬生长和总皂苷量的影响规律.结果表明:短葶山麦冬生物量总体分配格局表现为叶片>根茎>须根>叶基>块根.在胁迫至d 75(块根发生期)和d 130(块根膨大前期)时中度胁迫(50%FC)组具有最大的叶片和须根生物量及须根分配比例,d 195(块根膨大后期)时对照(80%FC)具有最大的叶片和须根生物量,但各处理差异未达显著水平.随土壤水分胁迫的加剧,叶生物量分配比例总体呈下降趋势.中度胁迫组具有最大的块根生物量和块根分配比例及根冠比,而重度胁迫推迟了块根的萌生.各土壤水分条件下须根总皂苷含量差异不显著,对照的须根总皂苷产量显著高于轻度和重度胁迫组.表明短葶山麦冬对土壤水分有较强的适应性,随土壤水分减少,趋于将更多的资源分配给根系以提高根冠比,50%FC土壤水分条件可提高块根产量,80%FC下可获最大的须根总皂苷产量.图3表1参19     

Slow developing demersal embryos and larvae of the antarctic sea star Odontaster validus

The early development of Odontaster validus at McMurdo Sound, Antarctica, is indirect and includes equal cleavage, a convoluted blastula, a free-swimming coeloblastula, a gastrula, and a feeding bipinnaria larva. Development differs from that of other asteroids in two respects: (1) The developmental rate is extremely slow; blastulae form nearly 2 days after fertilization, gastrulation begins after 7 days, and the bipinnaria develops in about 40 to 55 days. The slow developmental rate appears to be only partly related to the low environmental temperature (-1.5°C). (2) The embryos and larvae are largely demersal. Such behavior may be an adaptation to keep the larvae out of antarctic surface waters, as does brooding in many other polar echinoderms.     

In situ rates of body growth and palp regeneration of a spionid polychaete following simulated sublethal predation

Sublethal predation can be a significant trophic pathway in sediment communities, and the regeneration of damaged tissue affects the activity, growth, and reproduction of prey. A field experiment was conducted 12–18 July 2010 in the Tijuana Estuary, California (+32.56617°, −117.13152°), to measure in situ rates of body growth and palp regeneration of the polychaete Polydora cornuta after simulating sublethal predation by removing 2, 1, or 0 palps from labeled individuals. After 3 days in the field, individuals that had 2 palps removed grew significantly slower than worms that had 0 palps removed; 1-palp worms had intermediate growth. After 6 days in the field, rates of body growth were faster than those of worms recovered after 3 days, with similar trends among the three palp treatments. During the 3-day transplantation, removed palps regenerated to half the initial length of unmanipulated palps. After 6 days, palp lengths did not differ significantly among treatment groups, indicating complete regeneration. The regeneration rate of removed palps was significantly faster than the growth rate of undamaged palps, and palp regeneration rate did not differ significantly between worms that had 1 or 2 palps removed.     

单甲脒农药对模型池塘生态系统藻类群落结构的影响

在１．５－５０．０ｍｇ／Ｌ的浓度范围内，单甲脒农药对模型池塘生态系统中的浮游植物群落结构有明显影响。尤其在加药的头４ｄ内，藻类种类、数量、多样性指数、种类数比及增长率明显下降，优势比显著上升，敏感种及清洁种减少甚至消失，高浓度（５０．０ｍｇ／Ｌ）的单甲脒在２ｄ内可把藻类全部杀灭。随试验时间的延长，药物不断降解，６ｄ后藻类种类、数量、多样性指数又不断回升。随加药次数的增多，药物对藻类抑制作用明显减弱，藻类的种类、数量、多样性指数等指标不断上升，尤其是藻类数量增加明显，试验后期，藻类数量高低主要受Ｎ、Ｐ浓度大小的影响。