食管癌切除结肠代食管术44例

我们于１９８９年３月至１９９３年８月间，为４４例食管癌病人行食管癌切除、结肠代食管术。包括上段癌２３例，中段癌１８例，下段癌３例；其中上段癌病变长于７ｃｍ者６例，中段癌病变长于８ｃｍ者５例及下段癌中２例既往曾行胃大部切除术且病变长于９ｃｍ者均先行术前放疗，放疗剂量为３０～４０Ｇｙ。４０例（９０．９％）以结肠左动脉升支供血的横结肠行顺蠕动方向吻合，结果手术死亡１例，颈部吻合口瘘９例（２０．４５％）。我们认为本术式对中、上段癌病人疗效较满意，建议多采用以结肠左动脉为血供的横结肠作为移植段行顺蠕动方向吻合，为减少术后并发症，应注意加强病人围手术期的处置和护理。     

老年ICU-AW患者超声测得四肢骨骼肌厚度与MRC评分相关性及对预后的预测ROC曲线分析

目的 探讨老年重症加强护理病房(intensive care unit, ICU)获得性肌无力(ICU-acquiredweakness, ICU-AW)患者超声测得四肢骨骼肌厚度与英国医学研究委员会(medical research council, MRC)量表评分相关性,并绘制受试者工作特征(receiver operating characteristic, ROC)曲线评价其对预后的预测价值。方法 选取我院老年ICU-AW患者60例作为研究组,另选取同期老年ICU接受机械通气无ICU-AW患者60例作为对照组,比较2组超声测得四肢骨骼肌厚度、MRC评分,分析四肢骨骼肌厚度与MRC评分的相关性,比较不同预后患者临床资料、四肢骨骼肌厚度、MRC评分,分析四肢骨骼肌厚度、MRC评分与老年ICU-AW患者预后的关系及预测预后的价值。结果 研究组肱二头肌、桡侧腕屈肌、股四头肌、胫前屈肌厚度及MRC评分低于对照组(P<0.05);老年ICU-AW患者肱二头肌、桡侧腕屈肌、股四头肌、胫前屈肌厚度与MRC评分呈正相关(P<0.05);病死患者28 d时机械通气天数高于生存患者,肱...     

生活环境因素暴露对支气管哮喘非急性发作期患者呼出气一氧化氮水平的影响

背景 呼出气一氧化氮(FeNO)的测量具有安全、无创、简便、重复性好等特点已经被广泛应用于哮喘患者气道炎症的评估,但FeNO的测定结果受到多种因素的影响,生活环境因素暴露可能与FeNO水平有较为密切的关系,而目前关于生活环境因素暴露对FeNO水平影响的研究较少。目的 分析生活环境因素暴露对支气管哮喘非急性发作期患者FeNO水平的影响,以提高临床医生利用FeNO管理哮喘的效能。方法 纳入2018年7月至2020年6月就诊于广州医科大学附属第二医院呼吸内科门诊的109例支气管哮喘非急性发作期患者作为研究对象,通过问卷调查的方法收集资料,问卷信息主要包括一般资料(性别、年龄、身高、体质量)、生活环境因素(包括吸烟史,家人在家是否吸烟,过敏史,居住地位置,居住地离车流量大的主干道位置,居住地周围有无工厂,居住房屋楼层,房屋居住年限,床单、被/枕套清洗晾晒的频率,家中窗帘材料,家中有无盆栽花草,家中垃圾桶有无定期清洗,家中有无饲养宠物,家中有无蟑螂,厨房垃圾有无当天处置,家中是否有毛绒玩具),并收集FeNO的检查资料。根据FeNO水平将支气管哮喘患者分成3组:FeNO低水平组(FeNO<2...     

环氧酶-2抑制剂对关节炎大鼠小肠黏膜的影响

目的 探讨环氧酶-2抑制剂对关节炎大鼠小肠黏膜的影响。方法 将32只雄性SD大鼠随机分为空白对照组、造模对照组、空白给药组和造模给药组,造模对照组、造模给药组给予弗氏完全佐剂右后足跖注射,空白对照组、空白给药组注射等量生理盐水。1周后造模给药组、空白给药组给予选择性环氧酶-2抑制剂塞来昔布（溶于1%甲基纤维素）灌胃28 d,空白对照组、造模对照组给予等量溶剂。处死大鼠后观察小肠黏膜大体损伤、病理评分,酶联免疫吸附试验检测末段小肠前列腺素浓度。结果 造模对照组与造模给药组模型复制第7天的足周径比较,差异无统计学意义（P>0.05）,但两组分别与空白对照组和空白给药组比较,差异有统计学意义（P <0.05）,空白对照组与空白给药组比较,差异无统计学意义（P>0.05）。空白对照组与造模对照组小肠黏膜损伤面积比较,差异有统计学意义（P <0.05）,空白给药组与空白对照组比较,差异有统计学意义（P <0.05）。造模对照组、空白给药组和造模给药组组间小肠黏膜病理评分比较,差异无统计学意义（P>0.05）,且空白对照组与其他3组比较,差异有统计学意义（P &...     

Changes in Avidity and Level of Immunoglobulin G Antibodies to Mycobacterium tuberculosis in Sera of Patients Undergoing Treatment for Pulmonary Tuberculosis

Much is known about specific antibodies and their titers in patients with tuberculosis. However, little is known about the avidity of these antibodies or whether changes in avidity occur during the progression of the disease or during treatment. The aims of this study were to determine the avidity of antibodies to Mycobacterium tuberculosis in patients with pulmonary tuberculosis, to explore the value of avidity determination for the diagnosis of tuberculosis, and to study changes in levels of antibodies and their avidity during treatment. Antibody avidity was measured by an enzyme-linked immunosorbent assay with thiocyanate elution. Avidity indices and serum levels of immunoglobulin G to M. tuberculosis were determined for 22 patients with pulmonary tuberculosis before and during treatment and for 24 patients with other pulmonary diseases. Antibody levels and avidity were both significantly higher in untreated tuberculosis patients than in the controls. Avidity determination had more diagnostic potential than determination of the antibody levels. Tuberculosis patients with a long duration of symptoms had higher antibody avidity than those with a recent onset of symptoms, indicating affinity maturation of specific antibodies during active disease. In the early phase of treatment, a decrease in antibody avidity was observed for 73% of all tuberculosis patients, accompanied by an initial increase in antibody levels in 36% of these patients. These phenomena could be explained by an intense stimulation of the humoral response by antigens released from killed bacteria, reflecting early bactericidal activity of antituberculous drugs leading to the production of low-affinity antibodies against these released antigens.     

蜥蜴中脑神经通路和起源细胞的形态

本文采用 HRP 法研究了蛤蚧(Gekko gekko)和鳄蜥(Shinisaurus crocodilurus)视顶盖、中脑深核(NPM)与峡核之间的通路和起源细胞的形态。结果指出:1.顶盖与峡核大细胞部(Imc)呈相互区域对应投射;2.同侧顶盖—Imc 投射细胞主要位于第7层,系有径向树突的梨形细胞;同侧 Imc—顶盖投射细胞为小树突域的梨形或多角形细胞;3.顶盖注射标记的 NPM细胞呈纺锤形,染色浅;峡核注射标记的 NPM 细胞,其粗树突往往伸向顶盖;4.NPM 注射标记顶盖细胞和峡核细胞,前者主要位于顶盖第7层,后者散布在峡核大细胞部(Imc)和峡核小细胞部(Ipc)内。     

Immunosuppressive effect of polycyclic aromatic hydrocarbons by induction of apoptosis of pre-B lymphocytes of bone marrow

Polycyclic aromatic hydrocarbons (PAH) are ubiquitous environmental pollutants, distinguished by genotoxic, hepatotoxic, nephrotoxic and immunotoxic effects. Especially secondary toxicity after bioactivation by microsomal monooxygenases (dependent on cytochromes P450) is characteristic of them. The immunotoxic effect is the result of very global impact on immunological reactivity of an organism and immunosuppression by induction of apoptosis of pre-B lymphocytes represents one of its particular forms. It has been proved that the effect of PAH is caused mostly by the following mechanisms: enzymatic induction by the way of activation of AhR (Aromatic hydrocarbon Receptor); alteration of cellular DNA; development of oxidative stress; increase in the concentration of intercellular calcium and decline of activity of NF-kappaB (Nuclear Factor-kappa B). Most sensitive to these changes are particularly B-lymphocytic precursors and pre-B lymphocytes. Intensity of entire manifestations is also considerably dependent on the presence and intensity of mechanisms of active or passive resistance of cells.     

EXT1基因1633-26(C→A)突变可能致多发性外生性骨疣

目的研究1例散发多发性外生性骨疣患者的基因突变情况，确定其致病基因。方法采用聚合酶链反应结合DNA直接测序法检测EXT1以及EXT2基因的突变热点区域；并应用错配引物PCR扩增引入酶切位点结合限制性片段长度多态性方法检测和鉴定突变。结果经测序证实在患者EXT1基因的第7内含子3’剪接位点上游26bp处发现一杂合突变，此杂合突变不存在于其表型正常的父母双亲中，是一个新生突变；错配引物扩增与限制性片段长度多态性分析结果表明在150名家系外正常对照者中没有此突变。结论EXT1基因1633-26（C→A）突变可能是导致这个患者发生多发性外生性骨疣的致病突变。     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

股骨颈骨折空心钉内固定手术参数的优化分析

闭合复位空心钉内固定手术是目前治疗股骨颈骨折的常用方法,采用有限元方法对空心钉内固定手术进行力学综合分析,根据股骨近端力学实验的结果,建立股骨近端有限元分析模型,对可能影响手术效果的患者体重、骨折线角度、空心钉布局与角度等几个参数进行分组分析,提取骨折面、钉子的应力应变分析结果,获得了216组不同手术参数组合的情况下,影响术后愈合与承载能力的骨折端面的错位位移、钉孔底部应变、钉子最大应力、股骨最大应变四个参数,并进行综合分析比较,找到一组符合生物力学规律的内固定治疗参数,并应用于医疗机器人手术参数规划及手术效果的评价系统。