莱菔硫烷对ox-LDL诱导血小板活化的抑制作用

目的：探讨莱菔硫烷（sulforaphane,SFN）对氧化低密度脂蛋白（oxidized low-density lipoprotein,ox-LDL）诱导血小板活化的影响及其可能的分子机制。方法：在体外实验中,将健康人纯化血小板与不同浓度的SFN(1.0、2.5、5.0μmol/L)共同孵育40 min,然后用ox-LDL激活血小板20 min,并检测血小板活化的指标,包括CD62P的表达、胞内血小板因子4(platelet factor4,PF4)和趋化因子配体5(chemokine ligand 5,CCL5)的释放水平。机制上,用Western blot蛋白免疫印迹法检测血小板肉瘤酪氨酸激酶（sarcoma tyrosine kinase,Src）及其下游的脾酪氨酸激酶（spleen tyrosine kinase,Syk）磷酸化水平;用活性氧（reactive oxygen species,ROS）检测试剂盒测定胞内总ROS水平。结果：ox-LDL诱导的血小板CD62P的表达以及PF4和CCL5的释放水平均可被SFN显著抑制（P <0.05）;SFN显著下调ox-LD...     

耳大神经及腮腺筋膜解剖的再认识与腮腺切除手术的改良

目的：对耳大神经及腮腺筋膜解剖进行再认识，由此改良腮腺切除手术方法。方法：解剖成人尸体10侧，术中活体解剖20侧，对耳大神经和腮腺筋膜的解剖要素进行观察。根据观察结果进行改良腮腺切除术14例，即在腮腺筋膜表面翻瓣后，由前向后另翻腮腺筋膜瓣，切除腮腺后将筋膜瓣复位缝合，完整保留耳大神经和腮腺筋膜。结果：耳大神经在下颌角水平之上0-2cm依次分耳后、耳垂、耳前支，神经主干末段和分支起始段均分布于腮腺筋膜浅层表面，后者致密，其致密纤维包裹在神经周围。改良手术后2例（14．3％）发生轻度Frey’s综合征，无1例发生术区皮肤长期麻木、长期面瘫、涎瘘及肿瘤复发。结论：耳大神经各分支和腮腺筋膜具有不可代替的解剖生理功能，改良术式能将两者完好保留，显著降低术后并发症。     

Validation of low-cost models for minimal invasive surgery training of congenital diaphragmatic hernia and esophageal atresia

BackgroundMinimal invasive surgery (MIS) is increasingly used for the correction of congenital diaphragmatic hernia (CDH) and esophageal atresia (EA). It is important to master these complex procedures, preferably preclinically, to avoid complications. The aim of this study was to validate recently developed models to train these MIS procedures preclinically.MethodsTwo low cost, reproducible models (one for CDH and one for EA) were validated during several pediatric surgical conferences and training sessions (January 2017–December 2018), used in either the LaparoscopyBoxx or EoSim simulator. Participants used one or both models and completed a questionnaire regarding their opinion on realism (face validity) and didactic value (content validity), rated on a five-point-Likert scale.ResultsOf all 60 participants enrolled, 44 evaluated the EA model. All items were evaluated as significantly better than neutral, with means ranging from 3.7 to 4.1 (p < 0.001). The CDH model was evaluated by 48 participants. All items scored significantly better than neutral (means 3.5–3.9, p < 0.001), with exception of the haptics of the simulated diaphragm (mean 3.3, p = 0.054). Both models were considered a potent training tool (means 3.9).ConclusionThese readily available and low budget models are considered a valid and potent training tool by both experts and target group participants.Type of studyProspective study.Level of evidenceLevel II.     

Ergotamine suppositories

Investigations have been made on the stability of ergotamine tartrate containing suppositories which have hard fat as a base. Of the many well-known degradation reactions of ergotamine in aqueous media, only isomerization into ergotaminine and oxidation appear to occur in the used types of hard fat. The effects of the addition of tartaric acid, the characteristics of the used hard fat types, the addition of tocopherol as an antioxidant and the storage temperature have been examined. The favourable effect of the addition of tartaric acid probably is based on decreasing the amount of ergotamine tartrate which is dissolved in the base. Ergotamine in addition appears to be more stable in those types of hard fat in which the solubility of ergotamine tartrate is lowest, which probably is related to a low hydroxyl value of the base. Oxidation appears to occur in hard fat types with a relatively high peroxide value, for which not only peroxides but also other forms of activated oxygen may be responsible. Tocopherol reduced degradation in the examined base only slightly. In most bases the temperature greatly influenced the stability; this is probably caused by the influence on the reaction rates of oxidation and isomerization or the influence on the amount of dissolved ergotamine tartrate.     

男性海洛因依赖者性机能研究

目的 研究海洛因对男性性机能的影响。方法 对91例男性海洛因依赖者进行了性机能调查研究，并做性激素测定和分析。结果 男性海洛因依赖者性机能明显障碍，表现为性幻想减少，性欲减退，性高潮减退，性交频率降低。男性睾酮（T）及催乳素（PRL）均低于正常对照组（Z=8．118，P〈0．01；Z=4．444，P〈0．01），促黄体生成素（LH）及促卵泡刺激素（FSH）均高于正常对照组（Z=2．094，P〈0．05；Z=2．086，P〈0．05），雌二醇（E2）与正常对照组无统计学意义。结论 海洛因可致机体下丘脑-垂体-性腺轴功能紊乱，影响性机能，并且性问题在海洛因依赖性形成机制和戒断上的意义值得进一步探讨。     

脑得生提取物对动物心血管、呼吸及中枢神经系统影响的研究

目的：探讨脑得生提取物的安全性。方法：观察脑得生提取物对清醒脚犬心电图、血压、呼吸和小鼠一般行为、神经系统和运动协调功能的影响。结果：脑得生提取物在1．5～15g／kg给药剂量,对清醒Beagle犬的收缩压、舒张压、呼吸频率以及心电图指标无明显影响。脑得生提取物在10～30g／kg给药剂量,对清醒小鼠的一般行为和运动协调功能没有明显影响;100g／kg给药剂量对小鼠的翻正反射和爬杆试验有一定影响,在给药后2小时完全恢复。结论：脑得生提取物对动物心血管系统、呼吸系统及中枢神经系统均无明显影响。     

GC-MS分析四数九里香的挥发油成分

目的 研究四数九里香挥发油的成分.方法 采用GC-MS法分析四数九里香的挥发油成分.结果与结论 从四数九里香挥发油中分离出38个组分,确认了其中的37种,主要成分为薄荷酮(53%)、异薄荷酮(14.45%)、柠檬烯(13.21%)和胡椒酮(7.96%),其中15个成分为首次从四数九里香中分离得到.     

原发性精囊癌的诊断和治疗(附4例报告)

目的 探讨原发性精囊癌的临床表现、诊断及治疗.方法 回顾性分析4例原发性精囊癌患者的临床症状、体征、检查结果、手术方案及术后治疗.1例行双侧精囊连同膀胱、前列腺、直肠根治性切除术.2例行精囊、部分膀胱、前列腺切除术.1例行精囊、膀胱、前列腺、输尿管下段、直肠前壁切除术及回肠膀胱术.结果 2例患者术后随访5年未见复发与转移,1例术后2年死于结肠癌,1例术后随访3个月未见复发与转移.结论 原发性精囊癌的临床表现为血精或血尿,下尿路梗阻症状,大便性状与次数的改变,早期症状不明显,患者血清中前列腺特异抗原(PSA)、CEA阴性,细胞角蛋白(CK)阳性.治疗主要根据肿瘤侵及的范围采取相应的手术方式予以切除,术后应加以联合化疗.     

线粒体DNA3160-3755区域基因突变与2型糖尿病的关系

目的研究线粒体DNA3160-3755区域基因在延边地区2型糖尿病（T2DM）患者中的突变情况,探讨该区域线粒体基因突变与2型糖尿病的关系。方法应用聚合酶链反应-限制性片段长度多态性（polymorphismchainreaction-restrictionfragmentlengthpolymorphism,PCR-RFLP）技术和直接测序法对延边地区人群108例正常健康体检者、328例T2DM患者（其中2例合并耳聋）,进行线粒体DNA3160-3755区域基因突变筛查。结果线粒体DNA3316G-A在糖尿病组和正常对照组中的突变率分别为3．7％和3．8％。两组间差异无统计学意义（P〉0．05）;3394T→C在糖尿病组和正常对照组中的突变率分别为7．3％和1．9％,两组间差异有统计学意义（P〈0．05）;在糖尿病组及正常对照组中均未检测到线粒体DNA3243A→G、3593T→C和3714A→G突变。结论线粒体DNA3316G→A突变与延边地区T2DM的发生无关;线粒体DNA3,394T→C突变与延边地区T2DM的发生有关;线粒体DNA3423A→G,3593T→C,3714A→G突变在延边地区T2DM中的发生率为0,提示上述位点基因突变率极低。     

心肾综合征患者心脏结构功能、BNP、Cys-C变化与CKD分期的相关性

目的:探讨心肾综合征(cardiorenal syndrome,CRS)患者超声心动图变化及全血脑钠肽(brain natriuretic peptide,BNP)、胱抑素C(Cystatin C,Cys-C)水平等与慢性肾脏病(chronic kidney disease,CKD)分期的关系。方法:我院肾内科符合标准的84例CRS患者,检测入院时的全血BNP、Cys-C水平,并检测超声心动图及心电图,收集相关参数进行分析。结果:CKD3、4、5期CRS患者之间,全血BNP、Cys-C水平有显著差异,各组之间左室舒张末期内径(LVDd)、左室后壁厚度(LVPW)、E峰、E/A、心率差异有统计学意义(P<0.05),而BNP和LVDd与CKD分期的相关性更加密切。结论:CKD 3~5期CRS患者心脏结构改变主要表现在左室舒张末期内径、左室后壁厚度增加等,心功能障碍主要表现在舒张功能受累。联合全血BNP、Cys-C水平、超声心动图及心电图检查可以作为观察CRS病情的有效指标,有利于预防及早期治疗。