阴式全子宫切除术和腹腔镜下全子宫切除术的临床对比分析

目的:比较阴式全子宫切除术与腹腔镜下全子宫切除术的临床治疗效果。方法:回顾性分析2014年6月-2015年6月我院收治的137例子宫良性病变患者的临床病历资料,按照手术方式将其分为阴式组(行阴式全子宫切除术)和腹腔镜组(行腹腔镜下全子宫切除术),比较两组患者的术中、术后临床指标及术后并发症情况。结果:阴式组手术时间及术中出血量均少于腹腔镜组,差异有统计学意义(P0.05)。阴式组肛门排气时间、下床活动时间以及住院时间均短于腹腔镜组,住院总费用低于腹腔镜组,差异有统计学意义(P0.05)。两组患者并发症发生情况差异无统计学意义(P0.05)。结论:阴式全子宫切除术较腹腔镜下全子宫切除术而言,具有手术创伤小、术后恢复快的特点,值得临床推广。     

基层医院腹腔镜辅助阴式子宫全切除术临床分析

目的探讨基层医院腹腔镜辅助阴式子宫全切除术的治疗效果。方法回顾性分析2013年6月~2015年12月在我院行腹腔镜辅助阴式全子宫切除术患者47例的临床资料。结果 46例患者手术成功,成功率97.87%;1例因肌瘤较大中转开腹切除术。本组腹腔镜辅助阴式子宫切除手术时间平均104(81~195)min,出血量平均120(90~140)ml,术后住院时间4~5天。结论腹腔镜辅助阴式全子宫切除术具有创伤小,术后恢复快,安全性高,易于操作等优点,尤其适合在基层医院推广应用。     

腹腔镜胆囊切除术与开腹胆囊切除术对胆囊结石患者手术疗效、肝肾功能及机体应激的影响

目的:探讨腹腔镜胆囊切除术(LC)与开腹胆囊切除术(OC)对胆囊结石患者手术疗效、肝肾功能及机体应激的影响。方法:选取2015年3月～2018年7月期间我院收治的胆囊结石患者125例为研究对象。根据随机数字表法将患者分为对照组(n=62)和研究组(n=63),对照组给予OC治疗,研究组给予LC治疗,比较两组各项临床指标,检测两组术前、术后肝肾功能指标及机体应激指标水平,记录两组术后并发症发生情况。结果:研究组手术时间、术后住院时间、排气时间均短于对照组,术中出血量少于对照组(P0.05)。与术前比较,两组患者术后1 d总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)水平均升高,但研究组低于对照组(P0.05)。与术前比较,两组患者术后1 d Alb/UCr、NAG/UCr升高,且研究组高于对照组(P0.05);与术后1 d比较,两组患者术后3d白蛋白(Alb)/尿肌酐(UCr)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)/UCr降低(P0.05),但研究组与对照组比较差异无统计学意义(P0.05);两组患者术前、术后1d、术后3d血清尿素氮(BUN)、血清肌酐(SCr)比较差异无统计学意义(P0.05)。与术前比较,两组患者术后1d超氧化物歧化酶(SOD)水平降低,且研究组低于对照组(P0.05),丙二醛(MDA)、C-反应蛋白(CRP)水平升高,但研究组低于对照组(P0.05)。研究组并发症发生率低于对照组(P0.05)。结论:LC治疗胆囊结石患者安全有效,临床相关指标改善程度优于OC术式,术后肾功能恢复更快,且对患者肝功能、机体应激程度影响较轻。     

腹腔镜下全子宫切除术后阴道微生态乳杆菌干预的影响

目的 探讨腹腔镜下全子宫切除术后阴道微生态乳杆菌干预的影响。 方法 2018年3月—2019年3月间在本院接受腹腔镜下全子宫切除术治疗的患者106例,经随机数表法分为对照组、研究组,各53例。研究组患者在术后1月开始接受乳酸杆菌干预、对照组未采取任何措施。持续干预3个疗程后比较研究组、对照组患者的阴道微生态指标(pH值、菌群密集度、菌群多样性、优势乳杆菌分级),女性性功能指数(FSFI),阴道微生态失衡,阴道炎发生率以及研究组患者乳酸杆菌胶囊相关不良反应发生情况。 结果 术后2月,研究组、对照组pH值、菌群密集度、菌群多样性、优势乳杆菌分级差异有统计学意义(P结论 腹腔镜下全子宫切除术后早期使用乳酸杆菌干预,在优化阴道微生态、减少阴道炎发生方面具有一定作用,且不会引发明显不良反应。     

腹腔镜辅助下阴式子宫切除术与阴式子宫全切除术治疗子宫良性病变的临床比较

目的:探究阴式子宫全切除术与腹腔镜辅助下阴式子宫切除术治疗子宫良性病变的临床效果。方法:选择2011年10月~2013年9月我院收治的子宫良性病变的患者120例,其中行腹腔镜辅助下阴式子宫切除术80例(研究组)和行阴式子全宫切除术40例(对照组),观察并分析两组的临床指标及手术并发症。结果:研究组住院费用明显高于对照组(P0.05),手术时间、术中出血量及住院时间均低于对照组(P0.05);研究组无邻近脏器损伤,对照组输尿管损伤2例(5.00%),研究组患者出现手术损伤率明显低于对照组,差异存在统计学差异(x2=3.968,P=0.046);对两组患者术后随访1年,两组患者均无出现再手术情况;两组患者术后阴道残端均愈合较好,未出现阴道残端漏,患者无大小便困难及其他不适。结论:腹腔镜辅助下阴式子宫切除术治疗子宫良性病变疗效优于阴式子宫全切术,其手术时间、术中出血量及住院时间均较低,创伤小,更有利于患者恢复健康,在临床上值得应用推广。     

全子宫切除术对阴道菌群的影响

目的研究全子宫切除术后阴道菌群及pH的变化,寻求适当的治疗措施,以提高术后患者的生活质量。方法分别观察术后未发生阴道炎、发生老年性阴道炎及正常近龄妇女3组共90例,进行菌群分析、pH测定,并使用乳杆菌DM9811代谢物脂肪酸组分对发生老年性阴道炎者进行治疗。结果术后妇女检出各种菌的数量少,乳杆菌的数量更少,阴道内没有占绝对优势的菌种;发生阴道炎组乳杆菌数量下降更明显,葡萄球菌及大肠埃希菌数量相对增多。术后阴道pH在5.9~7.3,发生阴道炎组较未发生阴道炎组高;以乳杆菌DM9811代谢物脂肪酸组分阴道用药治疗老年性阴道炎,治愈率为82.14%。结论全子宫切除术后阴道乳杆菌数量下降,pH升高,易发生老年性阴道炎。治疗以乳杆菌DM9811代谢物脂肪酸组分阴道用药效果佳。     

艾司氯胺酮联合丙泊酚对腹腔镜全子宫切除术患者血清炎症因子和应激反应的影响

摘要 目的：观察艾司氯胺酮联合丙泊酚对腹腔镜全子宫切除术患者血清炎症因子和应激反应的影响。方法：选择2020年1月-2022年12月期间同济大学附属同济医院收治的行腹腔镜全子宫切除术患者86例。根据计算机随机生成分组,分为对照组（丙泊酚麻醉,43例）和研究组（艾司氯胺酮联合丙泊酚麻醉,43例）。对比两组血流动力学指标、疼痛情况、炎症因子、应激反应指标和不良反应发生率。结果：气管插管（T2）~切皮后30 min（T4）时间点,两组患者心率（HR）、平均动脉压（MAP）先升高,后下降,但研究组均低于对照组同时间点（P<0.05）。研究组术后6 h、术后12 h、术后24 h疼痛视觉模拟量表（VAS）评分均低于对照组（P<0.05）。两组术后24 h血清白介素-6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平均升高,但研究组均低于对照组（P<0.05）。两组术后24 h血清肾上腺素（AE）、多巴胺（DA）、去甲肾上腺素（NE）水平均升高,但研究组均低于对照组（P<0.05）。两组不良反应发生率对比未见差异（P>0.05）。结论：艾司氯胺酮联合丙泊酚用于腹腔镜全子宫切除术患者,镇痛效果显著,可维持血流动力学平稳,控制炎症因子和应激指标分泌,且安全有效。     

经腹腔镜子宫切除术

作者结合25例的腹腔镜子宫手术工作实践,重点介绍腹腔镜子宫切除术的手术技巧和常用的设备,并闸述腹腔镜全子宫切除的适应征。     

腹腔镜子宫切除术对宫颈癌患者近期疗效及远期复发率的影响

目的:探讨腹腔镜根治性子宫切除术对宫颈癌患者近期疗效及远期复发率和生存率的影响。方法:选取2013年5月-2015年5月在我院接受手术切除治疗的宫颈癌患者71例为研究对象,根据手术方法不同将所选患者分为两组。腹腔镜组37例患者采用腹腔镜根治性子宫切除术,开腹手术组34例患者采用改良式根治性肿瘤切除术。观察并比较两组患者的手术时间、术中出血量、肿瘤切除长度、淋巴结清扫数、盆腔引流量、术后拔管时间等近期疗效,以及远期复发率及生存率。结果:与开腹手术组比较,腹腔镜组患者手术时间长、术中出血量少,差异具有统计学意义(P0.05);两组患者的肿瘤切除长度及淋巴结清除数比较,差异无统计学意义(P0.05);与开腹手术组比较,腹腔镜组患者的盆腔引流量较少,术后排气时间较早,差异具有统计学意义(P0.05);但两组患者术后拔管时间及住院时间比较,差异无统计学意义(P0.05);两组患者术后五年的复发率及生存率比较,差异无统计学意义(P0.05)。结论:腹腔镜根治性子宫切除术治疗宫颈癌的近期疗效显著,且不会影响患者的远期复发率及生存率。     

应用护理程序对1例全子宫切除术患者的整体护理

21世纪护理实践发生了巨大变化,也给护理人员带来诸多挑战,提高护理专业技能,实施以病人为中心的整体护理,将健康教育融入整个护理工作中,满足病人及健康咨询者的需求,是当代护士进行护理工作时所面临的一个问题。我们运用护理程序这一科学的工作方法对1例全子宫切除术患者进行身心整体护理,现报告如下。     

不同麻醉方法对腹腔镜子宫切除术患者血清皮质醇及儿茶酚胺的影响

目的：观察不同麻醉方法对腹腔镜子宫切除术患者血清皮质醇及儿茶酚胺的影响。方法：选择行腹腔镜子宫切除术患者42例,随机分为3组：硬膜外麻醉组（A组）、全麻组（B组）、全麻复合硬膜外阻滞组（C组）各14例,于麻醉前10min（T0）、气腹后10min（T1）、气腹后40min（T2）和术后10min（T3）四个时间点,采集静脉血测定皮质醇（COR）和儿茶酚胺（CA）浓度,并观察P旷c02、SP02及血流动力学变化。结果：与T0相比,A组T1时MAP、HR显著下降（P〈0．05）,B组T1、T2时MAP、HR、COR和CA明显升高（P〈0．05）,C组各时点MAP、HR、COR和CA差异无统计学意义;组间相比,C组各时点MAP、HR、COR和CA显著低于B组（P〈0．05）。结论：全麻复合硬膜外阻滞可以有效地调控腹腔镜子宫切除术患者的应激反应。     

The ubiquitin codes in cellular stress responses

Ubiquitination/ubiquitylation, one of the most fundamental post-translational modifications, regulates almost every critical cellular process in eukaryotes. Emerging evidence has shown that essential components of numerous biological processes undergo ubiquitination in mammalian cells upon exposure to diverse stresses, from exogenous factors to cellular reactions, causing a dazzling variety of functional consequences. Various forms of ubiquitin signals generated by ubiquitylation events in specific milieus, known as ubiquitin codes, constitute an intrinsic part of myriad cellular stress responses. These ubiquitination events, leading to proteolytic turnover of the substrates or just switch in functionality, initiate, regulate, or supervise multiple cellular stress-associated responses, supporting adaptation, homeostasis recovery, and survival of the stressed cells. In this review, we attempted to summarize the crucial roles of ubiquitination in response to different environmental and intracellular stresses, while discussing how stresses modulate the ubiquitin system. This review also updates the most recent advances in understanding ubiquitination machinery as well as different stress responses and discusses some important questions that may warrant future investigation.     

The effect of oxidant stress on diamide-treated human granulocytes

The role of sulfhydryls in the protection of human polymorphonuclear neutrophils against extracellular oxidant attack was investigated by simultaneously exposing polymorphonuclear neutrophils to the thiol-oxidizing agent diamide and the oxidant-generating system xanthine-xanthine oxidase. Neither diamide nor the oxidants generated by the xanthine-xanthine oxidase system alone impaired the burst in chemiluminescence, hexose monophosphate shunt activity or formate oxidation normally seen during polymorphonuclear neutrophil phagocytosis. Incubation of the polymorphonuclear neutrophils simultaneously with diamide and xanthine-xanthine oxidase markedly impaired polymorphonuclear neutrophil phagocytosis, hexose monophosphate shunt activity, chemiluminescence and formate oxidation. Although the polymorphonuclear neutrophils exposed to diamide and xanthine-xanthine oxidase did not respond to a variety of phagocytizable stimuli, trypan blue exclusion was normal and hexose monophosphate shunt activity could be stimulated by diamide. The damaging effect of the diamide xanthine-xanthine oxidase system could be blocked by the addition of superoxide dismutase or catalase, but not by hydroxyl radical or singlet oxygen scavengers. We hypothesize that an unidentified population of thiols may play a role in protecting the polymorphonuclear neutrophil from endogenously derived oxidants.     

内质网应激的细胞效应分子机制

内质网应激（endoplasmic reticulum stress,ERs）是内质网腔内错误折叠蛋白聚积的一种适应性反应,适度ERs通过激活未折叠蛋白反应起适应性的细胞保护作用,而过高和持久的ERs则通过诱导转录因子CHOP表达、激活caspase-12和c—Jun氨基末端激酶（JNK）等导致细胞凋亡。近年来,越来越多的研究提示内质网应激是神经退行性病变、2型糖尿病以及肥胖等疾病发生过程中的重要环节。对内质网应激的细胞效应分子机制进行综述。随着对ERs机制理解的深入,有可能会发现新的分子标志物或新的诊疗策略。     

The effect of 5-azacytidine on wheat seedlings responses to NaCl stress

The effect of 5-azacytidine (5-azaC) on the alleviation of damaging effects of NaCl treatment was studied in two wheat (Triticum aestivum L.) cultivars differing in salt tolerance (salt-tolerant Dekang-961 and sensitive Lumai-15). The plants were pre-treated or not with 50 μM 5-azaC and then subjected to salt stress induced by 100 or 150 mM NaCl. Salinity caused reduction in biomass accumulation and increase in malondialdehyde content in root tissues in both cultivars, but less in pre-treated seedlings. The activities of superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD) in the roots of both cultivars increased during salt stress, but the rate of increase was higher in Dekang-961. Plants treated with 5-azaC had higher root SOD, CAT and POD activities under salt stress than untreated plants. Content of 5-methylcytosine (5mC) decreased in both cultivars under salt stress, and the level of demethylation was higher in Dekang-961 than that in Lumai-15. Moreover, the degree of methylation was lower in both cultivars under salt stress after 5-azaC application compared to only salt-treated groups. These findings suggested that 5-azaC could protect plants from salt stress.     

Cardiolipin and the osmotic stress responses of bacteria

Cells control their own hydration by accumulating solutes when they are exposed to high osmolality media and releasing solutes in response to osmotic down-shocks. Osmosensory transporters mediate solute accumulation and mechanosensitive channels mediate solute release. Escherichia coli serves as a paradigm for studies of cellular osmoregulation. Growth in media of high salinity alters the phospholipid headgroup and fatty acid compositions of bacterial cytoplasmic membranes, in many cases increasing the ratio of anionic to zwitterionic lipid. In E. coli, the proportion of cardiolipin (CL) increases as the proportion of phosphatidylethanolamine (PE) decreases when osmotic stress is imposed with an electrolyte or a non-electrolyte. Osmotic induction of the gene encoding CL synthase (cls) contributes to these changes. The proportion of phosphatidylglycerol (PG) increases at the expense of PE in cls⁻ bacteria and, in Bacillus subtilis, the genes encoding CL and PG synthases (clsA and pgsA) are both osmotically regulated. CL is concentrated at the poles of diverse bacterial cells. A FlAsH-tagged variant of osmosensory transporter ProP is also concentrated at E. coli cell poles. Polar concentration of ProP is CL-dependent whereas polar concentration of its paralogue LacY, a H⁺-lactose symporter, is not. The proportion of anionic lipids (CL and PG) modulates the function of ProP in vivo and in vitro. These effects suggest that the osmotic induction of CL synthesis and co-localization of ProP with CL at the cell poles adjust the osmolality range over which ProP activity is controlled by placing it in a CL-rich membrane environment. In contrast, a GFP-tagged variant of mechanosensitive channel MscL is not concentrated at the cell poles but anionic lipids bind to a specific site on each subunit of MscL and influence its function in vitro. The sub-cellular locations and lipid dependencies of other osmosensory systems are not known. Varying CL content is a key element of osmotic adaptation by bacteria but much remains to be learned about its roles in the localization and function of osmoregulatory proteins.     

The effect of stress on genome regulation and structure

BACKGROUND: Stresses exert evolutionary pressures on all organisms, which have developed sophisticated responses to cope and survive. These responses involve cellular physiology, gene regulation and genome remodelling. SCOPE: In this review, the effects of stress on genomes and the connected responses are considered. Recent developments in our understanding of epigenetic genome regulation, including the role of RNA interference (RNAi), suggest a function for this in stress initiation and response. We review our knowledge of how different stresses, tissue culture, pathogen attack, abiotic stress, and hybridization, affect genomes. Using allopolyploid hybridization as an example, we examine mechanisms that may mediate genomic responses, focusing on RNAi-mediated perturbations. CONCLUSIONS: A common response to stresses may be the relaxation of epigenetic regulation, leading to activation of suppressed sequences and secondary effects as regulatory systems attempt to re-establish genomic order.     

The salt stress relief and growth promotion effect of Rs-5 on cotton

The effect of the Rs-5 bacteria strain, identified as Klebsiella oxytoca and isolated with ACC as the sole nitrogen source, on salt stressed cotton seedling growth was studied. It was demonstrated that Rs-5 could obviously relieve salt stress and promote cotton seedling growth. After treatment with Rs-5, the individual plant height and dry weight of cotton increased by 14.9 and 26.9%, respectively, compared to the control. Further analysis found that Rs-5 exhibited the ability to increase the cotton’s absorption of the N, P, K, and Ca elements and decrease the absorbability of the Na element under salt stress. In addition, Rs-5 itself could produce phytohormone-auxin, and was capable of dissolving phosphorus (P). The ratio of the dissolved P diameter to the colony diameter was 1.86. The dissolved P was 81.6 mg·l⁻¹ in media after four days of incubation. Responsible Editor: Petra Marschner.