腹腔镜肝癌切除术对肝细胞癌中的治疗效果及对血清AFP、sEC、HGF、ICAM-1的影响

目的:研究腹腔镜肝癌切除术对肝细胞癌中的治疗效果及对血清AFP、sEC、HGF、ICAM-1的影响。方法:选择2012年3月至2017年3月在我院接受治疗的肝细胞癌患者196例,根据治疗方案不同分为观察组和对照组,对照组给予开腹切除术治疗,观察组给予腹腔镜切除术治疗。观察并比较两组手术前后血清甲胎蛋白(AFP)、sEC、人类生长因子(HGF)、细胞间黏附分子-1(ICAM-1)及总胆红素(TBIL)、直接胆红素(DBIL)、谷丙转氨酶(ALT)及白蛋白(Alb)水平,术中出血量、术后绝对卧床时间、住院时间以及并发症发生率。结果:术后,观察组血清AFP、sEC、HGF、ICAM-1水平均明显低于对照组(P0.05);观察组TBIL、DBIL、ALT水平均显著低于对照组,Alb则显著高于对照组(P0.05);观察组术中出血量、绝对卧床时间以及住院时间均明显低于对照组(P0.05);且观察组术后并发症发生率明显低于对照组(P0.05)。结论:使用腹腔镜肝癌切除术治疗肝细胞癌,可降低患者血清AFP、sEC、HGF、ICAM-1水平从而提高其治疗效果,且术后并发症发生率较低。     

全凭静脉麻醉复合椎旁神经阻滞对胸腔镜下肺病损切除术患者应激反应、血流动力学及术后镇痛的影响

目的:研究全凭静脉麻醉复合胸椎旁神经阻滞(TPVB)对胸腔镜下肺病损切除术患者应激反应、血流动力学及术后镇痛的影响。方法:选择2016年6月至2017年12月在我院行胸腔镜下肺病损切除术的80例患者为研究对象。采用简单随机抽样方法,分为对照组(n=40)和观察组(n=40)。对照组行单纯全身麻醉,观察组在超声引导下行TPVB复合全身麻醉。比较两组麻醉前、术毕、术后24 h的血糖、肾上腺素(E)、去甲肾上腺素(NE)及多巴胺(DA)的浓度,以及两组在麻醉时、手术开始时、手术开始后0.5 h、手术开始后1 h、术毕时的平均动脉压(MAP)和心率(HR),同时比较两组术后2 h、6 h、12 h、24 h静息及活动时的视觉模拟评分(VAS)及相关并发症的发生率。结果:两组患者在麻醉前及术毕的各应激反应指标比较无差异(P0.05),而术后24 h比较,观察组低于对照组(P0.05);两组患者麻醉时的MAP、HR比较无差异(P0.05),除手术开始后1 h和术毕的HR外,观察组各时间的MAP、HR均显著低于对照组(P0.05);除静息时24 h外,观察组各时间静息时和活动时的VAS评分均低于对照组(P0.05);两组患者术后各并发症的发生率比较无统计学差异(P0.05)。结论:全凭静脉麻醉复合TPVB在胸腔镜下肺病损切除术中应激反应小,对血流动力学的波动影响小,术后镇痛效果良好,且安全有效。     

选择性入肝血流阻断应用于肝癌合并门脉高压手术中的疗效观察

目的：探究选择性入肝血流阻断（SPVE 法）在肝癌合并门脉高压手术中的临床应用效果。方法：选择我院2009 年10 月 ~2014 年10 月期间确诊为肝癌合并门脉高压的患者80 例,按照随机数字数表法分为观察组和对照组各40 例,观察组行SPVE 法进行血流阻断,对照组行全入肝血流阻断法（Pringle 法）进行血流阻断。对比两组手术时间、阻断血流时间、手术中出血量、输血 量、手术前后患者肝功能相关指标及术后并发症发生率。结果：两组手术时间和血流阻断时间对比差异无统计学意义（P>0.05）,而 观察组术中出血量及输血量均小于对照组,差异具有统计学意义（P<0.05）;术后观察组血液中谷丙转氨酶（ALT）、谷草转氨酶 （AST）和总胆红素（TB）水平均低于对照组,而血清蛋白（ALB）和血红蛋白（Hb）水平高于对照组,差异均有统计学意义（均P<0. 05）;观察组并发症发生率为22.5%,明显低于对照组的37.5%,差异有统计学意义（P<0.05）。结论：SPVE法应用在肝癌合并门脉 高压手术中,可以显著减少术中的出血量和输血量,有利于术后肝功能的恢复,有效地降低术后并发症的发生。     

羟考酮注射液对腹腔镜胆囊切除术患者血流动力学及镇痛效果的影响

目的探讨羟考酮注射液对腹腔镜胆囊切除术患者血流动力学及镇痛效果的影响。方法选取2017年2～10月在我院行腹腔镜胆囊切除术的患者98例,采用随机数字表法分为对照组和观察组各49例,对照组患者于切皮前静脉注射舒芬太尼,观察组静脉注射羟考酮,观察比较两组患者的血流动力学及镇痛效果。结果与T0时比较,两组患者在T2、T3时的HR均增快,MAP均升高,差异均有统计学意义(P0.05)。观察组患者在T1～T3时的HR、MAP均较对照组低,差异有统计学意义(P0.05)。观察组术后30min、术后2h以及术后6h的VAS评分均较对照组低,差异均有统计学意义(P0.05)。结论羟考酮注射液可有效改善腹腔镜胆囊切除术患者血流动力学,提升镇痛效果,值得临床推广。     

视网膜激光光凝与复合式小梁切除术治疗新生血管性青光眼的临床疗效对比

目的:观察和比较视网膜激光光凝与复合式小梁切除术治疗新生血管性青光眼(NVG)的临床疗效和安全性。方法:选择2013年1月~2015年6月我院收治的新生血管性青光眼患者85例,随机分为两组,观察组采用视网膜激光光凝术治疗,对照组采用复合式小梁切除术治疗,比较两组的临床疗效和并发症的发生情况。结果:两组术后眼压均较治疗前明显降低(P0.05),且观察组明显低于对照组(P0.05);两组术后视力、虹膜新生血管退化情况相比差异无明显统计学意义(P0.05);观察组术中、术后前房出血发生率均明显低于对照组(P0.05)。结论:视网膜激光光凝与复合式小梁切除术对新生血管性青光眼均有较好的治疗效果,复合式小梁切除术对患者眼压控制效果更好,安全性更高。     

半肝阻断联合肝静脉阻断在复杂肝癌精准肝切除中的应用

目的:探讨半肝血流阻断联合肝静脉阻断技术在精准肝切除中的应用价值。方法:回顾性分析我科2013年1月至2014年12月共120例行半肝血流阻断联合肝静脉阻断的精准肝切除病例,作为治疗组。另选单用第一肝门阻断的复杂肝癌半肝切除患者318例为对照。结果:治疗组在控制术中出血和输血量方面优于单用半肝血流阻断的对照组,治疗组术中平均出血量为650±46 m L,平均输血量为410±76 m L,差别有统计学意义(P0.05);治疗组在平均手术时间和平均住院时间方面均少于对照组,但两组差别无统计学意义(P0.05)。结论:半肝血流阻断联合肝静脉阻断技术在复杂肝癌的精准肝切除术中合理使用能有效的减少术中出血,提高了手术安全,降低了术中输血量,最大限度保留剩余肝细胞体积,减少了缺血再灌注的损失。     

盐酸纳布啡联合舒芬太尼用于腹腔镜下肝癌切除术后静脉自控镇痛的临床观察

目的:探讨盐酸纳布啡联合舒芬太尼用于腹腔镜下肝癌切除术后静脉自控镇痛(PCIA)的临床疗效。方法:选取2016年1月至2018年1月安康市中心医院收治的104例行腹腔镜下肝癌切除术患者,按照随机数字表法将患者分为对照组(n=52)和研究组(n=52)。对照组术后给予舒芬太尼PCIA,研究组术后给予盐酸纳布啡联合舒芬太尼PCIA。比较两组术后6h、24h、48h的视觉模拟量表(VAS)评分和数字镇静量表(NSS)评分。检测并比较两组麻醉诱导前、术毕、术后6h、24h及48h血清中P物质(SP)、神经肽Y(NPY)、多巴胺(DA)、C反应蛋白(CRP)、α1-酸性蛋白(AAG)、结合珠蛋白(HP)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)水平。记录两组术后48h内不良反应发生情况。结果:研究组术后6h、24h、48h的VAS评分均明显低于对照组(P0.05);两组各时间点的NSS评分比较差异均无统计学意义(P0.05)。研究组术后6h、24h、48h的血清SP、NPY、DA、CRP、AAG、HP、IL-6及IL-8水平均明显低于对照组,血清IL-2水平明显高于对照组(P0.05)。术后48h内,两组不良反应发生率比较差异无统计学意义(P0.05)。结论:腹腔镜下肝癌切除术后采用盐酸纳布啡联合舒芬太尼PCIA方案,可缓解全身炎症反应,有效镇痛,且安全性较好。     

酚妥拉明、多巴胺联合心肺复苏对心搏骤停患者的影响

目的:研究酚妥拉明、多巴胺联合心肺复苏对心搏骤停患者的影响。方法:选择2015年2月至2016年4月在我院进行治疗的心搏骤停患者60名,按照治疗方法的不同分为观察组和对照组,对照组使用常规方法治疗,观察组在对照组基础上联合酚妥拉明及多巴胺治疗。观察和比较两组治疗后的临床疗效、生存情况、血清cTnI、CK、CK-MB、MDA、SOD水平和血流动力学参数的变化。结果:治疗后,观察组总病死率20%,明显低于对照组33.33%(P0.05)。观察组心肺复苏后0.5-1h血清c Tn I水平显著高于对照组(P0.05),2-24 h血清cTnI水平显著低于对照组(P0.05);观察组心肺复苏后各时点血清CK、CK-MB水平均显著低于对照组(P0.05);观察组复苏后24 h的MDA、SOD浓度较对照组[(1.86±1.65)μg/L vs(3.81±1.24)μg/L、(6.58±0.95)μg/L vs(3.74±0.56)μg/L](P0.05)。心肺复苏后,观察组患者从第2 h开始MAP值明显高于对照组水平(P0.05);观察组患者CO值及CI值从第6h开始明显升高显著高于对照组水平(P0.05);且观察组患者PCWP值各时段均显著低于对照组(P0.05)。结论:酚妥拉明联合多巴胺用于治疗心搏骤停患者可明显减轻患者心肌损伤,改善其血流动力学及患者预后,提高生存率,且安全性高。     

胸神经阻滞和肋间神经阻滞对乳腺癌根治术患者血流动力学、术后镇痛及呼吸功能的对比研究

目的:比较胸神经阻滞和肋间神经阻滞对乳腺癌根治术患者血流动力学、术后镇痛以及呼吸功能的影响,为乳腺癌根治术患者的临床麻醉选择提供参考。方法:选择2017年3月至2018年3月医院收治的120例行乳腺癌根治术的患者作为研究对象,按照麻醉方式不同分为观察组和对照组各60例,其中观察组患者给予胸神经阻滞复合全身麻醉,对照组患者给予肋间神经阻滞复合全身麻醉。比较两组患者术后2h、6h、12h、24h、48h的静态和动态的视觉模拟评分(VAS)评分,并比较两组患者切皮前5 min(T_0)、切皮即刻(T_1)、切皮后15 min(T_2)、30 min(T_3)、钉皮即刻(T_4)及拔管后15 min(T_5)的血流动力学以及呼吸功能指标,并分析两组患者术中用药、术后镇痛泵使用情况以及术后不良反应。结果:两组患者术后静息状态下不同时点的VAS评分差异无统计学意义(P0.05);动态状态下,观察组患者的VAS评分明显低于对照组(P0.05)。T_1-T_5期间,观察组患者的平均动脉压(MAP)、心率(HR)均明显低于对照组,每分钟通气量(MV)明显高于对照组(P0.05)。观察组患者的术中瑞芬太尼消耗量、丙泊酚用量、镇痛泵有效按压次数以及补救镇痛例数均明显低于对照组;恶心呕吐(PONV)、尿潴留、嗜睡等不良反应明显低于对照组(P0.05)。结论:与肋间神经阻滞相比,胸神经阻滞治疗乳腺癌根治术患者可以有效增强术后镇痛效果,术中血流动力学平稳,减少阿片类药物用量,降低术后不良反应发生率,改善术后呼吸功能,效果显著,值得临床推广使用。     

右美托咪定对颅脑损伤手术患者氧化应激反应的影响

目的:探讨右美托咪定对颅脑损伤手术患者氧化应激反应的影响。方法:选择2014年9月至2016年9月我院接诊的92例拟行急诊手术的颅脑损伤患者,通过随机数表法分为观察组(n=46)和对照组(n=46),观察组在诱导后给予右美托咪定的静脉注射,对照组给予相同剂量的生理盐水。比较两组术前术后血流动力学指标、血清S100β蛋白、神经元特异性烯醇化酶(NSE)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平的变化。结果:观察组在给药后(T1)、插管时(T2)、拔管时(T3)、手术完成(T4)时,收缩压(SBP)、舒张压(DBP)、心率(HR)水平均显著低于对照组组(P0.05);在T4、手术后6 h(T5)、手术后12 h(T6)时,观察组血清S100β、NES、MDA水平均明显低于对照组(P0.05),血清SOD均明显高于对照组(P0.05)。结论:右美托咪定应用于颅脑损伤患者手术可有效保持手术过程中血流动力学的稳定,减轻术后氧化应激反应。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

Interconnection of parameters of regulation system of lipid peroxidation and of morphophysiological parameters of mouse liver

A complex analysis of seasonal fluctuations of the mean group parameters of the system of regulation of lipid peroxidation has been performed in liver of Balb/c mice. Association of lipid characteristics and morphophysiological parameters is studied in the Balb/c mouse liver. An inter-connection is revealed between the liver index and the amount of lysoforms of phospholipids, the scale and character of the interconnection differing essentially depending on proportion of phos-phatidylcholine in mouse liver phospholipids.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

Physiological characteristics of various species of strains of carboxydobacteria

Seven strains of aerobic carbon monoxide-oxidizing bacteria (carboxydebacteria) when growing on CO as sole source of carbon and energy had doubling times which ranged from 12–42 h. The activity profiles obtained after discontinuous sucrose density gradient centrifugation indicated that the CO-oxidizing enzymes are soluble and the hydrogenases are membrane-bound in all strains examined. The CO-oxidizing enzymes of Pseudomonas carboxydohydrogena, Pseudomonas carboxydoflava, Comamonas compransoris, and the so far unidentified strains OM2, OM3, and OM4 had a molecular weight of 230,000; that of Achromobacter carboxydus amounted to 170,000. The molecular weights of the CO-oxidizing and H₂-oxidizing enzymes turned out to be identical. The cell sonicates were shown to catalyze the oxidation of both CO and H₂ with methylene blue, thionine, phenazine methosulfate, toluylene blue, dichlorophenolindophenol, cytochrome c or ferricyanide as electron acceptors. Methyl viologen, benzyl viologen, FAD⁺, FMN⁺, and NAD(P)⁺ were not reduced. The spectrum of electron acceptors was identical for all strains tested. Neither free formate, hydrogen nor oxygen gas were involved in the CO-oxidation reaction. Methylene blue was reduced by CO at a 1:1 molar ratio. The results indicate that CO-oxidation by carboxydobacteria is catalyzed by identical or similar enzymes and that the reaction obeys the equation CO+H₂OCO₂+2H⁺+2e^- as previously shown for Pseudomonas carboxydovorans.Dedicated to Otto Kandler remembering almost three decades of enjoyable cooperation     

Modulation of allostery of pyruvate kinase by shifting of an ensemble of microstates

Since the introduction of the concepts of allostery about four decades ago, much advancement has been made in elucidating the structure-function correlation in allostery. However, there are still a number of issues that remain unresolved. In this review we used mammalian pyruvate kinase (PK) as a model system to understand the role of protein dynamics in modulating cooperativity. PK has a triosephosphate isomerase (TIM)(α/β)₈ barrel structural motif. PK is an ideal system to address basic questions regarding regulatory mechanisms about this common (α/β)₈ structural motif. The simplest model accounting for all of the solution thermodynamic and kinetic data on ligand-enzyme interactions involves two conformational states, inactive E^T and active E^R. These conformational states are represented by domain movements. Further studies provide the first evidence for a differential effect of ligand binding on the dynamics of the structural elements, not major secondary structural changes. These data are consistent with our model that allosteric regulation of PK is the consequence of perturbation of the distribution of an ensemble of states in which the inactive E^T and active E^R represent the two extreme end states. Sequence differences and ligands can modulate the distribution of states leading to alterations of functions. The future work includes: defining the network of functionally connected residues; elucidating the chemical principles governing the sequence differences which affect functions; and probing the nature of mutations on the stability of the secondary structural elements, which in turn modulate allostery.     

（鱼句）亚科花（鱼骨）型鱼类骨骼系统的比较

对我国花型Hemibarbuspattern鱼类作了骨骼系统比较,结果表明,此类型鱼类脑颅较长,副蝶骨平直或稍弯曲,眶蝶骨腹纵嵴发达(铜鱼Coreius septentrionalis例外),下颞窝和咽突中等大,基枕骨后突发达;脑颅中的上筛骨的后突、侧筛骨的外筛突,蝶耳骨的外突、上耳骨的后突、围眶骨和后颞窝等均有明显的差异;咽颅中的舌颌骨、尾舌骨、鳃盖骨和下咽齿的列数等又有显著的区别;附肢骨骼中的腰带骨、脊椎骨中的复合神经骨和第4椎骨腹侧的悬器等也有不同之处。据此,这些差异和区别可作为属间或种间的分类依据。