小剂量纳洛酮硬膜外应用对胃癌术后芬太尼静脉自控镇痛效果及胃肠功能的影响

目的:探讨小剂量纳洛酮硬膜外应用对胃癌术后芬太尼静脉自控镇痛效果及胃肠功能的影响。方法:选取我院2010年7月-2015年7月收治的110例胃癌患者为研究对象,将所有患者随机分为试验组和对照组各55例,两组患者均行根治性肿瘤切除术,术后采用芬太尼静脉自控镇痛,试验组于术后硬膜外注入小剂量纳洛酮,对照组注入等量的生理盐水,对两组术后不同时间点(4 h、8 h、12 h、24 h)疼痛程度进行评分,对比两组肠鸣音恢复时间、肛门排气时间、肛门排便时间、胃动力恢复时间,镇痛泵药物消耗量及并发症发生率。结果:术后4 h,试验组疼痛评分明显低于对照组(P0.05),术后8 h、12 h两组患者的疼痛评分均有显著上升(P0.05),且试验组患者的疼痛评分均远低于对照组(均P0.05),术后24 h,试验组与术后12 h比较差异无统计学意义(P0.05),对照组术后24 h疼痛评分与术后12 h分相比有显著差异(P0.01);试验组患者肠鸣音恢复时间、肛门排气时间、肛门排便时间、胃动力恢复时间、镇痛泵药物消耗量、芬太尼用量均远远低于对照组(P0.05);试验组并发症总发生率(7.27%)远远低于对照组(23.64%),差异具有统计学意义(P0.05)。结论:采用小剂量纳洛酮硬膜外应用方法辅助术后镇痛可以有效的减轻患者的疼痛,降低并发症的发生率,促进胃肠功能恢复,疗效显著,值得在临床上推广使用。     

腹腔镜手术治疗结肠癌的临床应用

目的:探讨腹腔镜手术治疗结肠癌的临床效果.方法:选取我院结肠癌患者44例,随机分为观察组和对照组,各22例,观察组行腹腔镜手术,对照组行开腹手术,比较两组的治疗效果和安全性.结果:两组患者的手术时间差异无统计学意义(P＞0.05),观察组的术中出血量明显少于对照组,差异有统计学意义(P＜o.05),观察组术后排气时间、术后疼痛时间和住院时间均比对照组更短,差异有统计学意义(P＜0.05).观察组和对照组并发症发生率分别为9.09％和22.73％,差异有统计学意义(P＜0.05).两组患者3年内局部复发、远处转移、种植转移和总生存率差异均无统计学意义(P＜0.05).结论:腹腔镜手术治疗结肠癌有效、安全,具有创伤小,恢复快,并发症少等优点,适合临床广泛应用.     

腹腔镜手术与开放手术治疗肝胆疾病的效果观察

目的观察腹腔镜手术与开放手术治疗肝胆疾病的临床效果。方法对我院2015年2月~2016年9月普外科收治的86例肝胆疾病患者按入院顺序分为两组,对照组43例患者实施开放手术治疗,观察组43例患者行腹腔镜手术治疗,观察比较两组患者的手术相关指标及并发症发生情况。结果两组患者的手术指标比较,观察组术中出血量、手术时间、住院时间均明显低于对照组,差异具有统计学意义(P0.05);两组患者术后胃肠功能恢复时间、首次进食时间、肛门排气时间、排便时间比较,观察组均低于对照组,差异均有统计学意义(P0.05);两组术后并发症发生率比较,观察组的并发症发生率为4.65%(2/43)明显低于对照组的20.93%(9/43),差异具有统计学意义(P0.05)。结论腹腔镜手术治疗肝胆疾病的效果显著优于传统开放手术,能显著改善手术各项指标,值得临床推广。     

腹腔镜下保留盆腔神经功能的宫颈癌根治术与传统根治术的疗效比较

目的:探讨保留盆腔神经功能的根治性子宫切除术治疗宫颈癌的可行性及临床疗效.方法:110例宫颈癌患者作为研究对象,其中观察组60例、对照组50例,对比分析两组手术时间、术中出血量、清扫淋巴结数及术后膀胱功能恢复等.结果:两组患者在术中出血量、术中输血率、手术切除长度、盆腔淋巴结切除个数和腹主动脉淋巴结清扫例数方面的差异均无统计学意义(P＞0.05);观察组术后膀胱功能优于对照组(P＜0.05);对照组术后排气时间、术后排便时间均比观察组长(P＜0.05);两组患者术后尿流动力学方面的差异无统计学意义(P＞0.05).结论:保留盆腔神经功能的根治性子宫切除术技术上安全可行,有利于术后膀胱、直肠功能的恢复.     

电针穴位刺激治疗术后肠麻痹护理观察

目的总结电针穴位刺激治疗腹部术后肠麻痹的护理措施。方法将72例腹部术后肠麻痹患者随机分为两组,对照组给予单纯常规治疗及护理,治疗组给予基础治疗结合电针穴位刺激,观察两组患者肠鸣音恢复时间,首次肛门排气、排便时间。结果治疗组肠鸣音恢复时间,首次肛门排气、排便时间较对照组明显缩短,两组比较差异具有显著统计学意义(P0.05)。结论电针穴位刺激治疗术后肠麻痹,可缩短排气、排便时间,促进胃动力,改善胃肠功能。     

腹腔镜微创手术对胃穿孔患者的疗效及胃肠动力的影响

目的:探讨腹腔镜微创手术治疗胃穿孔患者的疗效及对胃肠动力的影响。方法:收集我院于2015年6月~2016年6月间收治的胃穿孔患者92例。通过随机数表法分为观察组及对照组各46例,给予观察组患者腹腔镜微创手术治疗,给予对照组患者开腹手术治疗,比较两组患者临床相关指标及胃肠动力指标,采用放射免疫法测定两组术前、术后第1h、1d、2d、3d血清中胃泌素(GAS)水平,统计两组患者并发症情况。结果:观察组患者术中出血量、住院时间均低于对照组,差异均有统计学意义(P0.05);观察组患者肠鸣音恢复时间、肛门排气时间均低于对照组,差异均有统计学意义(P0.05);观察组患者手术时间高于对照组,差异有统计学意义(P0.05)。两组患者术后第1d、2d、3d GAS水平均明显高于术前,且观察组患者均高于对照组,差异均有统计学意义(P0.05);观察组并发症发生率低于对照组,差异有统计学意义(P0.05)。结论:腹腔镜微创手术治疗胃穿孔具有出血量少,住院时间更短,胃肠动力恢复更快,并发症较少等多方面的优势,具有良好的应用前景。     

脾动脉介入栓塞治疗外伤性脾破裂的临床效果及对患者免疫功能的影响

目的:探讨脾动脉介入栓塞治疗外伤性脾破裂的临床效果及对患者免疫功能的影响。方法:选择2013年4月到2017年2月在中国人民解放军第九七医院进行急诊治疗的116例外伤性脾破裂患者,根据治疗方法的不同将其分为观察组60例与对照组56例,对照组接受脾脏切除手术,观察组给予脾动脉介入栓塞治疗,记录和比较两组的术后下床活动时间、术后住院时间、术后肛门排便时间、术后肛门排气时间、术中输血量、手术时间与治疗前后CD4~+/CD8~+、CD8~+、CD4~+、CD3~+的变化及不良反应的发生情况。结果:所有患者都完成治疗并抢救成功,观察组的术后下床活动时间、术后住院时间、术后肛门排便时间、术后肛门排气时间、术中输血量、手术时间都少于对照组(P0.05)。观察组围手术期间的急性肠梗阻、急性胰腺炎、肺炎等并发症发生率为3.33%,对照组为17.86%,观察组低于对照组(P0.05)。术后14天,两组白细胞与血小板含量均显著高于术前1天(P0.05),而观察组血小板含量显著低于对照组(P0.05),但两组白细胞含量比较差异无统计学意义(P0.05)。观察组术后14天与术后1个月的CD4+/CD8+、CD4+、CD3+值均明显高于对照组(P0.05),两组CD8+对比差异无统计学意义(P0.05)。结论:脾动脉介入栓塞治疗外伤性脾破裂能提高治疗的临床效果,减少术后并发症的发生,促进患者免疫功能的恢复。     

腹腔镜早期子宫内膜癌手术临床疗效分析

目的:探讨腹腔镜下早期子宫内膜癌分期手术与开腹手术的临床疗效的差异.方法:回顾性研究2008年1月～2012年10月在我院行子宫内膜癌分期手术的84例患者临床资料,手术病理分期为ⅠA～Ⅱ期.其中腹腔镜分期手术40例,开腹分期手术44例,比较2组手术时间、术中出血量、淋巴结清扫数目、术后胃肠功能恢复时间、并发症、术后住院时间.结果:腹腔镜组手术时间长于开腹组,两者相比具有统计学意义(P＜0.05);腹腔镜组术中出血量显著少于开腹组(P＜0.05);淋巴结清扫总数显著多于开腹组(P＜0.05);腹腔镜组在排气时间、尿管拔除时间、术后出院时间均显著早于开腹组(P＜0.05);两者并发症方面无统计学差异(P＞0.05).结论:腹腔镜分期手术较开腹手术更具微创价值,是治疗早期子宫内膜癌稳妥可行的选择.     

腹腔镜下结直肠癌手术的临床疗效观察及对胃肠功能的影响分析

目的探讨腹腔镜下结直肠癌手术的临床疗效及对胃肠功能的影响。方法选择2013年4月~2016年3月在我院实施结直肠癌手术的患者82例,根据患者及其家属对治疗的意愿将其分为对照组和研究组,对照组41例行传统开放式手术,研究组41例行微创腹腔镜手术,观察比较两组患者的手术时间、术中失血量、住院时间以及治疗前后胃泌素与胃动素水平、术后肠鸣音恢复时间、排气时间、术后并发症发生情况以及1年生存率。结果研究组患者术中失血量与住院时间明显低于对照组,差异有统计学意义(P0.05)。治疗后,研究组患者的胃动素与胃泌素均高于对照组(均P0.05),肠鸣音恢复时间及排气时间均低于对照组(均P0.05);术后并发症发生率比较,研究组为4.88%明显低于对照组的19.51%,差异有统计学意义(P0.05)。结论腹腔镜下行结直肠癌手术可有效促进术后胃肠功能恢复,提高治疗效果,且并发症少,值得临床应用。     

内镜圈套息肉摘除术治疗结肠大息肉的临床疗效

目的:探讨内镜与手术治疗结肠大息肉的临床疗效。方法:选取2011年12月至2013年12月本院诊治的结肠大息肉患者144例,随机分为观察组和对照组,每组72例。对照组患者采用传统手术治疗,观察组患者采用内镜治疗。观察并比较两组患者的治疗效果。结果:观察组手术时间、术中出血量、术后禁食时间、术后住院时间、住院费用均少于对照组,差异具有统计学意义(P0.05);观察组术后排气时间、下床活动时间、术后排便时间均早于对照组,差异具有统计学意义(P0.05)。观察组术后并发症发生率、术后复发率、二次手术率均明显低于对照组,随访1年镜检结果明显优于对照组,患者满意度明显高于对照组,差异均有统计学意义(P0.05)。结论:内镜与手术均是治疗结肠大息肉的有效方案,其中内镜治疗的效果更佳,创伤小,可明显缩短治疗时间和恢复时间,有助于减少住院费用,并发症少且安全性高,复发率低,易为患者所接受。     

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。