腹腔镜辅助胃癌根治术对胃癌肠道屏障功能、血清炎性因子水平影响及护理对策分析

为分析腹腔镜辅助胃癌根治术对胃癌肠道屏障功能、血清炎性因子水平影响及护理对策。本研究选取106例自2015年4月至2017年1月我院收治的胃癌患者,根据随机数字法分为对照组和观察组,每组53例。。对照组患者采用开腹胃癌根治术治疗,观察组患者采用腹腔镜辅助胃癌根治术治疗,分析两组患者治疗效果。术中及术后观察比较两组患者的手术时间、切口长度及血清炎性因子水平。结果显示,观察组患者手术时间较对照组更短;切口长度较对照组更短;观察组肠道功能恢复时间较对照组更短;下床活动时间也明显短于对照组(p0.05)。手术过程中,两组患者清扫淋巴结个数无统计学差异(p0.05)。术前,观察组与对照组患者D-乳酸、二胺氧化酶、CRP、IL-6、IL-8及HO-1水平无统计学差异(p0.05);手术后3 d,观察组患者CRP、IL-6、IL-8及HO-1水平均低于对照组,术后7 d时,观察组患者D-乳酸、二胺氧化酶水平均低于对照组(p0.05)。两组患者术前和术后7 d时RbP、PRE及ALB水平比较无统计学差异(p0.05)。研究表明,采用腹腔镜辅助胃癌根治术治疗胃癌创伤小,引起机体应激反应较轻,对肠道屏障功能影响较小,有利于患者术后恢复。     

直肠系膜切除术对直肠癌根治术后局部复发患者MMPs、CEA、CA199及生存率的影响

目的:探讨直肠系膜切除术对直肠癌根治术后局部复发患者血清基质金属蛋白酶、肿瘤标志物(CEA、CA199)及生存率的影响。方法:收集直肠原发癌位于直肠中下段的病例,行直肠癌根治术复发再入院患者48例(均为本院2010年4月-2014年3月手术后的病例),按照手术方式的不同分为2组,分别24例。对照组采用姑息性手术治疗,研究组采用直肠系膜切除术治疗,采用ELISA法测定血清MMP-2、MMP-9、CEA、CA199水平,记录所有患者术后并发症状况,术后进行随访时间为3年,比较两组1年、3年的生存率状况。结果:对照组在手术时间、出血量、住院时间上高于研究组,(P0.05);对照组在肛门排气时间上低于研究组,(P0.05);与治疗前比较,两组患者治疗2周后MMP-2、MMP-9表达水平降低,治疗2周后血清CEA、CA199表达水平降低(P0.05);与对照组比较,研究组患者治疗2周后MMP-2、MMP-9表达水平较低,治疗2周后血清CEA、CA199表达水平较低(P0.05);两组患者治疗期间并发症无差异(P0.05);两组间术后1年生存率,无差异(P0.05);研究组术后3年生存率(66.67%)高于对照组(37.50%),(P0.05)。结论:直肠系膜切除术可提高直肠癌根治术后局部复发患者的长期生存率,降低血清MMP-2、MMP-9、CEA、CA199水平,安全性高,值得广泛推广。     

腹腔镜胃癌根治术治疗胃癌的疗效及对患者血清TNF-α与IL-1β水平的影响

目的:研究腹腔镜胃癌根治术对胃癌患者的临床疗效及其对患者血清肿瘤坏死因子-α(TNF-α)与白介素-1β(IL-1β)的影响。方法:选取2014年8月至2015年7月本院收治的84例胃癌患者,随机分为观察组和对照组,每组42例。对照组采用传统开腹手术治疗,观察组采取腹腔镜胃癌根治术治疗。比较两组患者的手术指标,手术前后TNF-α、IL-1β细胞因子水平,术后并发症的发生情况。结果:两组患者的淋巴结清扫数量比较无显著性差异(P0.05),观察组手术时间长于对照组,但观察组的术中出血量明显少于对照组(P0.05),首次排气时间、首次下床活动时间、首次进食时间、术后住院时间明显短于对照组(P0.05)。术后1天,观察组的TNF-α与IL-1β水平显著低于对照组(P0.05)。观察组的切口感染、肺部感染发生率显著低于对照组(P0.05),两组患者的吻合口瘘、吻合口出血、术后胃瘫并发症发生率比较无显著性差异(P0.05)。结论:腹腔镜胃癌根治术治疗胃癌具有切口小、手术时间短、出血量少、恢复快、安全性高等优势,临床疗效良好,且能降低患者围术期血清TNF-α、IL-1β水平。     

直肠癌根治术治疗直肠癌的疗效及对b FGF、MTL及GDF-15的影响

目的:探讨直肠癌根治术治疗直肠癌的疗效及对重组人碱性成纤维细胞生长因子(b FGF)、胃动素(MTL)及生长分化因子-15(GDF-15)的影响。方法:选择2016年01月-2019年12月在我院接受治疗的104例直肠癌患者,采用抽签法分为观察组(n=54)和对照组(n=50)。对照组给予传统开腹直肠癌根治术治疗,观察组给予腹腔镜直肠癌根治术治疗。比较手术情况、血清b FGF、MTL、GDF-15、C反应蛋白(CRP)、超氧化物歧化酶(SOD)、丙二醛(MDA)、血管活性肠肽、胃泌素变化情况及并发症发生情况。结果:观察组手术时间显著高于对照组,术中出血量、住院时间、术后排气时间及切口长度均显著低于对照组,差异显著(P0.05);治疗前,两组血清b FGF、MTL及GDF-15水平无明显差异;治疗后,两组血清b FGF、MTL及GDF-15水平均显著降低,且观察组上述指标均低于对照组(P0.05);治疗前,两组应激反应水平无明显差异;治疗后,两组血清CRP、MDA水平均显著升高,且观察组上述指标均低于对照组,两组SOD均显著下降,观察组高于对照组(P0.05);治疗前,两组胃肠激素水平无明显差异;治疗后,两组血管活性肠肽均显著升高,且观察组低于对照组,胃泌素水平均显著降低,且观察组均高于对照组(P0.05);两组并发症总发生率为5.56%、26.00%,差异具有统计学意义(P0.05)。结论:在直肠癌患者中应用腹腔镜直肠癌根治术效果显著,可有效改善患者血清b FGF、MTL及GDF-15,且并发症较少。     

快速康复外科理念对结直肠癌根治术患者疗效及机体应激反应的影响

目的:探讨快速康复外科理念应用于结直肠癌根治术患者的疗效及其对机体应激反应的影响。方法:选取2012年1月-2013年6月我院收治的180例结直肠癌患者为研究对象,采用随机数字表法分为对照组与观察组,每组各90例。两组患者均进行结直肠癌根治术治疗,对照组患者围手术期采用传统处理措施,观察组患者围手术期采用快速康复处理措施,对比两组患者术中出血量、手术时间、术后住院时间、住院费用、术后排便时间、首次排气时间,同时比较两组患者手术当日、术后1 d、5 d血清白细胞介素-6(IL-6)、C反应蛋白(CRP)及血清淀粉样蛋白A(SAA)的水平,并观察两组患者并发症发生情况。结果:与对照组相比,观察组患者的术后住院时间、术后排便时间及首次排气时间均缩短,住院费用降低,差异有统计学意义(P0.05),两组患者术中出血量、手术时间对比差异无统计学意义(P0.05)。术前,两组患者的血清IL-6、CRP、SAA水平对比差异无统计学意义(P0.05),术后1 d、5 d,两组患者血清IL-6、CRP、SAA水平均高于术前,术后5 d血清IL-6、CRP、SAA水平低于术后1 d,差异有统计学意义(P0.05),观察组患者术后1 d、5 d血清IL-6、CRP、SAA水平均低于对照组,差异有统计学意义(P0.05)。观察组并发症总发生率为6.67%,与对照组的7.78%比较差异无统计学意义(P0.05)。结论:快速康复外科理念应用于结直肠癌根治术患者能够有效加快患者术后康复,降低术后应激反应,值得临床推广。     

单切口腹腔镜在结直肠手术中的应用效果及对炎症因子与应激反应的影响

目的:探讨单切口腹腔镜在结直肠手术中的应用效果及对炎症因子与应激反应的影响。方法:选择2018年1月至2019年10月我院接诊的98例结直肠癌患者,通过随机数表法分为2组,每组49例。观察组使用单切口腹腔镜结直肠癌根治术,对照组使用传统腹腔镜结直肠癌根治术,常规5孔操作法。比较两组围术期相关情况、手术前后血清炎症因子水平的变化、手术后应激反应及并发症的发生情况。结果:两组淋巴结清扫个数、中转开腹例数、术后排气时间比较差异均无统计学意义(P0.05),观察组手术时间明显长于对照组,脐切口长度、住院时间、术中出血量均显著短于或低于对照组;两组术后1 d、3 d、5 d时高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)水平均明显高于术前(P0.05);且观察组术后1d、3d、5d时hs-CRP、TNF-α、IL-6、NE、E、Cor较对照组显著降低(P0.05);两组吻合口瘘、吻合口狭窄、吻合口出血、小肠穿孔、肠梗阻、感染的总发生率比较差异无统计学意义(P0.05)。结论:和传统5孔操作法相比,单切口腹腔镜结直肠癌根治术治疗结直肠癌患者的手术时间更长,但术后炎症因子表达更低,应激反应更小,有利于患者术后恢复。     

腹腔镜微创对直肠癌患者肛肠动力学及血清CEA, CA724水平的影响

目的:探讨腹腔镜微创对直肠癌患者肛肠动力学及血清癌胚抗原(CEA)、糖链抗原724(CA724)水平的影响。方法:选择2014年3月~2016年3月38例直肠癌患者为研究组及同期40例非肿瘤性肠息肉患者为对照组,比较术前两组的肛肠动力学指标(肛管静息压(ARP)、直肠静息压(RRP)、肛管最大收缩压(MSP)、直肠最大耐受容量(MTV),检测研究组术前及术后3 d、1、2周血清CEA、CA724水平,并观察临床疗效。结果:研究组术前ARP、RRP、MSP、MTV与对照组比较无明显差异(P0.05),术后2、4周均明显降低(P0.05),之后逐渐恢复,并在术后12周基本恢复至术前水平。研究组术后3 d血清CEA、CA724水平与术前比较无明显差异(P0.05),术后1、2周均明显低于术前(P0.05)。临床有效率为65.8%。结论:腹腔镜微创治疗直肠癌的疗效确切,可有效降低肿瘤标志物水平,虽对肛肠动力学有一定的影响,但可在短期内恢复正常。     

依托咪酯持续输注对乳腺癌根治术患者血流动力学及炎症介质的影响

目的:研究依托咪酯持续输注用于乳腺癌根治术患者的镇痛效果及对血流动力学与炎症介质的影响。方法:选取2015年8月至2016年7月我院收治的84例乳腺癌根治术患者,根据患者入院顺序分为观察组和对照组,42例每组。观察组持续输注依托咪酯,对照组持续输注丙泊酚。比较两组患者手术后不同时点视觉模拟评分(VAS),拔管时舒张压(DBP)、收缩压(SBP)、心率(HR)及血清白介素-2(IL-2)、IL-10、IL-12水平的变化。结果:拔管时,观察组的DBP、SBP、HR水平显著低于对照组(P0.05)。观察组在术后1、5、10、24、48 h的VAS评分均显著低于对照组(P0.05)。观察组术后3天时血清IL-2水平显著高于对照组(P0.05),IL-10、IL-12水平显著低于对照组(P0.05)。结论:依托咪酯持续输注用于乳腺癌根治术患者中的镇痛效果良好,且对患者血流动力学与炎症反应的影响较小。     

腹腔镜膀胱癌根治术的临床疗效及对患者血清SF, SIL-2R及TSGF水平的影响

目的:分析腹腔镜膀胱癌根治术的临床疗效及对血清铁蛋白(SF)、可溶性白介素-2受体(SIL-2R)、肿瘤特异性生长因子(TSGF)的影响。方法:选择2012年8月~2016年2月于我院就诊的98例膀胱癌患者,参照抽签法分作对照组(n=49)与研究组(n=49),对照组采用开放性膀胱癌根治术治疗,研究组采用腹腔镜膀胱癌根治术治疗,观察两组手术时间、术中出血量、肛门排气时间、住院时间、淋巴结清扫数目,SF、SIL-2R、TSGF,白细胞数、皮质醇,并发症率及复发率。结果:研究组手术时间多于对照组,研究组术中出血量、肛门排气时间、住院时间均少于对照组,组间差异有统计学意义(P0.05)。两组淋巴结清扫数目、复发率比较无差异(P0.05)。术后,两组SF、SIL-2R、TSGF均降低,组间比较无差异(P0.05),两组白细胞数、皮质醇均上升,研究组低于对照组(P0.05)。结论:LRC与ORC的临床疗效相似,均可降低血清SF、SIL-2R、TSGF水平,但LRC的创伤较小,在严格掌握适应症的情况下可作为膀胱癌的首选方式。     

腹腔镜与开腹宫颈癌根治术对患者血清IL-4, IL-10, TNF-α及IFN-γ水平的影响

目的:探讨腹腔镜与开腹宫颈癌根治术对患者血清白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-a)、γ-干扰素(IFN-γ)水平的影响。方法:选取2014年3月至2016年9月在我院接受治疗的64例宫颈癌患者作为研究对象,通过随机方式分为腹腔组和开腹组。比较两组患者的手术时间、术中出血量、术后通气时间、治疗前后血清IL-4、IL-10、TNF-a、IFN-r水平的变化。结果:腹腔组患者的术中出血量和术后通气时间明显低于或短于开腹组(P0.05),而两组患者的手术时间比较差异无统计学意义(P0.05)。术前,两组患者的血清IL-4、IL-10、TNF-α及IFN-γ水平比较差异均无统计学意义(P0.05);术中,腹腔组的血清IL-4水平明显低于开腹组(P0.05),其余三组指标水平与开腹组比较差异无统计学意义(P0.05);术后1天和7天,腹腔组患者的血清IL-4、IL-10、TNF-α及IFN-γ水平均明显低于开腹组(P0.05)。结论:腹腔镜宫颈癌根治术在术中失血量更少,安全性更高,且对于患者术后的IL-4、IL-10、TNF-α和IFN-γ水平抑制效果更加明显,利于患者的术后恢复。     

GAP-43，Netrin-1，Collapsin-1和Neuropilin-1在出生后小鼠小脑中的动态表达

GAP-43,netrin-1,collapsin-1和neuropilin-1被认为在成网络分布的神经联系中发挥重要的作用．在年幼的啮齿类动物中,小脑包含5种不同的集中分布层：白质、内颗粒细胞层(IGL)、浦肯野氏细胞层(PCL)、分子层(ML)和外颗粒细胞层(EGL)．与浦肯野氏神经元在出生前产生这一点不同的是,EGL中的细胞在出生后产生,它们接受从前脑olivary核团发出的攀援纤维的主要神经投射,以及从内颗粒细胞发出的平行纤维的神经投射．这些神经投射主要在出生后的前3个星期内建立,同时还有浦肯野氏细胞的发育和成熟．而GAP-43,netrin-1,collapsin-1和neuropilin-1在出生后小脑发育的潜在作用仍然不清楚．为了更加清楚地探讨上述问题,检验了GAP-43,netrin-1,collapsin-1和neuropilin-1的mRNA与蛋白质在出生后5,10,20天和成年小鼠小脑中的表达情况．研究结果显示,这4种分子在小鼠出生后的小脑中有不同的时间和空间表达形式,这些结果与出生后发育和成年期间的轴突发生、延伸以及突触形成都有关联．通过免疫组织化学双标染色,发现小鼠出生后10天的小脑中,GAP-43阳性的浦肯野氏细胞也显示netrin-1或collapsin-1阳性,并且collapsin-1阳性的细胞也对 netrin-1 阳性．上述研究结果证明这4种分子可能参与了小脑的出生后发育．     

Conservation of a chemokine system, XCR1 and its ligand, XCL1, between human and mice

Understanding dendritic cell (DC) subset functions should lead to the development of novel types of vaccine. Here we characterized expression of XC chemokine receptor 1 (XCR1) and its ligand, XCL1. Murine XCR1 was the only chemokine receptor selectively expressed in CD8α⁺ conventional DCs. XCL1 was constitutively expressed in NK cells, which contribute to serum XCL1 levels. NK and CD8⁺ T cells increased XCL1 production upon activation. These expression patterns were conserved in human blood cells, including the BDCA3⁺ DC subset. Thus, in human and mice, certain DC subsets should be chemotactic towards NK or activated CD8⁺ T cells through XCR1.     

Ligand Perception,Activation, and Early Signaling of Plant Steroid Receptor Brassinosteroid Insensitive

Leucine-rich repeat receptor-like kinases （LRR-RLKs） belong to a large group of cell surface proteins involved in many aspects of plant development and environmental responses in both monocots and dicots. Brassinosteroid insensitive 1 （BRI1）, a member of the LRR X subfamily, was first identified through several forward genetic screenings for mutants insensitive to brassinosteroids （BRs）, which are a class of plant-specific steroid hormones. Since its identification, BRI1 and its homologs had been proved as receptors perceiving BRs and initiating BR signaling. The co-receptor BRIl-associated kinase 1 and its homologs, and other BRI1 interacting proteins such as its inhibitor BRI1 kinase inhibitor I （BKI1） were identified by genetic andbiochemical approaches. The detailed mechanisms of BR perception by BRI1 and the activation of BRI1 receptor complex have also been elucidated. Moreover, several mechanisms for termination of the activated BRI1 signaling were also discovered. In this review, we will focus on the recent advances on the mechanism of BRI1 phosphorylation and activation, the regulation of its receptor complex, the structure basis of BRI1 ectodomain and BR recognition, its direct substrates, and the termination of the activated BRI1 receptor complex.     

DISC1, PDE4B, and NDE1 at the centrosome and synapse

Disrupted-In-Schizophrenia 1 (DISC1) is a risk factor for schizophrenia and other major mental illnesses. Its protein binding partners include the Nuclear Distribution Factor E Homologs (NDE1 and NDEL1), LIS1, and phosphodiesterases 4B and 4D (PDE4B and PDE4D). We demonstrate that NDE1, NDEL1 and LIS1, together with their binding partner dynein, associate with DISC1, PDE4B and PDE4D within the cell, and provide evidence that this complex is present at the centrosome. LIS1 and NDEL1 have been previously suggested to be synaptic, and we now demonstrate localisation of DISC1, NDE1, and PDE4B at synapses in cultured neurons. NDE1 is phosphorylated by cAMP-dependant Protein Kinase A (PKA), whose activity is, in turn, regulated by the cAMP hydrolysis activity of phosphodiesterases, including PDE4. We propose that DISC1 acts as an assembly scaffold for all of these proteins and that the NDE1/NDEL1/LIS1/dynein complex is modulated by cAMP levels via PKA and PDE4.     

Interaction of myelin basic protein, melittin and bovine serum albumin with gangliosides, sulphatide and neutral glycosphingolipids in mixed monolayers

Some parameters that may regulate the miscibility and stability of mixed lipid-protein monolayers at the air-145 mM NaCl interface were studied employing six glycosphingolipids (acidic or neutral), three different types of proteins (soluble, extrinsic or highly amphipathic) and some phospholipids. The results obtained show that the percentage of the total area occupied by the protein at the interface is an important parameter leading to lateral phase separations; the amount and area contribution of the protein accepted in the film before the components become immiscible increase with the complexity of the polar head group of the glycosphingolipids. The interactions occur with progressive reductions of the intermolecular packing as the polar head group of the glycosphingolipid becomes more complex and this is accompanied by more negative values of the excess free energy of mixing. The lipid component seems to be the major responsible for the reduction in mean molecular area.     

Levels of ethylene, ACC, MACC, ABA and proline as indicators of cold hardening and frost resistance in winter wheat

Changes in ethylene production and in the contents of 1-aminocydopropane-1-carboxylic acid (ACC), 1-(malonylamin6)-cyclopropane-1-carboxylic acid (MACC), abscisic acid (ABA) and L-proline were determined after 40 days of cold hardening at 4°C in three wheat cultivars differing in frost resistance. Proline and especially ABA accumulated with hardening in all varieties in parallel with the degree of frost resistance, e.g. proline and ABA increases in the non-resistant cv. Slávia were 2x and 5x, whilst in the resistant cv. Mironovská 808 increases were 4X and 20X. Ethylene production and MACC level showed no significant changes with hardening in any of the cultivars after 40 d, but ACC levels did increase with hardening. The production of ethylene, ACC and MACC was studied during hardening. Ethylene production decreased sharply at low temperature and rose rapidly (within 1 day) on return to normal temperature, while ACC production reacted in the opposite direction. MACC levels rose rapidly during the first 4 days of cold, then more slowly for about 2 weeks, thereafter decreasing again steadily. The only varietal differences occurring at maximum levels were correlated with the degree of frost resistance.     

HIFs,angiogenesis, and cancer

Tumor hypoxia was first described in the 1950s by radiation oncologists as a frequent cause of failure to radiotherapy in solid tumors. Today, it is evident that tumor hypoxia is a common feature of many cancers and the master regulator of hypoxia, hypoxia‐inducible factor‐1 (HIF‐1), regulates multiple aspects of tumorigenesis, including angiogenesis, proliferation, metabolism, metastasis, differentiation, and response to radiation therapy. Although the tumor hypoxia response mechanism leads to a multitude of downstream effects, it is angiogenesis that is most crucial and also most susceptible to molecular manipulation. The delineation of molecular mechanisms of angiogenesis has revealed a critical role for HIF‐1 in the regulation of angiogenic growth factors. In this article, we review what has been described about HIF‐1: its structure, its regulation, and its implication for cancer therapy and we focus on its role in angiogenesis and cancer. J. Cell. Biochem. 114: 967–974, 2013. © 2012 Wiley Periodicals, Inc.     

E3 ubiquitin ligases in regulating stress fiber,lamellipodium, and focal adhesion dynamics

Recent discoveries have unveiled the roles of a complicated network of E3 ubiquitin ligases in regulating cell migration machineries. The E3 ubiquitin ligases Smurf1 and Cul/BACURD ubiquitinate RhoA to regulate stress fiber formation and cell polarity, and ASB2α ubiquitinates filamins to modulate cytoskeletal stiffness, thus regulating cell spreading and cell migration. HACE1, XIAP, and Skp1-Cul1-F-box bind to Rac1 and cause its ubiquitination and degradation, thus suppressing lamellipodium protrusions, while PIAS3, a SUMO ligase, activates Rac1 to promote lamellipodium dynamics. Smurf1 also enhances Rac1 activation but it does not ubiquitinate Rac1. Both Smurf1 and HECTD1 regulate focal adhesion (FA) assembly and (or) disassembly through ubiquitinating the talin head domain and phosphatidylinositol 4 phosphate 5-kinase type I γ (PIPKIγ90), respectively. Thus, E3 ubiquitin ligases regulate stress fiber formation, cell polarity, lamellipodium protrusions, and FA dynamics through ubiquitinating the key proteins that control these processes.