腔内大量盐水灌洗辅助取出乳房内聚丙烯酰胺水凝胶临床应用

目的：探讨聚丙烯酰胺水凝胶注射隆胸后取出新方法.方法：对48例注射聚丙烯酰胺水凝胶隆胸患者术前行双乳MRI或彩超检查结合触诊准确定位.全麻小切口开放直视下吸出水凝胶,再用大量生理盐水反复灌洗所有腔隙,直至手感探测不到硬结,盐水中无水凝胶为止.结果：48例患者术后无继发感染和出血等并发症.术前诸症状体征消失,无明显乳房变形,乳房形态术后恢复满意.术后双乳MRI复查未见明显异物残留.术后1 ～12月（6.2±0.3月）45例随访复查MRI亦未见异物残留,乳房修复完好.结论：注射隆乳后腔内大量盐水灌洗辅助取出水凝胶具有创伤小、出血少、操作简单、费用低廉的优点,是一种较好的、值得推广的凝胶取出术式.     

Process model comparison and transferability across bioreactor scales and modes of operation for a mammalian cell bioprocess

A Monod kinetic model, logistic equation model, and statistical regression model were developed for a Chinese hamster ovary cell bioprocess operated under three different modes of operation (batch, bolus fed‐batch, and continuous fed‐batch) and grown on two different bioreactor scales (3 L bench‐top and 15 L pilot‐scale). The Monod kinetic model was developed for all modes of operation under study and predicted cell density, glucose glutamine, lactate, and ammonia concentrations well for the bioprocess. However, it was computationally demanding due to the large number of parameters necessary to produce a good model fit. The transferability of the Monod kinetic model structure and parameter set across bioreactor scales and modes of operation was investigated and a parameter sensitivity analysis performed. The experimentally determined parameters had the greatest influence on model performance. They changed with scale and mode of operation, but were easily calculated. The remaining parameters, which were fitted using a differential evolutionary algorithm, were not as crucial. Logistic equation and statistical regression models were investigated as alternatives to the Monod kinetic model. They were less computationally intensive to develop due to the absence of a large parameter set. However, modeling of the nutrient and metabolite concentrations proved to be troublesome due to the logistic equation model structure and the inability of both models to incorporate a feed. The complexity, computational load, and effort required for model development has to be balanced with the necessary level of model sophistication when choosing which model type to develop for a particular application. © 2012 American Institute of Chemical Engineers Biotechnol. Prog., 2013     

Untersuchungen über den Vitamin B2-Bedarf der Legehenne

Because of the well established function of carnitine possible effects of carnitine were studied in poultry. In trial I it was investigated if carnitine and its precursors (lysine, methionine) reduce the formation of abdominal fat in broilers. Chickens (10 groups of 10 chickens each) were fed different diets (control, lysine and methionine in excess and deficient, respectively, with or without 5% fat supplement, L‐carnitine and DL‐carnitine supplement, respectively).Performance (body weight gain, feed conversion), amount of abdominal fat and carnitine concentration in blood, muscles (M. sartorius, M.pectoralis superficialis, cardiac), liver and kidney were determined. Performance and abdominal fat were influenced by dietary fat, lysine and methionine as expected and were not altered by carnitine. Excess and deficiency of lysine and methionine did not influence, fat supplement reduced and carnitine supplementation significantly increased tissue concentration of carnitine.

In trial II it was studied if supplementation of a commercial layers’ ration with either 500 mg L‐carnitine or 500 mg nicotinic acid or both per kg reduces the cholesterol concentration in yolk. Influence on body weight, feed intake, laying performance, serum and yolk cholesterol concentration could not be observed, but yolk concentration of carnitine was significantly increased in supplemented groups.

Trial III should clarify if the L‐carnitine content in broiler parentstock ration influences hatchability. Four groups of 1350 hens each were fed a commercial all‐mash supplemented with 0, 20, 50 and 100 mg L‐carnitine, respectively. Hatching rate was increased from 83% to 87% and from 82.4% to 85.3% in groups supplemented with 50 and 100 mg L‐carnitine, respectively, and in randomly sampled eggs of these groups carnitine concentration in yolk was higher.     

全凭静脉麻醉期间右美托咪定对靶控输注丙泊酚用量及血流动力学的影响

目的：探讨右关托咪定（dexmedetomidine,DEX）对行全凭静脉麻醉患者靶控输注（target controlled infusion,TCI）丙泊酚用量及拔管期间血流动力学的影响。方法：选择拟于全麻下行经鼻蝶窦垂体瘤切除术的患者30例（ASA I～II级）,随机分为两组,每组15例。试验组（D组）给予DEX负荷剂量0．5μg·kg-1,注药时间15rain,继以0．3μg·kg-1·h-1持续输注至修补硬膜时;对照纽（N组）在相同时间给予等容量生理盐水。两组麻醉诱导方法相同,术中以脑电双频指数（bispectral index,BIS）为麻醉深度监测指标,根据BIS值调节丙泊酚血浆靶浓度维持麻醉。记录拔管期间收缩压（SBP）、舒张压（DBP）和心率（HR）,并计算心肌氧耗指数（RPP）;记录丙泊酚平均用量、用药前后BIS值、呼吸恢复时间、睁眼时间、拔管时间及术中不良反应。结果：①D组给予负荷剂量后,BIS值由（95±3）降至（77±11）,差异有统计学意义（P〈0．01）。②与N组相比,D组丙泊酚用量减少28％,差异有统计学意义（P〈0．01）。⑧拔管期间SBP、DBP和HR与入室时比较,D组无明显变化,N组HR显著升高（P〈0．05）;D组拔管期间SBP、DBP、HR和RPP明显低于N组（P〈0．05）;④两组患者呼吸恢复时间、睁眼时间及拔管时间差异均无统计学意义;⑤两组不良反应（心动过缓、高血压、低血压）的发生率无显著性差异。结论：术中持续静脉输注DEX可减少TCI丙泊酚用量,能使BIS值进一步降低,产生良好镇静效应;同时可有效减轻拔管期间循环变化,降低RPP,减少心肌耗氧量,提高拔管质量。     

胸腔镜与传统手术方法对非小细胞肺癌患者的临床疗效

目的:比较电视胸腔镜手术与传统手术方法对非小细胞肺癌治疗的临床效果.方法:选择2010年5月至2012年6月本院收治的非小细胞肺癌患者84例,随机分为VATS组和OT组,各42例,VATS组行全胸腔镜肺叶切除术;OT组行传统开胸肺叶切除术.比较两组患者手术时间、淋巴结清扫数、术中出血量、术后引流时间、住院天数、术后疼痛和并发症发生情况,观察并比较两组患者术后3d血清CRP、TNF-α、IL-6、IL-10水平.结果:VATS组术后引流时间、住院时间明显短于OT组(P＜0.05);两组手术时间、淋巴结清扫数、术中出血量及并发症发生率比较无统计学差异(P＞0.05);VATS组术后1d、3d疼痛评分明显低于OT组(P＜0.05);VATS组术后3d血清CRP、TNF-α、IL-6、IL-10水平明显低于OT组(P＜0.05).结论:与传统手术相比,电视胸腔镜手术对患者创伤较小,患者术后炎症反应较低,痛苦较小,可作为非小细胞肺癌的推荐手术方式.     

妇科针对性护理对保守治疗、开腹手术治疗、腹腔镜微创手术治疗宫外孕患者机体恢复的影响

目的:目前宫外孕的发病率日趋增多,发病年龄也趋向年轻化,为减轻患者痛苦,促进其早日康复,本文旨在回顾性分析妇科护理工作在三种方式治疗宫外孕治疗中的作用.方法:选取2010年10月至2011年9月间,于我院妇科进行宫外孕手术的患者172例,针对172例患者所采取的保守治疗、开腹手术治疗、腹腔镜微创手术三种不同治疗方法,根据不同情况,实施多种妇科针对性护理措施,并对结果进行回顾性分析和总结.结果:172例宫外孕患者经腹腔镜微创手术治疗治愈126例,经过针对性妇科护理,平均住院6.56天;开腹手术治愈26例,经过针对性妇科护理,平均住院9.85天;保守治疗20例,保守治疗失败转为手术治疗3例,平均住院17.87天.经过对所有患者采取有效的针对性精心护理,护理效果较为满意,预后情况良好.结论:腹腔镜微创手术治疗因其创伤小、恢复快,且兼具明确诊断和治疗的作用,是目前临床治疗宫外孕的主要方法;对选择不同治疗方式的患者采取有效的针对性护理,可以提高护理质量和治疗效果,减轻患者痛苦、减少并发症的发生,确保患者早日康复出院.     

小儿慢性胃炎的消化道外表现(附864 例报道)

目的:分析和总结小儿慢性胃炎的消化道外表现。方法:选择2008年1月~2008年10月哈尔滨医科大学附属第二医院儿科门诊诊治的经腹部胃区叩诊法确诊为慢性胃炎的患儿864例,建立随访卡片,分析和总结其消化道内及消化道外的临床表现。结果:864例患儿常见的消化道症状依次为腹痛、恶心呕吐、便秘、上腹压痛。消化道外表现依次为头痛、刀枪刺、鼻出血、胸痛、多动抽动、手足搐搦。消化道外表现的发病率并不低于消化道表现,特别是头痛的发病率高达58.54%。腹痛、恶心呕吐症状缓解得最快,其次是头痛、头晕、胸闷、胸痛,多动症状较晚缓解,腹部叩痛的消失时间最晚。结论:小儿慢性胃炎的胃肠道外表现广泛存在,且极易与脑炎、心肌炎误诊,值得关注。头痛、胸痛的产生原因可能与内脏-内脏之间的牵涉痛有关。     

上胸段硬膜外阻滞治疗慢性心力衰竭合并房颤的临床研究

目的:比较上胸段硬膜外阻滞对有无合并房颤的扩张型心肌病心衰患者的疗效差异。方法:入选40例扩张型心肌病心衰患者,根据入院心电图有无房颤分为房颤组和非房颤组。所有患者均在抗心力衰竭常规治疗基础上,给予胸段硬膜外阻滞治疗4周,比较治疗前、后NYHA心功能分级、血浆N末端脑钠肽前体(NT-pro BNP)水平、左室射血分数(LVEF)、左室舒张期内径(LVEDD)及左房前后径(LAD)的变化情况。结果:与治疗前比较,两组患者经治疗后的NYHA心功能分级、NT-pro BNP、LVEF、LVEDD及LAD均明显改善(均P0.05),差异有统计学意义,但两组间各指标治疗前后的差值无统计学意义(P0.05)。结论:对于慢性心力衰竭合并房颤的患者而言,给予抗心力衰竭常规治疗基础上联合上胸段硬膜外阻滞治疗有效,且房颤的存在与否不影响上胸段硬膜外阻滞的疗效。     

Bringing the “General Strike” Back In: DuBois,Slavery and Emancipation

ABSTRACT

The “general strike” of slaves in the Civil War was a direct action that involved millions of small and large acts of defiance by slaves. These actions pushed President Lincoln from hesitation to full on military action, although this chapter of history has been neglected. The work of W.E.B. Du Bois reinserted the agency of slaves in their own liberation through the “general strike” but this analysis has also been pushed to the margins. David Roediger's “Seizing Freedom: Slave Emancipation and Liberty for All' is an important corrective to this historical omission.