Novel Comparative Efficiency of Ozone and Gamma Sterilization on Fungal Deterioration of Archeological Painted Coffin,Saqqara Excavation,Egypt

An archeological wooden painted coffin was excavated in Tety tomb from Saqqara excavation. It belonged to the Ministry of Antiquities. This coffin was discovered in a bad state of conservation with many destroyed big and small pieces in Saqqara stores. Analyses and investigation study were performed on the ground layer of the coffin by X-ray diffraction (XRD), Energy dispersive X ray analysis (EDX) equipped with environmental scanning electron microscopy (ESEM) and Fourier transform infrared spectroscopy (FTIR). Results confirmed that the degradation factors affecting the wooden painted coffin are essentially attributed to direct effects of microbial phenomena, which have lead to many deterioration forms as: macro- and microcracks, hydrated salts, flaking, coloration, scaling and defoliation microbiological spots. Nine deteriorating fungal species were isolated from the painted and ground layers of the tested coffin. Fusarium moniliforme followed by Aspergillus flavus able to significantly solublize calcium salts as major components of the ground layer of archeological wooden coffin. Effect of ozone and Gamma sterilization on growth; lipid, tryptophan oxidation and protein, nucleic acid leakage in the most dominant toxigenic deteriorated fungal species were detected. No mycelial growth was observed at 4 ppm of ozone at all exposure times. As Gamma radiation dose increased over 250 Gy, the growth parameter gradually decreased to reach the lethal dose at 2000 Gy. The production of mycotoxins by the tested toxigenic fungi was completely disappeared under the exposure to 3 ppm and 90 min to ozone.     

经鼻内镜手术进展

颅底手术正随着经鼻内镜手术的发展而发生着转变。经鼻内镜手术最初开发于鼻窦手术,但其适应症已逐渐扩大到其它领域,可以用于治疗大量的疾病。经鼻内镜手术的主要优点是：它利用天然的孔道来处理大量的颅内、鼻窦病变,避免了皮肤切口、面部骨瓣切口、脑回缩等直接开颅所不可避免的后遗症。与传统的神经外科手术相比,发病率和死亡率下降,并间接减少了住院时间和管理成本。本文就经鼻内镜手术的进展进行综述。在综述中阐述了经鼻内镜手术的适应症和基本原则,以及显露、特别是重建技术的进展,这些进展要求在可接受的并发症前提下达到更广泛的切除;讨论了经鼻内镜手术的局限性,尤其是,虽然这种手术往往是“微创”,但它并不是完全没有并发症;展望了经鼻内镜手术的适应症会不断拓宽,并发症会越来越少的美好未来。     

内镜下硬化剂和套扎治疗食管静脉曲张术后对门脉高压性胃病和胃底静脉曲张的影响

目的:探讨食管静脉曲张(EV)采用内镜下套扎术(EVL)和硬化剂(EVS)治疗对患者近远期并发胃底静脉曲张(GV)以及门脉高压性胃病(PHG)并发症的影响。方法:抽选我院肝硬化上消化道出血后接受内镜下治疗的患者97例为研究对象,其中19例予以内镜下EVS治疗,78例行内镜下EVL治疗,随访1年,观察治疗3个月、6个月、1年后并发GV、PHG的近远期概率。结果:治疗3个月后,本组患者GV、PHG等并发症的发生率为17.5%(17/97)、39.2%(38/97),与治疗前比较差异无显著性(P0.05);治疗6个月后,本组患者GV、PHG等并发症的发生率为32%(31/97)、70.1%(68/97),与治疗前相比,并发人数显著增加(P0.05);治疗1年后,GV、PHG的发生率为42.3%(41/97)、88.7%(86/97),并发人数显著高于治疗前(P0.05)。结论:内镜下EVS、EVL治疗在消退食管曲张静脉和良好地控制出血的同时,还可增加PHG、GV的并发几率,值得临床重视预防。     

经鼻内镜手术进展

颅底手术正随着经鼻内镜手术的发展而发生着转变。经鼻内镜手术最初开发于鼻窦手术,但其适应症已逐渐扩大到其它领域,可以用于治疗大量的疾病。经鼻内镜手术的主要优点是:它利用天然的孔道来处理大量的颅内、鼻窦病变,避免了皮肤切口、面部骨瓣切口、脑回缩等直接开颅所不可避免的后遗症。与传统的神经外科手术相比,发病率和死亡率下降,并间接减少了住院时间和管理成本。本文就经鼻内镜手术的进展进行综述。在综述中阐述了经鼻内镜手术的适应症和基本原则,以及显露、特别是重建技术的进展,这些进展要求在可接受的并发症前提下达到更广泛的切除;讨论了经鼻内镜手术的局限性,尤其是,虽然这种手术往往是"微创",但它并不是完全没有并发症;展望了经鼻内镜手术的适应症会不断拓宽,并发症会越来越少的美好未来。     

隧道法内镜下粘膜下剥离术治疗食道粘膜下肿瘤的临床价值

摘要 目的：探讨隧道法内镜下粘膜下剥离术治疗食道粘膜下肿瘤的临床价值。方法：2014年2月至2017年9月选择在本院诊治的食道粘膜下肿瘤患者172例，根据手术方法的不同分为观察组100例与对照组72例。观察组给予隧道法内镜下粘膜下剥离术，对照组给予内镜粘膜下剥离术治疗，记录与随访两组的预后情况。结果：两组手术时间对比无差异(P>0.05)，观察组的术中出血量、术后禁食天数与术后住院时间显著少于（短于）对照组(P<0.05)。观察组术后3 d的并发症发生率为3.0 %，显著低于对照组的15.3 %(P<0.05)。观察组术后1 d与术后14 d的血清IL-2、sIL-2R含量都显著低于对照组(P<0.05)。随访2年，观察组的1年与2年复发率分别为2.0 %和6.0 %，显著低于对照组的8.3 %和15.3 %(P<0.05)。结论：隧道法内镜下粘膜下剥离术治疗食道粘膜下肿瘤能减少创伤，减少并发症的发生，降低复发率，并促进患者免疫功能的恢复。     

内镜揭盖术与唇齿沟径路切除术治疗鼻前庭囊肿患者的疗效及对炎性因子的影响

目的:研究内镜揭盖术(ER)与唇齿沟径路切除术(LSPR)治疗鼻前庭囊肿(NVC)患者的临床疗效及对炎性因子的影响。方法:选择2015年7月至2017年6月来我院就诊的NVC患者106例,依据随机数字表法分别纳入ER组(53例)及LSPR组(53例)。ER组行ER治疗,LSPR组行唇齿沟径路切除术。观察两组术中出血量、手术时间、术后创口愈合时间、术后24 h疼痛评分及上皮化时间,两组术前、术后7 d白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平,两组术后并发症及复发情况。结果:ER组术中出血量、手术时间、术后创口愈合时间、术后24h疼痛评分及上皮化时间等手术指标均低于LSPR组,差异有统计学意义(P0.05);术后7 d,两组IL-6、IL-8、TNF-α及CRP水平均低于治疗前,且ER组低于LSPR组,差异有统计学意义(P0.05);ER组术后并发症发生率7.55%、术后复发率3.77%,均低于LSPR组的22.64%、20.75%,差异均有统计学意义(P0.05)。结论:与LSPR相比较,ER治疗NVC创伤小,恢复快,可有效降低术后炎性因子水平,术后并发症及复发率低,值得临床应用。     

Post-transplant cholangiopathy: Classification,pathogenesis, and preventive strategies

Biliary complications are the most frequent cause of morbidity, re-transplantation, and even mortality after liver transplantation. In general, biliary leakage and anastomotic and non-anastomotic biliary strictures (NAS) can be recognized. There is no consensus on the exact definition of NAS and different names and criteria have been used in literature. We propose to use the term post-transplant cholangiopathy for the spectrum of abnormalities of large donor bile ducts, that includes NAS, but also intraductal casts and intrahepatic biloma formation, in the presence of a patent hepatic artery. Combinations of these manifestations of cholangiopathy are not infrequently found in the same liver and ischemia-reperfusion injury is generally considered the common underlying mechanism. Other factors that contribute to post-transplant cholangiopathy are biliary injury due to bile salt toxicity and immune-mediated injury. This review provides an overview of the various types of post-transplant cholangiopathy, the presumed pathogenesis, clinical implications, and preventive strategies.     

超声内镜引导下细针穿刺活检联合基因检测对胰腺癌的诊断价值

目的:研究超声内镜引导下细针穿刺活检(EUS-FNA)联合K-ras基因检测对胰腺癌的诊断价值,为临床诊疗提供依据。方法:选取2013年11月到2015年11月我院收治的胰腺占位病变患者90例,患者入院次日行EUS-FNA,检测患者血清及活检物中K-ras基因阳性率,比较EUS-FNA单独与EUS-FNA联合K-ras基因检测对胰腺癌诊断的准确率与敏感性。结果:90例胰腺占位病变者中,经病理证实胰腺癌56例,EUS-FNA单独与EUS-FNA联合K-ras基因分别检出胰腺癌50例、53例,准确率分别为89.29%、94.64%,敏感性分别为92.59%、98.15%,两组比较差异均有统计学意义(P0.05)。胰腺癌患者活检物中K-ras阳性率为83.93%,明显高于血清中的41.07%(P0.05)。结论:EUS-FNA联合K-ras基因检测可提高对胰腺癌诊断的准确率与敏感性。     

内镜止血在急性非静脉曲张性上消化道出血治疗中的临床应用

目的:探讨内镜下金属钛夹止血在急性非静脉曲张性上消化道出血治疗中的应用价值。方法:按照随机数字表法将2014年1月-2014年12月我院收治的40例急性非静脉曲张性上消化道出血患者分为观察组(n=20)及对照组(n=20),观察组行内镜下金属钛夹止血治疗,对照组予以内镜下药物注射,比较两组治疗后的止血效果、临床疗效及并发症情况。结果:观察组患者治疗后的有效止血率、即时止血率为95.00%、100.00%,分别高于对照组的65.00%、75.00%,差异有统计学意义(P0.05)。治疗后观察组临床疗效优于对照组,差异有统计学意义(P0.05)。治疗后两组患者均未出现严重并发症。结论:内镜下金属钛夹止血用于急性非静脉曲张性上消化道出血具有止血效果好、并发症少等特点,临床有重要的参考价值。