慢性腹痛患儿C~(13)-尿素呼气试验与胃镜检查的临床意义

目的了解慢性腹痛患儿幽门螺杆菌(H.pylori)的感染状态及幽门螺杆菌感染患儿内镜下表现的特点。方法应用C13尿素呼气试验,对905例以慢性腹痛为主要症状的患儿进行检测,对C13呼气试验阳性者进行电子胃镜检查。结果905例慢性腹痛患儿中H.pylori呈阳性185例(20.44%),随年龄增长,其H.pylori阳性率升高,学年组已达高峰。对H.pylori阳性者进行胃镜检查结果显示十二指肠隆起病变47例占25.40%,结节性胃炎41例占22.1%,慢性浅表性`胃炎38例占20.5%,结节性胃炎伴十二指肠隆起病变23例占12.43%,十二指肠球部溃疡23例占12.4%。胃溃疡7例,占3.7%(其中包括1例复合性溃疡),结节性胃炎伴十二指肠炎6例,占3.2%。结论H.pylori感染为小儿慢性腹痛的主要原因之一,也是导致慢性胃炎及消化性溃疡的主要原因之一。C13尿素呼气试验方便,快速,无痛苦,无放射性,是一较好的H.pylori检测方法;对既有消化道症状同时C13呼气试验阳性者进行胃镜检查能够协助临床诊断及治疗。     

Regulation of particle transport within the ventral groove of the mussel (Mytilus edulis) gill in response to environmental conditions

To thoroughly understand the feeding processes of the blue mussel, Mytilus edulis, under the variable environmental conditions it experiences in nature, it is important to examine individually the different components of its feeding system. The ciliated ventral food groove represents one of these components, within which the majority of food particles trapped by the gill are transported to the labial palps and mouth. Any ability of the mussel to adjust food transport rates within this groove could serve as an important feeding regulatory mechanism in response to variations in the environment.

Mucous strand velocities in the ventral groove of the mussel, M. edulis, were determined by video endoscopy over different time periods and during short- and long-term manipulations of ambient particle concentration and temperature. Mucous strand velocity decreased with increasing ambient particle concentration at 14°C, but a similar relationship was not observed at 5°C. The data support the hypothesis that M. edulis possesses compensatory mechanisms to control particle transport at the level of the ventral groove cilia in response to changes in the environment. Furthermore, mucous strand velocity in the ventral groove increased when the ambient temperature of mussels acclimated to 5°C was increased to 15°C during acute and long-term acclimation temperature experiments. This response is consistent with standard physiological responses of ciliary systems to changes in temperature.     

内镜下黏膜剥除术治疗早期消化道腺瘤性肿瘤的临床疗效分析

目的:探讨内镜下黏膜剥除术治疗早期消化道腺瘤性肿瘤的临床效果。方法:将我院自2015年4月至2018年4月收治的消化道腺瘤性肿瘤患者85例作为研究对象,按照随机抽签法分为研究组43例和对照组42例,研究组使用内镜下黏膜剥除术进行治疗,对照组采用常规内窥镜手术治疗,观察和比较两组患者的临床疗效。结果:两组患者脂肪瘤、平滑肌瘤、间质瘤、异位胰腺和增生性息肉瘤的发生率比较差异无统计学意义(P0.05)。研究组患者病变最大径、创面长径、手术时间和术后住院时间均明显低于对照组,患者出血、穿孔等并发症发生率为4.65%,明显低于对照组(19.05%)。术后随访6个月,研究组无复发,对照组复发率为23.81%,组间比较差异具有统计学意义(P0.05)。结论:早期消化道腺瘤性肿瘤患者行内镜下黏膜剥除术能够提高切除率,缩短手术时间和住院时间,降低患者并发症发生率和复发率。     

MOOC-CBL教学模式在腔镜甲状腺外科临床教学中的效果评价

目的探讨慕课(Massive Open Online Course,MOOC)-病例为基础(Case-Based Learning,CBL)的教学模式在甲状腺外科临床教学中的应用效果。方法选择甲状腺外科临床实习的40名外科研究生作为研究对象,按照教学方式的不同分为实验组(A组)和对照组(B组),每组20名。A组采用MOOC-CBL教学法,B组采用讲授式教学模式(lecture-based learning,LBL),对两组教学后的理论知识(专业知识、病史采集、颈部查体、影像学检查、鉴别诊断、诊疗方案)和临床技能操作(术前准备、体位、消毒、手术操作)考核成绩以及两组的教学质量(学习兴趣、临床能力、临床思维、教学模式认同)进行比较。结果A组的颈部查体、鉴别诊断、诊疗方案的总成绩分高于B组,差异具有统计学意义(均P<0.05);两组的专业知识、病史采集、术前准备考核成绩分比较,差异无统计学意义(均P>0.05);A组的学习兴趣、临床技能、临床思维以及对教学模式认同度均高于B组,差异具有统计学意义(均P<0.05)。结论基于腔镜手术的MOOC-CBL教学模式在甲状腺外科临床教学中的应用效果优于LBL,值得推广应用。