腹腔镜手术治疗粘连性肠梗阻的疗效及安全性研究

目的：探讨腹腔镜粘连松解术治疗粘连性肠梗阻（AIO）的疗效，减少再梗阻率。方法：将120 例AIO 患者随机分为两组，每 组60 例，开腹组实施开腹手术，腹腔镜组实施腹腔镜粘连松解术，观察两组术后恢复及并发症发生情况，对再梗阻危险因素进行 Logistic 回归分析。结果：腹腔镜组术中失血量（73.48± 9.32）mL，少于开腹组的（207.45± 33.21）mL（P<0.05）；腹腔镜组手术、术后 镇痛、下床活动、肠恢复蠕动、肛门恢复排气、拔除尿管及住院时间分别为（69.15± 10.13）min、（14.67± 7.23）h、（27.14± 7.04）h、 （3.11± 0.96）d、（3.24± 1.02）d、（3.37± 1.23）d、（7.95± 3.05）d，均短于开腹组的（83.84± 9.24）min、（27.38± 8.02）h、（36.23± 5.87） h、（4.05± 1.35）d、（4.35± 1.74）d、（5.02± 2.13）d、（10.35± 3.71）d（P<0.05)；腹腔镜组并发症发生率、再梗阻率分别为10.00%、 10.00%，均低于开腹组的33.33%、40.00%（P<0.05)；多因素Logistic 回归分析显示开腹手术、手术时间≥ 60 min 是再梗阻发生的独 立危险因素。结论：腹腔镜手术治疗AIO 疗效优于开腹手术，而且并发症与再梗阻率低。     

现代监测仪的发展趋势

现代医学发展离不开高科技的支持。近年来,由于微电子技术的迅速发展,已出现了很多在10年前还无法想象的新技术和新设备。在临床医学领域,现代监测仪就是其中的代表。仅在数年以前,心电(ECG)监测、心输出量(CO)测定,脉搏血氧饱和度(SPO_2)监测等还都是各自分离的仪器,而现代监测仪已将这些功能集合在一台之中或做成插件,使医生可依病情需要,选择功能不同的插件,用一台监测仪监测不同的生理参数。有关各项     

Sea Urchin Spines as a Model-System for Permeable, Light-Weight Ceramics with Graceful Failure Behavior. Part I. Mechanical Behavior of Sea Urchin Spines under Compression

The spines of pencil and lance urchins Heterocentrotus mammillatus and Phyllacanthus imperialis were studied as a modelof light-weight material with high impact resistance.The complex and variable skeleton construction ("stereom") of body andspines of sea urchins consists of highly porous Mg-bearing calcium carbonate.This basically brittle material with pronouncedsingle-crystal cleavage does not fracture by spontaneous catastrophic device failure but by graceful failure over the range of tensof millimeter of bulk compression instead.This was observed in bulk compression tests and blunt indentation experiments onregular,infiltrated and latex coated sea urchin spine segments.Microstructural characterization was carried out using X-raycomputer tomography,optical and scanning electron microscopy.The behavior is interpreted to result from the hierarchicstructure of sea urchin spines from the rnacroscale down to the nanoscale.Guidelines derived from this study see ceramics withlayered porosity as a possible biomimetic construction for appropriate applications.     

追溯山茱萸科植物的性状进化和生物地理学历史——方法选择的影响?

This study compares results on reconstructing the ancestral state of characters and ancestral areas of distribution in Cornaceae to gain insights into the impact of using different analytical methods. Ancestral character state reconstructions were compared among three methods (parsimony, maximum likelihood, and stochastic character mapping) using MESQUITE and a full Bayesian method in BAYESTRAITS and inferences of ancestral area distribution were compared between the parsimony-based dispersal-vicariance analysis (DIVA) and a newly developed maximum likelihood (ML) method. Results indicated that among the six inflorescence and fruit characters examined, "perfect" binary characters (no homoplasy, no polymorphism within terminals, and no missing data) are little affected by choice of method, while homoplasious characters and missing data are sensitive to methods used. Ancestral areas at deep nodes of the phylogeny are substantially different between DIVA and ML and strikingly different between analyses including and excluding fossils at three deepest nodes. These results, while raising caution in making conclusions on trait evolution and historical biogeography using conventional methods, demonstrate a limitation in our current understanding of character evolution and biogeography. The biogeographic history favored by the ML analyses including fossils suggested the origin and early radiation of Cornus likely occurred in the late Cretaceous and earliest Tertiary in Europe and intercontinental disjunctions in three lineages involved movements across the North Atlantic Land Bridge (BLB) in the early and mid Tertiary. This result is congruent with the role of NALB for post-Eocene migration and in connecting tropical floras in North America and Africa, and in eastern Asia and South America. However, alternative hypotheses with an origin in eastern Asia and early Trans-Beringia migrations of the genus cannot be ruled out.     

离子通道递质受体大家族:每种受体所特有的变构调制中心在神经药理学中的重要性

美国飞迪亚-乔治城神经科学研究所所长、美国科学院院士E.Costa博士,1989年1月10日来北京接受北京医科大学授予名誉教授衔。Costa教授在该仪式上所作的报告指出了当前神经递质研究的新方向,具有重要的学术意义。特予介绍,以飨读者。     

1 生物动能学导言

1.1 生物学中的能流和物流地球上能量的基本来源是太阳的电磁幅射。高等植物、藻类和兰绿细菌利用这一幅射的可见和近短红外成分,驱动伴随分子氧释放的二氧化碳(光合自养生长)的还原同化作用     

Sieve element occlusion provides resistance against Aphis gossypii in TGR-1551 melons

Feeding behavior and plant response to feeding were studied for the aphid Aphis gossypii Glover on susceptible and resistant melons(cv.Iroquois and TGR-1551,respectively).Average phloem phase bout duration on TGR-1551 was<7% of the duration on Iroquois.Sixty-seven percent of aphids on TGR-1551 never produced a phloem phase that attained ingestion(EPG waveform E2)in contrast to only 7% of aphids on Iroquois.Average bout duration of waveform E2(scored as zero if phloem phase did not attain E2)on TGR-1551 was<3% of the duration on Iroquois.Conversely,average bout duration of EPG waveform El(sieve element salivation)was 2.8 times greater on TGR-1551 than on Iroquois.In a second experiment,liquid nitrogen was used to rapidly cryofix leaves and aphids within a few minutes after the aphids penetrated a sieve element.Phloem near the penetration site was then examined by confocal laser scanning microscopy.Ninety-six percent of penetrated sieve elements were occluded by protein in TGR-1551 in contrast to only 28% in Iroquois.Usually in TGR-1551,occlusion was also observed in nearby nonpenetrated sieve elements.Next,a calcium channel blocker,trivalent lanthanum,was used to prevent phloem occlusion in TGR-1551,and A.gossypii feeding behavior and the plants phloem response were compared between lanthanum-treated and control TGR-1551.Lanthanum treatment eliminated the sieve element protein occlusion response and the aphids readily ingested phloem sap from treated plants.This study provides strong evidence that phloem occlusion is a mechanism for resistance against A.gossypii in TGR-1551.