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。     

Metazoan parasites of sticklebacks on Sable Island, Northwest Atlantic Ocean: biogeographic considerations

Three species of sticklebacks ( Apeltes quadracus, Gasterosteus aculeatus , and Pungitius pungitius ( n = 236) were collected from five ponds on Sable Island. The nematodes Pseudoterranova decipiens, Contracaecum sp., Paracuaria adunca , and Cosmucephalus obvelatus , and the cestode Diphyllobothrium ditremum parasitized three-spined sticklebacks ( G. aculeatus ) and four-spined sticklebacks ( A. quadracus ) inhabiting four brackish water ponds. All the parasites except P. decipiens infected nine-spined sticklebacks ( P. pungitius ) from a freshwater pond. In addition, the cestode Schistocephalus pungitii , the copepod Thersitina gasterostei , and the monogenean Gyrodactylus canadensis occurred in nine-spined sticklebacks from the freshwater pond. The two cestodes, the copepod, and the sealworm, P. decipiens , were the most common parasites encountered. The remaining helminths were relatively rare. Most of the parasite species were larval forms which use gulls or seals as definitive hosts. These parasites probably colonized Sable Island with their definitive hosts, whereas only two species ( T. gasterostei and G. canadensis ) successfully colonized the island ponds with their fish hosts. The low parasite species richness encountered is attributed to the impoverished nature of the host fauna of Sable island, and the difficulty of colonization as a result of the island's isolation with respect to the mainland.     

Sheep tick Ixodes ricinus management on Welsh hill farms of designated conservation importance: implications for nationally declining birds

Impacts of sheep ticks Ixodes ricinus on livestock, gamebirds and wildlife are of concern across Europe. The present study describes livestock and tick management by 36 farmers from three upland sites of conservation importance in North Wales, where farmers consider that ticks have increased during the last 25 years. Sheep, average densities of 2.0 animals per ha were treated with pour‐on acaricides in spring, again in July, and also when removed from the moor in autumn. Given acaricide efficacy rates, sheep were susceptible to tick bites for half the period on the moor. Sheep from 17 farms were examined for ticks. Infestations were similar between farms and in relation to the acaricide used, averaging 9.3 ticks per sheep, although they were lower where the interval between successive acaricide treatments was shorter. Repeated sampling of sheep and red grouse chicks showed no annual difference in tick burdens on grouse chicks, which averaged 6.2 ticks per chick, although there were three‐fold fewer ticks on sheep in 2018 than in previous years. Tick bite rates on sheep and grouse were higher than elsewhere in the U.K. Most farmers interviewed would aim to improve their tick management using longer‐lasting acaricides and treating sheep more frequently, although they would need advice and financial help, which is currently unavailable via Government funded agri‐environment schemes.     

Scaling up from epidemiology to biogeography: local infection patterns predict geographical distribution in fish parasites

Aim We investigated how the spatial distribution of parasites, measured as either their geographical range size or their frequency of occurrence among localities, relates to either their average local abundance or the variance in their abundance among localities where they occur. Location We used data on the abundance of 46 metazoan parasite species in 66 populations of threespine sticklebacks, Gasterosteus aculeatus, from Europe and North America. Methods For each parasite species, frequency of occurrence was calculated as the proportion of stickleback populations in which it occurred, and geographical range size as the area within the smallest possible polygon delimited using the coordinates of the localities where it occurred. Generalized linear models were used to assess how these two measures of spatial distribution were influenced by several predictor variables: geographical region (North America or Europe), life cycle (simple or complex), average local abundance, the coefficient of variation in abundance across localities, and median prevalence (proportion of infected hosts within a locality). Results Our analyses uncovered four patterns. First, parasites in North America tend to have higher frequencies of occurrence among surveyed localities, but not broader geographical ranges, than those in Europe. Second, parasite species with simple life cycles have wider geographical ranges than those with complex cycles. Third, there was a positive relationship between average abundance of the different parasite species and their frequency of occurrence, but not between average abundance and geographical range size. Fourth, the coefficient of variation in abundance covaried positively with both the frequency of occurrence and geographical range size across the different parasite species. Thus, all else being equal, parasites showing greater site‐to‐site variability in abundance occur in a greater proportion of localities and over a broader geographical area than those with a more stable abundance among sites. Main conclusions Local infection patterns are linked with large‐scale distributional patterns in fish parasites, independently of host effects, such that local commonness translates into regional commonness. The mechanisms linking parasite success at both scales remain unclear, but may include those that maintain the continuum between specialist and generalist parasites. Regardless, the observed patterns have implications for the predicted changes in the geographical distributions of many parasites in response to climate change.     

基于“心与小肠相表里”理论探讨肠道微生态与骨质疏松症的关系

近年来相关研究显示,肠道微生态在骨质疏松症的发生发展中起着重要作用。中医脏腑理论密切关注脏腑之间的生理病理关系,以中医经典《内经》“心与小肠相表里”理论为基础,探讨心、小肠、肠道微生态与骨质疏松症之间的关系。研究发现肠道微生态可能是心系疾病导致骨质疏松症的途径之一,这一发现可能为骨质疏松症的研究与防治提供一定的理论依据。     

Íleo biliar como causa de dolor abdominal en el paciente anciano

Gallstone ileus is a rare and potentially serious complication of cholelithiasis. It is defined as a mechanical intestinal obstruction secondary to the presence of a gallstone in the intestinal luz. The most frequent cause is impaction of the calculus in the ileum after passing through a bilioenteric fístula. It has a high morbidity and mortality rate, mainly due to the difficulty and delay in its diagnosis. A retrospective study is presented of 4 cases of gallstone ileus treated between 2013 and 2017 in the Hospital Nuestra Señora del Prado. An analysis was performed on the clinical characteristics, diagnostic tests, and surgical treatment.