超声定位腔镜深筋膜下交通支离断术联合湿性换药技术治疗下肢静脉性溃疡

目的:探讨彩超定位下的腔镜深筋膜下交通支离断术(SEPS)联合湿性换药技术治疗下肢静脉性溃疡(VU)的方法及效果。方法:回顾性分析了8例VU患者共8条C6级下肢SEPS手术联合湿性换药技术的方法和效果。术前用彩色多普勒超声对功能不全交通支(ICPV)行体表定位,进行SEPS+大隐静脉高位结扎剥脱术+硬化剂注射术,术后湿性换药技术溃疡换药。结果:超声准确定位下SEPS联合湿性换药术后所有C6级患肢VU均在短期内愈合,随访期间无溃疡复发。结论:SEPS联合湿性换药技术治疗VU术后安全,疗效确切,并发症少。     

内镜下超声刀静脉交通支离断术治疗下肢静脉性溃疡

目的:探讨内镜下使用超声刀行静脉交通支离断术治疗下肢静脉性溃疡的临床应用及治疗价值.方法:90例下肢静脉功能不全伴静脉性溃疡患者,共有123条伴有静脉性溃疡的患肢,其中采用内镜下超声刀静脉交通支离断术治疗52例患者76条患肢(超声刀组,n=76),内镜下电凝钩静脉交通支离断术治疗38例47条患肢(电凝钩组,n=47),比较两组患肢平均离断交通支数、患肢平均手术时间(不包括浅静脉手术时间)、患肢平均术中出血量、术后并发症发生率和术后住院时间.结果:两组患肢平均离断交通支数差异没有统计学意义.在超声刀组,患肢手术平均时间(71.3±17.5)min,患肢平均出血量(30.3±5.4)ml,术后并发症发生率为(5.8±1.2)%,术后住院时间为(3.4±118)天,上述指标与电凝钩组比较,差异均有显著性(P＜0.05).结论:内镜下使用超声刀行使静脉交通支离断术更安全、更可靠、更精确,具有比普通电凝钩更好的使用价值和社会价值.     

超声定位穿静脉结扎对下肢静脉性溃疡术后愈合影响的临床研究

目的:观察下肢静脉性溃疡患者穿静脉功能不全情况,探讨超声定位下肢穿静脉结扎对下肢静脉性溃疡术后疗效的影响。方法:40例大隐静脉曲张患者随机分成两组:A组采用大隐静脉高位结扎、静脉腔内微波射频闭合术及超声定位穿静脉结扎治疗,B组采用大隐静脉高位结扎和静脉腔内微波射频闭合术治疗。观察两组患者治疗后静脉性溃疡的愈合时间、复发率及瓣膜功能不全穿静脉数量部位,并比较两组患者临床预后评分。结果:术前两组瓣膜功能不全穿静脉数量分别是47条和44条,两组比较差异无统计学意义(P=0.5520)。术后两组愈合时间分别是(7.5±4.389)周和(11.6±6.489)周,两组比较差异具有统计学意义(P=0.048)。两组临床预后评分分别为(2.3±0.6)分和(1.1±1.5)分,两组比较差异具有统计学意义(P=0.042)。结论:多普勒超声可有效检测定位瓣膜功能不全的下肢穿静脉,在超声定位下行大隐静脉高位结扎、静脉腔内微波射频闭合术联合穿静脉结扎治疗下肢静脉性溃疡的疗效优于穿静脉不结扎。     

超声引导射频消融联合外科微创手术治疗下肢静脉曲张的疗效及预后影响因素分析

摘要 目的：评估超声引导射频消融术（Radio Frequency Ablation, RFA）联合外科微创手术治疗对下肢各类型浅静脉曲张的临床疗效,分析影响射频消融靶静脉闭合率的相关因素。方法：对 2018年6月至 2019年6月在我院住院的 73例下肢静脉曲张患者（共137条静脉）采用RFA闭合和外科微创手术治疗（点式剥脱治疗交通支静脉和泡沫硬化处理小腿部浅表静脉）的联合治疗方法,所有患者在术后 6 个月进行超声随访,评价治疗效果并分析相关影响因素及影响射频闭合率的相关因素。结果：对 137 条治疗后的患肢进行随访,平均随访时间为 6 个月,74名患者症状均有所缓解,患者治疗后的下肢静脉疾病诊断标准 CEAP分级(clinical-etiology-anatomic-pathophysiologic classification system,CEAP)均显著低于治疗前（P＜0.05）。统计分析发现年龄是CEAP术后降低的相关影响因素（P＜0.05）;术后并未发现严重并发症。术后共 13条患肢射频靶静脉段出现再通,联合手术的成功率为 90%。其中大隐静脉（Great Saphenous Vein,GSV）6条、前副隐静脉（Anterior Accessory Saphenous Vein,AASV）2条,小隐静脉(Small Saphenous Vein, SSV)5条,三种静脉的手术成功率分别为91%,89%,76%。通过Logistic回归单因素、多因素分析发现,靶静脉直径、静脉种类与射频消融再通相关。靶静脉直径越大,射频消融静脉段再通的可能性越大;三种静脉再通可能性的大小比较为SSV＞AASV＞GSV。结论：超声引导下肢浅静脉的射频消融闭合术联合交通支静脉的外科微创手术治疗是治疗静脉曲张的一种安全有效的方式。RFA治疗靶静脉再通的重要危险因素是靶静脉的术前直径以及静脉种类。     

改良曲张静脉点式剥除术治疗中老年下肢静脉曲张的临床疗效

目的:探究改良曲张静脉点式剥除术在治疗中老年下肢静脉曲张的临床疗效。方法:收集我院已确诊为下肢静脉曲张的中老年患者37例,分成实验组与对照组。对照组18例行传统曲张静脉点式剥除术,实验组19例行改良曲张静脉点式剥除术。对比两组患者手术后的下肢静脉曲张的治疗效果。结果:实验组有效率(94.7%)显著高于对照组(72.2%),差异具有统计学意义(P0.05);与对照组相比,实验组患者手术时间较短、术中出血量较少、下床活动时间较早,术后并发症总治愈率较高,复发率、术后并发症发生率较低,其差异均有统计学意义(P0.05)。结论:采用改良曲张静脉点式剥除术治疗中老年下肢静脉曲张的患者能够更彻底的剥除曲张额静脉,有效的改善患肢症状,明显降低复发率。     

全蝎软膏治疗下肢静脉溃疡的临床研究

目的:观察全蝎软膏对下肢静脉溃疡患者创面的影响。方法:40例下肢静脉溃疡患者,按入院顺序随机分为两组,全蝎软膏组20例,凡士林组20例,两组患者均予基础治疗,全蝎软膏组予全蝎软膏局部创面换药,疗程14天,2个疗程后,观察患者溃疡创面的变化情况。结果:全蝎软膏组患者溃疡创面的改善优于凡士林组(p0.05)。结论:全蝎软膏可促进下肢静脉溃疡创面的愈合,具有明显疗效。     

聚桂醇在治疗下肢静脉曲张中初步临床应用

目的:探讨聚桂醇在治疗下肢大隐静脉曲张中的应用价值。方法:回顾性分析2013年9月-2015年9月医院确诊的下肢大隐静脉曲张患者75例(75条患肢)病例资料,根据治疗方案分为两组,33例(33条患肢)超声引导下注射聚桂醇泡沫硬化剂作为聚桂醇组,42例(42条患肢)行大隐静脉高位结扎+剥脱术作为手术组,记录手术时间、术中出血量、下床活动时间、住院时间、治疗费用及术后并发症发生率,门诊随访术后6、12个月,记录复发率。结果:聚桂醇组手术时间、下床活动时间均短于手术组,术中出血量、住院费用少于手术组,差异有统计学意义(P0.05);聚桂醇组皮下血肿、皮肤麻木感发生率明显低于手术组,差异有统计学意义(P0.05);聚桂醇组12个月复发率为12.12%低于手术组的33.33%,差异有统计学意义(P0.05)。结论:聚桂醇泡沫硬化剂注射是治疗下肢大隐静脉曲张的可选疗法。     

游离股前外侧皮瓣修复对急诊肢体复合组织缺损患者近期和远期预后的影响

摘要 目的：探讨与分析游离股前外侧皮瓣修复对急诊肢体复合组织缺损患者近期和远期预后的影响。方法：2015年4月到2021年9月选择在本院急诊的下肢复合组织缺损患者66例作为研究对象,根据1:1随机分配原则把患者分为研究组与对照组各33例。研究组给予游离股前外侧皮瓣修复治疗,对照组给予下肢外侧皮瓣修复治疗,观察与随访患者的近期和远期预后情况。结果：所有患者都顺利完成急诊修复治疗,所有皮瓣都创面都Ⅰ期愈合,研究组的术后住院时间、术后换药次数、术后上皮组织完全覆盖创面时间、术后创面愈合时间少于对照组（P<0.05）。研究组术后3个月的皮瓣血供优良率为100.0 %,高于对照组的84.8 %（P<0.05）。研究组术后3个月的血肿、伤口感染、血管危象、骨髓炎等并发症发生率为3.0 %,低于对照组的27.3 %（P<0.05）。研究组术后12个月的皮瓣保护性感觉率为100.0 %,高于对照组的78.8 %（P<0.05）。结论：游离股前外侧皮瓣修复在急诊肢体复合组织缺损患者的应用能促进患者康复,提高皮瓣血供优良率,还可减少并发症的发生,改善患者远期的皮瓣保护性感觉状况。     

糖尿病下肢溃疡影响因素分析及治疗方法

目的探讨糖尿病下肢溃疡的原因和治疗方法。方法回顾总结我院近年来急诊科临床收治的糖尿病并发下肢溃疡患者12例,全部病例均使用胰岛素控制血糖、抗生素抗感染、静脉滴注活血化瘀的中药、常规局部换药并结合使用具有去腐、生肌、消炎作用的中药膏剂进行治疗,同时对患者进行糖尿病相关知识的教育和自我护理技能培训。结果全部病人均治愈出院,其中截趾术后伤口愈合出院1例,点状邮票植皮后伤口愈合1例,经换药伤口愈合10例。随访期间全部病例溃疡未复发。结论糖尿病下肢溃疡是由血管、神经、感染等多重因素造成的。对糖尿病并发下肢溃疡患者采用多种方法综合治疗可以取得较好的疗效,同时强调重视糖尿病的管理和教育。     

实时灰阶超声造影股浅静脉瓣膜返流时间与病变严重程度的相关性探讨

目的:探讨超声造影股浅静脉瓣膜返流与病变严重程度的关系。方法:回顾性分析55例63条诊断为原发性深静脉功能不全患者的临床和超声造影资料,记录股浅静脉瓣膜返流时间和CEAP临床表现分级,并进行两者的相关性分析。结果:统计学分析表明,CEAP临床表现分级与瓣膜返流时间无相关性;但溃疡肢体组与非溃疡肢体组的股浅静脉瓣膜返流时间比较,两组有显著性差异(P0.05)。结论:超声造影检查股静脉瓣膜返流时间有可能预测患肢静脉性溃疡的发生。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.