不同肝血流阻断方式肝切除手术对原发性肝癌合并肝硬化患者肝功能及肠黏膜屏障的影响

目的:探讨肝切除手术运用Pringle法阻断、半肝血流阻断(HVC)后对原发性肝癌合并肝硬化患者肝功能及肠黏膜屏障的影响。方法:选取2016年4月～2019年9月期间我院收治的原发性肝癌合并肝硬化患者93例,根据随机数字表法将患者分为A组(n=46,Pringle法阻断)和B组(n=47,HVC),比较两组患者围术期指标、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)以及总胆红素(TBIL)]、肠黏膜屏障指标[D-乳酸,内毒素]及并发症发生情况。结果:两组阻断时间、术中失血量、手术时间比较无差异(P0.05);B组住院时间短于A组(P0.05)。两组术前、术后3 d、术后7 d ALT、AST、TBIL呈升高后降低趋势,且B组低于A组(P0.05)。两组患者术后并发症发生率比较无差异(P0.05)。两组术前、术后3 d、术后7dD-乳酸、内毒素呈升高后降低趋势,且B组低于A组(P0.05)。结论:与Pringle法阻断相比,原发性肝癌合并肝硬化患者在肝切除手术中运用HVC,可有效缩短住院时间,减轻肝功能及肠黏膜屏障损害,且不增加并发症发生率,临床应用价值较高。     

Denitrification measurements in aquatic sediments: A comparison of three methods

Measurements of denitrification using the acetylene inhibition,¹⁵N isotope tracer, and N₂ flux methods were carried out concurrently using sediment cores from Vilhelmsborg sø, Denmark, in an attempt to clarify some of the limitations of each technique. Three experimental treatments of overlying water were used: control, nitrate enriched, and ammonia enriched water. The N₂ flux and¹⁵N tracer experiments showed high rates of coupled nitrification/denitrification in the sediments. The acetylene inhibition method did not capture any coupled nitrification/denitrification. This could be explained by acetylene inhibition of nitrification. A combined¹⁵N tracer/acetylene inhibition experiment demonstrated that acetylene inhibition of N₂O reduction was incomplete and the method, therefore, only measured approximately 50% of the denitrification due to nitrate from the overlying water. Similar rates of denitrification due to nitrate in the overlying water were measured by the N₂ flux method and the acetylene inhibition method, after correcting for the 50% efficiency of acetylene inhibition. Rates of denitrification due to nitrate from the overlying water measured by the¹⁵N tracer method, however, were only approximately 35% or less of those measured by the acetylene inhibition or N₂ flux methods.     

维拉帕米对急性前壁心肌梗死行急诊PCI术患者再灌注室性心律失常的影响

目的:探讨经指引导管早期应用维拉帕米对急性前壁心肌梗死行急诊经皮冠状动脉介入治疗术(Percutaneous Coronary Intervention,PCI)患者再灌注室性心律失常的影响。方法:采用单中心、随机对照、前瞻性研究方法。选取2014年5月-2016年11月诊断为急性前壁心肌梗死并于我院行急诊PCI的患者,共纳入162例患者,按随机方法(随机数字表)分成2组,其中治疗组82例,对照组80例。治疗组患者在首次球囊扩张后早期经指引导管内给予维拉帕米(200μg),对照组患者则给予生理盐水。观察再灌注后室性心律失常发生率,PCI术后冠脉血流情况,心肌梗死相关血清指标(CK-MB,cTn I)的峰值,住院期间发生的主要不良心血管事件(MACE)。结果:维拉帕米治疗组患者再灌注心律室性失常及无复流的发生率显著低于生理盐水对照组(P0.05);维拉帕米治疗组患者cTnI和CK-MB峰值分别为(46.63±13.77)μg/L和(139.87±35.45)U/L,生理盐水组cTnI和CK-MB峰值为(54.36±12.59)μg/L和(158.34±40.18)U/L,两组比较,P均0.01。MACE事件两组间未见有统计学差异。结论:急性前壁心肌梗死患者急诊PCI术前经导管早期给予维拉帕米不但可显著减少无复流现象,还可显著减少再灌注后室性心律失常的发生,住院期间MACE事件的发生率无显著性差异。     

A comparison of major histocompatibility complex SNPs in Han Chinese residing in Taiwan and Caucasians

Summary Genetic dissection of complex diseases is both important and challenging. The human major histocompatibility complex is involved in many human diseases and genetic mechanisms. This highly polymorphic chromosome region has been extensively studied in Caucasians but not as well in Asians. Thus, we compared genotypic distributions, linkage disequilibria and haplotype blocks between Caucasian and Taiwan’s Han Chinese populations. Moreover, we investigated the population admixture and phylogenetic system in Han Chinese residing in Taiwan. The results show that Taiwan’s Han Chinese differ drastically in genotypic information compared with Caucasians but are relatively homogeneous among the three major ethnic subgroups, Minnan, Hakka and Mainlanders. Differences in allele frequency (AF) between Taiwanese and Caucasians in some disease-associated loci may reveal clues to differences in disease prevalence. The results of ethnic heterogeneity imply that public databases should be used with caution in cases where the study population(s) differs from the population characterized in the database. The high homogeneity we observed among the Taiwanese subpopulations mitigates the possibility of spurious association caused by ignoring population stratification in Taiwanese disease gene association studies. These results are useful for understanding our genetic background and designing future disease gene mapping studies.Electronic Supplementary Material Supplementary material is available for this article at and is accessible for authorized users.     

M16添加牛磺酸和EDTA支持昆明白小鼠体外受精并发育至囊胚

在以往研究工作的基础上证明了通过添加2.5mmol/L的牛磺酸和0.1mmol/L的EDTA至M16培养液中,可支持昆明白小鼠的体外受精（IVF）,并支持受精卵突破2－细胞阻滞发育至囊胚期。本研究进一步证明了牛磺酸和EDTA在昆明小鼠早期胚胎发育和克服2－细胞阻滞中起关键作用。 Abstract:The results of our early experiments show that the 2-cell block can be overcome by culturing zygote in modified M16 ,modified CZB and TE medium.Our research shows that the taurine and EDTA play key role in overcoming 2-cell block in Kunming mouse.The results show that the addition of taurine and EDTA to M16 medium can support the IVF and develoment to blastocyst in vitro in Kunming strain mice.This is the first report that M16 medium added with taurine and EDTA can be used in both IVF and culture medium to overcome the 2-cell block of embryo development in Kunming strain mouse.     

葡萄糖对ICR小鼠胚胎体外发育的影响

研究葡萄糖在小鼠早期胚胎体外发育中的作用。实验1将6—8周龄的ICR雌鼠超数排卵后与公鼠交配,收集1-细胞放入含0(对照组)、0.5、1、3、5、10mmol/L葡萄糖的CZB中培养;实验2将从超排的ICR雌鼠输卵管内收集的1-细胞放入无糖CZB中培养,分别于1细胞、2细胞、4细胞、桑椹胚阶段移入含3.0mmol/L葡萄糖(最适浓度)的CZB中,培养24h后又移回到无糖CZB中(桑椹胚阶段除外)继续培养以及整个胚胎培养过程均在含糖CZB中,对照组胚胎培养全程均在无糖CZB中。每组胚胎于37℃、5%CO2培养箱中培养120h,每24h在倒置显微镜下观察胚胎发育情况,分别计算2-细胞率、4-细胞率、桑椹胚率、囊胚率和孵化率,并进行囊胚细胞计数。结果显示,小鼠胚胎在含糖CZB中与在无糖CZB中4-细胞发育率无差异;含糖CZB中囊胚率显著高于对照组;3.0mmol/L浓度组囊胚细胞数显著高于其余组;2-细胞至4-细胞、4-细胞至桑椹胚前添加葡萄糖囊胚率显著高于对照组,1-细胞至2-细胞、桑椹胚及其以后阶段添加葡萄糖囊胚率与对照组无差异。实验证实,在ICR小鼠胚胎体外培养中加入葡萄糖不会导致2-细胞阻滞;葡萄糖浓度增至10mmol/L对ICR小鼠胚胎无毒性作用;ICR小鼠胚胎体外培养的最适葡萄糖浓度为3.0mmol/L;2-细胞至4-细胞、4-细胞至桑椹胚前添加葡萄糖是必要的。     

Modulation of immunogenicity of poly(sarcosine) displayed on various nanoparticle surfaces due to different physical properties

Poly(sarcosine) displayed on polymeric micelle is reported to trigger a T cell‐independent type2 reaction with B1a cells in the mice to produce IgM and IgG3 antibodies. In addition to polymeric micelle, three kinds of vesicles displaying poly(sarcosine) on surface were prepared here to evaluate the amounts and avidities of IgM and IgG3, which were produced in mice, to correlate them with physical properties of the molecular assemblies. The largest amount of IgM was produced after twice administrations of a polymeric micelle of 35 nm diameter ( G1 ). On the other hand, the production amount of IgG3 became the largest after twice administrations of G3 (vesicle of 229 nm diameter) or G4 (vesicle of 85 nm diameter). The augmented avidity of IgG3 after the twice administrations compared with that at the single administration was the highest with G3 . These differences in immune responses are discussed in terms of surface density of poly(sarcosine) chains, nanoparticle size, hydrophobic component of poly(L‐lactic acid) or (Leu‐ or Val‐Aib)_n, and membrane elasticity of the nanoparticles. Copyright © 2017 European Peptide Society and John Wiley & Sons, Ltd.     

不同容量胸段经椎间孔硬膜外注射阻滞范围的CT影像研究及诊断性阻滞的可行性分析

摘要 目的：探讨不同容量对胸段经椎间孔硬膜外注射（TFEI）药液扩散范围和镇痛效果的影响以及胸段TFEI用于诊断性阻滞的可行性。方法：选择2021年1月至2022年12月南京大学医学院附属鼓楼医院收治的胸段带状疱疹相关疼痛患者140例,随机分为4组,实施单次TFEI并分别注入不同容量含造影剂局麻药（A组：0.2 mL;B组：0.5 mL;C组：1.0 mL;D组：2 mL）,CT扫描并观察造影剂在硬膜外向头侧、尾侧及总扩散节段,造影剂在椎间孔、同侧椎旁间隙、同侧及对侧硬膜外间隙扩散情况,判断是否为选择性神经根阻滞。评估注射前、注射后30分钟及24小时视觉模拟评分（VAS）。结果：头侧和尾侧扩散节段以及总扩散节段数,D组最多,A组最少（P<0.05）;C组、D组造影剂扩散≥3个节段发生率明显高于B组（P<0.05）;C组、D组病例造影剂扩散至同侧椎旁间隙和对侧硬膜外间隙的发生率明显高于A组、B组（P<0.05）,仅A组37.1%的病例实现选择性神经根阻滞,其余各组均无选择性阻滞病例。注射后30分钟,C、D组VAS评分显著低于A、B组（P<0.05）;注射后24小时,D组VAS评分显著低于A、B组（P<0.05）。结论：胸段带状疱疹相关疼痛患者TFEI药液扩散范围随注射容量的增加而扩大,且在硬膜外倾向于头侧扩散,2 mL容量单次TFEI可阻滞3个以上的神经节段,获得良好的镇痛效果。胸段TFEI行诊断性阻滞的可行性较差。     

肋间神经阻滞复合全麻联合静脉自控镇痛对胸腔镜肺大疱切除术患者术后镇痛效果及恢复情况的影响

摘要 目的：探讨在胸腔镜肺大疱切除术中应用肋间神经阻滞复合全麻联合静脉自控镇痛的术后镇痛效果及患者恢复情况。方法：研究对象选取进行胸腔镜肺大疱切除术的80例患者,依据简单数字表法分为对照组和观察组,每组各40例。对照组接受全麻联合静脉自控镇痛,观察组在此基础上复合肋间神经阻滞,比较两组术后镇痛效果及恢复情况。结果：与术前比,术后12 h、24 h两组患者的CD4⁺、CD4⁺/CD8⁺均先降低后升高,且观察组各时间点均高于对照组;两组患者的CD8⁺均先升高后降低,且观察组各时间点均低于对照组（P<0.05）。术后24 h、48 h,观察组比对照组在镇痛泵按压次数和输注镇痛药物总量有减少（P<0.05）。与对照组比,观察组患者的术毕到拔管时间、下床活动时间、住院时间均更短（P<0.05）。与对照组（22.50%、20.00%）比,观察组患者的并发症、不良反应总发生率（2.50%、5.00%）更低（P<0.05）。结论：在胸腔镜肺大疱切除术中应用肋间神经阻滞复合全麻联合静脉自控镇痛,取得了显著的镇痛成效,不仅能够减轻患者的术后疼痛,还能减轻机体免疫抑制,同时不增加并发症和不良反应发生风险,临床应用安全性较高。     

The Exact Distribution of the Anderson-Kannemann Statistic

The Anderson-Kannemann test is a rank test for treatment effects in a randomized block design with K treatments and N blocks. In this paper, an algorithm for computing the exact distribution of the Anderson-Kannemann test statistic under the null hypothesis is deduced. Then, the exact distribution is compared with the asymptotic χ²-distribution, and it is shown that the exact distribution is approximated fairly well by the asymptotic distribution. Tables of the exact distribution are given for K = 3, N = 3(1)15; K = 4, N = 3(1)11; K = 5, N = 3(1)7; and K = 6, N = 3(1)5.