36 例急性Stanford A 型主动脉夹层动脉瘤的外科治疗体会

目的:总结急性Stanford A型主动脉夹层动脉瘤的外科治疗体会。方法:选择36例急性Stanford A型主动脉夹层动脉瘤患者,根据病变夹层破口的位置、累及范围、有无合并主动瓣关闭不全选择相应的手术方式,观察患者治疗后的临床疗效并随访治疗6个月后的临床预后。结果:3例患者术中死亡,术中死亡率为8.3%,平均手术时间156.7±56.7min,平均阻断时间98.5±32.7min,平均选择性脑灌注时间56.1±20.7min,术后平均ICU住院时间6.2±3.8d,术后平均总计住院时间25.4±7.3d;术后6个月后随访,3例患者死亡,其余30例患者恢复满意,生活质量与治疗前相比,均得到显著提高。结论:急性Stanford A型主动脉夹层动脉瘤患者应积极施行早期外科治疗,术前快速准确诊断,根据患者病情制定相应的手术方案,术后采取措施避免术后并发症。     

真菌球型上颌窦炎鼻内镜下两种手术路径的临床研究

目的:比较鼻内镜下中鼻道联合下鼻道小视窗双路径术和单独下中鼻道开窗术治疗真菌球型上颌窦炎的临床疗效。方法:采用前瞻性随机对照试验,将2013年8月~2015年5月在我院择期行手术治疗的50例真菌球型上颌窦炎患者分为观察组与对照组,每组25例,对照组行鼻内镜单独下中鼻道开窗术,观察组在对照组的基础上联合下鼻道小视窗术。术前及术后6个月采用鼻腔鼻窦结局测试20条量表(SNOT-20)对两组患者进行评分,术后6个月对鼻黏膜纤毛清除功能及疗效进行评估,比较两组手术时间及术中出血量。结果:术后6个月两组SNOT-20量表评分显著低于术前,且观察组显著低于对照组(P0.05)。术后6个月观察组粘膜纤毛传输时间(MTT)显著低于对照组(P0.05)。两组总有效率、手术时间及术中出血量比较,差异均无统计学意义(P0.05)。结论:鼻内镜下以上两种手术路径治疗真菌球型上颌窦炎的疗效相近,但鼻内镜下中鼻道联合下鼻道小视窗双路径术更有利于减轻患者症状及促进鼻黏膜纤毛清除功能恢复。     

Galileo Avionica’s Technologies and Instruments for Planetary Exploration

Several missions for planetary exploration, including comets and asteroids, are ongoing or planned by the European Space Agencies: Rosetta, Venus Express, Bepi Colombo, Dawn, Aurora and all Mars Programme (in its past and next missions) are good examples. The satisfaction of the scientific request for the mentioned programmes calls for the development of new instruments and facilities devoted to investigate the body (planet, asteroid or comet) both remotely and by in situ measurements. The paper is an overview of some instruments for remote sensing and in situ planetary exploration already developed or under study by Galileo Avionica Space & Electro-Optics B.U. (in the following shortened as Galileo Avionica) for both the Italian Space Agency (ASI) and for the European Space Agency (ESA). Main technologies and specifications are outlined; for more detailed information please refer to Galileo Avionica’s web-site at: . *Presented at: National Workshop on Astrobiology: Search for Life in the Solar System, Capri, Italy, 26 to 28 October, 2005.     

Effects of retinoic acid (RA) on the growth and phenotypic expression of several human neuroblastoma cell lines

It has been shown that retinoic acid (RA) can promote morphologic differentiation and inhibit the growth of a human neuroblastoma cell line, LA-N-1. The present study tests the histological generality of these phenomena by determining the effects of RA on seven other human neuroblastoma cell lines. Results show that RA strongly inhibited anchorage-dependent growth and induced morphologic alterations in six of seven of the cell lines. These alterations included morphologic differentiation as evidenced by formation of neurite extensions in four of the lines, cellular enlargement and vacuolization in one culture, and formation of large, flattened epithelial or fibroblastic-like cells in another culture. Although one cell line was relatively insensitive to the effects of RA in monolayer culture, all seven were strongly inhibited by RA in soft agar assays. Cellular RA-binding proteins were detected in 2/2 lines tested. These findings suggest that, as a histological group, human neuroblastoma cells are extremely sensitive to RA-induced growth inhibition and morphological alterations generally associated with reduced expression of the malignant phenotype of this type of cancer.     

Fasciola hepatica: The effect of challenge by the subcutaneous or intraperitoneal route with living adult flukes in sensitized rats

When rats, sensitized either by subcutaneous implantation of adult F. hepatica or by a normal oral infection with F. hepatica metacercariae, were challenged by implanting adult flukes in the peritoneal cavity, 23% of these flukes were killed in rats sensitized by subcutaneous implantation and 71% in the rats sensitized by the oral route. In contrast neither of these sensitization routes were effective against subcutaneous challenge with adult fluke. Histological evidence suggested that about half of the dead flukes found were killed shortly after transfer and these flukes were surrounded with mononuclear cells. The remaining dead flukes appear to have died after becoming surrounded with a cyst. These latter flukes were surrounded by neutrophils and this cell type was very prominent in the cysts of sensitized rats.     

Removal of the Schwann sheath from the giant nerve fiber of the squid: An electron-microscopic study of the axolemma and associated axoplasmic structures

Summary Surgical thyroidectomies were used as means of altering the thyroid state of adult recipients to study the possible influence of thyroid hormones on fibre formation in irides by immature noradrenaline neurons of the locus coeruleus grafted to the eye. Whole-mount preparations of irides were analysed using fluorescence histochemistry according to Falck-Hillarp, subjectively estimating on a blind basis the number of fibres, their pattern of distribution and individual morphology in the iris dilator plate. Neurones of the locus coeruleus formed nerve fibres in irides of thyroidectomized recipients to the same extent as in controls. Distribution and fine structure of these fibres, however, differed markedly. The numerous thick axon bundles from the attachment of the brain graft, normally seen to radiate out from locus coeruleus-neurones in oculo, were almost totally lacking in the thyroidectomized group. Also, the individual nerve fibres showed abundant peripheral accumulations of fluorescent material. This appearance of the outgrowth of fluorescent fibres in the experimental group, indicative of a disturbed formation of nerve fibres during development in oculo, was abolished by reversal of the thyroid hormone deficiency using daily injections of 1-thyroxin to the recipients throughout the experiment. This strongly indicates a role for thyroxin in the process of formation of nerve fibres originating from the neurones of the locus coeruleus during perinatal development. The present paper is supportive of recent reports claiming that during the development of the CNS thyroxin plays a crucial role in tubulin assembly, and thus presumably for the ability of neurones to form processes.     

Integrated analysis of metallic resource flows

In January 1997, the German Research Association (DFG) established a special research programme for an integrated analysis of metallic resource flows. The programme is a joint interdisciplinary effort of the Technical University of Aachen and of the Research Centre Jiilich. Apart from many other activities, a series of conferences is organised within this programme. In October 1997, a first conference was held on “The Economics of Resource Flows: The Case of Aluminium”. In December 1997, a second conference took place on “Life Cycle Assessment of Aluminium: Methods and Applications”. In April 1998 the third workshop was held entitled “Methodological Aspects of a Resource-oriented Analysis of Material Flows”. The next conference is planned for December 1998 on “Environmental related Aspects of Aluminium Production”. Finally, a conference on “Methods for an Integrated Evaluation of Material Flows” is under consideration for 1999.     

The business of biodiversity – What is needed for biodiversity markets to work

There has been considerable discussion in Australia about market-based initiatives with the potential to bring effective incentives and greater investment for farmers and other land managers to promote biodiversity conservation. These initiatives include biodiversity trading markets (also termed the nature repair market), stewardship schemes, certification programmes, sustainability frameworks, and natural capital accounting. We welcome these discussions and believe these initiatives would be true advances if they bring much greater investment in conservation and stronger protection and recovery of biodiversity. However, we also have major concerns about the integrity and scientific credibility of some of these initiatives. In this article, we discuss why it is critical that such initiatives both carefully define biodiversity and determine what elements of biodiversity are to be targeted in conservation efforts. We also discuss the fundamental importance of appropriate and agreed biodiversity metrics, as well as the critical need for rigorous, well designed and independent biodiversity monitoring. To ensure that initiatives like biodiversity trading markets, stewardship schemes, certification programmes, sustainability frameworks and natural capital accounting are rigorous, non-corruptible and actually deliver what they are intended to do, they will need to be underpinned by appropriate programme designs. This includes robust and transparent governance structures, high-quality monitoring and timely reporting of key metrics.     

血清PCT、sICAM-1联合HMGB1预测急性阑尾炎患儿手术切口感染风险的临床研究

摘要 目的：探讨血清降钙素原（PCT）、可溶性细胞间粘附分子-1（sICAM-1）联合高迁移率族蛋白B1（HMGB1）预测急性阑尾炎（AA）患儿手术切口感染风险的价值。方法：前瞻性选取2020年1月～2022年7月四川大学华西医院小儿外科收治的536例接受腹腔镜手术的AA患儿,根据术后是否发生手术切口感染分为感染组和未感染组。采用酶联免疫吸附法检测血清PCT、sICAM-1、HMGB1水平。采用多因素Logistic回归分析AA患儿手术切口感染的影响因素,采用受试者工作特征（ROC）曲线分析血清PCT、sICAM-1、HMGB1水平对AA患儿手术切口感染的预测价值。结果：536例AA患儿腹腔镜手术后手术切口感染发生率为11.94%（64/536）。与未感染组比较,感染组血清PCT、sICAM-1、HMGB1水平升高（P＜0.05）。多因素Logistic回归分析显示,病程＞24 h、阑尾穿孔、手术操作时间＞60 min、留置腹腔引流和PCT、sICAM-1、HMGB1水平升高为AA患儿手术切口感染的独立危险因素（P＜0.05）。ROC曲线分析显示,血清PCT、sICAM-1联合HMGB1预测AA患儿手术切口感染的曲线下面积（AUC）大于PCT、sICAM-1、HMGB1单独预测。结论：血清PCT、sICAM-1、HMGB1水平升高与AA患儿手术切口感染密切相关,血清PCT、sICAM-1联合HMGB1预测AA患儿手术切口感染的价值较高,可能成为AA患儿手术切口感染的辅助预测指标。     

外科急腹症48例临床诊疗分析

目的：探讨外科急腹症的早期诊断与治疗,以便总结经验,提高治愈率,降低致残率与病死率。方法：回顾性分析48例外科急腹症诊治的临床资料。结果：急诊手术40例,经严密观察后手术8例,术后并发症11例,治愈44例。死亡4例。结论：外科急腹症的诊断应结合病史,体征及辅助检壹等综合判断。对其早期确诊与及时处置和手术治疗是降低病死率的关键。