【摘要】目的 探讨腹腔镜技术在急腹症探查术中应用的临床意义。方法 回顾性总结我院行急诊腹腔镜探查及治疗的22例急腹症患者的临床资料。结果 22例经腹腔镜检查全部明确诊断,除1例肠系膜上动脉栓塞的患者中转开腹外，所有手术均在腹腔镜下或辅助下完成，均恢复顺利,无术后并发症及死亡。结论 急诊腹腔镜探查术不仅能对急腹症的病因作出明确诊断,而且可在腹腔镜下完成大部分患者的治疗。
Objective To investigate the effects of hand assistant laporoscopic splenectomy plus pericardial devascularization on systemic stress responses. Methods Forty patients with cirrhotic portal hypertension were selected， 20 cases of which were underwent hand assistant laparoscopic splenectomy plus pericardial devascularization (LAP group)， and the other 20 were underwent open splenectomy plus pericardial devascularization (OP group). The levels of blood glucose （BG）, insulin (Ins), triiodothyronine （T3）, tetraiodothyronine （T4）, corticosteroid （CS） and other related clinical data were measured before operation and on day 1-3 after operation, which were compared between two groups. Results There was no statistical significance between two groups on those levels before operation. On day 1 after operation， BG and CS level in both two groups were higher than those before operation (P＜0.05), but they were recovered on day 2 after operation in LAP group (Pgt;0.05), and on day 3 after operation in OP group (Pgt;0.05). BG and CS level in OP group were markedly higher than those in LAP group on day 2 after operation (P＜0.05). On day 1 after operation， Ins, T3 and T4 level of two groups were lower than those before operation (P＜0.05), but they were recovered on day 2 after operation in LAP group (Pgt;0.05) and on day 3 after operation in OP group (Pgt;0.05). Ins, T3 and T4 level in OP group were lower than those in LAP group on day 2 after operation (P＜0.05). There was no significant difference in operation time between two groups (Pgt;0.05). But laparoscopic surgery had more advantages than conventional open surgery such as reducing bleeding quantity in operation, shortening recovery time of bowel and urinary bladder function and the length of stay. Conclusion Compared with laparotomy, the laparoscope not only imposes less impact on physical stress system, but also makes recovery after operation more quickly.
ObjectivesTo investigate the knowledge, attitude and practice (KAP) of hepatitis E among Anlu residents and to identify the influencing factors.MethodsA stratified random sampling method was used and 1 840 Anlu residents were recruited between March 2019 and September 2019. Chi-square test and multivariate logistic regression model were used to analyze the influencing factors by SPSS 22.0 software.ResultsThe overall awareness rate of residents was 36.32%. There were statistically significant differences in age, occupation category and education (P<0.05). Qualification rate of awareness increased with age until age 40, but not with age after 40. Individuals occupationally exposed to swines (swine breeders, sales staff, slaughterers) had the lowest rates. Education level was positively associated with the qualification rate of awareness. The overall positive attitude rate was 53.89%. The overall healthy behavior rate was 82.95%.ConclusionsThe overall knowledge and awareness of hepatitis E among Anlu residents is low, especially individuals who have been occupationally exposed to swines. Health education and promotion programs are necessary.
【Abstract】ObjectiveTo investigate the relationship between expression of Seprase and the clinicopathologic characteristics in colorectal cancer. MethodsThe expression of Seprase in 50 cases of colorectal cancer was detected with immunohistochemistry, Western-blotting technique and semi-quantitative immunohistochemistry, and the relationship between the expression of Seprase and the clinicopathologic characteristics (age, gender, tumor location, tumor size, gross appearance, depth of infiltration, histological classification, lymph node metastasis, venous infiltration, Dukes stage, distant metastasis) was analyzed. ResultsThe expression of Seprase was found both in tumor cells and adjacent stromal cells. The level of Seprase protein was higher in cancer tissue than that in normal tissue, and a semiquantitative assessment of the immunohistochemistry revealed a significant correlation between Seprase expression and the Dukes stage and the lymph node metastasis. ConclusionThe abundant expression of Seprase in colorectal cancer tissue is associated with the Dukes stage and the lymph node metastasis.
ObjectiveTo investigate the role of protease-activated receptor-2 (PAR-2) activation on the expression of vascular endothelial growth factor (VEGF) in MKN28 gastric cancer cells. Methods①MKN28 cells were treated with increased concentrations of trypsin (0, 0.1, 1.0, 10.0, and 100.0 nmol/L respectively) for 6 hours, or treated with 10.0 nmol/L trypsin for 3, 6, 12, and 24 hours (blank control group was treated with PBS) respectively, then the expression levels of VEGF mRNA and its protein in MKN28 cells were detected by real-time reverse transcription polymerase chain reaction (qRT-PCR) and Western bolt method, with the concentration of VEGF protein in broth was detected by enzyme linked immunosorbent assay (ELISA) method.②MKN28 cells were divided into blank control group (treated with PBS), trypsin group, trypsin+PD98059 group, trypsin+SB203580 group, PD98059 group, and SB203580 group, then the expression levels of VEGF mRNA and its protein in MKN28 cells were detected by qRT-PCR method and Western bolt method respectively. Results①The effect of different concentration of trypsin. Compared with blank control group, the expression levels of VEGF mRNA and its protein in 0.1, 1.0, 10.0, and 100.0 nmol/L group were higher (P < 0.05); compared with 0.1 nmol/L group, the expression levels of VEGF mRNA and its protein in 1.0, 10.0, and 100.0 nmol/L group were higher (P < 0.05); compared with 1.0 nmol/L group, the expression levels of VEGF mRNA and its protein in 10.0 and 100.0 nmol/L group were higher (P < 0.05); but there was no significant difference between 10.0 nmol/L and 100.0 nmol/L group (P > 0.05). The broth concentration of VEGF protein in blank control group, 0.1, 1.0, 10.0, and 100.0 nmol/L group crept upward (P < 0.05).②The effect of different treated time of 10.0 nmol/L trypsin. The expression levels of VEGF mRNA in blank control group, 3, 6, 12, and 24 hours group crept upward, and there was significant difference between any 2 groups (P < 0.05). But the expression of VEGF protein was not similar with VEGF mRNA. Compared with blank control group, the expression levels of VEGF protein in 3, 6, 12, and 24 hours group were higher (P < 0.05); compared with 3 hours group, the expression levels of VEGF protein in 6, 12, and 24 hours group were higher (P < 0.05); but there was no significant difference among 6, 12, and 24 hours group (P > 0.05). The broth concentration of VEGF protein in blank control group, 3, 6, 12, and 24 hours group crept upward, and there was significant difference between any 2 groups (P < 0.05).③The effect of extracellular regulated protein kinase (ERK) inhibitor (PD98059) and p38 inhibitor (SB203580). The expression levels of VEGF mRNA and its protein in trypsin group were all higher than corresponding indexes of blank control group, trypsin+PD98059 group, trypsin+SB203580 group, PD98059 group, and SB203580 group (P < 0.01), but there was no significant difference among blank control group, trypsin+PD98059 group, trypsin+SB203580 group, PD98059 group, and SB203580 group (P > 0.05). ConclusionActivation of PAR-2 can induce the expressions of VEGF mRNA and its protein in MKN28 gastric cancer cells, that is mediated by ERK1/2-and p38-dependent pathway.
ObjectiveTo systematically review the efficacy of statins for contrast induced nephropathy (CIN) prevention in cardiac intervention surgery patients. MethodsWe electronically searched databases including PubMed, Web of Knowledge, The Cochrane Library (Issue 5, 2015), VIP, WanFang Data and CNKI to collect randomized controlled trials (RCTs) about statins for CIN prevention in cardiac intervention surgery patients from inception to May 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 25 RCTs involving 37 353 patients were included, among them, 3 794 were CIN patients. The results of meta-analysis indicated that: compared with the placebo/blank group, the incidence rate of CIN was decreased in the statins group with a significant difference (OR=0.68, 95%CI 0.63 to 0.73, P<0.000 01). ConclusionCurrent evidence shows statins can reduce incidence of CIN in cardiac intervention surgery patients. Due to limited quality and quantity of the included studies, the above conclusions need more high quality studies to verify.
Objective To summary the early experience of Dixon procedures with Da Vinci robotics surgical system for rectal cancer. Methods Eleven patients with rectal cancer underwent the combination of laparoscope and Da Vinci robotics surgical system with 4 trocars in our hospital from May. 2011 to Jan. 2012. Laparoscopy was firstly used to identify the possibility of the surgical procedure， then placed the 4 trocars， and maked sure the suspension of the sigmoid colon and the uterus. Transections of rectum were performed by a conventional laparoscopic method， and endoscopic separations were performed by Da Vinci robotics surgical system. The clinical data were retrospectively analyzed and the experience was summarized. Results The Da Vinci robotics-assisted Dixon procedures were successfully performed in 11 patients and no one turned to laparotomy. The operating time was 210-330min （mean 288.6min）；the blood loss was 20-100ml （mean 40ml）； The number of lymph nodes dissected was 12-21 per case （mean 13.9 per case）；the duration of bowel movement and hospital stay were 18-26h （mean 22h） and 7-16d （mean 11.5d）， respectively. There were no intraoperative or postoperative complications related to the use of robotics， and no residual cancer cells at resection margin. Conclusions Da Vinci robotics-assisted Dixion procedure with 4 trocars and suspension of sigmoid colon are safe and feasible， and it is beneficial to the recovery of patients