腹腔镜下直肠癌淋巴结清扫对比研究

目的对淋巴结清扫对直肠癌术后疗效的影响进行分析。方法收集2013年2月—2016年1月直肠癌患者90例随机分两组。开腹组采用传统直肠癌根治术和淋巴结清扫术进行治疗,腹腔镜组采用腹腔镜直肠癌根治术和淋巴结清扫术,并注意盆神经丛、腹前神经丛的保护。比较两组患者直肠癌缓解率;平均出血量、尿管拔除时间、淋巴结转移率;治疗前和治疗后患者外周血IL-6水平、免疫指标、生活质量的差异。结果腹腔镜组患者直肠癌缓解率和开腹组无显著差异,P0.05;腹腔镜组平均出血量、尿管拔除时间低于开腹组,P0.05;两组淋巴结转移率无显著差异,P0.05;治疗前两组外周血IL-6水平、免疫指标、生活质量比较无显著差异,P0.05;治疗后腹腔镜组外周血IL-6水平、免疫指标、生活质量明显优于开腹组,P0.05。结论腹腔镜和开腹手术淋巴结清扫范围和结果基本相同,但腹腔镜组有手术操作空间大,视野开阔、操作准确、创伤少、出血少等优点,值得推广。     

腹腔镜下后入路胰十二指肠切除术和传统开腹胰十二指肠切除术的比较

目的比较腹腔镜下后入路胰十二指肠切除术和传统开腹胰十二指肠切除术的近期临床效果,探讨腹腔镜下后入路胰腺十二指肠切除术的手术方式、安全性、可行性。方法选取2012年4月—2014年3月行腹腔镜下后入路胰十二指肠切除术和开腹胰十二指肠切除术各15例,比较两组术中情况(手术时间、术中出血量、术中输血量)情况和术后情况(ICU住院时间、排气时间、经口进食时间、术后住院时间、术后并发症、再手术率、病理学)。结果与开腹组比较,腹腔镜组手术时间明显延长[(524±77)min vs(358±72)min,t=6.093,P=0.001],术中出血量、术中输血量明显减少[(313±101)m L vs(417±100)m L,t=-2.828,P=0.017;(1.2±1.0)U vs.(2.2±0.6)U,t=-3.697,P=0.001],腹腔镜组术中清扫淋巴结数目明显增多[(17.2±4.5)枚vs(12.8±4.9)枚,(t=2.547,P=0.017)]。两组在ICU住院时间、排气时间、经口进食时间、术后住院时间、术后并发症发生率、R0切除率无显著差异。结论与传统开腹胰十二指肠切除术对比,腹腔镜下后入路胰十二指肠切除术是一种安全可行的手术方式,手术近期效果良好。     

持续静脉泵入及分次静点给予特治星治疗下呼吸道感染的效果观察

目的研究持续静脉泵入及分次静点给予特治星治疗下呼吸道感染的效果。方法选择116例下呼吸道感染患者,随机分为两组,观察组给予持续静脉泵入特治星治疗方案,对照组给予分次静脉点滴特治星治疗方案,治疗1周后观察治疗效果和安全性。结果观察组总有效率为94.83%显著高于对照组84.48%(P0.05),不良反应发生率为6.9%显著低于对照组20.69%(P0.05)。两组治疗后体温(T)、白细胞(WBC)及C反应蛋白(CRP)水平较治疗前均显著降低,观察组降低更为显著(P0.05)。两组治疗后氧分压(Pa O2)水平较治疗前均显著升高,观察组升高更为显著(P0.05)。结论持续静脉泵入能显著提高下呼吸道感染患者总有效率,降低不良反应发生率。     

87例结节性甲状腺肿术式改进及体会分析

目的比较传统与改良甲状腺次全切除术治疗结节性甲状腺肿的疗效,探讨改良甲状腺次全切除术临床应用价值。方法选择茂名市茂南区公馆中心卫生院2010年1月—2013年12月收治的结节性甲状腺肿患者87例,其中对照组40例患者接受传统甲状腺次全切除术治疗,观察组47例患者接受改良甲状腺次全切除术治疗。比较两组患者的手术时间、术中出血量、住院时间、VAS疼痛评分及并发症、复发情况。结果观察组患者的手术时间、术中出血量、住院时间均要优于对照组,差异有统计学意义(P0.05)。观察组患者的并发症发生率、复发率及VAS疼痛评分均低于对照组,差异有统计学意义(P0.05)。结论改良甲状腺次全切除术的临床疗效更为显著,不仅减少手术及住院时间,降低术中出血量及术后并发症发生率,而且切口更为美观,提高了患者的接受度,故值得推广应用。     

腹腔镜与开放手术治疗急性阑尾炎的疗效分析

目的对比分析应用腹腔镜手术治疗及开放手术治疗应对急性阑尾炎治疗的临床疗效。方法选择2014年3月至2015年3月于辽阳市弓长岭区中心医院就诊收治并确诊为急性阑尾炎的患者共计80例,进行随机分组,包括对照组40例,主要应用开放手术应对急性阑尾炎的治疗。研究组40例,主要应用腹腔镜手术应对其的治疗。观察对比两组病患围手术期的平均手术时间、术中出血量、首次肛门排气时间及手术费用及平均住院时间,并观察记录两组患者术后并发症发生情况,均作统计学分析。结果研究组40例病患围手术期的平均手术时间、术中出血量及首次肛门排气时间较之对照组均明显要低,P0.05。对照组病患手术费用较之研究组明显要高,P0.05;研究组病患平均住院时间较之对照组明显要短,P0.05。对照组病患术后并发腹腔脓肿、肠瘘,肠黏连各两例,并发切口感染5例,总并发症发生率为27.50%。研究组病患术后仅病患切口感染1例,并发症发生率为2.50%。研究组病患并发症发生率较之对照组明显要低,且P0.05。结论腹腔镜手术针对急性阑尾炎的临床治疗其疗程疗效颇优,安全性较高,具有临床推广应用价值。     

超声引导下连续腰交感神经节阻滞联合全麻对膝关节置换术患者镇痛及苏醒质量的影响

本文对超声引导下连续腰交感神经节阻滞联合全麻对膝关节置换术患者镇痛及苏醒质量的影响进行了分析和探讨。选取2017年1月～2019年1月本院膝关节置换术患者100例,依据随机数字表分为滞麻组和单麻组,每组50例,单麻组给予单纯全麻,滞麻组在此基础上给予超声引导下连续腰交感神经节阻滞,比较两组镇痛及苏醒质量、不良反应。结果显示,滞麻组切皮时（T1）、关节置换时（T2）、术毕（T3）的平均动脉压（MAP）、心率（HR）明显低于单麻组,滞麻组镇痛优良率明显高于单麻组,有统计学差异（P<0.05）;滞麻组呼之睁眼、呼之握拳、拔管、苏醒时间和苏醒并发症率明显低于单麻组,有统计学差异（P<0.05）;滞麻组和单麻组不良反应率比较,无统计学差异（P>0.05）。本文认为,超声引导下连续腰交感神经节阻滞联合全麻可有效改善膝关节置换术患者镇痛及苏醒质量,且安全性好,值得临床推广。     

数字减影血管造影引导下双侧子宫动脉栓塞术在穿透性凶险性前置胎盘中的应用

本文分析了数字减影血管造影（DSA）引导下双侧子宫动脉栓塞术在穿透性凶险性前置胎盘患者中的应用效果及对母婴结局的影响。选择2017年12月～2019年7月我院收治的穿透性凶险性前置胎盘患者45例,依据是否行子宫动脉栓塞术,将患者分为观察组（n=25例）和对照组（n=20例）。观察组行DSA引导下双侧子宫动脉栓塞术治疗,对照组行常规剖宫产手术治疗。术后7天对患者效果进行评估,比较两组手术指标、母婴结局及并发症发生率。结果显示：观察组失血量、红细胞输血量、冷沉淀输血量、住院时间,少（短）于对照组,新生儿1 min Agpar评分高于对照组,差异有统计学意义（P<0.05）。观察组新生儿肺炎、新生儿呼吸窘迫综合征、新生儿窒息及新生儿高胆红素血症发生率均低于对照组,差异有统计学意义（P<0.05）。观察组子宫切除、产后出血、失血性休克和DIC发生率均低于对照组,差异有统计学意义（P<0.05）。表明DSA引导下双侧子宫动脉栓塞术治疗穿透性凶险性前置胎盘的效果确切,可明显减少患者术中出血量及术后并发症,降低手术风险,改善临床结局,且微创、安全,值得临床推广应用。     

新辅助化疗在软组织肉瘤治疗中的应用分析

目的研究并探讨新辅助化疗在软组织肉瘤治疗中的应用效果。方法选取2013年1月—2016年6月期间甘肃中医药大学临床医学院收治的软组织肉瘤共80例作为研究对象,采取单盲随机分组法随机分为对照组和观察组各40例,对照组实施手术治疗,观察组在手术前实施新辅助化疗,比较两组患者的保肢率、治疗效果、术后半年复发情况。结果观察组患者的保肢手术率为77.50%,对照组患者为55.00%,差异具有统计学意义(P0.05);观察组患者的治疗总有效率明显高于对照组(P0.05);术后半年随访发现,观察组的复发率明显低于对照组(P0.05);观察组患者在新辅助化疗期间未出现严重的不良反应。结论在软组织肉瘤患者行手术治疗前实施新辅助化疗,可提高患者的保肢率,提高治疗效果,减少复发,有利于改善预后。     

不同肋间胸腔闭式引流治疗胸腔积液的疗效分析

目的探讨不同肋间胸腔闭式引流治疗胸腔积液的疗效。方法收集信丰县人民医院2015年1月—2016年1月86例胸腔积液患者,按照入院顺序分成观察组与对照组,观察组经第5肋间实施胸腔闭式引流术,对照组经第6、7肋间实施胸腔闭式引流术,对比两组患者术后疼痛评分、临床疗效、胸水完全吸收时间、引流管留置时间、住院时间及并发症情况。结果观察组术后疼痛评分均低于对照组(P0.05);观察组总有效率高于对照组(P0.05);两组胸水完全吸收时间、胸腔引流管留置时间、住院时间对比无显著差异(P0.05);两组并发症发生率对比无显著差异(P0.05)。结论第5肋间的胸腔闭式引流术在胸腔积液的临床治疗中具有更好的效果,可缓解术后疼痛,值得临床应用。     

延续性护理对缺血性脑卒中患者复发及治疗依从性的影响

目的探讨分析延续性护理干预对缺血性脑卒中患者复发及治疗依从性的影响。方法随机选取辽宁省抚顺市东洲区龙凤街道社区卫生服务中心62例缺血性脑卒中患者,将其分为常规组与实验组各31例,常规组实施常规护理,实验组实施延续性护理干预,比较两组患者治疗依从性及疾病复发情况。结果随访1年,实验组患者科学运动、合理饮食、规范用药等治疗依从性明显高于常规组(P0.05);实验组患者生活质量评分为(8.84±0.62)分,明显优于常规组(6.37±0.40)分(P0.05);实验组复发率为6.45%,显著低于常规组19.35%(P0.05)。结论对缺血性脑卒中患者实施延续性护理干预,能够有效提高患者治疗依从性及生存质量,降低疾病复发率,值得推广普及。     

Furyl- and thienyl-silatranes and germatranes

We review our research on the synthesis and study of the physical and biological properties of furyl- and thienylgermatranes and -silatranes.Translated from Khimiya Geterotsiklicheskikh Soedinenii, No. 6, pp. 725–732, June, 1992.     

Review and patents and literature

The use of the insect cell/baculovirus expression system for producing recombinant proteins of bacterial, plant, insect, and mammalian origin has become widespread. The popularity of this eukaryotic expression system is due to many factors, including (1) potentially high protein expression levels, (2) ease and speed of genetic engineering, (3) ability to accommodate large DNA inserts, (4) protein processing similar to higher eukaryotic cells (e.g., mammalian cells), and (5) ease of insect cell growth (e.g., suspension growth). The following review of the literature discusses two engineering aspects of recombinant protein synthesis by insect cell cultures: bioreactor scale-up and insect cell line selection. Following this review patent abstracts and additional literature pertaining to expression of recombinant proteins in insect cell culture are listed.     

多环芳二酐型聚酯亚胺膜的透气性能

多环芳二酐型聚酯亚胺膜的透气性能李悦生，丁孟贤，徐纪平（浙江大学高分子科学与工程研究所，杭州，３１００２７）（中国科学院长春应用化学研究所）关键词聚醚酰亚胺，聚酯酰亚胺，膜，透气性通常的聚酰亚胺加工性能较差，在芳环二酐的苯环间引入醚键等柔性基团后，其...     

Hard and soft acids and bases: structure and process

Under investigation is the structure and process that gives rise to hard-soft behavior in simple anionic atomic bases. That for simple atomic bases the chemical hardness is expected to be the only extrinsic component of acid-base strength, has been substantiated in the current study. A thermochemically based operational scale of chemical hardness was used to identify the structure within anionic atomic bases that is responsible for chemical hardness. The base's responding electrons have been identified as the structure, and the relaxation that occurs during charge transfer has been identified as the process giving rise to hard-soft behavior. This is in contrast the commonly accepted explanations that attribute hard-soft behavior to varying degrees of electrostatic and covalent contributions to the acid-base interaction. The ability of the atomic ion's responding electrons to cause hard-soft behavior has been assessed by examining the correlation of the estimated relaxation energies of the responding electrons with the operational chemical hardness. It has been demonstrated that the responding electrons are able to give rise to hard-soft behavior in simple anionic bases.     

微量元素与疾病诊断治疗的研究现状及展望

对国内外微量元素与疾病的关系及其诊断治疗的研究现状及研究动向进行了综述，包括：微量元素与地方病、癌肿、心血管病、糖尿病、眼病、神经系统病等。参考文献72篇。     

Preparation and photolysis of poly-p-ethylacrylophenone and poly-p-chloroacrylophenone and their copolymers with styrene and methyl methacrylate

Poly-p-ethylacrylophenone (PPEtAP) and poly-p-chloroacrylophenone (PPClAP) and their copolymers with styrene (PEtAP/S) and (PClAP/S) and with methyl methacrylate (PEtAP/MMA) and (PClAP/MMA) were prepared. Quantum yields of main-chain scissions at 366 nm at room temperature in benzene solution are of the same order as those of the unsubstituted polyacrylophenone and its copolymers. Substitution with chlorine and ethyl group in the para position compared to the unsubstituted polyacrylophenone and its copolymers leads to an increase of the lifetime for the n–π^* excited triplet state, as is evident from the measured quenching constants of photolysis. The low-temperature emission spectra of the copolymers are similar to the spectra of the model compounds in a polymer film. For the homopolymer, however, the character of the emission spectrum changes considerably.     

Concentrations and distributions of trace and minor elements in Chinese and Canadian coals and ashes

A total of 35 trace and minor elements including some of environmental significance were determined in each of a selection of 15 Chinese and 6 Canadian thermal coals and their ashes by using the SLOWPOKE-2 nuclear reactor facility of the University of Toronto. The concentrations and distributions of these constituents among the coals and their combustion products (viz. ash and volatile matter) are presented together with an interpretation of their significance in relation to the large scale combustion of these coals as thermal fuels in industrialized countries such as China and Canada. The detailed results showed wide variations in trace impurity concentrations (up to a factor of 100 and more) among the coals studied with few large differences between those of Chinese and Canadian origin except that the rare earths, Sc, Th, U, I, and Se were much higher in the former, other halogens, As and Na were lower. Values for elemental enrichment factors (EF) relative to normal crustal abundances indicated that only As(EF=13), Br(5.7), I(16), S(230), Sb(11) and Se(320) were appreciably enriched in coal. During static ashing at 750°C most of the halogens, S and Se were volatilized whereas most other inorganic constituents were highly retained and concentrated in the ash by factors of 6 to 11.