目的 探討丙泊酚-瑞芬太尼對肝臟缺血再灌注損傷的保護作用以及作用機制。 方法 2009年6月－2011年12月選擇擇期需阻斷肝門的肝臟手術患者40例，隨機分為丙泊酚-瑞芬太尼組（P組）和異氟醚組（I組），每組20例。在術前（T0）和肝門阻斷開放后30 min（T1）、60 min（T2）、6 h（T3）、24 h（T4）、72 h（T5）分別抽取動脈血，測定天冬氨酸氨基轉移酶（AST）、丙氨酸氨基轉移酶（ALT）和腫瘤壞死因子α（TNF-α）的含量。 結果 兩組AST、ALT、TNF-α較術前均有增高，差異有統計學意義（P＜0.05）；P組增高幅度明顯低于I組，差異有統計學意義（P＜0.05）。 結論 丙泊酚-瑞芬太尼對肝臟缺血再灌注損傷具有保護作用，抑制TNF-α的產生可能為其作用機制之一。
目的 探討體外循環（CPB）期間行肺動脈灌注液對術后肺功能的保護作用。 方法 2007年1月－2011年4月30例在CPB下行單純二尖瓣人工機械瓣置換術患者，隨機分成肺保護組和對照組各15例，肺保護組患者CPB期間經肺動脈灌注低溫肺保護液，對照組患者CPB期間未經肺動脈灌注低溫肺保護液。監測兩組患者在麻醉誘導后、阻斷主動脈l0 min及開放主動脈l0 min，2 、12、24 h各時間點的呼吸指數（RI）、氧合指數（OI）、白介素6（IL-6）、腫瘤壞死因子α（TNF-α）及術前、術后肺動脈壓力（PAPm）、靜態肺順應性（CLS）、氣道阻力（AR）變化，并比較術后ICU監護時間、術后呼吸機輔助時間、住院天數及有無術后并發癥等。 結果 兩組IL-6、TNF-α、RI、OI、PAPm、AR、CLS比較差異均有統計學意義（P＜0.05）。但術后ICU監護時間及住院時間比較差異均無統計學意義（P＞0.05）。 結論 CPB期間行肺動脈灌注對術后肺功能具有保護作用。
Objective To study the feasibility of transplanting autologous venous endothelial cells, as the liner, to the allogenic vein and to investigate the patency rate after such transplantation. Methods Autologous endothelial cells were gained after the administration of 0.2% collagenase and the centrifugalization of the enzyme liquid. The cells were not cultivated in a 60 ml plastic culture until the presence of the second generation. The cultivated cells were confirmed as endothelial cells by factor Ⅷ related antigen. The multiplied cells were lined in vitro onto the luminal surface of allogenic vein that was disposed by freeze-drying and radiation. The orthotopic transplantation of autologous venous endothelial cells was performed after the 9-day incubation. Results (9.47±0.35)×106 endothelial cells were obtained after the cultivation. Three hours after cell seeding, the luminal surface of allogenic vein was covered with vast endothelial cells but still had not formed an intact endomembrane. On day 9, the luminal surface was covered with a continuous endothelial monolayer and the arrangement and the shape of the cells all showed the perfect condition of endothelial cells. Eight weeks later, all the transplanted veins kept unobstructed. Conclusion The approach of lining allogenic vein with autologous endothelial cells in vitro may keep the vein unobstructed in the long term.
Objective To review the decellularized methods for obtaining extracellular matrix (ECM) and the applications of decellularized ECM scaffold in tissue engineering. Methods Recent and related literature was extensively and comprehensively reviewed. The decellularized methods were summarized and classified. The effects of different sterilization methods on decellularized scaffolds were analyzed; the evaluation criterion of extent of decellularization was put forward; and the application of decellularized ECM scaffold in different tissues and organs engineering field was summarized. Results The decellularized methods mainly include physical methods, chemical methods, and biological methods, and different decellularization methods have different effects on the extent of cell removal and ECM composition and structure. Therefore, the best decellularization method will be chosen according to the characteristics of the tissues and decellularization methods to achieve the ideal result. Conclusion It is very important to choose the appropriate decellularized method for preparing the biological materials desired by tissue engineering. The biological scaffolds prepared by decellularized methods will play an important role in tissue engineering and regenerative medicine.
目的 探討陽性激發點推拿治療對足底筋膜炎的臨床療效。 方法 對2011年3月－8月門診確診為足底筋膜炎的52例患者，采用隨機方式分為治療組和對照組各26例，治療組采用陽性激發點推拿，對照組采用電針治療。并對兩組患者治療5次后的即時療效率、日本骨科學會（JOA）足底治療療效評分、每次治療后的疼痛面譜量化評分、3個月隨訪疼痛復發率等療效進行對照分析。 結果 治療組和對照組經連續治療5次后，其JOA足底治療療效評分分別為（91.32 ± 10.61）、（82.92 ± 13.61）分，總有效率分別為96.15%、80.77%，差異均有統計學意義（P＜0.05）。疼痛面譜量化評分，治療組在第一次治療后較對照組改善明顯，差異有統計學意義（P＜0.05）。3個月后隨訪疼痛復發情況，治療組復發人數較對照組少，差異有統計學意義（P＜0.05）。結論 陽性激發點推拿治療法對改善足底筋膜炎引發的足底疼痛、步行不適等癥狀優于電針治療法，值得臨床推廣運用。
ObjectiveTo investigate the research progress of diagnosis and treatment of iliac vein compression syndrome (IVCS) so as to find the optimal diagnosis and treatment method in clinic. MethodLiterature about etiology, pathophysiology, clinical manifestations, diagnosis and treatment of IVCS in recent years was reviewed. ResultsIVCS was one of the pelvic vein obstructive diseases. The compression of left common iliac vein by right common iliac artery was more common in clinic, and it could also cause partial or complete occlusion of the iliac vein due to other external pressures. Clinical manifestations mainly included venous pain, edema, varicose veins, venous ulcer, skin pigmentation, and other skin nutritional changes. The examination methods mainly included color Doppler ultrasound, computed tomography venography, magnetic resonance venography, intravascular ultrasound, and venography. The treatment method had been changed from the original open venous reconstruction to intravascular treatment. Endovascular treatment was included thrombolysis, thrombectomy, percutaneous mechanical thrombectomy, balloon angioplasty, and endovascular stent treatment or combination treatment according to whether they were combined with iliac-femoral venous thrombosis or not. ConclusionBased on the existing researches, intravascular ultrasound is the first choice to diagnose and guide the intravascular treatment, and iliac vein stenting is an effective method for the treatment of IVCS with a good long-term patency and obvious symptom improvement.
With the aging of the population, the incidence of benign paroxysmal positional vertigo (BPPV) and osteoporosis have been increasing year by year, and the incidence of BPPV in vertigo related diseases has also been ranked first. There are similarities in structure, formation and metabolic mechanism between bone and otolith, but there is no consistent conclusion on the relationship between BPPV and osteoporosis. This article summarizes the current situation of the research on the correlation between BPPV and osteoporosis, the common risk factors and the related co-occurring mechanisms, aiming to provide more ideas for the prevention and treatment of BPPV patients, and improve the prevention and treatment ability of the co-diseases in the elderly.
Objective To observe the ultrastructure of theca interna of the de-endothelium allogenetic blood vessels in dogs by transmission and scanning electron microscope at different phases. Methods The endothelium of the allogenetic blood vessels were first removed and cryodensiccated, and were then end to end anastomosed to canine femoral artery. Samples were collected and observed with scanning and transmission electron microscope on the first, second, fourth, eighth, twelfth, sixteenth, and twentieth week after transplantation, respectively. Results A layer of cellulose membrane was formed on the surface of allogenetic blood vessels one week after transplantation; Fusiform cells were observed at the anastomotic stoma of the allogenetic blood vessels two weeks after transplantation, and theca interna, which was covered by fusiform cells and elliptical erythrocytes, was formed twelve weeks later; Slightly hyperplastic smooth muscle cells and collagenous fibers were observed under the endothelium twelve to twenty weeks after transplantation. Conclusion The endothelium cells could cover the surface of the allogenetic blood vessels without remarkable hyperplasia of intima during a short period of time, which may suggest the satisfactory histocompatibility of canine allogenetic blood vessels.
【Abstract】 Objective To investigate the method and effectiveness of expanded delto-pectoral and abdominalperforator flaps in repairing large defects of the face and upper limb after scar excision. Methods Between August 2000 and February 2011, 25 patients with large scars on face and upper l imb were treated. There were 14 males and 11 females with an average ageof 27 years (range, 7-36 years). Scars causes were burn and scald in 25 cases with a disease duration of 6 months to 7 years (mean, 4.5 years). The hypertrophic scars located at face in 15 cases, and at upper limb and hand in 10 cases. The soft tissue expanders (300-500 mL in volume) were implanted in the delto-pectoral zone and abdominal region in one-stage operation. In two-stage operation, after scars were resected, defects (9 cm × 7 cm to 17 cm × 8 cm) were repaired with the delto-pectoralperforator flaps (17 cm × 7 cm to 20 cm × 8 cm) in 15 facial scar cases and with the deep inferior epigastric artery perforator flaps (10 cm × 9 cm to 25 cm × 14 cm) in 10 upper limb and hand scar cases. The donor sites were sutured directly. Results Partial necrosis of the flaps occurred in 2 cases after operation, then the flap survived after expectant treatment. The other flaps and skin grafts survived successfully, and the incisions healed by first intention. Ten patients were followed up 6 months to 4 years. Theappearance, texture, and color of the flaps were similar to those at the donor site. Conclusion It is an effective method to use the delto-pectoral perforator flap and the deep inferior epigastric artery perforator flap for repairing soft tissue defects of the face and upper limb after scar excision.
With the development of computer technology, artificial intelligence (AI) has gradually been applied to various industries in society. In the healthcare industry, AI provides more choices for disease diagnosis and treatment, and also brings new vitality to the development of clinical medicine. In order to better promote the use of AI technology to improve the quality of otolaryngology teaching, this article provides a brief overview of the application of AI in otolaryngology, including the use of neural networks, deep learning for image analysis, disease diagnosis and treatment. It also discusses the significance and implementation methods of AI application in otolaryngology teaching from several aspects such as course design, teaching practice, and effectiveness assessment.