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Surgical Indications and Tips of Endoscopic Thyroidectomy

创伤性气管、食管裂伤一例

结肠癌并急性肠梗阻一期手术治疗11例报告

绝经后子宫颈巨大宫内膜囊肿一例

VULVAR RECONSTRUCTION USING GRACILIS MYOCUTANEOUS FLAPS AFTER RADICAL VULVECTOMY

OBJECTIVE To introduce the method using the gracilis myocutaneous flaps to repair of vulvar defect after radical vulvectomy. METHODS The gracilis myocutaneous flaps were applied in 4 cases with vulvar carcinoma which located vestibule of vulva and bulk, and the carcinoma was large after radical resection to repair vulvar defect simultaneously. RESULTS The incision of 3 cases was healing by first intention, and 1 case with type II diabetes mellitus was healing by second intention. After followed up 3-6 years, 1 case was recurrent in 2 years after operation, 3 cases were survival without complication. CONCLUSION Vulvar reconstruction with the use of gracilis myocutaneous flaps in radical vulvectomy could markedly decrease the rate of complication.

胸部闭合伤后支气管断裂八例

The Predicting Value of the Level of BUN for the Long Term Mortality of the STEMI Patients

目的:肾功能不全在急性冠脉综合症及其它心血管疾病中通常伴随着较高的死亡率。而血浆尿素氮是反映血液动力学改变及肾脏灌注改变的非常敏感的指标。本试验研究血浆尿素氮水平的高低对于急性ST段抬高型心肌梗塞患者死亡率的预测作用。方法:研究300名患急性ST段抬高型心肌梗塞患者长程的死亡率与入院时血浆尿素氮水平及住院时血浆尿素氮水平升高之间的关系。结果:在平均随访27个月,56(185%)个患者死亡。使用生存分析对于血浆尿素氮水平升高与血浆尿素氮水平正常两组患者进行研究,用log-rank检验将两组数据进行比较,有明显统计学意义,Plt;0.001。结论:对于患急性ST段抬高型心肌梗塞患者的长期死亡率,入院时的血浆尿素氮水平是一个独立的预测因素。BUN和BUN/creatinine比值的增高也能对患急性ST段抬高型心肌梗塞患者的长期死亡率提供一定的预测信息。同时,住院期间的BUN增高对于患急性ST段抬高型心肌梗塞患者的长期死亡率也能够提供额外的预测信息。

Research on the effects of interleukin-6 on proliferation of cervical cancer cell C-33A

ObjectiveTo explore the role of interleukin-6 (IL-6) in cervical cancer cell C-33A.MethodsThe cervical cancer cells C-33A were divided into the IL-6 group and the control group after culture. The IL-6 group were treated with 50 ng/mL of recombinant IL-6 protein, and the control group were without IL-6. Then cell viability and cell migration were detected by MTT assay and wound-healing assay, respectively. The mRNA and protein expressions of epithelial-cadherin (E-Cad), neural-cadherin (N-Cad), vimentin and transcription factors-snail1 (TFs-SNAIL1) were analyzed by real time quantitative polymerase chain reaction and Western blotting, respectively.ResultsCompared with the control group, in the IL-6 group the proliferation of cervical cancer cells C-33A was promoted (12 h: 0.388±0.025 vs. 0.597±0.057; 24 h: 0.547±0.021 vs. 0.798±0.036; 48 h: 0.745±0.056 vs. 1.296±0.122; 72 h: 1.074±0.053 vs. 1.805±0.113; P<0.05), and the relative migration ability of cervical cancer cell was promoted (12 h: 1.057±0.029vs. 1.200±0.045; 24 h: 1.189±0.036 vs. 1.428±0.181; 48 h: 1.273±0.059 vs. 1.569±0.143; 72 h: 1.409±0.047 vs. 1.623±0.170; P<0.05); meanwhile, compared with the control group, in the IL-6 group, the expression of E-Cad mRNA (1.012±0.098vs. 0.483±0.171, P<0.01) and E-Cad protein (1.032±0.015vs. 0.395±0.119; P<0.01) decreased, the expression of N-Cad mRNA (1.054±0.106vs. 1.465±0.230, P<0.01) and N-Cad protein (1.040±0.043vs. 1.605±0.128, P<0.01) increased, the expression of vimentin mRNA (1.050±0.083vs. 1.340±0.099, P<0.05) and vimentin protein (1.043±0.062vs. 1.430±0.077, P<0.05) increased, and the expression of TFs-SNAIL1 mRNA (1.058±0.176vs. 1.510±0.229, P<0.01) and Fs-SNAIL1 protein (1.022±0.015vs. 1.470±0.139, P<0.01) increased.ConclusionIL-6 may promote the proliferation, migration, and epithelial-mesenchymal transition of cervical cancer cell C-33A.

Application of Dexmedetomidine Hydrochloride in Sedation Practices during NPPV for Patients with Acute Exacerbations of COPD and Respiratory Failure

Objective To investigate the feasibility of dexmedetomidine hydrochloride in sedation practices during NPPV for patients with acute exacerbation of COPD ( AECOPD) and respiratory failure. Methods 50 patients with AECOPD and respiratory failure, admitted in ICU between January 2011 and April 2012, were divide into an observation group and a control group. All patients received conventional treatment and noninvasive positive pressure ventilation ( NPPV) . Meanwhile in the observation group, dexmedetomidine hydrochloride ( 1 μg/kg) was intravenously injected within 10 minutes, then maintained using a micropump by 0.1 ～0. 6 μg·kg- 1 ·h- 1 to maintaining Ramsay Sedation Scale ( RSS) score ranged from 2 to 4. The patients’compliance to NPPV treatment ( conversion rate to invasive ventilation) and ICU stay were compared between two groups. Heart rate,mean arterial pressure, respiratory rate, and arterial blood gas ( pH, PaO2 , PaCO2 ) before and 24 hours after treatment were also compared. Results After 24 hours treatment, heart rate, mean arterial pressure, respiratory rate, and arterial blood gas were all improved in two groups, while the improvements were more remarkable in the observation group. The conversion rate to invasive ventilation ( 4% vs. 16% ) and ICUstay [ ( 5.47 ±3.19) d vs. ( 8.78 ±3.45) d] were lower in the observation group than those in the control group. ( P lt;0.05) . Conclusion Dexmedetomidine hydrochloride may serve as a safe and effective sedative drug during NPPV in patients with AECOPD and respiratory failure.

心瓣膜置换术围术期甲状腺激素的动态观察

目的 探讨心瓣膜置换术围术期甲状腺激素的变化及其与病情程度的关系。方法 采用放射免疫分析法连续测定30例低温体外循环下心瓣膜置换术围术期甲状腺激素，并观察其动态变化。结果 两组患者三碘甲状腺原氨酸(T3)、游离T3(FT3)从转流前至术后72小时呈下降趋势，各时间点均明显低于术前；反三碘甲状腺原氨酸(rT3)均增高，术后72小时仍未恢复至术前水平(P＜0.05)。两组患者四碘甲状腺原氨酸(T4)、游离T4(FT4)、促甲状腺素(TSH)浓度均在生理范围内变化。结论 心瓣膜置换术围术期均表现为低T3综合征，且T3降低与疾病的严重程度有关。临床上通过监测其血清T3和FT3水平可作为了解病情及预后的客观指标。