Cholellthiasis is a kind of common and multiple diseases. In recent years, traolttonal laparommy has been challenged by a minimally invasive surgery. Through literature review, the therapeutic method, effect, and comp...Cholellthiasis is a kind of common and multiple diseases. In recent years, traolttonal laparommy has been challenged by a minimally invasive surgery. Through literature review, the therapeutic method, effect, and complications of minimally invasive treatment of intrahepatic and extrahepatic bile duct stones by combining our practical experience were summarized as follows. （1） For intrahepatic bile duct stones, the operation may be selected by laparoscopie liver resection, laparoscopic common bile duct exploration （LCBDE）, or percutaneous transhepatic cholangioscopy. （2） For concomitant gallstones and common bile duct stones, the surgical approach can be selected as follows： laparoscopic cholecystectomy （LC） combined with endoscopic sphincterotomy （EST） or endoscopic papillary balloon dilatation, LC plus laparoscopic transcystic common bile duct exploration, LC plus LCBDE, and T-tube drainage or primary suture. （3） For concomitant intrahepatic and extrahepatic bile duct stones, laparoscopic liver resection, choledochoscopy through the hepatic duct orifice on the hepatectomy cross section, LCBDE, EST, and percutaneous transhepatic cholangioscopic lithotripsy could be used. According to the abovementioned principle, the minimally invasive treatment approach combined with the surgical technique and equipment condition will be significant in improving the therapeutic effect and avoiding the postoperative complications or hidden dangers of intrahepatic and extrahepatic bile duct stones.展开更多
We investigated the anti-tumor effects of dual cancer specific-oncolytic adenovirus Ad-VP on esophageal cancer（EC）. The anti-tumor activity of Ad-VP was compared with that of the control recombinant adenoviruses （A...We investigated the anti-tumor effects of dual cancer specific-oncolytic adenovirus Ad-VP on esophageal cancer（EC）. The anti-tumor activity of Ad-VP was compared with that of the control recombinant adenoviruses （Ad-GP, Ad-Apoptin, Ad-EGFP） in human esophageal cancer cell EC-109 and human normal liver cell L02 in vitro. In 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide（MTT） assays, the growth of EC-109 cells was slightly inhibited by Ad-GP, Ad-Apoptin and Ad-EGFE However, Ad-VP induced a significant cytotoxic effect. Infection of EC-109 cells with Ad-VP resulted in a significant induction of apoptosis of them in vitro, detected by 4＇,6-diamidino-2-phenylindole（DAPI） or acridine orange and ethidium bromide staining. The results of Western blot and flow cytometric assay indicate the loss of mitochondrial membrane potential（Aψm）, the release of eytochrome c and the activation of caspase-3, 6 and 7 in Ad-VP infected EC-109 cells. In contrast, all these assays show almost no effects of the recombinant adenoviruses on L02 cells. These results demonstrate that the treatment of tumors with Ad-VP selectively inhibits tumor growth and induces apoptosis of esophageal cancer cells. Ad-VP may provide a novel and powerful strategy for cancer gene therapy.展开更多
In this paper, an updated vegetation map of the permafrost zone in the Qinghai-Tibet Plateau （QTP） was delineated. The vegetation map model was extracted from vegetation sampling with remote sensing （RS） datasets ...In this paper, an updated vegetation map of the permafrost zone in the Qinghai-Tibet Plateau （QTP） was delineated. The vegetation map model was extracted from vegetation sampling with remote sensing （RS） datasets by decision tree method. The spatial resolution of the map is 1 km×1 kin, and in it the alpine swamp meadow is firstly distinguished in the high-altitude areas. The results showed that the total vegetated area in the permafrost zone of the QTP is 1,201,751 km2. In the vegetated region, 50,260 km2 is the areas of alpine swamp meadow, 583,909 km2 for alpine meadow, 332,754 km2 for alpine steppe, and 234,828 km2 for alpine desert. This updated vegetation map in permafrost zone of QTP could provide more details about the distribution of alpine vegetation types for studying the vegetation mechanisms in the land surface processes of highaltitude areas.展开更多
Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients w...Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients with acute coronary syndrome（ACS）. Methods： Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups： 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1（ICAM-1）, chitinase-3-like protein 1（YKL-40） and lipoprotein-associated phospholipase A2（Lp-PLA2）. Results： Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference（P〉0.05）; ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS（P〈0.05）. Conclusion： Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.展开更多
目的:探讨血清N末端脑钠肽前体(NT-ProBNP)、可溶性髓系细胞触发受体1(sTREM-1)水平及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分对老年重症肺炎(SP)患者的预后评估价值。方法:选取我院收治的老年SP患者208例进行前瞻性研究,检...目的:探讨血清N末端脑钠肽前体(NT-ProBNP)、可溶性髓系细胞触发受体1(sTREM-1)水平及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分对老年重症肺炎(SP)患者的预后评估价值。方法:选取我院收治的老年SP患者208例进行前瞻性研究,检测患者第1、3、5天血清NT-ProBNP及sTREM-1水平变化,记录APACHEⅡ评分及预后情况。应用受试者工作特征(ROC)曲线分析血清NT-ProBNP、sTREM-1及APACHEⅡ评分对老年SP患者的预后价值,采用Logistic回归分析老年SP患者发生死亡的独立预测因素。结果:死亡组第1、3、5天血清NT-ProBNP(2 864.50±537.60 vs 1 146.30±318.42,4 205.63±738.52 vs 986.20±204.37,6317.45±912.64 vs 674.35±125.40,pg/mL)、sTREM-1(68.42±14.25 vs 54.28±10.13,76.20±17.60 vs 43.50±7.36,82.42±19.35 vs 40.72±7.50,pg/mL)及APACHEⅡ评分(24.80±4.50 vs 20.30±3.25,29.74±5.63 vs 18.26±3.14,35.82±6.12 vs 16.84±3.06,分)均明显高于存活组(均P<0.05)。Logistic回归分析显示,NT-ProBNP[OR=1.503(1.363~2.106)]、sTREM-1[OR=1.914(1.527~2.508)]及APACHEⅡ评分[OR=1.226(1.078~1.636)]升高是老年SP患者预后不良的独立影响因素(均P<0.05)。ROC曲线显示,第3天血清NT-ProBNP、sTREM-1及APACHEⅡ评分预测老年SP患者死亡的最佳截值分别为3 016.40 pg/mL、69.34 pg/mL和25.83分,三项联合预测老年SP患者死亡的AUC(95%CI)为0.962(0.925~0.998),其敏感度(98.0%)和特异度(89.5%)最高。结论:血清NT-ProBNP、sTREM-1及APACHEⅡ评分变化与老年SP患者病情严重程度及预后相关,第3天三项联合预测患者预后的价值最大。展开更多
目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者以肺部感染控制窗(PIC-W)为切换点撤机序贯经鼻高流量湿化氧疗(HFNC)与序贯无创正压通气(NPPV)对炎症指标及预后的影响。方法选取徐州医科大学附属医院急诊重症医学科2019年12月—2020年1...目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者以肺部感染控制窗(PIC-W)为切换点撤机序贯经鼻高流量湿化氧疗(HFNC)与序贯无创正压通气(NPPV)对炎症指标及预后的影响。方法选取徐州医科大学附属医院急诊重症医学科2019年12月—2020年12月收治的AECOPD有创机械通气患者70例,满足PIC窗后按随机数字表法分为HFNC组(n=35)和NPPV组(n=35),分别在常规治疗基础上予HFNC和NPPV序贯通气治疗。收集患者一般资料、拔管前24h最差APACHE II评分及SOFA评分;检测拔管24 h、72 h白细胞计数(WBC)、超敏C反应蛋白(CRP)、降钙素原(PCT);观察两组拔管后2 h、24 h、72 h氧合指数、动脉血PCO_(2)以及生理指标;记录患者不同时间点呼吸困难评分;统计临床结局/并发症相关指标(拔管后HFNC治疗时间及NPPV治疗时间、院内感染发生率、再插管率、ICU住院时间、总住院时间、28 d病死率)。结果与拔管前相比,两组拔管后24 h CRP、PCT及72h WBC、CRP、PCT较拔管前下降,拔管后72 h HFNC组WBC、CRP、PCT明显低于NPPV组,差异有统计学意义(P<0.05);与拔管前相比,两组拔管后72 h氧合指数均明显改善,PaCO_(2)明显下降,差异有统计学意义(P<0.05);两组拔管后72 h RR及HR均较拔管前降低,而HFNC组拔管后72 h RR低于NPPV组,差异有统计学意义(P<0.05);不同时间点HFNC组患者呼吸困难评分均低于NPPV组;HFNC组治疗时间、院内感染发生率均低于NPPV组,差异有统计学意义(P<0.05);两组再插管率、28 d病死率,ICU住院时间和总住院时间比较差异无统计学意义(P>0.05)。结论AECOPD患者以PIC-W为撤机切换点序贯HFNC或NPPV均能提高氧合指数,降低PaCO_(2)。HFNC较NPPV能够减少PCT、CRP等炎性因子释放,降低患者呼吸频率,改善患者呼吸困难,缩短无创治疗时间并降低院内感染发生率,可应用于AECOPD撤机患者。展开更多
文摘Cholellthiasis is a kind of common and multiple diseases. In recent years, traolttonal laparommy has been challenged by a minimally invasive surgery. Through literature review, the therapeutic method, effect, and complications of minimally invasive treatment of intrahepatic and extrahepatic bile duct stones by combining our practical experience were summarized as follows. （1） For intrahepatic bile duct stones, the operation may be selected by laparoscopie liver resection, laparoscopic common bile duct exploration （LCBDE）, or percutaneous transhepatic cholangioscopy. （2） For concomitant gallstones and common bile duct stones, the surgical approach can be selected as follows： laparoscopic cholecystectomy （LC） combined with endoscopic sphincterotomy （EST） or endoscopic papillary balloon dilatation, LC plus laparoscopic transcystic common bile duct exploration, LC plus LCBDE, and T-tube drainage or primary suture. （3） For concomitant intrahepatic and extrahepatic bile duct stones, laparoscopic liver resection, choledochoscopy through the hepatic duct orifice on the hepatectomy cross section, LCBDE, EST, and percutaneous transhepatic cholangioscopic lithotripsy could be used. According to the abovementioned principle, the minimally invasive treatment approach combined with the surgical technique and equipment condition will be significant in improving the therapeutic effect and avoiding the postoperative complications or hidden dangers of intrahepatic and extrahepatic bile duct stones.
基金Supported by the Genetically Modified Organisms Breeding Major Project of China(No.2009ZX08006-002B)the National Natural Science Foundation of China(Nos.81101140,81072210)+1 种基金the Key Technologies Research and Development Program of Jilin Province,China(Nos.10ZDGG007,201015166)the China Postdoctoral Science Foundation Funded Project(No.20100481057)
文摘We investigated the anti-tumor effects of dual cancer specific-oncolytic adenovirus Ad-VP on esophageal cancer（EC）. The anti-tumor activity of Ad-VP was compared with that of the control recombinant adenoviruses （Ad-GP, Ad-Apoptin, Ad-EGFP） in human esophageal cancer cell EC-109 and human normal liver cell L02 in vitro. In 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide（MTT） assays, the growth of EC-109 cells was slightly inhibited by Ad-GP, Ad-Apoptin and Ad-EGFE However, Ad-VP induced a significant cytotoxic effect. Infection of EC-109 cells with Ad-VP resulted in a significant induction of apoptosis of them in vitro, detected by 4＇,6-diamidino-2-phenylindole（DAPI） or acridine orange and ethidium bromide staining. The results of Western blot and flow cytometric assay indicate the loss of mitochondrial membrane potential（Aψm）, the release of eytochrome c and the activation of caspase-3, 6 and 7 in Ad-VP infected EC-109 cells. In contrast, all these assays show almost no effects of the recombinant adenoviruses on L02 cells. These results demonstrate that the treatment of tumors with Ad-VP selectively inhibits tumor growth and induces apoptosis of esophageal cancer cells. Ad-VP may provide a novel and powerful strategy for cancer gene therapy.
基金supported by the National Natural Science Foundation of China (Grant No.41101055)the Hundred Talents Program of the Chinese Academy of Sciences granted to Tonghua Wu (Grant No.51Y251571)the “National Basic Research Program of China (973 Program)” (Grant No.2010CB951402)
文摘In this paper, an updated vegetation map of the permafrost zone in the Qinghai-Tibet Plateau （QTP） was delineated. The vegetation map model was extracted from vegetation sampling with remote sensing （RS） datasets by decision tree method. The spatial resolution of the map is 1 km×1 kin, and in it the alpine swamp meadow is firstly distinguished in the high-altitude areas. The results showed that the total vegetated area in the permafrost zone of the QTP is 1,201,751 km2. In the vegetated region, 50,260 km2 is the areas of alpine swamp meadow, 583,909 km2 for alpine meadow, 332,754 km2 for alpine steppe, and 234,828 km2 for alpine desert. This updated vegetation map in permafrost zone of QTP could provide more details about the distribution of alpine vegetation types for studying the vegetation mechanisms in the land surface processes of highaltitude areas.
基金Supported by National Basic Research Program of China(973 program,No.2015CB554404)
文摘Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients with acute coronary syndrome（ACS）. Methods： Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups： 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1（ICAM-1）, chitinase-3-like protein 1（YKL-40） and lipoprotein-associated phospholipase A2（Lp-PLA2）. Results： Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference（P〉0.05）; ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS（P〈0.05）. Conclusion： Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.
文摘目的:探讨血清N末端脑钠肽前体(NT-ProBNP)、可溶性髓系细胞触发受体1(sTREM-1)水平及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分对老年重症肺炎(SP)患者的预后评估价值。方法:选取我院收治的老年SP患者208例进行前瞻性研究,检测患者第1、3、5天血清NT-ProBNP及sTREM-1水平变化,记录APACHEⅡ评分及预后情况。应用受试者工作特征(ROC)曲线分析血清NT-ProBNP、sTREM-1及APACHEⅡ评分对老年SP患者的预后价值,采用Logistic回归分析老年SP患者发生死亡的独立预测因素。结果:死亡组第1、3、5天血清NT-ProBNP(2 864.50±537.60 vs 1 146.30±318.42,4 205.63±738.52 vs 986.20±204.37,6317.45±912.64 vs 674.35±125.40,pg/mL)、sTREM-1(68.42±14.25 vs 54.28±10.13,76.20±17.60 vs 43.50±7.36,82.42±19.35 vs 40.72±7.50,pg/mL)及APACHEⅡ评分(24.80±4.50 vs 20.30±3.25,29.74±5.63 vs 18.26±3.14,35.82±6.12 vs 16.84±3.06,分)均明显高于存活组(均P<0.05)。Logistic回归分析显示,NT-ProBNP[OR=1.503(1.363~2.106)]、sTREM-1[OR=1.914(1.527~2.508)]及APACHEⅡ评分[OR=1.226(1.078~1.636)]升高是老年SP患者预后不良的独立影响因素(均P<0.05)。ROC曲线显示,第3天血清NT-ProBNP、sTREM-1及APACHEⅡ评分预测老年SP患者死亡的最佳截值分别为3 016.40 pg/mL、69.34 pg/mL和25.83分,三项联合预测老年SP患者死亡的AUC(95%CI)为0.962(0.925~0.998),其敏感度(98.0%)和特异度(89.5%)最高。结论:血清NT-ProBNP、sTREM-1及APACHEⅡ评分变化与老年SP患者病情严重程度及预后相关,第3天三项联合预测患者预后的价值最大。
文摘目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者以肺部感染控制窗(PIC-W)为切换点撤机序贯经鼻高流量湿化氧疗(HFNC)与序贯无创正压通气(NPPV)对炎症指标及预后的影响。方法选取徐州医科大学附属医院急诊重症医学科2019年12月—2020年12月收治的AECOPD有创机械通气患者70例,满足PIC窗后按随机数字表法分为HFNC组(n=35)和NPPV组(n=35),分别在常规治疗基础上予HFNC和NPPV序贯通气治疗。收集患者一般资料、拔管前24h最差APACHE II评分及SOFA评分;检测拔管24 h、72 h白细胞计数(WBC)、超敏C反应蛋白(CRP)、降钙素原(PCT);观察两组拔管后2 h、24 h、72 h氧合指数、动脉血PCO_(2)以及生理指标;记录患者不同时间点呼吸困难评分;统计临床结局/并发症相关指标(拔管后HFNC治疗时间及NPPV治疗时间、院内感染发生率、再插管率、ICU住院时间、总住院时间、28 d病死率)。结果与拔管前相比,两组拔管后24 h CRP、PCT及72h WBC、CRP、PCT较拔管前下降,拔管后72 h HFNC组WBC、CRP、PCT明显低于NPPV组,差异有统计学意义(P<0.05);与拔管前相比,两组拔管后72 h氧合指数均明显改善,PaCO_(2)明显下降,差异有统计学意义(P<0.05);两组拔管后72 h RR及HR均较拔管前降低,而HFNC组拔管后72 h RR低于NPPV组,差异有统计学意义(P<0.05);不同时间点HFNC组患者呼吸困难评分均低于NPPV组;HFNC组治疗时间、院内感染发生率均低于NPPV组,差异有统计学意义(P<0.05);两组再插管率、28 d病死率,ICU住院时间和总住院时间比较差异无统计学意义(P>0.05)。结论AECOPD患者以PIC-W为撤机切换点序贯HFNC或NPPV均能提高氧合指数,降低PaCO_(2)。HFNC较NPPV能够减少PCT、CRP等炎性因子释放,降低患者呼吸频率,改善患者呼吸困难,缩短无创治疗时间并降低院内感染发生率,可应用于AECOPD撤机患者。
