【摘要】 目的 探讨癫痫患者注意功能受损的特点。 方法 2008年12月-2009年12月选取69例癫痫患者作为病例组，35例正常人作为对照组，分别用持续操作任务实验（continuous performance test，CPT）、斯特鲁普实验（Stroop）和双任务实验测查持续注意、选择注意和分散注意功能。 结果 与对照组相比，病例组CPT反应时延长，漏报率增加（Plt;0.05）；Stroop实验冲突条件下反应时延长，冲突、一致和中性条件下错误率增加，冲突和中性条件下的反应时干扰量和错误率干扰量增加（Plt;0.05）；双任务比单任务划销方格数目减少，字符串正确率减少，双任务减退程度增加（Plt;0.05）。 结论 癫痫患者的持续注意、选择注意和分散注意功能均受损。【Abstract】 Objective To observe the damages of attentive function in the patients with epilepsy. Methods From December 2008 to December 2009, 69 patients with epilepsy and 35 healthy people were selected as the patients group and control group. All the selected ones underwent continuous performance test (CPT), Stroop test and dual task, respetviely, to assess their sustained attention, selected attention and divided attention. Results In CPT, the reaction time prolonged and the omission rate increased significantly in the patient group compared with those in the control group (Plt;0.05). In Stroop test, the reaction time in the patients group prolonged under incongruous condition, and error rate increased under incongruous, congruous and neutral conditions. The reaction time interfered effects and error interfered effects increased under incongruous and neutral conditions (Plt;0.05); the boxes crossed and right rate of digit strings decreased and decrement increased during dual task than single task in the patient group (Plt;0.05). Conclusion The sustained attention, selected attention and divided attention of patients with epilepsy are impaired.
The steps of searching evidence were introduced. How to select computer retrieval systems and searching engines were discussed including evidence retrieval systems and other medical information retrieval systems, bibliography systems and full-text systems, metasearch engine systems and single search engine systems, as well as the engines for evaluating information and the general medical search engines.
To evaluate the effect of intercellular adhesiveness molecule-1 (ICAM-1), E-selectin on hepatic microcirculation in acute cholangitis. The Changes of hepatic tissue, content of blood flow and Evan′s blue (EB) in hepatic tissue in acute cholangitis were determinated. Results: The number of PMN in hepatic tissue and sinusin increased, degenaration and necrosis of the hepatic cells and hepatic sinusoidal endothelial cells and content of blood flow in liver were reduced, and content of EB in hepatic tissue increased remarkbly in the rats with acute cholangitis. Pretreatment of anti ICAM-1 and E-selectin mAb reduced the damage of hepatic microcirculation. Conclusion: ICAM-1 and E-selectin may play an important role in damage to hepatic microcirculation in acute cholangitis.
Objective To evaluate the applicability of Transcranial Doppler (TCD) monitoring in brain protection in the process of aortic dissection surgical procedure. Methods From Feburary 2007 to November 2007, six patients with type I aortic dissection underwent surgical procedure in Xuanwu Hospital of Capital Medical University. All patients are male with their age ranged from 48 to 60 years. During the operation, right subclavian arterial cannulation technique was used to protect the brain, and TCD monitoring was adopted to guide cerebral perfusion. The function of nervous system after operation was observed, and the minimental state examination (MMSE) was used to assess the cognitive function of the patients. A twoyear followup was done to monitor patients’ aorta condition. Results The time of cardiopulmonary bypass (CPB) was 136 to 350 minutes. The time of selected cerebral perfusion was 20 to 65 minutes. The lowest cerebral blood flow was 31% of basic level according to TCD monitoring. All patients were successfully treated without neurological complication and cognitive dysfunction when discharged from hospital. MMSE score was 28 to 30 points. During the twoyear followup after operation, all aortic false lumen were closed and there was no dissection recurrence. Conclusion Monitoring blood change with TCD monitoring technique is safe and effective in evaluating brain protection by selective cerebral perfusion in aortic dissection surgical procedure.
【Abstract】Objective To investigate the preventive role of selective decontamination of the digestive tract (SDD) in gut-originated endotoxemia in acute necrotizing pancreatitis (ANP). Methods A lethal model of ANP was reproduced in Wistar rats by retrograde infusion of artificial bile into the main pancreatic duct. Normal control group (n=6), sham operation group (n=6), ANP group (n=14) and ANP+SDD (polymycin E, tobramycin and nystatin mixture) group (n=8) were randomly devided. Visceral pathologic changes, serum levels of TNFα and IL-1β, intestinal bacterial flora, plasma D(-)lactate and endotoxin contents, as well as the mortality were examined at 72h after operation in each group. Results Necrosis and inflammation of pancreas, with a remarkable elevation of serum TNFα and IL-1β and intestinal flora disturbance (with E.Coli content risen significantly) were seen in ANP rats. Simultaneously, ANP rats displayed elevated plasma concentration of D(-)lactate and endotoxin. In SDD group, enterobacteraceae and yeast were markedly depressed, while anaerobes were well preserved, with the value of B/E 〔Bifidobacterium/E.Coli, log10(CFU/CFU）〕 elevated in the ileac mucous membrane (1.73±1.23 vs -0.37±0.72 in ANP group,P＜0.01) and in the caecum content (∞ vs 0.88±0.77). In addition, depressed levels of D(-)lactate 〔（3.95±1.83） mg/L vs （8.05±3.05） mg/L in ANP group,P＜0.01〕, endotoxin 〔（0.227±0.084） EU/ml vs （0.423±0.155） EU/ml in ANP group, P＜0.01〕 and TNFα 〔（15.41±10.32） ng/L vs （46.79±24.31） ng/L in ANP group P＜0.01〕 in systemic or portal vein were observed in the SDD group. Moreover, SDD group displayed a declined 72h mortality(14.3% vs 58.8% in ANP group, P=0.005). Conclusion ANP is associated with gut barrier disorder and gut flora imbalance, which may exacerbate the process of gut-originated endotoxin translocation. By protecting gut flora and gut barrier against disorder, SDD attenuates ANPrelated endotoxemia and improves the outcome. SDD is advisable for the prophylaxis of gut-originated endotoxemia complicated from ANP.
ObjectiveTo investigate the role and mechanism of P-selectin glycoprotein ligand-1 (PSGL-1) in hydrochloric acid-induced acute lung injury (ALI) in mice.MethodsWild-type mice (WT) and PSGL-1 knockout mice (PSGL-1 -/-) were randomly subjected to normal saline (NS) or hydrochloric acid (HCl) challenged group. The mice were intratracheally instilled with NS or HCl (1 μl/g weight) into the left lung with a catheter. After 2 hours, respiratory function index enhanced pause (Penh), PaO2 and PaO2 were analyzed. The wet to dry weight ratio (W/D) of the left lung and total protein concentration in bronchoalveolar lavage fluid (BALF) were measured. The number of leukocytes in BALF was counted too. Targeted lung tissue was processed for further HE or immunohistochemistry staining. Meanwhile, the expressions of interleukin-6 (IL-6), IL-1β, nuclear factor-κB (NF-κB), IκBa and p-IκBa in lung tissue were measured.ResultsThe Penh (4.77±1.22 vs. 5.80±0.84) and PaCO2 [(63.7±3.9) mm Hg vs. (74.4±7.4) mm Hg] in the PSGL-1 knockout mice were significantly lower than those in the WT mice after HCl stimulation (P<0.05), while the PaO2 was higher than that in the WT mice [(81.0±7.1) mm Hg vs. (62.0±8.9) mm Hg, P<0.05)]. The lung W/D ratio (4.86±0.15 vs. 5.22±0.20), protein concentration [(3.71±0.64) μg/μl vs. (4.74±0.98) μg/μl] and total leukocyte count [(13.00±2.18) ×107/L vs. (49.42±3.35) ×107/L] in BALF were significantly lower in the PSGL-1 knockout mice challenged with HCl than those in the WT mice (P<0.05). Besides, the protein expressions of IL-6, IL-1β, p65 and p-IκBa in the PSGL-1 knockout mice were lower than those in the WT mice after HCl instillation, while the IκBa expression was higher than that in the WT mice (P<0.05). More numbers of neutrophils and macrophages were found in the lung of the WT mice than the PSGL-1 knockout mice challenged with HCl. However, the differences of above values between the WT mice and the PSGL-1 knockout mice instilled with NS were not found, all of which were significantly lower than the correspongding HCl group except for IκBa (P<0.05).ConclusionPSGL-1 may play important roles in the development of HCl-induced ALI via the NF-κB signaling pathway and inflammation.
Objective To investigate the effect of the morphological changes in the proximal femur on the prothesis selection in the total hip arthroplasty in the patients with ankylosing spondylitis. Methods The experimental group was composed of 13 patients (16 hips) with ankylosing spondylitis, which was treated with the total hip arthroplasty, and the control group was composed of 16 patients（19 hips）with non-ankylosing spondylitis，which was also treated with the total hip arthroplasty. In the two groups, the measurements of Singh index，canal flare index，morphological index of the cortex and cortical index were performed in the two groups. Results The results of the statistical analysis on Singh index，canal flare index, morphological index of the cortex and cortical index in the experimental group were 3.81±0.54, 2.63±0.41, 2.02±0.38 and 1.69±0.69, respectively, but 4.63±0.62, 3.03±0.27, 2.76±0.28 and 2.12±0.24, respectively in the control group. Therewas a significant difference in Singh index, canal flare index, and morphological index of the cortex between the two groups (Plt;0.05)，while there was no statistical difference in cortical index between the two groups (P＞0.05). The patientswith ankylosing spondylitis had more serious osteoporosis in their proximal femur. Conclusion Cemented femoral prosthesis should be used in the total hip replacement in patients with ankylosing spondylitis, and the revision total hip arthroplasty should be performed on patients with more serious osteoporosis.
Objective To summarize the blood supply to the sources and characteristics of advanced breast cancer，and explore the method，efficacy，and clinical applications of preoperative super-selective arterial catheterization chemoembolization under DSA for it. Methods Sixty patients with advanced breast cancer confirmed by the aspiration biopsy from February 2007 to October 2011 in this hospital were selected. Seldinger method was used，distributing of the tumor blood supply artery was identified and intubated the target artery by super-selective arterial catheterization via the femoral artery puncture under the DSA. Then，pirarubicin 60 mg plus paclitaxel 120 mg of two chemotherapy drugs was injected into slowly the target artery and the intervention infusion chemotherapy was performed，finally the tumor blood supply artery was embolizated by gelatin sponge particle. Results A total of 112 conclusive blood supply artery in 60 patients with DSA were found，including eight cases of single blood supply artery，52 cases of multiple blood supply arteries，mainly in the lateral thoracic artery and （or） internal thoracic artery-based. The complete remission rate was 25.0% （15/60），partial remission rate was 73.3% （44/60），stable disease rate was 1.7% （1/60），the total effective rate was 98.3% （59/60）. There was no progression disease. The median remission duration was 19 months，median survival time was 40 months. Conclusions The location of the original foci of breast cancer is closely related to blood supply arteries. The tumor in the lateral of the breast mainly dominates by the lateral thoracic artery blood supply. The tumor in the inner breast mainly dominates by the internal thoracic artery blood supply. The preoperative super-selective arterial catheterization chemoembolization under DSA can obviously improve the therapeutic effect，long-term survival，and the target of interventional chemoembolization.
Objective To compare the clinical effect of tissue selecting therapy stapler (TST) and procedure for prolapse and hemorrhoids (PPH) in treatment of hemorrhoid in Ⅲ-Ⅳ degree. Methods Clinical data of 80 cases of hemorrhoid in Ⅲ-Ⅳ degree who treated in The First Affiliated Hospital of Harbin Medical University from May 2015 to July 2015 were retrospectively collected. All the 80 cases were divided into TST group (n=40) and PPH group (n=40) according to the surgical types. The comparison of the clinical effect of 2 groups was performed. Results The operative time, hospital stay, intraoperative blood loss, anal fall bilge feeling score, postoperative pain score at 3 time points, and the incidence of anal secretions of TST group were lower or shorter than those corresponding indexes of PPH group (P<0.05). But there was no significant difference in cure rate, the incidence of urinary retention, the incidence of anal stenosis, the incidence of intractable pain, and satisfaction situation between the 2 groups (P>0.05). All of the cases were followed up for 3 months, during the follow-up period, no one suffered from rectal vaginal fistula, fecal incontinence, and recurrence. Conclusion TST and PPH both have satisfactory effect in treatment of hemorrhoid in Ⅲ-Ⅳ degree, but TST has advan- tages of less blood loss, shorter operative time, rapid postoperative recovery, and less pain.