目的 比较腹腔镜胆囊切除术（LC）与小切口胆囊切除术（MC）在老年患者中的临床效果，以指导临床选择应用。 方法 回顾性分析笔者所在医院2010年7月至2013年7月期间行LC（LC组，n=109）及MC（MC组，n=111）的老年患者的临床资料，比较2组术中和术后相关指标的差异。 结果 LC组和MC组患者的手术时间〔（45.72±6.14）min比（40.67±6.02）min〕、术中出血量〔（10.18±3.31）mL比（11.13±2.93）mL〕、住院时间〔（9±5）d比（10±5）d〕及总并发症发生率〔28.4%（31/109）比31.5%（35/111）〕比较差异均无统计学意义（P＞0.05）；但LC组患者的术后疼痛程度轻、胃肠道功能恢复时间短〔（46.3±10.5）h比（71.4±9.8）h〕、住院费用较高〔（8 010±450）元比（4 800±680）元〕、切口感染发生率较低〔0（0）比15.3%（17/111）〕、肺部感染发生率较高〔17.4%（19/109）比9.9%（11/111）〕，P＜0.05。 结论 LC对老年胆囊结石或胆囊炎患者具有更好的临床效果；但对心肺功能异常者，尤其是不能耐受全麻和气腹的患者选择MC更为合适，所以临床上应视患者具体情况加以选择。
Silicone oil is widely used in intraocular filling of fundus disease after vitrectomy, which improves retinal reattachment rate andpostoperative visual function of patients. With the era of minimally invasive vitreous surgery coming, the utilization rate of silicone oil filling is decreasing, however, it still plays an indispensable role in the surgical treatment of complex fundus diseases. In the process of using silicone oil, the indications should be strictly selected, and the potential risks should be fully considered and possibly avoided. The study of vitreous substitutes with certain physiological functions is currently a research hotspot in the field of fundus diseases.
Tuberculosis remains a major public health problem. Genetic epidemiological studies have shown that the differences in host genes partly determine the susceptibility to tuberculosis. The occurrence of tuberculosis is the result of the joint action of Mycobacterium tuberculosis and host gene regulation immune response. The study of susceptibility candidate genes has differences in race, population and region, and the study of susceptibility gene polymorphism still has a long way to go in clinical precision diagnosis and treatment. The study and clinical application of mendelian susceptibility to mycobacterial disease can be used as a classic application of precision medical treatment in tuberculosis; although it is a rare case, this model is worthy of reference.
ObjectiveTo evaluate the effects and safety of edaravone combined with shuxuening for cerebral infarction. MethodsThe Cochrane Library, PubMed, EMbase, CBM, CNKI and VIP databases were searched from their establishments up to March 31, 2013. We used the method recommended by the Cochrane collaboration to perform a meta-analysis of randomized controlled trails (RCTs) with RevMan 5.0 software. ResultsSeventeen studies were included. The results of Meta-analysis demonstrated that edaravone combined with shuxuening were more efficient in reducing the score of neural function deficient scale and higher in the total effective rate (P<0.05), while there was no difference in the incidence of adverse reactions (P>0.05). ConclusionThe study suggests that edaravone combined with shuxuening is effective for cerebral infarction, but it also needs further studies to provide more sufficient evidence.
Limitation of donor source for allograft makes the research on xenograft progress. Pig is regarded as one of the ideal donor animals. The major obstacle in xenograft is hyperacute rejection, which is caused by complements after they are activated by xenogeneic antigens combined with natural antibodies. It has been confirmed that alpha-Gal is the major target antigen, whose expression is incharged by alpha-1,3 galactosyltransferase (alpha-GT). The approaches to overcome hyperacute rejection against alpha-Gal included: immunoadsorption of xenogeneic natural antibodies, lysis of antigen by enzyme and genetic manupilation to obtain animal lack of alpha-GT. Besides alpha-Gal, there were other antigens binding to human serum antibody, such as gp65 and gp100, which was expressed on PAEC after induced by TNF, the A-like antigen. But their function was still unknown. It was debatable on the role of MHC in xenograft. Both direct and indirect pathway were involved in cellular response in xenograft.
Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. The existing treatment of postoperative AF mainly focuses on preoperative prevention, intraoperative protection and postoperative treatment for factors prone to AF before, during and after surgery, but the postoperative treatment in various areas and hospitals is different. This article combines the latest literature published in Europace about the practice guidance of cardioversion of AF and atrial flutter, and summarizes the treatment of electrical cardioversion, in order to provide clinical guidance for electrical cardioversion of AF after cardiac surgery.
OBJECTIVE: To provide a better treatment method of lumbar stenosis and root pain resulting from simple hypertrophy of ligamentum flavum. METHODS: By studying the records of 143 lumbar pain cases, we found 5 cases caused by simple hypertrophy of ligamentum flavum. All the patients were old man with a long progressed history. There was little difference of clinical features between the disc herniation and hypertrophy of ligamentum flavum. All cases accepted resection of ligamentum flavum. RESULTS: All the symptoms were relieved postoperatively. The patients could walk. CONCLUSION: The degeneration of lumbar ligamentum flavum can cause lumbar stenosis and root pain. Resection of ligamentum flavum can relieve the symptom.