目的 探讨体外循环（CPB）期间行肺动脉灌注液对术后肺功能的保护作用。 方法 2007年1月－2011年4月30例在CPB下行单纯二尖瓣人工机械瓣置换术患者，随机分成肺保护组和对照组各15例，肺保护组患者CPB期间经肺动脉灌注低温肺保护液，对照组患者CPB期间未经肺动脉灌注低温肺保护液。监测两组患者在麻醉诱导后、阻断主动脉l0 min及开放主动脉l0 min，2 、12、24 h各时间点的呼吸指数（RI）、氧合指数（OI）、白介素6（IL-6）、肿瘤坏死因子α（TNF-α）及术前、术后肺动脉压力（PAPm）、静态肺顺应性（CLS）、气道阻力（AR）变化，并比较术后ICU监护时间、术后呼吸机辅助时间、住院天数及有无术后并发症等。 结果 两组IL-6、TNF-α、RI、OI、PAPm、AR、CLS比较差异均有统计学意义（P＜0.05）。但术后ICU监护时间及住院时间比较差异均无统计学意义（P＞0.05）。 结论 CPB期间行肺动脉灌注对术后肺功能具有保护作用。
目的 探讨丙泊酚-瑞芬太尼对肝脏缺血再灌注损伤的保护作用以及作用机制。 方法 2009年6月－2011年12月选择择期需阻断肝门的肝脏手术患者40例，随机分为丙泊酚-瑞芬太尼组（P组）和异氟醚组（I组），每组20例。在术前（T0）和肝门阻断开放后30 min（T1）、60 min（T2）、6 h（T3）、24 h（T4）、72 h（T5）分别抽取动脉血，测定天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）和肿瘤坏死因子α（TNF-α）的含量。 结果 两组AST、ALT、TNF-α较术前均有增高，差异有统计学意义（P＜0.05）；P组增高幅度明显低于I组，差异有统计学意义（P＜0.05）。 结论 丙泊酚-瑞芬太尼对肝脏缺血再灌注损伤具有保护作用，抑制TNF-α的产生可能为其作用机制之一。
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.
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.
目的:总结经鼻内窥镜下手术治疗管内段视神经损伤的疗效。方法:回顾性分析11例视神经损伤住院患者的临床资料。结果:行视神经减压术的11例患者中1例失访，7例有效，其中4例视力有较明显的提高。结论:经鼻内镜视神经减压术损伤小，并发症少，手术时间短，疗效满意。
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.
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.
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.
目的 探讨阳性激发点推拿治疗对足底筋膜炎的临床疗效。 方法 对2011年3月－8月门诊确诊为足底筋膜炎的52例患者，采用随机方式分为治疗组和对照组各26例，治疗组采用阳性激发点推拿，对照组采用电针治疗。并对两组患者治疗5次后的即时疗效率、日本骨科学会（JOA）足底治疗疗效评分、每次治疗后的疼痛面谱量化评分、3个月随访疼痛复发率等疗效进行对照分析。 结果 治疗组和对照组经连续治疗5次后，其JOA足底治疗疗效评分分别为（91.32 ± 10.61）、（82.92 ± 13.61）分，总有效率分别为96.15%、80.77%，差异均有统计学意义（P＜0.05）。疼痛面谱量化评分，治疗组在第一次治疗后较对照组改善明显，差异有统计学意义（P＜0.05）。3个月后随访疼痛复发情况，治疗组复发人数较对照组少，差异有统计学意义（P＜0.05）。结论 阳性激发点推拿治疗法对改善足底筋膜炎引发的足底疼痛、步行不适等症状优于电针治疗法，值得临床推广运用。
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.