目的 探讨小于4 cm的胃神经鞘瘤（GS）的CT误诊与漏诊原因,从而加深影像科医师对GS的认识,提高其CT检出率及诊断准确率。方法 回顾性分析2019年3月—2022年10月经手术切除及病理证实的10例小于4 cm的GS患者的临床、CT及病理资料。在CT图像上评估肿瘤的位置、大小、形态、密度、强化特点及周围淋巴结等情况。结果 术前CT误诊7例,漏诊2例,仅1例正确诊断;10例病灶均起源于胃黏膜下;9例为圆形或类圆形;7例发生于胃体;平扫密度均低于肌肉组织,均呈渐进性强化。结论 小于4 cm的GS术前误诊率很高,且可发生漏诊。当CT检查提示胃体部黏膜下圆形或类圆形占位病变,平扫呈均匀稍低密度,增强呈渐进性强化时应考虑GS的可能,最终确诊需病理及免疫组化检查。

Objective To investigate the causes of CT misdiagnosis and missed diagnosis of gastric schwannomas（GS）smaller than 4 cm in size,and to improve radiologists’ awareness of GS and increase the detection rate and diagnostic accuracy．Methods Clinical,pathological and CT data of ten surgically and pathologically confirmed GS patients were retrospectively reviewed between March 2019 and October 2022．The location,size,shape,attenuation,enhancement features and surrounding lymph nodes of each tumor on CT were analyzed．Results Of the 10 patients,7 cases were misdiagnosed in preoperative CT examination,two cases were missed diagnosed and only one case was correctly diagnosed．All tumors originated from the submucosa in ten cases,and nine cases showed a round or oval shape．Seven lesions were located in the gastric body,and all tumors had homogeneous low attenuation compared to muscle on plain CT images．All cases displayed mild-moderate to obvious enhancement．Conclusions GS smaller than 4 cm have a high rate of misdiagnosis and missed diagnosis preoperatively．When CT examination indicates a submucosa tumor with a round-like shape in the gastric body and homogeneous mild hypoattenuation on plain CT,the possibility of GS should be raised．Pathological and immunohistochemical examinations are necessary to confirm the final diagnosis．

目的 探讨腹主动脉瘤腔内修复术后瘤体直径和瘤体体积的转归以及与术后内漏的关系。方法 回顾性分析2015年—2020年在我院行腹主动脉瘤腔内修复术的83例患者的临床及影像学资料。测量术前和术后各随访时间点瘤体最大直径及体积。CT评价术后内漏发生情况。定义瘤体（直径/体积）扩张/回缩及瘤体（直径/体积）稳定。以术前瘤体最大直径大小和术后内漏发生情况将患者分组,比较组间各随访时点的瘤体直径和体积转归情况。结果 患者术后平均随访时间24（10~62）个月。以瘤体直径<50 mm及≥50 mm分组,术后各随访时间点2组间瘤体体积及瘤体直径比较均无统计学差异。以术后有无内漏分组,术后各随访时间点组间比较瘤体体积变化比较差异均有统计学意义（P<0.05）,但瘤体直径变化组间比较差异均无统计学意义。结论 主动脉瘤瘤体体积与直径变化并不存在一致性,监测瘤体体积可以发现那些直径变化不明显的瘤体变化;腹主动脉瘤腔内修复术后内漏可能是导致瘤体增大的因素之一。

Objective To evaluate the outcome of aneurysm diameter and volume,and the role of endoleak after endovascular aneurysm repair of abdominal aortic aneurysm．Methods The clinical and imaging data from 83 patients who underwent endovascular repair of abdominal aortic aneurysm in our hospital from 2015 to 2020 were retrospectively analyzed．The maximum aneurysm diameter and volume were measured at the preoperative and postoperative follow-up time points．CT was used to evaluate the incidence of postoperative leakage．The aneurysm（diameter/volume）expansion/shrinkage and aneurysm（diameter/volume）stability were defined．Patients were divided into different groups according to the maximum preoperative aneurysm diameter and the incidence of postoperative endoleak,and the outcomes of aneurysm diameter and volume were compared at established follow-up points．Results The mean follow-up time was 24（10-62）months．There were no statistically significant differences in postoperative aneurysm volume and diameter at follow-up points between the patients with aneurysm diameter <50 mm and patients with aneurysm≥50 mm．There were statistically significant differences in postoperative aneurysm volume between the patients with postoperative endoleak and patients without postoperative endoleak（P<0.05）．However,there were no statistically significant differences in postoperative diameter between the two groups．Conclusions The changes of aneurysm volume and diameter were not closely related,and the detection of aneurysm volume can help to find the aneurysm changes with no obvious diameter changes．The postoperative endoleak after endovascular aneurysm repair may be one of the factors leading to aneurysm enlargement．

目的 丹酚酸B是传统中药丹参的重要生物活性组分,临床应用广泛。新近发现,丹酚酸B具有防治骨质疏松的作用。本研究拟在前期工作基础上,系统地研究丹酚酸B对去卵巢骨质疏松小鼠的作用,探讨其对小鼠间充质干细胞（MSCs）成骨分化的影响。方法 将18只8周龄SPF级别的C57雌性小鼠分为假手术组、骨质疏松组、丹酚酸B治疗组。骨质疏松组和丹酚酸B治疗组行双侧卵巢摘除术。而假手术组则保持正常的卵巢结构,同时去除局部的脂肪。3组均于术后3日内给予抗生素进行抗感染治疗。4周内,丹酚酸B治疗组给予丹酚酸B 2.5 mg/kg腹腔注射,连续12周,2天1次,其余2组在相同的时间内给予等量生理盐水。16周后,在麻醉状态下将所有小鼠处死。应用MicroCT测量了小鼠右后股骨的骨密度。采用qRT-PCR技术,分析小鼠左后股骨骨髓MSCs中Runx2和Osterix的表达。将小鼠右后股骨进行液氮研磨处理,提取蛋白质,用WB法测定OPG和RANKL的含量。结果 骨质疏松组小鼠股骨骨密度比假手术组低（P<0.05）,丹酚酸B治疗组小鼠股骨骨密度比骨质疏松组高,但差异无显著性意义（P<0.05）。骨质疏松组小鼠Runx2和Osterix水平低于假手术组（P<0.05）,丹酚酸B治疗组小鼠Runx2和Osterix水平比骨质疏松组高（P<0.05）。骨质疏松组小鼠OPG和RANKL蛋白水平低于假手术组（P<0.05）,丹酚酸B组小鼠OPG和RANKL蛋白水平比骨质疏松组高（P<0.05）。结论 绝经后骨质疏松症早期对小鼠的骨质疏松具有一定的影响,但还需要更多的实验来验证本研究的结论。

Objective Salvianolic acid B is an important bioactive component of traditional Chinese medicine Salvia miltiorrhiza and is widely used in clinic．Recently,salvianolic acid B has been found to have the effect of preventing osteoporosis．On the basis of previous work,this study intends to systematically explore the effect of salvianolic acid B on ovariectomized mice with osteoporosis,and its effect on the osteogenic differentiation of mouse mesenchymal stem cells（MSCs）．Methods Eighteen eight-week-old SPF C57 female mice were divided into sham operation group,osteoporosis group and salvianolic acid B treatment group（6 mice in each group）．The osteoporosis group and salvianolic acid B group underwent bilateral ovariectomy．The sham group maintained normal ovarian structure while removing local fat tissue．All three groups were given antibiotics for anti-infection treatment within 3 days after operation．Within 4 weeks,salvianolic acid B treatment group was given salvianolic acid B 2.5 mg/kg intraperitoneal injection for 12 weeks,once every 2 days,and the other 2 groups were given the same amount of saline at the same time．After 16 weeks,all mice were sacrificed under anesthesia．The bone density of the mouse right posterior femur was measured by MicroCT．The expressions of Runx2 and Osterix in the bone marrow of mouse left posterior femur were analyzed by qRT-PCR．The right posterior femur of mice was ground with liquid nitrogen to extract protein,and the contents of OPG and RANKL were determined by WB．Results The bone mineral density of the femur in the osteoporosis group was lower than that in the sham operation group（P<0.05）,and the bone mineral density of the femur in the salvianolic acid B treatment group was higher than that in the osteoporosis group,but the difference was not significant（P<0.05）．The levels of Runx2 and Osterix in the osteoporosis group were significantly lower than those in the sham operation group（P<0.05）,and the levels of Runx2 and Osterix in the salvianolic acid B treatment group were higher than those in the osteoporosis group（P<0.05）．The levels of OPG and RANKL protein in the osteoporosis group were significantly lower than those in the sham operation group（P<0.05）,while the levels of OPG and RANKL protein in the salvianolic acid B group were higher than those in the osteoporosis group（P<0.05）．Conclusions The early stage of postmenopausal osteoporosis has certain effects on osteoporosis in mice,but more experiments are needed to verify the conclusions of this study．

目的 了解广州市某三甲综合医院2016—2022年住院病例的疾病分布特征,探究新型冠状病毒感染（新冠）疫情对疾病谱的影响,为医院合理配置医疗资源、提高医院医疗水平提供参考。方法 回顾性收集广州市某三甲综合医院2016—2022年间住院病例的病例数据,按照ICD-10国际统计分类标准进行分类,建立Joinpoint回归模型对不同类别疾病构成比的时间变化趋势进行分析。结果 2016—2022年间,前12顺位的疾病种类不变,构成比呈上升趋势的有4种,分别是循环系统疾病、肿瘤、消化系统疾病以及眼和附器疾病,构成比呈下降趋势的有3种,分别是呼吸系统疾病、肌肉骨骼系统和结缔组织疾病以及妊娠、分娩和产褥期。对这7类系统疾病进行不同性别、不同年龄段和不同居住地（广州市内/市外）的亚组分析,结果显示,除眼和附器疾病与妊娠、分娩和产褥期外,其余5种系统疾病在男性和女性中变化趋势比较差异无统计学意义（均P>0.05）。25岁以上人群循环系统疾病、肿瘤和消化系统疾病比例呈上升趋势。45岁以上人群眼和附器疾病的住院比例逐年上升。呼吸系统疾病的下降趋势集中出现在0~5岁和65岁以上人群,肌肉骨骼系统和结缔组织疾病的下降趋势可在45岁以上人群中被观测到,妊娠、分娩和产褥期的下降趋势则可在45岁以下人群中被观测到。总体和市内来源的住院病例的各系统疾病构成比变化趋势均未发现有2019年的连接拐点。但对于居住地在广州市外的病例,有6种系统疾病均存在一个2019年的连接拐点,与2016—2019年相比,2020—2022年增长趋势普遍减弱或者略有降低,但均无统计学意义,2022年市外来源住院病例的多种疾病占比低于2019年。≤24岁年龄组的病例因妊娠、分娩和产褥期住院的比例在2019年以后降低趋势加快,但也无统计学意义,2020—2022年≤24岁人群因妊娠、分娩和产褥期住院的比例低于2019年水平。结论 2016—2022年期间住院病例疾病谱有较大变化,这种变化趋势在不同性别、不同年龄段和居住地间效应存在差异。2020—2022年的新冠疫情流行主要降低了居住地在广州市外的住院病例多个系统疾病的比例以及24岁及以下患者因妊娠、分娩和产褥期住院的比例。

Objective To understand the disease distribution characteristics of inpatients in a 3-A-grade general hospital in Guangzhou from 2016 to 2022,to explore the impact of the COVID-19 on the disease spectrum,and to provide reference for hospitals to reasonably allocate medical resources and improve medical level. Methods Inpatient case data of a 3-A-grade general hospital from 2016 to 2022 were retrospectively collected and were classified according to the ICD-10 international statistical classification standard. A Joinpoint regression model was established to analyze the temporal trend of disease composition ratios in different categories. Results From 2016 to 2022,the type of top 12 diseases remained unchanged. There were 4 diseases showing an upward trend in composition,namely circulatory system diseases,tumors,digestive system diseases and eye and accessory organ diseases. There were 3 diseases showing a downward trend in composition,namely respiratory system diseases,musculoskeletal system and connective tissue diseases,as well as pregnancy,childbirth and postpartum period. A subgroup analysis was conducted on these 7 types of systemic diseases by gender,age group and place of residence(within/outside Guangzhou). The results showed that except for eye and accessory organ diseases and pregnancy,childbirth and postpartum period,there was no significant difference in the trend of changes in the other 5 systemic diseases between males and females(all P>0. 05). The upward trend of circulatory system diseases,tumors and digestive system diseases could be observed in people over the age of 25. The hospitalization rate of eye and accessory organ diseases among people over 45 years old was increasing year by year. The downward trend of respiratory diseases was concentrated in people aged 0~5 and over 65 years old,while the downward trend of musculoskeletal and connective tissue diseases could be observed in people aged 45 and above. The downward trend of pregnancy,childbirth and postpartum period could be observed in people under 45 years old. The trend of changes in the proportion of systemic diseases among inpatient cases from both overall and within Guangzhou had not been found to have a joinpoint in 2019. However,for cases residing outside of Guangzhou,there were six systemic diseases that all had a joinpoint in 2019. Compared with the growth trend from 2016 to 2019,the growth trend from 2020 to 2022 generally weakened or showed a slightly downward trend,but none of them were statistically significant. In 2022,the proportion of multiple diseases in hospitalized cases from outside Guangzhou was lower than that in 2019. The proportion of cases in the age group ≤24 years old who are hospitalized due to pregnancy,childbirth and postpartum period has been decreasing rapidly since 2019,but there was no statistical significance. The proportion of cases hospitalized due to pregnancy,childbirth and postpartum period in the population ≤24 years old from 2020 to 2022 was significantly lower than the level in 2019. Conclusions The disease spectrum of inpatients had undergone significant changes between 2016 and 2022,and these trends of changes were different among different genders,age groups and places of residence. The prevalence of the COVID-19 from 2020 to 2022 mainly reduced the proportion of inpatients with multiple systemic diseases living outside Guangzhou,and the proportion of inpatients aged 24 and under hospitalized for pregnancy,childbirth and puerperium.

目的 采用体外试验的方法,研究弱酸性培养对人正常食管内皮细胞（HEEC）活力的影响及潜在的调控机制。方法 细胞培养液的pH值分别设为（6.0~6.5）和（7.0~7.4）。以中性培养组为对照。利用CCK8实验,检测弱酸培养条件下,不同时间点食管内皮细胞活力的变化。采用蛋白免疫印迹法检测p38和磷酸化p38（p-p38）的表达。利用酶联免疫吸附剂测定法检测培养基上清液中IL-1β和IL-8的表达水平,并检测加入p38激酶活性抑制剂SBS 203580后两者浓度的变化。结果 弱酸环境下,细胞活力下降。培养1 h时,弱酸组细胞活力为（96.4±8.0）%,培养3 h和6 h时分别为（88.7±6.2）%和（87.7±7.4）%。细胞中p38的水平与培养基的pH值无关。弱酸培养可以促使细胞内p-p38的含量增加。基线时,弱酸组p-p38的灰度值比值为（0.37±0.02）,在培养2 h和6 h时分别为（0.64±0.09）、（0.84±0.11）,差异显著（P<0.01）。弱酸刺激诱导食管内皮细胞表达更多的IL-8和IL-1β。基线时弱酸组上清液中IL-8和IL-1β的浓度分别为（8.64±1.31）pg/mL,（3.35±0.49）pg/mL。培养6 h后,二者的浓度分别上升至（36.85±2.02）pg/mL和（19.19±1.60）pg/mL,差异显著（P<0.01）。加入SBS 203580后,IL-8和IL-1β的浓度明显下降（P<0.05）。结论 弱酸刺激可以降低食管内皮细胞的活力。p38 MAPK可能通过调控IL-8和IL-1β的表达参与该调节过程。

Objective To study the effect of weak acidic culture on the viability of normal human esophageal endothelial cells(HEEC)and the potential regulatory mechanisms. Methods The pH values of cell culture medium were set at(6. 0-6. 5)and(7. 0-7. 4),respectively. The group in neutral medium was set as control. CCK8 experiment was used to detect the change of cell viability at different time points. The expressions of p38 and phosphorylated p38(p-p38)were detected by Western Blot experiment. Enzyme linked immunosorbent assay was used to detect IL-1β and IL-8 concentration in the medium supernatant before and after adding p38 activity inhibitor(SBS 203580). Results HEEC viability was decreased under weak acidic conditions. After 1 hour of cultivation,the HEEC viability was(96. 4±8. 0)%,after 3 and 6 hours,it decreased to(88. 7±6. 2)% and(87. 7±7. 4)%,respectively. The level of p38 in cells was independent of culture medium pH values. Weak acidic stimulation could promote an increase of p-p38 in HEEC. At baseline,the gray value ratio of p-p38 in the weak acidic group was(0. 37±0. 02),and after 2 and 6 hours of culturing,it increased to(0. 64±0. 09)and(0. 84±0. 11),respectively,which differences were significant(P<0. 01). More IL-8 and IL-1β were expressed after weak acidic stimulation. At baseline,the concentrations of IL-8 and IL-1β in the medium supernatant of weak acidic group were(8. 64±1. 31)pg/mL and(3. 35±0. 49)pg/mL. After 6 hours of culturing,they increased significantly to(36. 85±2. 02)pg/mL and(19. 19±1. 60)pg/mL(P<0. 01),while the concentrations were decreased after adding SBS 203580(P<0. 05). Conclusions The HEEC viability was reduced by weak acidic stimulation,p38 MAPK may participate in the process by regulating the expression of IL-8 and IL-1β.

严重烧伤后患者免疫功能的失调,易导致创面感染、全身炎症反应综合征、脓毒症、感染性休克等并发症,增加患者病死率。免疫细胞功能适度的活化将有助于烧伤患者抵御外界病原体的侵袭、促进创面的愈合,但功能过度激活或者功能低下,则会引发一系列严重的后果。本文旨在归纳严重烧伤后中性粒细胞、单核/巨噬细胞、肥大细胞、NK细胞及T淋巴细胞等免疫细胞的功能变化与炎症反应之间的关系,为完善烧伤患者诊疗、减少并发症、改善预后提供新的思路。

The imbalance of immune function in severely burned patients can easily lead to wound infection,systemic inflammatory response syndrome,sepsis,septic shock and other complications,which increase the mortality of patients. Moderate activation of immune cell function will help burned patients to resist the invasion of external pathogens and promote wound healing,but excessive activation or low function can lead to a series of serious consequences. The purpose of this paper is to summarize the relationship between the functional changes of immune cells such as neutrophils,monocytes/macrophages,mast cells,NK cells,T lymphocytes and inflammatory reaction after severe burns,and to provide new ideas for improving the diagnosis and treatment of burned patients,reducing complications and improving the prognosis.

目的 探讨剖宫产围术期患者采用布托啡诺治疗寒战的最佳剂量。方法 选取2019年10月—2020年11月期间于本院分娩的150例剖宫产妇女作为研究对象,按照随机数字表法分为A组、B组、C组,各组50例。A组给予0.01 mg/kg布托啡诺静脉注射,B组给予0.02 mg/kg,C组给予0.03 mg/kg。比较3组临床疗效、血流动力学、镇静(Ramesay)评分、不良反应、新生儿Apgar评分。结果 3组治疗有效率、 血流动力学、T₁、T₂时间段Ramesay评分及1 min、5 min、10 min 新生儿Apgar评分比较,差异无统计学意义(P＞0.05);C组不良反应发生率高于B组与A组(P＜0.05);T₃时间段Ramesay评分C组＜B组＜A组(P＜0.05)。结论 0.02 mg/kg剂量布托啡诺治疗剖宫产围术期寒战效果最为理想,产妇围术期血流动力学稳定,不良反应较轻,且对新生儿无明显影响。

Objective To investigate the optimal dose of butorphanol in the treatment of shivering in patients underwent cesarean section. Methods A total of 150 women with cesarean section in our hospital from October 2019 to November 2020 were selected as the research objects, and were divided into group A, group B and group C according to random number table method, with 50 cases in each group. Group A was given 0.01 mg/kg butorphanol intravenously, group B was given 0.02 mg/kg, and group C was given 0.03 mg/kg. Clinical efficacy, hemodynamics, sedation (Ramesay) scores, adverse drug reactions (ADR) and neonatal Apgar scores were compared among the three groups. Results There were no significant differences in effective rate, hemodynamics, Ramesay scores at T₁ and T₂ time periods and Apgar scores of neonates at 1 min, 5 min and 10 min among the three groups (P>0.05). The incidence of ADR in group C was higher than that in group B and A (P<0.05). Ramesay score at time of T₃ of group C was lower than group B and group A (P<0.05). Conclusion The 0.02 mg/kg dose of butorphanol in the treatment of perioperative shivering in cesarean section was the most ideal dose, perioperative hemodynamics of puerpera was stable, adverse reactions were mild, and there was no obvious influence on neonates.

目的 使用分层应变技术评价以mFOLFOX6化疗的结直肠癌患者左心室功能的变化。方法 收集30例病理确诊为结直肠癌患者,各位患者均采用mFOLFOX6(5-氟尿嘧啶+奥沙利铂+亚叶酸钙)化疗方案,以自身对照做研究,分别于化疗前、化疗中期、化疗后期行心脏超声检查,获取常规参数,并采集左心室心尖四腔、三腔、两腔切面、短轴二尖瓣、乳头肌、心尖切面的三维动态图像,获取左心室的心肌心内膜下、中层、心外膜下心肌的纵向应变(GLSendo、GLSmid、GLSepi)及左心室心肌心内膜下、中层、心外膜下圆周应变(GCSendo、GCSmid、GCSepi)的数值,计算△GLS(△GLS=GLSendo-GLSepi),△GCS(△GCS=GCSendo-GCSepi),并比较这些数值的绝对值在化疗前后的变化。结果 无论化疗前还是化疗后,各层心肌均有跨壁梯度的存在。与化疗前相比:化疗后各层心肌应变参数的绝对值均降低,GLSendo和GCSendo、ΔGLS下降更为显著(P<0.05),其中,GLSendo的ROC曲线下面积为0.766,P<0.001,选25.3%为诊断界点,灵敏度为83.3%,特异度为70%;ΔGLS的ROC曲线下面积为0.749,P<0.001,选4.1%为诊断界点,灵敏度为76.7%,特异度为73.3%。结论 心肌分层应变技术有助于早期发现mFOLFOX6致结直肠癌患者左心室各层心肌功能的变化,GLSendo、ΔGLS是该技术中较为敏感的指标。

Objective To evaluate the changes of left ventricular function in patients with colorectal cancer treated with mFOLFOX6 using layer-specific strain analysis. Methods The data of 30 patients with pathologically diagnosed with colorectal cancer were collected. All patients were treated with mFOLFOX6 (5-fluorouracil+oxaliplatin+calcium leucovorin) chemotherapy. The self-control study was carried out before, during, and after chemotherapy, and cardiac ultrasound was performed to obtain conventional parameters, and three-dimensional dynamic images of the left ventricular apex four-chamber, three-chamber, two-chamber section, short-axis mitral valve, papillary muscle, and apical sectionare were acquired. The longitudinal strain of the three layer of myocardium (GLSendo、GLSmid、GLSepi) and the circumferential strain of myocardium (GCSendo、GCSmid、GCSepi) were collected, and △GLS (△GLS=GLSendo-GLSepi), △GCS (△GCS=GCSendo-GCSepi) were calculated, and the absolute values of these indexes before and after chemotherapy were compared. Results No matter before or after chemotherapy, there was a transmural gradient in each layer of myocardium. Compared with those before chemotherapy, the absolute values of myocardial strain parameters of each layer were reduced after chemotherapy, and GLSendo and GCSendo and ΔGLS decreased more significantly (P<0.05),while the area under the ROC curve of GLSendo was 0.766, P<0.001.Selecting 25.3% as the diagnostic boundary, the sensitivity was 83.3%, and the specificity was 70%.The area under the ROC curve of ΔGLS was 0.749, P<0.001. Selecting 4.1% as the diagnostic boundary, the sensitivity was 76.7%, and the specificity was 73.3%. Conclusions The myocardial layer-specific strain analysis is helpful for early detection of changes in the myocardial function of the left ventricle, which caused by mFOLFOX6 in patients with colorectal cancer. GLSendo and ΔGLS are sensitive indicators in this technique.

目的 针对胆结石手术患者,评价应用快速康复外科(ERAS)理念辅助护理的实践效果,同时分析其对患者术后并发症以及机体康复情况的影响。方法 选取本院在2019年8月—2020月5月间收治的84例胆结石手术患者为研究对象,采取随机数字表法对纳入患者进行随机分组:实施常规护理干预的患者作为本研究的对照组,实施快速康复外科护理干预的患者作为本研究的干预组;对比术后患者并发症发生情况及恢复情况。结果 干预组患者术后拔管、首次肛门排气、排便及住院时间较对照组均有缩短(P<0.05);且干预组穿孔、感染、胰腺炎等总并发症发生几率低于对照组(2.38% vs 14.28%,P<0.05)。结论 在护理胆结石手术患者中,采取快速康复外科护理干预可有效预防多种术后并发症的发生,并能够有效加快患者术后康复进程,建议推广。

Objective To evaluate the practical effect of assisted nursing with the concept of enhanced recovery after surgery (ERAS) for patients underwent cholelithiasis surgery, and analyze its impact on postoperative complications and physical rehabilitation. Methods Eighty-four patients underwent cholelithiasis operation in our hospital from August, 2019 to May,2020 were selected as the research objects, and the patients were randomly divided into two groups by random number table. The control group was given routine nursing intervention, while the observation group was given nursing intervention based on ERAS.The postoperative complications incidence and recovery of patients were compared. Results Data showed that the postoperative extubation time, first anal exhaust, defecation time and hospitalization time in the observation group were significantly shorter than those in the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (2.38% vs 14.28%, P<0.05). Conclusions In nursing patients undergoing cholelithiasis surgery, ERAS nursing intervention can effectively prevent the occurrence of a variety of postoperative complications, and can effectively speed up the process of postoperative rehabilitation, which is recommended to popularize.

目的 通过研究微泡超声空化增强微波消融对兔VX2肿瘤的热消融效应来探究其在肿瘤治疗中的价值。方法 24只肝脏移植瘤兔随机分为空白对照组、单纯超声空化治疗组、单纯微波消融治疗组、超声空化联合微波消融治疗组4组。利用增强超声显示每组治疗前后肿瘤的大小、形状和轮廓并通过温度针来检测治疗区域的局部温度。结果 联合治疗组血流灌注缺损最严重,微波消融组和联合治疗组缺损体积分别为1.53±0.20和1.68±0.43(P=0.117);微波消融组以及联合治疗组消融治疗时温度达平台时间分别为(21.7±5.0)s和(10.3±5.0)s(P<0.01),最高温度(℃)分别为100.9±5.0和134.1±6.0(P<0.01)。结论 MWA联合MEUS治疗肝癌可使治疗区局部温度急剧升高至峰值温度,有望提高肝癌治疗效果。

Objective To investigate the thermal ablation effect of microbubble ultrasound cavitation combined with microwave ablation on rabbit VX2 tumors. Methods Twenty-four rabbits with liver transplantation tumors were randomly divided into four groups: blank control group, ultrasound-only cavitation treatment group, microwave-only ablation treatment group, and ultrasound-cavitation combined with microwave ablation treatment group. Enhanced ultrasound was used to show the size, shape and contour of the tumor before and after treatment in each group, and the local temperature of the treatment area was detected by a temperature needle. Results The blood flow perfusion defect was the most severe in the combined treatment group. The defect volume of the microwave ablation group and the combined treatment group were 1.53±0.20 and 1.68±0.43 (P=0.117). The temperature reached the plateau time in the microwave ablation group and the combined treatment group. It was (21.7±5.0)s and (10.3±5.0)s (P<0.01), and the highest temperature (℃) was 100.9±5.0 and 134.1±6.0 (P<0.01). Conclusion MWA combined with MEUS for liver cancer can sharply increase the local temperature in the treatment area to the peak temperature, which is expected to improve the treatment effect of liver cancer.