结直肠癌根治术后转移复发的相关因素分析

目的探讨结直肠癌根治术后转移复发的相关因素。方法 2000年1月至2007年5月结直肠癌根治患者321例,进行术后转移复发的相关因素分析。结果 321例结直肠癌根治患者复发转移85例,复发转移率为26.47%;术后复发转移的危险因素中年龄(P>0.05,OR值<1),差异无统计学意义。术后复发转移的危险因素年龄、肿瘤部位、肿瘤大小、肿瘤大体类型、病理分化、Dukes分期、淋巴结转移、术后化疗因素进行分析,(P<0.05,OR值>1),差异有统计学意义。结论年龄、肿瘤部位、肿瘤大小、肿瘤大体类型、病理分化、Dukes分期、淋巴结转移、术后化疗是导致结直肠癌转移复发的主要的相关因素,指导临床对结直肠癌术后转移复发因素的重视。     

腹腔镜直肠癌根治术的手术配合

目的探讨腹腔镜直肠癌根治术的临床护理手术配合过程及特点。方法回顾性总结46例患者的腹腔镜直肠癌根治术的术前准备与术中配合要点与过程。结果患者经过手术治疗与精心的护理,均顺利完成手术并且生活良好。结论腹腔镜直肠癌根治术的术前精心准备与术中配合是保证手术顺利进行完成的重要条件之一。     

70例男性包皮环切术后对男性性功能影响的调查研究

目的了解包皮环切术对男性性功能的影响。方法选择年龄22～45岁,性功能正常的70例男性作为调查对象,采用按照男性性功能问卷(O’LEARY 1995)性功能问卷调查并进行评分,将包皮环切术前、术后的性功能评分进行统计学检验。结果70例男性性功能问卷调查分6个方面进行评分,其评分结果统计性检验显示手术前、后无显著性差异。结论包皮环切手术对男性性功能没有影响。     

自理学说在直肠癌根治术后的护理体会

手术治疗是直肠癌治疗的基本措施。除了精湛的医疗技术之外,临床护理采取有力的护理措施对术后患者的康复和预防并发症起着至关重要的作用。现将自理学说的3种基本护理方法根据患者需要和自理能力的不同,提供完全补偿、部分补偿和辅助教育等护理。注重Miles的护理特点,严密观察和护理,积极预防并发症的发生,并加以对病情健康指导和出院指导,收到良好的护理效果。     

宫颈癌根治术中预防盆腔淋巴囊肿措施的探讨

目的探讨宫颈癌根治术中预防盆腔淋巴囊肿形成的最佳措施。方法对102例Ia-IIb早期的宫颈癌患者在宫颈癌根治术中,行T型单管经阴道引流27例,双管经阴道或经腹引流75例。2组均以电刀清扫淋巴结,结扎淋巴管,不紧张缝合后腹膜,应用生物蛋白胶。双管组闭孔区部分开放后腹膜。比较2组盆腔淋巴囊肿的发生率。结果2组盆腔淋巴囊肿的发生率:T型管组22.22%(6/27),双管组2.67%(2/75)。2组差异有显著性(P<0.01)。结论双管经腹或经阴道引流合并闭孔区部分开放后腹膜是宫颈癌根治术中预防盆腔淋巴囊肿形成的有效措施之一。     

腹腔镜手术对腹型肥胖直肠癌病人术后代谢的影响

目的观察腹型肥胖直肠癌病人术后胰岛素抵抗的特点及腹腔镜手术对术后胰岛素抵抗的影响。方法随机选择择期手术的直肠癌病人62例为研究对象,测量术前腰围、术后第1天空腹血糖和胰岛素。稳态模式评估法计算胰岛素抵抗指数。结果腹型肥胖病人术后胰岛素抵抗指数高于非腹型肥胖病人,腹腔镜组病人胰岛素抵抗指数低于开腹组。结论腹型肥胖直肠癌病人术后易发生代谢紊乱,腹腔镜手术能够降低术后胰岛素抵抗程度。     

乳腺癌根治术保留肋间臂神经的临床研究

目的探讨乳腺癌根治术中保留肋间臂神经的临床价值。方法回顾分析45例乳腺癌的临床资料。随机分成保留组及对照组,并随访半年至6年以观察患肢感觉障碍情况及局部复发率。结果患肢皮肤感觉障碍:保留组1例占4.5%,对照组17例占74%。2组比较有显著性差异(X2=20.79.P<0.01)。2组均未发现局部复发病例。结论乳腺癌根治术保留肋间臂神经,不影响手术疗效,不增加局部复发率,对提高患者术后生活质量,减少患肢感觉障碍,促进身心健康有益。     

护理干预对直肠癌麦氏术生活质量的影响

目的探讨护理干预对直肠癌麦氏术患者生活质量的影响。方法将病理确诊且手术方式确定的80例直肠癌患者随即分成2组,对照组采用常规护理,干预组在常规护理的基础上实施有效的心理护理,建立社会、家庭支持系统,音乐疗法,造口护理指导,化疗期间的健康教育等护理干预。结果12周后干预组的生活质量评分显著高于对照组(P<0.01)。结论护理干预可显著降低患者焦虑抑郁情绪,提高生活质量。     

乳腺癌改良根治术后病人的皮瓣护理

目的探讨乳腺癌改良根治术后胸壁皮瓣的护理。方法乳腺癌改良根治术80例,随机分为对照组和实验组各40例。对照组采用传统护理方法即橡胶管重力引流、胸壁胸带加压包扎、患肢早期开始功能锻炼;实验组采用负压引流,合理安排患肢功能康复时间,胸壁使用纱包、弹力网套包扎,观察并记录2组病例皮瓣积液、坏死及伤口愈合情况。结果实验组39例切口Ⅰ期愈合,1例Ⅱ期植皮愈合。对照组31例切口Ⅰ期愈合,9例Ⅱ期植皮愈合。实验组I期愈合率明显高于对照组(P<0.01)。结论术后妥善包扎,有效的负压引流,早期肩关节制动、患肢功能锻炼等护理措施,可有效预防皮瓣下积血、积液,另外及早观察发现皮瓣下积血、积液并积极处理,可预防皮瓣感染、坏死及延期愈合。     

乳腺癌根治术后的心理护理

目的对2009年2月至2009年8月在上海市普陀区人民医院普外科接受乳腺癌根治术治疗的女性患者进行心理护理。方法护理前后应用POMS-SF及GSES对2组患者进行测评。结果患者接受心理护理后情绪变化明显,心理护理组POMS-SF和GSES得分都要好于对照组。结论心理护理可以改善不良心理健康状况;提高应对疾病的能力。     

Transgenerational Effects of Di(2-Ethylhexyl) Phthalate on Anogenital Distance,Sperm Functions and DNA Methylation in Rat Offspring

Di(2-ethylhexyl) phthalate (DEHP) is widely used as a plasticizer in the manufacture of polyvinylchloride plastics and has been associated with concerns regarding male reproductive toxicity. In this study, we hypothesized that maternal exposure to DEHP induces transgenerational inheritance of adult-onset adverse reproductive outcomes through the male germline in the F1, F2, and F3 generations of male offspring. Pregnant rats were treated with 5 or 500 mg of DEHP/kg/day through gavage from gestation day 0 to birth. The offspring body weight, anogenital distance (AGD), anogenital index (AGI), sperm count, motility, and DNA fragmentation index (DFI) were measured for all generations. Methyl-CpG binding domain sequencing was performed to analyze sperm DNA methylation status in the F3. DEHP exposure at 500 mg/kg affected AGD, AGI, sperm count, mean DFI, and %DFI in the F1; AGD, sperm count, and mean DFI in the F2; and AGD, AGI, mean DFI, and %DFI in the F3. DEHP exposure at 5 mg/kg affected AGD, AGI, sperm count, and %DFI in the F1; sperm count in the F2; and AGD and AGI in F3. Compared with the control group, 15 and 45 differentially hypermethylated genes were identified in the groups administered 5 mg/kg and 500 mg/kg DEHP, respectively. Moreover, 130 and 6 differentially hypomethylated genes were observed in the groups administered 5 mg/kg and 500 mg/kg DEHP. Overall, these results demonstrated that prenatal exposure to DEHP caused transgenerational epigenetic effects, which may explain the observed phenotypic changes in the male reproductive system.     

The Involvement of Insulin-Like Growth Factor 1 and Nerve Growth Factor in Alzheimer’s Disease-Like Pathology and Survival Role of the Mix of Embryonic Proteoglycans: Electrophysiological Fingerprint,Structural Changes and Regulatory Effects on Neurotrophins

Alzheimer’s disease (AD)-associated neurodegeneration is triggered by different fragments of amyloid beta (Aβ). Among them, Aβ (25–35) fragment plays a critical role in the development of neurodegeneration—it reduces synaptic integrity by disruption of excitatory/inhibitory ratio across networks and alters the growth factors synthesis. Thus, in this study, we aimed to identify the involvement of neurotrophic factors—the insulin-like growth factor 1 (IGF-1) and nerve growth factor (NGF)—of AD-like neurodegeneration induced by Aβ (25–35). Taking into account our previous findings on the neuroprotective effects of the mix of proteoglycans of embryonic genesis (PEG), it was suggested to test its regulatory effect on IGF-1 and NGF levels. To evaluate the progress of neurodegeneration, in vivo electrophysiological investigation of synaptic activity disruption of the entorhinal cortex–hippocampus circuit at AD was performed and the potential recovery effects of PEG with relative structural changes were provided. To reveal the direct effects of PEG on brain functional activity, the electrophysiological pattern of the single cells from nucleus supraopticus, sensomotor cortex and hippocampus after acute injection of PEG was examined. Our results demonstrated that after i.c.v. injection of Aβ (25–35), the level of NGF decreased in cerebral cortex and hypothalamus, and, in contrast, increased in hippocampus, prompting its multidirectional role in case of brain damage. The concentration of IGF-1 significantly increased in all investigated brain structures. The administration of PEG balanced the growth factor levels accompanied by substantial restoration of neural tissue architecture and synaptic activity. Acute injection of PEG activated the hypothalamic nucleus supraopticus and hippocampal neurons. IGF-1 and NGF levels were found to be elevated in animals receiving PEG in an absence of amyloid exposure. We suggest that IGF-1 and NGF play a critical role in the development of AD. At the same time, it becomes clear that the neuroprotective effects of PEG are likely mediated via the regulation of neurotrophins.