目的 探讨在腹腔镜胆囊切除术(LC)中采取经胆囊注射吲哚菁绿(ICG)近红外线胆道成像(NIRC)技术用于治疗困难型胆囊的可行性及疗效。方法 回顾性分析2019年6月至2022年5月在如皋市中医院普外科及南通市第三人民医院肝胆外科行LC治疗的困...目的 探讨在腹腔镜胆囊切除术(LC)中采取经胆囊注射吲哚菁绿(ICG)近红外线胆道成像(NIRC)技术用于治疗困难型胆囊的可行性及疗效。方法 回顾性分析2019年6月至2022年5月在如皋市中医院普外科及南通市第三人民医院肝胆外科行LC治疗的困难型胆囊患者的病例资料。其中对照组(n=34)在白光模式下行常规LC手术,ICG组(n=34)在术中将胆汁与ICG混合后注入胆囊腔,然后在荧光模式下行LC。结果 两组均成功实施LC手术,ICG组均成功实施荧光成像。ICG组三管识别时间[(14.81±3.23)min vs (29.37±2.38)min,t=-18.52,P<0.001]、手术时间[(45.18±3.44)min vs (59.24±4.17)min,t=-11.26,P<0.001]、术后引流时间[(2.52±0.44)d vs (3.37±0.51)d,t=-7.67,P<0.001]、术后住院时间[(3.14±0.63)d vs (4.67±0.39)d,t=-7.81,P<0.001]均较对照组短,术中出血量较对照组少[(15.46±6.25)mL vs (25.76±4.23)mL,t=-6.45,P<0.001],差异均具有统计学意义。对照组1例因胆囊三角致密粘连、胆囊动脉损伤而中转开腹手术,2例发生胆囊管损伤;ICG组未见术中副损伤;两组术中副损伤差异无统计学意义[0 vs 8.8%(3/34),P=0.16]。术后第2天ICG组ALT、AST、TBIL均低于对照组,差异均有统计学意义(P<0.05)。结论 困难型胆囊患者LC术中经胆囊注射吲哚菁绿显影简单易行,可在困难型胆囊术中显示胆囊及胆管结构,有助于安全高效解剖肝外胆管及胆囊床的同时加快手术进度,减少手术创伤。展开更多
OBJECTIVE To investigate whether electroacupuncture(EA)ameliorates abnormal trigeminal neuralgia(TN)orofacial pain and anxiety-like behavior by altering synaptic plasticity in the hippocampus CA1.METHODS A mouse infra...OBJECTIVE To investigate whether electroacupuncture(EA)ameliorates abnormal trigeminal neuralgia(TN)orofacial pain and anxiety-like behavior by altering synaptic plasticity in the hippocampus CA1.METHODS A mouse infraorbital nerve transection model(pTION)of neuropathic pain was established,and EA or sham EA was used to treat ipsilateral acu⁃puncture points(GV20-Baihui and ST7-Xia⁃guan).Golgi-Cox staining and transmission elec⁃tron microscopy(TEM)were administrated to observe the changes of synaptic plasticity in the hippocampus CA1.RESULTS Stable and persistent orofacial allodynia and anxiety-like behav⁃iors induced by pT-ION were related to changes in hippocampal synaptic plasticity.Golgi stain⁃ings showed a decrease in the density of dendritic spines,especially mushroom-type dendritic spines,in hippocampal CA1 neurons of pT-ION mice.TEM results showed that the density of synapses,membrane thickness of the postsynaptic density,and length of the synaptic active zone were decreased,whereas the width of the synaptic cleft was increased in pTION mice.EA attenu⁃ated pT-ION-induced orofacial allodynia and anx⁃iety-like behaviors and effectively reversed the abnormal changes in dendritic spines and syn⁃apse of the hippocampal CA1 region.CONCLU⁃SION EA modulates synaptic plasticity of hippo⁃campal CA1 neurons,and reduces abnormal oro⁃facial pain and anxiety-like behavior,providing evidence for a TN treatment strategy.展开更多
目的探索品质管理圈(Quality control circle,QCC)在中医执业医师考试实践技能带教中的应用。方法选取2019年9月-2019年12月在山东中医药大学附属医院转科的30名硕士研究生,成立品管圈小组,运用头脑风暴法确定此次QCC活动主题为"...目的探索品质管理圈(Quality control circle,QCC)在中医执业医师考试实践技能带教中的应用。方法选取2019年9月-2019年12月在山东中医药大学附属医院转科的30名硕士研究生,成立品管圈小组,运用头脑风暴法确定此次QCC活动主题为"如何提升硕士研究生中医执业医师资格考试实践技能",采用5W1H(when、where、who、why、what和how)的方式从带教教师、实习学生、教学管理、科室硬件4个方面归纳影响硕士研究生中医执业医师资格考试相关临床操作技能的主要因素并制定实施对策。从有形成果和无形成果2个方面评价QCC活动效果。结果实施QCC活动后,实习学生的临床操作技能考核成绩明显高于实施QCC活动前,差异有统计学意义(P<0.05)。圈员各项能力均有提高,临床操作技能考核总分与无形成果中责任心、自信心、积极性呈正相关。结论QCC活动应用于中医执业医师考试实践技能带教,可以增强学生学习的积极性和主动性,提高带教教师的综合能力和QCC知识的应用能力。展开更多
文摘目的 探讨在腹腔镜胆囊切除术(LC)中采取经胆囊注射吲哚菁绿(ICG)近红外线胆道成像(NIRC)技术用于治疗困难型胆囊的可行性及疗效。方法 回顾性分析2019年6月至2022年5月在如皋市中医院普外科及南通市第三人民医院肝胆外科行LC治疗的困难型胆囊患者的病例资料。其中对照组(n=34)在白光模式下行常规LC手术,ICG组(n=34)在术中将胆汁与ICG混合后注入胆囊腔,然后在荧光模式下行LC。结果 两组均成功实施LC手术,ICG组均成功实施荧光成像。ICG组三管识别时间[(14.81±3.23)min vs (29.37±2.38)min,t=-18.52,P<0.001]、手术时间[(45.18±3.44)min vs (59.24±4.17)min,t=-11.26,P<0.001]、术后引流时间[(2.52±0.44)d vs (3.37±0.51)d,t=-7.67,P<0.001]、术后住院时间[(3.14±0.63)d vs (4.67±0.39)d,t=-7.81,P<0.001]均较对照组短,术中出血量较对照组少[(15.46±6.25)mL vs (25.76±4.23)mL,t=-6.45,P<0.001],差异均具有统计学意义。对照组1例因胆囊三角致密粘连、胆囊动脉损伤而中转开腹手术,2例发生胆囊管损伤;ICG组未见术中副损伤;两组术中副损伤差异无统计学意义[0 vs 8.8%(3/34),P=0.16]。术后第2天ICG组ALT、AST、TBIL均低于对照组,差异均有统计学意义(P<0.05)。结论 困难型胆囊患者LC术中经胆囊注射吲哚菁绿显影简单易行,可在困难型胆囊术中显示胆囊及胆管结构,有助于安全高效解剖肝外胆管及胆囊床的同时加快手术进度,减少手术创伤。
基金the National Natural Science Foundation of China(82001190)Natural Sci⁃ence Foundation of Shandong Province(ZR2021LZY016)+1 种基金Natural Science Foundation of Shandong Province(ZR2020MH348)Science and Technology Foundation of Shandong Traditional Chinese Medicine(2020Q035)。
文摘OBJECTIVE To investigate whether electroacupuncture(EA)ameliorates abnormal trigeminal neuralgia(TN)orofacial pain and anxiety-like behavior by altering synaptic plasticity in the hippocampus CA1.METHODS A mouse infraorbital nerve transection model(pTION)of neuropathic pain was established,and EA or sham EA was used to treat ipsilateral acu⁃puncture points(GV20-Baihui and ST7-Xia⁃guan).Golgi-Cox staining and transmission elec⁃tron microscopy(TEM)were administrated to observe the changes of synaptic plasticity in the hippocampus CA1.RESULTS Stable and persistent orofacial allodynia and anxiety-like behav⁃iors induced by pT-ION were related to changes in hippocampal synaptic plasticity.Golgi stain⁃ings showed a decrease in the density of dendritic spines,especially mushroom-type dendritic spines,in hippocampal CA1 neurons of pT-ION mice.TEM results showed that the density of synapses,membrane thickness of the postsynaptic density,and length of the synaptic active zone were decreased,whereas the width of the synaptic cleft was increased in pTION mice.EA attenu⁃ated pT-ION-induced orofacial allodynia and anx⁃iety-like behaviors and effectively reversed the abnormal changes in dendritic spines and syn⁃apse of the hippocampal CA1 region.CONCLU⁃SION EA modulates synaptic plasticity of hippo⁃campal CA1 neurons,and reduces abnormal oro⁃facial pain and anxiety-like behavior,providing evidence for a TN treatment strategy.
文摘目的探索品质管理圈(Quality control circle,QCC)在中医执业医师考试实践技能带教中的应用。方法选取2019年9月-2019年12月在山东中医药大学附属医院转科的30名硕士研究生,成立品管圈小组,运用头脑风暴法确定此次QCC活动主题为"如何提升硕士研究生中医执业医师资格考试实践技能",采用5W1H(when、where、who、why、what和how)的方式从带教教师、实习学生、教学管理、科室硬件4个方面归纳影响硕士研究生中医执业医师资格考试相关临床操作技能的主要因素并制定实施对策。从有形成果和无形成果2个方面评价QCC活动效果。结果实施QCC活动后,实习学生的临床操作技能考核成绩明显高于实施QCC活动前,差异有统计学意义(P<0.05)。圈员各项能力均有提高,临床操作技能考核总分与无形成果中责任心、自信心、积极性呈正相关。结论QCC活动应用于中医执业医师考试实践技能带教,可以增强学生学习的积极性和主动性,提高带教教师的综合能力和QCC知识的应用能力。
