There have been few reports that have focused on the combination of the laparoscopic approach and natural orifice specimen extraction (NOSE) surgery for complete rectal prolapse (CRP). The aim of this study was to compare the feasibility, safety and short-term clinical efficacy of NOSE surgery with those of conventional laparoscopic resection rectopexy in the treatment of CRP. In a group of 45 patients selected between January 2019 and October 2023, 28 patients underwent conventional laparoscopic resection rectopexy (LRR), and 17 patients underwent transanal NOSE laparoscopic resection rectopexy (NOSE–LRR). Preoperative and postoperative clinical variables of the two groups of patients were compared and analyzed. The mean operation time was longer in the NOSE–LRR group than in the LRR group (150.29 min versus 134.18 min, respectively, p < 0.001). The median length of hospital stay after surgery was significantly shorter in the NOSE–LRR group (5 versus 7 days, respectively, p < 0.001). A significant reduction in the incontinence score and constipation score was observed in both groups after surgery (p < 0.001). However, there was no significant difference in the postoperative constipation score or incontinence score between the two groups. In this study, LRR combined with NOSE appears to be a safe, technically feasible, cosmetically favorable, and effective surgical option for patients with CRP. NOSE–LRR was associated with a significantly shorter postoperative hospital stay but a longer operation time. However, further large-scale cohort studies are needed to validate these findings.

目的:探讨circAGFG1对胆管癌QBC939细胞增殖、迁移和侵袭的影响及可能机制.方法:收集2017年4月至2019年10月于联勤保障部队第九八八医院接受手术的33例胆管癌患者的癌组织及对应癌旁组织,qPCR法检测组织中circAGFG1和miR-4429表达水平.体外培养胆管癌QBC939细胞,分别转染si-circAGFG1、miR-4429 mimic、共转染si-circAGFG1与anti-miR-4429后,采用CCK-8法和克隆形成实验检测对细胞增殖的影响,划痕实验和Transwell法分别检测对细胞迁移和侵袭的影响,WB法检测对细胞中E-cadherin和N-cadherin蛋白表达的影响.双荧光素酶报告基因实验验证circAGFG1和miR-4429之间的靶向调控关系.结果:胆管癌组织中circAGFG1的表达量高于癌旁组织(3.89±0.26 vs 1.00±0.08,P<0.05),而miR-4429的表达量低于癌旁组织(0.28±0.03 vs 1.00±0.05,P<0.05).干扰circAGFG1或过表达miR-4429后,QBC939细胞增殖水平、克隆形成数、划痕愈合率、侵袭细胞数及细胞中N-cadherin蛋白表达均显著降低(均P<0.05),而E-cadherin蛋白表达显著升高(P<0.05).circAGFG1可靶向结合miR-4429,且干扰circAGFG1会促进QBC939细胞中miR-4429表达(均P<0.05).下调miR-4429表达能够逆转干扰circAGFG1对QBC939细胞增殖、迁移和侵袭的影响(均P<0.05).结论:circAGFG1在胆管癌组织中表达升高,其可能通过靶向抑制miR-4429促进胆管癌QBC939细胞的增殖、迁移和侵袭.

Objective: This study investigates the effect of romidepsin on the growth, proliferation and apoptosis of colon cancer cells by activating the AKT/ERK/NF-kappa B pathway. Methods: Human colon cancer cell lines were cultured in vitro to establish a mouse subcutaneous xenograft tumour model. When the tumours reached approximately 10 mm, the mice were randomly divided into a saline group and a romidepsin group (10 mg/kg), and the tumour size of the two groups were measured. Human colon cancer cell lines were treated with 1, 5 and 10 mg/L romidepsin. The proliferation of colon cancer cells was detected by CCK-8, the apoptosis by flow cytometry, and the phosphorylation levels of protein kinase B (AKT), externally regulated protein kinase (ERK) and nuclear transcription factor-kappa B (NF-kappa B) proteins by a western blot. Results: T26 cells were inoculated subcutaneously into the backs of mice. The tumour size was measured after its formation. It was noted that, compared with the saline group, the growth of colon cancer in mice was significantly inhibited in the romidepsin group (10 mg/L). In addition, compared with the control group, the proliferation rate was not significantly restrained in the romidepsin group (1 mg/L) (P>0.05) but greatly inhibited in the romidepsin group (5 and 10 mg/L), which was time-and dose-dependent (P< 0.05). After being treated with 1 mg/L, 5 mg/L and 10 mg/L romidepsin, the apoptosis rate of colon cancer cells gradually increased, and with the increase of drug concentration, the percentage of apoptosis elevated from the normal 5.42%+/- 0.15% to 41.83 %+/- 2.79% (P< 0.05). The expression levels of p-AKT, p-ERK and p-NF-kappa B in colon cancer cells treated with 10 mg/L romidepsin were significantly lower than those in the control group. Conclusions: Romidepsin can inhibit the growth and proliferation of colon cancer cells but can promote their apoptosis. The related mechanism may be achieved by regulating the AKT/ERK/NF-kappa B signalling pathway.

It has been reported that glutamate metabotropic receptor 8 (GRM8) is closely implicated in the progression of human neuroblastoma, lung cancer, and glioma, but its role in breast cancer remains unknown. Thus, the present study was performed to uncover it. Immunohistochemistry, real-time PCR (RT-PCR), and western blotting experiments were performed to test GRM8 expression levels in tissues and cells. Cell functions were assessed by Cell Count Kit 8 (CCK-8), flow cytometry, wound healing, transwell chambers, and in vivo xenotransplantation experiments. The relationship between miR-33a-5p and GRM8 was evaluated by luciferase gene reporter and western blotting assay. The results showed that GRM8 expression was increased in breast cancer tissues and cells, which was closely associated with lower overall survival rate. Ectopic expression of GRM8 significantly enhanced cell growth, migration, and invasion and tumorigenesis and repressed cell apoptosis. In addition, GRM8 was under the negative regulation of miR-33a-5p, which was downregulated in breast cancer tissues and served as a tumor suppressor. Moreover, overexpression of GRM8 abrogated the inhibitive role of miR-33a-5p played in breast cancer. Collectively, this study reveals that GRM8 functions as an oncogene in breast cancer and is regulated by miR-33a-5p.

目的 探讨双镜联合治疗胆总管结石术中不同一期缝合方式对病人的疗效及预后的影响.方法 胆囊结石合并胆总管结石病人68例,根据术中胆总管缝合方式分为研究和对照组,每组各34例,对照组采用薇乔线间断缝合,研究组采用倒刺线连续缝合,比较两组病人的临床疗效的差异.结果 除术中出血量外,研究组病人的手术时间、留置引流管时间及住院时间均优于对照组,差异有统计学意义(P<0.05);术后研究组病人的血清白细胞介素(IL)-6、C反应蛋白(CRP)及肾上腺素(EP)均好于对照组,差异有统计学意义(P<0.05);术后研究组病人的总并发症发生率低于对照组,差异有统计学意义(P<0.05);两组病人半年后的结石复发率比较差异无统计学意义(P>0.05).结论 双镜联合治疗胆总管结石术中采用倒刺线连续一期缝合胆总管的疗效更佳显著且安全,降低胆漏的发生率,减轻炎性反应程度.

Objective:To compare the effects of open and total laparoscopic radical resection of thyroid cancer.Methods:A total of 80 patients with thyroid cancer treated in the 988th Hospital of the Chinese People’s Liberation Army Zhengzhou Joint Logistics Support Force from November 2018 to October 2020 were selected, and they were divided into observation group and control group by random number table method, with 40 cases in each group. Patients in the observation group underwent total laparoscopic radical resection of thyroid cancer; and patients in the control group underwent open radical resection of thyroid cancer. The operation-related indicators, stress indicators, and postoperative complications of the two groups were compared.Results:The intraoperative blood loss and the 24-h visual analogue scale (VAS) score of the observation group were significantly lower than those of the control group, and the hospital stay was shorter than that of the control group ( P<0.05). There was no significant difference in the number of dissected lymph node between the two groups ( P>0.05). The levels of interleukin-6, C reactive protein, and white blood cell count of the observation group were significantly lower than those of the control group 72 h after treatment (all P<0.05). The incidences of postoperative numbness in hands and feet (2.5%, 1/40), and water coughing (0.0%, 0/40) in the observation group were significantly lower than those of the control group (17.5%, 7/40; 10.0%, 4/40), P<0.05. Conclusions:Total laparoscopic radical resection of thyroid cancer has less impact on patients, treated by which patients recover faster after surgery, have less stress response, and have fewer postoperative complications. The application effect is good.

目的 观察常规器械经脐单孔腹腔镜胆囊切除术(TUSPLC)治疗急性胆囊炎的临床效果.方法 随机将2017年6月～2019年6月在我院就诊的120例急性胆囊炎患者分为A、B两组(A=60,B=60),A组行LC治疗,B组行常规器械TUSPLC治疗.比较两组手术时间、出血量、胃肠功能恢复时间、出院时间、术后镇痛药物使用率、切口美观满意率和并发症发生率.结果 B组胃肠功能恢复时间、出院时间均早于A组,且术后镇痛药物使用率较低而切口美观满意率较高(P<0.05);两组不良反应发生率无组间差异(P>0.05).结论 常规器械TUSPLC术可有效降低手术创伤,有利于患者术后恢复,且取材较为方便,具有临床推广价值.

目的 研究新型改良沸石止血粉对家猪颈动脉致死性出血模型的止血效果.方法 随机将 24 只健康雄性家猪分为研究组,模型组和对照组,每组8 只.家猪暴露并剪开 1/3 右侧颈动脉直径,自由放血30 s,各组使用止血材料立即加压止血.5 min后观察止血情况,并采集相关数据.结果 各组失血量组间比较差异无统计学意义(P＞0.05);研究组与模型组止血期出血量差异无统计学意义(P＞0.05 ),与对照组比较,研究组与模型组出血量均较少,组间比较差异均具有统计学意义(P＜0.00 1 ).与对照组比较,研究组与模型组术中伤口表面最高温度均较高,组间比较差异均具有统计学意义(P＜0.001),研究组术中伤口表面最高温度明显低于模型组(P＜0.001).术后 1 h生存率研究组与模型组均为87.50%,对照组为 0%.各组术后血常规及凝血功能各项指标比较差异无统计学意义(P＞0.05).结论 研究组用新型改良的沸石止血粉能有效控制猪颈动脉出血,止血效果与同类沸石止血粉相似.

目的 探讨安替可胶囊联合吉西他滨和顺铂治疗晚期原发性肝癌的临床疗效.方法 选取2014年4月-2015年4月在中国人民解放军第一五三中心医院治疗的晚期原发性肝癌患者86例,根据用药的差别分为对照组(43例)和治疗组(43例).对照组静脉滴注注射用盐酸吉西他滨,1 000 mg/m2,1次/周,连续治疗3周,休息1周,同时静脉滴注顺铂注射液,80 mg/m2,1次/d,连续治疗3d,间隔3周再治疗.治疗组在对照组基础上饭后口服安替可胶囊,2粒/次,3次/d.两组均患者均治疗8周.观察两组患者临床疗效,同时比较治疗前后两组患者甲胎蛋白(AFP)、癌胚抗原(CEA)、糖抗原(CA242)、α-L-岩藻糖苷酶(AFU)、血管内皮生长因子(VEGF)、骨桥蛋白(OPN)、可溶性白细胞介素-2受体(sIL-2R)、缺氧诱导因子-2α(HIF-2α)水平.结果 治疗后,对照组患者ORR和CBR分别为41.86％和72.09％,均分别显著低于治疗组的69.77％和86.05％,两组比较差异具有统计学意义(P＜0.05).治疗后,两组患者血清AFP、CEA、CA242、AFU、VEGF、OPN、sIL-2R、HIF-2α水平均显著降低,同组比较差异具有统计学意义(P＜0.05),且治疗后治疗组患者上述肿瘤标志物水平明显低于对照组,两组比较差异具有统计学意义(P＜0.05).结论 安替可胶囊联合吉西他滨和顺铂治疗晚期原发性肝癌可显著降低机体肿瘤标志物水平,具有一定的临床推广应用价值.

目的 探讨腹腔镜肝部分切除术治疗原发性肝癌(PLC)患者外周血T淋巴细胞亚群和血清细胞因子水平的变化.方法 2014年2月～2015年2月于我院治疗的PLC患者68例,采用随机数字表法分为腔镜组34例和开腹组34例,分别在不同方式下行肝肿瘤切除术.采用免疫浊度法检测血清IgG、IgA、IgM含量,采用酶联免疫吸附法检测血清血管内皮生长因子(VEGF)、成纤维细胞生长因子(aFGF)和bFGF水平,使用流式细胞仪检测外周血CD3+、CD4+和CD8+T细胞百分比.结果 术前,两组外周血CD3+、CD4+、CD8+T细胞百分比无显著性差异(P>0.05),术后7 d,腔镜组CD3+、CD4+、CD8+T细胞百分比分别为(57.2±5.6)％、(46.9±7.2)％和(28.4±5.3)％,与开腹组比,存在显著性差异[分别为(51.9±3.2)％、(41.2±6.4)％和(33.6±2.3)％,P<0.05];血清VEGF、aFGF和bFGF水平分别为(18.4±5.1)ng/ml、(5.3±4.2)pg/ml和(6.5±4.3)pg/ml,显著低于开腹组[分别为(31.9±5.7)ng/ml、(8.7±5.2)pg/ml和(8.4±6.9)pg/ml,P<0.05];两组肝功能指标和血清免疫球蛋白水平变化无显著性差异(P>0.05).结论 腹腔镜下肝切除术与开腹肝切除术治疗PLC患者比,可能因为创伤小而对机体的免疫功能影响较小.

进行高原地区卫勤保障是军队卫勤力量的重要职责.野战医疗方舱是较为成熟的野战机动医疗系统,可灵活机动地实施快速投送和全面高效的医疗救治;展开后与其他网架卫生帐篷组合,可组成野战方舱医院.本文分析了某军队医院组建的野战方舱医院在高原地区训练中的伤病员救治和后送情况,认为,伤病员后送原因主要有严重急性高原反应、卫勤保障机制单一、缺少专科设备和器械、消毒灭菌措施有待加强等;并探讨了方舱医院提高伤病员救治能力的对策.

To sum up the experience of mobile field hospital applied in military exercise in the plateau area and to provide reference for the future application of mobile field hospital in military medical service in the plateau area, by establishing and deploying mobile field hospital for combat troops in real military exercise in the plateau area.

Using the military standard GJBI098 -91 Diagnosis and Treatment of Acute Mountain Sickness , the acute mountain sickness (AMS) was quantitatively investigated include 66 people in the mobile field hospital in combat training at the plateau.The result showed: the incidence rate of AMS was 92.1%,in which no response was 6.1%, mild reaction was 65.2%, moderate reaction was 24.2%, severe reaction was 4.5%.The reasons of AMS were analyzed and the countermeasures were put forward .

In the context of cabin hospital in plateau for drill, the author summarized organization and command and specific practices of shelter hospital from the aspects of long distance railway transportation, folding and unfolding, medical support and subject display, etc. In order to provide experience for participating in drill and emergency rescue.

野战医疗方舱是我军目前最先进的野战机动医疗系统,具有区别于野战医疗队或旅团卫生队的独特优点.通过总结野战方舱医院在高原条件下开展手术的经验,探讨方舱医院在高原开展手术的卫勤保障,以期为今后高原卫勤保障提供借鉴.