目的比较经耳廓后沟入路和经口腔前庭入路单孔腔镜甲状腺手术的临床效果。方法回顾性分析中山大学肿瘤防治中心头颈外科2021年6—8月开展的10例经耳廓后沟入路单孔腔镜甲状腺手术病例(耳后组)和2016年1月至2021年6月同中心开展的21例经...目的比较经耳廓后沟入路和经口腔前庭入路单孔腔镜甲状腺手术的临床效果。方法回顾性分析中山大学肿瘤防治中心头颈外科2021年6—8月开展的10例经耳廓后沟入路单孔腔镜甲状腺手术病例(耳后组)和2016年1月至2021年6月同中心开展的21例经口腔前庭入路腔镜甲状腺手术病例(口腔组)的资料。耳后组男性2例,女性8例,年龄(48.2±13.9)岁(范围:28~67岁);口腔组男性5例,女性16例,年龄(31.3±8.2)岁(范围:21~49岁)。两组患者均接受单侧腺叶+峡部切除。耳后组通过耳后沟处长3 cm单孔切口建腔,置入“手套式”套管,保留肩胛舌骨肌,左右拉开胸锁乳突肌和颈前肌,暴露并连续完整切除甲状腺单侧腺叶及中央区淋巴结。采用t检验、Mann-Whitney U检验、χ^(2)检验和Fisher确切概率法等比较两组患者的手术结果。结果两组患者均顺利完成手术。耳后组的手术时间长于口腔组[(256.8±77.0)min比(201.2±54.9)min,t=2.31,P=0.028],耳后组术后24 h C反应蛋白较术前增幅低于口腔组[8.58(13.24)mg/L比46.24(48.88)mg/L,Z=-4.311,P<0.01]。耳后组与口腔组淋巴结清扫数目无差异[2(5)枚比2(3)枚,Z=-0.326,P=0.759]。耳后组无并发症发生。结论与经口腔前庭入路相比,经耳廓后沟单孔腔镜甲状腺单侧腺叶+峡部切除术将切口隐蔽至耳后,解剖量小,能达到肿瘤连续完整切除。展开更多
Background Atherosclerosis is a kind of disease with multiple risk factors,of which hyperlipidemia is a major classical risk factor resulting in its pathogenesis and development.The aim of this study was to determine ...Background Atherosclerosis is a kind of disease with multiple risk factors,of which hyperlipidemia is a major classical risk factor resulting in its pathogenesis and development.The aim of this study was to determine the effects of short-term intensive atorvastatin （IA） therapy on vascular endothelial function and explore the possible mechanisms that may help to explain the clinical benefits from short-term intensive statin therapy.Methods After exposure to high-fat diet （HFD） for 8 weeks,the animals were,respectively,treated with IA or low-dose atorvastatin （LA） for 5 days.Blood lipids,C-reactive protein （CRP）,tumor necrosis factor-α （TNF-α）,interleukin-6 （IL-6）,nitric oxide （NO）,endothelin-1 （ET-1）,and endothelium-dependent vasorelaxation function were,respectively,measured.mRNA and protein expression of CRP,TNF-α,IL-6,macrophage chemoattractant protein-1 （MCP-1）,and 5-lipoxygenase （5-LO） were also evaluated in pericarotid adipose tissue （PCAT） and cultured adipocytes.Results HFD increased serum inflammatory factor levels; induced significant hyperlipidemia and endothelial dysfunction,including imbalance between NO and ET-1; enhanced inflammatory factors and 5-LO expression; and promoted macrophage infiltration into adipose tissue.Five-day IA therapy could significantly decrease serum inflammatory factor levels and their expression in PCAT; restore the balance between NO and ET-1; and improve endothelial function and macrophage infiltration without significant changes in blood lipids.However,all of the above were not observed in LA therapy.In vitro experiment found that lipopolysaccharide （LPS） enhanced the expression of inflammatory factors and 5-LO in cultured adipocytes,which could be attenuated by short-time （6 hours） treatment of high-dose （5 pmol/L） but not low-dose （0.5 μmol/L） atorvastatin.In addition,inhibiting 5-LO by Cinnamyl-3,4-dihydroxy-α-cyanocinnamate （CDC,a potent and direct 5-LO inhibitor） could significantly downregulate the above-mentioned gene expression in LPS-treated adipocytes.Conclusion Short-term IA therapy could significantly ameliorate endothelial dysfunction induced by HFD,which may be partly due to attenuating inflammation of PCAT through inhibiting 5-LO pathway.展开更多
文摘目的比较经耳廓后沟入路和经口腔前庭入路单孔腔镜甲状腺手术的临床效果。方法回顾性分析中山大学肿瘤防治中心头颈外科2021年6—8月开展的10例经耳廓后沟入路单孔腔镜甲状腺手术病例(耳后组)和2016年1月至2021年6月同中心开展的21例经口腔前庭入路腔镜甲状腺手术病例(口腔组)的资料。耳后组男性2例,女性8例,年龄(48.2±13.9)岁(范围:28~67岁);口腔组男性5例,女性16例,年龄(31.3±8.2)岁(范围:21~49岁)。两组患者均接受单侧腺叶+峡部切除。耳后组通过耳后沟处长3 cm单孔切口建腔,置入“手套式”套管,保留肩胛舌骨肌,左右拉开胸锁乳突肌和颈前肌,暴露并连续完整切除甲状腺单侧腺叶及中央区淋巴结。采用t检验、Mann-Whitney U检验、χ^(2)检验和Fisher确切概率法等比较两组患者的手术结果。结果两组患者均顺利完成手术。耳后组的手术时间长于口腔组[(256.8±77.0)min比(201.2±54.9)min,t=2.31,P=0.028],耳后组术后24 h C反应蛋白较术前增幅低于口腔组[8.58(13.24)mg/L比46.24(48.88)mg/L,Z=-4.311,P<0.01]。耳后组与口腔组淋巴结清扫数目无差异[2(5)枚比2(3)枚,Z=-0.326,P=0.759]。耳后组无并发症发生。结论与经口腔前庭入路相比,经耳廓后沟单孔腔镜甲状腺单侧腺叶+峡部切除术将切口隐蔽至耳后,解剖量小,能达到肿瘤连续完整切除。
基金This study was supported by grants from the National Natural Science Foundation of China （No.81100101 and No.81270212）,Natural Science Foundation of Guangdong Province （No.S2013010014011）,Medical Scientific Research Foundation of Guangdong Province （No.B2011085）,Yat-sen Scholarship for Young Scientist of Sun Yat-sen Memorial Hospital,Young Teacher Support Project,and Young Teacher Key Support Project of Sun Yat-sen University.
文摘Background Atherosclerosis is a kind of disease with multiple risk factors,of which hyperlipidemia is a major classical risk factor resulting in its pathogenesis and development.The aim of this study was to determine the effects of short-term intensive atorvastatin （IA） therapy on vascular endothelial function and explore the possible mechanisms that may help to explain the clinical benefits from short-term intensive statin therapy.Methods After exposure to high-fat diet （HFD） for 8 weeks,the animals were,respectively,treated with IA or low-dose atorvastatin （LA） for 5 days.Blood lipids,C-reactive protein （CRP）,tumor necrosis factor-α （TNF-α）,interleukin-6 （IL-6）,nitric oxide （NO）,endothelin-1 （ET-1）,and endothelium-dependent vasorelaxation function were,respectively,measured.mRNA and protein expression of CRP,TNF-α,IL-6,macrophage chemoattractant protein-1 （MCP-1）,and 5-lipoxygenase （5-LO） were also evaluated in pericarotid adipose tissue （PCAT） and cultured adipocytes.Results HFD increased serum inflammatory factor levels; induced significant hyperlipidemia and endothelial dysfunction,including imbalance between NO and ET-1; enhanced inflammatory factors and 5-LO expression; and promoted macrophage infiltration into adipose tissue.Five-day IA therapy could significantly decrease serum inflammatory factor levels and their expression in PCAT; restore the balance between NO and ET-1; and improve endothelial function and macrophage infiltration without significant changes in blood lipids.However,all of the above were not observed in LA therapy.In vitro experiment found that lipopolysaccharide （LPS） enhanced the expression of inflammatory factors and 5-LO in cultured adipocytes,which could be attenuated by short-time （6 hours） treatment of high-dose （5 pmol/L） but not low-dose （0.5 μmol/L） atorvastatin.In addition,inhibiting 5-LO by Cinnamyl-3,4-dihydroxy-α-cyanocinnamate （CDC,a potent and direct 5-LO inhibitor） could significantly downregulate the above-mentioned gene expression in LPS-treated adipocytes.Conclusion Short-term IA therapy could significantly ameliorate endothelial dysfunction induced by HFD,which may be partly due to attenuating inflammation of PCAT through inhibiting 5-LO pathway.
