腹膜巨大恶性间皮瘤1例

患者男,66岁.腹痛、腹胀、尿频1年,腹水2个月来我院就诊.患者半年前不明原因出现腹痛、腹胀,当地就诊诊断为肠梗阻,给予对症治疗后,症状稍有缓解.近半年来,症状逐渐加重且出现腹水,为求进一步诊治来我院就医.既往体健,无家族史及外伤史.     

青藤碱对炎症性肠病中肠道免疫炎症影响的研究进展

炎症性肠病(IBD)患者肠道免疫炎症反应异常,影响和调控肠道免疫炎性反应是其治疗方法之一.现已证明青藤碱(SN)可以通过抑制淋巴细胞增殖,影响免疫细胞功能,减少炎症介质生成,平衡细胞因子的分泌等多个环节来抑制机体免疫炎症反应.本文从IBD免疫发病机制入手,总结了目前SN对机体免疫功能影响方面的研究进展,为寻求SN调控肠道免疫炎症来治疗IBD提供参考.     

北京市西城区老人的主观幸福度

Background

In 2010 the Beijing Municipal Government promulgated a policy aimed at improving the quality of life and subjective well-being of elderly residents that included a component focused on mental health.

Aim

Identify factors associated with subjective well-being in a representative sample of elderly residents of Xi Cheng District in Beijing.

Methods

This cross-sectional study administered a self-completion survey to a stratified random sample of 2342 residents of Xi Cheng District who were 60 to 80 years of age. The level of well-being was assessed using a validated Chinese version of the Memorial University of Newfoundland Scale of Happiness (MUNSH). Detailed socioeconomic variables were obtained using a questionnaire developed by the authors. Social support, anxiety, and depression were assessed using validated Chinese versions of the Social Support Rating Scale (SSRS), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS).

Results

Among the 2342 respondents, 1616 (69.0%) had a total MUNSH score of 32 or above, indicating a high level of happiness; 423 (18.1%) has a total SSRS score 32 or below, indicating poor social support; 201 (8.6%) had a total SDS score of 53 or above, indicating significant depression; and 126 (5.3%) had a total SAS score of 50 or above, indicating significant anxiety. In the multivariate regression analysis the self-reported level of depression was the most important factor related to well-being. Anxiety, social support, income level, the quality of family relationships, the ability to self-regulate emotions, and regular exercise were also significantly related to well-being; but gender, marital status, age and educational level were not associated with well-being.

Conclusion

Among elderly urban residents in Beijing, self-reports of poor subjective well-being are closely associated with self-reports of depressive and anxiety symptoms and also associated with social factors such as social support, income level and family relationships. Prospective studies are needed to identify the causal relationships of these variables and, based on the findings, to develop targeted interventions aimed at improving the quality of life and well-being of elderly community members.     

槲皮素对人结肠癌细胞HT29的增殖抑制及诱导凋亡的体外实验研究

研究槲皮素(quercetin,Que)对人结肠癌细胞株HT29的增殖抑制作用及凋亡诱导效应,并通过Fas、Caspase-3蛋白的表达变化对其分子作用机制进行探讨。方法常规培养结肠癌HT29细胞,分别用40、80、120μmol.L-1 Que(Que1、Que2、Que3组)、4.02mmol.L-1苦参碱(Mat组,为阳性对照)作用于细胞,以未加药组为对照组。采用MTT法检测细胞的增殖抑制率,透射电镜观察细胞的超微结构,流式细胞仪(FCM)检测细胞凋亡率,Western Blot法检测细胞Fas和Caspase-3蛋白的表达。结果 Que能显著增加细胞增殖的抑制率(P<0.01),并呈剂量依赖关系;且Que2、Que3组的抑制率随着培养时间的延长而升高,呈时间依赖关系。电镜下Que各组均呈现不同程度的凋亡特征形态变化:核固缩、染色质边集、并见核碎裂,凋亡小体出现。Que能明显增加细胞的凋亡率(P<0.01)、能显著增加Fas和Caspase-3的表达(P<0.01),并均呈剂量依赖关系。结论 Que对HT29细胞具有增殖抑制作用,并能诱导其凋亡,其作用机制可能与激活死亡受体Fas介导的Fas-Caspase-3凋亡信号通路有关。     

外在和内在认知负荷对帕金森病患者步态影响的差异

目的 探讨内在和外在认知负荷对帕金森病患者步态的影响差异.方法 8名帕金森病患者和6名健康对照受试者完成负载外在的听觉认知负荷和负载内在的认知负荷下的步态测试.采用三维运动分析仪记录2种条件下的步态参数.使用FAB量表和Stroop-3测试评估患者的执行能力.结果 帕金森病组在节拍器刺激下步频、步速、单支撑相时间和摆动相时间[分别为(113.4±14.32)steps/rain,(78.90±16.35)cm/s,(40.50±2.58)%,(40.50±2.58)%],优于计算条件下[分别为(91.27±15.54)steps/min,(63.79±21.49)cm/s,(37.95±2.61)%,(37.95±2.61)%],差异具有显著性(P<0.05).计算条件下,帕金森病组的步幅变异、单支撑相时间变异和摆动相时间变异[分别为(6.69±3.99)cm,(8.56±5.69)%,(8.56±5.69)%]均大于对照组[分别为(3.23±1.34)cm,(5.02±2.54)%,(5.02±2.54)%],节拍器条件下,除步幅、单支撑相时间和摆动相时间变异之外,帕金森病组的步长和步速变异[分别为(11.92±5.86)cm,(6.89±4.98)cm/s]也大于对照组[分别为(7.35±3.32)cm,(2.5±1.53)cm/s],差异均具有显著性(P<0.05).帕金森病组FAB得分[(15.63±1.51)分]低于对照组[(17.67±0.52)分],Stroop-3错误率(0.087±0.056)高于对照组(0.027±0.03),差异均具有显著性,且Stroop-3错误率显著与计算条件下帕金森病组的步态参数相关.结论 外在的节律性听觉刺激不及内在的计算负荷对帕金森病步态的影响显著.

Abstract：

Objective To explore the effects of extrinsic and intrinsic recognition loading on gait in patients with Parkinson disease.Methods Eight patients with Parkinson disease and six control subjects were instrutted to walk with extrinsic and intrinsic recognition loading respectively.The gait parameters in two conditions were measured with three-dimension motion analysis equipment.FAB scale and Stroop Test were used as the evaluation of executive function.Results The velocity(cm/s),the cadence(step/min),single support and swing phase(%)in the audition stimulates condition in the patients group((113.4±14.32)step/min,(78.90±16.35)cm/s,(40.50±2.58)%,(40.50±2.58)%)were significantly better than those in the calculation condition(respectively(91.27±15.54)step/min,(63.79±21.49)cm/s,(37.95±2.61)%,(37.95±2.61)%).In the calculation condition,the coefficients of variability in stride length,swing and sinfle support phase were significantly higher in the patient group(respectively(6.69±3.99),(8.56±5.69),(8.56±5.69))than in thecontrol group(respectively(3.23±1.34),(5.02±2.54),(5.02±2.54));in the audition condition,except that,the coefficients of variability in step length and velocity also were significantly higher in the patient group(respeetively(11.92±5.86),(6.89±4.98))than the control group(respectively(7.35±3.32),(2.5±1.53)).In the patients group,the score of FAB(15.63±1.51)was lower and error rates of Stroop test(0.087±0.056)was higher than those in the control group(respectively(17.67±0.52),(0.027±0.03))significantly.The error rate of stroop-3 was significantly negative correlated with the gait variables of patient group in the calculation condition.Conclusion The extrinsic audition stimulates has lower effect on the gait of patients of Parkinson's disease than the intrinsic recognition loading.     

皮质厚度在骨质疏松性髋部骨折中的应用研究

骨质疏松性髋部骨折作为老年骨质疏松症的严重并发症,是临床医生重点关注的问题。临床中多通过骨密度来评价脆性骨折的发生风险。而通过常规影像学检查获得的皮质厚度,在预测髋部骨折风险方面具有重要的辅助作用,特别是结合骨密度、股骨近端几何结构以及多种生化指标时,可明显提高骨折风险评估的准确率。而对于骨折的治疗,皮质厚度在术式、内固定选择以及术中强化内固定稳定性等方面的作用得到了广泛认识。患者术后恢复情况及治疗的效果评价同样可以通过皮质厚度来评估。本文对皮质厚度的研究和临床应用状况进行综述。     

急性髓系白血病患者缺氧诱导因子-1α和糖酵解相关基因表达及意义

目的 观察急性髓系白血病(AML)患者缺氧诱导因子-1α(HIF-1α)及糖酵解相关基因表达情况,探讨HIF-1α对AML患者预后的影响及可能机制。方法 2015年7月—2018年7月郑州大学第一附属医院、郑州大学附属儿童医院初诊AML患者90例为AML组,健康异基因造血干细胞移植供者18例为对照组,采用实时荧光定量PCR法检测2组骨髓单个核细胞HIF-1α mRNA相对表达量及糖酵解相关基因HK2、PFKM、ALDOA、PGK1、PDK1、LDHA mRNA相对表达量,采用Spearman相关法分析AML患者HIF-1α mRNA相对表达量与HK2、PFKM、ALDOA、PGK1、PDK1、LDHA mRNA相对表达量的相关性。AML组患者采用“3+7”方案诱导化疗,1个疗程后达完全缓解者45例,未达完全缓解者45例,比较完全缓解者与未完全缓解者HIF-1α mRNA相对表达量。以HIF-1α mRNA相对表达量中位数(2.040)为界,将AML患者分为低表达组(HIF-1α mRNA相对表达量<2.040)45例与高表达组(HIF-1α mRNA相对表达量≥2.040)45例...     

卵巢颗粒细胞瘤术后27年膈肌转移1例

正患者女性,68岁,8天前无明显诱因出现右下腹疼痛,呈阵发性,持续数分钟后疼痛症状稍缓解,伴腹胀。查腹MRI示肝右叶和膈肌占位,腺瘤合并出血可能性大(图1)。血清学检查:AFP:1.33 ng/mL(正常值0～20 ng/mL),CEA:1.51ng/mL(正常值0～5 ng/mL)。查体见小腹平坦,未见胃肠型及蠕动波,下腹可见长约15 cm手术瘢痕;右下腹压痛、无反     

负压引流技术用于修复四肢开放骨折创面23例

<正>随着汽车等高速交通工具的普及,各种高速所致的复杂损伤日趋增多。使用负压引流技术辅助治疗四肢开放骨折创面,能减轻患者痛苦,降低感染率,提高治愈率,是严重四肢开放骨折中软组织缺损较好的治疗方法[1]。我院自2008年以来,将该方法用于临床,效果较好,现报道如下。     

连枷臂综合征1例报告

患者男,71岁。因右上肢无力4个月余,左上肢无力2个月余,加重1个月于2009年4月18日入住贵阳医学院附属医院。患者于4个月前无明显诱因出现右侧上肢无力,以近端肌肉为重,抬举困难,无明显肌肉萎缩及肌肉震颤,无肌痛,无晨轻暮重,无意识障碍及大小便失禁等症状。