医用几丁糖凝胶预防输卵管复通后的粘连

背景：近年来随着微创技术的普及，输卵管介入复通治疗输卵管阻塞已较普遍，但患者术后粘连仍是困扰临床医生的一大难题。 目的：总结近年来医用几丁糖凝胶预防输卵管再通术后粘连的应用现状。 方法：由第一作者检索1998-02/2011-02万方数据库，以“医用几丁糖凝胶；腹腔镜；治疗；输卵管妊娠”等为检索词，检索几丁糖在输卵管介入再通术中预防术后粘连方面的文献。排除重复研究或较陈旧文献。共保留相关文献30篇进行分析。 结果与结论：医用几丁糖是一种具有良好生物相容性、生物可降解性、生物学活性的医用高分子多糖类物质。其具有广谱抑菌作用，选择性促进上皮细胞、内皮细胞生长而抑制成纤维细胞生长的生物学特性，从而促进组织生理性修复，促进切口迅速修复，抑制瘢痕形成，减少组织粘连，具有润滑、生物屏障作用，能有效的阻止粘连发生，促进输卵管功能的恢复，为再次妊娠打下基础。     

支气管腔内放疗治疗肺癌的疗效

目的：探讨支气管腔内后装近距离腔内放疗的方法、剂量和疗效。方法：用导丝导入法行支气管腔内放疗，可达亚段支气管。参考点20mm，单次剂量6-7GY，5-7日/间隔，2-4次/人。治疗中央型肺癌（均侵犯支气管）76例212人次。结果：病灶消失22例，缩小39例，稳定12例，进展3例，总有效率85.5％。起效时间均短于3周。结论：支气管腔内后装放疗是治疗腔内肿瘤及缓解伴随症状的有效方法。疗效及起效优于外照射和化疗。对复治患者仍然有效。     

Chinese herbal compounds containing scorpion in the treatment of epilepsy: A protocol for systematic review and meta-analysis

Background:Epilepsy is 1 of the common neurodevelopmental diseases. It can affect about 0.5% to 1.0% of the population regardless of their race and social class. Despite the development of a wide range of treatments, there remaining about one-third of patients still experience seizures. Chinese herbal compounds containing scorpion (CHCCS) have shown an outstanding curative effect on nerve protection and epilepsy. But there''s no study to assess its clinical efficacy and safety.Methods:Each data of CHCCS in treating epilepsy from related English and Chinese databases will be searched. The primary outcome is the efficacy of the CHCCS on epilepsy. And the secondary outcomes include recurrence rate and side effects. The risk of bias will be assessed, and RevMan5.3 and Stata14.0 will be performed for meta-analysis. Finally, we will assess the level of the resulting evidence.Results:The results of the study will be combined with current evidence and published in a peer-reviewed journal.Conclusions:This study will specifically investigate the effectiveness and safety of CHCCS in treating epilepsy.INPLASY registration number:INPLASY202120056.     

The meta-analysis of the effect of 68Ga-PSMA-PET/CT diagnosis of prostatic cancer compared with bone scan

Background:⁶⁸Ga-PSMA-PET/CT (positron emission tomography/computed tomography) is a promising method for prostate cancer (PC) detection. However, the ability of ⁶⁸Ga-PSMA-PET/CT to detect malignant bone lesions, and whether this method is superior to the existing bone imaging methods are still lack of systematic analysis.Purpose:To evaluate the value of ⁶⁸Ga-PSMA-PET/CT and bone scan in clinical diagnosis of prostatic cancer from the perspective of evidence-based medicine.Methods:PubMed, The Cochrane Library, EMBASE, Springer Link, Sinomed, CNKI, Wanfang database, and CQVIP database were searched to find the satisfactory studies that needed systematic review of trials and compared the value of 68Ga-PSMA-PET/CT and bone scan. All studies published from inception to March 31, 2020. According to the inclusion and exclusion criteria, 2 reviewers independently evaluated and extracted the literature. Review Manager 5.3 was applied to evaluate the included literature quality. The heterogeneity of the included literature was tested by Meta Disc 1.4, and the effect model was selected according to the heterogeneity test results, and the sensitivity (SEN), specificity (SPE), PLR, NLR and diagnostic odds ratio (DOR) were analyzed. After testing the heterogeneity results of literature by using the 95% confidence interval and the forest map.Results:A total of 4 studies were eligible for inclusion in the meta-analysis, which included 318 patients, 120 cases with bone metastasis and 198 cases without bone metastasis. The results of summary evaluation for ⁶⁸Ga-PSMA-PET/CT and bone scan in diagnosis of prostatic cancer as follow respectively: The SEN were 0.97 and 0.86; the SPE were 1.00 and 0.87; the DOR were 1468.33 and 36.23; PLR were 88.45 and 6.67; NLR were 0.05 and 0.19; and the area under curve (AUC) and 95% CI were 0.9973 (1.0000–0.9927) and 0.8838 (0.9584–0.8092).Conclusion:By comparing the diagnostic results of ⁶⁸Ga-PSMA-PET/CT and bone scan imaging diagnosis methods, the ⁶⁸Ga-PSMA-PET/CT has a higher SEN and SPE than bone scan, and it has a higher diagnostic efficiency for prostate cancer bone metastasis, which is worthy of clinical application.     

CHA2DS2-VASc score predicts the slow flow/no-reflow phenomenon in ST-segment elevation myocardial infarction patients with multivessel disease undergoing primary percutaneous coronary intervention

ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) have a higher incidence of slow-flow/no-reflow (SF-NR) phenomenon during primary percutaneous coronary intervention (PPCI) than those with single vessel disease. Currently, no effective tools exist to predict the risk of SF-NR in this population. The present study aimed to evaluate whether CHA₂DS₂-VASc score can be used as a simple tool to predict this risk.This study consecutively included STEMI patients hospitalized in Beijing Anzhen Hospital from January 2005 to January 2015. Among these patients, 1032 patients with MVD were finally enrolled. Patients were divided into SF-NR (+) group and SF-NR (–) group according to whether SF-NR occurred during PPCI. SF-NR was defined as the thrombolysis in myocardial infarction (TIMI) grade ≤2.There were 134 patients (13%) in the SF-NR (+) group. Compared with the SF-NR (–) group, patients in the SF-NR (+) group are elder, with lower left ventricular ejection fraction and higher CHA₂DS₂-VASc score. Multiple logistic regression analysis indicated that CHA₂DS₂-VASc score ≥3 (odds ratio [OR], 2.148; 95% confidence interval [CI], 1.389–3.320; P = .001), current smoking (OR, 1.814; 95% CI, 1.19–2.764; P = .006), atrial fibrillation (OR, 2.892; 95% CI, 1.138–7.350; P = .03), complete revascularization (OR, 2.307; 95% CI, 1.202–4.429; P = .01), and total length of stents ≥40 mm (OR, 1.482; 95% CI, 1.011–2.172; P = .04) were independent risk factors of SF-NR. The incidence of SF-NR in patients with CHA₂DS₂-VASc score ≥3 was 1.7 times higher than that in patients with CHA₂DS₂-VASc score <3. Additionally, patients with CHA₂DS₂-VASc score ≥3 plus ≥2 risk factors have 3 times higher incidence of SF-NR than those with CHA₂DS₂-VASc score ≥3 plus 0 to 1 risk factor.CHA₂DS₂-VASc score ≥3 can be used as a simple and sensitive indicator to predict SF-NR phenomenon and guide the PPCI strategy in STEMI patients with MVD.     

GATA3基因变异导致甲状旁腺功能减退症患者的临床特征和分子机制

目的分析GATA3基因变异导致甲状旁腺功能减退症(hypoparathyroidism, HP)患者的临床特点及分子机制。方法在1975年至2020年间于北京协和医院内分泌科随诊并行靶向基因捕获联合二代测序的198例未成年人(≤18岁)起病的非手术性HP患者中筛查到5例GATA3基因致病/可疑致病性变异, 回顾性收集分析其临床资料, 并对基因检测结果进行生物信息学分析。结果 5例患者HP的起病年龄为0.5(0.1, 1.3)岁, 发病至诊断为HP和甲状旁腺功能减退-耳聋-肾发育不良(hypoparathyroidism-deafness-renal dysplasia, HDR)综合征的时间分别为(7.0±5.2)年和(15.0±5.4)年。临床表现为手足搐搦伴癫痫样发作、颅内钙化各5例, 白内障1例, 听力减退4例, 肾脏畸形或缺如2例。治疗前血钙和血甲状旁腺激素(PTH)分别为(1.65±0.31)mmol/L和(4.64±2.63)ng/L。5例患者GATA3基因的杂合变异, 分别引起无义突变、移码突变和剪接位点突变, 经Clin Var数据库预测及美国医学遗传学和基因组学学会(...     

Myositis-specific autoantibodies and their clinical associations in idiopathic inflammatory myopathies: results from a cohort from China

Clinical Rheumatology - The purpose of this study was to determine the incidence of myositis-specific autoantibodies (MSAs) in a cohort of Chinese patients with idiopathic inflammatory myopathies...     

Standardized nursing and clinical efficacy of OxyContin in reducing oral mucosal pain in patients with nasopharyngeal carcinoma: A randomized,double-blind,placebo-controlled study protocol

Background:Pain caused by oral mucositis (OM) is the main problem in the process of concurrent chemoradiotherapy for the nasopharyngeal carcinoma (NPC). This protocol aims to explore the standardized nursing and therapeutic effect of OxyContin on OM pain in the patients with NPC undergoing the concurrent chemoradiotherapy.Methods:The experiment is a randomized clinical research, which was granted through the Research Ethics Committee of Shandong Provincial Third Hospital (No.20200802097). In this research, 90 NPC patients with OM induced by chemotherapy are enrolled, and the score of visual analogue >5 and the grade of OM >1 are evaluated. Patients with known allergy to OxyContin, the opioid abuse history, or major organ dysfunction, for instance, hepatic insufficiency, renal failure, and respiratory and heart failure, as well as a series of severe mental illness are excluded from our research. Patients in study groups receive standardized nursing and oral OxyContin. Patients in control groups only receive oral OxyContin. The analgesic effect could be assessed with the comparison of the visual analogue scale after and before the treatment. Safety evaluations contain the assessment of the vital signs, laboratory tests, as well as adverse events. The Karnofsky performance status standards of the International Cancer Control Union is utilized to evaluate the quality of life.Results:The comparison of outcomes after taking OxyContin in both groups will be shown in Table ​Table1Table1 .Table 1The comparison of outcomes after taking OxyContin in both groups.

Deciphering principles of morphogenesis from temporal and spatial patterns on the integument

Background : How tissue patterns form in development and regeneration is a fundamental issue remaining to be fully understood. The integument often forms repetitive units in space (periodic patterning) and time (cyclic renewal), such as feathers and hairs. Integument patterns are visible and experimentally manipulatable, helping us reveal pattern formative processes. Variability is seen in regional phenotypic specificities and temporal cycling at different physiological stages. Results: Here we show some cellular/molecular bases revealed by analyzing integument patterns. (1) Localized cellular activity (proliferation, rearrangement, apoptosis, differentiation) transforms prototypic organ primordia into specific shapes. Combinatorial positioning of different localized activity zones generates diverse and complex organ forms. (2) Competitive equilibrium between activators and inhibitors regulates stem cells through cyclic quiescence and activation. Conclusions: Dynamic interactions between stem cells and their adjacent niche regulate regenerative behavior, modulated by multi‐layers of macro‐environmental factors (dermis, body hormone status, and external environment). Genomics studies may reveal how positional information of localized cellular activity is stored. In vivo skin imaging and lineage tracing unveils new insights into stem cell plasticity. Principles of self‐assembly obtained from the integumentary organ model can be applied to help restore damaged patterns during regenerative wound healing and for tissue engineering to rebuild tissues. Developmental Dynamics 244:905–920, 2015. © 2015 Wiley Periodicals, Inc.