多裂肌间隙入路与经皮入路联合伤椎置钉治疗无神经损伤的胸腰段椎体骨折的对比研究

目的 探讨多裂肌间隙入路和经皮入路分别联合伤椎置钉治疗无神经损伤胸腰段椎体骨折的临床疗效。方法 回顾性分析苏州大学附属第一医院2015年1月-2018年1月采用多裂肌间隙入路和经皮入路分别联合伤椎置钉治疗无神经损伤的胸腰段椎体骨折的52例患者的临床资料。经多裂肌间隙入路患者25例(A组),男19例、女6例,年龄35~67 (49.84±9.11)岁;经皮入路患者27例(B组),男20例、女7例,年龄21~66(48.44±11.02)岁。比较两组患者一般资料,以及手术出血量、手术时间、术后镇痛药物使用率、术后下地时间及术后住院时间;手术前后不同时间点的腰背部疼痛视觉模拟评分(VAS);比较两组手术前、术后下地前及术后12个月时伤椎前缘高度比值和矢状位Cobb角变化。结果 两组患者一般资料比较差异均无统计学意义(P值均＞0.05)。均顺利完成手术,术后随访12个月。A组的手术时间、术后下地时间分别为120(90,136)min、2(1,3)d,均短于B组的144(110,220)min、4(2,5)d,差异均有统计学意义(P值均＜0.05);A组术后使用镇痛药物例数(2例)少于B组(15例),差异有统计学意义(P＜0.05);两组患者手术出血量、术后住院时间差异均无统计学意义(P值均＞0.05)。两组患者术后VAS评分均较术前有明显改善,差异均有统计学意义(P值均＜0.01);A、B组间术前、术后12个月VAS评分比较,差异均无统计学意义(P值均＞0.05),但术后第3天VAS评分比较,A组低于B组,差异有统计学意义(P＜0.05)。两组患者术后下地前及术后12个月伤椎前缘高度比值、矢状面Cobb角较术前改善明显,差异均有统计学意义(P值均＜0.05),但两组间同时间点伤椎前缘高度比值和矢状面Cobb角比较差异均无统计学意义(P值均＞0.05)。结论 多裂肌间隙入路和经皮入路分别联合伤椎置钉治疗无神经损伤的胸腰段椎体骨折均取得良好疗效,在改善骨折畸形及远期腰背部疼痛上无明显差异,但经皮入路手术时间更长、术后短期腰背部疼痛更严重、下地时间更晚,相较于多裂肌间隙入路手术并不具有明显优势。     

Fe-Ga合金磁特性测试装置的设计与实验

设计了一种新型Fe-Ga合金磁特性测试装置。建立了该测试装置磁路部分三维有限元磁场分析模型，在该模型基础上通过调整结构和元件尺寸优化了磁路结构，并制作了样机。搭建了磁特性测试装置的实验平台，进行了Fe-Ga合金磁特性测试。实验结果表明，该装置可对Fe-Ga合金磁致伸缩棒材磁致伸缩效应和逆磁致伸缩效应进行静态、准静态和动态测量，测量结果与国外报道的结果一致。设计的磁特性测试装置具有稳定可靠、精度高、操作简单、自动记录等优点。该装置还适用于Fe-Ni、Fe-Co等饱和磁场低的磁致伸缩材料的磁特性测量。     

HE4 as a predictor of adjuvant chemotherapy resistance and survival in patients with epithelial ovarian cancer

The aim of this study was to investigate the value of serum human epididymis protein 4 (HE4) and HE4 tissue protein expression to predict tumor resistance to adjuvant chemotherapy, progression‐free survival (PFS), and overall survival in patients with epithelial ovarian cancer (EOC). Consecutive inclusion of 198 patients diagnosed with EOC was conducted. Blood samples were collected prior to surgery and tissue samples during surgery. Patient data were registered prospectively in the Danish Gynecologic Cancer Database. The association between serum HE4 and HE4 tissue protein expression, resistance to adjuvant chemotherapy, PFS, and overall survival were analyzed in univariate analyses and in multivariate analyses adjusted for age, performance score, surgical outcome, stage, grade, and histological subtype. Serum HE4 levels predicted chemotherapy resistance, PFS, and overall survival correlated significantly (p < 0.001) in the univariate analyses; but after adjustment in a multivariate model, serum HE4 was insignificant, except in a subgroup analysis of postmenopausal women, where serum HE4 significantly predicted resistance to chemotherapy and progression‐free survival. HE4 tissue protein expression predicted PFS (p = 0.022) and overall survival (p = 0.047) in the univariate analysis, while HE4 tissue protein expression failed to predict these outcomes in the adjusted multivariate analyses. Serum HE4 or HE4 tissue protein expression are not independent factors of chemotherapy resistance or survival in patients with EOC, but serum HE4 might predict chemotherapy resistance and PFS in postmenopausal women.     

GSK3β inhibitor promotes myelination and mitigates muscle atrophy after peripheral nerve injury

Delay of axon regeneration after peripheral nerve injury usually leads to progressive muscle atrophy and poor functional recovery. The Wnt/β-catenin signaling pathway is considered to be one of the main molecular mechanisms that lead to skeletal muscle atrophy in the elderly. We hold the hypothesis that the innervation of target muscle can be promoted by accelerating axon regeneration and decelerating muscle cell degeneration so as to improve functional recovery of skeletal muscle following peripheral nerve injury. This process may be associated with the Wnt/β-catenin signaling pathway. Our study designed in vitro cell models to simulate myelin regeneration and muscle atrophy. We investigated the effects of SB216763, a glycogen synthase kinase 3 beta inhibitor, on the two major murine cell lines RSC96 and C2C12 derived from Schwann cells and muscle satellite cells. The results showed that SB216763 stimulated the Schwann cell migration and myotube contraction. Quantitative polymerase chain reaction results demonstrated that myelin related genes, myelin associated glycoprotein and cyclin-D1, muscle related gene myogenin and endplate-associated gene nicotinic acetylcholine receptors levels were stimulated by SB216763. Immunocytochemical staining revealed that the expressions of β-catenin in the RSC96 and C2C12 cytosolic and nuclear compartments were increased in the SB216763-treated cells. These findings confirm that the glycogen synthase kinase 3 beta inhibitor, SB216763, promoted the myelination and myotube differentiation through the Wnt/β-catenin signaling pathway and contributed to nerve remyelination and reduced denervated muscle atrophy after peripheral nerve injury.     

Nonmotor symptoms of 820 Taiwanese patients with Parkinson’s disease: an exploratory-comparative study

Journal of Neurology - Nonmotor symptoms (NMSs) severely affect the daily quality of life of patients with Parkinson’s disease (PD). Although many studies have documented the clinical...     

Risk factors for internal carotid artery injury in adults during simple nasopharyngeal surgeries

The purpose of this study attempted to analyze the potential risk factors for internal carotid artery injury during simple nasopharyngeal surgeries with or without an endoscopic aid. One hundred and seventy magnetic resonance imaging scans (340 halves) of the brain were retrospectively reviewed and studied. Anatomic variations of carotid arteries were classified, and various distances from the internal carotid arteries to the nasopharyngeal subsites were directly measured on the scans. The mean distances between the internal carotid arteries and nasopharyngeal subsites were significantly shortened in patients with nasopharyngeal internal carotid artery aberrancy, female gender, and lower body weight. The distance to the posterior nasopharyngeal wall was also shortened with age. However, the severity of nasopharyngeal carotid artery variations (kinking and coiling) did not reflect the shortening of mean distances to nasopharyngeal subsites. In conclusion, from multiple linear regression analysis, we found that the risk of an internal carotid artery injury during simple nasopharyngeal surgeries with or without an endoscopic aid is greatest in adult patients with nasopharyngeal carotid artery aberrancy, followed by female gender, lower body weight, and increasing age.