先天性脊柱侧凸与青少年特发性脊柱侧凸矫形术中神经电生理监测对比分析

目的:对比分析先天性脊柱侧凸(congenital scoliosis,CS)和青少年特发性脊柱侧凸(adolescence idio-pathic scoliosis,AIS)患者脊柱后路矫形术中神经电生理监测(intraoperative neurophysiological monitoring,IONM)的结果...     

石斛属菲类成分及其药理作用研究进展

菲类化合物是石斛属植物的特征成分之一,可分为简单菲、二氢菲、双菲及菲醌（酮）等菲衍生物4种类型。综述了金钗石斛、铁皮石斛、束花石斛、细茎石斛、流苏石斛、密花石斛、鼓槌石斛、曲轴石斛、石斛兰和绒毛石斛10种石斛属植物中毛兰菲、鼓槌菲、杓兰素等20个菲类活性成分,并介绍其抗肝纤维化、抗肿瘤、抗炎、抗氧化、降血糖等药理活性,希望为该属植物的新药研发和临床应用提供参考。     

Intra-Operative Neurophysiological Monitoring in Patients with Thoracic Spinal Stenosis: Its Feasibility and High-Risk Factors for New Neurological Deficit

Objective

Considering the high risk of postoperative neurological complications for patients with thoracic spinal stenosis (TSS), intra-operative neurophysiological monitoring (IONM) has been used for detecting possible iatrogenic injury timely. However, the IONM waveforms are often unreliable. This article is designed to determine the test performance of somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) during surgical thoracic decompression in patients with TSS, and to investigate the risk factors associated with deteriorated neurologic function at immediate postoperation.

Methods

Patients undergoing posterior spinal fusion from February 2009 to December 2020 were retrospectively reviewed. Patients were divided into the deteriorated neurologic function (DNF) group and the improved/intact neurological function (INF) group based on the postoperative neurological status. Demographic parameters such as gender, age, height, weight, etiology and IONM data were compared between groups. Demographics and IONM data between DNF and INF groups were compared by independent t or nonparametric tests. The incidence of abnormal SEP was analyzed by Chi-square test.

Results

A total of 108 patients (63 males, 45 females) with an average age of 53.5 ± 14.0 years were included. The SEP and MEP records were available in 94 and 98 patients, with the overall success rates being 87.0% and 90.7%, respectively. The sensibilities and specificities were 100% and 88.2% for SEP, 100% and 98.8% for MEP, respectively. There were 17 patients in DNF group and 91 patients in INF group. High weight (79.1 ± 14.6 vs 69.7 ± 15.7 kg, P = 0.024), high inter-side difference of MEP amplitude (899.1 ± 997.5 vs 492.3 ± 512.4 μV, P = 0.013) and high incidence of abnormal SEP (94.1% vs 64.8%, P = 0.024) were observed in the DNF group. Fourteen (82.4%) patients in the DNF group showed improvement in neurological status during follow-up.

Conclusions

The overall success rates were 87.0% for SEP and 90.7% for MEP in patients with TSS.     

石斛属中药生物碱抗肿瘤药理作用及机制研究进展

石斛属 Dendrobium Sw. 中药生物碱类成分结构新颖,药理作用丰富多样,特别是在抗肿瘤方面的表现尤为突出,多种石斛属中药生物碱已被证实对肺癌、胃癌、肝癌、乳腺癌、结肠癌、宫颈癌等有显著的抗肿瘤活性,显示出新药开发潜力。但目前对其抗肿瘤药理作用及机制的系统分析仍然不足,使得在理解和应用石斛属生物碱的过程中存在一定的盲点和局限性。梳理并深入探讨石斛属中药生物碱成分对不同癌症的药理作用,对其常规的抗肿瘤作用机制如诱导肿瘤细胞凋亡、增强机体免疫功能、抑制肿瘤细胞的迁移、细胞周期调控进行解析,并揭示其可能的作用靶点,为其在抗肿瘤研究领域的深入探索和开发利用提供有力的参考和依据。