隐动脉筋膜蒂的交腿皮瓣修复小腿严重软组织缺损

目的探讨一种小腿严重软组织缺损的修复方法。方法以健侧隐动脉为蒂的顺行或逆行交腿皮瓣修复患侧小腿软组织缺损。结果本组8例均有效地覆盖受区创面,随访三个月,皮瓣全部成活。结论该皮瓣不牺牲小腿的重要血管,质地与受区相似,方法简单易行,血运可靠,血管蒂长,是修复小腿严重软组织缺损的较好方法。     

LncRNA-MAFG-AS1在结直肠癌中的表达及临床意义

目的 探讨LncRNA-MAFG-AS1在结直肠癌中的表达及临床意义。方法 选取我院行手术切除的结直肠癌组织及对应的癌旁正常组织各80例,应用定量即时聚合酶链锁反应(quantitative real time polymerase chain reaction, qRT-PCR)检测结直肠癌组织及癌旁正常组织中LncRNA-MAFG-AS1的表达水平,并分析其与结直肠癌临床病理特征之间的关系,所有患者随访截止日期到2019年12月31日,应用Kaplan-Meier(K-M)法进行生存分析,采用Cox回归模型分析结直肠癌预后的危险因素。结果 结直肠癌组织中LncRNA-MAFG-AS1相对表达量为2.398±0.214,高于癌旁正常组织的1.032±0.132,差异有统计学意义(P<0.05)。当患者TNM分期更高、中高分化及存在淋巴结转移和远期转移时,LncRNA-MAFG-AS1过表达(P<0.05)。K-M生存分析显示高表达患者无进展生存时间(progression-free survival, PFS)为(20.36±3.21)个月,低表达患者为(29.71±4....     

2022年欧洲临床营养与代谢学会和欧洲肥胖研究学会《肌肉减少性肥胖的定义和诊断标准共识》解读及启示

近年来,欧洲临床营养与代谢学会（ESPEN）和欧洲肥胖研究学会（EASO）的专家组成员对肌肉减少性肥胖（SO）的相关研究进行了系统地评价。2022年2月,ESPEN和EASO共同发布了《肌肉减少性肥胖的定义和诊断标准共识》,该共识对SO的定义和诊断进行了详细的阐述,旨在就SO的定义和诊断达成共识,为研究人员和临床工作者提供参考依据,以推进SO预防和治疗的发展。本文主要对《肌肉减少性肥胖的定义和诊断标准共识》中SO的定义,诊断流程包括筛查、诊断和分期标准,拟采用的方法和相关的参数等主要内容进行梳理和解读,旨在为国内医务工作者提供更多参考。     

新型冠状病毒肺炎预防与营养治疗方案汇总分析

目的:全面检索国内新型冠状病毒肺炎(以下简称:COVID-19)疫情发生以来预防与营养治疗的专家建议、指南及相关文献,就COVID-19预防与营养治疗策略做一分析总结,以期为临床应用提供参考。方法:检索国家卫生健康委、中医药管理局官方网站以及中国知网、万方、维普等相关数据库,纳入有关COVID-19预防与营养治疗的推荐方案(截止日期到2020年4月1日),分类汇总分析。结果:共检索出中文文献20篇,发表时间为2020年1月至3月。其中膳食营养预防5篇、营养治疗专家建议6篇、指南1篇、危重症病人规范化营养治疗路径1篇、营养评估1篇、个体化1篇、呼吸系统疾病营养支持系统评价1篇及特殊人群4篇。结论:合理的营养膳食以及时机恰当、方案个体化、监护常态化的营养支持是COVID-19预防及治疗过程中必不可少的手段之一,临床应在规范的前提下推广应用。     

Hand grip strength as a predictor of recovery from low back pain in the pregnant women-a prospective study

BackgroundLow back pain (LBP) is a common musculoskeletal problem during pregnancy with an estimated prevalence ranging from 30% to 78%. The symptoms usually disappear gradually after delivery, but some women may have persistent problems even later in their lives. The definite mechanism behind LBP during pregnancy remains unknown. Therefore, the purpose of this study was to investigate whether hand grip strength (HGS), which is a straightforward and reliable indicator of overall muscle strength, is associated with unrecovered LBP after delivery.Methods257 pregnant women who registered at obstetrics units in two tertiary hospitals from January 2016 to June 2017 and meanwhile suffered the LBP during pregnancy were included. They were grouped based on whether they recovered from LBP after delivery (recovery was de?ned as a pain rating of ≤3). The variables such as age, HGS, and education level were recorded and examined for the risk analysis of unrecovered LBP. Also, the Pearson correlation between HGS levels and pain intensities was investigated.ResultsLBP without recovery at two years after delivery was reported among 22.7% of the subjects. Women with increasing age, low HGS (<25 kg), LBP in a previous pregnancy, back pain, sick leave, and a large amount of physical demand (all p < 0.05), were more likely to report LBP without recovery. Besides, there was a significant correlation between HGS values and the intensities of LBP (r = ?0.525; p = 0.003).ConclusionsLow HGS has the highest OR value (adjusted OR = 9.12, P < 0.001) among these factors. The present findings may be used to design and encourage a specific stabilization exercise regime to build well stability of the lumbar spinal column and thus alleviating the LBP.     

Reconstruction of Soft Tissue Defects in the Hand with a Free Anterolateral Thigh Deep Fascia Flap

ObjectiveTo report our experience in the reconstruction of soft tissue defects in the hand with a free anterolateral thigh deep fascia flap and describe the clinical outcomes.MethodsThis study was a retrospective trial. From November 2016 to January 2020, six patients (four men and two women) with soft tissue defects in the hand were included in this study. The average age of the patients was 33.7 ± 12.7 years (range, 20 to 50 years). All patients underwent reconstructions with free anterolateral thigh deep fascia flaps. Relevant clinical characteristics were recorded prior to surgery. The size and thickness of the deep fascia flap and the thickness of the skin were measured intraoperatively. The survival of the flaps and skin grafts and the occurrence of infection were recorded after the operation. At follow‐up, donor site complications and postoperative effects were evaluated according to the outcome satisfaction scale. The pain in the injured hand was assessed using the visual analog scale.ResultsThe average body mass index (BMI) was 26.6 ± 1.7 kg/m² (range, 23.9 to 28.7 kg/m²). The defect sizes ranged from 5 cm × 5 cm to 13 cm × 8 cm (average, 53.1 ± 27.9 cm²). The six anterolateral thigh deep fascia flaps ranged from 7 cm × 6 cm to 14 cm × 9 cm in size (average, 71.8 ± 29.1 cm²). The thicknesses of skin ranged from 25 mm to 40 mm (average, 32.5 ± 4.8 mm), and the thicknesses of the deep fascia flaps ranged from 2 mm to 3 mm (average, 2.5 ± 0.5 mm). After the operation, the blood supply of the deep fascia flap was normal in all cases. The second‐stage skin grafts of most patients survived completely. The skin graft in one case was partially necrotic and healed after a dressing change. No infection occurred. At follow‐up (average, 16.3 ± 6.9 months), there was only a linear scar and no loss of sensation at the donor site of each patient. According to the outcome satisfaction scale, the outcome satisfaction score ranged from 6 to 8 (average, 7.2 ± 0.9), all of which were satisfactory. Apart from one patient who reported mild pain, all the other patients reported no pain. Three typical cases are presented in this article.ConclusionsThe free anterolateral thigh deep fascia flap, which is suitable for reconstruction of soft tissue defects in the hand, can provide very good outcomes both functionally and aesthetically.     

糖尿病性黄斑水肿抗VEGF治疗对视网膜毛细血管影响的研究进展

抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物对于治疗视网膜疾病,比如渗出性年龄相关性黄斑变性、糖尿病视网膜病变(diabetic retinopathy,DR)、视网膜静脉阻塞具有革命性意义。玻璃体腔内注射抗VEGF药物后能明显减轻黄斑水肿,但同时是否也会破坏视网膜微循环、加快视网膜毛细血管闭塞？本文通过相干光断层扫描血流成像(optical coherence tomography angiography,OCTA)和超广角眼底血管造影(ultra-widefield fluorescein angiography,UWFA)技术观察糖尿病性黄斑水肿(diabetic macular edema,DME)患者抗VEGF治疗对视网膜毛细血管的影响,从黄斑无血管区面积、无灌注区大小及血流密度三方面进行综述。     

412例真菌性角膜炎的回顾性分析

目的：对真菌性角膜炎患者的流行病学特征、实验室检查方法和结果及治疗效果进行分析,为真菌 性角膜炎诊治提供依据。方法： 回顾性系列病例研究。对2012年1月至2017年12月在冀中能源邢 台矿业集团总医院诊治的412例（412眼）真菌性角膜炎的流行病学特点、临床体征、病原学诊断方式、 结果及治疗效果采用Kruskal-Wallis H检验等统计学方法进行分析。结果：9-12月份是真菌性角膜 炎高发期,占全年患者总数的61.2%（252/412）。患病人群以农民为主,占59.5%（245/412）,植物性 外伤为首要病因者185例（44.9%）,其次为非植物性外伤86例（20.9%）。男女比例为1.82∶1。年龄 14～81（45.6±14.3）岁,41～60岁患者占53.9%（222/412）。真菌培养阳性率为88.8%（366/412）,高 于氢氧化钾湿片法[77.2%（318/412）],2种检测方式比较差异有统计学意义（χ2 =31.14,P<0.001）。 前几位的致病菌依次是镰刀菌属167例（40.5%）,链格孢菌属75例（18.2%）,曲霉菌属62例（15.0%）, 青霉菌属28例（6.9%）。真菌性角膜炎所致典型临床体征中以菌丝苔被最为常见（366例,88.8%）, 其次为伪足（224例,54.4%）、前房积脓（111例,26.9%）。镰刀菌属、链格孢菌属、曲霉菌属及青 霉菌属所致真菌性角膜炎的病情分级和预后水平比较差异均有统计学意义（Hc=40.676,P< 0.001; Hc=40.109,P<0.001）,显示镰刀菌属和曲霉菌属的病情分级重于链格孢菌属和青霉菌属,预后水平 也差于链格孢菌属和青霉菌属。结论：真菌性角膜炎患者呈逐年增多趋势;氢氧化钾湿片法和真菌 培养都是有效的诊断方法,镰刀菌属和曲霉菌属所致的真菌性角膜炎较链格孢菌和青霉菌引起的真 菌性角膜炎病情相对较重,且预后较差。