Association of Kir6.2 gene rs5219 variation with type 2 diabetes: A meta-analysis of 21,464 individuals

Aims

rs5219 is in Potassium inwardly-rectifying channel, subfamily J, member 11 (KCNJ11) E23K gene, located at 11p15.1. Researches on the association between rs5219 gene polymorphism with type 2 diabetes mellitus (T2DM) were performed extensively, but the results remain controversial. To investigate the relationship, a meta-analysis involving 21,464 individuals was conducted.

The Study on the Efficacy of Fibrin Glue in Preventing Post-traumatic Focal Pancreatitis (PTFP) After Radical Gastrectomy

Objective

This study was intended to evaluate the efficacy of fibrin glue (FG) in preventing post-traumatic focal pancreatitis (PTFP) after radical gastrectomy by examining the drainage fluids over 7 days post-op.

Methods

Ninety-five patients who underwent D2 radical gastrectomy for gastric cancer were randomly assigned to a fibrin glue group (n?=?48) receiving fibrin glue on the raw surface of the pancreas during surgery and a control group (n?=?47), which did not receive fibrin glue.

Results

We found no significant difference in operation time and intraoperative blood loss between groups (p?>?0.05); no deaths occurred during surgery. The volume of ascitic fluid containing blood cells in the fibrin glue group was significantly lower than that in the control group (p?<?0.001) at all times observed. Amylase levels in the drained fluids were highest at 24 h postoperatively in both groups, suggesting pancreatitis, but gradually decreased to normal levels within 7 days. The amylase in the drains in the control group was significantly higher than that in the FG group (p?<?0.001) at all times observed, but it returned to normal 72 h postoperatively in the FG group. One death by hemorrhagic shock associated with PTFP was recorded in the control group.

Conclusion

Fibrin glue is safe and effective in preventing PTFP following gastric surgery and shortens the clinical course of the disease.     

INSM1在肺神经内分泌肿瘤活检标本和细胞学样本中的表达

目的:分析胰岛素瘤相关蛋白-1 (insulinoma-associated protein 1,INSM1)在肺神经内分泌肿瘤组织学和细胞学样本中的表达。方法:采用免疫组织化学En Vision两步法检测INSM1在193份活体组织检查(以下简称活检)标本及80份细胞学标本中的表达,其中包括:肺小细胞癌(42份)、肺大细胞神经内分泌癌(6份)、低级别肺神经内分泌肿瘤(19份)、肺腺癌(69份)、肺鳞癌(57份)活检标本及肺小细胞癌(9份)、肺腺癌(48份)和间皮细胞增生(23份)细胞学样本。结果:1) INSM1在肺小细胞癌,肺大细胞神经内分泌癌和低级别肺神经内分泌肿瘤中的阳性率分别为90.5%(38/42),66.7%(4/6),94.7%(18/19),显著高于肺腺癌(2.9%,2/69)、肺鳞癌(1.8%,1/57)中的阳性率(均P<0.01)。2)INSM1在肺小细胞癌细胞学样本中全部呈阳性表达,显著高于肺腺癌(2.1%, 1/48)和反应性间皮细胞增生(0,0/23)中的阳性率(均P<0.01)。3) INSM1免疫组织化学染色在32份活检和细胞学配对的标本中检测结果具有高度一致性(κ=1)。4) INSM1在肺神经内分泌肿瘤中的敏感性为90.1%(64/71),显著高于突触小泡蛋白(synaptophysin,Syn)和嗜铬粒蛋白A (chromogranin A,Cg A)(均P<0.001)。5)INSM1在肺神经内分泌肿瘤中的特异性为97.6%,显著高于Sy n(P<0.05),但是与Cg A相比差异无统计学意义(均P>0.05)。结论:INSM1在肺神经内分泌肿瘤中高表达,是鉴别诊断肺神经内分泌肿瘤比较可靠的标志物。     

Intravenous butorphanol administration reduces intrathecal morphine-induced pruritus after cesarean delivery: a randomized, double-blind, placebo-controlled study

Purpose

Pruritus associated with intrathecal opioid administration is a common side effect. There is evidence that κ-opioid receptor agonists have antipruritic activity. Butorphanol has agonist actions at both κ-opioid and μ-opioid receptors. This study was designed to evaluate the antipruritic efficacy of butorphanol after intrathecal morphine administration in the setting of a randomized, double-blind study of parturients undergoing cesarean section.

Methods

Ninety-one women who received combined spinal–epidural anesthesia with 1.2?ml 0.5?% isobaric bupivacaine and 0.1?mg preservative-free morphine were included in this study. After delivery of the baby, the parturients were randomly allocated to two groups: butorphanol group (n?=?46) and physiological saline group (n?=?45). In the butorphanol group, parturients received an intravenous loading dose of 1?mg butorphanol followed by infusion of 0.2?mg/h butorphanol. The physiological saline group received an infusion of the same volume of physiological saline. The presence of pruritus, visual analog scores for pain, sedation scores, and adverse effects were recorded 1, 2, 4, 6, 8, 10, 12, and 24?h after intrathecal morphine administration.

Results

The incidence of pruritus at 24?h was significantly more frequent in the physiological saline group than in the butorphanol group (48.9 vs. 13.0?%, P?<?0.001). The severity of pruritus was significantly greater in the saline group than in the butorphanol group 2, 4, 6, 8 and 10?h after intrathecal morphine injection (P?=?0.004, 0.001, 0.002, and 0.003, respectively). The visual analog scale scores at 24?h were significantly lower in the butorphanol group than in physiological saline group (P?<?0.001). The Ramsay sedation score in the butorphanol group was significantly higher than that in the physiological saline group after 1, 2, 4, 6, 8, 10, 12, and 24?h (P?<?0.05). There were no significant differences between the two groups in nausea/vomiting and other adverse effects.

Conclusion

Administration of intravenous butorphanol after delivery of the baby can reduce pruritus that has been induced by intrathecal morphine administration in cesarean delivery with combined spinal–epidural anesthesia.     

黄煌经方内科医案(六)——睡眠障碍治验2则

睡眠障碍为中医科常见病症。黄煌老师从体质辨证入手,选用柴胡加龙骨牡蛎汤、温胆汤、栀子厚朴汤、酸枣仁汤、黄连阿胶汤、百合知母汤、八味活血汤、八味解郁汤、八味除烦汤、柴归汤、温经汤、桂枝加龙骨牡蛎     

黄煌经方内科医案赏析(一)——呼吸系统疾病治验2则

医案是中医临床的记录。医案的阅读与整理是中医传统的学习与研究方式。对于中医临床医生来说,日常医案的整理与研究是必不可少的工作。因为方证的识别以及所谓的"同病异治""异病同治",主要是以个体差异为基础,而反映个体差异的临床文件,以中医医案为著。医案所表现出的现场感、个体特征,能帮助读者进一步理清思路,加强对经方方证的认识。我认为,初学者固然要认真抄录和整理老师的个案,研究人员更要注重专题个案的分析与研究。薛蓓云、李小荣两学生整理总结的本人内科医案,记录详实,分析细致,开掘深入,可为楷模。     

完全植入式输液港植入术后导管头端异位介入复位6例北大核心CSCD

目的 探讨完全植入式输液港(TIAP)植入术后导管头端异位的原因、确诊方法及处理措施。方法 回顾性分析2016年3月至2021年12月在江阴市人民医院接受TIAP植入术的2 234例患者临床资料。记录术后导管头端异位发生率、发生时间,分析原因,评价处理措施。结果 2 234例患者均成功植入TIAP。6例(0.27%)术后发生导管头端异位,均经影像学检查证实。6例中男4例,女2例,年龄(61.5±18.2)岁,26~79岁。TIAP植入至发现导管头端异位时间为18~119 d,主要原因为导管位置过浅、剧烈咳嗽、肢体活动和肥胖。采用介入猪尾导管勾挂法,6例导管头端异位均获成功复位。1例复位后再次异位,后取出TIAP并经锁骨上入路穿刺锁骨下静脉重新植入TIAP,未再出现异位。结论 TIAP植入术后导管头端异位发生率低,易于确诊和复位。介入猪尾导管勾挂法复位简便、安全,但仍需警惕因导管头端异位所导致的不良后果。     

Characterization of the contribution of buccal absorption to internal exposure to bisphenol A through the diet

The gavage route is often used for the toxicological evaluation of food contaminants. This route does not take into account absorption of the toxicants through the buccal mucosa, as evidenced in dogs for bisphenol A (BPA). Our goal was to determine the functional significance of buccal BPA absorption during dietary exposure. Four ewes received BPA by nasogastric gavage (100 mg/kg) and through food pellets (10 mg/kg), 13 days apart. The time course of serum concentrations of BPA and its main metabolite BPA-G was submitted to non-compartmental analysis. The dietary route led to 3-fold higher bioavailability as compared to gavage. The ratio of BPA-G to BPA concentrations varied greatly over time after the food administration, but not after gavage, suggesting a delayed metabolism of BPA after dietary exposure. The maximum entrance rate of BPA in the systemic circulation, determined by deconvolution analysis, was much higher after dietary administration than after gavage and a biphasic pattern of BPA entry was observed in 3 of the 4 ewes. Our results evidenced a dual mechanism of BPA absorption (buccal and digestive) after dietary exposure and highlight the necessity to take buccal absorption into account when evaluating food contaminants.     

高眼压青光眼白内障三联手术的临床观察

目的:探讨高眼压状态下白内障青光眼联合术的临床疗效。方法:对18例18眼白内障青光眼患者在高眼压下行小切口非超声乳化白内障囊外摘出人工晶状体植入联合小梁切除术,术后观察视力,眼压及并发症情况。结果:术后眼压均比术前用降眼压药的情况下明显下降,11～22mmHg者17例,其中眼压26mmHg者1例。术后视力均较术前有不同程度的提高,术后并发症发生率及严重程度并不比小梁切除术或白内障囊外摘除人工晶状体植入术高。结论:在高眼压下行小切口非超声乳化白内障囊外摘出人工晶状体植入联合小梁切除术发生并发症的机会增多,但仍是一种安全、有效的治疗白内障合并青光眼的联合手术。     

黄煌运用《金匮要略》薯蓣丸治疗肿瘤验案分析

薯蓣丸出自《金匮要略·血痹虚劳病脉证并治第六》：“薯蓣三十分,当归、桂枝、 、干地黄、豆卷各1分,甘草二十八分,人参七分,芎窮、芍药、白术、麦门冬、杏仁各六分,柴胡、桔梗、