功能性垂体腺瘤患者性功能障碍的研究进展

 功能性垂体腺瘤不仅会产生内分泌紊乱的症状,而且常引发性功能障碍。功能性垂体瘤与性功能之间的关系逐渐得到重视,其发生机制可能与垂体肿瘤影响下丘脑-垂体-性腺轴有关。治疗上应首先治疗垂体肿瘤原发病,在肿瘤被切除或控制后,则可选择补充睾酮或应用磷酸二酯酶5型抑制剂治疗性功能障碍。本文就功能性垂体腺瘤患者性功能障碍的发病率、临床表现、发病机制、诊断及治疗的最新研究进展作一综述。     

Effect of light pressure stroking massage with sesame (Sesamum indicum L.) oil on alleviating acute traumatic limbs pain: A triple-blind controlled trial in emergency department

ObjectivesDue to adverse effects of common medications used for traumatic pain management, it is crucial to use complementary methods to alleviate this pain. Present study aimed to assess the effect of light pressure stroking massage with topical sesame oil on pain severity of patients with limbs trauma.MethodsThis triple-blinded randomized trial was conducted on 40 patients with upper or lower extremities trauma in emergency department of Busheher Amir Al-Momenian Hospital, Busheher, Iran, in 2015–2016. Patients received a 5 min massage with either liquid paraffin (placebo) or sesame oil on trauma site twice a day for 9 days duration. Pain severity was assessed by visual analogue scale in first day (baseline), 3th, 6th and 9th days of intervention in the both groups.ResultsMean changes of pain severity between two groups was significant in the 6th (−0.20 ± 1.36; P = 0.036) and 9th (−0.36 ± 1.12; P < 0.001) days of intervention. Regarding to intake of diclofenac, no significant difference was seen between sesame oil and placebo groups during 9 days of intervention (575.23 ± 3.11 and 625.13 ± 4.23 respectively, P = 0.601). There were no adverse effects during the study in the both groups.ConclusionMassage with topical sesame oil was associated with significant reduction in pain severity of patients with limbs trauma. Therefore, it is suggested to use this oil on complementary medicine for pain relief due to low cost, easy usage and lack of adverse effects.     

Efficacy and safety of traditional Chinese medicine on thromboembolic events in patients with atrial fibrillation: A systematic review and meta-analysis

ObjectivesTraditional Chinese medicine (TCM) in combination with Western medicine (WM) has been widely used worldwide. This systematic review aimed to evaluate the efficacy and safety of TCM in prevention of thromboembolic events in patients with atrial fibrillation (AF).MethodsPotential studies were searched through the Cochrane Library, PubMed, EMBASE, CBM, VIP, CNKI, and Wanfang databases up to February 2016. Randomized controlled trials (RCTs) investigating the thromboembolic events and/or safety outcome of TCM in patients with AF were included.ResultsA total of 905 AF patients from 9 RCTs were identified. Meta-analysis showed that TCM in combination with warfarin was better than warfarin alone for preventing total thromboembolic events with a 68% reduction of risk (risk ratio [RR] 0.32; 95% confidence interval [CI] 0.13–0.78) without increasing the risk of total bleeding (RR 0.71; 95% CI 0.29–1.72). Compared with warfarin, TCM therapy was associated with lower risk of total bleeding (RR 0.13; 95% CI 0.04–0.47), but increased the risk of total thromboembolic events (RR 1.84; 95% CI 1.03–3.27).ConclusionsThis meta-analysis suggests that TCM combined with warfarin is superior to warfarin alone for the prevention of total thromboembolic events in patients with AF, with equal risk of bleeding as warfarin alone.     

FHL1对肺腺癌细胞株A549生物学特性的影响

 目的 研究FHL1的表达对人肺腺癌细胞株A549生物学特征的影响。方法 以FHL1 mRNA及shRNA慢病毒载体转染肺腺癌细胞株A549,并采用Western blot及RT-PCR法筛选检测稳定过表达FHL1肺腺癌细胞株模型及低表达细胞株模型;运用CCK-8实验、Transwell实验、流式细胞仪、细胞集落形成实验等方法对其增殖、侵袭、凋亡及锚定非依赖性生长生物学特性进行检测评估。结果 FHL1稳定过表达及低表达组的Western blot及RT-PCR法检测显示病毒转染效果可靠稳定;CCK-8实验提示低表达组的细胞增殖情况明显高于过表达组及空白组(P=0.002 2);流式细胞仪检测提示过表达组的细胞总体凋亡率为50.48%,明显高于两个低表达组(16.41%、20.12%)及空白对照组(25.90%),差异有统计学意义(P<0.001);Transwell实验提示过表达组细胞表现出的侵袭性明显低于低表达组及空白组差异有统计学意义(P<0.001);成集落实验显示过表达组细胞株形成的集落数为28.7±6.0,明显少于两个低表达组(157.0±6.4、150.7±9.5),差异有统计学意义(P<0.001)。结论 稳定过表达FHL1肺腺癌细胞株A549模型及低表达模型构建成功。FHL1的表达对于肺腺癌细胞株A549的增殖、侵袭及转移均有抑制作用,并能够诱导其加速凋亡。     

Intake of fruit and vegetables and risk of bladder cancer: a dose–response meta-analysis of observational studies

Background

Observational studies suggest an association between fruit and vegetables intake and risk of bladder cancer, but the results are controversial.

Methods

We therefore summarized the evidence from observational studies in categorical, linear, and nonlinear, dose–response meta-analysis. Pertinent studies were identified by searching EMBASE and PubMed from their inception to August 2013.

Results

Thirty-one observational studies involving 12,610 cases and 1,121,649 participants were included. The combined rate ratio (RR, 95 % CI) of bladder cancer for the highest versus lowest intake was 0.83 (0.69–0.99) for total fruit and vegetables, 0.81 (0.70–0.93) for total vegetables, 0.77 (0.69–0.87) for total fruit, 0.84 (0.77–0.91) for cruciferous vegetables, 0.79 (0.68–0.91) for citrus fruits, and 0.74 (0.66–0.84) for yellow–orange vegetables. Subgroup analysis showed study design and gender as possible sources of heterogeneity. A nonlinear relationship was found of citrus fruits intake with risk of bladder cancer (P _{for nonlinearity} = 0.018), and the RRs (95 % CI) of bladder cancer were 0.87 (0.78–0.96), 0.80 (0.67–0.94), 0.79 (0.66–0.94), 0.79 (0.65–0.96), and 0.79 (0.64–0.99) for 30, 60, 90, 120, and 150 g/day. A nonlinear relationship was also found of yellow–orange vegetable intake with risk of bladder cancer risk (P _{for nonlinearity} = 0.033). Some evidence of publication bias was observed for fruit, citrus fruits, and yellow–orange vegetables.

Conclusion

This meta-analysis supports the hypothesis that intakes of fruit and vegetables may reduce the risk of bladder cancer. Future well-designed studies are required to confirm this finding.     

Asymmetry between the superior and inferior endplates is a risk factor for lumbar disc degeneration

Endplate pathology plays an important role in the development of lumbar disc degeneration. Previous research paid little attention to differences between the superior and inferior endplates as a possible risk factor for disc degeneration. The purpose of this study was to test the hypothesis that asymmetry between the superior and inferior endplates is a risk factor for the development of lumbar disc degeneration. A total of 134 patients with lumbar disc herniation (LDH) and 100 healthy adults (“Controls”) underwent magnetic resonance imaging scans. Each disc was categorized as non‐degenerated (Pfirrmann grades I–II) or degenerated (Pfirrmann grades III–V) and get the following three groups: “Degenerated LDH” discs (n = 145), “Non‐degenerated LDH” discs (n = 525) and “Non‐degenerated Control” discs (n = 500). On mid‐sagittal image, the lumbar endplate morphology could be categorized into three types: Flat, concave, and irregular. Superior and inferior endplates of a given disc were “symmetric” if both were of the same type, and “asymmetric” if they were of different types. The proportion of asymmetric endplates at L4–5 was higher in the “Degenerated LDH” discs group (47%) than in the “Non‐degenerated LDH” discs group (21%) or “Non‐degenerated Control” discs group (7%) (p < 0.05). At L5‐S1 the proportions were 73%, 55%, and 38% (p < 0.05). Asymmetry of superior and inferior endplates in the mid‐sagittal plane is a risk factor for lumbar disc degeneration. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2469–2475, 2018.

     

有限切开微型钢板与克氏针内固定治疗掌骨骨折的对比研究

目的观察有限切开微型钢板与克氏针内固定治疗掌骨骨折的疗效及其并发症发生率。方法选择70例掌骨骨折患者,其中男性50例,女性20例;年龄18~60岁,平均年龄36.66岁。随机分为观察组和对照组,每组各35例。观察组予以有限切开微型钢板内固定,对照组予以克氏针内固定。观察两组治疗的疗效、手术时间、术中出血量、骨折愈合时间、住院时间和并发症发生率。结果观察组优良率明显高于对照组(97.14%vs 77.14%),差异有统计学意义(χ2=4.590,P0.05)。观察组与对照组手术时间和术中出血量相比(28.32 min±2.78 min vs 27.86 min±1.37 min、16.83 m L±3.27 m L vs15.29 m L±4.32 m L),差异均无统计学意义(P0.05),而观察组骨折愈合时间和住院时间明显短于对照组(14.29%vs42.86%;P0.01)。观察组并发症发生率明显低于对照组(χ2=4.375,P0.05)。结论有限切开微型钢板内固定治疗掌骨骨折疗效确切,具有微创、术后恢复快、并发症低等优点,是掌骨骨折治疗的理想选择。     

慢性肾小球肾炎患者外周血Th1/Th2及CD28~+细胞的变化及其临床意义

目的探讨慢性肾小球肾炎(CGN)患者外周血Th1/Th2及CD28+细胞百分率的变化在疾病进程中可能的细胞免疫学机制。方法采用流式细胞术检测50例CGN患者及30名正常人(对照组)外周血Th1/Th2和CD28+细胞的百分率,用SPSS 16.0软件对试验结果进行统计分析。结果与对照组比较,CGN患者外周血CD3+CD4+细胞百分率和CD4/CD8比值明显降低(P0.05),Th1和Th2细胞百分率差异无统计学意义(P0.05),但Th1/Th2比值明显增高(P0.05);CGN患者CD28+、CD4+CD28+细胞百分率明显减少(P均0.01)。结论 CGN患者体内T细胞免疫功能紊乱和活化受限,细胞免疫功能低下,Th1和Th2细胞失衡,通过对CGN患者外周血Th1/Th2及CD28+细胞的检测,有助于了解患者的细胞免疫状态,为临床诊断和免疫治疗提供参考依据。     

上海市闵行区中老年人群颈动脉粥样硬化现状及危险因素分析

目的通过超声检查了解上海市闵行区中老年人群颈动脉粥样硬化现状,分析相关危险因素,为该地区中老年心脑血管疾病的预防和诊治提供依据。方法选择2013年1月~2014年5月在复旦大学附属上海市第五人民医院行颈动脉超声检查的闵行区中老年人共3100名,年龄40~90岁,其中,男、女分别为1504、1596名,将受试者按年龄段分成五组进行问卷调查、体格检查及颈动脉检查,并对相关危险因素进行统计学分析。结果 1颈动脉内膜-中层厚度(carotid intima-media thickness,CIMT)增厚及颈动脉粥样硬化(carotid artery atherosclerotic,CAS)斑块检出率分别为61.6%、50.2%,其中,男性分别为33.5%、26.5%,女性为28.1%、23.7%;颈动脉狭窄检出率为12.1%,以轻、中度为主,分别为6.1%、3.4%。2性别、年龄、高血压、糖尿病、脑梗死及吸烟在CIMT增厚组与非增厚组间比较,差异有统计学意义(P<0.05);性别、年龄、高血压、糖尿病、脑梗死、冠心病及吸烟在CAS斑块组与非斑块组间比较,差异有统计学意义(P<0.05)。3多因素Logistic回归分析显示,CIMT增厚的危险因素为性别、年龄、高血压及吸烟(P<0.05);CAS斑块形成的危险因素为性别、年龄、高血压、脑梗死、冠心病及吸烟(P<0.05)。结论 1随着年龄的增长,中老年人群CAS程度呈逐渐加重的趋势,且男性CAS程度较女性显著;2性别、年龄、高血压及吸烟是CIMT增厚的独立危险因素;3性别、年龄、高血压、脑梗死、冠心病及吸烟是CAS斑块形成的独立危险因素。     

2型糖尿病病人胰岛素注射意愿与糖化血红蛋白、胰岛素注射技能相关性分析

[目的]探讨2型糖尿病病人胰岛素注射意愿与糖化血红蛋白(HbA1c)、胰岛素注射技能相关性,为开展胰岛素注射技能教育提供理论依据。[方法]采用方便抽样法选取200例2型糖尿病病人,进行规范化胰岛素注射技能教育,测量病人住院及出院3个月后的HbA1c,采用胰岛素注射技能评价表对病人出院时及出院后3个月的胰岛素注射技能进行评分。[结果]以四分位法将200例2型糖尿病病人按出院3个月后继续注射胰岛素意愿分为4组,Q4组(9.0分及以上)的病人占40.0%;出院时及出院3个月后的HbA1c差值比较,Q2组、Q4组与Q1组比较差异有统计学意义(P0.05),Q3组与Q1组比较差异有统计学意义(P0.01);出院时及出院3个月后的胰岛素注射技能得分差值比较,4组组间比较差异均有统计学意义(P0.01);Spearman相关分析结果显示:2型糖尿病病人出院时胰岛素注射技能得分与继续使用胰岛素注射意愿呈负相关(r=-0.595,P0.01),病人出院3个月后胰岛素注射技能得分与继续使用胰岛素注射意愿呈正相关(r=0.233,P0.01),病人出院时及出院3个月后的胰岛素注射技能得分差值与继续使用胰岛素注射意愿呈正相关(r=0.846,P0.01);多元线性逐步回归分析显示:病人出院时及出院3个月后的胰岛素注射技能得分差值是影响2型糖尿病病人继续使用胰岛素注射意愿的一个独立因素。[结论]病人出院3个月后继续使用胰岛素注射意愿并不高,糖尿病专科护士在为病人制定并实施技能教育时可以充分考虑到相关影响因素,从而制定更为有效的教育手段,以提高2型糖尿病病人胰岛素治疗的意愿。