A Ca2+ chelator ameliorates chromium (VI)-induced hepatocyte L-02 injury via down-regulation of voltage-Dependent anion channel 1 (VDAC1) expression

Hexavalent chromium could result in cell malfunctions. Intracellular Ca²⁺ ([Ca²⁺]_i) content and VDAC1 expression are both important features related to cell survial. This study aimed to explore the mechanism of cell injury induced by Cr(VI) and tentatively offer clues to repairing this cell damage using [Ca²⁺]_i and VDAC1. L-02 hepatocytes were treated with Cr(VI)/BAPTA, and the levels of [Ca²⁺]_i and cell injury associated with Cr(VI) were determined in addition to the effect of BAPTA. The expression of VDAC1 in Cr(VI)-induced cells was evaluated. The results showed a dose-dependent elevation of the level of VDAC1 and the mRNA level of the VDAC1 biogenesis-related gene Sam50. BAPTA could ameliorate less severe damage induced by 4 μM Cr(VI) via reducing VDAC1 and Sam50. Additionally, cell injury caused by less than 4 μM Cr(VI) could be ameliorated by VDAC1 knockdown. Taken together, the findings of this study suggest that inhibition of intracellular Ca^2± overload could protect cells from damage and that VDAC1 plays a considerable role in Cr(VI)-induced liver injury.     

人结直肠锯齿状腺癌的研究现状

结直肠锯齿状腺癌（serrated adenocarcinoma，SAC）作为大肠癌的一种特殊临床类型，因其癌变途径的特殊性，检测以及较差的治疗反应和预后逐渐引起众多研究者的兴趣。其产生的途径主要为“锯齿状通路”途径，锯齿状通路途径以BRAF突变、微卫星体不稳定（microsatellite instability，MSI））和CpG岛的甲基化（CpG island methylator phenotype，CIMP）为特征。由于特殊的形态和内镜特征及特殊的发生部位，在结肠镜检查时很容易漏诊，甚至病理评估时也极易被忽视，临床确诊时往往已处于进展期，患者预后差，生存率低。本文针对锯齿状结直肠腺癌流行病学、危险因素、临床特征、病理学特征、分子特征等作一综述。     

多囊卵巢综合征伴胰岛素抵抗对生育影响的研究进展

多囊卵巢综合征（PCOS）是育龄妇女常见的内分泌性疾病，跨越了妇女生命的全过程，以高胰岛素血症、高雄激素血症和（或）无排卵为特征，目前病因尚不明确，然而胰岛素抵抗（IR）是PCOS患者常见的代谢紊乱性疾病。由此产生的高胰岛素血症可导致激素水平改变、卵泡生长受限、子宫内膜容受性改变，增加流产率或导致不孕等，同时可增加妊娠合并症的发病率，甚至让患者产生焦虑、抑郁等心理问题，因此PCOS伴IR越来越受到人们的重视。阐述PCOS伴IR对生育影响的研究进展。     

PDCA教学模式在完全中间入路腹腔镜右半结肠CME术中的应用价值

目的探讨PDCA教学模式在完全中间入路腹腔镜右半结肠CME术中的应用价值。方法以2017年1月1日—8月1日时间段随机选取23例于我院行完全中间入路腹腔镜右半结肠癌CME术的患者,依据建档顺序作为对照组,以及2018年1月1日—8月1日时间段随机选取23例我科在施行PDCA教学模式后行相同术式,相同入路,依据建档顺序作为研究组。通过比较实施PDCA学习模式前后,两组手术的手术时间、术中出血量、淋巴结清扫情况、术后恢复时间及住院时间等疗效指标。结果应用PDCA教学模式后,淋巴结清扫更彻底、手术时间缩短、术中出血量减少(P<0.05)。而肠功能恢复时间和术后住院时间上差异无统计学意义(P>0.05)。结论应用PDCA教学模式后,在进行完全中间入路腹腔镜下右半结肠CME手术过程中,熟练度及手术质量有提高,效果显著。     

Lateral Medullary Syndrome Following Injury of Lateral Vestibulospinal Tract: Diffusion Tensor Imaging Study

BackgroundUnilateral lesions of vestibular nucleus can cause lateral medullary syndrome. Little is known about injury of medial and lateral vestibulospinal tract (VST) after dorsolateral medullary infarct. We investigated injury of the lateral VST in patients with typical central vestibular disorder using diffusion tensor tractography (DTT).MethodsSeven patients with lateral medullary syndrome and ten control subjects were recruited. For the medial VST, we determined seed region of interest (ROI) as medial vestibular nuclei of pons and target ROI on posteromedial medulla. For the lateral VST, the seed ROI was placed on lateral vestibular nuclei of pons, and the target ROI on posterolateral medulla. Fractional anisotropy (FA), mean diffusivity (MD), and tract volume were measured.ResultReconstructed lateral VST on both sides had significantly lower FA values in patients than controls (p<0.05). Tract volume of lateral VST in affected side was significantly lower than unaffected side and control group (p<0.05). However, no DTI parameters of the medial VST differed between patients and controls (p>0.05).ConclusionInjury of the lateral VST was demonstrated in patients with lateral vestibular syndrome following dorsolateral medullary infarct. Analysis of the lateral VST using DTT would be helpful in evaluation of patients with lateral medullary syndrome.     

浅述肺动脉栓塞栓子来源

肺栓塞是临床常见的高病死率疾病，其起病急骤、进展迅速，是世界范围内主要的健康问题。肺栓塞栓子来源多样、发病机制复杂，不同栓子类型的肺栓塞其发病机制不尽相同，尤其是非血栓性肺栓塞较血栓性肺栓塞少见，在临床工作中容易漏诊、误诊，其发病机制尚不明确，除机械性阻塞外，可能还与栓子性质有关，这为临床医师及时明确诊断带来困难。本文现就肺栓塞各栓子来源及病理生理进行简要综述，旨在为临床医师对肺栓塞的早期预防及肺栓塞病因分析提供一定参考。     

20G直置式留置针在极低出生体重儿PICC的临床应用及效果观察

目的研究20G直置式留置针代替1.9 FrPICC导入鞘导入导管在极低出生体重儿临床应用的效果。方法选取家长签单PICC 60例极低出生体重儿,随机分为对照组30例和实验组30例,实验组使用20G留置针导入导管,对照组使用1.9FrPICC导入鞘导入导管。结果实验组在一次性穿刺成功率、静脉炎发生率、穿刺费用方面明显优于对照组,P0.05;两组患儿在其它并发症方面无明显差别,P0.05。结论 20 G直置式留置针代替1.9 FrPICC导入鞘导入导管在极低出生体重儿临床应用穿刺成功率高,静脉炎发生率低,经济费用少,值得临床推广应用。