Use of intravoxel incoherent motion MR imaging to assess placental perfusion in patients with placental adhesion disorder on their third trimester

ObjectiveOur primary aim was to investigate if women with placenta accreta can be differentiated with women without using IVIM quantitative assessment of the placental perfusion. A second aim was to investigate if IVIM parameters could be used to differentiate placenta accreta from increta.MethodsThe study population included 17 patients with placenta accreta, 29 patients with placenta increta and 16 patients without placenta accreta between 28 + 0 to 41 + 6 weeks. All women underwent a MRI examination including an IVIM sequence at 1.5 T. The perfusion fraction (f), pseudodiffusion coefficient (D*) and standard diffusion coefficient (D) were calculated. Results Women with placenta accreta and increta had a smaller placenta perfusion fraction (P < 0.05) than patients without placenta accreta, placental perfusion fraction didn't differ between placenta accreta and increta (p > 0.05). Differences of D and D* in three groups showed no statistical significance (p > 0.05).ConclusionPlacenta accreta and increta differ in placental perfusion fraction from women without the disease. The perfusion fraction can be used as a feasible index to evaluate placenta perfusion.     

Évaluation des pratiques d’antibioprophylaxie en chirurgie thoracique

ObjectiveTo assess the compliance to the procedure of antimicrobial prophylaxis attitudes during pneumonectomies.Materials and methodsA retrospective chart analysis was conducted. All patients who underwent a pneumonectomy between March and May 2006 were included. All data regarding antimicrobial prophylaxis, drug allergy antecedents, pre- and post-intervention antibiotic treatments, timing of surgery and drain withdrawal were obtained from the anesthesiology and hospitalization records. The primary evaluation end-point was the compliance to the procedure with 3 levels: good compliance (adequate drug, nominal duration and dosage, nominal timing ±30 minutes), poor compliance (less than 2 timing excursions), lack of compliance (other cases).ResultsTwenty patients were included. In 7 cases (35%) there was a good compliance to procedures, in 1 case there was a poor compliance, and in 12 cases there was a lack of compliance.DiscussionTwo thirds of included patients did not receive exactly the drug as specified by the procedure. In most cases, the reason was atypical timing in drug administrations and/or early stopping of antimicrobial prophylaxis. Some formal ambiguities of the procedure may have impaired its compliance. Optimization possibilities are discussed.     

米非司酮和米索前列醇对中期妊娠引产效果比较

目的 回顾性分析米非司酮和米索前列醇对孕12～16、20～26周妊娠的引产效果。方法 收集2001年7月～2003年12月入院的186例中期妊娠同时用米非司酮和米索前列醇口服引产的病例，分为孕13～16和20～26两组。结果 12～16周组引产成功率为98．2％，20～26周引产组成功率为86．3％。前组比后组显著有效（P〈0．01）。结论 米非司酮和米索前列醇口服更适合于孕12～16周妊娠引产，是一种有效、安全的中期妊娠引产方法。     

腰椎间盘退变危险因素的病例-对照研究

[目的]探索腰椎间盘退变的危险因素。[方法]采用病例-对照研究方法,以CT确诊有腰椎间盘退变者114人为病例组;随机选择体检人员中无腰背痛史且腰椎功能正常者211人为对照。问卷调查腰椎疾患家族史、腰背部受伤史和5种职业危险因素的暴露情况,包括坐位、全身振动、弯腰扭腰、提举重物和重体力作业,对各因素暴露以工龄权重求得暴露指数。[结果]非条件Logistic回归分析显示腰椎疾患家族史危险性最高(OR=89.12),其次是腰背部受伤史(OR=78.60)、职业危险因素中全身振动(OR=8.58)、弯腰扭腰(OR=4.62)和重体力作业(OR=9.05)进入模型。业余运动OR为0.47。[结论]腰椎疾患家族史和腰背部受伤史是腰椎间盘退变的主要危险因素,而业余运动可能有一定保护作用。     

超声乳化联合IOL植入术围手术期瞳孔直径和反应的变化

探究晶状体超声乳化联合人工晶状体（IOL）植入术围手术期瞳孔直径、反应的变化。方法：前瞻性临床研究。收集于2016年1-9月上海交通大学医学院附属第九人民医院眼科行超声乳化联合IOL植入术的连续白内障和高度近视透明晶状体置换患者。采用动态瞳孔测量仪（Metro-vision MONCV3）测量术前、术后1周、术后1个月在4种光照度下（0、1、10和100 cd/m2 ）的瞳孔直径,并检测瞳孔反应（如瞳孔初始直径、收缩幅度、收缩潜伏期、收缩持续时间、收缩速度、扩张潜伏期、扩张持续时间和扩张速度等）。采用重复测量方差分析、Pearson相关分析及Spearman相关分析对数据进行分析。结果：共纳入患者53例（53眼）。在4种光照度下,术前瞳孔直径随年龄增加而下降（r0=-0.467,P0<0.001;r1=-0.383,P1=0.005;r10=-0.374,P10=0.006;r100=-0.312,P100=0.023）。 4种光照强度下瞳孔直径手术前后总体差异有统计学意义（F0=206.9,P0<0.001;F1=106.8,P1<0.001; F10=41.7,P10<0.001;F100=36.7,P100<0.001）,与术前相比,4种光照强度下瞳孔直径术后1周、1个月均下降（均P<0.001）。手术前后瞳孔反应的初始直径、收缩幅度、收缩和扩张速度总体差异有统计学意义（F初始直径=99.5,P初始直径<0.001;F收缩幅度=36.2,P收缩幅度<0.001;F收缩速度=51.9,P收缩速度<0.001;F扩张速度=23.8,P扩张速度<0.001）,与术前相比,术后1周、1个月初始直径、收缩幅度、收缩和扩张速度均下降（均P<0.001）。结论：超声乳化联合IOL植入术后1个月内可引起瞳孔缩小,瞳孔反应的收缩、扩张速度变慢,为IOL设计中确定有效光学区范围提供依据。     

Comparison of total hip arthroplasty with minimally invasive SuperPath approach vs. conventional posterolateral approach in elderly patients: A one-year follow-up randomized controlled research

ObjectiveTo compare difference between SuperPath approach and conventional posterolateral approach in total hip arthroplasty (THA) in elderly patients.MethodsThe present prospective randomized controlled single blinded study enrolled a total of 96 elderly patients who received THA in our hospital during April 2015 to December 2018. All patients were randomly divided into the SuperPath group and the conventional group. General demographic characteristics and intraoperative data, as well as hospitalization time were recorded. Harris scores were used for measurement of hip function and visual analogue scale (VAS) was used for pain measurement. Serum levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and creatine phosphokinase (CK) were measured before and 24 h after surgery. Gait analysis was conducted by the method of footprints.ResultsThe mean surgical time was remarkably longer, the mean blood loss and incision length were significantly lower and the hospitalization time was also shorter in the SuperPath group compared with the conventional group. Both levels of CRP and CK were remarkably lower in the SuperPath group. At time points of 7 d and 1 mon after surgery, the VAS scores were significantly lower, and at 7 d, 1 mon and 3 mon the Harris scores were markedly higher in the SuperPath group compared with the conventional group. The step length and stride speed were significantly larger in the SuperPath group at 7 d and 1 mon after surgery than the conventional group. Joint dislocation was found in 2 cases of patients in the conventional group and no dislocation case was found in the SuperPath group. The angles of anteversion showed no significant difference, while the angles of abduction were significantly lower in the SuperPath group.ConclusionPatients with SuperPath approach had lower levels of CRP, ESR and CK, better hip function and less pain, as well as better gait condition than patients with conventional posterolateral approach in elderly patients.     

姜黄素通过新型蛋白激酶-θ亚型抑制大鼠海马神经元中通道的研究

目的探讨姜黄素对Ca2+通道电流的选择性抑制作用。方法使用10 mmol/L的钡离子作为电荷载体,利用膜片钳技术记录大鼠海马神经元的全细胞电流;免疫印迹法检测大鼠海马神经元中蛋白激酶C(PKC)的分型;进行全细胞膜片钳技术分析。结果姜黄素浓度依赖性抑制高电压门控Ca2+通道电流(IBa),姜黄素对Ca2+型通道的激活无显著影响,但能够使Ca2+通道的失活曲线向超极化方向移动;此外,在体外培养的大鼠海马神经元中,细胞内应用PKC-θ的抑制肽PKC-θ-IP,能消除黄素诱导抑制的作用;新型PKC-δ、PKC-ε和PKC-θ,但不包括PKC-η在神经元中内源性表达。结论姜黄素在大鼠海马神经元中通过新型的PKC-θ依赖途径抑制IBa,这个结论可能有利于证明姜黄素的神经保护作用。     

Protective effect of platycodin D on liver injury in alloxan-induced diabetic mice via regulation of Treg/Th17 balance

Platycodin D is a major pharmacological constituent of Platycodi Radix with immunomodulatory activity. The present study was designed to investigate how platycodin D (PLD) reveals liver injury in diabetic mice and its mechanism. Fifty mice were divided into five groups randomly: control group, model group, rosiglitazone (ROG, 10 mg/kg) group, PLD (50 mg/kg) group, and PLD (100 mg/kg) group. Diabetes was induced with the injection of alloxan monohydrate (150 mg/kg) subcutaneously, and animals with blood glucose level of ≥ 250 mg/dl were considered as diabetic mice. After the first day of diabetes induction, the treatments were performed for 8 weeks. Then the animals were anaesthetized, and blood and liver samples were also collected for further assay. PLD significantly decreased the serum levels of glucose, insulin, interleukin-6 (IL-6), interleukin-1β, tumor necrosis factor-α (TNF-α), and interleukin (IL)-17A and increased IL-10 level in serum. PLD effectively downregulated aspartate transaminase (AST), alanine aminotransferase (ALT), total cholesterol (TC), and triglycerides (TG) in liver. PLD also attenuated liver histological change. In addition, PLD significantly attenuated IL-17A and IL-10 levels in vitro, flow cytometry (FCM) studies also showed that PLD remarkably inhibited Th17 cells and significantly increased Treg cells in liver tissues and spleen cells. Western blot demonstrated PLD inhibited the phosphorylation of JAK and STAT-3 and the expression of RORγt and increased the expression of Foxp3. The findings showed that PLD exerts beneficial effects on alloxan-induced liver injury in mice.