Systematic review and network meta-analysis assess the comparative efficacy and safety of transsphenoidal surgery for pituitary tumor

Neurosurgical Review - To quantitatively synthesize the comparative efficacy and safety of the most common surgical approaches including endonasal transsphenoidal endoscopic surgery (ETES),...     

Study of platelet-rich fibrin promoting endothelial cell differentiation and angiogenesis induced by transplantation of adipose-derived stem cells

Diabetic patients are characterized by long wound healing time, and adipose stem cells (ADSCs) can secrete growth factors to promote angiogenesis and improve diabetic wound healing. In this research, we attempted to interrogate the impact of platelet-rich fibrin (PRF) on ADSCs in diabetic wound healing. ADSCs were harvested from human adipose tissues and identified through flow cytometry. After pretreatment with cultured medium supplemented with different concentrations of PRF (2.5%, 5%, and 7.5%), proliferation and differentiation capacity of ADSCs were assessed by CCK-8 assay, qRT-PCR and immunofluorescence (IF), respectively. Tube formation assay measured angiogenesis. Western blot analysis analyzed expression of endothelial markers and the extracellular signal-regulated kinase (ERK) and serine/threonine kinase (Akt) pathways in PRF-induced ADSCs. The CCK-8 experiment indicated that PRF enhanced proliferation of ADSCs in dose-dependent manner, relative to normal control group. The expression of endothelial markers and the capacity of tube formation were significantly promoted by 7.5% PRF. The release of growth factors containing vascular endothelial grow factor (VEGF) and insulin-like growth factor-1 (IGF-1) from PRF was increased with the extension of detection time. When the receptors of VEGF or/and IGF-1 were neutralized, ADSCs differentiation into endothelial cells were obviously inhibited. Additionally, PRF stimulated ERK and Akt pathways, and the inhibitors of ERK and Akt attenuated PRF-induced differentiation of ADSCs into endothelial cells. In conclusion, PRF promoted endothelial cell differentiation and angiogenesis induced by ADSCs in diabetic wound healing, which appears to give guidance for treating patients.     

动脉血气分析碱剩余在创伤救治中的研究进展

动脉血气分析碱剩余作为创伤早期评估和预后指标,可预测创伤患者的休克、复苏、输血、死亡率及重症监护室（Intensive Care Unit,ICU）入住率等,在儿科创伤、老年创伤和创伤骨科患者的评估中也仍然具有价值。随着急诊床旁即时检验（Point-of-care Testing,POCT）血气分析的发展,其结果也可快速获取。近年来动脉血气分析碱剩余值在创伤救治中已有一定的研究。本文将就动脉血气分析中碱剩余在各种创伤中的应用进行回顾总结,同时提出了碱剩余在未来临床应用中的展望。     

Glutamate-containing dipeptides do not modulate ligand binding at excitatory amino acid receptors

Dipeptides of the structure X-Glu (e.g. X = Phe, Leu) have been proposed as allosteric modulators of excitatory amino acid receptors in rat brain membranes. Here we report that these dipeptides reduce the binding of L-[3H]Glu (predominantly N-methyl-D-aspartate-sensitive sites) and of [3H]kainate to postsynaptic density preparations isolated from rat brain. However, several observations indicate that the effects of these dipeptides are mediated not by allosteric modulation, but by free L-Glu liberated by the actions of a membrane-associated aminopeptidase. The absolute and relative potencies of the dipeptides are similar at all acidic amino acid binding sites examined to date, suggesting the involvement of a factor with similar activity at each site (e.g. L-Glu). N-Acetyl-Met-Glu is a weak inhibitor of L-Glu and kainate binding, and N-blocked peptides are known to be poor substrates of aminopeptidases. Bestatin, an inhibitor of aminopeptidases, decreases or abolishes the effects of substrate dipeptides on L-Glu and kainate receptor binding, while having no effect itself.     

ω-3鱼油脂肪乳对胃肠肿瘤术后患者免疫功能影响的Meta分析

目的 评价ω-3鱼油脂肪乳对胃肠肿瘤术后患者免疫功能的影响。方法 检索Pubmed、EMbace、MEDLINE、万方和CNKI等数据库,经筛选纳入符合要求的随机对照研究（RCT）,用修改后Jadad评分评价纳入研究质量,并提取需要的研究数据,采用Revman 5.3进行统计分析。结果 共纳入12篇RCT研究,共848例胃肠肿瘤术后患者,分析结果显示鱼油脂肪乳能显著增加CD3⁺T细胞[WMD=5.79,95% CI（3.07,8.50）,P<0.01]和CD4⁺T细胞[WMD=6.22,95% CI（3.85,8.59）,P<0.01]水平,减低CD8⁺T细胞水平[WMD=-1.74,95% CI（-2.96,-0.52）,P<0.01]。结论 ω-3鱼油脂肪乳加强的肠外营养对胃肠肿瘤术后患者免疫功能有增强作用。     

咽旁间隙神经鞘瘤诊断及手术入路选择

目的探讨咽旁间隙神经鞘瘤的诊断与手术入路方式的选择。方法对咽旁间隙神经鞘瘤患者14例病历资料进行回顾性分析,术前根据CT和MRI判断肿瘤与扁桃体包膜距离关系及肿瘤主体位置考虑手术径路,与扁桃体包膜距离≤1cm、肿瘤主体突入到口内者行经口内径路,与扁桃体包膜距离1cm、瘤体主体突向外侧者经颈外径路,手术径路与肿瘤大小关系不大。经口内径路4例,颈外径路10例。结果所有患者均获得顺利手术,术后随访6个月～6年均未见复发。结论颈部CT、MRI及DSA是诊断及鉴别诊断的良好手段,手术径路取决于肿瘤与扁桃体包膜的距离及肿瘤主体位置,无论采取何种径路,均无严重的并发症。     

针刺对脑卒中后认知功能障碍相关机制研究进展

脑卒中后认知功能障碍的干预方法多样,主要有认知功能训练、药物治疗、针刺干预等。大量临床实践已证实针刺对卒中后认知功能障碍的恢复具有一定的疗效。本研究搜集近几年关于针刺对脑血流、对神经细胞内部结构以及相关分子生物学等的影响,并从以上几方面将针刺治疗脑卒中后认知功能障碍部分作用机制做简单阐述;提出目前针刺治疗本病的问题及展望。     

芩荑合剂治疗实验性哮喘动物模型气道变应性炎症的机理研究

目的：以芩荑合剂为基础，制成超声雾化液，通过实验观察探讨其作用机理。方法：观察谊方对卵白蛋白致敏哮喘动物模型支气管肺泡灌洗液（BALF）中Eo、IL-3、IL-5、GM．CSF、SIL-2R、NO的影响。结果：实验发现：芩荑合剂雾化液能显著降低炎性指标（Eo、IL-3、IL-5、GM-CSF、SIL-2R、NO）。病理切片证实治疗组支气管肺组织中E0等炎症细胞浸润减少。结论：芩荑合剂具有解痉、平喘、抗炎、祛痰等作用。其作用机理可能与拮抗了气道的E0等炎症细胞浸润、活化及相关细胞因子、炎性介质释放有关。     

产儿科住院医师整合培养模式探讨

随着医学教学模式的更新,整合医学教育及围产医学理念的不断强化,产科与儿科的人才培养模式有了新的定位。临床案例中多学科合作抢救的模式的频频成功,产科与儿科的合作交流促进有了新的需求。分析产科与儿科目前住院医师规范化培训的特点,总结阐述整合培养不仅可以增强产儿科医师的自信力和职业归属感,提升围产保健的质量和救治力,而且可以培养出“高精尖”的产儿科储备人才以及缓和产儿科特殊的医患关系。从实际出发,针对具体的整合培训时长,可优化的带教形式,模拟训练的模式,反馈及奖惩制度等各方面进行探讨研究,以使整合培养的模式能落到实处,真正实现“高精尖”人才的培养,最终更好的服务于孕产妇及新生儿,提高我国围产医学领域的影响力。