袖状胃切除术对肥胖合并2型糖尿病病人糖代谢和胃肠激素的影响

目的 探讨腹腔镜袖状胃切除术(LSG)对肥胖合并2型糖尿病病人糖代谢和胃肠激素的影响.方法 前瞻性收集2012年1月-2015年1月肥胖合并2型糖尿病病人80例,将病人按完全随机数字表原则随机分为LSG组和对照组,每组40例.主要观察指标为体质量指数(BMI)、血清糖化血红蛋白(HbA1C)、胰岛素、胰高血糖素样多肽-1(GLP-1)、肠抑胃肽(GIP)和胃泌素.结果 两组病人入院时BMI、HbA1C、胰岛素水平、GLP-1和胃泌素水平差异无统计学意义(P>0.05).但与对照组相比,治疗12个月后LSG组病人BMI显著降低[(25.48±2.49) kg·m-2 vs (29.49±2.48) kg·m-2,P<0.001)];HbA1C水平显著降低[(7.26±0.73)% vs (7.99±0.89)%,P<0.001)];胰岛素水平显著降低[(1.32±0.31) μg·L-1 vs (3.13±0.98) μg·L-1,P<0.001)];GLP-1水平显著升高[(39.85±13.56) μg·L-1 vs (12.58±5.32) μg·L-1,P<0.001];胃泌素水平显著降低[(17.46±7.46) μg·L-1 vs (34.73±11.49) μg·L-1,P<0.001].两组病人术前术后GIP水平均差异无统计学意义(P>0.05).结论 LSG对肥胖合并2型糖尿病病人糖代谢水平和胃肠激素影响显著.     

A nomenclature for sequence-based forensic DNA analysis

Forensic DNA analysis of casework samples using massively parallel sequencing (MPS) technology requires a system of nomenclature for uniquely labeling sequence-based alleles and artifacts. The DNA Commission of the ISFG has published considerations concerning a nomenclature format that addresses the requirement for unique labeling of sequences. Nomenclatures based on this format can be used in databasing, or communicating sequence types, but the format is lengthy for software interfaces. The sequence identifier (SID) nomenclature addresses this gap by generating short labels able to uniquely identify all sequences (allelic and artifactual) in single-source or casework profiles. Sequences in casework profiles can be uniquely labeled with only two or three SID characters, making the format compact. SID labels can be used in algorithms for identifying and filtering artifacts, and for expressing associations between artifacts and their likely parent alleles. The nomenclature is suitable for use in downstream mixture analysis by any software able to accept character values rather than numeral values. The SID nomenclature is described, and its ability to discriminate sequence-based alleles and artifacts is demonstrated, and its applicability to forensic mixture analysis is demonstrated.     

两种肠道准备方式对胃肠道恶性肿瘤术后手术部位感染的影响

目的:探讨两种肠道准备方式对胃肠道恶性肿瘤术后手术部位感染(Surgical site infection, SSI)的影响。方法:将238例胃肠道恶性肿瘤患者术前随机分为两组,分别为机械性肠道准备组(Mechanical bowel preparation MBP)和联合组,联合组在MBP组基础上联合口服抗生素肠道准备(Antibiotic bowel preparation, ABP),比较两组间SSI发生率的差异;术后将患者根据SSI诊断标准分为SSI组及非SSI组,围手术期监测白细胞(White blood cell, WBC)、白蛋白(Albumin, Alb)、降钙素原(Prcoalcitonin, PCT)、C-反应蛋白(C-reactive protein, CRP)等水平,分析两组间各血液指标对SSI的预测作用,并筛选出发生SSI的危险因素。结果:联合组SSI发生率低于MBP组(χ²=12.472,P<0.001)。由重复测量方差结果可得两组间PCT水平整体间差异有统计学意义(F=42.983,P<0.001),且术后第1、3、5 d...     

蜂巢式髓芯减压术治疗早中期股骨头缺血性坏死的有限元分析

目的应用有限元分析的方法对蜂巢式髓芯减压术(Honeycomb core decompression surgery,HCD)和单孔髓芯减压术(Core decompression surgery,CD)治疗早中期股骨头缺血坏死(Avascular necrosis of the femoral head,ANFH)进行比较研究。方法选择在我院住院治疗的股骨头坏死患者,FicatⅠ、Ⅱ、Ⅲ期各1例,按照成人股骨头坏死诊疗专家共识(2012版)标准进行纳入和排除。用GE 64排Light spead VCT工作站获取数据,以Dicom格式导入IBM w520个人笔记本电脑,用Mimics16.0软件进行建模。利用Mimics 16.0 CAD功能和3Matic3.0软件,建立Ⅰ、Ⅱ、Ⅲ期共6个单孔和蜂巢式髓芯减压模型。将6个模型在3Matic3.0软件内进行面网格划分和体网格划分,然后导回Mimics16.0软件中,并参照软件中材料公式及灰度值进行材料赋值。导入到ANSYS14.0软件中,进行有限元仿真实验。计算股骨颈和通道应力集中部位的应力,在应力集中部均匀选取10个节点,计算其均值。结果通过有限元数据分析,Ⅰ、Ⅱ、Ⅲ期中,加载一定应力后,CD和5孔HCD分别比较股骨头应力,股骨头应变。股骨头和粗隆处髓芯减压术开口处等数据分析说明:股骨头缺血坏死不论Ⅰ期还是Ⅲ期,减压后,无论应力和变形,HCD均优于单孔髓芯减压术。多通道减压更稳定、安全。结论蜂巢式髓芯减压术治疗早中期股骨头坏死具有手术疗效肯定,创伤小,出血少,术后恢复快特点,易于在临床应用推广。     

急性下壁心肌梗死病人急诊PCI术中 出现无复流的相关危险因素探讨

目的探讨急性下壁心肌梗死病人直接经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）中无复流的发生情况及其危险因素。方法收集126例急性下壁心肌梗死行急诊PCI治疗病人的病历资料,采用logistic回归分析无复流发生的相关危险因素。结果126例急性下壁心肌梗死病人均成功进行急诊PCI治疗,其中有16例发生无复流,发生率12.70%。多因素logistic回归分析结果显示,急性下壁心肌梗死病人急诊PCI术中出现无复流的危险因素为糖尿病（OR=1.647,95%CI:1.242~1.845,P < 0.05）、发病至急诊PCI时间（OR=5.281,95%CI:2.782~10.018,P=0.002）、术前TIMI血流分级（≤1级）（OR=2.735,95%CI:1.040~3.062,P=0.020）和术前收缩压（OR=1.844,95%CI:1.153~3.638,P=0.015）。结论无复流在急性下壁心肌梗死病人急诊PCI术中具有较高的发生率,应对无复流发生的相关影响因素采取有效的预防措施,降低PCI术中出现无复流的风险。     

纳布啡在骨科手术麻醉镇痛中的研究进展

μ 阿片受体激动剂临床应用悠久广泛,多年来作为镇痛的主要药物,因其副作用多而影响镇痛 效果。纳布啡（Nal）是大部κ 阿片受体激动剂和小部分μ 阿片受体拮抗剂,该文探求Nal 在骨科手术麻醉 中的临床应用和研究,以及将来可能的发展方向。综述Nal 药学特性、动物实验、小儿及成人患者关于骨科 手术麻醉方面的用药情况,证实其镇痛可靠且副作用少、安全性高;预测Nal 可用于多种用药方式的镇痛。     

Local injection of bone-marrow derived mesenchymal stromal cells alters a molecular expression profile of a contact frostbite injury wound and improves healing in a rat model

IntroductionFrostbite is a traumatic injury of the tissues upon low temperature environment exposure, which is characterized by direct cell injury due to freezing-thawing followed by development of an acute inflammatory process. Severe frostbite can lead to necrosis of soft tissues and loss of a limb. Mesenchymal stromal cells (MSCs) have a unique ability to modulate pathogenic immune response by secretion of paracrine factors, which suppress inflammation and mediate more efficient tissue regeneration. It should be noted that potential of stem cell therapy for frostbite injury treatment has not been investigated so far. Here, we evaluated a healing capacity of bone-marrow derived MSCs for the treatment of contact frostbite injury wound in a rat model.MethodsCold-contact injury in a Wistar rat model was induced by 1-minute tight application of the cooled probe (?196 ?C) to the skin surface of the left hip. Rat bone marrow MSCs were phenotypically characterized and used for local injections into non-damaged tissues surrounding the wound of animals from the experimental group. The second group of rats was treated in the same manner with 1 mL of isotonic sodium chloride solution. Analysis of cytokine and growth factor expression profile in сold-contact injury wounds was performed on days 5, 9, and 16 using immunoblotting and enzyme-linked immunosorbent assay. Animal recovery in MSC-treated and vehicle-treated groups was evaluated by several criteria including body weight recording, determination of eschar desquamation and re-epithelialization terms, assessment of wound closure kinetics, and histological scoring of the wounds on day 23.ResultsIt turned out that a single subcutaneous administration of MSCs around the wound site resulted in elevated expression of pro-survival and pro-angiogenic VEGF-A and PDGF and 3–5-fold decrease in pro-inflammatory IL-1β as compared with the frostbite wound treated with a vehicle. Moreover, treatment with MSCs caused accelerated wound re-epithelialization (p < 0.05) as well as a better histological score of the MSC-treated wounds.ConclusionsThus, our data suggested that the use of MSCs is a promising therapeutic strategy for the treatment of cold-induced injury wounds.     

脱落金属托槽底板处理方法的研究现状

目的 正畸托槽是固定矫治中不可或缺的部件,因其使用时间长,易脱落等特点,而使用新托槽又增 加患者经济负担,故其回收再利用的方法一直受到人们广泛关注。目前,常用的托槽回收方法较多,均存 在一定优点与不足,本文对脱落金属托槽底板处理方法及具体操作方式作一综述,旨在探讨各方法的优缺 点以及研究进展,以期为临床脱落托槽的再利用提供参考意义。     

蒙药那仁满都拉调控Wnt/β-catenin信号通路抗骨质疏松的作用及机制

目的 观察蒙药那仁满都拉对去卵巢骨质疏松模型大鼠骨微结构与骨形成的影响,初步探讨其防治骨质疏松的作用及机制。方法 将30只雌性大鼠随机分为假手术组、模型组、蒙药那仁满都拉低、中、高剂量组,每组6只,利用去卵巢大鼠构建骨质疏松模型大鼠,模型制备成功后用蒙药灌胃,假手术组用相同体积的生理盐水灌胃。连续12周后,通过对股骨组织进行Micro-CT、骨骼力学检测、HE染色,分别观察大鼠骨密度、骨骼力度、骨组织病理形态,检测Wnt、β-catenin蛋白表达情况;从1日龄大鼠颅骨中提取成骨细胞用低、中、高浓度的含药血清干预后检测ALP染色、矿化染色,观察其ALP分泌、矿化结节大小,检测Wnt、β-catenin蛋白表达情况。结果 在模型大鼠股骨组织中Micro-CT显示,蒙药组均能增加骨小梁密度;骨骼力学分析显示,蒙药组均能提高骨骼力学的载荷与刚度,其中中、高剂量组具有显著统计学意义(P<0.01,P<0.05)。HE染色结果显示蒙药组均可明显改善骨小梁病理变化;Western blot结果提示蒙药组中Wnt、β-catenin蛋白表达明显升高(P<0.000 1);蒙药含药血...     

铝的毒性和膳食暴露评估研究进展

近年来,食品中含铝添加剂的使用受到公众的广泛关注,许多研究均表明铝的过多暴露会对人体造成健康损害,将从铝的毒性、国内外膳食铝暴露评估研究进展及可行性控制措施3方面来综述,为食品中铝的健康风险评估研究提供相关依据。