褪黑素对昼夜节律和脂质代谢的影响

褪黑素是一种由松果体分泌的神经内分泌激素,在调控昼夜节律及抑制脂肪异位沉积生物学效应中发挥着重要的作用,但其与昼夜节律及脂质代谢的关系仍未完全阐明。     

The diagnosis and treatment of a variant type of auricular sinus: postauricular sinus

European Archives of Oto-Rhino-Laryngology - To make otolaryngologists aware of the variant types of auricular sinus, we have performed a systematic review of patient diagnoses and presented our...     

Exogenous hydrogen sulfide causes different hemodynamic effects in normotensive and hypertensive rats via neurogenic mechanisms

BackgroundIncreasing evidence suggests that disturbances in H₂S homeostasis may participate in the development of hypertension. In this study we compared hemodynamic responses to intracerebroventricular (ICV) infusions of sodium hydrosulfide (NaHS), a H₂S donor, between normotensive rats (WKY), spontaneously hypertensive rats (SHR) and angiotensin II – induced hypertensive rats (WKY-Ang II).MethodsWe tested the effects of NaHS on mean arterial blood pressure (MABP) and heart rate (HR) in 12–14-week-old, male rats. MABP and HR were continuously recorded at baseline and during ICV infusion of either vehicle (Krebs–Henseleit buffer) or NaHS.ResultsICV infusions of the vehicle did not affect MABP and HR. WKY rats infused with 30 nmol/h of NaHS showed a mild decrease in MABP and HR. ICV infusion of 100 nmol/h produced a biphasic response i.e. mild hypotension and bradycardia followed by an increase in MABP and HR, whereas, the infusion of 300 nmol/h of the H₂S donor caused a monophasic increases in MABP and HR. In contrast, SHR rats as well as WKY-Ang II rats showed a decrease in MABP and HR during ICV infusions of NaHS.ConclusionsThe results provide further evidence for the involvement of H₂S in the neurogenic regulation of the circulatory system and suggest that alterations in H₂S signaling in the brain could be associated with hypertension.     

前交叉韧带损伤后炎症因子致膝关节创伤后骨关节炎的研究进展

]膝关节创伤后骨关节炎是一种常见的膝关节软骨退变性疾病,前交叉韧带损伤是其常见的发病原因之一。前交叉韧带损伤可通过刺激炎症因子生成,诱导细胞凋亡,破坏软骨细胞外基质,降解基质中的Ⅱ型胶原蛋白和蛋白多糖,减少膝关节软骨细胞数量,最后导致膝关节创伤后骨关节炎发生。因此,深入了解前交叉韧带损伤后炎症因子在膝关节创伤后骨关节炎发生发展中的具体作用机制,可为临床膝关节创伤后骨关节炎的诊断和治疗提供指导。     

Ⅲ-pN2期非小细胞肺癌术后复发模式分析:对术后放疗临床靶区体积范围的建议

目的：本研究旨在分析Ⅲ-pN2期非小细胞肺癌患者术后化疗后局部复发的高危因素，并依据术后复发部位及频率为该类肺癌术后放疗范围提供参考。方法：回顾性分析2013年1月至2016年12月我院105例术后病理证实为Ⅲ-pN2期NSCLC患者的临床资料，分析其局部复发的影响因素，并分析以不同肺叶原发灶及病理证实不同阳性淋巴结区域为基础术后化疗后的局部复发模式。结果：多因素分析显示PN2站数(P＝0.004)、分化程度(P＝0.012)、LN阳性率＞1／3(P＝0.030)及年龄＞55岁(P＝0.049)是局部复发的独立预测因素。本研究中50例患者术后出现局部复发(首发或累积)，最常见的复发部位依次为同侧肺门(20.0％)、残端(19.0％)、LNs4R(18.1％)、LNs4L(17.1％)、LNs7(15.2％)；不同肺叶局部复发情况不同，大部分右侧肿瘤以同侧复发为主，而左侧肿瘤多累及对侧纵隔，尤其是LNs4R(15.8％)。大多数患者(76.0％)局部复发时伴远处转移。结论：建议考虑Ⅲ-pN2NSCLC患者的PORTCTV时应根据原发肿瘤所处左、右侧不同肺叶来设计。除支气管残端、同侧肺门及阳性LNs外，左肺PORTCTV常规包括LNs4、LNs7、LNs5及LNs6，右肺PORTCTV常规包括LNs4R及LNs7。     

细胞焦亡与脑卒中关系的研究进展

细胞焦亡(pyroptosis)是近年来新发现的一种由核苷酸寡聚化结构域样受体(NLRs)炎症小体介导的依赖于半胱天冬酶(Caspase)家族的促炎性程序性细胞死亡方式。其主要分为依赖于Caspase-1的经典途径和依赖于Caspase-4/5/11的非经典途径。目前认为,细胞焦亡作为一种新型细胞死亡方式广泛参与了脑卒中的病理生理过程。本文现对细胞焦亡在脑卒中的作用及其最新研究进展进行综述,以期为脑卒中后脑损伤的治疗及预后提供新策略。     

Understanding influenza vaccine protection in the community: An assessment of the 2013 influenza season in Victoria,Australia

BackgroundThe influenza virus undergoes frequent antigenic drift, necessitating annual review of the composition of the influenza vaccine. Vaccination is an important strategy for reducing the impact and burden of influenza, and estimating vaccine effectiveness (VE) each year informs surveillance and preventative measures. We aimed to describe the influenza season and to estimate the effectiveness of the influenza vaccine in Victoria, Australia, in 2013.MethodsRoutine laboratory notifications, general practitioner sentinel surveillance (including a medical deputising service) data, and sentinel hospital admission surveillance data for the influenza season (29 April to 27 October 2013) were collated in Victoria, Australia, to describe influenza-like illness or confirmed influenza during the season. General practitioner sentinel surveillance data were used to estimate VE against medically-attended laboratory confirmed influenza. VE was estimated using the case test negative design as 1 − adjusted odds ratio (odds of vaccination in cases compared with controls) × 100%. Cases tested positive for influenza while non-cases (controls) tested negative. Estimates were adjusted for age group, week of onset, time to swabbing and co-morbidities.ResultsThe 2013 influenza season was characterised by relatively low activity with a late peak. Influenza B circulation preceded that of influenza A(H1)pdm09, with very little influenza A(H3) circulation. Adjusted VE for all influenza was 55% (95%CI: −11, 82), for influenza A(H1)pdm09 was 43% (95%CI: −132, 86), and for influenza B was 56% (95%CI: −51, 87) Imputation of missing data raised the influenza VE point estimate to 64% (95%CI: 13, 85).ConclusionsClinicians can continue to promote a positive approach to influenza vaccination, understanding that inactivated influenza vaccines prevent at least 50% of laboratory-confirmed outcomes in hospitals and the community.     

女性尿道憩室外文文献计量分析

目的提高女性尿道憩室的临床认知度。方法应用国外数据库PubMed检索近十年内有关女性尿道憩室的所有文献,采用文献定性/定量分析方法,对国外有关女性尿道憩室的论文各个方面进行整理和数据评价分析。结果相关论文共计37篇,有效病例数375例。对所有患者描述的相关症状及体征进行归纳分析显示,国外患者临床表现多是排尿困难及尿失禁。在我国相关文献报道中,诊断女性尿道憩室主要体征为阴道肿物以及挤压尿道后有液体从尿道流出,而在外文中女性尿道憩室的挤压征未有详细描述。所有病例均予以实施外科手术切除憩室治疗,无统一术式,疗效均可。对国内外患者临床症状进行对比分析,排尿困难症状两者差异无统计学意义(P>0.05),尿失禁症状两者差异有统计学意义(P<0.05)。结论女性尿道憩室发病率存在争议,临床表现不具有特异性,可合并结石和尿失禁等,并存在癌变可能,需要提高临床重视程度,同时需要临床工作者重视临床研究,才能提高临床诊断治疗水平,降低漏诊、误诊率。     

炎症与椎间盘退行性变关系的研究进展

椎间盘退行性变(IDD)是引起椎间盘突出、椎管狭窄等相关疾病的病理基础,也是导致腰腿痛的主要原因之一[1].椎间盘髓核组织蛋白多糖减少、纤维环裂隙出现,导致髓核组织从纤维环的裂口中突出,引起相应的免疫炎性反应,且同时脊髓和神经根受到突出髓核的压迫,导致患者出现腰腿痛症状.     

聚焦超声治疗外阴白色病变97例疗效观察

目的：探讨聚焦超声治疗外阴白色病变的临床疗效。方法：对97例外阴白色病变患者采用聚焦超声治疗并进行随访,观察治疗后患者的症状变化,并分析其疗效。结果：97例患者治疗后,症状均有明显改善。不同病理类型外阴白色病变的治疗效果比较,差异无统计学意义（P〉0.05）。鳞状细胞增生型患者51例,聚焦超声治疗总有效率为90.2%,痊愈率为60.8%;硬化苔癣型患者39例,聚焦超声治疗总有效率为92.3%,痊愈率为60.0%;混合型患者7例,聚焦超声治疗总有效率为85.7%,痊愈率为57.1%。不同病程患者聚焦超声治疗效果比较,差异有统计学意义（P〈0.05）。结论：聚焦超声治疗外阴白色病变是一种无创的、行之有效的新方法。