品管圈预防妇科腹腔镜术后下肢深静脉血栓的效果观察

目的:探讨品管圈活动对妇科腹腔镜手术后下肢深静脉血栓的影响。方法:成立品管圈,确立"降低妇科腹腔镜手术后下肢深静脉血栓的发生率"为活动主题,进行现状调查、要因分析、拟定对策,运用PDCA循环原则进行对策的实施和效果核查、标准化处置等。结果:实施品管圈活动后妇科腹腔镜手术后下肢深静脉血栓的发生率从2.59%降至0.50%,经比较具有统计学意义(P0.05)。结论:品管圈活动可降低妇科腹腔镜手术后下肢深静脉血栓的发生率,对患者的康复起着良好的促进作用,同时有助于提高护士的主动性和解决临床问题的能力。     

Effect of Intravenous Administration of Liposomal Prostaglandin E1 on Microcirculation in Patients with ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Intervention

Background:

Several studies have demonstrated that primary percutaneous coronary intervention (PCI) can result in reperfusion injury. This study aims to investigate the effectiveness of liposomal prostaglandin E1 (Lipo-PGE1, Alprostadil, Beijing Tide Pharmaceutical Co., Ltd.) for enhancing microcirculation in reperfusion injury. In addition, this study determined the optimal administration method for acute ST elevation myocardial infarction (STEMI) patients undergoing primary PCI.

Methods:

Totally, 68 patients with STEMI were randomly assigned to two groups: intravenous administration of Lipo-PGE1 (Group A), and no Lipo-PGE1 administration (Group B). The corrected thrombolysis in myocardial infarction (TIMI) frame count (cTFC) and myocardial blush grade (MBG) were calculated. Patients were followed up for 6 months. Major adverse cardiac events (MACE) were also measured.

Results:

There was no significant difference in the baseline characteristics between the two groups. The cTFC parameter in Group A was significantly lower than Group B (18.06 ± 2.06 vs. 25.31 ± 2.59, P < 0.01). The ratio of final MBG grade-3 was significantly higher (P < 0.05) in Group A (87.9%) relative to Group B (65.7%). There was no significant difference between the two groups in final TIMI-3 flow and no-reflow. Patients were followed up for 6 months, and the occurrence of MACE in Group A was significantly lower than that in Group B (6.1% vs. 25.9% respectively, P < 0.05).

Conclusions:

Myocardial microcirculation of reperfusion injury in patients with STEMI, after primary PCI, can be improved by administering Lipo-PGE1.     

Knockdown of long noncoding RNA SPRY4-IT1 suppresses glioma cell proliferation,metastasis and epithelial-mesenchymal transition

Long noncoding RNAs (lncRNAs), a class of ribonucleic molecules, participate in various cellular processes. They are highly expressed in several types of cancer and their expression was related to pathophysiological characteristics of tumor growth, therefore, they can be considered as a promising diagnostic tool and a convenient prognostic biomarker. SPRY4-IT1, belonging to a group of intron-retained lncRNAs, was reported to affect tumor development of many types of cancer. However, the expression and the role of SPRY4-IT1 in glioma are still unclear. Therefore, in this study, we examined for the first time the expression and role of SPRY4-IT1 in glioma cells. The results of our study showed that SPRY4-IT1 was up-regulated in human glioma tissues and cell lines. Knockdown of SPRY4-IT1 could inhibit glioma cell growth and migration. Moreover, knockdown of SPRY4-IT1 could inhibit epithelial-mesenchymal transition (EMT) phenotype in glioma cells. Based on these findings, SPRY4-IT1 may be used as a new target for diagnosis and treatment of glioma.     

肥胖大鼠形成过程中血清瘦素、血浆Ghrelin及下丘脑神经肽Y水平的变化

目的 观察在食源性肥胖（DIO）大鼠模型形成过程中,血清瘦素（Leptin）、血浆Ghrelin及下丘脑神经肽Y（NPY）的变化. 方法 取模型形成过程中2个时间点,分为正常对照（NC）组、DIO4周组（高脂饮食喂养4周）和DIO 8周组（高脂饮食喂养8周）.测量血清Leptin、血浆Ghrelin水平及下丘脑NPY浓度和mRNA的表达. 结果 在DIO大鼠模型形成过程中,DIO 4周和DIO 8周组空腹血清Leptin浓度明显高于NC组[（0.34±0.05）,（0.49±0.03） vs （0.24±0.03） ng/ml]（P＜0.05）;空腹血浆Ghrelin浓度明显低于NC组[（1.84±0.21）,（1.62±0.23） vs （2.01±0.20） ng/ml]（P＜0.05）;下丘脑NPY浓度及mRNA表达均明显高于NC组[NPY浓度：（162.8±20.1）,（196.2±19.9）vs（134.3±17.2）pg/ml;NPY mRNA：（1.16±0.13）,（1.55±0.16）vs（0.87±0.16）]（P均＜0.05）.下丘脑NPY浓度及mRNA表达与血清Leptin浓度呈正相关（r分别为0.950、0.914,P＜0.05）,与血浆Ghrelin浓度呈负相关（r分别为-0.889、-0.908,P＜0.05）. 结论 随着DIO大鼠肥胖动物模型的形成,下丘脑NPY表达逐渐增强,与空腹血清Leptin浓度正相关,与空腹血浆Ghrelin浓度负相关.     

急性脑梗死患者血清抵抗素水平与胰岛素抵抗的关系

目的 探讨急性脑梗死患者血清抵抗素水平与胰岛素抵抗的关系.方法 选择68例急性脑梗死患者和40例健康体检者(对照组),采用ELISA检测血清抵抗素、空腹胰岛素等指标,并分析血清抵抗素水平与胰岛素抵抗指数及其他检测指标的相关性.结果 与对照组比较,急性脑梗死组血清抵抗素水平、胰岛素水平、胰岛素抵抗指数明显升高(P＜0.01),胰岛素敏感性指数、高密度脂蛋白胆固醇水平明显低于对照组(P＜0.05);急性脑梗死组抵抗素水平与体质指数、空腹胰岛素、胰岛素抵抗指数呈正相关,与高密度脂蛋白胆固醇、胰岛素敏感性指数呈负相关(P＜0.05).对脑梗死的危险因素行多因素Logistic回归分析显示,抵抗素、胰岛素抵抗指数、胰岛素敏感性指数、血压控制情况和年龄进入回归方程(OR分别为3.505、2.222、-0.589、5.367及2.481).结论 脑梗死患者可能存在胰岛素抵抗,血清抵抗素水平可能与胰岛素抵抗密切相关.     

Clinical characteristics,rates of blindness,and geographic features of PACD in China

ObjectiveTo analyze the rates of blindness with the demographics and clinical characteristics of patients with primary angle-closure disease (PACD) to provide a comprehensive epidemiologic reference in China.MethodsA retrospective analysis was conducted in the Chinese Glaucoma Study Consortium database, which is a national multicenter glaucoma research alliance of 111 hospitals participating between December 21, 2015 and September 9, 2018. The diagnosis of PACD was made by qualified physicians through examination. Comparison of sex, age, family history, subtypes of PACD, and blindness were analyzed.ResultsA total of 5762 glaucoma patients were included, of which 4588 (79.6%) had PACD. Of PACD patients, 72.1% were female with the sex ratio (F/M) of 2.6, and the average age of patients was 63.8±9.3 years with the majority between 60 and 70 years. Additionally, 30% of these patients had low vision in one eye, 8.8% had low vision in both eyes, 1.7% had blindness in one eye, and 0.3% had blindness in both eyes. There were statistical differences with regards to age between male and female patients with PACD, with male patients being older on average. Primary angle-closure glaucoma was more commonly diagnosed in males (60%) compared to females (35.9%), whereas acute primary angle closure (APAC) was more commonly diagnosed in females (54.3%) compared to males (37.7%). The visual acuity in APAC patients was lower and the rate of low vision and blindness was higher than other subtypes.ConclusionPACD was the major type of glaucoma in Chinese hospitals. There were more female patients with PACD, mostly between 60 and 70 years old, with higher rates of APAC in women. APAC resulted in the worst visual outcomes of all PACD subtypes.     

腹腔镜下食管裂孔疝修补联合胃底折叠术治疗食管裂孔疝及长期疗效的评估

目的观察分析腹腔镜下食管裂孔疝修补联合Nissen/Dor胃底折叠术治疗食管裂孔疝临床疗效及食管测压与pH值监测对长期疗效的预估意义。 方法回顾性分析2018年1月至2020年1月于河北北方学院附属第二医院收治的120例食管裂孔疝患者的临床资料,其中64例行腹腔镜下食管裂孔疝修补联合Nissen胃底折叠术（Nissen组）,56例行腹腔镜下食管裂孔疝修补联合Dor胃底折叠术（Dor组）。术后随访1年,对比观察2组患者手术情况、住院时间、术后并发症、记录食管测压及pH检测等指标变化情况、Gerd Q、DeMeester评分等。 结果Nissen组术程以及术中出血量明显高于Dor组（P<0.05）,2组总住院时间差异无统计学意义（P>0.05）。2组患者术后总并发症发生率比较,差异无统计学意义（P>0.05）;2组患者术后1年食管反流情况与DeMeester评分较术前均得到明显改善。Nissen组在减少反流次数、长反流次数和最长反流时间方面均优于Dor组（P<0.05）。2组在反流时间、酸反流时间百分比与DeMeester评分比较,差异均无统计学意义（P>0.05）;术后2组患者食管下括约肌压力、静息呼吸平均值、食管残余压较术前均显著提升（P<0.05）,但2组间术后比较无明显差异（P>0.05）。术后2组患者食管松弛率、无效吞咽与Gerd Q评分均较术前也均明显降低,但2组间差异无统计学意义（P>0.05）。 结论腹腔镜疝修补术联合Nissen或Dor胃底折叠术治疗食管裂孔疝均有明显效果,临床应根据患者自身情况选择合适的手术方式。