普罗布考在心血管疾病中的应用进展

<正>普罗布考(probucol),化学名为丙丁酚,化学式为4,4'-[(1-甲基亚乙基)二双]2,6-二(1,1-二甲基乙基)苯酚,于20世纪7 0年代首先于美国上市并应用于临床,以往认为其主要作用是降低血清胆固醇。近年来研究发现,普罗布考除具有降脂作用外,还具有抗动脉粥样硬化(atherosclerosis,AS)、抗氧化应激、保护血管内皮、预防对比     

Up-regulated microRNA-155 expression is associated with poor prognosis in cervical cancer patients

BackgroundMicroRNAs (miRNAs) play important roles in tumor development and progression. The purposes of the study was to investigate the role of miR-155 in cervical cancer.MethodsQuantitative real-time RT-PCR (qRT-PCR) was performed to examine miR-155 expression in cervical cancer tissues and adjacent non-cancerous tissues. The association with overall survival of patients was analyzed by Kaplan-Meier survival analysis. Small interfering RNA (siRNA) was used to suppress miR-155 expression in cervical cancer cells. In vitro assays were performed to further explore the biological functions of miR-155 in cervical cancer.ResultsWe found that miR-155 expression was markedly up-regulated in cervical cancer tissues and correlated with FIGO stage, lymph nodes metastasis, vascular invasion and HPV. Patients with high miR-155 expression level had poorer overall survival than those with low miR-155 expression. Furthermore, multivariate Cox regression analysis suggested that increased miR-155 was an independent prognostic indicator for cervical cancer (P = 0.007; HR = 2.320; 95%CI: 1.259–4.276). Moreover, knockdown of miR-155 was demonstrated to inhibit cell proliferation, migration, and invasion in vitro.ConclusionOur study presents that miR-155 is a novel molecule involved in cervical cancer progression, which provide a potential prognostic biomarker and therapeutic target.     

成人后孟氏骨折与经尺骨近端骨折后脱位的鉴别与治疗

经典孟氏骨折的定义是尺骨骨折伴上尺桡关节脱位,如合并桡骨头后脱位,即肱桡关节后脱位时,称为后孟氏骨折。而对于不伴有上尺桡关节脱位者,不应笼统称为后孟氏骨折,可称为经尺骨近端骨折后脱位。对于伴有上尺桡关节脱位后孟氏骨折,临床相对少见,其冠突骨折通常粉碎,上尺桡关节遭到破坏,环状韧带及骨间膜损伤,治疗时在恢复骨性结构及处理外侧韧带复合体后,还须关注与处理上尺桡关节的稳定,预后疗效不确定。而经尺骨近端骨折后脱位临床相对多见,其冠突骨折块通常完整,环状韧带及骨间膜完好,在治疗上以恢复骨性结构为主,同时处理肘关节外侧韧带复合体,预后效果好。通过解剖基础、影像学特征、损伤特点、治疗方法及预后等方面鉴别和区分后孟氏骨折与经尺骨近端骨折后脱位。     

新型防旋支具在中西医结合保守治疗胫腓骨骨折中的应用

[目的]探讨新型防旋支具在中西医结合保守治疗胫腓骨骨折中的临床应用效果。[方法]2015年9月—2017年1月行保守治疗的胫腓骨骨折患者64例,随机分为试验组(32例)和对照组(32例)。两组患者入院后均行跟骨牵引术,中医正骨手法复位联合小夹板固定,辅以中药外敷内服。试验组术后采用新型防旋支具固定患肢,防止足部外旋;对照组术后采用传统的方法防止足部外旋。定期进行疼痛视觉模拟评分法(VAS法)评分,应用Kolcaba舒适状况量表(GCQ)检测舒适度改善状况,计算机断层扫描(CT)检查测量骨折旋转移位角度,随访记录骨折愈合时间及并发症情况,采用Johener-Wruhs评分系统对患肢功能进行评价。[结果]试验组骨折旋转移位角度小于对照组,牵引术后第1、3、7天的VAS疼痛评分均低于对照组,舒适度GCQ总分和其中的生理、心理精神维度单项得分均高于对照组,骨折愈合时间短于对照组,肢体功能Johner-Wruhs评分优良率高于对照组。两组间差异具有统计学意义(P0.05)。[结论]中西医结合保守治疗胫腓骨骨折过程中应用新型防旋支具,可以有效维持足部中立位,纠正成角及旋转畸形,辅助复位,减轻疼痛,提高患者舒适感受,缩短骨折愈合时间,有利于患肢功能恢复,且不增加并发症的发生,便于护理,安全可靠。     

CRP monitoring in fractured neck of femur. A waste of resource?

AimWe aim to assess post-operative CRP serum values in a cohort of patients who underwent surgical treatment for neck of femur fracture (NOF#), and whether CRP is a valid tool for the assessment of these patients post-operatively.Study Design and MethodsRetrospective analysis was carried out on all NOF#'s admitted for surgical fixation between August 2015 and July 2016 in a district general hospital. Primary analysis included serum CRP levels until day 7 post-operatively, with secondary analysis of any documented evidence of post-operative complications (medical and surgical) within 30 days post-operatively.ResultsA total of 365 patients were surgically treated for NOF#’s over the study period. CRP serum levels peaked over the first two days post-operatively to median (IQ range) of 226 mg/L (158–299 mg/L), decreasing to 67 mg/L (45.5–104 mg/L) by day 7 post-operatively. 116 patients had documented post-operative complications within 30 daysof operation. CRP levels in patients with and without complications showed no statistical significance in day-1, day-2 and day-3 post-operatively. However, a significant difference was demonstrated on day-4 (p = 0.017), day-5 (p = 0.003), day-6 (p = 0.02) and day-7 (p = 0.031).ConclusionsDuring the first three days of the postoperative period we cannot recommend routine CRP serum blood test monitoring in NOF# patients, as it is not diagnostic in the acute inflammatory phase for medical or surgical complications.     

前列腺癌及直肠癌对盆腔筋膜侵犯的MRI表现

目的 探讨前列腺癌及直肠癌对盆腔主要筋膜侵犯的MRI表现特点.资料与方法 回顾性分析5例前列腺肿瘤侵犯尿生殖膈及Denonvilliers筋膜患者、4例直肠肿瘤侵犯直肠系膜或直肠系膜筋膜患者的MRI表现特点.结果 肿瘤对筋膜侵犯的MRI表现可分为直接征象和间接征象,直接征象为筋膜连续性中断,局限结节样侵犯；间接征象为脂肪间隙消失,周围淋巴结肿大.结论 MRI可以清晰地显示盆腔筋膜受累情况,对确定肿瘤分期有意义.     

Sexual dimorphism in the effect of maternal obesity on antioxidant defense mechanisms in the human placenta

IntroductionMaternal obesity creates an adverse intrauterine environment, negatively impacts placental respiration, is associated with a higher incidence of pregnancy complications and programs the offspring for disease in adult life in a sexually dimorphic manner. We defined the effect of maternal obesity and fetal sex on pro- and anti-oxidant status in placenta and placental mitochondria. Methods: Placental villous tissue was collected at term via c-section prior to labor from four groups of patients based on fetal sex and prepregnancy/1st trimester body mass index: lean - BMI 22.1 ± 0.3 (6 male, 6 female) and obese - BMI 36.3 ± 0.4 (6 male, 6 female). Antioxidant enzyme activity, mitochondrial protein carbonyls, nitrotyrosine residues, total and nitrated superoxide dismutase (SOD) and nitric oxide synthesis were measured. Results: Maternal obesity was associated with decreased SOD and catalase activity, and total antioxidant capacity (TAC), but increased oxidative (protein carbonyls) and nitrative (nitrotyrosine) stress in a sexually dimorphic manner. Placentas of lean women with a male fetus had higher SOD activity and TAC (p < 0.05) than other groups whereas obese women with a male fetus had highest carbonyls and nitrotyrosine (p < 0.05). Glutathione peroxidase and thioredoxin reductase activity increased with obesity, significantly with a male fetus, perhaps as a compensatory response. Conclusion: Maternal obesity affects oxidative stress and antioxidant activity in the placenta in a sexually dimorphic manner. The male fetus of a lean women has the highest antioxidant activity, a protection which is lost with obesity perhaps contributing to the increased incidence of adverse outcomes with a male fetus.     

稽留流产胚胎绒毛染色体异常的分析研究

目的 探讨稽留流产与胚胎染色体异常之间的关系。方法 在无菌条件下，采集87例首次稽留流产患者的胚胎绒毛，采用长期培养法制备绒毛染色体标本，进行绒毛320～400条带染色体分析。结果 有84例绒毛染色体制备成功，绒毛培养的成功率为96．6％，其中发现核型异常45例（核型异常发生率为53．6％），染色体数目异常43例（染色体数目异常发生率为95．6％）。年龄≥35岁的患者核型异常的发生率为71．4％，＜35岁的患者核型异常的发生率为44．6％，两者比较有显著性差异（χ^2=5．385，P＜0．05）。结论 染色体数目异常是稽留流产的重要原因之一，尤其是≥35岁患者的染色体数目异常的发生率明显升高。绒毛染色体分析是稽留流产病因诊断的重要手段，可为再次生育提供优生指导依据。