胫骨骨内脂肪瘤1例

正患者,男,21岁,因"无明显诱因出现左小腿下段间歇性疼痛4年余"入院。患者于4年前长时间站立后出现左小腿下段疼痛,当时未行治疗,后症状逐渐加重,就诊于当地医院,行X线、MRI等检查,当时考虑病变较小,建议定期复查。2018年2月26日患者在剧烈运动后疼痛加重就诊我院。入院查体:左小腿远端前内侧压痛阳性,未触及肿块,局部皮肤无红肿、发热、破溃等异常,肢体远端足趾颜色红润、毛细血管反应良好,足背动脉可扪及。     

Patellar inward pushing method relieves knee osteoarthritis via regulating cytokines

BackgroundKnee osteoarthritis (KOA) is a chronic degenerative disease characterized by pain, morning stiffness and swelling in the knee joints. And KOA is common in the elderly and seriously affects the exercise function and physical health of patients. This study aimed to explore the curative effects of patellar inward pushing method (PIPM) on KOA.Material and methodIn this study, we established rabbit animal models of KOA for the research by using the New Zealand white rabbits. 30 New Zealand white rabbits were divided into 5 groups by random number table method: blank group, model group, glucosamine hydrochloride (GH) group, PIPM group and PIPM combined with GH group, then the rabbits were modeled.ResultsAfter 9-weeks cultured in groups, 5 ml blood was collected from the heart, and cytokines were detected. The result suggested that iNOS, NO and TNF-α were the pathogenic inflammatory factor of KOA, and aggravated cartilage damage and degeneration. Besides, this study indicated that PIPM combined with GH treatment significantly reduced the activity of inflammatory cytokines in serum and joint fluid of KOA models in rabbits. In addition, PIPM combined with GH therapy exhibited the best therapeutic effect among these treatments, which was working on KOA better than PIPM treatment alone or GH treatment alone.ConclusionsPIPM could effective treat KOA via regulating cytokines, and the PIPM combined with GH therapy could be a novel therapeutic strategy of KOA.     

PD-1抑制剂联合靶向药物治疗晚期原发性肝癌的安全性及临床疗效观察

目的:探讨PD-1抑制剂联合靶向药物治疗晚期原发性肝癌的安全性及有效性。方法:选取2020至2021年本院收治的70例晚期原发性肝癌患者作为研究对象，分为两组，分别予以单药PD-1抑制剂治疗（单药治疗组）、PD-1抑制剂联合靶向药物治疗（联合用药组），并对两组患者的相关病历资料及获取的有效性及安全性数据行回顾性分析。结果:安全性比较可知，单药治疗组发生不良事件的比率分别为皮肤及皮下组织类疾病占17.14%，肝功能异常占25.71%，血液学毒性占31.42%，全身性症状占8.57%，胃肠道占17.14%，呼吸系统、胸及纵隔疾病占11.43%，代谢及营养类疾病占20.00%，肾脏及泌尿系统疾病占5.71%，内分泌系统疾病占5.71%；联合用药组发生不良事件的比率分别为皮肤及皮下组织类疾病占22.85%，肝功能异常占28.57%，血液学毒性占25.71%，全身性症状占11.43%，胃肠道占20.00%，呼吸系统、胸及纵隔疾病占14.29%，代谢及营养类疾病占17.14%，肾脏及泌尿系统疾病占8.57%，内分泌系统疾病占2.86%，两组比较差异均无统计学意义（P＞0.05），联合用药并不会增加不良事件发生。有效性比较可知，单药治疗组患者的完全缓解率为8.57%、部分缓解率为31.43%、疾病稳定率为48.57%、疾病进展率为11.43%；联合治疗组患者的完全缓解率为14.29%、部分缓解率为54.29%、疾病稳定率为25.71%、疾病进展率为5.71%，差异具有统计学意义（P＜0.05）。联合用药组对疾病更为有效。T淋巴细胞水平高于单药组（P＜0.05）。结论:对晚期原发性肝癌患者行PD-1抑制剂联合靶向药物治疗比单药PD-1抑制剂提升T淋巴细胞水平，治疗能取得更好的临床效果，保证患者足够的安全性。