Comparative study of different transplantation methods of adipose tissue-derived stem cells in the treatment of erectile dysfunction caused by cavernous nerve injury

We aimed to compare intracavernosal injection (ICI), tail vein injection (IV), and periprostatic injection (PPI) of adipose-derived stem cells (ADSCs) for their ability to improve erectile function in cavernous nerve injury-induced erectile dysfunction (CNIED) rats and to explore the possible mechanism. Eighty-four male SD rats were divided into the sham group (n = 6), BCNI group (bilateral CN crush injury, n = 6), PBS-ICI group (n = 6), PBS-IV group (n = 6), PBS-PPI group (n = 6), ADSC-ICI group (n = 18), ADSC-IV group (n = 18) and ADSC-PPI group (n = 18). ADSCs were labelled with 5-ethynyl-2′-deoxyuridine (EdU), and six rats each in the ADSC-ICI group, ADSC-IV group, and ADSC-PPI group were sacrificed 2, 7, and 28 days after injection. EdU-labelled ADSCs were tracked by immunofluorescence staining. The intracavernosal pressure (ICP)/mean arterial pressure (MAP) ratio, neuronal nitric oxide synthase (nNOS)-positive nerve fibres in the dorsal penile nerve and the smooth muscle/collagen ratio in the cavernosum between groups were also evaluated. ADSCs can significantly improve erectile function through ICI or IV. The two are similar in efficacy and superior to PPI. The mechanism may be that after CN injury, ADSCs are recruited to around the MPG and secrete a variety of neurotrophic factors that promote the repair of the CN, thereby improving erectile function.     

Clinical study on effect of Kang’aibao oral liquid in treating 103 patients of malignant tumor) in treating 103 patients of malignant tumor

Objective: To observe the clinical efficacy of Kang’aibao oral liquid (KABL), a Chinese herbal preparation in treating malignant tumor of middle or advanced stage.Methods: A comparative study was done by observing the effect of 103 patients treated with KABL, and another 90 patients treated with chemotherapy at the same time were taken as the control group.Results: The immunologic function, short-term effective rate (complete relieved rate and partial relieved rate), survival quality, 1-, 2- and 3-year survival rate, median survival time, and carcinoembryonic antigen (CEA) declining rate of the KABL group were significantly higher than those of the control group.Conclusion: KABL has the effects of inhibiting tumor growth, prolonging survival time and improving survival quality of tumor patients.     

异体巩膜移植联合任意皮瓣成形术治疗中重度眼睑深层和全层缺损的疗效

目的：探讨异体巩膜移植联合任意皮瓣成形术治疗中重度眼睑深层和全层缺损的临床效果。

方法：回顾性分析2017-06/2020-06于我院行异体巩膜移植联合任意皮瓣成形术治疗的中重度眼睑深层和全层缺损患者103例103眼。术后随访1～6mo,观察异体巩膜吸收融合状态、皮瓣成活状态、眼睑形态、眼睑开合功能、眼睑瘢痕等情况,评估手术疗效。

结果：术后随访期间,异体巩膜逐渐被受体组织代替,所有患者眼睑内层异体巩膜均为结膜细胞覆盖,眼睑外层异体巩膜与皮肤黏连紧密,无明显排异反应,皮瓣成活良好,眼睑形态良好,闭合自然,瘢痕不明显。

结论：异体巩膜移植联合任意皮瓣成形术治疗中重度眼睑深层和全层缺损疗效确切,能够达到外观与功能兼具,临床疗效显著。     

丁公藤注射液促进骨质疏松性大鼠骨折愈合的作用机制研究

目的 研究丁公藤注射液(injection erycibe，IE)对骨质疏松性大鼠骨折愈合的促进作用及其作用机制。方法 通过卵巢切除术和骨折术建立骨质疏松性骨折大鼠模型，50只健康SD大鼠(♀)随机分为假手术组、模型组和1，2，4mL·kg^-1 IE组，检测大鼠股骨骨密度、生物力学指标和血清钙、碱性磷酸酶含量，HE染色观察大鼠骨骼病理组织学变化。对分离的骨髓间充质干细胞(mesenchymal stem cells，MSCs)进行药物干预，分为对照组、5，10，20mg·L^-1 IE组、诱导组(成骨诱导培养基诱导分化)、NC siRNA组、NCK1 siRNA组、IE+NC siRNA组和IE+NCK1 siRNA组，采用MTT检测MSCs增殖，RT-qPCR检测成骨分化相关基因ALP、Runx2和Osterix mRNA水平，Western blotting检测NCK1和p-AKT蛋白表达水平，茜素红染色观察MSCs钙结节数量。结果 与模型组比较，2，4mL·kg^-1 IE组大鼠股骨骨密度、生物力学指标、血清生化指标均明显升高(P<0.05)，且呈剂量依赖性，4mL·kg^-1 IE组效果最佳。与对照组比较，10，20mg·L^-1IE组MSCs增殖和成骨分化相关基因表达量明显升高(P<0.05或P<0.01)，NCK1和p-AKT蛋白表达水平明显升高(P<0.05)，MSCs内钙结节量明显增加，且呈剂量依赖性，20mg·L^-1 IE组效果最佳。与IE+NC siRNA组比较，IE+NCK1 siRNA组成骨分化相关基因表达量明显降低(P<0.01)，NCK1和p-AKT蛋白表达水平明显降低(P<0.01)。结论 IE通过促进NCK1蛋白表达，激活AKT信号通路，对骨质疏松性大鼠骨折愈合起到一定促进作用。     

公立医院内部控制管理现状思考

随着公立医院改革的深化,公立医院会计报告不真实、组织效率不高、违规行为时有发生等现象越来越受到主管部门和社会的关注。2011年10月,《行政事业单位内部控制规范》征求意见稿出台,意图通过加强内部控制改变这些现状。该文从公立医院内部控制的现状入手,分析了目前公立医院内部控制成效不理想的原因,并提出了具体的控制措施。     

PPI联合FOLFOX方案在结肠癌术后化疗中对肠道黏膜屏障功能及生存质量的影响

目的:探讨质子泵抑制剂（PPI）联合奥沙利铂+亚叶酸钙+氟尿嘧啶（FOLFOX方案）在结肠癌根治术后辅助化疗期间应用的价值。方法: 选取我院2015年3月-2017年3月收集的110例结肠癌患者,所有患者均接受结肠癌根治手术,采用随机数字表法分为观察组和对照组各55例;对照组术后接受FOLFOX方案化疗,观察组术后采用奥美拉唑联合FOLFOX方案治疗,对比两组化疗前、化疗结束时的二胺氧化酶（DAO）、血乳酸、尿乳果糖/甘露醇（L/M）、生存质量、各类化疗毒副反应发生率。结果: 治疗前,观察组和对照组的血清DAO、血乳酸、L/M水平差异不具有统计学意义（P>0.05）;治疗后,观察组患者的血清DAO、血乳酸、L/M水平均低于对照组（P<0.05）,两组患者治疗后的血清DAO、血乳酸、L/M水平较治疗前均显著的升高（P<0.05）;治疗前,观察组和对照组的各维度生存质量评分差异无统计学意义（P>0.05）;治疗后,观察组患者的躯体功能、角色功能、认知功能、社会功能、整体生活质量评分均高于对照组（P<0.05）,观察组的疲乏、恶心/呕吐、呼吸困难、失眠、食欲丧失、腹泻评分低于对照组（P<0.05）;观察组患者的腹泻、恶心/呕吐发生率显著低于对照组（P<0.05）,两组患者的脱发、骨髓抑制、肝肾损害发生率差异无统计学意义（P>0.05）。结论: PPI联合FOLFOX方案在结肠癌根治术后应用较单纯化疗有利于减轻患者的不良反应,保护肠道功能,提高患者的生存质量。     

大麻素受体1型基因多态性对利拉鲁肽治疗早期2型糖尿病患者临床疗效的影响研究

背景　利拉鲁肽在Ⅲ期临床试验中被证实可以有效降低糖尿病患者血糖水平,然而在临床应用过程中利拉鲁肽的降糖效果仍存在较大的个体差异。研究表明,基因多态性是造成众多药物出现个体差异的原因之一。目的　大麻素受体1型基因（CNR1）在糖尿病及其并发症中发挥重要作用,本研究旨在探讨CNR1多态性对利拉鲁肽治疗早期2型糖尿病（T2DM）患者临床疗效的影响。方法　选取2016年3月-2018年10月河南省直第三人民医院内分泌科收治的230例早期T2DM患者作为研究对象。患者均皮下注射利拉鲁肽进行治疗,治疗16周后测量体质指数（BMI）、空腹血糖（FPG）、餐后2 h血糖（2 hPG）和糖化血红蛋白（HbA1c）。另外,收集患者外周血及部分患者新鲜外周血标本分别用来进行CNR1基因1260G>A位点的基因分型及CNR1 mRNA的表达测定。结果　治疗16周后患者BMI、FPG、2 hPG、HbA1c水平均低于治疗前（P<0.05）。230例患者CNR1基因1260G>A位点的基因分型为：GG型188例（81.7%）,GA型39例（17.0%）,AA型3例（1.3%）,最小等位基因频率为0.098,三种基因型分布频率符合哈迪温伯格平衡（P=0.550）。治疗16周后,GA/AA型患者BMI、FPG、HbA1c水平均低于GG型（P<0.05）。GG型和GA/AA型患者治疗16周后BMI、FPG、2 hPG、HbA1c水平均低于治疗前（P<0.05）。125例具有合适标本的CNR1 mRNA表达分析显示,GG型患者CNR1 mRNA表达水平高于GA/AA型患者（P<0.05）。不同基因型患者恶心呕吐、低血糖及总体不良反应发生率比较,差异均无统计学意义（P>0.05）。结论　利拉鲁肽在早期T2DM患者治疗中安全有效。CNR1基因1260G>A位点的GA/AA型可能通过影响该基因mRNA的表达进而影响利拉鲁肽对T2DM患者的疗效。     

Analysis of brain-stem auditory evoked potential and visual evoked potential in patients with Parkinson disease

INTRODUCTION The exact cause of Parkinson disease (PD) has not been known yet[1]. The overwhelming progress had been made in the treatment and pathogenesis of PD in recent 30 years, especially 10 years[2]. But it is still no way now to prevent or postpone…     

The pivotal role of the coronal fracture line for a new three-dimensional CT-based fracture classification of bicondylar proximal tibial fractures

IntroductionClassical fracture classifications (AO/OTA, Schatzker) are commonly used to characterize bicondylar proximal tibial fractures. However, none of these classifications allows for a treatment algorithm. The aim of our study was to use 3D appearance of these fractures in CT imaging to improve the clinical value of the classification.Materials and methods3D appearance of 81 CT scans of bicondylar proximal tibial fractures were systematically analyzed and were classified in 3 subtypes, based on the fracture lines orientation. The novel classification was compared for reliability and for clinical relevance with AO and Schatzker classification.ResultsA total of 159 fracture lines were identified which were most frequently oriented in sagittal (89/159), and in coronal (41/159) direction. Based on the orientation of the major fracture lines three fracture types were defined. A special emphasis was drawn to the coronal fracture line of the medial plateau leading to a surgical treatment algorithm. Interobserver reliability was analyzed for all 81 patients resulting in an excellent reliability of К = 0.936 for the 3D classification scheme compared to К = 0.720 for the AO/OTA, К = 0.785 for the Schatzker classification. Correlations with clinical parameters were only observed for the 3D classification.DiscussionThe presented classification scheme based on the 3D geometry of bicondylar proximal tibial fractures demonstrates a good reliability of clinical relevance.     

年青甲亢及糖尿病女性患者跟骨超声骨参数的变化

目的 研究年青女性甲亢和糖尿病人超声骨参数的变化,以了解这二种疾病对峰值骨量期骨量的影响及骨量丢失发生比的差异。方法 测定健康对照组（A组）、甲亢组（B组）、糖尿病组（C组）3组研究对象的跟骨超声骨参数。结果 B组超声传导速度（SOS）、振幅衰减（BUA）、骨强度指数（STI）显低于A、C二组,A、C二组无显差异。B组骨量丢失17例（占31．5％）,C组骨量丢失4例（占9．3％）,二组差异显。结论 在病程早期甲亢比糖尿病更易影响骨代谢,此差异可能与二骨转换形式不同有关。