阴道上皮内瘤变治疗方式的研究进展

阴道上皮内瘤变(Va IN)是一种不常见的无症状的癌前病变。其病因和演变成浸润性癌的潜在原因尚不清楚。其发病率虽较低,但仍会威胁患者的生命健康,特别是高级别的病变。Va IN经早期治疗后常常可以转归,但由于高危的复发及进展可能需长期谨慎的随诊。目前该病无标准的治疗指南,且每种治疗方法都有其优缺点,因此就每例患者的特点而选择恰当的方法显得尤其重要。     

PPARs信号通路参与肠道菌群和棕色脂肪组织的代谢调控肥胖

背景:肠道菌群与棕色脂肪组织之间存在着复杂的调控机制和广泛联系,但是目前机制尚未阐明。目的:揭示棕色脂肪组织与肠道菌群间的潜在关系,为接下来的研究提供实验思路。方法:由第一作者应用计算机以“brown adipose tissue,intestinal flora,obesity,peroxisome proliferator activated receptor family”为英文检索词,以“棕色脂肪组织,肠道菌群,肥胖,过氧化物酶体增殖物激活受体家族”为中文检索词在PubMed、万方、维普、知网数据库中检索1994-01-01/2020-06-01的相关文献,并对文献的相关内容进一步筛选、归纳分析与总结,最终纳入38篇相关文献进行综述。结果与结论:①肠道菌群失调会影响过氧化物酶体增殖物激活受体(peroxisome proliferator-activated receptors,PPARs),PPARs又可以影响棕色脂肪组织的代谢进而调控肥胖;PPARα、PPARβ和PPARγ都与脂肪代谢有关,可以被相应的激活剂激活促进棕色脂肪组织的表达,其中PPARγ在肠道菌群和棕色脂肪组织中的联系最为密切,肠道菌群代谢的变化可以上调PPARγ的表达,从而激活棕色脂肪组织达到减肥的目的;②调节肠道菌群与棕色脂肪组织的关系可以治疗肥胖症;③从棕色脂肪组织、PPARs信号通路两者中研究抵抗肥胖的相关药物前景可观。     

分娩方式选择的影响因素分析与护理对策

妊娠分娩是人类历史延绵的生理过程,分娩方式的选择及分娩因素的控制对人类的优生优育具有决定性作用,影响人类社会的发展方向。分娩受到产道、产力、胎儿及产妇心理因素等多方面因素的影响,加强对分娩影响因素的研究有助于使各方面因素协调统一,共同促进产妇分娩。本文旨在分析影响孕妇分娩方式的选择因素,并提出阴道分娩及剖宫产围产期的护理方法。     

产程中阴道检查代替肛门检查的临床观察

目的 探讨在产程的观察过程中使用碘伏消毒行阴道检查替代肛门检查的临产观察.方法 在产程观察过程中使用使用-山东利尔康碘伏消毒液,其有效碘含量在4.5~5.5/15%的碘伏消毒会阴部行阴道检查(以下用5%的碘伏或碘伏表示).结果 310例产妇无一人感染,可靠率100%.结论 在产程观察过程中,使用5%的碘伏消毒会阴部行阴道检查替代肛门检查在临产上是可以使用的.     

中药膏剂对钳刮术患者术后阴道流血的作用

目的 观察中药膏剂贴敷于相关穴位对行人工流产钳刮术患者术后阴道流血的改善情况。方法 将来我院妇科行人工流产钳刮术的患者分为对照组87例和观察组82例，对照组患者按照常规人工流产钳刮术后护理方式护理；观察组同时采用中药（包括当归、川芎、三七、炮姜）制作的膏药贴敷于相关穴位（包括神阙、气海、中极穴位），观察两组患者术后不同时间阴道流血量和流血持续时间。结果 与对照组相比，观察组患者术后1h、2h及6h阴道流血量和术后阴道流血持续时间均减少（P〈0．05）。结论 采用此中药膏剂贴敷于相关穴位能减少人工流产钳刮术患者术后出血量和出血时间，促进患者术后康复。     

Multivariate normal tissue complication probability modeling of vaginal late toxicity after brachytherapy for cervical cancer

PurposeTo explore the best variables combination for a predictive model of vaginal toxicity in cervical cancer patients undergoing brachytherapy (BT).Methods and MaterialsClinical and 3-dimensional dosimetric parameters were retrospectively extracted from an institutional database of consecutive patients undergoing intracavitary BT after external beam radiation therapy from 2006 to 2013 for a cervical cancer. A least absolute shrinkage and selection operator selection procedure in Cox's proportional hazards regression model was performed to select a set of relevant predictors for a multivariate normal tissue complication probability model of Grade ≥2 vaginal late toxicity. Outcomes reliability was internally assessed by bootstrap resampling method.ResultsOne hundred sixty-nine women were included in the present study with a median followup time of 3.8 years (interquartile range [IQR], 1.9–5.6 years). The 2 years and 5 years cumulative incidence rates of Grade ≥2 late vaginal toxicity were 19.9% and 27.5%, respectively. Among 31 metrics and six clinical factors extracted, the optimal model included two dosimetric variables: V70_Gy and D5_% (the percentage volume that received a dose greater or equal to 70 Gy and the minimum dose given to the hottest 5% volume, respectively). Area under the ROC curve at 2 and 5 years of followup were 0.85 and 0.91, respectively. Regarding internal validation, median area under the ROC curve of bootstrap predictions was 0.83 (IQR, 0.78–0.88) and 0.89 (IQR, 0.85–0.93) at 2 and 5 years of followup, respectively.ConclusionsA multivariate normal tissue complication probability model for severe vaginal toxicity based on two dosimetric variables (V70_Gy and D5_%) provides reliable discrimination capability in a cohort of cervical cancer treated with external beam radiation therapy and BT.     

慢传输便秘大鼠肠道菌群的ERIC-PCR指纹图谱分析

目的 应用细菌基因共有重复序列指纹图谱技术,探讨慢传输便秘肠道菌群的变化.方法 选取Wistar大鼠30只,随机分为对照组15只、造模组15只,造模组给予易蒙停灌胃.收集每24 h排出粪便,计数排便粒数,称量粪便质量,及24 h进食量及进水量,通过碳末灌胃测定肠道传输时间.留取造模组与对照组不同时段粪便,提取肠道细菌DNA,进行ERIC-PCR指纹图谱分析.结果 造模组大鼠24 h内排便粒数、排便质量、进食量较对照组明显减少,进水量没有明显差异.造模组大鼠肠道传输时间明显高于对照组.造模组大鼠肠道菌群ERIC-PCR结果优势条带依然存在,但是较对照组及给药前条带增多且亮度增高.结论 易蒙停给药致慢传输便秘大鼠造模成功,造模组大鼠肠道菌群较对照组ERIC-PCR结果可能存在细菌数量及种类增多.     

The Queuine Micronutrient: Charting a Course from Microbe to Man

Micronutrients from the diet and gut microbiota are essential to human health and wellbeing. Arguably, among the most intriguing and enigmatic of these micronutrients is queuine, an elaborate 7-deazaguanine derivative made exclusively by eubacteria and salvaged by animal, plant and fungal species. In eubacteria and eukaryotes, queuine is found as the sugar nucleotide queuosine within the anticodon loop of transfer RNA isoacceptors for the amino acids tyrosine, asparagine, aspartic acid and histidine. The physiological requirement for the ancient queuine molecule and queuosine modified transfer RNA has been the subject of varied scientific interrogations for over four decades, establishing relationships to development, proliferation, metabolism, cancer, and tyrosine biosynthesis in eukaryotes and to invasion and proliferation in pathogenic bacteria, in addition to ribosomal frameshifting in viruses. These varied effects may be rationalized by an important, if ill-defined, contribution to protein translation or may manifest from other presently unidentified mechanisms. This article will examine the current understanding of queuine uptake, tRNA incorporation and salvage by eukaryotic organisms and consider some of the physiological consequence arising from deficiency in this elusive and lesser-recognized micronutrient.