利咽散结方对自发性高血压大鼠血压及相关炎性因子的影响

目的研究利咽散结方对自发性高血压大鼠血压及相关炎性因子的影响。方法将36只自发性高血压大鼠随机分为利咽散结方组、氨氯地平组、模型组,每组12只。正常WKY大鼠12只作为正常组。利咽散结方组给予利咽散结方药液15.6 g/kg灌胃,氨氯地平组给予氨氯地平药液0.001 g/kg灌胃,模型组和正常组均给予等体积的蒸馏水灌胃,均1次/d,连续8周。测量各组大鼠灌胃前及灌胃2周、4周、6周、8周后血压,末次灌胃结束后用ELISA法测定血清炎性因子肿瘤坏死因子(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平。结果利咽散结方组与氨氯地平组灌胃2周、4周、6周、8周后收缩压与舒张压均显著低于同期模型组(P均<0.05);利咽散结方组灌胃2周、4周、6周、8周后收缩压均显著高于同期氨氯地平组(P<0.05),而舒张压与同期氨氯地平组比较差异均无统计学意义(P均>0.05)。模型组血清TNF-α、hs-CRP、IL-6水平均明显高于正常组(P均<0.05),IL-10水平明显低于正常组(P<0.05);利咽散结方组与氨氯地平组血清TNF-α、hs-CRP、IL-6水平均明显低于模型组(P均<0.05),且利咽散结方组均明显低于氨氯地平组(P均<0.05);利咽散结方组与氨氯地平组血清IL-10水平均明显高于模型组(P均<0.05),且利咽散结方组明显高于氨氯地平组(P<0.05)。结论利咽散结方可显著降低自发性高血压大鼠血压,其降收缩压效果不如氨氯地平,降舒张压效果与氨氯地平相近,其作用机制可能与调节炎性因子水平有关。     

Orthogonally oriented scaffolds with aligned fibers for engineering intestinal smooth muscle

Controlling cellular alignment is critical in engineering intestines with desired structure and function. Although previous studies have examined the directional alignment of cells on the surface (x–y plane) of parallel fibers, quantitative analysis of the cellular alignment inside implanted scaffolds with oriented fibers has not been reported. This study examined the cellular alignment in the x–z and y–z planes of scaffolds made with two layers of orthogonally oriented fibers. The cellular orientation inside implanted scaffolds was evaluated with immunofluorescence. Quantitative analysis of coherency between cell orientation and fiber direction confirmed that cells aligned along the fibers not only on the surface (x–y plane) but also inside the scaffolds (x–z & y–z planes). Our study demonstrated that two layers of orthogonally aligned scaffolds can generate the histological organization of cells similar to that of intestinal circular and longitudinal smooth muscle.     

Lifitegrast clinical efficacy for treatment of signs and symptoms of dry eye disease across three randomized controlled trials

Objective: Report efficacy findings from three clinical trials (one phase 2 and two phase 3 [OPUS-1, OPUS-2]) of lifitegrast ophthalmic solution 5.0% for treatment of dry eye disease (DED).

Research design and methods: Three 84-day, randomized, double-masked, placebo-controlled trials. Adults (≥18 years) with DED were randomized (1:1) to lifitegrast 5.0% or matching placebo. Changes from baseline to day 84 in signs and symptoms of DED were analyzed.

Main outcome measures: Phase 2, pre-specified endpoint: inferior corneal staining score (ICSS; 0–4); OPUS-1, coprimary endpoints: ICSS and visual-related function subscale (0–4 scale); OPUS-2, coprimary endpoints: ICSS and eye dryness score (EDS, VAS; 0–100).

Results: Fifty-eight participants were randomized to lifitegrast 5.0% and 58 to placebo in the phase 2 trial; 293 to lifitegrast and 295 to placebo in OPUS-1; 358 to lifitegrast and 360 to placebo in OPUS-2. In participants with mild-to-moderate baseline DED symptomatology, lifitegrast improved ICSS versus placebo in the phase 2 study (treatment effect, 0.35; 95% CI, 0.05–0.65; p?=?0.0209) and OPUS-1 (effect, 0.24; 95% CI, 0.10–0.38; p?=?0.0007). Among more symptomatic participants (baseline EDS ≥40, recent artificial tear use), lifitegrast improved EDS versus placebo in a post hoc analysis of OPUS-1 (effect, 13.34; 95% CI, 2.35–24.33; nominal p?=?0.0178) and in OPUS-2 (effect, 12.61; 95% CI, 8.51–16.70; p?<?0.0001).

Limitations: Trials were conducted over 12 weeks; efficacy beyond this period was not assessed.

Conclusions: Across three trials, lifitegrast improved ICSS in participants with mild-to-moderate baseline symptomatology in two studies, and EDS in participants with moderate-to-severe baseline symptomatology in two studies. Based on the overall findings from these trials, lifitegrast shows promise as a new treatment option for signs and symptoms of DED.     

颞下颌关节强直动物模型中最大张口度与强直严重程度关系研究

目的　研究主、被动最大张口度（AMMO、PMMO）与颞下颌关节强直严重程度的关系。方法　选取28只健康雄性绵羊随机分为实验组和对照组，每组各14只。实验组绵羊双侧颞下颌关节模拟髁突矢状骨折，其中左侧翼外肌被切断以阻断其功能；对照组绵羊未进行手术。于术前及术后12、24周对所有绵羊体重、AMMO、PMMO、颞下颌关节形态学特点进行测量评估。结果　实验组只有右侧保留翼外肌功能的颞下颌关节发生了骨强直。术后12、24周，实验组绵羊AMMO、PMMO、极限距离均显著低于对照组，差异均有统计学意义（均P < 0.05）。实验组绵羊AMMO和PMMO与骨融合区宽度、长度、面积及钙化程度均呈负相关（均P < 0.05），其中骨融合区面积为主要影响因素（术后12、24周相关系数r分别为-0.94、-0.95）。结论　颞下颌关节强直动物模型中阻断翼外肌功能可阻止骨强直的发生；对于早期髁突矢状骨折，可通过牙合垫或牙合板进行张口训练，进而阻断翼外肌功能。当颞下颌关节发生骨强直时，骨融合区面积越大，张口受限越明显。     

A modality-specific somatosensory evoked potential test protocol for clinical evaluation: A feasibility study

ObjectiveWe aimed to establish an objective neurophysiological test protocol that can be used to assess the somatosensory nervous system.MethodsIn order to assess most fiber subtypes of the somatosensory nervous system, repetitive stimuli of seven different modalities (touch, vibration, pinprick, cold, contact heat, laser, and warmth) were synchronized with the electroencephalogram (EEG) and applied on the cheek and dorsum of the hand and dorsum of the foot in 21 healthy subjects and three polyneuropathy (PNP) patients. Latencies and amplitudes of the modalities were assessed and compared. Patients received quantitative sensory testing (QST) as reference.ResultsWe found reproducible evoked potentials recordings for touch, vibration, pinprick, contact-heat, and laser stimuli. The recording of warm-evoked potentials was challenging in young healthy subjects and not applicable in patients. Latencies were shortest within Aβ-fiber-mediated signals and longest within C-fibers. The test protocol detected function loss within the Aβ-fiber and Aδ-fiber-range in PNP patients. This function loss corresponded with QST findings.ConclusionIn this pilot study, we developed a neurophysiological test protocol that can specifically assess most of the somatosensory modalities. Despite technical challenges, initial patient data appear promising regarding a possible future clinical application.SignificanceEstablished and custom-made stimulators were combined to assess different fiber subtypes of the somatosensory nervous system using modality-specific evoked potentials.     

疼痛管理在创伤骨科护理管理中的应用价值

目的探究创伤骨科护理管理中疼痛管理的应用价值。方法 82例患者选取于2017年6月-2018年6月,所有患者均来源于本院骨科收治的住院患者,数字表为患者分组原则,常规组41例,疼痛组41例,分别予以常规护理、常规护理+疼痛管理,比较满意度、疼痛评分及平均住院时间。结果疼痛组满意度92.68%比常规组73.17%高,差异具有统计学意义(χ^2=5.513,P <0.05),患者干预后的疼痛评分低于常规组,平均住院时间短于常规组,差异存在统计学意义(P<0.05)。结论疼痛管理用于创伤骨科护理管理中,患者疼痛明显减轻,患者满意度高,缩短了患者的平均住院时间。     

Aging changes agonist induced contractile responses in permeabilized rat bladder

Aging alters bladder functions where a decrease in filling, storage and emptying is observed. These changes cause urinary incontinence, especially in women. The aim of this study is to examine how aging affects the intracellular calcium movements due to agonist-induced contractions in permeabilized female rat bladder. Urinary bladder isolated from young and old female Sprague-Dawley rats were used. Small detrusor strips were permeabilized with β-escin. The contractile responses induced with agonists were compared between young and old groups. Carbachol-induced contractions were decreased in permeabilized detrusor from old rats compared to young group. Heparin and ryanodine decreased carbachol-induced contractions in young rats where only heparin inhibited these contractions in olds. Caffeine-induced contractions but not inositol triphosphate (IP₃)-induced contractions were decreased in old group compared to youngs. The cumulative calcium response curves (pCa 8–4) were also decreased in old rats. Carbachol-induced calcium sensitization responses did not alter by age where GTP-β-S and GF-109203X but not Y-27632 inhibited these responses. Carbachol-induced contractions decrease with aging in rat bladder detrusor. It can be postulated as IP₃-induced calcium release (IICR) is primarily responsible for the contractions in older rats where the decrease in carbachol contractions in aging may be as a result of a decrease in calcium-induced calcium release (CICR), rather than carbachol-induced calcium sensitization.     

乳腺炎性肌纤维母细胞瘤的研究进展

炎性肌纤维母细胞瘤（inflammatory myofibroblastic tumor，IMT）作为一种低度恶性潜能的间叶组织来源的肿瘤，病因及发病机制不明。主要见于儿童和青少年,最常见的部位是肺、肠系膜、网膜，发生于乳腺的比较罕见，且往往单发。乳腺炎性肌纤维母细胞瘤的临床症状及影像学特点均不典型，术前易造成误诊，本文复习国内外文献报道的乳腺炎性肌纤维母细胞瘤，从发病机制、临床表现、影像学特征、病理学特征、鉴别诊断、治疗及预后等方面作一系统综述。     

Anatomically contoured large femoral heads can reduce iliopsoas impingement: A cadaver verification study

While use of large heads in total hip arthroplasty (THA) continues to grow, concerns have been raised regarding anterior hip pain resulting from impingement of the prosthetic head against soft-tissues like the iliopsoas. To address these concerns, a new anatomically contoured head (ACH) was developed. In this study cadaver tests were utilized to show that iliopsoas impingement/tenting caused by conventional heads is significantly relieved with the more rounded and reduced distal profile of the ACH. Thus, the ACH implant may be able to decrease the risk of soft-tissue impingement with conventional heads, particularly in the smaller hip.