人工全膝关节置换术中胫骨假体旋转对线方法研究进展

目的通过总结人工全膝关节置换术中胫骨假体旋转对线的方法，为临床医生选择胫骨假体旋转对线方法和进一步研究提供参考。方法查阅近年来国内外相关文献，分析总结各种胫骨假体旋转对线方法的优势和不足。结果目前有关胫骨假体旋转对线的方法很多，主要包括参考相关解剖标志、ROM（range of motion）技术、计算机辅助导航及个性化截骨等。胫骨结节中内 1/3 是较为精确的参考解剖标志，但易受肥胖、严重膝关节畸形和发育异常等因素干扰，对胫骨假体的精确放置会产生一定影响。ROM 技术无需参考胫骨解剖标志，不受其变异的影响，可用于严重膝关节内外翻畸形及术中解剖标志难以辨识的情况，但存在假体内旋放置的可能性。计算机辅助导航技术及个性化截骨在矢状位、冠状位及股骨假体旋转对线方面均可获得更加精准的对线，但由于缺乏固定可靠的胫骨相关解剖标志，是否有助于胫骨假体旋转对线仍存有争议。结论术者应掌握各种胫骨假体旋转对线的方法，做好术前计划，针对不同患者选择合适的对线方法，做到个体化。同时，术中应适当多参照几种解剖标志，可用于检测胫骨假体的放置位置，避免出现较大的旋转误差。     

The patient-reported outcome of age-related cataract using Catquest-8SF questionnaire

AIM: To assess the patient-reported outcome of phacoemulsification with posterior chamber single focus foldable intraocular lens (SIOL) using the Chinese version of Catquest-8SF questionnaire (Catquest-8SF-CN), evaluate the applicability of Catquest-8SF scale in northern Chinese and its sensitivity to cataract surgery. METHODS: Prospective clinical case follow-up study. The patients were recruited from the Central Hospital of Tai’an and completed the Catquest-8SF questionnaire by face-to-face interviews before and 3mo after surgery at the hospital. RESULTS: A total of 120 cataract patients with median age 67.6y and 52.5% female completed the Catquest-8SF. The Cronbach’s α coefficient of the total scale, daily-activity sub-table and comprehensive-evaluation sub-table were 0.861, 0.853 and 0.748 respectively. There was a high level of consistency between two investigators. The cumulative contribution rate was 66.64% by using the principal component analysis and the maximum variance orthogonal rotation method. The preoperative score of the Catquest-8SF-CN had a significant negative correlation with preoperative binocular mean weighted visual acuity and age (P<0.05), while a significant positive correlation with education level (F=6.094, P<0.001). The patients without systemic comorbidities got higher score than those who with (P<0.05). Three months after surgery, 102 (85%) patients came for follow-up and completed the questionnaire. Significant improvement of visual acuity was observed in both binocular and monocular surgery groups (t=10.404, P<0.001). There was higher improvement in binocular weighted visual acuity of binocular surgery group than in monocular surgery group (t=-20.77, P<0.001). The postoperative score was significantly higher in both groups than before (P<0.001). There was a significant improvement in the total score after cataract surgery. The 94 patients (92.2%) were very satisfied or satisfied with the operation; 92 patients (90.2%) thought the surgery achieved their expectations, and they all felt satisfactory. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery. CONCLUSION: The Chinese version of Catquest-8SF questionnaire is suitable for the age-related cataract population in northern China. It is highly responsive to cataract surgery and brief, so it may have the potential to become part of a routine clinical assessment for cataract surgery in China. The patient’s overall satisfaction is high, which illustrates that the medical service we provide matches the patient’s needs. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery.     

孟鲁司特钠对稳定期慢性阻塞性肺疾病患者肺功能和血清白细胞介素-8、白细胞介素-10 等指标的影响

目的：研究孟鲁司特钠（montelukastsodium,MS）对于稳定期（stableperiod,SP）慢性阻塞性肺疾病（COPD）患者肺功能和血清白细胞介素-8（IL-8）、白细胞介素-10（IL-10）等指标的影响.方法：将2013年1-8月共60例在我院的呼吸内科接受治疗的SPCOPD患者以随机抽样法分成常规组（30例）及MS组（30例）.常规组实施常规疗法,MS组则另加服MS;另选同期在我院接受体检的30例健康者作为对照组.测定患者血清IL-8、IL-10与血液流变学相关指标以及肺功能指标,进行对比分析.结果：MS组临床疗效显著优于对照组,差异有统计学意义（P＜0.05）.COPD患者（含MS组及常规组）在治疗前的血液流变学指标水平显著高于对照组,差异有统计学意义（P＜0.05）.相比于治疗前,MS组患者治疗后的IL-10、第一秒用力呼气量（FEV1）及用力肺活量（FVC）的比值（FEV1/FVC）、FEV1占预计值的百分比（FEV1/预计值,FEV1％）等水平明显上升（P＜0.05）;而IL-8及血液流变学等指标水平均明显下降（P＜0.05）.相比于对照组治疗后,MS组患者治疗后的全血高切黏度（HSR）、全血低切黏度（LSR）、血浆黏度（ηp）、血沉（ESR）、红细胞压积（HCT）、血浆纤维蛋白原（FIB）、IL-8均下降,但IL-10、FEVI％、FEV1/FVC等水平明显上升,差异均有统计学意义（P＜0.05）.结论：MS治疗SPCOPD患者具有较好的疗效,值得临床推荐.     

吗啡和曲马多对MADB-106乳腺癌细胞增殖和凋亡的影响

目的观察不同浓度吗啡和曲马多对MADB-106乳腺癌细胞增殖和凋亡的影响,并对其机制进行初步研究。方法将不同浓度吗啡和曲马多与MADB-106乳腺癌细胞直接作用24 h后采用流式细胞法检测细胞凋亡,MTT法检测细胞增殖。采用Western blot法检测细胞半胱氨酸蛋白酶-3（caspase-3）和半胱氨酸蛋白酶-8（caspase-8）的表达。结果吗啡和曲马多均可浓度依赖性促进MADB-106乳腺癌细胞的凋亡、抑制细胞生长与增殖;等效镇痛浓度吗啡与曲马多对MADB-106乳腺癌细胞的增殖与凋亡的影响并无差异;吗啡可促进MADB-106乳腺癌细胞caspase-3和caspase-8激活片段表达。而曲马多仅促进caspase-3激活片段表达,caspase-8激活片段无显著变化。结论吗啡和曲马多均可浓度依赖性促进MADB-106乳腺癌细胞的凋亡、抑制肿瘤细胞的生长与增殖;吗啡和曲马多均可激活caspase-3途径诱导MADB-106乳腺癌细胞的凋亡,同时吗啡可激活caspase-8途径,而曲马多无此作用。     

PARP抑制剂WZ-8体内外抗肿瘤作用研究

目的 研究PARP抑制剂WZ-8对人源性肿瘤细胞增殖及裸鼠移植人结肠癌（HCT116）生长的抑制作用。方法 SRB染色法和裸小鼠移植瘤模型研究WZ-8在体内外抗肿瘤作用。结果 体外WZ-8对多种人肿瘤细胞增殖有明显抑制作用,其中对结肠癌细胞HCT116的半数抑制浓度IC50为（0.21±0.01）mg·mL^-1。体内研究表明WZ-8（20 mg·kg-1）对小鼠移植HCT116肿瘤生长有一定抑制效果,其体内外抗肿瘤活性均高于同类化合物Iniparib。结论 WZ-8在体外对人源性肿瘤细胞增殖有明显抑制作用,在体内可抑制裸鼠移植人结肠癌细胞HCT116的生长。     

Attenuation of Donor‐Reactive T Cells Allows Effective Control of Allograft Rejection Using Regulatory T Cell Therapy

Regulatory T cells (Tregs) are essential for the establishment and maintenance of immune tolerance, suggesting a potential therapeutic role for Tregs in transplantation. However, Treg administration alone is insufficient in inducing long‐term allograft survival in normal hosts, likely due to the high frequency of alloreactive T cells. We hypothesized that a targeted reduction of alloreactive T effector cells would allow a therapeutic window for Treg efficacy. Here we show that preconditioning recipient mice with donor‐specific transfusion followed by cyclophosphamide treatment deleted 70–80% donor‐reactive T cells, but failed to prolong islet allograft survival. However, infusion of either 5 × 10⁶ Tregs with direct donor reactivity or 25 × 10⁶ polyclonal Tregs led to indefinite survival of BALB/c islets in more than 70% of preconditioned C57BL/6 recipients. Notably, protection of C3H islets in autoimmune nonobese diabetic mice required islet autoantigen‐specific Tregs together with polyclonal Tregs. Treg therapy led to significant reduction of CD8⁺ T cells and concomitant increase in endogenous Tregs among graft‐infiltrating cells early after transplantation. Together, these results demonstrate that reduction of the donor‐reactive T cells will be an important component of Treg‐based therapies in transplantation.