围产期PFOS暴露对幼鼠海马BDNF/TrkB/CREB信号通路影响

目的 探讨观察母孕鼠围产期全氟辛烷磺酸盐(perfluorooctane sulphonate,PFOS)暴露对幼鼠海马组织BDNF/TrkB/CREB信号通路关键基因表达的影响。 方法 20只昆明种雌性小鼠随机分为对照组和低、中、高剂量组,从孕鼠怀孕第2 d开始(gestation day2, GD2)到幼鼠出生后21 d(postnatal day21,PND21)分别给予低、中、高剂量组孕鼠PFOS剂量为 0.1、1.0、5.0 mg/(kg·bw)灌胃染毒,对照组给予等体积的0.05% Tween-20水溶液。灌胃量为0.1 ml/10 (g·bw)。PND 21 d处死幼鼠,收集脑组织,分离海马及皮层。HE染色观察脑组织常规病理改变,实时荧光定量PCR(Quantitative Real-time PCR,QPCR)检测海马组织中BDNF、TrkB、CREB、Syn1及Syp的mRNA表达水平。 结果 与对照组相比较,低、中、高三个剂量组对幼鼠的死亡率和体质量的影响差异无统计学意义(P>0.05)。但是在高剂量组幼鼠海马组织出现空泡,海马BDNF、TrkB、CREB mRNA水平显著降低,分别由对照组的(0.98±0.11)、(1.03±0.09)、(1.08±0.12)下降到(0.22±0.21)、(0.71±0.14)、(0.37±0.26),并在中、高剂量组引起了幼鼠突触相关蛋白Syn1和Spy的mRNA水平显著降低,分别由对照组的(1.10±0.09)、(0.97±0.08)下降到中剂量的(0.41±0.23)、(0.71±0.17)和高剂量的(0.39±0.19)、(0.63±0.19),差异均有统计学意义(P<0.05)。 结论 PFOS损伤海马BDNF/TrkB/CREB信号通路可能是PFOS神经发育毒性之一。     

Agminated fibroblastic connective tissue nevus in a 1‐year‐old boy

Fibroblastic connective tissue nevus (FCTN) is a benign cutaneous mesenchymal lesion characterized by proliferation of CD34‐positive fibroblastic/myofibroblastic spindle‐shaped cells. We report a case of agminated FCTN on the right lower abdomen of a 1‐year‐old boy.     

A review of suture anchors

Suture anchors are designed to allow soft tissue to bone healing in cases where inadequate soft tissue stock on bone makes it impossible to perform a direct soft tissue-to-soft tissue repair. Suture anchor fixation is one of the most important innovations in arthroscopic glenohumeral shoulder surgery, optimizing the link between bone and soft tissue at the rotator cuff footprint. Newer developments and techniques have expanded the use of suture anchors to most other musculoskeletal tissues including the hip, elbow, hand, knee foot and ankle.Their success depends on having an understanding of the biology and biomechanics that affect their use and knowing the factors that may affect the clinical outcome. This review concentrates on the design, insertion technique, composition and evolution of suture anchors in orthopaedic surgery and the ways in which they are utilised in different tissues.     

Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants

Our aim was to evaluate neurosensory symptoms after lateralisation of the inferior alveolar nerve (IAN). We studied a retrospective case series with one-year follow up that included 139 procedures in 123 patients. After the IAN had been located it was deflected from the mandibular body and the implant placed. Sensitivity was mapped 24 hours, one month, six months, and one year after the intervention by gently pressing the skin and lips with the tip of a probe. A total of 337 implants were placed in 123 patients aged between 44 and 68 years.There were 33 men and 90 women and they all recovered. The IAN was mobilised by one of two procedures, one that involves the nerve directly (transposition) and one that does not (lateralisation). During lateralisation the nerve is deflected laterally through a mandibular osteotomy, while the mental nerve and mental foramen are not manipulated. The resulting hypoaesthetic area was drawn on a graph to assess its extension. Although different techniques are available for placing implants in atrophic jaws, mobilisation of the IAN is indicated in certain cases in which other techniques are not feasible or have a high risk of complications.     

超声造影增强模式鉴别软组织肿块良恶性

Objective: To investigate the ability of contrast enhancement patterns of contrast-enhanced ultrasound in differentiating benign and malignant soft tissue tumours.     

实时超声弹性成像在诊断慢性乙肝肝纤维化程度中的应用价值

【摘要】 目的 探讨实时超声弹性成像在诊断慢性乙肝肝纤维化程度中的应用价值。方法 以2016年1月～2019年1月我院收治的慢性乙型肝炎（CHB）患者146例为研究对象。分别行肝脏穿刺检查及实时组织弹性成像（RTE）检查，然后进行病理分期，并记录相应的应变均值（MEAN）、标准偏差（SD）、蓝色区域面积比（%AREA）、复杂度（COMP）、峰度（KURT）、偏度（SKEW）、对比度（CONT）、均等性（ENT）、杂乱度（IDM）、一致性（ASM）、相关性（CORR），并计算得出肝纤维化指数（LFI）值。结果 与S0、S1、S2期比较，S4期MEAN显著降低（P＜0.05）；与S0、S1、S2、S3期比较，S4期%AREA、COMP显著升高（P＜0.05）；与S0、S1、S2期比较，S4期SKEW、LFI显著升高（P＜0.05）；与S0期比较，S3期LFI显著升高（P＜0.05）。Spearman相关分析结果示，MEAN、ENT与肝纤维化分期呈负相关（P＜0.05）。SD、%AREA、COMP、SKEW、IDM、ASM、LFI与肝纤维化分期呈正相关（P＜0.05）。RTE参数MEAN、%AREA、COMP、SKEW、IDM、LFI诊断肝纤维化程度的ROC曲线下面积均在0.7~0.9。当MEAN、%AREA、COMP、SKEW、IDM、LFI 6个参数的截断值分别取10029、3014、2752、042、012、281时，诊断肝纤维化程度的准确性和特异性均在70%以上。〖HT5"H〗结论〖HTK〗〓实时组织弹性成像与慢性乙型肝炎肝纤维化分期具有较高的相关性，其中与肝纤维化指数的相关系数最大，其在慢性乙型肝炎肝纤维化的诊断和评估中具有重要应用价值。     

Brain impedance variation of directional leads implanted in subthalamic nuclei of Parkinsonian patients

ObjectiveConventional deep brain stimulation (DBS) systems with ring-shaped leads generate spherical electrical fields. In contrast, novel directional leads use segmented electrodes. Aim of this study was to quantify the impedance variations over time in subjects with the directional Cartesia-Boston® system.MethodsImpedance records, programming settings, and clinical data of 11 consecutive Parkinsonian patients implanted with DBS directional leads in two Italian centers (Udine and Vicenza) were retrospectively evaluated. Data were collected before starting stimulation (in the operating room and at days 5 and 40) and after switching stimulation on at the successive follow-up visits (1, 6 and 12 months).ResultsDirectional leads have significantly higher impedance than ring leads. Stimulated contacts had always lower impedance compared to non-stimulated contacts. Before DBS-on, all contacts had higher impedance in the operating room, with an initial decrease five days post-surgery and a subsequent increase at day 40, more evident for directional contacts. The impedance of directional leads increased post-implantation at 1 and 6 months with a plateau at 12 months.ConclusionsThere was a significant difference between the directional and ring leads at baseline (before activation of DBS) and during follow-up (chronic DBS).SignificanceOur study reveals new information about the impedance of segmented electrodes that is useful for patient management during the initial test period, as well as during long-term DBS follow-up.