以宫腔积液为首发症状的胃型宫颈腺癌1例报道并文献复习

宫腔积液指宫腔内液体积存(积水、积血或积脓),是绝经后女性常见体征之一,常于超声检查时发现。持续宫腔积液患者,需宫腔镜检查寻找病因。本文报道1例以宫腔积液为首发症状,经宫腔镜检查确诊为胃型宫颈腺癌的患者。通过病例回顾并文献复习,以期为更多绝经后宫腔积液及宫颈病变的诊断提供参考,避免漏诊及误诊。1病例资料患者67岁,女,主因"绝经18年,不规则阴道出血2月"于2020年5月就诊于首都医科大学附属北京妇产医院妇科微创中心。     

中药复方治疗肥胖作用机制的研究进展＊

肥胖是世界上较为普遍的慢性病，不仅是糖尿病、心血管疾病和非酒精性脂肪肝等多种疾病的危险因素，还是感染性疾病的易感因素。西药在治疗肥胖上疗效明显，但是不良反应也显而易见。中药复方在肥胖等慢性代谢性疾病的临床疗效上具有突出的优势。然而，中药复方的减肥机制仍不清楚。因此，本文对近年来有关中药复方减肥的文献进行了综述和分析，重点对中药复方治疗肥胖症的机理进行了总结分析，以期为新药配伍的实验设计提供一些新的思路和方法。     

一例EB病毒阳性Richter综合征病例报道并文献复习

经典的Richter综合征(Richter’s symdrome, RS)是指慢性淋巴细胞白血病 (chronic lymphocytic leukemia, CLL)向侵袭性淋巴瘤转化,其生存时间短,治疗效果差,尚未有统一的治疗方案。现报道一例EB病毒阳性Richter综合征病例并对RS的诊疗进展,特别是靶向药物时代RS诊治变化进行文献复习。     

国内健康信息研究作者合著网络及研究主题分析

目的分析核心作者、作者合著网络特征,推测国内健康信息研究的发展阶段、主要研究力量及主要研究主题。方法以CNKI期刊库为数据源,以"健康信息"及相关词为主题词,检索2000—2018年的相关文献,基于普莱斯定律及综合指数法确定核心作者,使用数据统计软件Excel及社会网络分析软件Vcinet,利用综合指数以及社会网络分析法计算作者间联系合作紧密度,并离析高产合作子网。结果文献量以较快指数型速率增长。作者合作率较高且信息传输渠道较通畅,2000—2018年国内研究的合著率稳定在80%,但学者的合作关系较为单一,多集中在同一机构或同一师门,阻碍了跨机构学者的交流合作。主要合作团队活跃度较高且核心成员多为研究领域的核心作者,科研产出量较大且被引频次较高。结论国内研究正处于旺盛发展期,但未形成稳定的核心作者群体。学者间因同机构或师门关系产生固定合作,健康信息管理、公众健康行为、健康教育等为核心作者或活跃团队研究的主要主题。     

血清IL-6和胃蛋白酶原Ⅰ/Ⅱ比值对老年胃癌患者预后评估的价值

目的探究老年胃癌患者术前血清白细胞介素6 (IL-6)、胃蛋白酶原(PG)Ⅰ、Ⅱ及PG-Ⅰ/Ⅱ比值在患者预后评估中的意义。方法选择2016年1月—2017年1月南通大学附属海安医院收治的101例外科手术治疗的老年胃癌患者为研究对象。收集患者的临床病理资料,检测血清IL-6和PG-Ⅰ/Ⅱ水平。以全因死亡为随访终点,使用Kaplan-Meier曲线明确患者预后与各指标间的关系。结果受试者工作特征曲线提示,IL-6、PG-Ⅰ和PG-Ⅰ/Ⅱ比值在最佳切割值为10.23pg/mL、30.65μg/L和2.44时,可评估患者的预后,而PG-Ⅱ则无法评估患者的预后。与IL-6≤10.23pg/mL组相比,IL-6> 10.23pg/mL组的肿瘤细胞分化更差、TNM分期Ⅲ期比例明显升高。Kaplan-Meier曲线结果表明,IL-6> 10.23pg/mL组的中位生存期显著短于IL-6≤10.23pg/mL组(28个月vs47个月,P<0.001);PG-Ⅰ≤30.65μg/L组的中位生存期显著短于PG-Ⅰ>30.65μg/L组(34个月vs49个月,P=0.008);PG-Ⅰ/Ⅱ≤2.44组的中位生存期显著短于PG-Ⅰ/Ⅱ> 2.44组(29个月vs56个月,P=0.02)。多因素Cox回归分析表明,肿瘤分化程度、TNM分期、IL-6及PG-Ⅰ/Ⅱ比值是影响患者生存率的独立危险因素。结论术前检测IL-6及PG-Ⅰ/Ⅱ比值有助于评估老年胃癌患者的预后。     

Biomechanical comparison of stemless humeral components in total shoulder arthroplasty

BackgroundThe purpose of this study was to compare initial fixation strength between various stemless and stemmed humeral components and to correlate implant fixation strength with bone mineral density (BMD).MethodsFive humeral stem designs were investigated: Stemless-A (four hollow fins), Stemless-B (central body, three solid fins), Stemless-C (central screw, peripheral rim-fit), Short stem (50 mm), and Standard stem (130 mm). Fifty cadaveric human humerii were obtained and divided into five groups. BMD within the humeral head was determined for all samples. The mean BMD was similar between groups. The 25 samples with the lowest and highest BMDs were categorized as “Low” and “High,” respectively, with a BMD threshold of 0.35 g/cm², creating BMD subgroups. After implantation, each sample underwent a standardized biomechanical testing protocol, with axial loading followed by torsional loading. Sensors attached to the specimen recorded micromotion throughout testing. Axial loading consisted of cyclic loading for 100 cycles at 3 peak forces (220, 520, and 820 N). Torsional loading consisted of 100 cycles of internal/external rotation at 0.1 Hz at 6 peak torques, or until failure (±2.5, 5, 7.5, 10, 12.5, and 15 Nm). Failure was defined as the torque at which any bone fracture, implant detachment from anchor/stem, or an excess of 50° internal/external rotation occurred. Groups and BMD subgroups were compared.ResultsAt maximal axial loading, Stemless-B demonstrated greater micromotion (540 μm) than Stemless-C (192 μm) (P = .003). Stemless-B and Stemless-A (387 μm) also had greater micromotion than Short stem (118 μm, P < .001, P = .03) and Standard stem (85 μm, P < .001, P = .01). When comparing low-BMD samples at maximal axial loading, these differences were accentuated, but comparison of high-BMD samples showed no significant differences between groups. Torsional testing demonstrated that Standard stem failed at greater torque (7.2 Nm) than Stemless-B (2.3 Nm, P < .001), Stemless-A (1.9 Nm, P < .001), and Stemless-C (3.9 Nm, P = .01). When comparing torsional testing results of low-BMD samples, both Standard stem and Short stem failed at greater torque than Stemless-B (P = .02, P = .003) and Stemless-A (P = .03, P = .004) but failed at a similar torque to Stemless-C. Torsional testing of high-BMD samples showed that Standard stem failed at a greater torque than all stemless designs.ConclusionStemless humeral implants should be used with caution in low-BMD settings (<0.35 g/cm²). A central screw and peripheral rim-fit stemless anchor design demonstrated greater fixation strength at low BMD when compared with other designs, while all stemless designs performed similarly at high BMD.Level of evidenceBasic Science Study; Cadaveric Study     

Correction to: The protean world of non-coding RNAs in glioblastoma

Journal of Molecular Medicine -