自制低钠风险评估表在慢性心力衰竭患者饮食教育中的应用

目的 根据慢性充血性心力衰竭患者的情况正确给予饮食指导,预防低钠血症.方法 参考相关文献自制低钠血症风险评估表,根据评估结果制定合理的饮食方案及实施健康教育.结果 根据低钠风险评估表的结果对患者进行相关健康教育后,患者低钠血症发生率显著降低,饮食相关知识掌握度显著提升（均P＜0.01）.结论 对慢性充血性心力衰竭患者实施针对性的饮食健康教育可有效防御低钠血症的发生.     

开颅血肿清除和硬通道穿刺治疗基底节区高血压脑出血的疗效对比

目的：对比开颅血肿清除和硬通道穿刺治疗高血压基底节区脑出血的效果及预后。方法回顾性分析2005年1月～2013年12月我科192例高血压脑出血的临床资料,其中开颅血肿清除术（开颅组）和穿刺引流术（微创组）各96例。2组年龄、性别、血肿侧别及Glasgow昏迷评分差异无显著性（P＞0．05）。对比2组术中出血量、术后残余血肿量、手术时间、住院时间和术后3周及6个月的临床疗效。结果与开颅组比较,微创组手术时间短[中位数31（24～39） min vs．152（131～170）min,Z＝-11．975,P＝0．000],术中出血少[30例0 ml、66例＜5 ml vs．（332．4±20．2）ml],术后住院时间短[中位数14（10～17）d vs．64（44～75）d,Z＝-44．217,P＝0．000],但术后残余血肿量多[中位数13（8～17）ml vs．7（4～12）ml, Z＝-11．573,P＝0．000]。治疗3周后,微创组Glasgow 预后评分高[中位数4（2～4）分 vs．3（1～4）分,Z＝-8．215,P＝0.000],Barthel指数高[（59．9±4．5） vs．（54．9±4．9）,t＝7．370,P＝0．000]。治疗6个月,微创组Glasgow预后评分高[中位数3（2～4）分vs．2（1～4）分,Z＝-7．448,P＝0．000],Barthel指数高[（64．3±8．4） vs．（59．7±6．8）,t＝4．156,P＝0．000],2组病死率差异无显著性（P＞0．05）。结论微创颅内血肿硬通道穿刺引流术在一定程度上明显优于开颅血肿清除术,值得临床推广应用。     

Bex2 Controls Proliferation of Human Glioblastoma Cells Through NF-κB Signaling Pathway

Glioblastoma is the most common and fatal human brain malignancy in adults with highly proliferative capacity. Despite advances in surgery and adjuvant therapy, the median survival of patients has changed little over recent decades. Identifying molecules critical for glioma development is significant for devising effective targeted therapy. We previously reported that Bex2, a member of the brain expressed X-linked gene family, promoted the progression of glioma by promoting cell proliferation. In the present study, we investigated the main mechanism of Bex2 promoting the proliferation of glioblastoma cells. We found that Bex2 downregulation inhibited glioma cell proliferation and the expression of NF-κB p65, but Bex2 overexpression promoted them. Similarly, the proliferation of glioma cells was inhibited by p65 downregulation but increased by p65 overexpression. In addition, Bex2 overexpression-induced cell proliferation was abolished by p65 downregulation. Furthermore, Bex2 with nuclear localization signal deleted no longer promoted p65 expression. In conclusion, this study demonstrates that Bex2 promotes proliferation of human glioblastoma cells via NF-κB signaling pathway and Bex2 nuclear location is critical for p65 expression.     

Mechanisms of Anti-inflammatory Property of Conserved Dopamine Neurotrophic Factor: Inhibition of JNK Signaling in Lipopolysaccharide-Induced Microglia

Microglia are important resident immune cells in the central nervous system (CNS) and involved in the neuroinflammation caused by CNS disorders, including brain trauma, ischemia, stroke, infections, inflammation, and neurodegenerative diseases. Our study explores the hypothesis that conserved dopamine neurotrophic factor (CDNF), a secretory neurotrophic factor, may provide a novel therapy for associated with neuroinflammation related to the microglia. We observed that CDNF was upregulated in rat primary microglia treated with 1 μg/mL lipopolysaccharide, an inflammatory inducer, for 24 h. Thus, we hypothesize that CDNF may play a role, mediator or inhibitor, in regulating the inflammation in microglial cells induced by LPS. Finally, our data showed that CDNF significantly attenuated the production of proinflammatory cytokines (PGE2 and IL-1β) and remarkably alleviated the cytotoxicity (percentage of lactate dehydrogenase released) in the LPS-induced microglia by suppressing the phosphorylation of JNK, but not the P38 or ERK pathways. These results demonstrate the anti-inflammatory property of CDNF by inhibition of JNK signaling in LPS-induced microglia, suggesting that CDNF may be a potential novel agent for the treatment of neuroinflammation in the CNS disorders.     

微创单纯抽吸术与皮下组织剥离剪除术治疗腋臭的临床效果对比

目的 通过对腋毛区两种术式治疗腋臭的疗效对比,探索一种更好地治疗腋臭的手术方法.方法 对72例腋臭患者随机分为两组,36例行微切口单纯抽吸术（A组）,另36例经腋皱襞切开行皮下组织剥离剪除术（B组）,对两组的手术时间、疗效、并发症、瘢痕、恢复时间等进行总结对比分析.结果 经6～12个月随访,两组患者腋臭治疗总有效率100％.A组在手术时间、术后并发症、恢复时间、瘢痕、腋毛存活等方面明显优于B组,两组差异有统计学意义（P＜0.05）.结论 微创单纯抽吸术治疗腋臭疗效可靠,安全便捷,瘢痕更小而隐匿,并发症少,恢复快,更易被患者接受.     

骶神经调节术治疗顽固性便秘疗效观察

目的：观察骶神经调节术（SNM）治疗顽固性便秘的临床效果。方法第四军医大学西京消化病医院消化外科于2013年1月至2014年1月期间,采用骶神经调节测试系统经皮穿刺,刺激第3骶神经根,治疗7例复杂便秘患者,其中4例患者既往进行过至少1次的便秘手术。通过排粪日记、Cleveland便秘评分及视觉模拟评分（VAS）进行疗效评价。结果7例患者在接受体外临时测试治疗后,便秘症状均明显改善。其中6例接受永久性骶神经调节器植入术,围手术期未见并发症。术后随访中位时间4（2～12）月,6例患者的每周排粪次数由治疗前（0．6±0．5）次／周,增加到（8．0±2．5）次／周（P＜0．01）;排粪时间从（22．9±11．5） min减少到（3．7±0．8） min（P＜0．01）;Cleveland便秘评分从（24．6±4．2）分下降到（9．0±0．9）分（P＜0．01）;VAS评分从（8．1±0．9）分增加到（82．5±5．2）分（P＜0．01）。结论 SNM是治疗顽固性便秘的一种微创而安全有效的新方法。     

水胶体敷料对腹膜透析患者手术切口的愈合护理效果

目的 探讨水胶体敷料的换药方法替代传统敷料的换药方法对腹膜透析患者手术切口的愈合护理效果.方法 回顾性分析了88例腹膜透析患者手术切口的护理效果,其中使用水胶体敷料换药的患者为实验组,共44例,使用传统敷料换药的患者为对照组,共44例.比较两组手术切口的愈合天数.结果 实验组的伤口愈合时间为（9.0±6.3）d,对照组愈合时间为（14.0±9.8）d,两组比较有显著性差异（P＜0.05）.结论 水胶体敷料能促进腹膜透析患者手术切口的愈合,减轻患者的痛苦,提高舒适度.     

125I放射性粒子植入治疗晚期胰腺癌26例临床分析

目的 探讨125I放射性粒子植入治疗晚期胰腺癌的临床效果.方法 选择无外科根治性手术适应证的胰腺癌患者26例,开腹行125I放射性粒子植入术,胆肠Rou-en-y吻合术.术后观察：（1）术后胆红素下降情况;（2）术后1周内每日患者疼痛的缓解情况;（3）术后并发症发生情况.随访观察肿瘤变化、疼痛缓解程度以及存活期.结果 （1）术后1周内胆红素值降至术前一半的占52.3％（11/21）,以后胆红素继续缓慢下降,所有患者均在3周内降至正常;（2）术后1周94.7％的患者疼痛缓解,平均缓解时间为（5.0±1.5）d.18例（69.2％）术后出现胃肠功能紊乱,6例出现胃瘫（23％）,平均治愈时间为（16±5.1）d.胰漏3例经保守治疗痊愈,24例患者进行术后随访,平均生存期（12±5.1）个月,肿瘤较术前有缩小9例（37.5％）,肿瘤无明显增大10例（41.6％）,肿瘤明显增大5例（20.8％）.结论 125I放射性粒子植入可有效改善晚期胰腺癌症状,一定程度上抑制肿瘤,是晚期胰腺癌有效治疗方法之一.     

Evidence of a Sophisticatedly Heterogeneous Population of Human Umbilical Vein Endothelial Cells

Induction and promotion of angiogenesis play a role in a diverse range of physiologic and pathophysiologic processes that are especially relevant to the field of regenerative medicine. For assessing vasculogenesis and neo-angiogenesis, identifying angiogenic factors, angiocrine factors, and vascular niche, facilitating tissue-repair and tumor growth, efficiently generating induced pluripotent stem cells, and coculturing with organ-specific stem cells, isolation and characterization of the subpopulation of human umbilical vein endothelial cells (HUVECs) and their endothelial progenitor cells (EPCs) are needed. In this study, primary HUVECs were collected from fresh umbilical cords and fractionated and characterized with the use of flow cytometry. Clonal colony assay showed that endothelial colony-forming units in culture frequently existed in fresh HUVECs. Antigenic profiling demonstrated that undifferentiated EPCs in HUVECs had normal endothelial marker CD31 with a subpopulation of cells positive for hematopoietic stem cell marker CD34 and c-Kit. With continuing passages, EPC markers CD34 and vascular endothelial growth factor receptor 2 expression decreased dramatically. Moreover, a distinct subpopulation with different proliferative capability and angiogenesis from the early-passage HUVECs was shown. In conclusion, it is possible to isolate accurately and to enrich EPCs or hematoangioblast-like cells from a heterogeneous population of HUVECs, and to explore the differential process with flow cytometry for further investigations.     

A prospective,randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion

Purpose

Total cervical artificial disc replacement (TDR) simulates normal disc structure, thus avoiding the drawbacks of anterior cervical decompression and fusion (ACDF). This prospective, randomized, controlled and multicentre study aimed to evaluate clinical and radiographic outcomes by comparing cervical disc replacement using Mobi-C disc prostheses with ACDF.

Methods

This prospective, randomized, controlled and multicentre study consisted of 111 patients undergoing single-level Mobi-C disc prosthesis replacement (TDR group, n?=?55) or ACDF (n?=?56) from February 2008 to November 2009 at 11 medical centres across China. Patients were assessed before surgery, at seven days postoperation and one, three, six, 12, 24, 36 and 48 months postoperation. Clinical and neurological outcome was determined by measuring the Japanese Orthopaedic Association (JOA) scores, visual analogue scale (VAS) and Neck Disability Index (NDI). Static and dynamic radiographs were obtained of the cervical curvature, the functional spinal unit (FSU) angle and range of motion (ROM) of the cervical spine, FSU angle and treated and adjacent segments.

Results

A total of 111 patients were included and randomly assigned to either Mobi-C disc prosthesis replacement or ACDF. JOA, VAS and NDI showed statistically significant improvements 48 months after surgery (P?p?>?0.05). ROM in the ACDF group was significantly reduced at one month and remained so throughout the follow-up. By 48-months, more ACDF patients required secondary surgery (four of 56 patients).

Conclusions

Although ACDF may increase the risk of additional surgery, clinical outcomes indicated that both Mobi-C artificial cervical disc replacement and ACDF were reliable. Radiographic data showed that ROM of the cervical spine, FSU angle and treated and adjacent segments were relatively better reconstructed and maintained in the Mobi-C group compared with those in the ACDF group.