应用PASO标准评估两种手术方式治疗单侧醛固酮瘤疗效的对比研究

目的 通过应用原发性醛固酮增多症手术结局(PASO)标准比较肾上腺全切与部分切除术治疗单侧醛固酮瘤的疗效,为单侧醛固酮瘤的手术方式选择提供依据.方法 回顾性分析2013年1月至2020年3月该院泌尿外科收治的245例单侧醛固酮瘤患者的临床资料,其中行后腹腔镜肾上腺全切术(TA)124例(50.6％,TA组),行后腹腔镜肾上腺部分切除术(PA)121例(49.4％,PA组).术后随访6～72个月,中位24个月.比较两组患者基本特征、手术资料、围术期并发症、术后激素补充和术后随访结果.结果 245例患者手术均获成功,无中转开放手术患者.两组患者手术时间、术中出血量、24 h血红蛋白下降值、围术期输血率、术后临床指标、术后住院时间、术后激素补充百分比比较,差异均无统计学意义(P>0.05).TA组患者中多发瘤15例(12.1％);肾上腺静脉取血诊断准确率为89.4％,CT诊断准确率为76.4％.依据PASO标准,TA组患者总体临床缓解率(完全缓解、部分缓解,97.6％)、总体生化缓解率(99.2％)与PA组(分别为94.2％、99.2％)比较,差异均无统计学意义(P>0.05).TA组患者复发率(0)低于PA组(2.5％),但差异无统计学意义(P>0.05).结论 单侧TA可能是单侧醛固酮瘤更有效的手术方式.     

绝经后妇女骨密度和血清骨转换指标与骨桥蛋白水平的相关性研究

目的探讨绝经后妇女循环骨桥蛋白(OPN)水平与骨转换和骨密度(BMD)之间的关系。方法 2015年7月至2017年8月,共有287名绝经后妇女纳入本研究。分析血清OPN水平,核因子κB(NF-κB)配体受体激活剂(RANKL)和骨转换标志物。采用双能X线吸收仪测定BMD。结果根据世界卫生组织(WHO)标准,102名受试者(35.5%)被诊断为骨质疏松症,125名(43.6%)骨质减少,60名(20.9%)正常骨密度。骨质疏松组的OPN水平显著高于骨量减少组和正常组(均为P0.001)。OPN诊断绝经后骨质疏松症的临界值为10.2 ng/mL,敏感性为90.1%,特异性为56.8%,曲线下面积为0.949。血清OPN和骨质疏松症组中甲状旁腺激素(PTH),腰椎BMD和股骨颈骨密度呈负相关,与I型前胶原氨基端前肽(PINP),I型的羧基端交联端肽胶原(CTX)和RANKL呈正相关。在多元回归分析中,腰椎骨密度,PTH和RANKL可以作为血清OPN水平的预测指标。结论 OPN血清水平与BMD呈负相关,与中国绝经后妇女骨转换水平呈正相关。     

Deferoxamine promotes recovery of traumatic spinal cord injury by inhibiting ferroptosis

Ferroptosis is an iron-dependent novel cell death pathway. Deferoxamine, a ferroptosis inhibitor, has been reported to promote spinal cord injury repair. It has yet to be clarified whether ferroptosis inhibition represents the mechanism of action of Deferoxamine on spinal cord injury recovery. A rat model of Deferoxamine at thoracic 10 segment was established using a modified Allen's method. Ninety 8-week-old female Wistar rats were used. Rats in the Deferoxamine group were intraperitoneally injected with 100 mg/kg Deferoxamine 30 minutes before injury. Simultaneously, the Sham and Deferoxamine groups served as controls. Drug administration was conducted for 7 consecutive days. The results were as follows:(1) Electron microscopy revealed shrunken mitochondria in the spinal cord injury group.(2) The Basso, Beattie and Bresnahan locomotor rating score showed that recovery of the hindlimb was remarkably better in the Deferoxamine group than in the spinal cord injury group.(3) The iron concentration was lower in the Deferoxamine group than in the spinal cord injury group after injury.(4) Western blot assay revealed that, compared with the spinal cord injury group, GPX4, xCT, and glutathione expression was markedly increased in the Deferoxamine group.(5) Real-time polymerase chain reaction revealed that, compared with the Deferoxamine group, mRNA levels of ferroptosis-related genes Acyl-CoA synthetase family member 2(ACSF2) and iron-responsive element-binding protein 2(IREB2) were up-regulated in the Deferoxamine group.(6) Deferoxamine increased survival of neurons and inhibited gliosis. These findings confirm that Deferoxamine can repair spinal cord injury by inhibiting ferroptosis. Targeting ferroptosis is therefore a promising therapeutic approach for spinal cord injury.     

医药类高职院校生物化学实验教学改革实践与思考

生物化学是医学类课程中一门重要的基础学科。生物化学实验是医药类高职院校各专业的必修课。当今生物化学实验不断翻新，教学改革迫在眉睫。针对当前高职院校生化实验基本情况，结合江苏医药职业学院的生物化学实验教学的改革情况，从所需物资设备、完善规章制度、实训内容安排等方面总结和提出相应的改革措施，以及具体问题和意见，可为同类院校生化实验教学改革提供借鉴。