脂肪移植治疗黑眼圈的研究进展

黑眼圈是一种复杂的眼部美容问题，临床上需要根据病因选择合适的治疗方法。脂肪移植对于由皮肤过薄引起的皮下肌肉、血管透过皮肤可见所导致的血管性黑眼圈和结构性黑眼圈有较好的效果。近年来，脂肪移植技术的发展为治疗黑眼圈提供了更多新的方案。本文就脂肪移植治疗黑眼圈的研究进展进行综述，旨在为眼整形医生治疗黑眼圈提供参考资料。     

Association of genetic variants at MYP10 and MYP15 with high myopia in a Han Chinese population

Background: Previous genome-wide association study (GWAS) has revealed the association between MYP10 at 8p23 and MYP15 at 10q21.1 and high myopia (HM) in a French population. This study is managed to discover the connection between some single nucleotide polymorphism (located at MYP10 and MYP15) and Han Chinese HM.

Methods and Results: This case-control association study contained 1673 samples, including 869 ophthalmic patients and 804 controls. Twelve tag SNPs have been selected from the MYP10 and MYP15 loci and genotyped by SNaPshot method. Among 12 SNPs, rs4840437 and rs6989782 in TNKS gene were found significant association with HM. Carriers of rs4840437G allele and rs4840437GG genotype created a low risk of high myopia (P = .036, OR = 0.81, 95%CI = 0.71–0.93; P = .016, OR = 0.73, 95%CI = 0.56–0.96; respectively). Carriers of rs6989782T allele and rs6989782TT+CT genotype also had a decreased risk of high myopia (P = .048, OR = 0.82, 95%CI = 0.71–0.94; P = .006, OR = 0.74, 95%CI = 0.59–0.92; respectively). Other 10 SNPs displaced nonsignificant association with HM. Additionally, the risk haplotype AC and the protective haplotype GT, generated by two SNPs in TNKS, were considerably more likely to be association with HM (for AC, P = .002 and OR = 1.26; for GT, P = .027 and OR = 0.84).

Conclusions: Our results demonstrated that some heritable variants in the TNKS gene are associated with HM in the Han population. The possible functions of TNKS in the development and pathogenesis of hereditary high myopia still require further researches to identify.     

Regional gray matter abnormality in hepatic myelopathy patients after transjugular intrahepatic portosystemic shunt: a voxel-based morphometry study

Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. This study aimed to investigate the gray matter changes in patients with hepatic myelopathy secondary to transjugular intrahepatic portosystemic shunt and to examine their clinical relevance. This was a cross-sectional study. Twenty-three liver failure patients with hepatic myelopathy(hepatic myelopathy group), 23 liver failure patients without hepatic myelopathy(non-hepatic myelopathy group) after transjugular intrahepatic portosystemic shunt, and 23 demographically matched healthy volunteers were enrolled from March 2014 to November 2016 at Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China. High-resolution magnetization-prepared rapid gradient-echo brain imaging was acquired. Group differences in regional gray matter were assessed using voxel-based morphometry analysis. The relationship between aberrant gray matter and motor characteristics was investigated. Results demonstrated that compared with the non-hepatic myelopathy group, gray matter volume abnormalities were asymmetric, with decreased volume in the left insula(P = 0.003), left thalamus(P = 0.029), left superior frontal gyrus(P = 0.006), and right middle cingulate cortex(P = 0.021), and increased volume in the right caudate nucleus(P = 0.017), corrected with open-source software. The volume of the right caudate nucleus in the hepatic myelopathy group negatively correlated with the lower limb clinical rating of the Fugl-Meyer Assessment(r = –0.53, P = 0.01). Compared with healthy controls, patients with and without hepatic myelopathy exhibited overall increased gray matter volume in both thalami, and decreased gray matter volume in both putamen, as well as in the globus pallidus, cerebellum, and vermis. The gray matter abnormalities we found predominantly involved motor-related regions, and may be associated with motor dysfunction. An enlarged right caudate nucleus might help to predict weak lower limb motor performance in patients with preclinical hepatic myelopathy after transjugular intrahepatic portosystemic shunt. This study was approved by the Ethics Committee of Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China(approval No. 20140227-6) on February 27, 2014.     

研析奥氮平治疗老年晚期癌症患者抑郁状态的血药浓度与临床疗效关系

目的：研析奥氮平治疗老年晚期癌症患者抑郁状态的血药浓度与临床疗效的关系，促进合理用药。方法：80例这类患者服用2.5 ~ 10 mg·d-1奥氮平，应用全自动二维液相色谱法（2D-LC/UV）检测患者用药后4周内每周奥氮平血药浓度（C奥氮平）；采用汉密尔顿抑郁量表（HAMD-24）于治疗前、治疗后4周内每周评估疗效，应用线性回归方程分析奥氮平剂量与血药浓度相关性，运用Logistic回归和受试者工作曲线（ROC）分析奥氮平血药浓度与临床疗效相关性；采用副反应量表（TESS）评估药物不良反应。结果：奥氮平日剂量（D日）和C奥氮平线性方程呈正相关（r=0.634，P<0.001）。治疗的第1、2、3、4周末，有效组与无效组患者D日、C奥氮平、HAMD-24量表减分率存在显著性差异（P<0.05）。经Logistic回归分析得出年龄大、奥氮平血药浓度低是导致奥氮平治疗效果不理想的影响因素。以C奥氮平作为疗效预测因子绘制治疗第1、2、3、4周末ROC曲线，得出约登指数最大时对应的最佳临界值切点分别11.18、13.89、11.55、12.44 ng·mL-1；未发现C奥氮平与TESS量表评分相关（P>0.05）。结论：奥氮平血药浓度与日剂量、临床疗效密切相关，治疗老年晚期癌症患者抑郁状态最低有效血药浓度范围为11~14 ng·mL-1。     

Clinical analysis of high-intensity focussed ultrasound ablation for abdominal wall endometriosis: a 4-year experience at a specialty gynecological institution

Objective: To evaluate the long-term clinical effect of high-intensity focussed ultrasound (HIFU) as a non-invasive modality for ablation of abdominal wall endometriosis (AWE) foci.

Methods: All women who were diagnosed with cutaneous endometriosis and underwent HIFU ablation and 4-year follow-up were included. Patient symptoms, imaging performed, HIFU ablation, recurrence, lesion location, size and number were collected and analyzed.

Results: A total of 51 women with 57 painful abdominal wall masses with a median volume of 4.00?cm³ and a mean age of 30.5±2.12 years were treated with HIFU. The main symptoms were a palpable painful abdominal mass (93%), protrusion of the skin (28.1%, 16) or lack of protrusion of the skin (71.9%, 41). Ultrasound was initially performed in 100% (51) of women, whereas 6% (3) required MRI examinations to distinguish the features and range of the masses. Ablation was performed with a median 300?s of sonication time, 40?min treatment time, 150?W of power and 41800?J of total energy to treat lesions that were a median volume of 3.83?cm³. No severe complications occurred, except in one patient with a first-degree skin burn, during the 48-month follow-up period. The pooled recurrence of cutaneous endometriosis occurred in 3.9% (2) of women.

Conclusion: The diagnosis of AWE should be confirmed with imaging of the lesion number, location, size and features before HIFU ablation. HIFU should be the first choice for the treatment of AWE as it is a non-invasive method, with high efficiency and safety and rapid postoperative recovery.     

Enteral Nutrition Support Does Not Improve PNI in Radiotherapy Patients with Locally Advanced Esophageal Cancer

Objective: The assessment of prognostic nutritional index (PNI) before and during radiotherapy is an important parameter for the prognosis in patients with cancer. In this study, enteral tube feeding (ETF) was used during radiotherapy in patients with EC. Dynamic changes of various nutritional indicators (including PNI) were monitored.

Methods: Patients with EC who underwent radiotherapy between June 2016 and July 2017 were enrolled. ETF was performing with the energy of 25?kcal?×?kg/d. Nutritional status were evaluated. Least significant difference (LSD) was used for multiple comparisons between groups.

Results: A total of 148 patients were admitted, including 51 patients fed via ETF. For patients who were not scheduled to nutritional support, significant difference were observed in albumin (ALB) (P?<?0.001), prealbimnin (PA) (P?=?0.05) and PNI (P?<?0.001) compared to levels before radiotherapy. In the patients fed via enteral tube, no significant difference were found in weight, BMI, ALB, retinol binding protein (RBP) and PA before and after radiotherapy, while PNI significantly decreased (P?<?0.001).

Conclusion: After preforming ETF with the energy of 25?kcal?×?kg/d in patients with EC during radiotherapy, PNI, the key nutritional index reflecting prognosis, significantly decreased.     

缺血后处理对脑缺血大鼠学习记忆能力的影响

目的研究缺血后处理(IP)对大鼠脑缺血再灌注损伤后的学习和记忆能力的影响,探讨各组大鼠脑缺血再灌注后海马CA1区β淀粉样蛋白前体(APP)表达。方法将48只雄性SD大鼠随机分为3组:假手术组、对照组和缺血后处理组(IP组),每组16只大鼠。术后用Morris水迷宫方法测定大鼠认知记忆能力变化。3组大鼠脑组织切片行HE染色和APP染色,并行统计学分析。结果 Morris水迷宫试验显示,对照组大鼠训练第1~4天逃避潜伏期长于IP组(P 0. 01);跨越原平台次数IP组明显多于对照组(P 0. 05)。HE染色结果显示,对照组大鼠海马CA1区神经元细胞脱失明显,而IP可减轻这种形态学改变。免疫组化结果显示,在脑缺血再灌注144 h后对照组中APP表达明显高于假手术组(P 0. 01); IP组海马CA1区APP表达较对照组减少(P 0. 05)。结论缺血后处理可通过抑制APP的表达改善缺血再灌注后大鼠的记忆减退。