Infección por el virus de la hepatitis C y nuevas estrategias de tratamiento

Hepatitis C is a major public health problem worldwide. This disease is caused by the hepatitis C virus, which is characterised by its genetic diversity. The infection is usually asymptomatic. However, between 60% and 80% of HCV-infected individuals will progress to chronic hepatitis, 20% to liver cirrhosis in the medium-to long-term and, each year, between 1% and 4% of these patients with cirrhosis will develop hepatocellular carcinoma (HCC). A Spanish consensus document has recently been drafted to diagnose hepatitis C in a single step, consisting of active investigation (antibodies and viremia) in a single sample, which according to the experts, would reduce the time to access treatment and avoid tracking losses. To definitively change the hepatitis C treatment paradigm, direct-acting antiviral drugs (DAAs) have been approved, whose development has been based on achieving cure rates close to 100% regardless of the genotype of the virus, ie, pangenotypes, with good tolerance and bioavailability. These drugs have constituted a real therapeutic revolution. Supplement information: This article is part of a supplement entitled «SEIMC External Quality Control Programme. Year 2016», which is sponsored by Roche, Vircell Microbiologists, Abbott Molecular and Francisco Soria Melguizo, S.A.© 2019 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosasy Microbiología Clínica. All rights reserved.     

Human epididymis protein 4 (HE4) levels inversely correlate with lung function improvement (delta FEV1) in cystic fibrosis patients receiving ivacaftor treatment

Background

We have recently shown that human epididymis protein 4 (HE4) levels correlate with the severity of cystic fibrosis (CF) lung disease. However, there are no data on how HE4 levels alter in patients receiving CFTR modulating therapy.

Control oncológico en cáncer de próstata de alto riesgo tras prostatectomía radical y radioterapia de rescate en comparación con radioterapia más hormonoterapia primaria

Introduction

In patients with high-risk localized prostate cancer (HRPCa), multimodal treatment plays a fundamental role.

Aortitis no infecciosa: experiencia con tocilizumab en un hospital comarcal

ObjectivesDescribe patients with noninfectious aortitis and their response to treatment in a regional hospital.MethodsReview of patients with noninfectious aortitis, diagnostic technique used and immunosuppressive therapy received.ResultsWe report 8 patients (7 women and one man) diagnosed with aortitis by positron emission tomography (PET). The mean age was 69 years (interquartile range [IQR] 62-72.2). Three months of treatment with tocilizumab improved symptoms, erythrocyte sedimentation rate and C-reactive protein level (P < .001 and P < .012, respectively) in the 6 patients in whom it was used.ConclusionsTocilizumab was an effective and safe treatment in those patients diagnosed with aortitis refractory to steroids and conventional immunosuppressive therapy.     

3D 打印金属假体在关节外科的临床应用

目的总结 3D 打印金属假体在关节外科的应用进展。方法广泛查阅相关文献，总结 3D 打印金属假体治疗关节外科疾病的疗效，包括假体稳定性、术后并发症、骨长入等假体移植中的关键性问题。结果3D 打印金属假体具有良好的匹配度，可精确重建并恢复关节功能，节省手术时间，早中期随访患者满意度较高，在关节外科的应用取得了良好进展。结论3D 打印技术可制造任意形状的个性化微孔结构假体，很好地解决了传统假体存在的特殊患者关节匹配度较差的问题，在骨科领域有巨大应用潜力。     

膝关节前外侧韧带的研究进展

目的对膝关节前外侧韧带（anterolateral ligament，ALL）的研究进展进行综述，为临床诊治提供参考。方法广泛查阅近年来国内外有关 ALL 损伤诊断及治疗的文献，总结膝关节 ALL 解剖形态、生物力学以及 ALL 损伤机制、治疗现状。结果膝关节 ALL 具有限制胫骨内旋及前移作用，影响膝关节轴移。ALL 损伤后可结合患者体征和 MRI 检查诊断。膝关节 ALL 手术指征尚未统一，但多数学者倾向于对需进行前交叉韧带（anterior cruciate ligament，ACL）重建或翻修且伴有高度轴移试验阳性的患者进行 ALL 重建。目前 ALL 重建方式较多，但尚无最佳治疗术式。此外，由于缺乏高质量的术后长期随访研究，远期临床疗效仍不明确。结论ALL 在维持膝关节稳定性方面具有一定作用，但 ALL 重建技术及临床疗效仍待进一步研究。     

辨证论治联合西药治疗IgA肾病的临床研究

目的研究辨证分型联合西药治疗免疫球蛋白a(Ig A)肾病的临床效果。方法选取收治的74例Ig A肾病患者,采用均衡分组法分为西药组和联合组,各37例。西药组采用氯沙坦钾片治疗,联合组辅以辨证分型治疗,治疗6个月后开展随访观察疗效。结果联合组治疗总有效率94.59%高于西药组的64.86%,联合组并发症发生率2.70%低于西药组的21.62%,联合组不良反应发生率2.70%低于西药组的24.32%,对比差异有统计学意义(P<0.05)。治疗后,联合组血肌酐高于西药组和治疗前,尿红细胞、尿蛋白指标低于西药组和治疗前,对比有统计学意义(P<0.05)。结论辨证分型联合西药治疗Ig A肾病的临床效果显著,可降低并发症及不良反应发生风险,改善其血液指标,具有较高临床推广价值。     

lncRNA MALAT1靶向miR-150对口腔鳞癌细胞增殖和凋亡的影响及分子机制

目的:研究MALAT1对口腔鳞癌细胞SCC-25增殖、凋亡的影响，并探讨其机制。方法:运用qRT-PCR检测人口腔鳞癌细胞SCC-25、人永生化口腔上皮细胞HIOEC中MALAT1和miR-150的mRNA表达；将si-con组（转染si-con）、si-MALAT1组（转染si-MALAT1）、miR-150组（转染miR-150 mimics）、miR-con组（转染miR-con）、si-MALAT1+anti-miR-con组（si-MALAT1和anti-miR-con共转染）、si-MALAT1+anti-miR-150组（si-MALAT1和anti-miR-150共转染），均以脂质体法转染至SCC-25细胞；MTT法检测各组细胞的增殖；流式细胞术检测各组细胞的凋亡；双荧光素酶报告基因检测实验检测各组细胞的荧光活性。结果:与人永生化口腔上皮HIOEC细胞（Normal组）相比，口腔鳞癌SCC-25细胞（Tumor组）中MALAT1表达显著上调，miR-150显著下调（P＜0.05）；敲减MALAT1、过表达miR-150均可抑制SCC-25细胞增殖，促进凋亡；MALAT1靶向miR-150。抑制miR-150逆转了敲减MALAT1对口腔鳞癌细胞的增殖抑制和凋亡促进作用。结论:MALAT1可促进口腔鳞癌细胞增殖并抑制凋亡，其机制可能与靶向miR-150有关，可为口腔鳞癌的治疗提供新靶点。     

髋关节镜治疗髋臼盂唇损伤的研究进展

目的对髋关节镜治疗髋臼盂唇损伤的常见手术方式进行综述，为临床治疗提供参考。方法查阅近年国内外髋关节镜治疗髋臼盂唇损伤的手术方式和临床结果相关文献，进行分析和总结。结果在髋关节镜开展的早期，对撕裂的盂唇进行清理是主要治疗方案。目前的治疗原则是根据盂唇撕裂程度决定手术方式，包括髋臼盂唇清理术、髋臼盂唇修复术、髋臼盂唇重建术以及髋臼盂唇加强术等。结论髋关节镜手术已成为治疗盂唇损伤的主流技术，条件允许时应首选髋臼盂唇修复术，在盂唇无法修复时则采用髋臼盂唇重建术。