结直肠癌基因治疗研究进展

【摘要】〓结直肠癌是常见的消化道恶性肿瘤,传统治疗以外科手术为主,辅以放、化疗,术后5年生存率仅为50%左右。近年来结直肠癌基因治疗备受人们青睐,且有许多研究成果成功运用于临床。目前对结直肠癌基因治的方法主要有原癌基因治疗、抑癌基因治疗、免疫基因治疗以及多基因联合治疗等。     

肝卵圆细胞对大鼠肝硬化组织TGFβ/smad信号传导的影响

【摘要】〓目的〓探讨肝卵圆细胞对TGFβ/smad信号传导通路影响的机制,并证明肝卵圆细胞对肝硬化的发展是否有阻止和逆转的作用。方法〓对肝卵圆细胞进行增殖、分离、培养后,移植于肝硬化大鼠肝脏组织,以未经移植的大鼠做对照,分别进行组织病理学和肝功能及蛋白表达水平的检测,分析ALB、AST、ALT、TGFβ1、TGFβRⅡ、Smad2、Smad4 、Smad7的情况。结果〓移植肝卵圆细胞的鼠肝硬化组织纤维化减少,肝功能明显改善(P<0.05),肝硬化组织TGFβ/smad信号通路中各蛋白表达量有差异。结论〓肝卵圆细胞刺激肝硬化细胞后TGFβ/smad信号通路中各蛋白的表达是不同的,肝卵圆细胞对肝硬化组织有阻止和逆转的作用。     

腹腔镜联合肾镜液电碎石仪在基层医院胆道结石手术的运用

【摘要】〓目的〓探讨与研究基层医院在胆道结石手术中运用腹腔镜联合肾镜液电碎石仪的可行性与实用性。方法〓选取我院于2013年1月至2014年1月在我院行手术治疗的胆囊结石合并肝内外胆管结石患者53例,均采用腹腔镜联合肾镜探查液电碎石仪治疗术式,通过观察患者手术时间、术中术后胆道出血、术后胆道结石残余、术后住院时间。结果〓53例患者均顺利完成手术,无中转开腹。术中35例采用液电碎石,每例碎石次数约3~10次,每次持续放电约2~3秒,其中2例较大者反复击打约15次。术中胆道出血者3例,没有出现难以控制的出血以及胆管穿透或胆管壁撕裂病例。术后平均住院时间7.1±2.6天,无腹腔感染病例。所有患者均得到术后半年随访,2例发现术后结石残余,经消化内镜取石。未发现胆总管狭窄病例。 结论〓腹腔镜联合肾镜液电碎石仪治疗胆道结石,在基层医院中有一定的可行性与实用性。     

血清F-PSA/T-PSA检测在前列腺疾病鉴别诊断中的应用

近年来,前列腺癌(PC a)在我国发病率呈上升趋势,迄今为止,前列腺特异性抗原(PSA)仍然是PC a最重要的肿瘤标志物,但它是前列腺组织特异性抗原[1],除了PC a,其他的一些前列腺疾病血清PSA也有不同程度的升高,另外血清中存在少量的游离PSA,计算F-PSA/T-PSA,进一步探讨了F-PSA/TPSA检测PC a的临床价值,报告如下。1对象和方法1.1对象PC a患者42例,年龄60~85(平均66.7)岁;良性前列腺增生(BPH)30例,年龄45~80(平均58.8)岁。均经临床和病理确诊。1.2方法采用电化学发光免疫分析法,试剂盒由罗氏诊断公司提供,批号04641655,仪器是罗氏…     

Spinal cord injury increases the risk of Type 2 diabetes: a population-based cohort study

Background contextPrevious studies on the risk and prevalence of diabetes among spinal cord injury (SCI) patients are limited and controversial.PurposeTo compare the risk and incidence rate (IR) of Type 2 diabetes in SCI and non-SCI patients.Study designThis is a population-based retrospective cohort study.Patient sampleData from Taiwan's National Health Insurance Research Database for the period 1997 to 2010 were analyzed. Patients aged 20 years and older newly identified with SCIs during this period were included in the SCI cohort. A non-SCI comparison cohort was randomly selected from National Health Insurance beneficiaries and matched with the SCI cohort based on age, sex, and index date.Outcome measuresBoth cohorts were followed until the first of the following occurred: the diagnosis of Type 2 diabetes (International Classification of Disease, Ninth Revision, Clinical Modification codes 250), withdrawal from the insurance system, the end of 2010, or death.MethodsA Cox proportional hazards regression analysis was used to estimate the risk of developing diabetes.ResultsTaiwan possesses an older SCI population, with a mean age of 51.6 years. The IR for diabetes in patients with and without SCIs was 22.1 per 10,000 person-years and 17.2 per 10,000 person-years, respectively. The adjusted hazard ratio (HR) for diabetes was 1.33 times higher in patients with SCIs than in those without SCIs. In patients with SCIs, men (adjusted HR=1.23, 95% confidence interval (CI)=1.04–1.44), older people (adjusted HR=4.26 in patients older than 65 years, 95% CI=3.16–5.74), patients with comorbidity (adjusted HR=1.36, 95% CI=1.14–1.62), and patients with a complete thoracic SCI (T-spine injury) (adjusted HR=2.13, 95% CI=0.95–4.79) were more likely to be diagnosed with diabetes than other patient subgroups.ConclusionsOur findings may facilitate the prioritizing of preventive health strategies and planning of long-term care for SCI patients.     

Self‐reported Internalizing and Externalizing Behaviours among Junior High School Students at 2 and 4 Years after the 921 Earthquake in Taiwan

We examined the impact of the 921 Taiwan Earthquake on internalizing and externalizing behaviours among junior high school students 2 and 4 years after the earthquake. This study was a secondary analysis using data extracted from the Taiwan Education Panel Survey and included 12111 students. The impact of the earthquake was assessed by the length of time to restore the home environment and whether a family member died or was severely injured in the earthquake. Generalized estimating equations showed that living in an urban area and a longer duration after the earthquake were associated with increased internalizing and externalizing behaviours. Boys reported more externalizing but fewer internalizing behaviours than girls. After adjustment for those variables, having a family member who had died or was severely injured was not significantly associated with increased internalizing and externalizing behaviours. However, a longer duration of time to restore the home environment was significantly associated with these behaviours. Regardless of the impact level of the disaster, adolescents had increased internalizing and externalizing behaviours from the seventh to ninth grades. Post‐disaster mental health services should continue monitoring and supporting children whose ordinary home living is affected by a natural disaster up to 4 years post‐disaster. Copyright © 2013 John Wiley & Sons, Ltd.     

Unilateral versus bilateral fixation for lumbar spinal fusion: a systemic review and meta-analysis

Purpose

The objective of this study was to systematically compare the efficacy and safety of unilateral fixation to bilateral fixation for the lumbar degenerative disease.

Study design

Systematic review and meta-analysis.

Methods

We searched databases including PubMed Central, MEDLINE (from 1966), EMBASE (from 1980), and Cochrane Central Register of Controlled Trials databases for randomized controlled trials or non-randomized controlled trials that compare unilateral fixation with bilateral fixation for the treatment for lumbar disease. Exclusion criteria were non-controlled studies, follow-up <6 months, combined anterior and posterior surgery, lumbar tumors, and non-English writing paper. Methodologic quality was assessed, relevant data were retrieved, and the appropriate meta-analysis was performed. Two review authors independently selected studies, extracted data, and assessed the risk of bias. The main end points included the rate of fusion, visual analogue scale (VAS), Oswestry disability index (ODI), intra-operative blood loss, operating time, and the rate of complications.

Results

A total of seven studies were included in the meta-analysis. Four relevant randomized controlled trials, one prospective study, and two retrospective studies involving 499 patients were identified. Patients in unilateral pedicle fixation group compared with bilateral pedicle screw fixation group on the fusion rate, VAS, ODI scores, and complication rate demonstrated no significant differences (P > 0.05, respectively). However, intra-operative blood loss and operating time in unilateral fixation group were significantly less than bilateral fixation group (P < 0.0001, respectively).

Conclusions

Unilateral fixation seems to be an effective, feasible, and safe procedure in one or two segmental disease when compare with bilateral instrumentation.