中药药浴治疗痉挛型脑性瘫痪患儿的临床效果

目的研究中药药浴治疗痉挛型脑性瘫痪患儿的临床效果。方法选取2021年1月至12月于粤北人民医院儿童康复科确诊的80例痉挛型脑性瘫痪患儿,按随机数字表法分为对照组和观察组,每组各40例。对照组实施常规康复疗法,涉及运动疗法、作业疗法、物理因子治疗等,观察组进行常规康复治疗并结合中药药浴疗法,分别评估两组的肌张力及大运动功能并进行比较。结果治疗后观察组的肌张力低于对照组,大运动功能评估得分高于对照组,差异均有统计学意义(P<0.05)。结论中药药浴治疗痉挛型脑性瘫痪患儿可获得显著的效果,可改善肌张力,促进大运动功能提升,具有临床推广价值。     

Severe periodontitis is associated with the serum levels of hypersensitive C reactive protein and lipoprotein-associated phospholipase A2 in the patients of acute ischemic stroke

BackgroundPeriodontitis is associated with the pathogenesis of atherosclerotic plaque, and hypersensitive C reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) are the serum biomarkers of the stability of atherosclerotic plaque. Whether periodontitis is associated with the serum level of hs-CRP and Lp-PLA2 of acute ischemic stroke remains unclear.Material and MethodsWe recruited 103 cases with acute ischemic stroke within 7 days after stroke onset. Pocket depth and clinical attachment loss were assessed by oral examination to define the severe periodontitis. Demographic information including gender, age and body weight index, income level, education level, past medical history include smoking history, drinking history, ischemic stroke history, coronary heart disease, hypertension, diabetes and hyperlipidemia were collected, and serum biomarkers including white blood cell (WBC), fibrinogen, total cholesterol (TC), triglyceride (TG), lower density lipoprotein (LDL-C), high density lipoprotein (HDL-C), hs-CRP, HemoglobinA1c (HbAlc), Homocysteine (HCY) and Lp-PLA2 were tested.Results65 (63.1%) cases were diagnosed as severe periodontitis. Severe periodontitis group showed more male, age, drinking history, higher levels of hs-CRP and Lp-PLA2. Multivariate logistic regression showed that severe periodontitis was were significantly associated with hs-CRP (OR = 2.367, 95%CI: 1.182–4.738; P = .015) and Lp-PLA2 (OR = 2.577, 95% CI: 1.010–6.574; P = .048).ConclusionsSevere periodontitis is independently associated with the serum Level of hs-CRP and Lp-PLA2 in patients with acute ischemic stroke. Whether the improvement of periodontitis could decrease the occurrence and re-occurrence of ischemic stroke by stablizating atherosclerotic plaque need be further studied in future.     

微创多枚空心加压螺钉固定治疗股骨颈骨折的疗效分析

【摘要】 目的 探讨微创多枚螺钉固定治疗股骨颈骨折的临床疗效。方法 对2008年8月~2010年8月于广州市第一人民医院创伤骨科及粤北人民医院关节外科采用闭合复位微创空心加压螺钉内固定治疗股骨颈骨折71例,对其随诊资料作回顾性的分析。患者包括男30例,女41例,年龄16~80岁,平均年龄62.4岁,全部为新鲜闭合性骨折。按股骨颈骨折Garden分型:Ⅰ型8例,Ⅱ型21例,Ⅲ型32例,Ⅳ型10例。随访时间14~60个月,平均31.5个月。结果 截至2012年8月,59例患者获骨性愈合,骨折平均愈合时间为5.1个月(3.6~11.3月),愈合率为83%;术后发生骨折不愈合,最终出现股骨头缺血性坏死12例(17%);髋关节功能按Harris评分:优良率84.7%;Garden Ⅰ、Ⅱ、Ⅲ、Ⅳ型的骨愈合率分别为100%、95.2%、78.1%、60%;Graden复位指数A、B、C组的愈合率分别为92.9%、77.3%、42.9%。结论 应用良好的牵引闭合复位和微创多枚空心加压螺钉内固定在治疗garden Ⅲ型以内的股骨颈骨折是一种疗效理想,操作简单、固定牢靠、创伤小的优良治疗方法。     

无骨折脱位颈髓损伤的MRI分型及临床意义

[目的]前瞻性研究无骨折脱位颈髓损伤患者MRI定量和定性特征及对神经功能的影响;探讨MRI分型标准.[方法] 2009年12月～2011年12月本院骨科收治的47例无骨折脱位颈髓损伤患者,在MRI影像学上测量颈髓损伤的范围、损伤节段纤维椎管的矢状径和骨性椎管的矢状径,分析结果及对神经功能的影响;制定无骨折脱位颈髓损伤患者的MRI分型标准.用加权Kappa值检验放射科医师和骨科医师的MRI分型一致性.[结果]无骨折脱位颈髓损伤患者纤维椎管的矢状径C5/6节段最小,为(6.03 ±1.49) mm;骨性椎管矢状径C4/5节段最小,为(11.85±1.21) mm,纤维椎管与同节段骨性椎管相比差异有显著性(P＜0.05).无骨折脱位颈髓损伤范围(2.76±1.29) cm;其中27例脊髓水肿损伤范围为(2.58±1.22) cm;20例脊髓出血损伤范围为(2.89±1.30) cm;本组病例术后末次随访与术前JOA评分差异有显著性(P＜0.01),改善率为55.1％.放射科医师和骨科医师间的MRI分型一致性KA1C1=0.527、KB1D1=0.411;KA1B1=0.661;KC1D1=0.659;4个评估者两次评估间的一致性KA-D=0.493-0.723.[结论]该MRI分型是一种新的方法,经临床检验对颈椎无骨折脱位颈髓损伤诊断和治疗有临床意义.无骨折脱位颈髓损伤MRI分型是一个比较可靠的有效性评估方法,对指导治疗和预后评估有意义.     

多西他赛联合奈达铂同步调强适形放疗治疗局部晚期鼻咽癌

目的探讨多西他赛联合奈达铂同步调强适形放疗(IMRT)治疗局部晚期鼻咽癌(NPC)的临床疗效和毒副反应。方法 64例经病理学确诊的初治局部晚期NPC患者随机均分为2组,观察组32例患者行多西他赛联合奈达铂化疗同步IMRT,对照组患者则行奈达铂联合5-氟尿嘧啶化疗同步IMRT。治疗后评价2组临床疗效和毒副反应。结果 2组患者鼻咽大体肿瘤靶区和颈部转移淋巴结体积缩小的百分率比较差异无统计学意义(P>0.05);2组患者NPC病灶和颈部转移淋巴结病灶完全缓解率比较差异均无统计学意义(P>0.05)。观察组Ⅲ、Ⅳ度中性粒细胞减少、恶心或食欲减退、呕吐、腹胀、口腔黏膜反应的发生率均明显低于对照组(P<0.05)。观察组患者1、2 a总生存率和无进展生存率分别为100.00%、96.88%和100.00%、93.75%,对照组分别为100.00%、93.75%和100.00%、90.63%,比较差异均无统计学意义(P>0.05)。结论多西他赛联合奈达铂同步IMRT治疗局部晚期NPC的安全有效,值得在临床上推广应用。     

膀胱癌患者术后生活质量状况及其影响因素分析

目的探讨膀胱癌患者术后生活质量状况,并分析其影响因素。方法选取2011年1月至2013年4月间收治的42例膀胱癌患者为观察组,另选42名健康成人为对照组,采用世界卫生组织生活质量测定(QOL-BREF)量表标准评估两组患者的生活质量,同时比较观察组患者不同年龄、分期、淋巴结转移、文化程度及社会支持程度的评分结果。结果观察组患者的生活质量状况评分均低于对照组。观察组患者中,年龄≥60岁、临床分期Ⅲ~Ⅳ期、存在转移灶、低文化程度及低社会支持患者的生活质量状况评分较低,差异有统计学意义(P<0.05)。结论膀胱癌患者术后生活质量状况较差,年龄、分期、转移情况、文化程度及社会支持程度是其生活质量的重要影响因素。     

早期康复训练对老年急性心肌梗死患者疗效及生活质量的影响

目的探讨早期运动康复训练对老年急性心肌梗死患者的疗效及生活质量影响。方法选取急性心肌梗死老年患者118例,按照就诊顺序将其随机分为两组,各59例。对照组给予常规心肌梗死药物治疗,观察组在对照组的基础上进行早期运动康复训练,比较两组患者的临床治疗效果以及生活质量的改善情况。结果观察组治疗后心力衰竭、室性心律失常、梗死后心绞痛并发症的发生率和病死率均显著低于对照组(P<0.05);观察组治疗后生活质量评分显著高于对照组(P<0.05)。结论对老年急性心肌梗死患者进行早期康复训练可以有效地降低患者并发症发生率和病死率,提高其生活质量,具有较高的临床应用价值。     

血清Ghrelin水平与糖尿病肾病腹部肥胖患者的相关性

目的探讨血清Ghrelin在糖尿病肾病(DN)腹部肥胖患者发生发展中的作用。方法选择收治的57例腹部肥胖DN患者为A组,60例非肥胖的DN患者为B组,及同期健康肥胖者60例为C组。对所有入选者测量计算体质量指数(BMI),检测血糖、血脂、肾功能,应用酶联免疫法检测Ghrelin。结果 A组BMl、腰围、空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))、尿白蛋白排满泄率(UAER)、Ghrelin高于B、C组,且A组尿素氮(BUN)、血肌酐(SCr)高于C组(P<0.05,P<0.01),3组总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)比较差异无统计学意义(P>0.05)。相关性分析表明,A组Ghrelin与BMI、腰围、FPG、HbA_(1c)呈负相关(r=-0.412、r=-0.401、r=-0.331、r=-0.391,P<0.05),与TC、BUN、UAER呈正相关(r=0.411、r=0.374、r=0.561,P<0.05),与HDL-C、LDL-C、SCr未表现相关性(P>0.05)。B组Ghrelin与BMI、FPG、HbA_(1c)呈负相关(r=-0.312、r=-0.401、r=-0.410,P<0.05),与TC、BUN、UAER呈正相关(r=0.384、r=0.402、r=0.556,P<0.05),与腰围、HDL-C、LDL-C、SCr未表现相关性(r=0.264,r=0.187,r=0.201,r=0.116,P>0.05)。结论血清Ghrelin在腹部肥胖的DN患者发生、发展中起着重要作用,或可成为预后的重要指标。     

Mir-664 promotes osteosarcoma cells proliferation via downregulating of FOXO4

BackgroundUncontrol cell growth and proliferation is acknowledged to responsible for cancer-related deaths by disorganizing the balance of growth promotion and growth limitation. Aberrant expression of microRNA play essential roles in cancer development, leads to cell proliferation, growth and survival, and promotes the development of various human tumors, including osteosarcoma. Elucidating the molecular mechanism of this abnormality in osteosarcoma carcinogenesis may improve diagnostic and therapeutic strategies for this malignancy.MethodsThe expression of miR-664 in osteosarcoma cell lines and osteosarcoma tissues was examined using real-time PCR. The effects of miR-664 on osteosarcoma cell proliferation were evaluated by 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay, colony formation and Anchorage-independent growth ability assay. The effect of miR-664 on FOXO4 was determine by luciferase assays and western blot assay.ResultsThe expression of miR-664 was markedly upregulated in osteosarcoma cell lines and tissues, and upregulation of miR-664 enhanced, whereas downregulation of miR-664 inhibited the proliferation of osteosarcoma cells in vivo. Furthermore, using bioinformatics and biological approaches, we showed that miR-664 directly targeted and suppressed the expression of tumor suppressors FOXO4.ConclusionsOur findings suggest that miR-664 functions as an oncogene miRNA and has an important role in promoting human osteosarcoma cell proliferation by suppressing FOXO4 expression. These data suggests that miR-664 may represent a novel therapeutic target of microRNA-mediated suppression of cell proliferation in osteosarcoma.     

Postoperative complications of Goel-Harms C1-C2 screw-rod fixation technique for C1-C2 instability after C2 nerve sacrifice,a prospective study over two years follow up

BackgroundAtlantoaxial instability is mainly caused by trauma. C2 nerve is usually needed to be sacrificed for adequate exposure of the lateral mass and screw insertion.ObjectivesThis study aimed to investigate the clinical outcome of postoperative complications of C1 and C2 screw-rod fixation using the Goel-Harms technique for C1-C2 instability after sacrificing the C2 nerve root.MethodsAmongst forty patients with C1-C2 pathology, twenty-seven cases were enrolled into the study, then variables, including age, sex, primary pathology, operation duration, postoperative pain, paresthesia, anesthesia, and other specific conditions, were documented. Data analyzed by an expert biostatistician. p-value < 0.05 was considered significant.ResultsRegardless of gender, the most postoperative adverse effect was occipital anesthesia (81.5%). Most of the patients (63%) had both occipital pain and anesthesia one-month post-surgery. At 3- and 6-months post-surgery, occipital pain and anesthesia were seen in 40.7% and 14.8%, respectively.ConclusionThe most common postoperative adverse effect of C2 nerve root scarification after C1-C2 fixation is occipital anesthesia followed by occipital paresthesia and pain, which are reduced in severity over time.