微创治疗方法在输尿管上段结石中应用进展

输尿管上段结石为临床中常见泌尿系结石类型之一,如不能及时诊治,可引起重度积水、泌尿系感染,甚至脓毒血症,对患者肾功能、健康造成严重影响。随着微创治疗技术在泌尿系结石中应用,微创治疗方法能降低对患者造成治疗性创伤,降低相关并发症发生率,促进患者康复,了解临床中微创治疗输尿管上段结石方法,对临床中合理治疗输尿管上段结石有重要价值。     

BL型麻风复发降级为LL型麻风一例

正临床资料患者,男,52岁。云南省文山州丘北县人。因躯干、四肢结节、斑块5个月余,伴疼痛性结节10余天就诊。患者2019年2月因"接触油漆"后于双上肢出现结节、斑块,逐渐蔓延至双下肢、躯干,伴瘙痒,当地县中医医院考虑"过敏性皮炎",予抗过敏治疗(具体药物不详)后,结节、斑块未完全消退,偶有痒感,自用草药外洗治疗(具体药物不详),病情无好转,10天前患者四肢及躯干相继出现大小不等的结节,自觉疼痛。     

Hepatotoxicity of cantharidin is associated with the altered bile acid metabolism

Cantharidin (CTD) is an effective antitumor agent. However, it exhibits significant hepatotoxicity, the mechanism of which remains unclear. In this study, biochemical and histopathological analyses complemented with ultra-high-performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS)-based targeted metabolomic analysis of bile acids (BAs) were employed to investigate CTD-induced hepatotoxicity in rats. Sixteen male and female Sprague–Dawley rats were randomly divided into two groups: control and CTD (1.0 mg/kg) groups. Serum and liver samples were collected after 28 days of intervention. Biochemical, histopathological, and BA metabolomic analyses were performed for all samples. Further, the key biomarkers of CTD-induced hepatotoxicity were identified via multivariate and metabolic pathway analyses. In addition, metabolite–gene–enzyme network and Kyoto Encyclopedia of Genes and Genomes pathway analyses were used to identify the signaling pathways related to CTD-induced hepatotoxicity. The results revealed significantly increased levels of biochemical indices (alanine aminotransferase, aspartate aminotransferase, and total bile acid). Histopathological analysis revealed that the hepatocytes were damaged. Further, 20 endogenous BAs were quantitated via UHPLC-MS/MS, and multivariate and metabolic pathway analyses of BAs revealed that hyocholic acid, cholic acid, and chenodeoxycholic acid were the key biomarkers of CTD-induced hepatotoxicity. Meanwhile, primary and secondary BA biosynthesis and taurine and hypotaurine metabolism were found to be associated with the mechanism by which CTD induced hepatotoxicity in rats. This study provides useful insights for research on the mechanism of CTD-induced hepatotoxicity.     

改良三点式重睑成形术的临床应用研究

目的:探讨改良三点式重睑术的临床应用疗效。方法:2012年6月-2019年6月,共165例单睑患者采用了改良三点式重睑术,沿术前标记线将三点处皮肤切开,剪刀将切口下唇的眼轮匝肌适当去除,同时将切口与切口在皮下层打通,剪除切口与切口之间的眼轮匝肌,6-0可吸收线挂睑板前筋膜或提上睑肌腱膜及切口下唇皮下组织缝合,三点切口各缝1针。再用6-0单丝尼龙线按照常规重睑线缝合方法挂切口下唇皮肤、睑板前筋膜或提上睑肌腱膜及切口上唇皮肤缝合打结,三点切口各缝1针。伴内眦赘皮者同时行内眦赘皮矫正术。结果:152例患者获得随访,随访患者大部分获得了比较满意的重睑,睁眼重睑流畅、自然,闭眼刀口痕迹不明显。2例患者出现内侧重睑线变浅,1例患者出现外侧重睑线变浅,所有患者均未出现重睑消失。5例患者双侧重睑线有轻度不对称。患者总体满意率为94.7%(144/152)。结论:改良三点式重睑术具有创伤小、并发症少、效果逼真、不易脱落、手术痕迹不明显等优点,值得推广应用。     

桂枝汤加减治疗营卫不和型慢性瘾疹的临床疗效

目的:观察桂枝汤加减治疗营卫不和型慢性瘾疹的临床疗效。方法:将我院门诊2017年10月-2019年10月收治的48例营卫不和型慢性瘾疹患者,按随机数表法分成对照组(24例)与实验组(24例)。对照组实施常规西药治疗,实验组实施桂枝汤合地骨皮、白鲜皮加减治疗。对照两组治疗前后症状积分、临床疗效及并发症发生率。结果:两组治疗前症状积分相比无显著差异(P>0.05)。治疗后,两组症状积分均有所下降,实验组低于对照组;实验组临床总有效率为91.67%(22/24)高于对照组的66.67%(16/24);实验组并发症发生率0(0/24)低于对照组的16.67%(4/24),差异具有统计学意义(P<0.05)。结论:在营卫不和型慢性瘾疹治疗中,采取桂枝汤加减治疗,可明显降低症状积分,提高临床治疗效果,减少并发症,效果理想。     

Myeloid-derived suppressor cell (MDSC) key genes analysis in rat anti-CD28-induced immune tolerance kidney transplantation

BackgroundIn the field of transplantation, inducing immune tolerance in recipients is of great importance. Blocking co-stimulatory molecule using anti-CD28 antibody could induce tolerance in a rat kidney transplantation model. Myeloid-derived suppressor cells (MDSCs) reveals strong immune suppressive abilities in kidney transplantation. Here we analyzed key genes of MDSCs leading to transplant tolerance in this model.MethodsMicroarray data of rat gene expression profiles under accession number {"type":"entrez-geo","attrs":{"text":"GSE28545","term_id":"28545"}}GSE28545 in the Gene Expression Omnibus (GEO) database were analyzed. Running the LIMMA package in R language, the differentially expressed genes (DEGs) were found. Enrichment analysis of the DEGs was conducted in the Database for Annotation, Visualization and Integrated Discovery (DAVID) database to explore gene ontology (GO) annotation and their Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Their protein-protein interactions (PPIs) were provided by STRING database and was visualized in Cytoscape. Hub genes were carried out by CytoHubba.ResultsThree hundred and thirty-eight DEGs were exported, including 27 upregulated and 311 downregulated genes. The functions and KEGG pathways of the DEGs were assessed and the PPI network was constructed based on the string interactions of the DEGs. The network was visualized in Cytoscape; the entire PPI network consisted of 192 nodes and 469 edges. Zap70, Cdc42, Stat1, Stat4, Ccl5 and Cxcr3 were among the hub genes.ConclusionsThese key genes, corresponding proteins and their functions may provide valuable background for both basic and clinical research and could be the direction of future studies in immune tolerance, especially those examining immunocyte-induced tolerance.     

参芪润肠通便汤治疗小儿便秘的临床疗效

目的观察参芪润肠通便汤治疗小儿便秘的临床疗效。方法选定麻城市人民医院中医儿科门诊治疗的小儿便秘患儿80例,研究时段自2017年2月—2019年1月,按照治疗方式进行分组,分对照组(40例,常规药物治疗)、试验组(40例,参芪润肠通便汤治疗),回顾分析患儿临床资料,比较临床疗效、症状积分。结果试验组临床总有效率(95.00%)显著较对照组(77.50%)高,P<0.05;试验组治疗前1 d大便全程干燥、腹部胀满、胃纳减退评分与对照组相比存在差异,但P<0.05,治疗2周后两组上述评分均降低,且试验组较对照组低,P<0.05。结论针对小儿便秘患儿,参芪润肠通便汤可改善患者症状,促进其病情恢复,患儿整体状态得以改善,值得借鉴。