串联指动脉岛状皮瓣修复相邻两指指端软组织缺损

目的报道指动脉双岛状皮瓣修复相邻两指指端软组织缺损的疗效。方法切取以指总动脉为蒂的串联两个指根部皮瓣,分别逆行岛状修复相邻两指指端软组织缺损6例,其中食、中指3例,中、环指3例;手指末节残端软组织缺损10指,末节指腹缺损2指;10指伴有指骨外露,2指伴有肌腱外露。于指根部切取近侧皮瓣面积为1．2cm×1．5cm～1．5cm×2．0cm．远侧皮瓣面积为1．0cm×1．5cm～1.5cm×1．5cm。结果术后6例12块皮瓣全部成活,4例经6～24个月随访．皮瓣血供及质感良好。结论一侧指动脉皮瓣供区同时切取成2块带指动脉的皮瓣,修复相邻两指指端软组织缺损,可减少对另一指外形及功能损伤．同时也对此类型供血皮瓣的应用提供一种新的思路．     

胰岛素泵治疗应用于糖尿病患者的临床观察

目的对应用胰岛素泵技术对患有糖尿病的患者实施治疗的临床效果进行研究。方法抽取86例患有糖尿病的患者,随机分为对照组和治疗组,平均每组43例。采用多次皮下注射胰岛素方式对对照组患者实施治疗;采用胰岛素泵技术对治疗组患者实施治疗。结果治疗组患者糖尿病病情的控制效果明显优于对照组．胰岛素应用剂量明显少于对照组,血糖水平恢复时问和住院接受治疗总时间明显短于对照组,治疗前后血糖水平改善幅度明显大于对照组。结论应用胰岛素泵技术对患有糖尿病的患者实施治疗的临床效果非常明显。     

PRSS2 regulates EMT and metastasis via MMP-9 in gastric cancer

Serine protease 2 (PRSS2) is upregulated in gastric cancer tissues, correlates with poor prognosis and promotes migration and invasion of gastric cancer cells. However, the exact mechanism by which PRSS2 promotes metastasis in gastric cancer is unclear. We examined serum PRSS2 levels in healthy controls and gastric cancer patients by enzyme linked immunosorbent assay (ELISA) and analyzed the correlation between PRSS2 serum level with the clinicopathological characteristics of gastric cancer patients and matrix metalloproteinase-9 (MMP-9) expression. A lentiviral MMP-9 overexpression vector was constructed and used to transfect gastric cancer cells with stable silencing of PRSS2, and migration, invasion and epithelial-mesenchymal transition (EMT) of gastric cancer cells were examined. High serum PRSS2 levels were detected in gastric cancer patients and associated with lymphatic metastasis and TNM stage. Serum PRSS2 was positively correlated with serum MMP-9 level. PRSS2 silencing inhibited EMT, and knock-down of PRSS2 partially abrogated cell metastasis and EMT caused by overexpression of MMP-9. These results suggest that PRSS2 promotes the migration and invasion of gastric cancer cells through EMT induction by MMP-9. Our findings suggest that PRSS2 may be a potential early diagnostic marker and therapeutic target of gastric cancer.     

全肘关节弥漫性腱鞘巨细胞瘤1例报告

患者,男性,29岁.右肘关节发现肿物8年,近2年自觉肿物缓慢生长,近3个月出现胀痛,于2008年10月2日入院.该患者干活劳累时疼痛加重,休息后可缓解,伴有功能障碍.查体:右肘关节肿胀,关节周围可触及多个大小不等的肿物,质硬、活动度差,压痛不明显,肘关节屈伸时,肿物大小有改变.     

Decreased concentrations of soluble interleukin-1 receptor accessory protein levels in the peritoneal fluid of women with endometriosis

Interleukin 1 (IL1) may play an important role in endometriosis-associated pelvic inflammation, and natural specific inhibitors, including soluble IL1 receptor accessory protein (sIL1RAcP) and soluble IL1 receptor type 2 (sIL1R2), are critical for counterbalancing the pleiotropic effects of IL1. The objective of this study was to evaluate the levels of sIL1RAcP, together with those of sIL1R2 and IL1β, in the peritoneal fluid of women with and without endometriosis. Peritoneal fluid samples were obtained at laparoscopy and assessed by ELISA. sIL1RAcP concentrations were reduced in endometriosis stages I–II and III-IV. sIL1R2 concentrations were decreased, and those of IL1β were significantly increased in endometriosis stages I–II. sIL1RAcP and sIL1R2 concentrations were significantly decreased in the secretory phase of the menstrual cycle, and IL1β concentrations were elevated in the proliferative and the secretory phases. sIL1RAcP and sIL1R2 concentrations were reduced in women with endometriosis who were infertile, fertile, suffering from pelvic pain or pain-free. However, IL1β concentrations were significantly reduced in women with endometriosis who were infertile or had pelvic pain. These changes may exacerbate the local peritoneal inflammatory reaction observed in women with endometriosis and contribute to endometriosis pathophysiology and the major symptoms of this disease.     

The Effects on Cardiac Arrhythmias of Antihypertensive Therapy Causing Regression of Left Ventricular Hypertrophy

To examine the effects of antihypertensive therapy causing regression of left ventricular hypertrophy on cardiac arrhythmias, 26 hypertensive subjects were treated with ramipril with felodipine if required, and followed for 6 months after blood pressure control.Compared with baseline, left ventricular mass index (LVMI) was significantly reduced both at blood pressure control and after a further 6 months of treatment (baseline, blood pressure control, 6 months after blood pressure control; LVMI 142 ± 3.6, 131 ± 3.4, 123 ± 3.8* g/m², *P < .01 compared with baseline). There was a significant relationship between the decrease in systolic blood pressure and the decrease in LVMI after 6 months of blood pressure control compared with baseline (r = 0.41, P = .05). Compared with baseline, the average total number of ventricular ectopics decreased after blood pressure was controlled (88 ± 59 and 21 ± 12 respectively); however this reduction was not maintained after 6 months of further treatment, either before (78 ± 50) or after drug washout (86 ± 40). Compared with baseline (639 ± 590) supraventricular ectopic total was not initially reduced after blood pressure control (650 ± 604), but was reduced after a further 6 months of treatment (294 ± 261). This reduction was maintained after drug washout (267 ± 254), although this did not reach statistical significance. Radionuclide scanning at baseline was not a predictor of patients with the highest risk of arrhythmia and there was no correlation between improvement or worsening of a defect with changes in ventricular ectopic total.In conclusion, antihypertensive therapy with ramipril and felodipine, although causing regression of left ventricular hypertrophy did not lead to a sustained reduction in ventricular ectopic total.