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1.
目的 研究凉血通瘀方对高血压大鼠急性脑出血模型脑组织miRNA表达的影响,对差异表达的miRNA靶基因进行分析,探索凉血通瘀方可能的药效机制。方法 将自发性高血压大鼠随机分成对照组(B)和实验组(C)。适应性饲养一周后,C组灌胃凉血通瘀方,B组灌胃等体积生理盐水,连续5天,每天1次。构建脑出血模型后收集脑组织,借助全转录组测序技术获得miRNA表达量,与miRBase数据库比对获取已知miRNA,使用miRDeep2预测新miRNA。差异分析软件为DESeq2,筛选阈值为|log2FC| ≥1 并且P <0.05。对显著差异表达的miRNA进行靶基因预测,对靶基因进行GO功能、KEGG通路富集和PPI网络分析。结果 实验组和对照组对比,共发现21个显著差异表达的miRNA,上调有9个,下调有12个,共预测得到1243个有统计学意义的靶基因。GO富集分析发现,生物过程中突触囊泡分泌的调节、神经递质分泌的调节和神经递质运输的调节占前三位,神经元投射终点、全膜、质膜区域和细胞投射则是主要的细胞成分。分子功能分别为小GTPase绑定、底物特异性跨膜转运蛋白活性和离子跨膜转运体活性。通路分析结果显示,靶基因在癌证通路、pI3K-Akt信号通路、人类乳头瘤病毒感染、神经活性配体-受体相互作用和MAPK通路等分布广泛。采用STRING网站和Cytoscape软件,根据MCC算法筛选出ADRA2C、CASR、CCL28、CCR1、DRD2、GNAT3、GRM2、DYNC1LI1、GABBR1、GNAI1等核心靶基因。结论 凉血通瘀方对脑出血急性期鼠脑组织内miRNA的表达有重要影响;显著差异表达miRNAs可能通过靶向核心基因调控凉血通瘀方干预急性脑出血的病理过程及预后。  相似文献   
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IntroductionSurgery is the cornerstone of the treatment for advanced ovarian cancer. Reaching complete cytoreduction resulting in no gross residual disease often requires complex surgery. The aim of this study was to assess the impact of increased surgical radicality on the risk of complications in the treatment of advanced ovarian cancer.Materials and methodsAll consecutive patients with advanced ovarian cancer (FIGO Stage IIIB-IVB) who had undergone primary or interval debulking surgery during a six-year study period were identified. In the midst of the study period, a surgical practice change towards maximal surgical effort occurred. Two groups were formed for the analysis: cohort A, that consisted of patients operated before the surgical paradigm shift and cohort B, that consisted of patients operated under the period of increased surgical radicality.Results252 patients were included in the analysis. Complete resection (R0) was achieved in 21.3% of surgeries in cohort A and in 51.2% in cohort B. The total postoperative complication rate was 76.2%. Most of the complications (86.5%) were minor (Clavien-Dindo I-IIIA). The patients in cohort B were at increased risk for complications, OR 2.94 (95%CI 1.58–5.47; p = 0.001). As for the approach to cytoreduction (primary vs. interval debulking), there was no statistically significant association with the occurrence of postoperative complications (p = 0.659).ConclusionIn the present study more extensive surgeries led to better surgical results but increased postoperative morbidity. Postoperative complication rates were similar in both primary and interval debulking surgeries.  相似文献   
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目的:探讨个体怀旧疗法对年轻晚期癌症患者预期性悲伤和生活质量的干预效果。方法:选择2019年10月至2020年7月在某肿瘤专科医院就诊的90例年轻晚期癌症患者配偶为研究对象,随机分为对照组和观察组各45例。对照组给予常规健康教育和指导,观察组在对照组的基础上联合个体怀旧疗法。采用中文版预期性悲伤量表、癌症患者照顾者生活质量调查表进行干预效果评价。结果:干预后观察组除失去的感觉维度外,预期性悲伤总分及其他各维度得分均低于对照组,观察组身体健康、心理健康维度得分和生活质量总分高于对照组,差异有统计学意义(P<0.05)。结论:个体怀旧疗法可降低年轻晚期癌症患者配偶的预期性悲伤水平,提高其生活质量。  相似文献   
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目的探讨超微血管成像(superb microvascular imaging, SMI)对子宫肌瘤变性的诊断价值。方法选取2020年9月—2021年4月在丹东市中心医院行手术治疗的子宫肌瘤患者82例,对所有患者90个病灶的SMI、高级动态血流显像(advanced dynamic flow, ADF)和彩色多普勒血流显像(colordoppler flow imaging, CDFI)检查结果资料进行回顾性分析,将变性的30个病灶设为观察组,未变性的60个病灶设为对照组,以病理诊断结果为金标准判定3种检查方法对子宫肌瘤变性的诊断效能。结果对照组SMI、ADF和CDFI血流分级均高于观察组,差异均具有统计学意义(P<0.05)。CDFI对子宫肌瘤变性诊断的敏感度、特异度和准确度分别为60%、75%和70%,ADF分别为53.33%、81.67%和72.22%,SMI分别为43.33%、90%和74.44%。结论 SMI对子宫肌瘤的血管显示能力高于ADF和CDFI,对子宫肌瘤变性的诊断具有较高特异性。  相似文献   
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目的探讨第二产程中侧位分娩对产妇分娩效果及舒适度的影响。方法100例足月产妇,随机分为治疗组和对照组,各50例。治疗组产妇第二产程中采用侧位分娩,对照组第二产程中采用正常体位分娩。观察比较两组产妇会阴裂伤情况、产后出血量、产程时间、产妇舒适度及新生儿Apgar评分。结果治疗组新生儿出生后1、5 min Apgar评分分别为(9.27±0.54)、(9.73±0.45)分,与对照组的(9.19±0.61)、(9.72±0.45)分比较,差异无统计学意义(P>0.05)。治疗组会阴裂伤发生率20.00%低于对照组的64.00%,差异有统计学意义(P<0.05)。治疗组会阴裂伤程度优于对照组,差异有统计学意义(P<0.05)。治疗组产后2、24 h出血量分别为(101.23±71.53)、(259.23±70.41)ml,均少于对照组的(168.35±60.41)、(373.62±60.49)ml,差异有统计学意义(P<0.05)。治疗组第二产程用时为(40.22±12.37)min,短于对照组的(57.84±16.37)min,差异有统计学意义(P<0.05)。治疗组产后2、12 h下肢疼痛发生率均低于对照组,差异有统计学意义(P<0.05);两组产后24 h下肢疼痛发生率及产后2、12、24 h四肢麻木发生率比较差异无统计学意义(P>0.05)。结论第二产程中应用侧位分娩能够降低产后出血风险,且会阴裂伤程度较轻,有助于产妇快速康复,值得临床推广应用。  相似文献   
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BackgroundRecent studies have described the use of telehealth for pediatric surgical care during the COVID-19 pandemic. We aimed to evaluate equity in telehealth use by comparing rates of utilization and satisfaction with pediatric surgical telemedicine among Hispanic patients.MethodsWe conducted a retrospective cohort study of patients seen by a surgical subspecialty provider in the outpatient setting at a quaternary pediatric hospital between April 1 and June 30, 2020. Patients evaluated in the same three-month period in 2019 were analyzed as a historic control. Differences in Family Experience Survey (FES) responses based on race and ethnicity and preferred language of care were assessed using univariable and multivariable generalized linear modeling.ResultsThe pandemic cohort included fewer patients of Hispanic ethnicity and fewer Spanish-speakers. After controlling for visit type, comparison of Spanish-speaking and English-speaking patients revealed that Spanish-speaking families had significantly lower scores for FES items that evaluated healthcare provider explaining (IRR 0.74, 95% CI: 0.61–0.90), listening (IRR 0.76, 95% CI: 0.63–0.92), and time spent with the family (IRR 0.73, 95% CI: 0.60–0.89). There were no differences in FES responses based on insurance status or degree of medical complexity.ConclusionsTelehealth services were less commonly used among Hispanic and Spanish-speaking patients. Language may differentially affect family satisfaction with healthcare and telehealth solutions. Strategies to mitigate these inequities are needed and may include strengthening interpreter services and providing language-concordant care.Level of evidenceLevel IV.  相似文献   
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PurposeTo evaluate in vivo parameters as biomarkers of limbal stem cell function and to establish an objective system that detects and stage limbal stem cell deficiency (LSCD).MethodsA total of 126 patients (172 eyes) with LSCD and 67 normal subjects (99 eyes) were included in this observational cross-sectional comparative study. Slit-lamp biomicroscopy, in vivo laser scanning confocal microscopy (IVCM), and anterior segment optical coherence tomography (AS-OCT) were performed to obtain the following: clinical score, cell morphology score, basal cell density (BCD), central corneal epithelial thickness (CET), limbal epithelial thickness (LET), total corneal nerve fiber length (CNFL), corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), and tortuosity coefficient. Their potential correlations with the severity of LSCD were investigated, and cutoff values were determined.ResultsAn increase clinical score correlated with a decrease in central cornea BCD, limbal BCD, CET, mean LET, maximum LET, CNFL, CNFD, CNBD, and tortuosity coefficient. Regression analyses showed that central cornea BCD, CET and CNFL were the best parameters to differentiate LSCD from normal eyes (Coef = 3.123, 3.379, and 2.223; all p < 0.05). The rank correlation analysis showed a similar outcome between the clinical scores and the central cornea BCD (ρ = 0.79), CET (ρ = 0.82), and CNFL (ρ = 0.71). A comprehensive LSCD grading formula based on a combination of these parameters was established.ConclusionsA comprehensive staging system combining clinical presentation, central cornea BCD, CET, and CNFL is established to accurately and objectively diagnose LSCD and stage its severity.  相似文献   
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目的:探讨MRI在G1/G2胰腺神经内分泌肿瘤(pNENs)病理分级及临床分期中的价值,寻找同时与G1/G2 pNENs病理分级及临床分期相关的MRI征象。方法:回顾性分析62例经手术病理证实为pNENs患者的临床及MRI资料,采用独立样本t检验、秩和检验、卡方检验、Fisher’s精确概率法等对pNENs不同病理分级及临床分期的临床表现及MRI征象进行比较。结果:边界是否清晰、肿瘤直径、有无周围组织浸润、增强后强化均匀与否、ADC比值在不同pNENs病理分级及临床分期间的差异均有统计学意义(P值均<0.05)。DWI信号及静脉期、延迟期MRI信号在不同病理分级间的差异均有统计学意义(P值均<0.05);性别、pNENs病灶呈囊实性、淋巴结转移及肝转移情况在不同临床分期间的差异均有统计学意义(P值均<0.05)。结论:边界不清、强化不均、周围组织浸润、较大的肿瘤直径、较低的ADC比值同时与pNENs较高的病理分级及临床分期相关,MRI检查有助于术前准确且全面评估pENEs的异质性,辅助患者的个性化治疗。  相似文献   
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