少腹逐瘀汤联合孕三稀酮治疗子宫内膜异位症前瞻性研究

目的:探讨少腹逐瘀汤联合西药保守治疗子宫内膜异位症的临床价值。方法:我院诊治的80例子宫内膜异位症患者为研究对象,按随机双盲分组原则分为观察组和对照组,各40例。两组均给予孕三稀酮进行治疗,观察组在此基础上加用少腹逐瘀汤。对比两组临床疗效,记录两组治疗前后中医症状评分、血液流变学(血浆黏度、全血高切黏度、全血低切黏度、红细胞沉降速率、红细胞聚集指数、纤维蛋白原)及外周血糖类抗原125(CA125)含量,并观察两组在治疗期间不良反应发生情况。结果:观察组临床总有效率90.00%显著高于对照组72.50%,差异有统计学意义(P<0.05)。两组治疗后痛经、腰骶肛门坠胀、月经周期、经期、形寒肢冷症状评分较治疗前显著降低(P<0.05); 观察组治疗后痛经、腰骶肛门坠胀、月经周期、经期、形寒肢冷症状评分显著低于对照组(P<0.05)。观察组治疗后血液流变学指标及外周血CA125含量显著低于对照组(P<0.05)。结论:采用少腹逐瘀汤联合孕三稀酮治疗子宫内膜异位症,能提高临床疗效,减轻患者临床症状,加快病情康复。     

The potential contribution of impaired brain glucose metabolism to congenital Zika syndrome

The Zika virus (ZIKV) became a major worldwide public concern in 2015 due to the congenital syndrome which presents the highest risk during the first trimester of pregnancy and includes microcephaly and eye malformations. Several cellular, genetic and molecular studies have shown alterations in metabolic pathways, endoplasmic reticulum (ER) stress, immunity and dysregulation of RNA and energy metabolism both in vivo and in vitro. Here we summarise the main metabolic complications, with a particular focus on the possibility that brain energy metabolism is altered following ZIKV infection, contributing to developmental abnormalities. Brain energetic failure has been implicated in neurological conditions such as autism disorder and epilepsy, as well as in metabolic diseases with severe neurodevelopmental complications such as Glut‐1 deficiency syndrome. Therefore, these energetic alterations are of wide‐ranging interest as they might be directly implicated in congenital ZIKV syndrome. Data showing increased glycolysis during ZIKV infection, presumably required for viral replication, might support the idea that the virus can cause energetic stress in the developing brain cells. Consequences may include neuroinflammation, cell cycle dysregulation and cell death. Ketone bodies are non‐glycolytic brain fuels that are produced during neonatal life, starvation or fasting, ingestion of high‐fat low‐carbohydrate diets, and following supplementation with ketone esters. We propose that dietary ketones might alter the course of the disease and could even provide some degree of prevention of ZIKV‐associated abnormalities and potentially related neurological conditions characterised by brain glucose impairment.     

Effect of propanal and diacetyl on quantity of remaining double bonds of chemically cured BisGMA/TEGDMA resins

The aim of the present study was to determine the effect of propanal and diacetyl addition on the quantity of remaining double bonds of chemically cured dental resins. Propanal (propionaldehyde) or diacetyl (2.3-butanedione) was added to monomer mixtures, which were then made chemically curable. The monomer mixtures were varied with respect to content of propanal or diacetyl. Addition of propanal or diacetyl to chemically curable resins resulted in a decrease in the quantity of remaining double bonds from 19.6% to 1.9% and from 19.6% to 11.4%, respectively. A negative correlation of statistical significance was found between content of propanal and quantity of remaining double bonds, while the relationship between content of diacetyl and quantity of remaining double bonds was found not to be linear. Propanal was equally effective in reducing the quantity of remaining double bonds in chemically cured and in the light cured resins studied previously. As regards diacetyl, a more pronounced effect on quantity of remaining double bonds was noted for light cured resins as compared with chemically cured resins. The most likely common reaction mechanism of propanal and diacetyl seemed to be that of chain transfer reactions. Furthermore, analysis of the data indicated a possible additional photoinitiating function of diacetyl.     

麝香不同成熟阶段化学成分变化规律

目的探索不同成熟阶段麝香中化学成分变化规律。方法通过“活麝取香”法采集不同成熟阶段麝香,测定含水量,并通过GC-MS分析其主要成分含量变化规律。结果6月底麝香平均含水量为55.921%,高于10月底的36.029%(P<0.05)。从6月到8月和10月,麝香中成分种类呈先升后降的变化趋势。6月底麝香中检测到55种成分,低于8月底(P<0.05)。8月底麝香中酮类占大多数,而10月底麝香中烷烃类和酮类较多。在6月底麝香中没有检测到麝香酮和8-环十六烯-1-酮,而8月底和10月底麝香中其相对含量较高。结论麝香酮及8-环十六烯-1-酮的生成很有可能是在林麝分泌香液后的成熟过程中产生,从而造成了在初香液并不具备麝香特有的香味,而是具有浓烈的腥臭味。     

Medical textiles in orthopedics: An overview

The use of textile in the medical field is not new; this has given rise to a new branch known as medical textiles. These are being used to repair or replace various other musculoskeletal tissues. The most common uses of biomaterials are to create aseptic conditions for protection, general health care, and hygiene including bedding and clothing, surgical gowns, face masks, head and shoe covers, sterilization wraps, suture anchors, fiber cast and braces/orthotics. These are also used as materials for preparation of wipes, swabs, wound dressings, bandages, gauzes, plasters, pressure garments, orthopedic belts and for new applications, such as heart valves, vascular grafts, artificial veins, artificial ligaments, artificial joints, artificial skin, and artificial cartilage. The truth is that nowadays the use of biomedical textiles is more rampant than anyone realizes. Commonly used materials for preparation of biomedical textiles includes Cotton, Nylon, Silk, Ultra-high molecular weight polyethylene, Polyester, Polypropylene, Poly tetra-fluoro ethylene, Polyether ether ketone, and Polyether ketone. These are prepared from various monomers in varying proportions as per the requirement of the material to be used. Various methods are used in their preparation like Braiding, Knitting, and Weaving, which helps in the development of certain kinds of materials with different specificity and character. Other important measures in the preparation of the medical textile include Denier (the filament counts in multifilament fibers), Tenacity (the strength per denier) and Heat shrink (the amount of shrinkage at a particular time and temperature).     

Effect of micro-roughening of poly(ether ether ketone) on bone marrow derived stem cell and macrophage responses,and osseointegration

Poly(ether ether ketone) (PEEK) has emerged as a candidate to replace metal implants because of its satisfactory mechanical properties, radiolucency, and lack of metal allergy. However, PEEK lacks osseointegration ability limiting its clinical applications. To overcome this problem, we prepared PEEK with a micro-rough surface using the sandblast method to modulate its osseointegration property; the sandblast method is simple, cost-effective, and is already applied to clinical metal implants. The surface roughness of the sandblasted PEEK was about 2.3 μm, whereas that of mirror-polished PEEK was 0.06 μm. Rat bone marrow-derived mesenchymal stem cells (RMSCs) showed higher proliferation, osteocalcin (OC) expression and bone-like nodule formation on micro-roughened PEEK compared with those cultured on mirror-polished PEEK, suggesting that micro-roughening facilitated RMSCs proliferation and differentiation. The micro-roughened surface slightly mitigated secretion of inflammatory C-C motif chemokine 2 (CCL-2) from lipopolysaccharide (LPS)-stimulated macrophages, but not of tumor necrosis factor α (TNFα) and interleukin-6 (IL-6). Finally, to compare osseointegration, specimens were implanted in rat femur bone marrow cavities, and then the pull-out force was measured. The pull-out force of micro-roughened PEEK was about four times higher than that of the mirror-polished PEEK. These results showed that micro-roughening of PEEK using the sandblast method was able to improve osseointegration, partly through elevating proliferation and differentiation of RMSCs.     

A novel modification of the Thrombelastograph assay, isolating platelet function, correlates with optical platelet aggregation

Flow cytometry, singlet platelet counting, and optical aggregation have been used to monitor clopidogrel and glycoprotein IIb/IIIa (GPIIb/IIIa) platelet antagonists. Optical aggregation is considered the gold standard, but neither it nor flow cytometry is convenient in larger-scale clinical studies or point-of-care systems. Singlet platelet counting, a point-of-care assay correlated with optical platelet aggregation, only provides a measurement of platelet function at a single point in time. The Thrombelastograph is used to assay whole blood for thrombin-generated maximal clot-shear elasticity, referred to as the maximal amplitude (MA). Although platelet dysfunction, thrombocytopenia, and the in vitro effect of strong inhibitors such as IIb/IIIa antagonists can be observed, with thrombin generation milder platelet inhibitors cannot be assessed. We modified the Thromboelastograph assay, using reptilase and factor XIIIa, to form a clot, without thrombin generation, in heparinized whole blood. The resulting clot MA is dependent on added platelet agonists such as ADP or arachidonic acid, is sensitive to platelet antagonists, and provides a continuous measure of platelet function more analogous and better correlated with optical aggregation. This novel modification of the Thromboelastograph assay should prove to be a useful point-of-care whole-blood assay with which to monitor the effects of GPIIb/IIIa, ADP, and thromboxane A(2)-receptor-inhibiting drugs in patients.     

Functional deterioration of the liver by elevated inferior vena cava pressure: A proposed upper safety limit of pressure for maintaining liver viability in dogs

Objective Abnormally elevated central venous pressure is considered to be an etiological factor in the onset of acute hepatic failure following modified Fontan operation. This paper hypothesises that an increase in inferior vena cava pressure (IVCP) after such an operation has adverse effects on hepatic energy status.Design Various degrees of venous hypertension were produced in 10 mongrel dogs by clamping the thoracic IVC with an active veno-venous shunt and varying its flow rate from 60–2.5 ml/min/kg. Arterial ketone body ratio (KBR), reflecting the hepatic mitochondrial redox state, was measured as an index of hepatic energy status.Measurements and results: The lower the flow rates of the shunt, the higher the pressures of IVC and portal vein, while systolic blood pressure was maintained above 100 mmHg. CO significantly decreased when the pump speed was less than 30 ml/min/kg. KBR showed a negative correlation to IVCP as well as a positive correlation to portal blood flow (p<0.05).Conclusion From the simple regression line obtained between IVCP and KBR, it was determined that an upper safety limit of IVCP may lie at about 27 cmH₂O (20.5 mmHg), and that a IVCP of 35 cmH₂O (26.6 mmHg) seems to be the critical level for maintaining liver viability.Supported in part by grants from the Scientific Research Fund of the Ministry of Education and a Grant-in-Aid for Cancer Research from the Ministry of Health and Welfare, Japan     

Titanium and polyether ether ketone (PEEK) patient-specific sub-periosteal implants: two novel approaches for rehabilitation of the severely atrophic anterior maxillary ridge

The aim of this study was to assess two new protocols for single-stage rehabilitation of the severely atrophic maxillary ridge using customized porous titanium or polyether ether ketone (PEEK) sub-periosteal implants. Ten patients with a severely atrophic anterior maxillary alveolar ridge were divided randomly into two groups (five patients in each) to receive customized sub-periosteal implants fabricated via CAD/CAM technology: group 1, porous titanium implants; group 2, PEEK implants. Prosthetic loading with fixed acrylic bridges was performed 1 month postoperative. The implants were followed-up for 12 months and evaluated for the presence of any sign of radiographic bone resorption, mobility, infection, prosthetic fracture, or implant exposure. The immediate postoperative period was uneventful except for one case complicated by wound dehiscence in group 1. At 12 months, all implants were functionally stable and the patients were comfortable with the prostheses. No signs of radiographic bone resorption, mobility, infection, or prosthetic fracture were observed. Within the limitations of this study, the application of customized porous titanium and PEEK sub-periosteal implants produced through CAD/CAM technology appears to be an acceptable method for single-stage prosthetic rehabilitation of the severely atrophic edentulous anterior maxilla.This study was awarded the best case study at the academy of osseintegration annual meeting 2017, Orlando, Florida.     

Transcatheter Hepatic Arterial Drug Infusion Therapy for Hepatocellular Carcinoma: Effect on the Arterial Ketone Body Ratio

The arterial ketone body ratio (acetoacetate to β-hydroxybutyrate) was measured in 15 patients with chronic liver disease before and after the infusion of anticancer drugs or embolic agents (gelatin sponge or iodized oil) into the hepatic artery. The arterial ketone body ratio decreased after hepatic angiography and decreased further at 15 min after infusion therapy. When the arterial ketone body ratio decreased to 1.0 or less on at least one occasion after infusion therapy, the ratio after hepatic angiography was always 1.35 or less. Such patients developed marked systemic symptoms like fever and severe liver dysfunction. Ascites also developed in three patients in whom the arterial ketone body ratio was reduced to 0.7 or less at 24 h after infusion therapy. The arterial ketone body ratios improved at 3–7 days after infusion therapy. In the seven patients treated with gelatin sponge embolization, the ratio at 3–7 days after therapy was actually higher than that before angiography.