手法复位超腕关节夹板联合石膏托固定治疗Salter-HarrisⅡ型儿童桡骨远端骨骺骨折

目的:探讨手法复位超腕关节夹板联合石膏托固定治疗Salter-HarrisⅡ型儿童桡骨远端骨骺骨折的临床疗效与安全性。方法:2015年11月至2018年11月,收治44例桡骨远端骨骺骨折患者。男35例,女9例。年龄6~17岁,中位数10岁。左侧26例,右侧18例。均为闭合性损伤,根据Salter-Harris分型均属于Ⅱ型,其中不稳定型5例。20例合并尺骨茎突骨折,均不合并神经、血管损伤。均因跌倒致伤,受伤至治疗时间1 h至2 d,中位数8 h。均先进行手法复位,复位后先以超腕关节夹板固定,然后辅以石膏托固定。随访观察骨折愈合及并发症发生情况,测量腕关节活动度,采用Gartland-Werley腕关节评分系统评价综合疗效。结果:43例患者获得随访,随访时间6~24个月,中位数13个月。骨折均愈合,愈合时间(1.5±0.1)个月,塑形时间(3.0±0.5)个月。43例患者腕关节掌屈55°±5°、背伸40°±15°、桡偏25°±5°、尺偏35°±5°,下尺桡关节旋前80°±5°、旋后90°±5°。末次随访时,Gartland-Werley腕关节评分(1.8±0.6)分,优40例、良3例。所有患儿均未发现桡骨远端骨骺早闭。结论:手法复位超腕关节夹板联合石膏托固定可有效治疗Salter-HarrisⅡ型儿童桡骨远端骨骺骨折,安全性高。     

他汀类药物早期干预对急性冠脉综合征患者血脂、高敏C反应蛋白和纤维蛋白原的影响

目的 比较他汀类药物和阿司匹林联合用药与单用阿司匹林对急性冠脉综合征患者血脂、高敏C反应蛋白及纤维蛋白原的影响。方法 所有患者均在急性冠脉综合征发病后72h内开始接受药物治疗，他汀组(40例)应用他汀类药物加阿司匹林治疗8周，对照组(16例)单用阿司匹林治疗，观察两组总胆固醇、低密度脂蛋白胆固醇、高敏C反应蛋白和纤维蛋白原水平的变化。结果 治疗8周后，他汀组各指标显著降低，面对照组仅高敏C反应蛋白水平显著下降。他汀类药物降低高敏C反应蛋白、纤维蛋白原的程度与其降脂作用无关。结论 他汀类药物与阿司匹林联合用药降低高敏C反应蛋白和纤维蛋白原的作用可能优于单用阿司匹林，并与其抗炎作用有关。     

弧形吻合治疗187例食管癌的临床观察

目的:探讨食管胃弧形吻合在预防食管癌术后返流性食管炎和吻合口狭窄方面的疗效。方法:食管断端外弧形切断,胃壁弧形切口并剥除弧形瓣浆肌层,暴露粘膜下层后与食管逐排吻合,后壁悬套,形成后壁的半弧瓣。术后观察指标:进食情况;吻合口大小及钡剂返流情况;餐前、后食管液pH值测定;食管24小时pH值监测。结果:吻合口狭窄发生率1.6%,进普食者73.3%。24小时pH值监测:立位和卧位对比无显著性差异(P>0.05)。结论:该吻合方式能预防返流性食管炎,减少术后吻合口狭窄发生率,提高术后患者的生活质量(进普食者居多)。     

阿托伐他汀对2型糖尿病大鼠心肌炎症的影响

目的:探讨核转录因子-кB(NF-кB)、肿瘤坏死因子(TNF-α)及基质金属蛋白酶-9(MMP-9)在2型糖尿病大鼠心肌中的表达及阿托伐他汀对其影响.方法:将60只SD大鼠随机分为对照组(N组),糖尿病组(D组)和阿托伐他汀处理组(A组).采用放射免疫法检测血浆及心肌TNF-α.采用RT-PCR方法检测各组大鼠心肌组织中NF-кB、TNF-α及MMP-9的mRNA表达水平,用免疫组织化学染色法检测其蛋白表达.结果:D组大鼠血和心肌中TNF-α浓度较N组明显升高(P＜0.01),大鼠心肌组织中NF-кB及TNF-α、MMP-9 mRNA及蛋白表达较N组明显增加(P＜0.01).A组用阿托伐他汀处理12周后,NF-кB及TNF-α、MMP-9 mRNA及蛋白表达较D组明显降低(P＜0.05或P＜0.01).结论:阿托伐他汀可抑制糖尿病大鼠心肌组织中NF-кB及TNF-α、MMP-9的表达,对大鼠2型糖尿病性心肌病的炎症有一定防治作用.     

A randomized controlled trial protocol of the cardiovascular safety and efficacy of liraglutide in the treatment of type 2 diabetes

Background:Recently, many clinical experiments have evaluated the influences of liraglutide in the treatment of type 2 diabetes. However, the outcomes of these studies are inconsistent, and the number of high-quality prospective trials that conducted to assess the cardiovascular safety is limited. Hence, for this research, it was implemented for the assessment of the cardiovascular effectiveness and safety of liraglutide in type 2 diabetes patients.Methods:This research was a 26-week active controlled and randomized trial. Our research protocol follows the guidelines of Good Clinical Practice issued via the Helsinki Declaration and International Conference on Coordination. All the patients will receive the written informed consent in order to involve in our clinical experiment. The participants with type 2 diabetes aged from 18 years to 80 years, patients with 45.0 kg/m² body-mass index or less, and with glycosylated hemoglobin of 7.5 to 10.0 percent, and received metformin (daily 1500 mg or more) for 3 months or longer were eligible. All the patients were randomized to 1 of 2 interventions (in the ratio of 1:1): liraglutide placebo once daily (blinded) and liraglutide once daily (blinded), respectively, both combined with the glimepiride and metformin (open-labeled). For the efficacy variable, the major endpoint was the baseline glycated hemoglobin change after treating for 26 weeks. The secondary end points involved: the percentage of participants who achieved the goals of postprandial blood glucose, fasting blood glucose, and glycosylated hemoglobin; the changes of mean postprandial blood glucose, fasting blood glucose, and the body weight, pancreatic B-cell function index, and changes in blood pressure and insulin resistance assessed by homeostasis model.Conclusions:For this research, the limitations involve the short trial period and the limitation of glimepiride in some countries, thus excluding the maximum doses of glimepiride.Trial registration:This study protocol was registered in Research Registry (researchregistry6306).     

The effect of drug dose and duration of adjuvant Amoxicillin-plus-Metronidazole to full-mouth scaling and root planing in periodontitis: a systematic review and meta-analysis

Clinical Oral Investigations - The aim is to explore the optimal drug dose and duration of adjunctive Amoxicillin-plus-Metronidazole (AMX/MET) to full-mouth scaling and planing (FMSRP) in...     

多肽mPEG-SC20k-HM-3联合奥沙利铂对人肝癌细胞SMMC-7721裸鼠移植瘤的抑制作用

mPEG-SC_20k-HM-3是具有整合素亲和性的一种新型高效血管生成抑制多肽,为探索其与传统化疗药物联用的抗肿瘤活性,建立人肝癌细胞SMMC-7721裸鼠移植瘤模型,选用奥沙利铂为化疗药物,根据临床前抗肿瘤药效学方法评价联合用药的抑瘤作用,并用金氏公式判断两种药物的联合作用。结果显示,与单独用药相比,联合用药组的抑瘤效果更好,且均具有显著差异(P<0.05)。其中,奥沙利铂(7.5 mg/kg)联合mPEG-SC_20k-HM-3(73.4 mg/kg)的肿瘤抑制率为84.6%,抑制作用比单用奥沙利铂(7.5 mg/kg)和单用mPEG-SC_20k-HM-3(73.4 mg/kg)均有显著提高。根据金氏公式计算,其Q值为1.164(>1.15),可判定该组的用药组合表现出协同作用。结果表明,mPEG-SC_20k-HM-3与奥沙利铂单独给药均能抑制肿瘤生长,两者联用对肝细胞癌具有协同作用。     

MOF-derived ZnCo2O4 porous micro-rice with enhanced electro-catalytic activity for the oxygen evolution reaction and glucose oxidation

A porous ZnCo₂O₄ micro-rice like microstructure was synthesized via calcination of a Zn–Co MOF precursor at an appropriate temperature. The as-prepared ZnCo₂O₄ sample presented good electrocatalytic oxygen evolution reaction performance with a small overpotential (η₁₀ = 389 mV) and high stability in basic electrolyte. Furthermore, in basic medium, the as-synthesized ZnCo₂O₄ micro-rice also showed good electrocatalytic activity for glucose oxidation. A ZnCo₂O₄ micro-rice modified glass carbon electrode may be used as a potential non-enzymatic glucose sensor. The excellent electrocatalytic OER and glucose oxidation performances of ZnCo₂O₄ might be attributed to the unique porous structure formed by the nanoparticles. The porous architecture of the micro-rice can provide a large number of electrocatalytically active sites and high electrochemical surface area (ECSA). The result may offer a new way to prepare low-cost and high performance oxygen evolution reaction and glucose oxidation electrocatalysts.

A porous ZnCo₂O₄ micro-rice like microstructure was synthesized via calcination of a Zn–Co MOF precursor at an appropriate temperature.     

雷公藤多苷片对高脂小鼠血脂的影响

目的 研究雷公藤多苷片对高脂小鼠血脂的影响。方法 采用高血脂小鼠模型,通过小鼠尾静脉注射不同剂量（0.5,1.0,1.5 mg·kg^-1·d^-1）雷公藤多苷,测定不同时间段小鼠体质量和血清总胆固醇（total cholesterol,TC）、甘油三酯（totaltriglyceride,TG）、高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、低密度脂蛋白胆固醇（low densitylipoprotein cholesterol,LDL-C）的含量及卵磷脂胆固醇酰基转移酶（lecithin cholesterol acyltransferase,LCAT）、肝脂酶（hepatic lipase,HL）和脂蛋白脂酶（lipoprotein lipase,LPL）的活性,研究雷公藤多苷对小鼠体质量、血脂代谢、动脉粥样硬化指数、肝脏LCAT水平等的影响。结果 给予高脂饲料后小鼠体质量和血脂显著升高（P<0.01）,动脉粥样硬化指数显著升高（P<0.01）,抗动脉粥样硬化指数显著下降（P<0.01）。注射雷公藤多苷能显著降低高血脂模型小鼠血清TC、TG和LDL-C,同时显著降低高脂饮食所导致的动脉粥样硬化指数升高。此外,雷公藤多苷片能显著提高血清LCAT水平和HL、LPL的活性。结论 雷公藤多苷片具有一定的降血脂功能,并能有效降低动脉粥样硬化的发生几率。