急性胰腺炎大鼠血浆内皮素和一氧化氮水平变化及卡托普利的早期干预作用

目的 观察急性胰腺炎大鼠血浆内皮素、一氧化氮水平变化及血管紧张素转换酶抑制剂卡托普利对其的早期干预作用。方法 63只SD大鼠分对照组、急性胰腺炎组、卡托普利干预组3组进行不同处理。对照组仅作胃窦切开再缝合术；急性胰腺炎组用十二指肠闭襻法制作急性胰腺炎模型；卡托普利干预组在胰腺炎模型制备后立即腹腔注射卡托普利针(5mg／kg)，在病程不同时点测定血浆内皮素、一氧化氮水平，并观察胰腺组织病理学改变。结果 急性胰腺炎组随病变的进展，胰腺炎病理由水肿向出血坏死发展，而内皮素和一氧化氮从两者平行升高逐渐转向内皮素单一升高，致内皮素／一氧化氮比值上升；卡托普利干预组则胰腺炎病理改变减轻，胰腺组织病理学评分降低，且血浆内皮素水平低于急性胰腺炎组，而一氧化氮总体水平与急性胰腺炎组比较差别无显著性意义，内皮素／一氧化氮比值基本与对照组一致。结论 早期应用卡托普利可维持内皮素与一氧化氮平衡，对大鼠急性胰腺炎病变可能有保护作用。     

食管癌血管生成与淋巴结转移的关系

目的 探讨食管因管生成与淋巴结转移的关系,方法 采用免疫组织化学的方法检测了1994－1995年手术切除的50例食管癌病人石蜡标本中微血管密度和血管内皮生长因子及受体蛋白的表达。其中有食管旁淋巴结转移者18例,胃左动脉旁淋巴结转移15例。光镜下行MVD、VEGF、Flt、KDR蛋白表达细胞的计数。结果 食管旁和胃左动脉旁淋巴结转移组的微血管密度（MVD）、血管内皮生长因子（VEGF）、血管同皮生长因子受体（Flt、KDR）蛋白表达均高于未转移组,结论 食管癌中MVD、VEGF、Flt、KDR蛋白表达与肿瘤转移行为密切相关,有可能作为判定肿瘤生物学行为、转移潜能及预后的指标。     

Clinicopathologic features and clinical outcomes of intravenous leiomyomatosis of the uterus: A case series

Rationale:Intravenous leiomyomatosis (IVL) is a rare and special type of smooth muscle tumor originating in the uterus. It is classified as a benign disease according to its histological features but shows the behavioral characteristics of a malignant tumor. It is easily misdiagnosed and recurrent. The purpose of this study was to retrospectively analyze clinicopathological data of 25 cases of IVL in order to enhance clinicians’ understanding of this rare disease.Patient concerns:We screened and identified 25 cases of IVL at our hospital from October 2013 to January 2020. Five patients had tumors.Diagnoses:The diagnosis in each case was pathologically confirmed after surgical treatment.Interventions:All patients were managed surgically. Although the surgical procedures were different, the surgical approach was geared towards achieving complete excision. Three patients received hormonal therapy with gonadotropinreleasing hormone agonists after surgery.Outcomes:We retrospectively reviewed all medical records and analyzed the clinicopathologic features and clinical outcomes of this disease as well as the correlations between the clinical features and risk of recurrence. Neither the symptoms nor the preoperative imaging results were suggestive of IVL in any of the cases. Except for two patients who were lost to follow-up, twenty-three patients who were followed up are still alive. Three patients experienced a recurrence.Lessons:The clinical manifestations and ultrasound images of IVL in the early stages are not typical; thus, IVL is easily misdiagnosed as uterine leiomyoma. Radiologists, pathologists, and surgeons should have a thorough understanding of IVL and a high index of vigilance for IVL in clinical practice. Surgery should always be aimed at achieving complete tumor excision. Patients with large lesions (≥7 cm) and lesions extending to the broad ligament may have an increased risk of recurrence. Early detection, diagnosis, and treatment are very important; once the diagnosis is confirmed, regular follow-ups are crucial.     

Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study

Journal of Thrombosis and Thrombolysis - Patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) are at increased risk for thrombotic and bleeding...     

妊娠合并宫颈癌的诊治进展

宫颈癌是妊娠期妇女第3大常见恶性肿瘤,仅次于恶性黑色素瘤和乳腺癌。妊娠合并宫颈癌的处理,应在治疗患者肿瘤本身及维护母儿健康之间取得平衡,这给临床医师带来极大挑战。目前全球范围内的妊娠合并宫颈癌治疗共识及指南,均以小样本回顾性研究及专家共识为基础制定,缺乏可靠的循证医学证据,在治疗方案上也存在分歧,迄今对该病尚无统一的治疗方案。笔者拟就妊娠合并宫颈癌的诊疗进展进行探讨,以期为临床决策提供可供参考的依据。     

高龄髋部骨折患者围术期D-二聚体的测定及临床意义

目的探讨围术期高龄髋部骨折患者血液中D-二聚体(D-D)水平的变化及其临床意义。方法对60例80岁以上髋部骨折患者手术前、手术后血液中D-D水平进行检测。手术前包括入院时(T1)、即将手术时(T2),T后包括手术后即刻(T3)和手术后第1天(T4)。结果 T1、T2、T3、T4D-D阳性率分别为6.67%、16.67%、41.67%、80.00%,T3、T4与T1、T2相比,T3与T4相比,差异均有统计学意义(P0.05);T1与T2相比,差异无统计学意义(P0.05)。结论高龄髋部骨折患者手术前后D-D水平变化显著,D-D水平的变化是反映下肢深静脉血栓的有效指标,对于高龄髋部骨折患者围术期进行D-D水平动态监测有着极其重要的临床意义。     

右旋美托咪啶对惊厥性癫痫持续状态大鼠认知功能和神经炎症的影响

目的 惊厥性癫痫持续状态(CSE)是一种神经元异常放电引起的严重神经系统疾病,能导致海马损伤和认知障碍。该研究旨在探讨右旋美托咪啶(DEX)对CSE大鼠认知功能和神经炎症的影响。方法 90只Sprague-Dawley大鼠均分为对照组、CSE组和DEX组。Morris水迷宫试验测量认知功能。进行急性海马切片以检测长时程增强(LTP)。免疫组织化学法检测海马α7烟碱乙酰胆碱受体(α7-nAChR)的表达。酶联免疫吸附试验(ELISA)测定海马组织白细胞介素-1β(IL-1β),肿瘤坏死因子-α(TNF-α),S-100β和脑源性神经营养因子(BDNF)水平。结果 DEX明显改善CSE引起的认知功能障碍、降低癫痫发作严重程度、增加LTP的振幅和持续时间。DEX增加CSE大鼠海马组织α7-nAChR表达,降低海马IL-1β,TNF-α和S-100β水平,增加BDNF水平。α7-nAChR激动剂尼古丁可以模拟DEX对癫痫发作严重程度和LTP的改善作用,但DEX的作用可以被α-银环蛇毒素(α-BGT)减弱。结论 DEX显著改善CSE大鼠的空间认知功能障碍,癫痫发作严重程度降低和LTP增加,与DEX激活胆碱能抗炎通路密切相关。     

Association of an insertion/deletion polymorphism in IL1A 3′-UTR with risk for cervical carcinoma in Chinese Han Women

Emerging evidence has demonstrated that polymorphisms of interleukin-1 (IL-1) may be involved in human tumorigenesis by regulating the production of this cytokine. Previous studies have investigated the association between two genetic variants (rs3783553 and rs17561) of IL1A and many diseases. The present study was conducted to evaluate whether these two variants are associated with cervical carcinoma (CC). These two polymorphisms were genotyped in 319 CC patients and 424 healthy controls by polymerase chain reaction polyacrylamide gel electrophoresis (PCR-PAGE) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Significantly reduced CC risk was observed to be associated with the insertion allele of rs3783553 (P = 0.014, OR = 0.71, 95% CI = 0.57–0.88). Stratification analysis based on different certain clinical features showed that patients with the heterozygous genotype were associated with a reduced predisposition advancing to clinical stage II-III or developing non-squamous cell carcinoma. Furthermore, patients with the insertion homozygous genotype were also associated with a reduced risk to have a poor tumor differentiation. No significant association was observed between rs17561 and CC. The present study provided evidence that the rs3783553 in IL1A 3′-UTR is inversely associated with CC risk, suggesting an important role IL-1α may play in cervical carcinogenesis.     

冠心病辨证分型的客观化研究

冠心病(CHD)是一种常见的心血管疾病,属中医"胸痹心痛","厥(真)心痛"范畴.20世纪70年代起我国开始了冠心病中医辨证分型研究.现在,冠心病中医证型研究已广泛结合现代医学的客观指标和量化手段,无论是在中医辨证分型,还是证型客观化方面,都取得了丰硕的成果,使冠心病中医辨证论治体系更加规范化和客观化,从而提高了冠心病辨证论治的水平.笔者就近年来冠心病中医证型客观化研究进展作一简要评述.     

食管癌APC/MCC、DCC基因杂合丢失的研究

目的研究ＡＰＣ（ａｄｅｎｏｍａｔｏｕｓｐｏｌｙｐｏｓｉｓｃｏｌｉ）、ＭＣＣ（ｍｕｔａｔｉｏｎｉｎｃｏｌｏｒｅｃｔａｌｃａｎｃｅｒ）和ＤＣＣ（ｄｅｌｅｔｅｄｉｎｃｏｌｏｒｅｃｔａｌｃａｎｃｒ）基因在人食管癌组织中的变化。方法采用聚合酶链反应（ＰＣＲ）及限制性片段长度多态现象（ＲＦＬＰ）法检测了４６例食管癌组织中ＡＰＣ、ＭＣＣ和ＤＣＣ基因的杂合缺失。结果ＡＰＣ、ＭＣＣ和ＤＣＣ位点的杂合性丢失的发生频率分别为２９．０％（９／３１）、３３．３％（８／２４）和３２．４％（１２／３７）。然而,这些基因位点的杂合性丢失与肿瘤病理学类型、肿瘤的大小、浸润性及转移性无统计学的显著相关性（Ｐ＞０．０５）。结论ＡＰＣ、ＭＣＣ和ＤＣＣ基因位点的杂合性丢失在一定程度上是食管癌基因改变的普遍现象,并可能在肿瘤的发生中起作用。