经皮椎体成形术导致巨大腹膜后血肿成功救治1例报道

经皮椎体成形术是一种安全有效的微创手术,腹膜后血肿是其罕见但严重的并发症。我们报告一例经皮椎体成形术RH阴性(熊猫血)患者术后并发巨大腹膜后血肿,经保守和输血等支持治疗,病人康复出院。脊柱医生应了解这种罕见但潜在致命的并发症,因为早期认识和及时预防是降低其发病率的基础。     

Optimize the management of urological tube-related emergencies during the coronavirus disease 2019 (COVID-19) pandemic

BackgroundTo introduce and determine the value of optimized strategies for the management of urological tube-related emergencies with increased incidence, complexity and operational risk during the global spread of coronavirus disease 2019 (COVID-19).MethodsAll emergent urological patients at Tongji Hospital, Wuhan, during the period of January 23 (the beginning of lockdown in Wuhan) to March 23, 2020, and the corresponding period in 2019 were recruited to form this study’s COVID-19 group and control group, respectively. Tongji Hospital has the most concentrated and strongest Chinese medical teams to treat the largest number of severe COVID-19 patients. Patients in the control group were routinely treated, while patients in the COVID-19 group were managed following the optimized principles and strategies. The case incidence for each type of tube-related emergency was recorded. Baseline characteristics and management outcomes (surgery time, secondary complex operation rate, readmission rate, COVID-19 infection rate) were analyzed and compared across the control and COVID-19 periods.ResultsThe total emergent urological patients during the COVID-19 period was 42, whereas during the control period, it was 124. The incidence of tube-related emergencies increased from 53% to 88% (P<0.001) during the COVID-19 period. In particular, the incidence of nephrostomy tube-related (31% vs. 15%, P=0.027) and single-J stent-related problems (19% vs. 6%, P=0.009) increased significantly. The mean surgery times across the two periods were comparable. The number of secondary complex operations increased from 12 (18%) to 14 (38%) (P=0.028) during the COVID 19-period. The number of 2-week postoperative readmission decreased from 10 (15%) to 1 (3%) (P=0.049). No participants contracted during the COVID-19 period.ConclusionsUrological tube-related emergencies have been found to have a higher incidence and require more complicated and dangerous operations during the COVID-19 pandemic. However, the optimized management strategies introduced in this study are efficient, and safe for both urologists and patients.     

A Network Pharmacology Study of Reduning Injection for the Treatment of Coronavirus Disease-19

Objective: The 2019 novel coronavirus (2019?nCoV) outbreak has escalated into a global pandemic. According to Chinese guidance for coronavirus disease?19 (COVID?19): Prevention, control, diagnosis, and management, Reduning injection can effectively treat, the disease caused by the virus. To identify the active ingredients of Reduning injection and COVID?19 disease?related pathways, we conducted a network pharmacology study. Methods: The Traditional Chinese Medicine Systems Pharmacology database was used to screen the chemical constituents and potential targets of Reduning injection. The gene names were converted to the corresponding protein names using UniProt. GeneCards and OMIM databases were used to select targets related to 2019?nCoV. Using Cytoscape 3.7.2 software platform and STRING database, we constructed drug?common target and target protein protein?protein interaction network diagrams. Rx64 3.6.2 software and Bioconductor biological information software package were used for? Gene Ontology (GO) functional enrichment and KEGG pathway analyses. Results: In Reduning injection, a total of 33 effective chemical components were obtained that were involved in 151 signaling pathways, of which 44 targets were considered therapeutically relevant. Conclusion: Reduning injection can be potentially applied for the treatment of COVID-19 based on the results of our network pharmacology study.     

术前预后营养指数对肺癌术后并发症风险的预测价值

目的:探讨术前预后营养指数（prognostic nutritional index，PNI）对肺癌术后并发症风险的预测价值。方法:回顾分析2015年12月至2018年3月于我院行手术治疗的非小细胞肺癌患者180例，收集患者的临床资料以及术后并发症的发生情况，采用Logistic回归分析患者术后并发症的影响因素。结果:多因素Logistic回归分析表明，术前低PNI值是术后并发症Clavien-Dindo评分≥II级的独立危险因素（OR:1.10，95%CI:1.02~1.17，P=0.023）；根据术前PNI值将患者分为三组，分别为PNI≥50组（n=113）、45≤PNI<50组（n=47）、PNI<45组（n=20），各组术后并发症Clavien-Dindo评分≥II级以及Clavien-Dindo评分≥III级发生的比例分别为22.1%、40.4%、40.0%和6.2%、17.0%、25.0%，不同PNI值术后并发症发生率存在显著差异；PNI值可作为术后并发症发生风险及气胸、肺外感染的独立危险因素。结论:PNI值可作为肺癌患者术后并发症风险的有效预测因子。     

Attenuation of Replication-Competent Adenovirus Serotype 26 Vaccines by Vectorization

Replication-competent adenovirus (rcAd)-based vaccine vectors may theoretically provide immunological advantages over replication-incompetent Ad vectors, but they also raise additional potential clinical and regulatory issues. We produced replication-competent Ad serotype 26 (rcAd26) vectors by adding the E1 region back into a replication-incompetent Ad26 vector backbone with the E3 or E3/E4 regions deleted. We assessed the effect of vectorization on the replicative capacity of the rcAd26 vaccines. Attenuation occurred in a stepwise fashion, with E3 deletion, E4 deletion, and human immunodeficiency virus type 1 (HIV-1) envelope (Env) gene insertion all contributing to reduced replicative capacity compared to that with the wild-type Ad26 vector. The rcAd26 vector with E3 and E4 deleted and containing the Env transgene exhibited 2.7- to 4.4-log-lower replicative capacity than that of the wild-type Ad26 in vitro. This rcAd26 vector is currently being evaluated in a phase 1 clinical trial. Attenuation as a result of vectorization and transgene insertion has implications for the clinical development of replication-competent vaccine vectors.     

Chemical constituents from the whole herb of Hemiphragma heterophyllum

Phytochemical investigation on Hemiphragma heterophyllum led to the isolation of two new compounds, heterophyllumin A (1) and heterophylliol (3), along with nine known compounds, (?)-sibiricumin A (2), iridolactone (4), jatamanin A (5), dihydrocatalpolgenin (6), 25-hydroperoxycycloart-23-en-3β-ol (7), 24-methylenecycloartanol (8), (+)-pinoresinol (9), hexadec-(4Z)-enoic acid (10), and 9,12, 15-octadecatrienoic acid (11). Their structures were elucidated on the basis of detailed spectroscopic analyses and by comparison with literature data. Further, the structure of compound 3 was unambiguously confirmed by single-crystal X-ray analysis. Some of those compounds showed moderate activity in the α-glucosidase inhibition assay.

     

Echocardiographic features of interventricular septal dissection in patients with Behçet's disease

Involvement of the heart in Behçet's disease (BD) is rare. We retrospectively analyzed these three patients with interventricular septal (IVS) dissection in BD and discussed the echocardiographic manifestations of IVS dissections. In our patients, the echocardiographic characteristics of IVS dissection were echo‐free space in the IVS basal segment or basal to middle segment, dilatation in the diastole and contraction in systole, and abnormal turbulent blood flow in the heart.     

耳内镜下夹层法鼓膜成形术治疗鼓膜大穿孔的临床研究

目的探讨耳内镜下夹层法鼓膜成形术治疗鼓膜大穿孔的临床疗效。方法回顾性分析该科在2017年1月-2017年10月对18例患者的21侧鼓膜大穿孔进行耳内镜下夹层法鼓膜成形术,统计分析手术时间、出血量,术后6个月随访观察鼓膜愈合情况,比较术前和术后的听力情况。结果21侧患耳平均手术时间(44.95±8.50)min,手术平均出血量(19.19±3.16)ml。19侧鼓膜完全愈合,鼓膜成形术成功率为90.48%;2侧鼓膜完全愈合后因真菌感染再次穿孔。术后6个月的平均气导听阈、平均气骨导差较术前下降,差异有统计学意义(P<0.05)。结论耳内镜下夹层法鼓膜成形术治疗鼓膜大穿孔具有创伤小、恢复快和疗效好的优点,是一种值得推广的手术方法。     

The Role of TP53 Gene Codon 72 Polymorphism in Leukemia: A PRISMA-Compliant Systematic Review and Meta-Analysis

The purpose of this meta-analysis was aimed to evaluate the association of tumor protein p53 (TP53) gene codon 72 polymorphism with leukemia susceptibility.We searched PubMed to identify relevant studies, and 16 case-control studies from 14 published articles were identified as eligible studies, including 2062 leukemia patients and 5826 controls. After extracting data, odds ratio (OR) with the corresponding 95% confidence interval (95%CI) was applied to assess the association between TP53 codon 72 polymorphism and leukemia susceptibility. The meta-analysis was performed with the Comprehensive Meta-Analysis software, version 2.2.Overall, no significant association between TP53 codon 72 polymorphism and leukemia susceptibility was found in this meta-analysis (Pro vs Arg: OR = 1.05, 95%CI = 0.90–1.21; Pro/Pro vs Arg/Arg: OR = 1.13, 95%CI = 0.84–1.52; Arg/Pro vs Arg/Arg: OR = 0.94, 95%CI = 0.76–1.15; [Pro/Pro + Arg/Pro] vs Arg/Arg: OR = 0.99, 95%CI = 0.80–1.21; Pro/Pro vs [Arg/Arg + Arg/Pro]: OR = 1.19, 95%CI = 0.93–1.51). Similar results were also found in subgroup analysis by ethnicity, source of controls, and types of leukemia (either acute myeloid leukemia or acute lymphocytic leukemia).Our meta-analysis demonstrates that TP53 codon 72 polymorphism may not be a risk factor for acute leukemia; however, due to the limitations of this study, it should be verified in future studies.