脑血管畸形致脑出血患者手术治疗效果观察

目的分析脑血管畸形致脑出血患者应用手术治疗的临床疗效。方法纳入本院2018年1月—2020年1月收治的60例脑血管畸形致脑出血患者,随机分组(每组样本容量共计30例),参照组给予保守治疗,观察组给予手术治疗,对比两组临床疗效、治疗前、治疗1月后NIHSS评分、住院时间。结果临床总有效率观察组(93.33%)明显高于参照组(63.33%),观察组治疗1月后NIHSS评分明显低于参照组,观察组住院时间明显比参照组短,差异均具有统计学意义(P<0.05)。结论脑血管畸形致脑出血患者采纳手术治疗,可有效减轻患者神经功能受损情况,缩短治疗时间。     

骨髓脂肪组织与疾病相关性及机制的研究进展

骨强度不仅与骨密度(BMD)、骨微结构相关,还受骨髓微环境的影响。骨髓脂肪组织(MAT)与骨小梁、造血细胞、神经血管组织共同存在于骨髓腔中,对骨重建、骨髓造血、维持骨髓微环境的稳定起重要作用。近年研究表明,MAT可通过分泌脂联素等细胞因子参与介导代谢性疾病、血液系统肿瘤、癌症等疾病的发生发展,为疾病预防、治疗及监测提供了新的思路。本文拟对MAT生物学特性、影像学测量方法、MAT与疾病相关性及可能的作用机制予以综述。     

PBL结合CBL教学法在胸外科规范化培训中的应用

目的总结基于问题教学法(problem-based learning,PBL)联合基于案例教学法(case-based learning,CBL)的教学模式在胸外科住院医师规范化培训中的应用经验和价值。方法选取2015年7月—2018年7月在中国医科大学附属盛京医院胸外科住院医师规范化培训的40名医师作为研究对象,按入科批次随机分组法分为两组,试验组和对照组,每组20人,试验组采用PBL联合CBL教学模式;对照组采用PBL教学模式,以出科理论考试成绩及临床操作技能考试成绩作为客观测评指标,主观测评依据调查问卷结果为主观评测指标。结果两组学生的理论考试成绩差异无统计学意义(P>0.05),而试验组的临床操作技能考试成绩明显优于对照组(P<0.05)。问卷结果显示试验组的医师在评价问卷中,除“提高临床思维能力”“提高文献查阅能力”两项外,认同及满意人数均显著多于对照组(P<0.05),试验组规培住院医师在“提高临床思维能力”“提高文献查阅能力”两项上认同人数虽多于对照组,但差异无统计学意义。结论在胸外科的住院医师规范化培训中,采用PBL联合CBL教学模式优于单纯采用PBL教学模式,既能增加学生学习的积极性和学习热情,提高学生的临床操作技能、又能使学生综合分析问题的能力提高,教学效果反馈好。     

Short or Long Sleep Duration and CKD: A Mendelian Randomization Study

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机器人辅助ALPPS手术治疗右肝巨块型肝癌

正【内容简介】ALPPS全称为联合肝脏离断和门静脉结扎的二步肝切除术,一期手术离断或分割肝实质,结扎门静脉分支;二期手术彻底离断病肝并取出。此术式主要针对因肝脏肿瘤占位过大、常规切除会导致剩余肝脏体积(FLR)不够且需要行扩大肝切除术的肝脏恶性肿瘤而采用的手术方法。其目的为通过一期手术促进健侧肝脏增生,从而为二期手术施行根治性切除创造有利条件。该视频病例采用机器人辅助进行一期手术,开腹     

A Mathematical Model and Experimental Verification of Optimal Nozzle Diameter in Needle-Free Injection

Needle-free injection (NFI), as an alternative drug delivery strategy, owns great potential. It is able to reduce complaints about needle phobia and avoid the occurring of accidental needle stick injuries. The nozzle diameter is inherently important in determining the injection dose, injection depth, and pain associated with NFIs. In this work, needle-free injectors with nozzle diameters of 0.17, 0.20, 0.30, 0.40, and 0.50 mm were studied in the simulation and experiment. This article optimizes the mathematical model for spring-powered NFI by considering the hydraulic loss due to the abrupt change in the nozzle exit area and the friction force between the piston and ampoule. We explore the dispersion pattern in gels with different nozzle diameters. Mice insulin injection was conducted to investigate the pharmacological effect of different injection methods. The experimental results show that there is the best dispersion effect and available injection depth while the nozzle diameter is 0.30 mm, which is in agreement with the result predicted by the mathematical model. Also, there is a satisfactory pharmacological effect on the mice insulin injection under the same injection condition. Undoubtedly, the mathematical model is capable of predicting the suitable nozzle diameter under the given conditions.     

直缘乌头内生真菌Alternaria solani化学成分研究

摘 要 目的：对直缘乌头内生真菌Alternaria solani 的化学成分进行研究。方法: 采用各种柱色谱对直缘乌头内生真菌Alternaria solani的甲醇提取物进行分离纯化,经波谱数据 (¹ H-NMR,¹³ C-NMR,MS) 进行结构鉴定。结果:分离得到15个化合物,分别鉴定为：20 羟基麦角甾 4,6,8(14),22-四烯-3-酮（1）、(22E,24R)- 麦角甾-4,6,8(14),22-四烯-3-酮（2）、(22E,24R)-麦角甾-7,22-二烯-3-β-醇（3）、24-亚甲基-麦角甾-7-烯-3β-醇（4）、过氧麦角甾醇（5）、cyclo(D)-Pro-(D)-Leu（6）、cyclo-(L-Val-L-Pro)（7）、cyclo-(S-Pro-S-Ile)（8）、tentoxin（9）、porrotoxin（10）、7-dehydroxyl-zinniol（11）、zinniol（12）、8-zinniol methyl ether（13）、3-甲氧基-4-甲基-5-(3’,3′-二甲基烯丙氧基)-2-甲氧基甲基苯甲酸（14）、拟盘多毛孢H2-倍半萜内酯（15）。结论:从直缘乌头内生真菌Alternaria solani中分离得到15个化合物,其中化合物2~10,12~15是首次从该植物内生真菌中分离得到。     

ARL4C stabilized by AKT/mTOR pathway promotes the invasion of PTEN-deficient primary human glioblastoma

Phosphatase and tensin homolog deleted on chromosome 10 (PTEN) deficiency in primary human glioblastoma (GBM) is associated with increased invasiveness and poor prognosis with unknown mechanisms. Therefore, how loss of PTEN promotes GBM progression remains to be elucidated. Herein, we identified that ADP-ribosylation factor like-4C (ARL4C) was highly expressed in PTEN-deficient human GBM cells and tissues. Mechanistically, loss of PTEN stabilized ARL4C protein due to AKT/mTOR pathway-mediated inhibition of ARL4C ubiquitination. Functionally, ARL4C enhanced the progression of GBM cells in vitro and in vivo. Moreover, microarray profiling and GST pull-down assay identified that ARL4C accelerated tumor progression via RAC1-mediated filopodium formation. Importantly, targeting PTEN potently inhibited GBM tumor progression in vitro and in vivo, whereas overexpression of ARL4C reversed the tumor progression impaired by PTEN overexpression. Clinically, analyses with patients' specimens validated a negative correlation between PTEN and ARL4C expression. Elevated ARL4C expression but PTEN deficiency in tumor was associated with poorer disease-free survival and overall survival of GBM patients. Taken together, ARL4C is critical for PTEN-deficient GBM progression and acts as a novel prognostic biomarker and a potential therapeutic candidate. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.