Does hand hygiene reduce SARS-CoV-2 transmission?

Graefe's Archive for Clinical and Experimental Ophthalmology -     

Revision Knee Arthroplasty for Bone Loss: Choosing the Right Degree of Constraint

Revision total knee arthroplasty (TKA) in the setting of bone deficiency requires varied levels of constraint to restore knee stability. However, the outcomes between different levels remain controversial. Clinical outcomes for 183 AORI Type I knees, 168 Type II knees and 124 Type III knees utilizing posterior stabilized (PS), unlinked constrained (UC) or hinged prostheses were evaluated with standardized clinical assessment tools and radiographic results over an average of 7.4 years. PS yielded superior knee scores in AORI Type I patients (P < 0.05), UC in Type II and III aseptic patients (P < 0.05), and a hinge was preferred in septic Type II or III knees (P < 0.05). Revision TKA conducted with increased constraint appears effective in the setting of increased bone deficiency.     

两种微创术式治疗胆囊结石合并胆总管结石的应用体会

目的探讨腹腔镜胆囊切除胆总管探查术(LC-LBDE)与内镜下奥迪氏括约肌切开取石术(EST)联合腹腔镜胆囊切除术(LC)治疗胆囊结石合并胆总管结石的临床效果及术式选择。方法回顾分析我院2009年7月~2013年12月施行LC-LBDE 31例和EST+LC35例患者的临床资料,对手术时间、并发症、住院时间及住院费用等进行比较分析。结果两种治疗方式在手术疗效上无明显差异,并发症中LC-LBDE组发生率较高,住院费用相比,EST+LC组较高。结论对于胆囊结石合并胆总管结石的患者,上述两种手术方式均能达到有效的治疗目的,但是要根据不同的患者选择最合适的治疗方式。     

Microcirculatory characteristics of acupuncture points obtained by laser Doppler flowmetry

Acupuncture points (acupoints) form part of the meridian system that constitutes the most fundamental concept in oriental medicine, but their physiological basis has not been clarified. In this study we employed laser Doppler flowmetry (LDF) to extract the microcirculatory characteristics of acupoints and their surrounding tissues, and we interpreted the results from the viewpoint of microcirculatory physiology. Three groups of measurements were performed focusing on the following two important acupoints in oriental medicine in healthy volunteers (n = 13 for group A and n = 9 for groups B and C, respectively): Hoh-Ku (Li4, on the hand) and Ching-Ku (B64, on the foot). The two groups of measurements around Hoh-Ku (Groups A and B) were so designed as to examine the effect of the direction of the nonacupoint away from the acupoint, whereas comparison between the Hoh-Ku and the Ching-Ku measurements was to verify whether the phenomenon was consistent in the upper and the lower extremities. We found that the mean LDF signals were significantly larger at the acupoints than in their surrounding tissues (all p < 0.05), which indicates a larger blood supply into the microvascular beds of acupoints. The results indicate that the physical properties of the vascular structure of acupoints may affect the perfusion resistance, and thereby modulate the microcirculatory perfusion in accordance with tissue needs. This finding facilitates the localization of acupoints, helps in identifying the connection between microcirculatory physiology and responses to acupoint stimulation, and introduces an objective research method for understanding the mechanisms that underlie oriental medicine.     

非洲人腰椎间盘突出术后复发原因与治疗

目的：探讨非洲人LDH（Lumbar Disc Herniated）术后复发的原因及再次治疗的最佳方法。方法：采用骶管硬膜外前间隙介入注射利得合剂（A组）和休息＋口服消炎镇痛药物（B组）治疗LDH术后复发，运用统计学分析，并进行对比研究，根据Prolo腰椎术后评定标准，对全都复发病例（56例）进行了3～9个月的随访。结果：A组30例中，8～10分11例，6～7分15例，〈5分4例；B组26例中，8～10分6例，6～7分12例，〈5分8例。两组结果经统计学比较差别有显著性（P〈0．05）。结论：非洲人LDH术后复发的原因也是多方面的，骶管硬膜外前间隙介入注射利得合荆也是一种行之有效的治疗方法。     

乌司他丁治疗急性胰腺炎疗效的系统评价

目的评价乌司他丁治疗急性胰腺炎的有效性和安全性.方法应用国际Cochrane协作网系统评价方法对乌司他丁治疗急性胰腺炎的随机对照试验(RCT)进行系统评价.计算机检索Cochrane临床对照试验资料库(2004年第3期)、MEDLINE(1966～2004)、EMBASE(1984～2004)和中国生物医学文献数据库(1978～2004),手工检索发表与未发表的中文文献,纳入乌司他丁与其他治疗措施相比较的随机对照试验,是否使用盲法语种均不受限制.统计学处理采用Cochrane协作网提供的RevMan 4.2软件.结果共纳入17个RCT,1 199例患者,所有纳入试验在治疗末均未进行随访.乌司他丁加常规治疗与常规治疗比较:6个试验的Meta 分析结果显示,乌司他丁组的治疗有效率(176/189,93.12%)明显高于对照组(143/195,73.33%),其差异具有统计学意义[Peto OR 4.29,95%CI(2.49,7.37), P<0.00001].乌司他丁组平均住院日低于对照组,其差异具有统计学意义[WMD -4.93,95%CI (-7.76,-2.09), P＝0.0007].乌司他丁加常规治疗与其他药物加常规治疗比较:2个试验的Meta分析结果显示,乌司他丁组的治疗有效率(131/151,86.75%)与对照组(99/123,80.49%)相比有增高趋势,但差异无统计学意义[Peto OR1.46,95%CI(0.76,2.80), P=0.26].1个试验显示,乌司他丁组的平均住院日为23.5±7.5天,低于对照组34.0±6.4天,其差异有统计学意义(P<0.05).且不良反应发生率(7/488,1.43%)较低.结论本研究所纳入试验的方法学质量均较低,虽显示乌司他丁在改善急性胰腺炎近期临床疗效指标方面优于常规治疗,但因尚无评价远期疗效的试验,尚不能对其疗效得出可靠的结论.     

脊柱侧弯矫形术前自身悬吊牵引的应用研究

[目的]研究自身悬吊牵引对脊柱侧弯术前辅助治疗的可行性。[方法]将我院诊治的120例脊柱侧弯病人随机分为实验组与对照组各60例。实验组利用病人自身的重力进行自身悬吊牵引，对照组病人在牵引床上行常规头盆牵引。[结果]两组牵引前后的X光片Cobb角数据经统计学比较无统计学意义（P〉0．05）。[结论]自身悬吊牵引是脊柱侧弯术前护理简单、方便、经济、可靠的一种辅助治疗方法。     

Lnk controls mouse hematopoietic stem cell self-renewal and quiescence through direct interactions with JAK2

In addition to its role in megakaryocyte production, signaling initiated by thrombopoietin (TPO) activation of its receptor, myeloproliferative leukemia virus protooncogene (c-Mpl, or Mpl), controls HSC homeostasis and self-renewal. Under steady-state conditions, mice lacking the inhibitory adaptor protein Lnk harbor an expanded HSC pool with enhanced self-renewal. We found that HSCs from Lnk-/- mice have an increased quiescent fraction, decelerated cell cycle kinetics, and enhanced resistance to repeat treatments with cytoablative 5-fluorouracil in vivo compared with WT HSCs. We further provide genetic evidence demonstrating that Lnk controls HSC quiescence and self-renewal, predominantly through Mpl. Consistent with this observation, Lnk-/- HSCs displayed potentiated activation of JAK2 specifically in response to TPO. Biochemical experiments revealed that Lnk directly binds to phosphorylated tyrosine residues in JAK2 following TPO stimulation. Of note, the JAK2 V617F mutant, found at high frequencies in myeloproliferative diseases, retains the ability to bind Lnk. Therefore, we identified Lnk as a physiological negative regulator of JAK2 in stem cells and TPO/Mpl/JAK2/Lnk as a major regulatory pathway in controlling stem cell self-renewal and quiescence.