C1–2 transarticular screws combined with C1 laminar hooks fixation: a modified posterior atlantoaxial fixation technique and outcome in 72 patients

Purpose

To retrospectively evaluate the outcome of C1–2 transarticular screws combined with C1 laminar hooks fixation.

Methods

All patients underwent atlantoaxial fixation during a 5-year period. The surgical technique and treatment procedures were intensively reviewed and clinical symptoms, neurological function and imaging appearance were retrospectively evaluated.

Results

The clinical and radiology follow-up indicated a stable arthrodesis and clinical relief from symptoms for all patients. All patients with neurological defects improved an average of 1.33 grade at their most recent clinical assessment, P < 0.05; their average admission ASIA motor score, pin prick score and light touch score improved to an average follow-up ASIA score of 99.80 (99.83 ± 0.38), 111.83 (111.83 ± 0.45), and 111.89 (111.89 ± 0.32), respectively. No neurovascular impairment and case of implant failure were observed.

Conclusions

The C1–2 transarticular screws combined with C1 laminar hooks fixation is a reliable technique for atlantoaxial instability.     

中晚期肝癌化学免疫治疗与单纯TAE治疗疗效比较

本文采用肝动脉化学栓塞(TAE)后1～2周内行LAK/IL2的化学免疫治疗(Chemo-immu-notherapy CIT)中晚期肝癌(Mid-advanced HCC)42例(CIT组),TAE治疗2 7例为对照(TAE组)。结果:Ⅱ期HCC 2年生存率47.4％,Ⅱ期HCC部分缓解率(PR)和3个月、半年、1年生存率分别为39.1％、73.9％、56.5％和34.7％,显著高于TAE组Ⅱ期HCC二年生存率16.7％,(P<0.05)和Ⅱ期HCC部分缓解率为6.7％,三个月、半年、1年生存率40.0％,13.3％和6.7％,P<0.05;Ⅱ期HCC 1年内肝外转移率(25.5％)明显低于TAE组(66.7％,P<0.05)。表明化学免疫治疗能显著提高中晚期肝癌疗效。     

氧暴露剂量对人肺呼吸功能的影响

本文对８名受试者在０．２５～０．２７ＭＰａ下进行三种氧剂量暴露后的肺呼吸功能和Ｘ线胸片跟踪观察，目的在于验证整体实验功能结果对本室以往肺表面活性物质（ＰＳ）物理特性测定结果的符合性。结果表明，氧暴露剂量达到１０６０ＵＰＴＤ（肺型氧中毒剂量单位）时，对呼吸道粘膜、肺泡内皮细胞可产生一定程度影响，导致ＦＥＶ１、ＦＥＶ，％、ＭＭＦ、Ｖ１０（呼气流速）显著改变（Ｐ＜０．０５或Ｐ＜Ｏ．０１），但在停止暴露后４—１２ｈ内上述指标完全恢复。以上与本室以往ＰＳ物理特性测定结果相一致。本义肺活量降低程度较Ｗｒｉｇｈｔ（１９７２）报道的小，Ｘ线胸片无异常；因此，间断用氧要达到连续用氧的等效剂量，应对Ｗｒｉｇｈｔ计量法进行一些修正。     

CT evaluation of upper thoracic spine for surgical application of transarticular screw placement

Introduction

Although pedicle screw fixation has been increasingly used in the upper thoracic spine in recent years, controversies exist about the safety and complications such as nerve or vascular intrusion associated with the technique. In this study, an alternative method of transarticular screw fixation was validated.

Materials and methods

Morphometric analysis was performed on computed tomography (CT) scans of the upper thoracic zygapophysial joints of C7, T1, T2 and T3 in 20 male and 20 female patients in the axial and sagittal planes. The degree of screw angulation was recorded in the sagittal and axial planes and the screw length was measured at the spinal level from C7 to T3.

Results

The smallest medial–lateral diameter and anterior–posterior diameter of IAP was found at T3 in the female patients and C7 in the male patients. The screw trajectory length ranged from 14.9 to 20.5 mm in all patients. All the above measurements were significantly different between male and female patients at all levels (P < 0.05). The mean value of screw trajectory angle was 19.3°–20.1° in the axial plane and 44.3°–45.7° in the sagittal plane. There was no statistically significant difference (P > 0.05) between male and female patients in the axial and sagittal angles.

Conclusion

The morphometric data of C7–T3 zygapophysial joints indicate the suitable screw diameter and screw length for this technique. Transarticular screw fixation proved to be a potentially safe alternative to pedicle screw fixation in this region.     

情景式健康教育在初产妇母乳喂养培训中的应用

目的 探讨情景式健康教育在初产妇母乳喂养知识与技能培训中的有效性.方法 将120例初产妇按随机数字表法分为观察组与对照组各60例,对照组采用传统模式对初产妇进行母乳喂养健康教育,观察组进行情景式健康教育,比较两组健康教育的效果.结果 观察组初产妇母乳喂养知识、技能掌握及实践能力显著优于对照组(均P＜0.01);产妇对健康教育效果的满意度显著优于对照组(P＜0.01).结论 情景式健康教育可促进初产妇母乳喂养知识与技能的掌握,提高其实践能力;提高患者满意度,促进护患和谐.     

高职护理新生职业生涯规划教育的效果评价

目的 探讨对高职护理新生实施职业生涯规划教育的效果.方法 将328名三年制大专护理专业一年级学生按班级随机分为对照组(165名)和实验组(163名).对照组给予新生入校专业教育,实验组在此基础上开设护士职业生涯规划课程进行教育干预,采用高护生职业生涯规划调查问卷评价干预效果.结果 干预后,实验组在自我认识、环境评估、职业目标、行动计划和反馈修正5个维度得分及总分高于对照组,差异有统计学意义(P<0.05,P<0.01).结论 对护生开展职业规划课程教育,可唤起护生的生涯意识,增强其对护理专业的认同感,促使其热爱护理事业,为今后的护理工作奠定良好的基础.     

酒精性肝炎自噬关键基因的筛选及生物信息学分析

目的 筛选酒精性肝炎（AH）的自噬关键基因,探讨AH潜在的生物标志物和治疗靶点。 方法  采用基因表达综合数据库（GEO）中的2个AH基因芯片和从MSigDB、GeneCards数据库中获得的自噬相关数据集,通过加权基因共表达网络分析（WGCNA）获取关键基因。对筛选的关键基因进行基因本体（GO）、京都基因和基因组百科全书（KEGG）功能富集分析,蛋白质相互作用（PPI）分析,免疫浸润分析,构建信使RNA（mRNA）-微小RNA（miRNA）网络,进行酒精性肝病不同分期的自噬相关关键基因的表达差异分析,并进一步通过实时荧光定量逆转录聚合酶链反应（RT-qPCR）在AH患者和小鼠肝脏组织中验证。 结果  本研究筛选得到了11个与AH自噬相关的基因（EEF1A2、CFTR、SOX4、TREM2、CTHRC1、HSPB8、TUBB3、PRKAA2、RNASE1、MTCL1、HGF）,均为上调基因。在AH患者和小鼠肝脏组织中,SOX4、TREM2、HSPB8、PRKAA2在AH组中的相对表达量均高于对照组。 结论  SOX4、TREM2、HSPB8、PRKAA2可能是AH潜在的生物标志物和治疗靶点。     

Transient receptor potential vanilloid 1 activation enhances gut glucagon-like peptide-1 secretion and improves glucose homeostasis

Type 2 diabetes mellitus (T2DM) is rapidly prevailing as a serious global health problem. Current treatments for T2DM may cause side effects, thus highlighting the need for newer and safer therapies. We tested the hypothesis that dietary capsaicin regulates glucose homeostasis through the activation of transient receptor potential vanilloid 1 (TRPV1)-mediated glucagon-like peptide-1 (GLP-1) secretion in the intestinal cells and tissues. Wild-type (WT) and TRPV1 knockout (TRPV1(-/-)) mice were fed dietary capsaicin for 24 weeks. TRPV1 was localized in secretin tumor cell-1 (STC-1) cells and ileum. Capsaicin stimulated GLP-1 secretion from STC-1 cells in a calcium-dependent manner through TRPV1 activation. Acute capsaicin administration by gastric gavage increased GLP-1 and insulin secretion in vivo in WT but not in TRPV1(-/-) mice. Furthermore, chronic dietary capsaicin not only improved glucose tolerance and increased insulin levels but also lowered daily blood glucose profiles and increased plasma GLP-1 levels in WT mice. However, this effect was absent in TRPV1(-/-) mice. In db/db mice, TRPV1 activation by dietary capsaicin ameliorated abnormal glucose homeostasis and increased GLP-1 levels in the plasma and ileum. The present findings suggest that TRPV1 activation-stimulated GLP-1 secretion could be a promising approach for the intervention of diabetes.     

理气定喘丸的质量标准研究

目的建立理气定喘丸的质量控制方法。方法采用薄层色谱法对方中陈皮、知母、当归、紫苏叶进行鉴别。采用高效液相色谱法测定陈皮中橙皮苷的含量。色谱条件：色谱柱：ODS—C18色谱柱;流动相：乙腈-0．05％磷酸（21：79）;流速：1ml／min;检测波长：283nm;柱温：40℃。结果采用薄层色谱法鉴别了方中陈皮、当归、知母、紫苏叶。含量测定橙皮苷在0．1204～1．8072ug范围内线性良好,r=0．9997。平均回收率为101．9％,RSD为1．7％（n=6）。结论本方法重复性好、简便易行,可作为理气定喘丸的质量控制方法。     

PLGA–PTMC–Cultured Bone Mesenchymal Stem Cell Scaffold Enhances Cartilage Regeneration in Tissue‐Engineered Tracheal Transplantation

The treatment of long‐segment tracheal defect requires the transplantation of effective tracheal substitute, and the tissue‐engineered trachea (TET) has been proposed as an ideal tracheal substitute. The major cause of the failure of segmental tracheal defect reconstruction by TET is airway collapse caused by the chondromalacia of TET cartilage. The key to maintain the TET structure is the regeneration of chondrocytes in cartilage, which can secrete plenty of cartilage matrices. To address the problem of the chondromalacia of TET cartilage, this study proposed an improved strategy. We designed a new cell sheet scaffold using the poly(lactic‐co‐glycolic acid) (PLGA) and poly(trimethylene carbonate) (PTMC) to make a porous membrane for seeding cells, and used the PLGA–PTMC cell‐scaffold to pack the decellularized allogeneic trachea to construct a new type of TET. The TET was then implanted in the subcutaneous tissue for vascularization for 2 weeks. Orthotopic transplantation was then performed after implantation. The efficiency of the TET we designed was analyzed by histological examination and biomechanical analyses 4 weeks after surgery. Four weeks after surgery, both the number of chondrocytes and the amount of cartilage matrix were significantly higher than those contained in the traditional stem‐cell–based TET. Besides, the coefficient of stiffness of TET was significantly larger than the traditional TET. This study provided a promising approach for the long‐term functional reconstruction of long‐segment tracheal defect, and the TET we designed had potential application prospects in the field of TET reconstruction.