内镜手术与显微手术治疗垂体腺瘤疗效的Meta分析

目的比较内镜手术与显微手术治疗垂体腺瘤的安全性和有效性。方法计算机检索Pubmed、EMbase、CBM、CNKI、万方及VIP等数据库,查找所有比较内镜手术与显微手术治疗垂体瘤的随机对照试验或病例对照研究,检索时限均为建库至2014年5月31日。按纳入排除标准由两人独立进行研究的筛选、资料提取和质量评价后,采用Rev Man5.2软件进行Meta分析。结果共纳入8个研究、712例患者,结果显示,与显微手术相比,内镜手术肿瘤全切率[优势比(OR)=1.23;95%可信区间(CI)(0.62~2.46);P=0.56]、手术时间(P0.05)、术后激素水平改善率[OR=1.21;95%CI(0.58~2.55);P=0.61]、术后脑脊液漏发生率[OR=1.44;95%CI(0.80~2.58);P=0.23]、脑/脑膜炎发生率明显减少[OR=1.15;95%CI(0.38~3.48);P=0.81]、尿崩发生率[OR=1.17;95%CI(0.71~1.94);P=0.53]均无明显改善,而术后鼻出血发生率[OR=0.24;95%CI(0.07~0.78);P=0.02]和术后住院天数明显缩短(P0.05)。结论内镜手术与显微手术相比其术后鼻出血患者较少,术后住院天数短。     

Comparison of the practicability of ultrasound and spiral computed tomography in the diagnosis of colon cancer: A protocol for systematic review and meta-analysis

Background:Colon cancer is a common malignant tumor of the gastrointestinal tract. Therefore, a clear diagnosis is particularly important for the treatment of colon cancer. Ultrasound and spiral computed tomography (CT) can both be used in the diagnosis, but each has its own advantages and disadvantages, which could cause confusion in clinical choice. The purpose of this study was to systematically evaluate the practicability of spiral CT and ultrasound in the diagnosis of colon cancer.Methods:A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu [VIP], CBM). Besides, manually search for Google and Baidu academic of diagnostic experimental study of ultrasound and spiral CT in the diagnosis of Colon Cancer. The retrieval time limit was from the establishment of the database to October 2020. Two researchers independently extracted and evaluated the quality of the data in the included study. A meta-analysis was performed using Meta Disc1.4 and RevMan5.3 software.Results:Sensitivity, specificity, positive Likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were used to determine the diagnostic efficacy of ultrasonography and helical CT in colorectal cancer.Conclusions:This study will compare the practicability of CT and ultrasound in the diagnosis of colon cancer and provide reliable evidence-based basis for clinicians to choose the appropriate or best evidence-based basis.Ethics and dissemination:The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.OSF Registration number:DOI 10.17605/OSF.IO/WAJHQ     

黄蜀葵花治疗2型糖尿病肾病早期蛋白尿40例临床观察

目的:探讨黄蜀葵花干预2型糖尿病肾病(T2DKD)早期蛋白尿的临床疗效.方法:将80例T2DKD早期患者随机分为治疗组和对照组,每组各40例.对照组给予西医常规治疗,治疗组在对照组的基础上加用黄蜀葵花片治疗.2组疗程均为6个月.观察2组治疗前后血糖、血脂、肝肾功能、肾小球滤过率(eGFR)、尿白蛋白与尿肌酐比值(UACR)的变化.结果:治疗组脱落2例,对照组脱落1例.2组血压、血糖、血脂、肝肾功能、eGFR、合并用药情况治疗后组间比较,差异均无统计学意义(P＞0.05),而UACR及UACR下降程度治疗后组间比较,差异均有统计学意义(P＜0.05).结论:黄蜀葵花可明显减轻T2DKD早期患者尿蛋白水平,该疗效不依赖于血压和糖脂代谢的变化.     

从形气神谈溃疡性结肠炎的中西医认识

溃疡性结肠炎(Ulcerative colitis,UC)是一种病情反复、迁延难愈的炎症肠病,已被世界卫生组织列为现代难治病之一[1]。本病病因及发病机制尚不明确,西药治疗效果欠佳。近年来中医药的介入,临床取得显著疗效。西医学认为疾病是机体在一定致病因素的作用下自稳调节紊乱,经过机体内损伤和抗损伤反应的相互斗争,表现出的一系列功能。     

谷氨酸对腺苷A2A受体调节一氧化氮合酶活力的影响

目的探讨谷氨酸是否能够影响腺苷A2A受体对一氧化氮合酶（NOS）活力的调节。方法用1000ng／ml脂多糖（LPS）刺激小胶质细胞，分别加入100nmol／L A2A受体激动剂CGS21680以及不同浓度的谷氨酸（0，1，0，25，0，5mmol／L）干预，观察NOS活力变化。结果LPS诱导NOS活力增高，激活A2A受体可以产生抑制作用；0，25及0．5mmoL／L谷氨酸和A2A受体激动剂同时存在时，NOS活力进一步增高。结论高浓度谷氨酸可逆转腺苷A2A受体激动剂抑制升高NOS活力的作用。     

输卵管卵巢脓肿的CT诊断价值

目的 总结分析女性输卵管卵巢脓肿的CT特征，以寻求和探讨鉴别诊断依据及CT诊断的价值。方法 回顾性分析10例输卵管卵巢脓肿患者CT腹盆腔增强扫描资料。结果 10例患者CT均显示附件区厚壁囊性或囊实混合性肿块，肿块外缘模糊毛糙，增强多见脓肿壁呈厚壁分层强化及内部强化分隔。其他伴随的CT表现：子宫骶骨韧带增厚9例，直肠周围、骶前脂肪密度增高模糊9例，显示输卵管扩张积脓或积液的管状结构影6例，宫腔积液4例。CT观察到脓肿与盆腔结构粘连包括：肿块与子宫粘连者9例，与直肠、乙状结肠粘连者4例，与盆腔小肠肠管及盆壁结构广泛粘连3例；显示腹膜增厚伴腹水及右侧输卵管卵巢脓肿伴阑尾炎各2例。结论 CT除了能观察附件区囊实性肿块，还能显示相邻盆腔器官的受累粘连及盆底软组织或筋膜层的炎性浸润，能对附件脓肿做定性和定位诊断，对诊断不清的可疑妇科感染有鉴别价值。     

Dexamethasone treatment attenuates early seawater instillation-induced acute lung injury in rabbits.

There is very little evidence on the value of giving corticoids in cases of seawater drowning induced acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Therefore, this study aimed to investigate whether dexamethasone treatment can attenuate seawater instillation-induced acute lung injury in rabbits. Seawater (4 ml/kg body weight) was instilled into the lower trachea of ventilated, anesthetized rabbits. Then these rabbits were assigned randomly 20 min later to receive intravenous injection of 1mg/kg body weight of dexamethasone (dissolving in 2 ml of normal saline) or 2 ml of normal saline. All animals demonstrated immediate drops in arterial oxygen tension (PaO2) and the total thoracic compliance, which were significantly improved after 2 h of dexamethasone treatment. Histopathological study also indicated that dexamethasone treatment markedly attenuated lung histopathological changes, alveolar hemorrhage and inflammatory cells infiltration with evidence of decreasing of myeloperoxidase (MPO) activity and tumor necrosis factor-alpha (TNF-alpha) concentration in lung tissue. In addition, dexamethasone treatment reduced extravascular lung water and lung epithelial-endothelial barrier permeability, up-regulated the expression of surfactant protein-A (SP-A) and alpha-epithelial Na+ channel, and increased Na+/K+-adenosine triphosphatase (Na+/K+-ATPase) activity and Na+/K+-ATPase-alpha1 protein abundance. Thus, these data indicate that dexamethasone treatment might be of benefit in patients with seawater aspiration-induced ALI.     

前循环缺血性卒中老年患者颈动脉斑块及其稳定性与血流壁切应力的关系

目的通过探讨前循环缺血性卒中老年患者颈总动脉分叉处血流壁切应力的水平分析其在颈动脉斑块形成过程中的影响。方法本研究选择前循环缺血性卒中老年患者,应用经皮血管彩超测量颈动脉斑块及其稳定性以及对研究对象测量患侧颈动脉血流速度、血管内径和血液粘滞度,通过公式计算血流壁切应力。结果无斑块组和有斑块组之间、高回声和低回声斑块组之间血流壁切应力均有显著性差异(P<0．01)。结论血流壁低切应力促进颈动脉斑块、尤其是不稳定斑块的形成。     

56例踝关节骨折的内固定治疗分析

目的总结踝关节骨折手术治疗方法及临床疗效。方法对自2004年1月～2004年12月踝关节骨折56例手术进行性回顾分析。结果56例获6～18个月随访，骨折愈合时间12～18周，疗效评定依据Baird-Jackson评分标准：本组优37例，良13例，可5例，差1例，优良率89.3％。结论合理的手术时机和内固定治疗踝关节骨折可取得满意的疗效。