伊立替康治疗结直肠癌相关胆碱能综合征89例

目的:观察和分析伊立替康治疗结直肠癌相关胆碱能综合征的发生情况.方法:应用2种FOLFIRI方案治疗转移性结直肠癌患者89例,观察和记录胆碱能综合征发生情况,并将其与患者临床资料、其他不良反应和所应用的治疗方案进行相关性分析.结果:53例(59.6%)患者发生胆碱能综合征,中位发生时间为伊立替康开始滴注后150min(30min-25h),绝大多数在用药后24h内逐渐消退,预防性应用阿托品可以有效预防胆碱能综合征发生;≥60岁老年患者胆碱能综合征明显高发(75.9%vs51.7%,P=0.029),未发现其与性别、ECOG评分等临床特征有关;出现胆碱能综合征患者迟发性腹泻有减少趋势(52.8%vs34.0%,P=0.077),未发现胆碱能综合征与其他不良反应相关;采用高剂量氟尿嘧啶治疗方案患者黏膜炎明显高发(50.0%vs27.5%,P=0.029).结论:伊立替康相关胆碱能综合征高发,应引起临床医生重视;胆碱能综合征对后续可能发生的迟发性腹泻和/或骨髓抑制无预测作用.     

A meta-analysis of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty

To identify the risk factors of the secondary fractures for osteoporotic vertebral compression fractures (OVCFs) after percutaneous vertebroplasty (PVP).We conducted a search of relevant articles using Cochrane Library, PubMed, Medline, Science Direct, Embase, the Web of Science and other databases. The time range we retrieved from establishment of the electronic database to November 2017. Gray studies were found in the references of included literature reports. STATA version 11.0 (Stata Corporation, College Station, Texas) was used to analyze the pooled data.Fourteen studies involving 1910 patients, 395 of whom had fracture secondary to the surgery were included in this meta-analysis. The result of meta-analyses showed the risk factors of the secondary fractures for OVCFs after PVP was related to bone mineral density (BMD) [95%CI (−0.650, −0.164), SMD=−0.407, P=.001], cement leakage ((RR=0.596, 95%CI (0.444,0.798), P = .001)), and kyphosis after primary operation ((SMD=0.741, 95%CI (0.449,1.032), P = .000)), but not to gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approaches.Bone mineral density, cement leakage, and kyphosis after primary operation are the risk factors closely correlative to the secondary fracture after PVP. There have not been enough evidences to support the association between the secondary fracture and gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approaches.     

深度融合教育本质的教务系统案例解析

本文从剖析教务管理系统种种现状困境出发，导引出教务系统设计应遵循的教育核心本质。指出教育、教学、教务和谐共存的方向应该是管理、支持、服务的生态化发展。     

Iodine-125 brachytherapy alone for advanced primary parotid gland carcinoma

This study aimed to evaluate the efficacy of iodine-125 (¹²⁵I) brachytherapy alone for the treatment of advanced parotid gland carcinoma and to identify predictors of tumour control and patient survival. Primary parotid gland carcinoma patients (n = 23) treated with ¹²⁵I brachytherapy alone between 1 October 2005 and 31 July 2013 at Peking University Stomatology Hospital were enrolled in this retrospective study. All had clinical stage IV disease. The prescribed dose was 60–160 Gy. The local control rate, survival rate, and predictors of the prognosis were evaluated. Adverse events related to treatment were also noted. The average follow-up time was 29 months (range 9–74 months). Among the 23 patients, six had local failure and 11 died during the follow-up period. The 1-, 3-, and 5-year overall survival rates were 87.0%, 55.4%, and 47.5%, respectively. The 1-, 3-, and 5-year progression-free survival rates were 73.9%, 47.0%, and 39.2%, respectively. The 1-, 3-, and 5-year local control rates were 82.1%, 73.9%, and 73.9%, respectively. Age and distant metastasis were independent predictors of survival, while the preoperative duration of the disease was an independent predictor of local control. The use of ¹²⁵I seed brachytherapy alone for the treatment of primary parotid gland carcinoma can provide good short-term results without causing any severe side effects.     

Effects of Ions on Insulin Aggregation Status and Formation of Insulin Fibrils

<正>It is crucial that maintain the insulin in solution in the monomer state to guarantee its physiological activity.Therefore,it is necessary to find the related ions which are able to promote depolymerization of insulin hexamer,while inhibition of the formation of insulin β-amyloid fibrils.The research on these ions can be a clue to help to improve the bioavailability of insulin formulations and be references for the diagnosis,     

Restoration and protection of brachial plexus injury： hot topics in the last decade

Brachial plexus injury is frequently induced by injuries, accidents or birth trauma. Upper limb function may be partially or totally lost after injury, or left permanently disabled. With the de- velopment of various medical technologies, different types of interventions are used, but their effectiveness is wide ranging. Many repair methods have phasic characteristics, i.e., repairs are done in different phases. This study explored research progress and hot topic methods for pro- tection after brachial plexus injury, by analyzing 1,797 articles concerning the repair of brachial plexus injuries, published between 2004 and 2013 and indexed by the Science Citation Index database. Results revealed that there are many methods used to repair brachial plexus injury, and their effects are varied. Intervention methods include nerve transfer surgery, electrical stimula- tion, cell transplantation, neurotrophic factor therapy and drug treatment. Therapeutic methods in this field change according to the hot topic of research.     

Microelectronic neural bridging of toad nerves to restore leg function

The present study used a microelectronic neural bridge comprised of electrode arrays for neural signal detection, functional electrical stimulation, and a microelectronic circuit including signal amplifying, processing, and functional electrical stimulation to bridge two separate nerves, and to restore the lost function of one nerve. The left leg of one spinal toad was subjected to external mechanical stimulation and functional electrical stimulation driving. The function of the left leg of one spinal toad was regenerated to the corresponding leg of another spinal toad using a microelectronic neural bridge. Oscilloscope tracings showed that the electromyographic signals from controlled spinal toads were generated by neural signals that controlled the spinal toad, and there was a delay between signals. This study demonstrates that microelectronic neural bridging can be used to restore neural function between different injured nerves.