核苷(酸)类药物治疗过程中发生病毒学突破的慢性乙型肝炎患者152例耐药分析

自从1998年拉米夫定(LAM)被用于治疗慢性乙型肝炎(CHB)以来,核苷(酸)类药物(NAs)的抗病毒作用和重要地位逐步得到认可[1].目前我国大陆上市的NAs除LAM外,还有阿德福韦酯(ADV)、替比夫定(LdT)和恩替卡韦(ETV),这些NAs的广泛使用大大促进了CHB的抗病毒治疗,但是随着临床实践的深入,NAs长期使用导致耐药突变株产生的风险也日益突显.目前临床上HBV对NAs的耐药已成为CHB治疗的一大难点,因此,及时监测NAs相关耐药突变的发生,指导临床合理使用NAs十分必要.本研究采用PCR产物直接测序法分析接受NAs治疗过程中出现病毒学突破的CHB患者体内HBV基因型耐药情况.     

Traditional Chinese medicine for pressure ulcer: a meta‐analysis

To assess the effect of Traditional Chinese Medicine (TCM) [Chinese herbal medicine ointment (CHMO), acupuncture and moxibustion] on pressure ulcer. In this study, we searched MEDLINE, EMBASE, CENTER, CBM, CNKI, WAN FANG and VIP for articles published from database inception up to 4 April 2011. We included randomised controlled trials (RCTs), which compared the effects of TCM with other interventions. We assessed the methodological quality of these trials using Cochrane risk of bias criteria. Ten of 565 potentially relevant trails that enrolled a total of 893 patients met our inclusion criteria. All the included RCTs only used CHMO intervention, because acupuncture and moxibustion trials failed to meet the inclusive criteria. A meta‐analysis showed beneficial effects of CHMO for pressure ulcer compared with other treatments on the total effective rate [risk ratio (RR): 1·28; 95% confidence interval (CI): 1·20–1·36; P = 0·53; I² = 0%), curative ratio (RR: 2·02; 95% CI: 1·73–2·35; P = 0·11; I² = 37%) and inefficiency rate (RR: 0·16; 95% CI: 0·02–0·80; P = 0·84; I² = 0%). However, the funnel plot indicated that there was publication bias in this study. The evidence that CHMO is effective for pressure ulcer is encouraging, but due to several caveats, not conclusive. Therefore, more rigorous studies seem warranted.     

Influence of hyaluronic acid on wound healing using composite porcine acellular dermal matrix grafts and autologous skin in rabbits

This study aims to explore the influence of hyaluronic acid (HA) on wound healing during xenogeneic porcine acellular dermal matrix (PADM) composite skin grafting. The results will facilitate the development of methods for improving graft contracture and poor elasticity of composite transplantation. Exogenous HA was added to composite PADM grafts and to thin autologous skin grafts during rabbit full‐thickness skin wound repair. The influence of HA on wound healing was evaluated according to its contracture rate and its expression of collagen types I and III. The possible mechanism was then explored based on HA metabolism and vascularisation in the skin graft. The results show that exogenous HA relieves graft contracture on rabbit wound surfaces, increases collagen I and III expression and decreases the ratio between collagen types. HA stimulates the generation of more CD44 receptors to strengthen its enzymolysis. The resulting metabolites promote the vascularisation of the wound surface, which are conducive for mitigating graft contracture, and further improve the composite grafting effect.     

Current status, crisis and trends in Chinese dental technicians

Background: Chinese dental technicians play a significant role in the globalised market of dental prosthesis fabrication, but this subject has not been investigated in detail. The demand for dental prostheses increases as individuals pay increasing attention to their oral health. Therefore, it is important to investigate the status of Chinese dental technicians. Objective: To evaluate the current status of Chinese dental technicians. Methods: Dental technicians’ resumés, which reveal information regarding dental technician manpower, degrees, working age and salary, etc., were analysed and compared with those abroad. We also estimated the future demands of dental technician manpower, and discussed some potential solutions. Results: There are fewer dental technicians in China than in other developed countries; they are also of a lower standard. Male technicians outnumber females. The education level of technicians is insufficient, and the education programme is still in its exploratory stage. Conclusions: The development of dental technician teams in China represents both an opportunity and a challenge. It is important to move forward from the current situation to yield long‐term development. This article provides information on the Chinese dental technology industry, identifies the problems and offers solutions for its development.     

Childhood giant pituicytoma: A report and review of the literature

Objective

Pituicytoma is a rare, benign, primary tumour, almost all of which occur in adults. Here, we present one case of giant pituicytoma in a boy and a review literature to assist in understanding its natural history, behaviour, clinicopathological features and treatment options.

Methods

A PUBMED search using the keywords “pituicytoma” was performed, and the citations were reviewed.

Results

We found 65 cases of pituicytomas, including our report, in the international literature to date; among these cases, only three were diagnosed in patients under 14 years old.

Conclusion

Pituicytoma is a slow-growing, rare, low-grade glial neoplasm that originates in the neurohypophysis. Currently, the optimal treatment is gross total resection, and confirmed diagnosis relies upon pathological tests. Regular MRI follow-up is recommended.     

Brain white matter diffusion tensor metrics from clinical 1.5T MRI distinguish between ALS phenotypes

Patients with amyotrophic lateral sclerosis (ALS) can present with varying degrees of upper motor neuron (UMN) and lower motor neuron dysfunction. Previous diffusion tensor imaging (DTI) studies, in which ALS patients were not separated by the degree of UMN dysfunction, have resulted in conflicting or inconclusive results. We hypothesized that (1) categorizing ALS patients by their clinical phenotype can reveal differences in DTI abnormalities along the corticospinal tract (CST), and (2) data obtained from routine clinical DTI scans can provide this type of information. Clinical DTI scans were obtained at 1.5T in 87 ALS patients (categorized into four subgroups based on clinical phenotype) and in 12 neurologic controls. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity values from the CST were compared between ALS subgroups and controls. Significantly reduced FA and elevated MD values were observed in ALS patients compared to controls at the subcortical motor cortex level. Significant differences in AD values were not only seen between control and ALS patients but also between the ALS subgroups, suggesting divergent pathologies in these ALS patients. Classifying ALS patients by phenotype reveals differences in CST abnormalities between subgroups and may provide novel insights into disease mechanisms. The close similarity of our results from routine clinical scans with published research studies suggests wider accessibility to useful DTI metrics.     

亚低温抑制重型颅脑创伤诱导Tau蛋白过度磷酸化的实验研究

目的 观察亚低温对重型颅脑创伤诱导的Tau蛋白磷酸化的影响.方法 体外研究通过细胞液压冲击仪建立SK-N-SH细胞损伤模型,观察冲击1h、6h和12h后Tau蛋白的磷酸化水平.体内研究通过小动物液压冲击仪建立大鼠重型颅脑损伤模型(2.4 atm),接受或不接受亚低温治疗(33℃,4h).观察液压冲击6h、24 h和72 h后Tau蛋白的磷酸化水平,以及亚低温对此变化的影响.结果 SK-N-SH细胞在液压冲击后,Tau蛋白在Thr231和Ser396位点的磷酸化水平从1h开始升高,到6h左右达到高峰.SD大鼠在液压冲击后,Tau蛋白在Thr231和Ser396位点的磷酸化水平从6h开始升高,到24h左右达到高峰,到72 h仍处于高水平;免疫组化的结果也显示,大鼠脑部海马CA1区和皮质区的Tau蛋白磷酸化水平在Thr231位点也明显增高.亚低温可显著逆转液压冲击诱导的SD大鼠Tau蛋白过度磷酸化(P＜0.01).结论 亚低温可抑制重型颅脑创伤诱导的Tau蛋白过度磷酸化.