触摸及其在护理工作中的应用研究进展

通过对触摸的定义、分类、影响因素及其在护理领域的应用与效果评价等进行综述,提出对我国触摸相关研究的建议,为护理人员合理运用触摸加强护患沟通、开展触摸相关研究提供参考。     

Effect of gut flora mediated-bile acid metabolism on intestinal immune microenvironment

According to reports, gut microbiota and metabolites regulate the intestinal immune microenvironment. In recent years, an increasing number of studies reported that bile acids (BAs) of intestinal flora origin affect T helper cells and regulatory T cells (Treg cells). Th17 cells play a pro-inflammatory role and Treg cells usually act in an immunosuppressive role. In this review, we emphatically summarised the influence and corresponding mechanism of different configurations of lithocholic acid (LCA) and deoxycholic acid (DCA) on intestinal Th17 cells, Treg cells and intestinal immune microenvironment. The regulation of BAs receptors G protein-coupled bile acid receptor 1 (GPBAR1/TGR5) and farnesoid X receptor (FXR) on immune cells and intestinal environment are elaborated. Furthermore, the potential clinical applications above were also concluded in three aspects. The above will help researchers better understand the effects of gut flora on the intestinal immune microenvironment via BAs and contribute to the development of new targeted drugs.     

参茸片致中毒性表皮坏死松解症合并急性肾损伤1例

患者男, 58岁, 因全身泛发皮疹及黏膜病变伴发热10 d, 于2019年1月10日就诊。患者10 d前口服4片参茸片当日即出现全身多发红色丘疹伴瘙痒, 后进展为全身大面积红斑、糜烂及大疱, 伴口唇黏膜糜烂、渗出, 双手非凹陷性水肿及四肢无力、行走困难、发热。3 d前出现小便失禁且神志不清, 于外院急诊予抗生素治疗1 d效果不佳。既往史:2型糖尿病、寻常型银屑病、陈旧性脑积水。否认家族中有类似病史者。     

Allogeneic umbilical cord mesenchymal stem cell conditioned medium (secretome) for treating posterior cruciate ligament rupture: a prospective single-arm study

Background

Outcomes of the current management of posterior cruciate ligament (PCL) rupture are still unsatisfactory. Recent literature demonstrated the efficacy of the paracrine action of mesenchymal stem cells (MSC) in ligament rupture healing. This study aimed to evaluate the outcome of arthroscopic administration of allogeneic umbilical cord-derived MSC (UC-MSC) conditioned medium (secretome) for the treatment of PCL rupture.

Patients and methods

This is a prospective study including 12 individuals with PCL rupture grade 1 or 2 who were performed arthroscopy and secretome administrations. The functional and radiologic outcome of the knee was examined one year following intervention.

Results

Preoperatively, posterior drawer test revealed three cases of grade 2+ and nine cases of grade 1+, whereas the final follow-up revealed two cases of grade 2+ and ten cases of grade 1+ PCL rupture. At final follow-up, the mean scores for the IKDC, modified Cincinnati, and Lysholm were 90.58 ± 4.30, 90.90 ± 2.15, and 89.42 ± 3.16, respectively. The means of the serial hop tests were 90.33, 94.16, 93.66, and 95.33 for single, triple, crossover, and time hop tests, respectively. Five patients were able to resume competitive sport after an average of 25.8 weeks (25–38). The final MRI analysis revealed that six knees (50%) regained PCL continuity with low signal intensity, five knees (41.6%) returned near-normal PCL continuity, and one knee (8.3%) regained PCL continuity but with deformed outlines.

Conclusions

Short-term follow-up indicated that the secretome generated from allogenic UC-MSC produces excellent functional and radiographic results in grade I-II PCL rupture.

     

钉道强化股骨近端防旋髓内钉治疗高龄Seinsheimer Ⅴ型股骨转子下骨折的有限元分析

目的 探讨骨水泥钉道强化股骨近端防旋髓内钉治疗高龄Seinsheimer Ⅴ型股骨转子下骨折的可行性。方法 选取1名志愿者的CT资料导入Mimics 19.0和Geomagic studio 2017软件中进行提取、优化，得到右侧股骨三维模型；运用Solidworks 2017软件画出内固定模型并与股骨模型按照标准手术技术装配，以STEP格式导入Hypermesh14.0软件中截骨得到Seinsheimer Ⅴ型普通股骨近端防旋髓内钉股骨转子下骨折模型，将螺旋刀片近端周围松质骨重新定义为骨水泥，得到钉道强化股骨近端防旋髓内钉模型。设置材料属性参数、边界条件、施加载荷，分别储存为K文件导入LS-DYNA软件求解。结果 ①与普通PFNA模型相比，钉道强化PFNA模型螺旋刀片基本无切割，头颈骨块的内翻和旋转角度较小，虽然局部应力稍大，但整体更趋稳定；②骨水泥强大的锚固力能稳定螺旋刀片，增强三点支撑的内侧作用点，并能传导、分散压力。结论 与普通股骨近端防旋髓内钉相比，钉道强化股骨近端防旋髓内钉治疗高龄Seinsheimer Ⅴ型股骨转子下骨折可以有效减少头颈骨块内翻的旋转，避免螺旋刀片切割，更趋稳定。     

Gastrointestinal biopsy of normal mucosa or nonspecific inflammation and risk of neurodegenerative disease: Nationwide matched cohort study

Background and purpose

Evidence has accumulated to support the early involvement of altered gastrointestinal (GI) function in neurodegenerative disease. However, risk of Alzheimer disease (AD) and Parkinson disease (PD) among individuals with a GI biopsy of normal mucosa or nonspecific inflammation is unknown.

Methods

This matched cohort study included all individuals in Sweden with a GI biopsy of normal mucosa (n = 480,346) or nonspecific inflammation (n = 655,937) during 1965–2016 (exposed group) as well as their individually matched population references and unexposed full siblings. A flexible parametric model and stratified Cox model were used to estimate hazard ratio (HR) and its 95% confidence interval (CI).

Results

Individuals with normal mucosa or nonspecific inflammation had a higher risk of AD and PD during the 20 years after biopsy. Compared with the population references, individuals with normal mucosa had an increased risk of AD (incidence rate [IR] difference = 13.53 per 100,000 person-years, HR [95% CI] = 1.15 [1.11–1.20]) and PD (IR difference = 6.72, HR [95% CI] = 1.16 [1.10–1.23]). Elevated risk was also observed for nonspecific inflammation regarding AD (IR difference = 13.28, HR [95% CI] = 1.11 [1.08–1.14]) and PD (IR difference = 6.83, HR [95% CI] = 1.10 [1.06–1.14]). Similar results were observed in subgroup and sensitivity analyses and when comparing with their unexposed siblings.

Conclusions

Individuals with a GI biopsy of normal mucosa or nonspecific inflammation had an increased risk of AD and PD. This adds new evidence of the early involvement of GI dysfunction in neurodegenerative disease.     

Impact of the International Consensus Classification of myelodysplastic syndromes

The impact of the 2022 International Consensus Classification (ICC) of myelodysplastic syndromes (MDS) needs study. We analysed data from 989 MDS subjects classified using the 2016 World Health Organization (WHO) criteria to determine the impact of the new proposal. Our analyses suggested the ICC criteria of MDS-SF3B1 identifies a more homogenous disease entity than the WHO 2016 criteria of myelodysplastic syndromes with ring sideroblasts (MDS-RS). MDS, not otherwise specified with single lineage dysplasia (MDS, NOS-SLD) patients had a better prognosis than MDS, NOS with multilineage dysplasia (MDS, NOS-MLD) patients. MDS with mutated TP53 and MDS/acute myeloid leukaemia with mutated TP53 patients had the briefest survivals. These data support the ICC of MDS, which allows more accurate diagnoses and risk stratification.     

云芝胞内糖肽的糖类含量测定和指纹图谱研究

目的 建立云芝胞内糖肽的游离糖和水解单糖指纹图谱和含量测定的检测方法。方法 游离糖测定以水为溶剂超声提取后PMP衍生化，水解单糖测定酸水解后PMP衍生化，采用HPLC对来自不同企业的云芝胞内糖肽原料、中间体的游离糖和水解单糖进行定性和定量分析。通过化学计量学分析对指纹图谱进行了分析，探讨不同生产企业生产的云芝胞内糖肽差异性。结果 2种方法均通过方法学验证；不同企业的样品分别聚类，有3种游离糖和2种水解单糖对云芝胞内糖肽的质量差异贡献较大。结论 建立的分析方法可有效用于云芝胞内糖肽中游离糖和水解后的单糖的测定和指纹图谱研究，采用的化学计量学研究方法对云芝胞内糖肽的质量控制提供了指导意义。