儿童鼻窦炎眶并发症诊治31例及文献分析

目的 探讨儿童鼻窦炎眶并发症发病特点、诊断方法及治疗原则。 方法 对31例鼻窦炎引发眶并发症儿童患者临床资料进行回顾性分析和总结。 结果 儿童鼻窦炎眶并发症具有不同发展阶段及相应临床特点、影像学表现,本组所有病例全部临床治愈出院,随访时间6~24个月,无复发者,遗留睑外翻和鞍鼻各1例,未出现海绵窦化脓性炎症和颅内感染等严重并发症。脓液及鼻分泌物细菌培养阳性率达55%,其中金黄色葡萄糖球菌4例,肺炎链球菌4例。 结论 儿童鼻窦炎眶并发症冬春季节高发,男童居多,与上呼吸道感染关系密切。首发症状不典型,常首诊于其他科室而延误诊治。治疗原则是早期应用足量、敏感抗生素控制感染,头孢哌酮钠舒巴坦钠是治疗儿童鼻源性眶并发症首选经验用药。保守治疗无效者,结合其临床及影像学表现变化,判断疾病所处阶段,严格把握手术指征,可获得满意疗效。     

血管内皮生长因子及其受体表达和侵袭性垂体腺瘤血管生成关系的研究

目的研究血管内皮生长因子(VEGF)及其受体Flt-1在人垂体腺瘤中的表达,探讨其表达变化、微血管密度(MVD)与侵袭性垂体腺瘤血管生成的关系.方法采用免疫组织化学技术检测52例垂体腺瘤的VEGF及其受体表达水平,同时检测CD34表达,用于测定垂体腺瘤的MVD,比较其在侵袭性和非侵袭性垂体腺瘤中的差异.结果VEGF及其受体和MVD与垂体腺瘤的侵袭性密切相关(P＜0.01).结论VEGF可能通过促进新生血管形成刺激垂体腺瘤生长和侵袭,其作用机制有待进一步研究.     

Insight into the photoelectrical properties of metal adsorption on a two-dimensional organic–inorganic hybrid perovskite surface: theoretical and experimental research

In order to study the photoelectric properties of the adsorption of different metal atoms on a two-dimensional (2D) perovskite surface, in this article, we built many models of Ag, Au, and Bi atoms adsorbed on 2D perovskite. We studied the rules influencing 2D perovskite adsorbing metal atoms with different n values (the n value is the number of inorganic layers of 2D perovskite; here n = 1, 2, and 3). Based on n = 2 2D perovskite, we successively used Ag, Au, and Bi metal atoms to adsorb on the 2D perovskite surface. Firstly, we calculated their adsorption energies. Based on the lowest energy principle, we found that Bi atom adsorption on the 2D perovskite surface gave the most stable structure among the three metal adsorptions because the energy of the Bi adsorption system was the smallest. Secondly, the electron transport process takes place from the s to the p orbital when Au and Ag atoms adsorb on the 2D perovskite surface, but in the Bi atom adsorption, the electron transport process takes place from the p to the p orbital, because the p–p orbital transport energy is lower than that of the s–p orbital. Therefore, Bi atom adsorption on the 2D perovskite surface can improve charge carrier transfer. Thirdly, we calculated the bond angles and bond energies of different metal adsorptions on 2D perovskite. Bi adsorption has greater interaction with the surface atoms of 2D perovskite than Ag or Au atom adsorption, which effectively enhances the surface polarization effects, and enhances the photoelectric properties of 2D perovskite. The light absorption spectrum further confirms that Bi atom adsorption has a greater impact on the 2D perovskite than the action of Ag or Au adsorption. Finally, in an experiment, we fabricated a 2D perovskite solar cell with an ITO/PEDOT:PSS/2D perovskite/PEI/Ag (Au, Bi) structure. The Bi electrode solar cell achieves the highest photoelectric conversion efficiency (PCE) of 15.16% among the three cells with forward scanning, which is consistent with the theoretical analysis. We believe that the adsorption of metals like Bi on a 2D perovskite surface as an electrode is conducive to improving the charge transport performance.

Bi atom adsorption on a 2D perovskite surface structure has the minimum adsorption energy. When it uses on the solar cell electrode, the 2D perovskite solar cell of ITO/PEDOT:PSS/2D perovskite/PEI/Bi structure exhibits the highest photoelectric conversion efficiency (PCE) of 15.16%.     

Incidence of readmission to the ICU after cardiac surgery: a systematic review and meta-analysis

BackgroundDue to the complexity of cardiac surgery, almost all patients need to be admitted to the intensive care unit (ICU) for postoperative care after surgery. After being discharged from the ICU, some patients need to be readmitted due to disease deterioration during hospitalization. We conducted a meta-analysis of the literature to investigate the incidence of readmission to the ICU in patients undergoing cardiac surgery.MethodsThe PubMed, Medline, and Elsevier databases were searched using the keywords “cardiac surgery,” “readmission,” “intensive care unit,” and “ICU” to retrieve English-language articles published from January 2000 to January 2021. The articles were screened, and their quality was evaluated. A meta-analysis was performed on the outcomes of patients after readmission to the ICU using Stata16.0 software.ResultsUltimately, 9 articles were included in the meta-analysis, comprising 32,825 cardiac surgery cases, of whom 1,302 were readmitted to the ICU. The incidence of readmission to the ICU was 3.97%. Among the direct reasons for readmission to the ICU, respiratory failure accounted for 13.6–48.6%, while hemodynamic instability accounted for 21.6–51.9%. The results of the meta-analysis showed that the mortality rate of patients readmitted to the ICU was significantly higher than that of patients not readmitted to the ICU [risk difference (RD) =8.05, 95% confidence interval (CI): 5.10–12.69, Z=8.965; P<0.0001], as was the length of hospital stay [standard mean difference (SMD) =3.17, 95% CI: 1.40–4.94, Z=3.504; P<0.001], and the incidence of complications (odds ratio =1.97, 95% CI: 1.35–2.87, Z=3.507; P<0.001).ConclusionsNine articles were included in this meta-analysis on the incidence rate of readmission to the ICU of patients undergoing cardiac surgery. The results showed that the proportion of readmission to the ICU was 3.97%. Patients readmitted to the ICU had a higher rate of complications, longer hospital stay, and higher mortality rate than those not readmitted.     

颅颌面三维头影中解剖标志点定位测量的稳定性研究

目的探讨颅颌面三维头影测量时解剖标志点定位方法的稳定性。 方法首先收集20例颌面部发育正常人群的CT数据,利用Mimics Research 19.0分别对软、硬组织进行三维重建,再将重建的三维数据以STL文件格式导入Geomagic Studio 2014软件中。然后利用软件的对象移动器功能重新建立坐标系并确定测量头位。其次,3名观察者根据给定的45个颌面部软、硬组织解剖标志点定义进行实验前的软件操作培训。2周后,按照0、1、2个月的时间间隔,分别对20例三维重建数据进行标志点的标定和测量,得到20例头颅模型的45个标志点的9组坐标数据,然后用观察者内、观察者间组内相关系数（ICC）和混合效应模型分析对各标志点的坐标值进行分析。 结果（1）ZvR、ZvL、OrL、PR、PL等5个标志点的观察者内ICC结果在0.75 ~ 0.9,表示可重复性较好;（2）ZvR、ZvL、OrL、ZpR、ZpL等5个标志点观察者间ICC结果在0.75 ~ 0.9,表示可重复性较好,其中ZpR、ZpL等2个标志点主要表现在Y轴的异常;（3）ANS、BcR、BcL等3个标志点观察者内和观察者间ICC结果<0.75,表示可重复性差,且主要集中于X轴的不稳定;（4）PR、PL等2个标志点的观察者间ICC<0.75,表示可重复性差,主要为X轴的不稳定;（5）剩余的35个解剖标志点的观察者内和观察者间ICC值均≥0.9,具有很高的可重复性。 结论颅颌面部解剖标志点的三维头影测量时,常规定点方法的稳定性有限,并不能保证全部解剖标志点有很高的可靠性,还需建立另一种定点方法予以补充,为得到更准确的诊断评价提供帮助。     

超声评价女性围绝经期及雌激素补充治疗后心血管结构功能的研究进展

正激素补充治疗(hormone replacement therapy,HRT)指对卵巢功能衰退的女性个体化给予低剂量的雌激素和(或)孕激素药物治疗,也可称为绝经相关激素治疗(menopause related therapy,MHT)或激素治疗(hormone therapy,HT)~([1])。HRT在临床中的应用经历了复杂的过程,从19世纪的推崇到20世纪的抵制,再到如今的认可,目前学界初步达成的共识是时间窗口假说和HRT对心血管的不同效应学     

Laparoscopic resections of colorectal cancer and synchronous liver metastases: a case controlled study

Purpose: To investigate the efficacy and safety of laparoscopic simultaneous resections of colorectal cancer and synchronous colorectal liver metastases (SCRLM), relative to open surgery.

Methods: Between 1 January 2009 and 20 April 2014, 20 of 25 patients who underwent laparoscopic simultaneous colorectal cancer and SCRLM resections were matched with 20 of 29 patients who underwent an open approach, based on prognostic propensity scores. Perioperative results and survival outcomes were compared.

Results: The laparoscopic and open groups were comparable in demographics, cancer characteristics, surgery characteristics, and chemotherapy treatment. No postoperative mortality occurred in either group. The estimated blood loss and postoperative stay were significantly greater in the open group than in the laparoscopic group (all, p?Conclusions: The postoperative complications and survival rates of patients given laparoscopic simultaneous colorectal cancer and SCRLM resections were similar to those treated with an open approach, but with greater short-term benefits. Laparoscopy in this setting by an experienced surgical team appears safe and effective, and is a feasible alternative to an open approach for selected patients.     

Serum vascular endothelial growth factor receptor 3 as a potential biomarker in psoriasis

To discover novel biomarkers of psoriasis, a target‐specific antibody array screening of serum samples from psoriasis patients was initially performed. The results revealed that vascular endothelial growth factor receptor 3 (VEGFR‐3) was significantly elevated in the sera of psoriasis patients, compared to healthy controls. Next, ELISA validation studies in a larger cohort of psoriasis patients (N = 73) were conducted, which confirmed that serum VEGFR‐3 was indeed significantly increased in patients with psoriasis compared to healthy controls (P < 0.001). Furthermore, receiver operating characteristic curve analysis demonstrated that serum VEGFR‐3 exhibited potential in distinguishing healthy controls from psoriasis patients: area under the curve = 0.85, P < 0.001. In addition, serum levels of VEGFR‐3 were correlated with Psoriasis Area Severity Index scores (R = 0.32, P = 0.008) in psoriasis patients. Interestingly, serum VEGFR‐3 levels were significantly elevated in psoriatic arthritis compared to non‐psoriatic arthritis (P = 0.026). A pilot longitudinal study demonstrated that serum levels of VEGFR‐3 could reflect disease progression in psoriasis. Collectively, serum VEGFR‐3 may have a clinical value in monitoring disease activity of psoriasis.     

Support for the involvement of the ERBB4 gene in schizophrenia: A genetic association analysis

Cellular, animal and human studies support the involvement of aberrant NRG–ErbB signaling in the pathogenesis of schizophrenia. The aim of the present study was to examine whether genetic variation in the human ERBB4 gene is associated with susceptibility to schizophrenia. Two hundred and twenty-seven unrelated chronic inpatients with schizophrenia were enrolled in the study, and the genetic variation in the polymorphisms of the ERBB4 gene in the patients was compared with that of the control group, which consisted of 223 subjects free of psychiatric illness. The results showed that one coding-synonymous polymorphism (rs3748962, Val1065Val) was in genotypic (p = 0.0027) and allelic (p = 0.0007) association with schizophrenia. In comparison with subjects of the rs3748962-TT type, those of the rs3748962-CT and rs3748962-CC types were at 1.74- and 2.64-fold greater risk of schizophrenia (CT vs. TT: OR = 1.71 (95% CI = 1.15–2.53), p = 0.0014; CC vs. TT: OR = 2.64 (95% CI = 1.37–5.23), p = 0.0047), which supports the hypothesis of an additive model of transmission (p = 0.0006). Furthermore, the frequency of haplotype ATC of rs3791709–rs2289086–rs3748962 was found to be significantly higher in the patients with schizophrenia than in the controls (case vs. control = 36.0% vs. 24.4%, permutation p-value = 0.0002). The findings support the involvement of the ERBB4 gene in schizophrenia in Han Chinese.     

Molecular and clinical analyses of 84 patients with tuberous sclerosis complex

Background

Tuberous sclerosis complex (TSC) is an autosomal dominant disease characterized by the development of multiple hamartomas in many internal organs. Mutations in either one of 2 genes, TSC1 and TSC2, have been attributed to the development of TSC. More than two-thirds of TSC patients are sporadic cases, and a wide variety of mutations in the coding region of the TSC1 and TSC2 genes have been reported.

Methods

Mutational analysis of TSC1 and TSC2 genes was performed in 84 Taiwanese TSC families using denaturing high-performance liquid chromatography (DHPLC) and direct sequencing.

Results

Mutations were identified in a total of 64 (76 %) cases, including 9 TSC1 mutations (7 sporadic and 2 familial cases) and 55 TSC2 mutations (47 sporadic and 8 familial cases). Thirty-one of the 64 mutations found have not been described previously. The phenotype association is consistent with findings from other large studies, showing that disease resulting from mutations to TSC1 is less severe than disease due to TSC2 mutation.

Conclusion

This study provides a representative picture of the distribution of mutations of the TSC1 and TSC2 genes in clinically ascertained TSC cases in the Taiwanese population. Although nearly half of the mutations identified were novel, the kinds and distribution of mutation were not different in this population compared to that seen in larger European and American studies.