儿童肱骨外髁骨折的治疗体会

目的总结儿童肱骨外髁骨折的治疗效果。方法 35例JakobⅠ~Ⅲ度儿童肱骨外髁骨折患儿中,8例(Ⅰ度)采用石膏托外固定治疗,27例(Ⅰ度8例、Ⅱ度11例、Ⅲ度8例)采用切开复位克氏针内固定治疗。结果手术治疗的27例获11个月~5年随访,骨折均骨性愈合;根据Hardacre评分:优17例,良8例,差2例,优良率为25/27。非手术治疗的8例获11个月~2年随访,骨折均骨性愈合;根据Hardacre评分:优6例,良2例,优良率为8/8。结论儿童肱骨外髁骨折手术或非手术治疗均可获得较满意效果。如行非手术治疗,必须严密观察,一旦发现骨折移位应早期手术治疗。     

动态增强磁共振参数与局部晚期鼻咽癌患者预后相关性的前瞻性长期随访研究

目的 探讨动态增强磁共振（DCE-MRI）半定量参数与局部晚期鼻咽癌患者长期预后的关系,为局部晚期鼻咽癌患者预后寻找无创性的预测指标。方法 收集贵州省肿瘤医院2011年1月至2012年1月一项前瞻性临床研究的局部晚期鼻咽癌患者的临床信息,国际抗癌联盟（UICC）2010分期Ⅲ、Ⅳ_A、Ⅳ_B期,先行多西紫杉醇+顺铂+5''-氟尿嘧啶（TPF）方案时辰诱导化疗3周期;后予调强放疗（IMRT）同期紫杉醇化疗2周期。诱导化疗前均行DCE-MRI检查,并获取DCE-MRI相关半定量参数,将DCE-MRI相关半定量参数与同期放化疗结束的鼻咽病灶近期疗效进行相关性分析。结果 77例患者中,71例完成治疗并有长期完整随访信息,中位随访77个月（9~86个月）,3年、5年OS分别为80.2%、67.6%;3年、5年PFS分别为73.2%、60.5%;同步放化疗结束鼻咽病灶近期疗效评价完全缓解（CR）组与部分缓解（PR）组之间的造影剂到达组织时间的差异具有统计学意义（t=0.537,P<0.05）;单因素生存分析发现,造影剂到达组织时间短组的OS（χ²=3.982,P<0.05）和PFS（χ²=4.019,P<0.05）均高于造影剂到达组织时间长组;年龄≥ 45岁的患者OS（χ²=7.593,P<0.05）和PFS（χ²=5.624,P<0.05）明显低于年龄<45岁的患者。Cox多因素回归模型发现,临床分期晚（Ⅳ_A、Ⅳ_B期）（P=0.048）、年龄≥ 45岁（P=0.031）是鼻咽癌患者OS的独立不良预后因素;而造影剂到达组织时间长（P=0.018）、年龄≥ 45岁（P=0.004）、N（2~3期）分期晚（P=0.032）和强化峰值<3 000（P=0.005）则为鼻咽癌患者PFS的独立不良预后因素。结论 DCE-MRI参数造影剂到达组织时间可能作为局部晚期鼻咽癌患者预后可靠的影像学指标。     

Tract-based spatial statistics of diffusion tensor imaging after corpus callosotomy in relation to seizure recurrence

Purpose

To delineate microstructural changes in transected white matter tracts after corpus callosotomy in relation to seizure recurrence using tract-based spatial statistics of diffusion tensor imaging (DTI-TBSS).

Methods

We retrospectively included 12 total corpus callosotomy patients who had undergone serial pre- and postoperative DTI studies. The first postoperative DTI was performed within 6 months after callosotomy. The second postoperative DTI was performed in five patients with seizure recurrence (symptomatic group) and in seven patients without seizure recurrence (asymptomatic group) after 1 year following surgery. Group comparisons of fractional anisotropy (FA) with age- and sex-matched controls were performed in a whole brain voxel-wise manner using DTI-TBSS.

Results

The first postoperative DTI-TBSS showed a significant FA decrease in the entire corpus callosum in all patients. The second postoperative DTI-TBSS showed that a significant FA decrease remained in the entire corpus callosum in the asymptomatic group. However, in the symptomatic group, no significant decrease of FA was observed in some parts of the posterior body and splenium of the corpus callosum, although there was still a significant FA decrease in the genu of the corpus callosum.

Conclusions

Using DTI-TBSS analysis, we characterized and visualized microstructural white matter changes over time in relation to seizure recurrence in callosotomy patients, suggesting that reorganization of some transected white matter tracts may be related to seizure recurrence. DTI-TBSS analysis can provide reliable and useful information about the state of white matter bundles affected by corpus callosotomy in a noninvasive manner.     

Steered polymorphic nanodomains in TiO2 to boost visible-light photocatalytic oxidation

A breakthrough in enhancing visible-light photocatalysis of wide-bandgap semiconductors such as prototypical titania (TiO₂) via cocatalyst decoration is still challenged by insufficient heterojunctions and inevitable interfacial transport issues. Herein, we report a novel TiO₂-based composite material composed of in situ generated polymorphic nanodomains including carbon nitride (C₃N₄) and (001)/(101)-faceted anatase nanocrystals. The introduction of ultrafine C₃N₄ results in the generation of many oxygen vacancies in the TiO₂ lattice, and simultaneously induces the exposure and growth of anatase TiO₂(001) facets with high surface energy. The photocatalytic performance of C₃N₄-induced TiO₂ for degradation of 2,4-dichlorophenol under visible-light irradiation was tested, its apparent rate being up to 1.49 × 10⁻² min⁻¹, almost 3.8 times as high as that for the pure TiO₂ nanofibers. More significantly, even under low operation temperature and after a long-term photocatalytic process, the composite still exhibits exceptional degradation efficiency and stability. The normalized degradation efficiency and effective lifespan of the composite photocatalyst are far superior to other reported modified photocatalysts.

A novel TiO₂-based composite material composed of in situ generated biomimetic polymorphic nanodomains including carbon nitride (C₃N₄) and (001)-/(101)-faceted anatase nanocrystals is reported.     

急诊智能化信息系统构建

详细介绍基于医护患一体的急诊智能化信息系统建设目标、具体实现等方面,指出该系统有助于缩短急救患者救治时间,实现诊疗流程精细化管理,为医院质控部门提供有力的数据支撑。     

A multicenter retrospective study of transurethral prostate split for benign prostate hyperplasia

BackgroundTransurethral split of the prostate (TUSP) is effective in treating benign prostatic hyperplasia (BPH). However, there is still a lack of research focusing on the optimal target population for TUSP. This study aimed to compare the efficacy of TUSP in patients with different prostate volumes or ages.MethodsThe study was a multicenter retrospective study. The outcomes of TUSP in BPH patients with different prostate volumes or different ages were compared. A total of 439 patients were included in the study. Patients were divided into two groups according to prostate volume, with a cut-off value of 50 mL. Similarly, the cut-off value for the age groups was 70 years. Baseline patient characteristics and perioperative outcomes were recorded. Follow-up was performed at 1, 6, and 12 months after surgery.ResultsThe mean age of the patients was 73.4 years, and the mean prostate volume was 51.2 mL. At 12-month follow-up after TUSP treatment, the patients’ International Prostate Symptom Scores (IPSS), quality of life (QoL) scores, and postvoid residual (PVR) volumes decreased significantly, while peak urinary flow rate (Qmax) increased significantly. Intraoperative hemoglobin (Hb) reduction was significantly lower in the small volume group than in the large volume group. The incidence of postoperative urinary urgency and transient incontinence was lower in the small volume group. IPSS score, PVR, and Qmax in the small volume group showed more remarkable changes at several time points compared to the preoperative period. Postoperative pain scores were higher in the small volume group than in the large volume group. There were no differences between the two groups in terms of long-term complications. The younger group showed greater variation in PVR and Qmax at some time points but less variation in QoL than the older group.ConclusionsTUSP is overall safe and effective in treating BPH. This study showed differences in the outcomes of TUSP in treating different prostate volumes or ages of BPH patients. The optimal surgical approach for BPH patients might be selected clinically based on a combination of prostate volume or patient age.     

Systematic review and meta-analysis on laparoscopic cystectomy in bladder cancer

BackgroundThis study aimed to systematically evaluate the efficacy of laparoscopic radical cystectomy (LRC) surgical therapy in patients with bladder cancer (BC), and to provide evidence for the clinical treatment of BC.MethodsThe Embase, Ovid, PubMed, Medline, Springer, and Web of Sciences database were searched to screen articles with clinical controlled trials on LRC treatment of BC. The Cochrane Handbook 5.0.2 software and Review Manager 5.3 software were adopted to evaluate the risk of bias and to perform a meta-analysis of the included articles in this study.ResultsA total of 12 articles were obtained, including 1,283 research cases. The meta-analysis results showed that relative to the control group (Ctrl), the observation group (Observ group) had significantly lower intraoperative blood loss (IBL) after LRC [mean difference (MD) =−458.75; 95% confidential interval (CI): −505.75 to −411.76; Z=19.13; P<0.00001], blood transfusion rate (BTR) (odds ratio =0.36; 95% CI: 0.13–0.94; Z=2.08; and P=0.04), use of analgesics (MD =−24.53; 95% CI: −39.04 to −10.01; Z=3.31; and P=0.0009), and incidence of postoperative complications (Risk ratio =0.58; 95% CI: 0.39–0.85; Z=2.77; and P=0.006). However, and the length of hospital stay could not be shortened (MD =–2.43; 95% CI: –4.83 to –0.02; Z=1.98; and P=0.05).DiscussionLRC treatment of BC could effectively reduce the amount of IBS, and lower the intraoperative BTR, use of analgesics, and incidence of postoperative complications. Therefore, it could be used in the clinical surgical treatment of BC patients.     

心脑脉络复元汤对异丙肾上腺素致大鼠心肌损伤的保护作用

目的观察心脑脉络复元汤对异丙肾上腺素致大鼠心肌损伤的保护作用。方法 Wistar大鼠随机分为生理盐水对照组、异丙肾上腺素缺血组、复方丹参片对照组和心脑脉络复元汤干预组。于大鼠皮下注射异丙肾上腺素(40mg/kg)制备心肌损伤模型。分别用HE染色、DNA末端标记法(TUNEL)以及免疫组织化学染色法观察心肌组织病理变化、心肌细胞凋亡与相关基因Bax、Bcl-2蛋白表达的变化。结果心脑脉络复元汤可明显减轻异丙肾上腺素所致的心肌细胞坏死;可通过下调Bax、上调Bcl-2的表达,明显抑制异丙肾上腺素所致的心肌细胞凋亡。结论心脑脉络复元汤对大剂量异丙肾上腺素引起的缺血性心肌损伤有很好的保护作用。     

CD147、E-cadherin在肾细胞癌中的表达及意义

目的 检测人肾癌组织中CD147、E-cadherin的表达,探讨二者在肾癌中表达的相关性及其与预后的关系. 方法利用组织芯片技术构建82例肾癌与26例癌旁正常肾组织芯片,应用Envision免疫组织化学方法检测CD147与E-cadherin在肾癌组织和癌旁组织中的表达. 结果肾癌中CD147的表达率为70.7%（58/82）,癌旁正常肾组织26.9%（7/26）显著高于正常肾组织（P＜0.01）.肾癌中E-cadherin的表达率为37.8%（31/82）,癌旁正常肾组织的表达率69.2%（18/26）显著低于正常肾组织（P＜0.01）. 结论肾癌中CD147异常高表达,而E-cadherin表达下降,可能参与肿瘤的发生发展,检测CD147与E-cadherin可能作为评估肾癌预后的指标.