奥利司他对肥胖IGT人群糖尿病预防效果

目的 探讨奥利司他(Orlistat,赛尼可)对肥胖糖耐量低减(IGT)患者的干预效果。方法 患者随机分两组奥利司他治疗组(50例)和对照组(51例),治疗为期1年,于治疗前后测量血脂、口服糖耐量试验(OGTT)、体重、身高等指标。结果1年后,治疗组上述指标明显改善(P<0.01),其恶化为糖尿病的发病率明显低于对照组(P<0.01)。结论 在肥胖IGT干预治疗中,奥利司他加饮食和运动治疗后可使体重减轻,改善糖耐量,明显减少糖尿病的发生。     

RT-3DE定量评价心梗患者PCI术前后左室功能的变化

为探讨实时三维超声心动图(RT-3DE)定量评估心梗患者经皮冠状动脉介入治疗(PCI)术前后左室收缩功能及同步性参数的变化,选取100例接受PCI治疗的心肌梗死患者和100例正常对照组,应用RT-3DE技术对正常对照组和心梗患者PCI术前及术后1个月测量左心室收缩功能及同步性参数并进行比较。心梗患者PCI术前组左心室各功能参数值均劣于正常对照组,而术后1个月左心室各参数值均较术前明显改善。PCI术前、术后应用RT-3DE能够准确定位、定量反映左心室收缩功能及运动同步性,对心肌梗死的临床诊断及疗效评估具有重要价值。     

Effect of inflammation on endothelial cells induced by poly-L-lactic acid degradation in vitro and in vivo

Abstract

As a promising candidate, biodegradable Poly-L-lactic Acid (PLLA) has been extensively used in coronary artery stents. In our previous reports, PLLA stents implanted in porcine coronary arteries showed safety without stent thrombosis. However, inflammatory responses were observed, which needed further study. In this study, human aortic endothelial cells (HAEC) were treated with different volume percentages of extract of pre-degraded PLLA (extract of PLLA) in vitro, and the cell growth curve and morphological changes were examined. The expression of inflammatory cytokines such as NF-κB, VEGF and VCAM-1 were also observed by ELISA. In addition, PLLA stent was implanted in porcine coronary artery to examine morphological changes, functional marker eNOS and inflammatory responses. The extract of PLLA caused significant growth inhibition and release of NF-κB, VEGF and VCAM-1 in HAEC with volume percentage-dependence. Although re-endothelialization and expression of eNOS was observed, expression of NF-κB and lymphocytes surrounding PLLA were also found after PLLA stents were implanted in the artery. This study demonstrated the effects of inflammation on endothelial cells induced by PLLA degradation in vitro and showed the inflammation in vivo, suggesting that anti-inflammatory strategy is necessary for PLLA stent implantation in the artery.     

Pancreas Pseudocyst Associated with L-asparaginase Treatment: a Case Report

A major complication of L-asparaginase used in the treatment of paediatric malignancies in children is pancreatitis (2%-16%). However, only seven paediatric cases of pancreatic pseudocyst caused by the utilization of the agent have been reported in literature. We present the case of a 5-year old girl who had abdominal pain and epigastric dullness after the third course of BMF-95 protocol with a diagnosis of ALL. A pancreatic pseudocyst of 10 χ 10 cm size was found by abdominal tomography. The cyst was treated by percutaneous external drainage, total parenteral nutrition (TPN), administration of octreotide and antibiotherapy for one month. Percutaneous external drainage has proven to be an effective, noninvasive method in this special case with a systemic disorder and the high risk of mortality should a surgical intervention have been performed.     

生活饮用水铊短期超标的风险评估探讨

目的 针对2017年突发饮用水铊污染事件，开展饮用水中铊短期暴露对人群健康的风险评估。方法 结合国家十二五重大专项课题“突发事件供水短期暴露风险与应急管控技术研究”科研成果，采用收集和分析相关数据、确定健康效应分离点、选择不确定系数和推导短期饮水水质安全浓度的健康风险评价模型开展短期暴露健康风险评估。结果 饮用水中铊短期暴露饮水水质安全浓度（SWSC）为0.007mg/L。2017年嘉陵江饮用水铊污染事件中铊最高浓度为0.00059mg/L，虽超过《生活饮用水卫生标准》（GB5749-2006）的限值要求，但处于短期暴露饮水水质安全浓度范围内。结论 本次污染事件铊的短期暴露健康风险处于可接受水平。     

Immediate Continence Rates in RALRP: A Comparison of Three Techniques

Methods:We retrospectively analyzed the patients who underwent RALRP for localized prostate cancer by a single surgeon in our clinic from January 1, 2009–February 1, 2016. Continence was defined as no leakage or use of a safety pad for minimal leakage. The main outcome measure was continence at postoperative week 1 and months 1, 6, and 12.Results:Between 2009 and 2016, 239 patients underwent RALRP for localized prostate disease. Seventy-four patients underwent a standard approach (group 1), 88 had posterior reconstruction (group 2), and 77 had posterior reconstruction with total anatomic restoration (group 3). After 1 week, 24.3% of the patients in group 1 (18/74), 31.8% in group 2 (28/88), and 45.8% in group 3 (33/72) were continent (P = .02). One month after the surgery, continence rates for groups 1, 2, and 3 were 56.7, 67, and 75%, respectively (0.065). After 6 and 12 months, continence rates for groups 1, 2, and 3 were 72.9 and 87.8%, 81.8 and 89.7%, and 84.7 and 91.6%, respectively (P = .178 and .7484).Conclusion:Anatomic restoration improves continence rates in the early period after RALRP. Even though other parameters were higher in the total restoration group, immediate continence (at 1 week) was significantly better.     

An unexpected complication of acute pancreatitis: Intra-cardiac thrombus

Left atrial thrombus after acute pancreatitis (AP) is a rare clinical statement. Because of induction of systemic prothrombotic process by AP; some patients with underlying risk factors may develop an intra-cardiac thrombus. We present a 53 years-old-woman with moderate mitral stenosis and atrial fibrillation. However the patient was under warfarin treatment, she developed a big left atrial big thrombus which was originated from left atrial appendage after she was suffered from AP.