新型冠状病毒感染者航班同乘风险人员排查效果分析

目的 分析新型冠状病毒（新冠病毒）感染者航班同乘人员新冠病毒核酸阳性检出情况,为有效确定风险人员排查范围提供依据。方法 回顾性收集我国2020年4月1日至2022年4月30日本土新冠病毒感染者航班同乘人员信息,采用χ²检验分析比较指示病例发病前不同时间、不同座位距离和不同新冠病毒变异株流行期的同乘人员核酸阳性检出率。结果 研究期间,新冠病毒感染者共涉及370架次航班和23 548名同乘人员,累计判定指示病例433名。指示病例的同乘人员中,核酸检测阳性人员72名,其中,与指示病例同行人员57名,非同行人员15名。对15名非同行的阳性同乘人员进一步分析显示,86.67%在指示病例诊断后3 d内发病或检测阳性,乘机时间均在指示病例发病前4 d内,指示病例前后三排内的阳性检出率为0.15%（95%CI：0.08%~0.27%）,显著高于前后三排外的阳性检出率［0.04%（95%CI：0.02%~0.10%）,P=0.007］,前后三排内各排的阳性检出率差异无统计学意义（P=0.577）。不同类型变异株流行期间,非同行的同乘人员阳性检出率差异无统计学意义（P=0.565）。Omicron变异株流行期中,非同行人员阳性检出集中在指示病例发病前3 d内。结论 指示病例航班同乘人员的风险排查时间可设定为指示病例发病前4 d内。指示病例前后三排内的同乘人员应作为优先排查人员,并作为密切接触者进行管理,座位距离在指示病例前后三排外的同乘人员可作为一般风险人员进行排查和管理。     

Minimally invasive versus open transforaminal lumbar fusion: a systematic review of complications

Purpose

The aim of this study is to compare mTLIF vs. oTLIF with regard to peri-operative complications, operative time, estimated blood loss, fluoroscopic time, and the length of hospital stay.

Methods

The PubMed and EMBASE databases were searched for relevant articles reporting patients undergoing TLIF, and a comparison between mTILF and oTLIF was performed. The database included patient demographic information, complications, operative time, fluoroscopic time, and the length of hospital stay.

Results

Fourteen studies were included in this systematic review. The total number of subjects included was 901, of which 455 underwent mTLIF (50 %) and 446 underwent oTLIF (50 %). The operating time for the mTLIF was ranged from 116 to 390 minutes, compared with 102 to 365 minutes for oTLIF, the operating time tended to be longer in the mTLIF group than the oTLIF group. The estimated blood loss was lower in the mTLIF group, ranging from 51 to 578 ml in mTLIF and 225 to 961 ml in oTLIF, respectively. Length of hospital stay was short for the mTLIF with a 2.3 to 10.6 days hospitalization compared to 2.9 to 14.6 days for oTLIF. However the fluoroscopic time was consistently higher in the mTLIF group with a 49 to 106 seconds of fluoroscopy compared to 16.4 to 44 seconds for oTLIF. The complications divided into technical complications and infection complications. The main technical and infection complications included dural tears, screw malposition, and wound infection. Systemic complications included pneumonia, urinary tract infection, and DVT. The numbers of patients with complication was 54 out of 455 (11.87 %) in the mTLIF, and 64 out of 446 (14.35 %) in the oTLIF.

Conclusion

The review shows mTLIF offers several potential advantages in reducing blood loss and the length of hospital stay, especially lowering the complication rates for patients compared with oTLIF. However, it required much more operative time and radiation exposure. Class I evidence and high-quality randomized controlled trials are needed for further study.

     

EphA5 protein,a potential marker for distinguishing histological grade and prognosis in ovarian serous carcinoma

Background

Ovarian serous carcinoma (OSC) is the most common ovarian epithelial malignancy. Disregulation of Eph/ephrin signaling has been implicated in oncogenesis and tumor progression. EphA5 receptor is one of large families of Eph tyrosine kinase receptor and is documented in the development of nervous system. Till now, there is no published data about the role of EphA5 in ovarian epithelial neoplasmas.

Methods

This study aims to investigate the expression of EphA5 protein in ovarian serous carcinoma, and its relationship to clinical pathological characteristics. Sixty-one cases of ovarian serous carcinoma, 24 cases of benign ovarian serous tumors, 42 cases of serous borderline tumors and 20 cases of normal fallopian tubes were examined using immunohistochemical staining. The relationship between EphA5 expression and pathological parameters was analyzed. Kaplan-Meier survival function was used to analyze prognosis of patients.

Results

Immunostaining analysis demonstrated that the EphA5 protein was highly expressed in 100% (20/20) of normal fallopian tube samples, 100% (24/24) of benign epithelial ovarian tumors, 76% (32/42) of ovarian serous borderline tumors, and 31% (19/61) of ovarian serous carcinomas. Loss of EphA5expression was associated with tumor grade (P?<?0.001) and FIGO stage (P?=?0.005). The survival analysis showed that patients with negative or weak expression of EphA5 protein had a poor outcome than those with positive expression (P?=?0.004).

Conclusions

Our results show that EphA5 may be a potential biomarker for distinguishing high-and low-grade ovarian serous carcinoma and a potential prognostic marker.

     

小檗碱治疗代谢性疾病抗炎作用的研究进展

慢性非可控性炎症在代谢性疾病如糖尿病、非酒精性脂肪性肝病（NAFLD）和动脉粥样硬化的发生和发展过程中发挥关键作用。天然产物小檗碱对代谢性疾病有良好的改善作用并对其伴随的慢性炎症有明显的抑制作用。研究显示小檗碱主要通过调控AMP依赖的蛋白激酶（AMPK）、核转录因子-κB（NF-κB）和肠道菌群来发挥抗炎活性。对小檗碱抗炎作用的深入研究将为其应用于临床治疗代谢性疾病提供进一步科学依据。     

彩色多普勒超声检查早期诊断急性感染性胆囊炎的临床研究

目的：探讨彩色多普勒超声检查早期诊断急性感染性胆囊炎的临床价值,以期提高急性感染性胆囊炎诊断水平。方法选择36例急性感染性胆囊炎患者为研究对象（观察组）,随机选取同期体检正常者为对照组,观察两组彩色多普勒超声声像图的表现,测量两组肝动脉和胆囊动脉的血流最大峰值流速（ Vmax）和阻力指数（ RI）。采用ROC曲线观察彩色多普勒超声对该疾病的特异性。结果对照组胆汁透声差、胆囊壁厚、胆囊肿大、超声Murphy阳性发生率分别为25．0％、16．7％、22．2％、8．3％,观察组胆汁透声差、胆囊壁厚、胆囊肿大、超声Murphy阳性发生率分别为72．2％、47．2％、100．0％、94．4％,两组差异均有统计学意义（χ2＝4．571、4．571、4．589、5．689,均P＜0．05）;两组肝动脉和胆囊动脉的Vmax和RI差异有统计学意义（P＜0．05）。进行ROC曲线比较,观察组胆囊增大的正确率最高,为90．7％,特异性为90．7％,灵敏度为90.6％,与其他超声指标比较差异无统计学意义（χ2＝0．893,P＞0．05）。结论彩色多普勒超声检查能显示急性感染性胆囊炎的形态、胆囊壁程度、胆汁透声等情况,可提高对该疾病的诊断价值。     

Severity evaluation of obstructive sleep apnea based on speech features

Sleep and Breathing - There are upper airway abnormalities in patients with obstructive sleep apnea (OSA), and their speech signal characteristics are different from those of unaffected people. In...     

Definitive chemoradiotherapy with capecitabine and cisplatin for elder patients with locally advanced squamous cell esophageal cancer

Purpose

The aim of this retrospective study is to evaluate the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) or sequential chemoradiotherapy (SCRT) with capecitabine and cisplatin for elderly patients with locally advanced esophageal squamous cell carcinoma (ESCC).

Methods

A total of 75 patients elder than 65 years with histologically proven stage II–III ESCC were enrolled, in whom 40 patients were treated with CCRT consisted of two cycles of intravenous cisplatin and oral capecitabine during and after radiotherapy and 35 patients were treated with SCRT as two cycles of capecitabine plus cisplatin before and after radiotherapy. Response rate, overall survival, progression-free survival and toxicity were compared.

Results

The overall response rate (CR + PR) in the CCRT group (91.6 %) was significantly higher than that in the SCRT group (67.7 %), P = 0.023. The median PFS and median OS were significantly higher in CCRT group (19.7 and 33.6 months) than those in SCRT group (11.6 and 15.7 months), P < 0.05. The acute toxic effect was more severe in the CCRT group than in the SCRT group, but the grade 3–4 acute toxicities were similar in two groups.

Conclusions

It suggested that both CCRT and SCRT with capecitabine and cisplatin are tolerable and effective for elderly patients with locally advanced ESCC. Concurrent CRT might be superior to SCRT.     

呼吸针控联合病灶最大面积投影用于CT引导下经皮经肺穿刺近膈肝肿瘤微波消融术

【摘要】 目的 探讨“呼吸针控”联合“病灶最大面积投影”用于CT引导下经皮经肺穿刺近膈肝肿瘤微波消融术（MWA）的应用价值。方法 回顾性分析CT引导下经皮经肺穿刺近膈肝肿瘤行MWA术的53例患者,对其中29例（研究组）在CT引导下经皮经肺穿刺MWA中采用“呼吸针控”消除呼吸运动对穿刺的影响,联合“病灶最大面积投影”准确规划进针路径、预测消融范围;24例（对照组）行常规CT引导下经皮经肺穿刺MWA。比较两组术中穿刺次数、并发症及消融病灶的近期疗效。 结果 研究组术中穿刺次数少于对照组[（1.1±0.3）次 vs（3.1±0.9=）次],差异有统计学意义（P＜0.05）。两组患者术后并发症表现为气胸、肝包膜下出血、膈肌损伤（主要表现为术中和/或术后肩背部疼痛）;研究组气胸、肝包膜下出血、膈肌损伤发生率均低于对照组[（6.9%（2/29）、10.3%（3/29）、0%（0/29））比54.2%（13/24）、37.5%（9/24）、33.3%（8/24）],差异均有统计学意义（P＜0.05）。研究组术后6个月内肝肿瘤完全消融率明显高于对照组[93.1%（27/29）比70.8%（17/24）],差异有统计学意义（P＜0.05）。 结论 “呼吸针控”联合“病灶最大面积投影”可提高CT引导下经皮经肺穿刺近膈肝肿瘤微波消融术的完全消融率,减少并发症,值得推广。     

药物联合窄谱UVB治疗银屑病68例临床疗效观察及护理分析

目的：探讨采取药物联合窄谱UVB治疗银屑病的临床疗效以及护理的效果。方法2013年2月~2014年2月,选取来本院皮肤科就诊的患有银屑病的68例患者。以随机数字法将上述68例患者分成观察组和对照组各34例。观察组对患者使用外用药物涂抹并联合窄谱UVB进行治疗,而对照组则使用常规外用涂抹的药物进行治疗。两组患者在进行为期2个月的治疗与护理后比较两组患者的临床效果、不良反应以及护理效果满意度等情况。结果观察组在总有效率、不良反应和满意度方面的对比均高于对照组,差异有统计学意义（P＜0.05）。结论采用药物联合窄谱UVB治疗银屑病的临床治疗效果良好,患者对治疗结果普遍反应为满意,患者及家属对于护理的结果也普遍满意,值得在临床上广泛推广。