关节镜观察前十字韧带断裂继发膝关节软骨损伤的临床研究

目的分析前十字韧带 (anterior cruciate ligament, ACL)断裂继发膝关节软骨损伤的原因及规律 ,探讨早期重建 ACL的意义。方法应用膝关节镜观察继发的膝关节软骨损伤的病理改变、发生部位、损害程度,并对损伤发生率、发生时间、损伤程度与 ACL损伤后病程的关系以及股骨髁软骨损伤与半月板损伤的关系等进行统计学分析与对比研究。结果 ACL陈旧性断裂合并软骨损伤发生率 (75％ )明显高于急性损伤组 (26％ ),差异有非常显著性意义 (P< 0.01);软骨损伤的病理改变不同,但以股骨髁软骨“垄沟”状病损为特征性改变;病程在 1年以内者软骨损伤发生率为 60％, 1年以上者为 79.6％;病程 1年以上者软骨重度损伤发生率 (44.9％ )明显高于 1年以内者 (4.76％ ),差异有非常显著性意义 (P< 0.01);有股骨髁软骨损伤的 43例 (67.2％ ),其中伴有半月板损伤者 55.8％,无半月板损伤者 44.2％。结论 ACL断裂后膝关节软骨损伤发生率明显增高;软骨损伤程度随病程延长而加重;关节软骨损伤以股骨髁软骨负重区受累最重,但与半月板损伤无明显关系,主要因 ACL断裂后膝关节不稳所致。 ACL断裂后应尽早手术重建,恢复膝关节稳定性,改善功能,预防和中止对软骨的损害。     

Diagnóstico de infertilidad masculina: necesidad de valoraciones funcionales y cromatínicas

ObjectivesTo evaluate the incidence of functional and chromatin alterations on spermatozoids in patients grouped according to normality of standard semen parameters based on the 5th edition of the World Health Organization (WHO) guidelines. To identify and correlate the most frequently altered characteristics in the normal standard semen parameters sub-population.Materials and MethodsA prospective study was performed. It evaluated standard semen parameters (volume, sperm concentration, motility and morphology, round cells, peroxidase-positive cells) according to WHO guidelines, as well as functional tests (24 hours survival, hypoosmotic swelling test, modified stress test), and additional assays (aniline blue, nitroblue-tetrazolium, TUNEL) in 110 semen samples from patients and 6 from fertile donors (control). Based on standard semen parameters values, patients were divided into two groups (A: all standard parameters normal; B: one altered standard parameter at least).ResultsAt least one of the variables analyzed was altered in 96.61% of the samples. Groups A and B showed statistically significant differences in all the complementary tests. At least one of the complementary tests were altered in 93.68% of the samples in group A, and the most frequently affected variable was sperm DNA fragmentation (16.95%).ConclusionsPerforming a more in-depth seminal study within the routine functional and chromatin assays provides a more precise diagnosis of male infertility. The WHO standards should be considered as a primary approach.     

银杏叶提取物对氧诱导视网膜病新生鼠视网膜血管形态和密度的影响

目的探讨银杏叶提取物(金纳多)对氧诱导早产儿视网膜病变(ROP)新生鼠视网膜血管形态和密度的影响。方法将48只SD新生鼠随机分为对照组、模型组、治疗组各16只,模型组与治疗组建立波动氧诱导的新生鼠ROP模型,治疗组于造模第7天开始予以金纳多50mg/(kg·d)腹腔注射7天。各组分别于第14天和第19天随机抽取8只新生鼠,一侧眼球采用视网膜铺片ADP酶染色,观察视网膜血管形态改变,另一侧眼球行组织切片HE染色,观察并计数突破视网膜内界膜的血管内皮细胞核数目。结果视网膜铺片ADP酶染色显示,第14天和第19天时,模型组较对照组血管主干变细、形态异常,而治疗组血管形态和密度较模型组明显好转。HE染色显示模型组第14天和第19天视网膜各层细胞排列紊乱;第19天突破内界膜的细胞核数对照组、模型组、治疗组分别为(5.0±2.1)、(34.6±5.3)、(12.6±3.4),模型组高于对照组和治疗组,差异均有统计学意义(P<0.001)。结论高幅度氧浓度波动可成功构建ROP动物模型。金纳多在氧诱导视网膜病变新生鼠模型中对视网膜发挥保护作用。     

Association of optical cataract indices with cataract severity and visual function

International Ophthalmology - The purpose of this study is to determine the correlation between subjective and optical measurements used during cataract evaluation, including the iTrace...     

1 - 硝基芘对GC - 2细胞的损伤效应及AhR信号通路的活化

目的 研究1 - 硝基芘（1 - nitropyrene, 1 - NP）对小鼠精母细胞株GC - 2的损伤效应及芳香烃受体（aryl hydrocarbon receptor, AhR）信号通路的影响。方法 建立不同剂量1 - NP染毒的GC - 2细胞模型，采用CCK - 8法检测细胞活性，流式细胞术检测细胞周期，Western blot分析各组细胞DNA双链断裂损伤标志物γ - H2AX、DNA损伤反应通路蛋白以及AhR通路蛋白的表达。实时荧光定量PCR检测细胞色素450 (CYP)1a1和1b1 mRNA表达水平。结果 1 - NP处理可导致GC - 2细胞活性降低及G2/M期细胞比例升高，同时诱导γ - H2AX蛋白表达升高，DNA损伤反应及细胞周期G2/M期检测点蛋白ATM、Chk1、Cdc25c、Cdc2的磷酸化表达水平升高，Cyclin B1表达降低。1 - NP染毒也提高了GC - 2细胞中AhR核蛋白及下游靶基因CYP1A1的蛋白表达，提高了Cyp1a1和Cyp1b1的转录表达水平。结论 1 - NP暴露造成小鼠生精细胞的DNA损伤、细胞周期阻滞和细胞活性抑制，其效应可能与AhR信号通路的活化及对化学物的代谢活化有关。     

Dimethyl fumarate treatment in multiple sclerosis: Recent advances in clinical and immunological studies

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS) in which demyelination and neurodegeneration occurs. The immune system of MS patients is characterized by a dysregulation in the balance between pro- and anti-inflammatory immune cells, whereby both the innate and adaptive immune system are involved. Dimethyl fumarate (DMF) was licensed in 2013 as an oral first-line therapy for relapsing-remitting (RR)MS patients. It has a strong efficacy with neuroprotective and immunomodulatory effects and a favourable benefit-risk profile. However, the effects of DMF on the immune system of MS patients were not clear before entering the market. During the last years, numerous in vitro and ex vivo studies have clarified the working mechanism of DMF in MS. Here, we discuss the pharmacokinetics of DMF and its effect on molecular immune-related pathways, which is further linked to the clinical and immunological effects of DMF treatment. The efficacy and safety of DMF treatment for RRMS is discussed as reported from clinical trials. Further, the immunological effects of DMF treatment in RRMS patients are addressed in more detail, including the distribution and function of immune cells. Taken together, evidence from recent studies points to a multifactorial working mechanism of DMF treatment in MS which leads to a restored immune balance favouring a more tolerogenic or anti-inflammatory immune profile.