高频超声内镜在食管癌高发区早期癌及癌前病变诊治中的价值

  目的  探讨超声内镜在食管癌高发区早期癌及癌前病变诊断及治疗中的价值。  方法  回顾分析2008年6月至2010年6月在食管癌高发区涉县、磁县进行普查发现的118例早期食管癌及癌前病变患者, 所有病例均行超声内镜(endoscopic ultrasonography, EUS)检查, 符合镜下治疗标准的内镜辅以碘染色并行内镜下黏膜切除术(endoscopic mucoscal resection, EMR), 余手术治疗。对所有行EMR术及手术治疗的患者术前EUS及术后病理结果进行对照分析。  结果  EUS判断食管早期癌及癌前病变影像学结果显示: 黏膜层癌97例、黏膜下层癌21例, EUS与病理检查结果对照判断浸润深度, 结果相符者103例, 准确率87%, 其中对黏膜层癌判断的准确率90%, 对黏膜下层癌判断的准确率76%。  结论  EUS准确评估病灶内镜可切除性, 使得内镜下黏膜切除手术更为安全有效, 对指导高发区早期食管癌和癌前病变内镜下治疗具有重要价值。      

定期晨间集体交接班在门诊的实施

目的 探讨门诊护士定期进行晨间集体交接班制的实施方法和效果.方法 于每周一工作前30 min,全体门诊护士集中进行交接班,由交班护士、护士长及科护士长对上周工作进行总结及点评.结果 实施门诊护士定期晨间集体交接班制后门诊满意度显著提高,与实施前比较,差异有显著性意义(P＜0.01).结论 门诊护士定期晨间集体交接班的实施,对培养门诊护士的综合素质及提高门诊护理服务质量起到积极的促进作用.     

Endocrine basis for disruptive effects of cortisol on preovulatory events

Stress activates the hypothalamo-pituitary-adrenal axis leading to enhanced glucocorticoid secretion and concurrently inhibits gonadotropin secretion and disrupts ovarian cyclicity. Here we tested the hypothesis that stress-like concentrations of cortisol interfere with follicular phase endocrine events of the ewe by suppressing pulsatile LH secretion, which is essential for subsequent steps in the preovulatory sequence. Cortisol was infused during the early to midfollicular phase, elevating plasma cortisol concentrations to one third, one half, or the maximal value induced by isolation, a commonly used model of psychosocial stress. All cortisol treatments compromised at least some aspect of reproductive hormone secretion in follicular phase ewes. First, cortisol significantly suppressed LH pulse frequency by as much as 35%, thus attenuating the high frequency LH pulses typical of the preovulatory period. Second, cortisol interfered with timely generation of the follicular phase estradiol rise, either preventing it or delaying the estradiol peak by as much as 20 h. Third, cortisol delayed or blocked the preovulatory LH and FSH surges. Collectively, our findings support the hypothesis that stress-like increments in plasma cortisol interfere with the follicular phase by suppressing the development of high frequency LH pulses, which compromises timely expression of the preovulatory estradiol rise and LH and FSH surges. Moreover, the suppression of LH pulse frequency provides indirect evidence that cortisol acts centrally to suppress pulsatile GnRH secretion in follicular-phase ewes.     

Reclassification of odontogenic keratocyst as tumour. Impact on the odontogenic tumours prevalence

Oral Diseases (2010) 16 , 185–187 Aim: The aim of this study was to establish the impact of the redefinition and reclassification of odontogenic keratocyst (OKC) as a tumour on the prevalence of odontogenic tumours (OT). Methods: We revised 15 435 files of a teaching head and neck histopathology service in the time period from January 1981 to December 2008 and 478 cases of OT were selected. The 342 cases from 1981 to 2004 were classified according 1992 to the World Health Organization (WHO)‐classification (excluding keratocystic OT) while the 136 cases from 2005 onwards were classified according to the 2005 WHO‐classification (including keratocystic OT). Age and gender were obtained from medical records. The frequency distribution and prevalence of OT from each periods of time were compared. A chi‐square test was performed (P < 0.05 95% confidence interval). Results: The prevalence of OT increases 92% in the 2005–2008 period; from 2.6% (1981–2004 period) to 5% (2005–2008 period) (P 0.000).The most frequent OT in the 1981–2004 period was odontoma (45% of all OT) while in the 2005–2008 period was Keratocystic Odontogenicv Tumour (38.9%). Conclusions. The redefinition of OKC as a tumour produced an increase in the frequency and prevalence of OT.     

Lutein/zeaxanthin isomers regulate neurotrophic factors and synaptic plasticity in trained rats

Background/aim This study was conducted to elucidate the effects of lutein/zeaxanthin isomers (L/Zi) on lipid metabolism, oxidative stress, NF-κB/Nrf2 pathways, and synaptic plasticity proteins in trained rats.Materials and methods Wistar rats were distributed into four groups: 1) control, 2) L/Zi: rats received L/Zi at the dose of 100 mg/kg by oral gavage, 3) exercise, 4) exercise+L/Zi: rats exercised and received L/Zi (100 mg/kg) by oral gavage. The duration of the study was eight weeks. Results Exercise combined with L/Zi reduced lipid peroxidation and improved antioxidant enzyme activities of muscle and cerebral cortex in rats (p < 0.001). In the Exercise + L/Zi group, muscle and cerebral cortex Nrf2 and HO-1 levels increased, while NF-κB levels decreased (p <0.001). Also, L/Zi improved BDNF, synapsin I, SYP, and GAP-43 levels of the cerebral cortex of trained rats (p < 0.001). The highest levels of BDNF, synapsin SYP, and GAP-43 in the cerebral cortex were determined in the Exercise+L/Zi group.Conclusion These results suggested that exercise combined with L/Zi supplementation might be effective to reduce neurodegeneration via improving neurotrophic factors and synaptic proteins, and oxidative capacity in the cerebral cortex.     

Evaluation of systemic involvement of Coronavirus disease 2019 through spleen; size and texture analysis

Background/aimTo investigate the changes in the spleen size, parenchymal heterogeneity, and computed tomography (CT) texture analysis features of patients diagnosed with Coronavirus disease 2019 (COVID-19)Materials and methodsThe size and parenchymal structure of the spleen in 91 patients who underwent thoracic CT examination due to COVID-19 were evaluated. For the evaluation of parenchymal heterogeneity, CT texture analysis was performed using dedicated software (Olea Medical, France). The texture analysis of each case consisted of 15 first-order intensity-based features, 17 gray level co-occurrence matrix-based features, and 9 gray level run length matrix-based features.ResultsA total of 91 patients (45 males, 46 females) with a mean age of 54.31 ± 16.33 years (range: 18–81) were included in the study. A statistically significant decrease in spleen size was seen in the follow-up CT examinations (p < 0.001) whereas no statistically significant difference was found between the Hounsfield unit (HU) values. The radiomics consisted of first-order intensity-based features such as 90th percentile, maximum, interquartile range, range, mean absolute deviation, standard deviation, and variance, all of which showed statistically significant differences (p - values: < 0.001, < 0.001, 0.001, 0.003, 0.001, 0.001, and 0.004, respectively). “Correlation” as a gray level co-occurrence matrix-based feature and “gray level nonuniformity” as a gray level run length matrix-based feature showed statistically differences (p-values: 0.033 and < 0.001, respectively).ConclusionsAlthough COVID-19 manifests with lung involvement in the early stage, it can also cause systemic involvement, and the spleen may be one of its target organs. A decrease in the spleen size and parenchymal microstructure changes can be observed in the short follow-up time. It is hoped that the changes in the parenchymal microstructure will be demonstrated by a noninvasive method: texture analysis.