一种新型的声门外通气设备——喉导管

喉导管是一种新型的声门外通气设备.在气道的建立和维持上和喉罩相比有相似的优缺点.喉导管和喉罩总的插管成功率相近,一次插管成功率喉导管要远远高于喉罩.喉导管的气道封闭性更好.喉导管可用于四肢、泌尿、妇科和躯干体表手术以及困难气道的插管.在喉部空间狭小患者和颈髓损伤患者气道的建立上比喉罩更有优势,亦可用于心肺复苏时紧急气道的建立.     

LRIG1下调原代星形细胞瘤细胞增殖的机制

目的观察LRIGl蛋白表达对表皮生长因子（EGF）促肿瘤细胞增殖作用的影响，探讨LRIGl抑制肿瘤细胞增殖的机制。方法原代培养19例星形细胞瘤细胞，用原位杂交检测LRIGl的表达，用噻唑蓝（MTT）法观察EGF对培养细胞的促增殖作用，并分析培养细胞LRIGl表达和EGF干预后的细胞生长率的关系。结果（75．3±11．6）％的培养细胞表达LRIGl蛋白；EGF促进培养细胞增殖（38．0±14．8）％，EGF促细胞增殖的细胞生长率与LRIGl表达程度呈负相关。结论LRIGl蛋白可能通过抑制EGF—EGFR信号抑制肿瘤细胞的增殖。     

New insights into thyroid stem cells.

Stem cells exhibit an extraordinary ability for self-renewal. They also give rise to many specialized cells. The potential of stem cells in regenerative medicine, developmental biology, and drug discovery has been well documented. Although advances in stem cell science have raised broad ethical concerns, it is clear that stem cell technology has revolutionized our thinking in modern biology and medicine and provided the basis for understanding many of the mechanisms controlling basic biological processes and disease mechanisms. This review details the nascent field of thyroid stem cell research, exploring the current status of thyroid stem cell differentiation from the perspectives of both developmental biology and cell replacement therapy. It highlights successes to date in the generation of thyroid follicular cells from embryonic stem cells in the laboratory and the identification and characterization of adult stem cells from human thyroid glands and thyroid cancers. Finally, it outlines future challenges with a focus on potential stem cell therapy for thyroid patients.     

18F-FDG PET can replace conventional work-up in primary M staging of nonkeratinizing nasopharyngeal carcinoma.

Conventional work-up (CWU) with chest radiography, abdominal ultrasonography, and skeletal scintigraphy has limited value in M staging of nonkeratinizing nasopharyngeal carcinoma (NPC). Our aim was to evaluate whether (18)F-FDG PET could replace CWU by comparing their diagnostic efficacies. METHODS: Patients with histologically proven nonkeratinizing NPC and no prior treatment were prospectively enrolled. All study participants underwent CWU and (18)F-FDG PET for primary M staging. Distant metastasis was considered to be present if there was any reliable evidence identified within 1 y after diagnosis. The comparative diagnostic efficacies of (18)F-FDG PET, CWU, and the combination of (18)F-FDG PET and CWU (PET+CWU) were evaluated using the areas under the receiver-operating-characteristic (ROC) curves. RESULTS: Sixty-one (20.3%) of 300 eligible patients were found to have distant metastases. On a patient-based analysis, (18)F-FDG PET was found to be more effective than CWU (P < 0.001), whereas it was equally effective with PET+CWU (P = 0.130). On region-based analyses, (18)F-FDG PET was more effective than skeletal scintigraphy and chest radiography for detecting bone metastases (P < 0.001) and chest metastases (P < 0.001), respectively. (18)F-FDG PET and abdominal ultrasound were equally effective for detecting hepatic metastases (P = 0.127). On region-based analyses, the combination of (18)F-FDG PET and CWU did not yield any noticeable increase in diagnostic efficacy. CONCLUSION: (18)F-FDG PET can replace CWU in primary M staging of nonkeratinizing NPC.     

Quantitative three-dimensional power Doppler ultrasound predicts the outcome of placental chorioangioma.

The relationship of large and vascularized chorioangiomas to adverse pregnancy outcome is well recognized. We present a patient with a large placental tumor and signs of impending fetal cardiac failure. The angioarchitecture of the tumor depicted by three-dimensional (3D) power Doppler ultrasound enabled us to accurately diagnose a placental chorioangioma. During the follow-up period, quantitative flow data obtained using 3D power Doppler indicated altered hemodynamics in the tumor and concomitant improvement in the condition of the fetus, enabling us to manage the mother conservatively. Spontaneous delivery occurred at 38 weeks without any complications. This report demonstrates the potential value of 3D power Doppler in prenatal diagnosis and monitoring of pregnancies complicated by large, vascularized chorioangioma.     

危重新生儿应激性高血糖及其预后分析

目的探讨危重新生儿预后与应激性高血糖之间的关系。方法对85例危重新生儿入院后即采静脉血用葡萄糖氧化酶法测血糖,血糖>7mmol/L诊断为高血糖,此后应用微量血糖仪进行动态监测。结果入院时高血糖者56例,占65.9%,治愈组与死亡组的血糖值分别为7.38±2.70、17.8±8.50mmol/L(P<0.01);无脏器功能衰竭、单器官及多器功能衰竭患儿的血糖分别为6.02±2.82、10.8±3.85、14.1±4.80mmol/L(P<0.01)。高血糖与器官功能衰竭关系密切,血糖越高,病情越严重,预后越差。结论危重新生儿血糖水平可作为预后判断的一项依据。     

Proposal of a modified Child-Turcotte-Pugh scoring system and comparison with the model for end-stage liver disease for outcome prediction in patients with cirrhosis.

The model for end-stage liver disease (MELD) has a better predictive accuracy for survival than the Child-Turcotte-Pugh (CTP) system and has been the primary reference for organ allocation in liver transplantation. The CTP system, with a score range of 5-15, has a ceiling effect that may compromise its predictive power. In this study, we proposed a refined CTP scoring method and investigated its predictive ability. An additional point was given to patients with serum albumin < 2.3 g/dL, bilirubin > 8 mg/dL or prothrombin time prolongation > 11 seconds. The modified CTP system, containing class D, was compared to the MELD and original CTP system in 436 patients. There was a significant correlation between the MELD and modified CTP score (rho = 0.59, P< 0.001). Using mortality as the endpoint, the area under receiver operating characteristic curve for modified CTP system was 0.895 compared with 0.872 for MELD (P = 0.450) and 0.809 for original CTP system (P < 0.001) at 3 months; the area was 0.890, 0.837 and 0.756, respectively (P = 0.051 and < 0.001, respectively) at 6 months. The risk ratio per unit increase for the modified CTP score was 2.7 and 3.08 at 3 and 6 months respectively (P < 0.001). In conclusion, the modified CTP system can be proposed as an alternative prognostic model for cirrhotic patients. By extending the score range according to the influence of the laboratory-derived variables, the modified CTP system has a better performance than the original system and is as efficient as the MELD for outcome prediction.     

The outcome of ganglion clipping in hyperhidrosis and blushing

A total of 114 patients with various sympathetic disorders underwent endoscopic sympathetic block over different thoracic ganglions by the clipping method. The advantages of this method include the recognition of the clipped level, changeability, and reversibility. However, 4.4% of patients were unilaterally clipped at the wrong level.     

Proteasome Inhibitors Sensitize Hepatocellular Carcinoma Cells to TRAIL

A poptosis, an evolutionarily conserved form of cell suicide, oc- curs in two physiological stages: commitment and execution.[1] It has been found that several Bcl-2 family proteins are located in the outer mitochondrial membrane, where they control relea…