胰头癌全胰腺系膜切除的争论与进展

区域性淋巴结清扫对病人预后是否受益,切除远站的淋巴结是否会增加术后的并发症,一直受到人们质疑.胰腺癌周围神经丛浸润十分常见,胰内神经丛浸润可蔓延至胰外神经丛,是导致切缘阳性的重要因素,因而整块切除腹膜后组织包括部分神经丛应作为胰头癌手术的一个基本组成部分.全胰腺系膜切除（total mesopancreas excision,TMpE）理念的提出,要求包括神经、毛细血管及淋巴结在内的所有软组织的廓清,在不增加手术并发症和死亡的基础上,可提高RO切除率,有助于改善病人预后.     

血管紧张素转化酶抑制剂对表皮干细胞增殖、分化、迁移的影响

目的 观察血管紧张素转化酶(ACE)抑制剂卡托普利对表皮干细胞(ESCs)增殖、迁移、分化的影响,探讨ACE在维持ESCs生物学功能中的作用.方法 利用差速贴壁法获得10例儿童的ESCs,进行离体培养,检测ACE在ESCs的表达.用XTT法检测不同浓度(1 ×l0-5、1×10-6、l×10-7、1×10-8mol/L) ACEI卡托普利对ESCs增殖的影响;体外创伤模型观察1×10-6mol/L的卡托普利对ESCs 6、12、18、24h各时间段的迁移能力;流式细胞仪检测K10的表达观察1×10-6mol/L的卡托普利对ESCs分化的影响.结果 培养的细胞经β1-整合素和K19免疫荧光双重标记染色,83.55％细胞为双标记阳性细胞,即ESCs.免疫荧光染色和逆转录-聚合酶链反应(RT-PCR)结果显示ESCs表达ACE.流式细胞仪定量检测培养的细胞ACE阳性率为74.2％.1×10-6mol/L的卡托普利可明显抑制ESCs的增殖(P＜0.05),且在第5天达到峰值.1×10-6 mol/L的卡托普利可明显抑制细胞的迁移能力(P＜0.05)和克隆能力(P＜0.05).流式细胞仪检测结果表明,l×10-6 mol/L的卡托普利并不影响K10的表达(P＞0.05).结论 ACE通过影响ESCs的增殖,迁移从而影响皮肤的损伤修复和自我更新.     

Pregnancy outcomes in women with type 1 diabetes in China during 2004 to 2014: A retrospective study (the CARNATION Study)

BackgroundWe aimed to report pregnancy outcomes of women with type 1 diabetes (T1D) in China, on which data were sparse.MethodsThis is a nationwide retrospective study conducted in 11 general medical centers in 8 cities across China. We investigated the clinical data of all women who attended these centers with a singleton pregnancy and whose pregnancy ended between 1 January 2004 and 31 December 2014. Pregnancies of women with pregestational T1D were ascertained and compared with those of women without T1D.ResultsFrom over 300 000 pregnancies over the 11‐year study period, we identified 265 singleton pregnancies of women with T1D. One maternal death was documented among 265 (0.37%) women with T1D and 83 among 318 486 (0.03%) women without T1D. Women with T1D suffered from higher rates of pregnancy loss (13.21% vs 2.92%, crude risk ratio [cRR] 5.08 [95% CI, 3.56‐7.26]) and preeclampsia (17.74% vs 4.20%, cRR 4.94 [95% CI, 3.60‐6.77]) compared with those without T1D. Infants of these women with T1D had elevated rates of neonatal death (5.65% vs 0.16%, cRR 37.36 [95% CI, 21.21‐65.82]) and congenital malformation(s) (8.26% vs 3.53%, cRR 2.46 [95% CI, 1.54‐3.93]) compared with those of women without T1D. No significant improvement in pregnancy outcomes in women with T1D was observed over the period 2004 to 2014.ConclusionsPregnancy outcomes were persistently poor in women with T1D during 2004 to 2014 in China. Pregnancy care needs to be improved to reduce adverse pregnancy outcomes among Chinese women with T1D.     

风险护理联合早期活动量表预防老年胃肠癌术后静脉血栓的形成

目的:探究风险护理联合早期活动量表预防老年胃肠癌术后静脉血栓(VTE)形成的效果.方法:选取中国科学技术大学附属第一医院(安徽省立医院)普外科胃肠外科病区2018-07 ～2020-07收治的老年胃肠癌患者116例,随机数字表法均分为对照组和试验组,各58例.对照组给予风险护理,试验组在对照组基础上再给予早期活动量表指...     

血管紧张素Ⅱ受体在深Ⅱ度烧伤大鼠创面愈合过程中的表达

目的 观察血管紧张素(Ang)Ⅱ1型(AT1)和2型(AT2)受体在烧伤创面愈合过程中的表达及其与细胞增殖和凋亡的关系.方法 在大鼠深Ⅱ度烧伤后即刻、3、7、14和21 d取创面皮肤标本,采用免疫荧光组织化学染色法检测AT1和AT2的表达;采用增殖细胞核抗原(PcNA)标记和原位末端转移酶标记技术(TUNEL)染色法观察细胞增殖和凋亡.结果 在正常皮肤,AT1和AT2表达强度较弱.但伤后第7天表达达高峰,14 d降低,AT1的表达下调更明显.烧伤后7 dPCNA阳性细胞数最多,14 d后降低.烧伤后7～14 d TUNEL阳性细胞数维持在较高水平,随后下降.结论 烧伤愈合过程中AT1和AT2的表达具时空特性,这种变化与创面修复细胞增殖和凋亡密切相关.     

Rational design of M–N4–Gr/V2C heterostructures as highly active ORR catalysts: a density functional theory study

Inspired by the composites of N-doped graphene and transition metal-based materials as well as MXene-based materials, heterostructures (M–N₄–Gr/V₂C) of eight different transition metals (M = Ti, Cr, Mn, Fe, Co, Ni, Cu, and Zn) doped with nitrogen-coordinated graphene and V₂C as potential catalysts for the oxygen reduction reaction (ORR) using density functional theory (DFT) were designed and are described herein. The calculations showed that the heterostructure catalysts (except for Zn–N₄–Gr/V₂C) were thermodynamically stable. Ni–N₄–Gr/V₂C and Co–N₄–Gr/V₂C showed higher activities towards the ORR, with overpotentials as low as 0.32 and 0.45 V, respectively. Excellent catalytic performance results were observed from the change in electronic structure caused by the strong interaction between V₂C and the graphene layers as well as the synergistic effect between the MN₄ groups and the graphene layers. This study further provides insights into the practical application of ORR catalysts for MXene systems through the modulation of the electronic structure of two-dimensional materials.

Heterostructures (M-N₄-Gr/V₂C) of eight different transition metals (M = Ti, Cr, Mn, Fe, Co, Ni, Cu and Zn) were designed as potential catalysts for oxygen reduction reactions (ORR).     

Underlying mechanisms of saphenous vein graft stenosis after coronary artery bypass caused by clipping of the side branches: an experimental study

BackgroundSaphenous veins are regular bypass conduits selected in non-left anterior descending artery (LAD) coronary artery bypass graft (CABG) surgery. Despite the technical errors, acute thrombosis, intimal hyperplasia and arteriosclerosis which could lead to saphenous vein graft (SVG) failure, the metal-clipping-related SVG failure is unique and rare. This study was conducted to investigate the clinical and underlying mechanisms of the metal-clipping-related SVG failure.MethodsWe collected 6 typical cases of the metal-clipping-related SVG failure in 41 patients who were diagnosed graft stenosis by coronary angiograph after CABG in the Department of Cardiology, Beijing Anzhen Hospital, from January 2020 to September 2021. Furthermore, we built an in vitro model to verify the identical intravascular ultrasound (IVUS) pattern of metal clip.ResultsThere were 6 in 41 cases of SVG stenosis caused by clipping of the side branches. We found that the stenosis of SVG caused by metal clipping mostly occurred at the corner and multipole clipping points. In this situation, great resistance could be felt when pushing the instruments through the stenosis and crystallized cholesterol was rarely caught by the distal protection device. We verified the similar IVUS pattern of metal clip at the side-branches of SVG in vitro.ConclusionsThe metal-clipping-related stenosis may lead to SVG failure. The stenosis of SVG caused by metal clipping mostly occurred at the corner and multipole clipping points. IVUS showed great modality for clarification.     

健康教育路径对轮状病毒性肠炎患儿症状消退及家属疾病知识掌握的影响

目的:探讨健康教育路径对轮状病毒性肠炎患儿的应用效果.方法:回顾性分析2017年7月—2020年7月期间于驻马店市中医院就诊的80例轮状病毒性肠炎患儿的临床资料,依据干预方式的不同分为两组,对照组(常规护理模式,40例)和观察组(健康教育路径,40例),对比两组患儿症状消退时间及家属疾病知识掌握度.结果:干预后,对照组知识掌握度为75.00％,观察组为97.50％,观察组高于对照组,差异有统计学意义(P<0.05);观察组患儿临床症状消退时间较对照组明显缩短,差异有统计学意义(P<0.05);对照组为77.50％,观察组为97.50％,观察组高于对照组,差异有统计学意义(P<0.05).结论:健康教育路径对轮状病毒性肠炎患儿临床应用效果显著,能提高家属对疾病知识的掌握度,且缩短了患儿临床症状的消退时间,利于临床推广应用.     

酶法、离子选择电极法检测血清钙方法的比较

目的用酶法、离子选择电极法(ISE)进行同步检测血清钙的含量,从中找出一种更为简便、灵敏、经济适用、快速准确的检测方法。方法随机抽取门诊病人标本30份,分别用酶法、离子选择电极法检测血清钙的含量,进行统计学处理和分析。结果30份标本中,酶法和离子选择电极法检测发现它们的回收率、线性范围、精密度均符合要求,重复性良好,结果无显著性差异。结论离子选择电极法较酶法速度快,适于抢救急诊重危病人使用;但对实验室条件及外电电源要求较高,电极需定期精心维护保养。酶法较为稳定,适合全自动化仪器和大批量标本检测的应用,但对黄疸较深和乳糜血、溶血等标本结果影响较大。     

Adipose-derived stem cells in stroke treatment: translational possibility and mechanism

Stroke has become one of the secondary worldwide mortal diseases that burdens the family and the society both emotionally and economically. The announcement of China＇s Ministry of Health in 2008 showed that stroke had been the first cause of death in urban and rural residents.1.2 Traditional therapies such as thrombolysis, anti-platelets, and rehabilitation showed limited effects. Replacement therapy with stem cells promises to be a good solution due to its possible thorough therapy for the damaged brain area, reconstruction of neuronal circuitry, and probable long-term efficacy. Previous studies demonstrated that stem ceils have played crucial roles in various kinds of tissue repair and immune disorders such as cardiovascular diseases, skeletal diseases, arthritis diseases, and lupus erythematodes.37 Evidence from lab experiments and clinical trials implies that adipose-derived stem cells （ADSCs） would be a feasible and ideal cell therapy source because of their multi-differentiation potentials, easy collection, low invasion to donor patients, rapid in vitro amplification, reliable biosafety, non-immunogenicity, privileged immune modulation, and escaping from ethical issues.8-12： Data on neurological disease treatment found that ADSCs transplantation protected against acute inflammatory injury, delayed neuron degeneration, and improved neurological behaviors.12-15 Previously, the detailed mechanisms by which transplanted ADSCs induce functional recovery for stroke treatment are far from being clearly demonstrated. Some proposed reasonable mechanisms just stayed at the level of explanation and hypothesis due to the absence of solid experimental evidence.13-14 In this article, we analyzed the previous data to figure out some new paths or ideas which may do favor to future translational clinical studies.