CX3CL1与CX3CR1参与牙髓炎症及痛觉过敏的实验研究

目的: 观察大鼠实验性牙髓炎过程三叉神经节中CX3CL1与CX3CR1的动态表达,探讨三叉神经系统参与牙髓炎病理改变的信号调节作用。方法: 建立大鼠牙髓炎动物模型,应用免疫荧光染色方法检测三叉神经节中CX3CL1与CX3CR1的表达变化。结果: 免疫荧光染色结果显示,CX3CL1免疫阳性卫星胶质细胞围绕在神经元周围,形成典型的环状结构,而CX3CR1主要表达在神经元细胞体上。统计学分析显示, CFA致炎后2周,CX3CL1阳性细胞率达到峰值,明显高于正常对照组;CFA致炎后24 h及72 h,CX3CR1阳性细胞率与正常对照组相比明显增高。结论: 三叉神经系统通过调节CX3CL1与CX3CR1的表达参与牙髓炎症及痛觉过敏的发生发展。     

Evaluation of Kato–Katz examination method in three areas with low-level endemicity of schistosomiasis japonica in China: A Bayesian modeling approach

The Kato–Katz technique is widely used to determine faecal egg counts of intestinal schistosomiasis. Although numerous studies have reported considerable underestimation of the ‘true’ infection prevalence while using this method, little is known regarding how many infections are missed as a function of the overall endemicity of intestinal schistosomiasis. In the present study, we used a Bayesian modeling approach to assess how much the Kato–Katz technique underestimates the prevalence of Schistosoma japonicum in three low endemic areas, characterized by different levels of infection. We found that up to 83% of S. japonicum infections were missed in an average when only a single Kato–Katz thick smear was examined. We further analyzed inter- and intra-specimen variation using agreement analysis. The results revealed a clear trend of higher agreement with infection intensity. In addition, our data also confirmed that intra-specimen consistency was better than that of inter-specimen. Our results suggest that a single Kato–Katz thick smear could only detect a certain small part of infections in areas with low endemicity; the disagreement of Kato–Katz results are mainly driven by day-to-day variation of eggs in stool; and light intensities are characterized by very high underestimation rates. There is a pressing need to develop more sensitive diagnostic tools for accurate detection of light infection intensities of schistosome infections.     

Optimal targeting of sympathetic chain levels for treatment of palmar hyperhidrosis: an updated systematic review

Background

Palmar hyperhidrosis involves excessive sweating of the palms, with no known etiology. Endoscopic thoracic sympathectomy (ETS) is a safe and effective treatment for palmar hyperhidrosis, but compensatory hyperhidrosis is a common complication after ETS, leading to reduced patient satisfaction and postoperative quality of life. However, the appropriate level of the sympathetic chain to target with ETS to achieve maximum efficacy and reduce the risk of compensatory hyperhidrosis (CH) is controversial. In this systemic review, we investigated the appropriate level of sympathectomy for palmar hyperhidrosis.

Methods

PRISMA guidelines were implemented to complete a systematic review. We performed a computerized systematic literature search using PubMed and EMBASE from January 1990 to July 2016. We chose the Cochrane Collaboration’s tool and the methodological index for non-randomized studies tool for examining study bias.

Results

A total of 4075 citations were identified, of which 91 were eligible for inclusion, including 68 observational studies and 23 comparative trials. In observational studies, sympathectomies showed similar efficacies for curing PH at different levels. However, T2-free groups (i.e., at levels T3, T4, or T3–T4 combined) could render a lower risk of Horner’s syndrome (0 vs. 1.21?±?0.49%, p?=?0.036) and CH (28.75?±?7.25 vs. 57.46?±?3.86, p?=?0.002) compared with T2 involved. In comparative trials, there were 12 studies describing the comparison between T2-free ETS and T2 involved, and 9 of 12 (75%) showed T2-free ETS could reduce the incidence of CH. Overall, lowering the level and limiting the extent of sympathectomy could reduce the incidence of complications.

Conclusions

Cumulative data from more than 13,000 patients suggest that ETS is a safe, effective, and reproducible procedure with a high degree of patient satisfaction. Currently available evidence suggests that T2-free ETS may reduce the incidence of compensatory hyperhidrosis without compromising success rates and safety.

     

肺癌侵袭力的影像学表现与c-erbB-2及bcl-2基因蛋白表达的关系

目的和方法：利用免疫组化技术ＬＳＡＢ法和计算机图像分析系统的结合,测定经手术病理证实之３７例肺鳞癌及４８例肺腺癌组织中ｃ－ｅｒｂＢ－２及ｂｃｌ－２基因蛋白的表达水平,分析其表达或共表达与反映肺癌侵袭力的影像征象的关系。结果：ｃ－ｅｒｂＢ－２及ｂｃｌ－２基因蛋白在两种不同类型肺癌组织中的阳性表达及表达定位有明显的差异,并且,ｃ－ｅｒｂＢ－２基因蛋白表达阳性的肺癌,肿块毛刺征的出现率明显高于表达阴性者;ｂｃｌ－２基因蛋白表达阳性的肺癌,肿块毛刺征及三级支气管受累的出现率明显高于表达阴性者（Ｐ＜００５）;当两种基因蛋白在肺鳞癌中共表达时,肿块毛刺征及肺门或纵隔淋巴结转移的出现率明显高于它们单独表达者（Ｐ＜００５）。结论：ｃ－ｅｒｂＢ－２及ｂｃｌ－２基因蛋白与反映肺癌侵袭力的某些影像征象之间可能存在密切的关系。     

Maternal Schistosomiasis japonica is associated with maternal, placental, and fetal inflammation

Schistosomes infect ～40 million women of childbearing age and result in the elaboration of proinflammatory cytokines that have been implicated in fetal growth restriction. In murine models and two observational studies in humans, schistosome infection during pregnancy was associated with reduced birth weight, although a recent treatment trial in Schistosoma mansoni did not detect this association. We conducted an observational study among 99 pregnant women living in an area of Schistosoma japonicum endemicity in the Philippines. We enrolled women at 32 weeks gestation and measured S. japonicum and geohelminth infection intensity. We collected maternal peripheral blood at 32 weeks gestation and placental and cord blood at delivery to assess inflammatory status. At delivery, we collected a placental-tissue sample and measured birth weight. In multivariate models adjusted for geohelminths, maternal schistosomiasis was associated with increased levels of inflammatory cytokines in maternal peripheral (tumor necrosis factor alpha [TNF-α] and interleukin 10 [IL-10]), placental (TNF-α, IL-6, TNF-α receptor II [RII], and IL-1β), and cord (IL-1β and TNF-α RII) blood, as well as acute subchorionitis and increased TNF-α production by syncytiotrophoblasts assessed by immunohistochemistry (all P < 0.05). After adjusting for confounders, placental IL-1β, and TNF-α production by syncytiotrophoblasts was independently associated with decreased birth weight (both P < 0.05). Our data indicate that maternal schistosomiasis results in a proinflammatory signature that is detectable in maternal, placental, and fetal compartments, and a subset of these responses are associated with decreased birth weight. This potential mechanistic link between maternal schistosomiasis and poor birth outcomes will contribute to the debate regarding treatment of maternal schistosome infections.     

血管分支血液对流换热分析

为分析血液与周围组织换热情况,建立符合循环系统实际结构的血管树分支模型.通过用有限元方法数值求解定壁温条件下分支结构中血液的流动、传热耦合方程,得出血液的速度场、温度场和努赛尔数;并利用该模型,分析半径比、分支角、血管半径、血液流速对分支血管截面平均努赛尔数的影响.结果表明:分支血管入口处速度场和温度场均为非轴对称分布;分支血管人口段的努赛尔数明显小于单个直管的努赛尔数,分支血管努赛尔数收敛值约为3.75;分支角越小、半径比越小、分支血管半径越大、分支血管流速越大时,人口段截面的平均努赛尔数越大;分支血管半径、流速越小,截面平均努赛尔数的收敛速度越快.计算血液与组织换热,需要考虑血管分支的影响.     

集体心理干预改善乳腺癌患者的生活质量

目的:探索集体心理干预对乳腺癌患者生活质量的改善效果。方法:根据分层随机分组的方法,将133名确诊为乳腺癌并正在接受临床治疗的女性患者分为两组,对照组89人,干预组44人。采用生活质量核心问卷对两组被试的生活质量进行3次测查,分别为初测(入组时)、后测(入组后第5周或集体心理干预结束后当周)和随访(后测之后3个月)。结果:与初测相比,干预组被试和对照组被试随访时总体健康状况[(11.8±28.2)vs.(-7.4±25.2)]、情绪功能[(11.8±24.4)vs.(-6.2±27.9)]、认知功能[(4.8±20.7)vs.(-7.6±25.3)]的变化差异有统计学意义(均P0.05),干预组被试各项功能好转而对照组被试各项功能变差。随访时,干预组中高总体健康状况被试与低总体健康状况被试的各项生活质量指标差异均无统计学意义,而对照组中高总体健康状况被试的总体健康状况[(68.5±21.1)vs.(49.7±21.9)]、躯体功能[(66.8±17.0)vs.(54.3±24.3)]、角色功能[(48.2±24.2)vs.(28.0±26.3)]、情绪功能[(67.1±24.2)vs.(43.5±20.9)]、认知功能[(62.0±19.6)vs.(42.9±28.1)]和社会功能[(49.1±25.9)vs.(30.4±26.5)]均好于低总体健康状况被试(均P0.05)。结论:乳腺癌患者集体心理干预改善生活质量的效果在干预后3个月得以显现。集体心理干预对生活质量较差的乳腺癌患者更有效。     

A survey on the application of oral propranolol and atenolol for the management of infantile hemangiomas in mainland China: Survey on propranolol atenolol hemangiomas

Since 2008, oral propranolol has evolved as the first-line therapy for infantile hemangiomas (IHs). Meanwhile, oral atenolol gradually shows comparative effectiveness versus oral propranolol with few side effects. Here, we conducted a mobile internal survey among a group of Chinese clinicians about how they choose the dosage, dose regimen, and dose escalation methods of propranolol and atenolol for the treatment of IH.A mobile-ready internal survey on the application of oral propranolol and oral atenolol for IH in mainland China was performed and distributed to 333 potential clinicians from different levels of healthcare institutions in mainland China. Eighty-one doctors responded to the survey. All the respondents had the experience of treating IH with oral propranolol and 32 had the experience with oral atenolol.Most of the doctors from tertiary hospitals chose 2 mg/kg/d twice daily, while most of those with the experience of propranolol from private hospitals chose 1 mg/kg/d once daily. More doctors from tertiary hospitals had the experience of atenolol than those from private hospitals.Oral atenolol has become another medication intervention option for IH in mainland China. This survey is helpful to standardize and develop a guideline of oral atenolol therapy for IH.     

An experimental study on the effects of curcumin on posterior capsule opacification in young rabbit eyes

Background  Posterior capsule opacification (PCO) compromises vision development in infants after cataract surgery and lead to amblyopia. To observe the effects of curcumin on PCO in infant rabbits, curcumin was injected under the capaule and into the anterior chamber during phacoemulsification.

Methods  Seventy-five 1-month-old healthy New Zealand white rabbits were randomized into 3 groups, one eye of each rabbit was randomly selected to be operated. The operation involved continuous circular capsulorhexis, followed by hydrodissection with 0.6 ml each of balanced salt solution (BSS, group A), hydroxypropyl-β-dodextrin (HP-β-CD, 90 µg/ml, group B) or CUR-HP-β-CD (123 µg/ml, group C), respectively. After phacoemulsification, 0.4 ml of each drug solution was injected into the anterior chamber via an incision. The extent of corneal edema and the inflammatory response within the anterior chamber were considered as measures PCO and observed postoperatively. All eyes were examined 1 and 2 months postoperative by slit lamp microscopy and photography after pupil dilation. On the third day postoperative, 6 rabbits from each group were executed. Paraffin-embedded sections were stained with hematoxylin-eosin (HE) or terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL, indicative of apoptosis). Stained sections were observed under light microscopy. Proliferation of lens epithelial cells (LECs) was observed microscopically on day 3, day 7, month 1 and month 2 after the operation with HE staining.

Results  The remission of cornea edema occurred earlier in group C than in groups A and B (P <0.05); there were no significant differences between groups A and B. The remission of anterior chamber exudation in group C was earlier than those in groups A and B (P <0.05). No significant difference in the times when PCO occurred, was observed among groups. Compared to groups A and B, the extent of PCO was less severe (P <0.05). Three days after the operation, LECs aggregated at the orbit. Meanwhile, minor apoptosis was observed in all groups. One month after the operation transparent, cortex and proliferating LECs were observed near the orbit in groups A and B. Two months postoperative, heavy cortex proliferation was observed in all groups: epithelial cells migrated and aggregated at the posterior capsule and rearranged under the anterior capsule in the control group. Proliferation was also observed in group C, but to a less severe extent than in the other two groups.

Conclusion  CUR-HP-β-CD exerts an inhibitory effect on PCO.