四方联动防跌护理在社区跌倒高危老年人中的应用

目的探讨专科护士-社区护士-个体-家庭四方联动防跌护理模式在社区跌倒高危老年人中的应用与效果。方法选取深圳市龙岗区的2个社区,随机分为观察组和对照组,从两个社区登记建档的跌倒高风险老年居民中分别随机抽选45名进行干预。观察组采用"专科护士-社区护士-个体-家庭"四方联动推进的综合干预方案。对照组接受社区防跌倒常规护理。于干预前及干预后12个月使用修订版社区老年人跌倒危险评估量表、步态和平衡测试量表对两组老年人进行评测,记录两组1年内跌倒发生例次。结果干预期间跌倒发生情况:观察组1人次,对照组6人次。观察组步态和平衡测试得分提高,跌倒危险评估表得分降低,与对照组比较,差异有统计学意义(均P0.01)。结论四方联动的综合干预方案应用于社区居家老年人,能有效降低老年人跌倒风险,提升其防跌能力,对预防社区老年人跌倒的发生有积极作用。     

Lucio phenomenon mimicking antiphospholipid syndrome: The occurrence of antiphospholipid antibodies in a leprosy patient

Lucio phenomenon is an atypical reaction of leprosy, characterized by vasculitic lesions that can mimic antiphospholipid syndrome (APS) clinically. Distinguishing the two can be difficult as antiphospholipid autoantibodies may be present in patients with leprosy. We report on a 32‐year‐old female patient presenting with a sudden onset of fever, hemorrhagic bullae, and skin necrosis on her lower legs. She was treated for APS due to the presence of antiphospholipid antibodies but had an inadequate response. A skin biopsy revealed thrombotic vasculopathy and necrotizing vasculitis associated with aggregation of foam cells in the perivascular area and subcutis, with acid‐fast bacilli in the histiocytes and blood vessel walls. Direct immunofluorescence showed IgM, C3, and fibrinogen deposition in the superficial and deep dermal blood vessels. The pathology confirmed the diagnosis of Lucio phenomenon, and appropriate therapy was given. It is essential to evaluate the patient comprehensively, including clinical, serological, and pathological aspects, to obtain the correct diagnosis.     

Effect of corneal stromal pocket irrigation in small-incision lenticule extraction

ObjectivesTo investigate the effect of corneal stromal pocket irrigation after small-incision lenticule extraction (SMILE) on visual acuity, intraocular pressure (IOP), corneal parameters and complications after surgery.MethodsA total of 242 eyes of 121 patients undergoing SMILE were enrolled in this prospective controlled study, and it was designed for one eye to randomly undergo SMILE with balanced salt solution irrigation of the corneal stromal pocket, while the other eye was not. The uncorrected distance visual acuity (UDVA) and slit lamp examination were recorded at 1 hour, 1 day, 1 week, and 1 month. Postoperative corneal density, corneal biomechanical, corneal endothelial cell number, and anterior OCT images were compared at 1 day, 1 week, and 1 month.ResultsCompared with the nonirrigation group, the irrigation group showed significantly higher UDVA at 1 day postoperatively (P < 0.05), but there was no significant difference during the rest of the postoperative period (1 hour, 1 week, and 1 month). In addition, no significant differences were found in IOP, corneal density, corneal biomechanics, corneal endothelial cells, and corneal morphology. No visual decline or severe postoperative complications were found in the patients in this study.ConclusionsInterlamellar irrigation did not affect IOP, corneal parameters, morphology, complications, or UDVA at 1 hour, 1 week, and 1 month after the operation, but it may promote UDVA 1 day after the operation.Subject terms: Refractive errors, Outcomes research, Surgery     

加强型鼻咽通气道应用于鼻腔手术后气道管理临床研究

目的研制加强型鼻咽通气道应用于五官科鼻腔手术后的气道管理。方法选取2014年1月至2015年3月行五官科鼻腔手术的患者60例,将其分为A组和B组,各30例。A组作为加强型鼻咽通气道组,术毕在膨胀止血海绵中放置加强型鼻咽通气道保留鼻腔通气;B组作为对照组,术毕采用传统单纯填塞膨胀止血海绵。通过术后24、48 h随访,对两组患者进行疼痛、睡眠质量、口干程度评分,并对其进行对比分析。结果加强型鼻咽通气道具有良好的抗压抗折性;A组患者24、48 h睡眠质量、口干程度评分均明显优于B组,差异均有统计学意义(P<0.05)。结论加强型鼻咽通气道用于五官科鼻腔手术后气道管理可增强气道管理安全性及患者舒适度。     

维纳托克在肝癌细胞中的抗肿瘤活性及其机制

目的探讨维纳托克(Venetoclax)在HepG2、Hep3B 2个肝癌细胞株的抗癌活性。方法对人肝癌细胞株HepG2、Hep3B细胞株进行体外培养,采用不同浓度的Venetoclax(0、3、10、30μmol/L)处理肝癌细胞,以细胞计数试剂盒(CCK-8)检测细胞活性,0,3,10和30μmol/L Venetoclax作用细胞48 h,锥虫蓝拒染法检测细胞的死亡,0,5μmol/L Venetoclax,作用24 h,流式细胞学检测细胞凋亡率,蛋白质印迹法(Western blot)检测Venetoclax诱导半胱氨酰天冬氨酸特异性蛋白酶(Caspase)-3活化,聚腺苷二磷酸核糖聚合酶(PARP)裂解。组间比较采用t检验。结果Venetoclax对HepG2、Hep3B细胞株均有较强活性抑制作用。不同浓度的Venetoclax处理肝癌细胞48、72 h,Venetoclax在HepG2细胞株中取得的半数细胞活性抑制率(IC50)值分别为46.5μmol/L和14.2μmol/L;在Hep3B细胞的IC50值分别为24.6μmol/L和11.2μmol/L。处理24 h,30.0μmol/L的Venetoclax在HepG2和Hep3B细胞株中诱导57%[对照组、实验组凋亡率分别为(4.00±1.00)%、(56.67±8.51)%,t=-10.650,P<0.01]和54%[对照组、实验组凋亡率分别为(5.67±1.53)%、(54.33±9.87)%,t=-8.440,P<0.01]的肝癌细胞发生凋亡,并能诱导肝癌细胞的Caspase-3活化,PARP裂解,差异均有统计学意义。用0、3、10和30μmol/L的Venetoclax处理48 h,在HepG2细胞株中可诱导3%(3.26±1.71)%,12%[(12.36±1.99)%,(t=-12.36,P<0.05)],32%[(32.38±4.57)%,(t=-10.350,P<0.01)]和67%[(66.71±6.29)%,(t=-16.86,P<0.01)]的细胞死亡,差异均有统计学意义;在Hep3B细胞株诱导2%(1.91±0.68)%,16%[(15.72±3.40)%,(t=-6.890,P<0.05)],42%[(42.39±6.86)%,(t=-10.180,P<0.01)]和73%[(73.32±2.69)%,t=-44.490,P<0.01]的细胞死亡,差异均有统计学意义。应用半胱氨酸蛋白酶(Caspase)抑制剂预处理,Venetoclax对HepG2和Hep3B细胞的死亡率分别从56%(56.71±6.29)%降低至11%(10.70±1.43)%,(t=12.350,P<0.01)和68%(68.05±10.16)%至12%(12.7±6.12)%,(t=8.080,P<0.01),差异有统计学意义。结论Venetoclax能够通过诱导Caspase的活化,诱导肝癌细胞发生凋亡,并对肝癌细胞进行杀伤。     

Role of macrophages in peripheral nerve injury and repair

Resident and inflammatory macrophages are essential effectors of the innate immune system. These cells provide innate immune defenses and regulate tissue and organ homeostasis. In addition to their roles in diseases such as cancer, obesity and osteoarthritis, they play vital roles in tissue repair and disease rehabilitation. Macrophages and other inflammatory cells are recruited to tissue injury sites where they promote changes in the microenvironment. Among the inflammatory cell types, only macrophages have both pro-inflammatory(M1) and anti-inflammatory(M2) actions, and M2 macrophages have four subtypes. The co-action of M1 and M2 subtypes can create a favorable microenvironment, releasing cytokines for damaged tissue repair. In this review, we discuss the activation of macrophages and their roles in severe peripheral nerve injury. We also describe the therapeutic potential of macrophages in nerve tissue engineering treatment and highlight approaches for enhancing M2 cell-mediated nerve repair and regeneration.     

营养风险与腹膜后肿瘤患者住院时间的相关性研究

目的 探讨营养风险与腹膜后肿瘤患者住院时间的相关性。方法 采用回顾性研究，选取2012年1月至2018年12月四川大学华西医院血管外科新入院腹膜后肿瘤患者60例，采用营养风险筛查表评估患者营养风险，收集患者体质指数、围术期血红蛋白和白蛋白水平、住院天数、术后恶心呕吐发生情况、术后排气、排便时间和首次进食时间。采用单因素分析比较不同患者住院时间，采用多重线性逐步回归分析患者住院时间的影响因素。结果 纳入的60例腹膜后肿瘤患者中，40例患者（66.7%）术前存在营养风险，52例患者（86.7%）术后存在营养风险；单因素分析显示，患者术前、术后营养风险 （术前P<0.001，术后P=0.043）、术前白蛋白 （P=0.019）、术后血红蛋白 （P=0.019）、术后白蛋白（P=0.025） 水平以及术后恶心呕吐 （P=0.001） 均会影响患者的住院时间；患者住院时间与围术期营养风险筛查工具评分、术后首次进食时间、术后排气时间和排便时间具有相关性，且相关性强（r=0.759~0.770； P<0.01）；多因素分析显示术前营养风险是腹膜后肿瘤患者住院时间的重要预测因素（β=0.399）。结论 术前营养风险是腹膜后肿瘤患者住院时间的预测因子。