腺苷酸活化蛋白激酶在牙周病发生发展中的研究进展

牙周病是以特殊致病菌和破坏性免疫反应相互作用导致的牙周支持组织病理性吸收为特征。腺苷酸活化蛋白激酶（AMPK）作为关键的能量调节因子,通过参与调节重要组织器官脂肪酸和葡萄糖的代谢,从而维持身体内环境的稳态,在代谢性疾病中已被广泛研究。AMPK也可以通过参与牙周骨代谢、免疫反应、基质金属蛋白酶的分泌以及细胞自噬的调节来调控牙周病的发生和发展,在牙周病发病机制中具有潜在作用,并为牙周病的治疗提供了新的治疗靶点。本文对AMPK及其在牙周病发病机制中的研究进展做一综述。     

Sleep‐disordered breathing in heart failure patients with different etiologies

BackgroundThe prevalence of sleep‐disordered breathing (SDB) is closely related to the severity of heart failure (HF), and the severity of HF is different in patients with HF of different etiologies. Hypothesis: This study aimed to explore the prevalence of SDB in patients with HFof different etiologies.MethodsHospitalized HF patients were consecutively enrolled. All patients underwent portable overnight cardiorespiratory polygraphy. Patients were divided into five groups according to the etiology of HF: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB and clinical data was compared among the five groups.ResultsIn total, 248 patients were enrolled in this study. The prevalence of SDB in HF was 70.6%, with the prevalence of obstructive sleep apnea (OSA) at 47.6% and central sleep apnea (CSA) at 23.0%. Patients were divided into five groups: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB among the five groups was 75.3%, 81.4%, 77.8%, 51.9%, and 58.5% (p = .014), respectively. The prevalence of OSA among the five groups was 42.7%, 72.1%, 36.1%, 37.0%, and 49.1% (p = .009), whereas the CSA was 32.6%, 9.3%, 41.7%, 14.8%, and 9.4% (p < .001), respectively.ConclusionsSDB is common in HF patients. The prevalence and types of SDB varied in HF with different etiologies, which may be related to the different severities of HF. SDB was highly prevalent in patients with ischemic, hypertensive, and myocardial HF. Hypertensive HF patients were mainly complicated with OSA, while myocardial HF patients were mainly complicated with CSA. Both conditions were highly prevalent in ischemic HF patients. The prevalence of SDB was relatively low in valvular and arrhythmic HF patients, and OSA was the main type.     

经尿道前列腺电切术中不同温度冲洗液对老年患者体温和血小板功能的影响

目的探讨经尿道前列腺电切术中不同温度冲洗液对老年患者体温和血小板功能的影响。方法90例经尿道前列腺电切手术患者,依据冲洗液温度不同,随机分为室温冲洗液组和体温冲洗液组,观察体温、血小板计数(PLT)、血浆凝血酶原时间(PT)、部分激活凝血活酶时间(APTT)和血小板聚集率(PAgt)的变化。结果室温冲洗液组术毕体温较术前明显下降(P<0.05),下降值的中位数为2.2℃;术后6h APTT、PT与术前相比无明显变化(P值均>0.05),术后第1、3天APTT较体温冲洗液组明显延长(P值均<0.05);PLT在术后6 h和术后第1天较术前明显下降(P值均<0.05),至术后第3天恢复;PAgt在术后6h至第3天均较术前明显下降(P值均<0.01),也明显低于体温冲洗液组(P值均<0.01)。体温冲洗液组术毕体温较术前下降值的中位数为0.4℃,但差异无统计学意义(P>0.05);凝血指标也无明显改变(P值均>0.05)。结论经尿道前列腺电切术中室温冲洗液可引起体温下降、血小板减少、血小板聚集功能受抑;而体温冲洗液则能较好地维持体温,对凝血功能也无明显影响。     

Risk factors of perioperative complications and management with enhanced recovery after primary surgery in women with epithelial ovarian carcinoma in a single center

The present study aimed to evaluate the postoperative complications and the impact of an enhanced recovery programme in patients who underwent primary surgery (including extensive upper abdominal surgery) for epithelial ovarian carcinoma (EOC). All patients with stage I–IV ovarian carcinoma who underwent primary surgery were identified, and postoperative complications were evaluated and graded according to the Clavien-Dindo classification. Of 161 patients, 46 (28.57%) underwent surgical staging, 27 (16.77%) standard cytoreduction, 12 (7.45%) en bloc debulking and 76 (47.20%) extraradical debulking. A total of 157 patients (97.52%) achieved optimal tumor reduction (<1 cm). The mean postoperative hospitalization time was 17.33±11.29 days after completion of the initial postoperative chemotherapy (IPC), and the IPC interval was 16.22±10.09 days. A total of 13 patients (8.07%) had grade 3 complications (9 with wound dehiscence, 3 with digestive tract leakage and 1 with a bladder fistula). A total of 2 patients (1.24%) had grade 4–5 complications [1 patient with severe pneumonia returned to the intensive care unit (ICU) for tracheotomy and respiration rehabilitation; the other patient died of septicemia on day 19]. The multivariate analysis of the preoperative factors revealed that a human epididymis protein 4 (HE4) level of ≥717 pM (P=0.015) and Federation International of Gynecology and Obstetrics (FIGO) stage IV (P=0.004; compared with stage IIIC) were associated with grade 3–5 complications. The bootstrap analysis revealed that a cancer antigen 125 (CA125) level of ≥1,012 U/ml (P=0.034), a HE4 level of ≥717 pM (P=0.007) and FIGO stage IV (P=0.002; compared with stage IIIC) were significantly associated with grade 3–5 complications. Meanwhile, the multivariate analysis of the postoperative factors did not reveal any risk factors associated with grade 3–5 complications; the bootstrap analysis revealed that only transfer to the ICU after surgery (P=0.026) was significantly associated with grade 3–5 complications. In conclusion, the study found that application of enhanced recovery after surgery protocols is feasible in patients with EOC, especially in those undergoing advanced extensive upper abdominal surgery, and CA125, HE4 and FIGO stage IV were related with the occurrence of adverse perioperative outcomes.     

Association between plasma Vitamin B5 levels and all‐cause mortality: A nested case‐control study

We aimed to evaluate the prospective association of vitamin B5 with all‐cause mortality and explore its potential modifiers in Chinese adults with hypertension. A nested, case‐control study was conducted in the China Stroke Primary Prevention Trial, including 505 deaths of all causes and 505 matched controls. The median follow‐up duration was 4.5 years. The primary outcome measure in this investigation was all‐cause mortality, which encompassed deaths for any reason. The mean plasma vitamin B5 concentration for cases (43.7 ng/mL) was higher than that in controls (40.9 ng/mL) (p = .001). When vitamin B5 was further assessed as quintiles, compared with the reference group (Q1: < 33.0 ng/mL), the risk of all‐cause mortality increased by 29% (OR = 1.29, 95% CI: 0.83‐2.01) in Q2, 22% (OR = 1.22, 95% CI: 0.77‐1.94) in Q3, 62% (OR = 1.62, 95% CI: 1.00‐2.62) in Q4, and 77% (OR = 1.77, 95% CI: 1.06‐2.95) in Q5. The trend test was significant (p = .022). When Q4‐Q5 were combined, a significant 41% increment (OR = 1.41, 95% CI: 1.03‐1.95) in all‐cause death risk was found compared with Q1‐Q3. The adverse effects were more pronounced in those with normal folate levels (p‐interaction = .019) and older people (p‐interaction = .037). This study suggests that higher baseline levels of plasma vitamin B5 are a risk factor for all‐cause mortality among Chinese patients with hypertension, especially among older adults and those with adequate folate levels. The findings, if confirmed, may inform novel clinical and nutritional guidelines and interventions to optimize vitamin B5 levels.     

调神疏肝针刺法治疗脑卒中后抑郁的临床效果

目的 观察调神疏肝针刺法治疗脑卒中后抑郁（PSD）的临床效果。方法 选取2019年6月至2021年6月福建中医药大学附属康复医院收治的80例PSD患者作为研究对象,采用信封随机数字表法将患者分为治疗组和对照组,各40例。在进行基础疾病对症治疗的基础上,治疗组予调神疏肝针刺法治疗,对照组内服抗抑郁药物盐酸氟西汀胶囊。经过8周干预治疗后,比较两组患者治疗前后的汉密尔顿抑郁量表（HAMD）、日常生活活动量表（ADL）结果及治疗有效率。结果 治疗组的治疗总有效率高于对照组,差异有统计学意义（P<0.05）。治疗前,两组患者的HAMD、ADL评分比较,差异无统计学意义（P>0.05）。治疗后,两组患者的HAMD均低于治疗前,ADL评分均高于治疗前,差异有统计学意义（P<0.05）。治疗后,治疗组的HAMD评分低于对照组,ADL评分高于对照组,差异有统计学意义（P<0.05）。结论 调神疏肝针刺法可以有效改善患者脑卒中后抑郁。     

Diagnostic significance of long non-coding RNAs expression in tuberculosis patients: A systematic review and meta-analysis

Objectives:It is crucial to identify effective diagnostic biosignatures of tuberculosis (TB) to optimize its treatment. Herein, we conducted a systematic review to elucidate the diagnostic efficacy of long noncoding RNA (lncRNAs) as TB biomarkers.Methods:We searched Medline, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, VIP, and China Biology Medicine disc databases up to February 18, 2020. These studies focusing on lncRNAs as diagnosis markers of TB were collected. STATA 12.0 and Meta-disc1.4 software were used to analyze the data extracted from eligible studies.Results:We included 8 articles with 1058 TB patients, and 1896 healthy controls in our study. The values of pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.63, 0.86, 4.48, 0.43, and 10.31, respectively. Additionally, we plotted the summary receiver operating characteristic curve to evaluate the diagnostic accuracy, and the area under the curve was 0.80.Conclusion:The present study is the first meta-analysis to assess the diagnostic accuracy of lncRNAs in TB patients. We found that lncRNAs might constitute potential biomarkers for the diagnosis of TB patients. More population-based high-quality research should be conducted to validate the efficacy lncRNAs in TB patients.     

抢救车分级管理方案的应用效果

目的 探讨抢救车分级管理方案的应用效果。方法 回顾性分析2018年1月至12月萍乡矿业集团有限责任公司总医院和萍乡市第二人民医院分级管理实施前71辆抢救车的使用情况,据此制订抢救车分级管理方案,并于2020年1月至12月正式投入临床应用,比较分级管理方案实施前后抢救车过期药品的损耗数量、损耗金额、抢救车管理工作总耗时及医护人员对管理方案的满意度。结果 分级管理方案实施后,抢救车药品过期数量及损耗金额均低于实施前,差异有统计学意义（P<0.05）;抢救车科室质控次数、护理部质控次数和科室护理人员质控耗时均低于实施前,差异有统计学意义（P<0.05）;共有71名医护人员参与本研究方案的满意度评价工作,分级管理方案实施后,医护人员的总满意度高于实施前,差异有统计学意义（P<0.05）。结论 抢救车分级管理方法具有临床应用价值,该方案能够减少药品损耗、提高质控工作效率,医护人员对该方案满意度较高。