磁共振成像在无髁突骨折的颞颌关节即刻损伤中的诊断价值

  目的   探讨磁共振成像（magnetic resonance imaging,MRI）在无髁突骨折的颞颌关节即刻损伤后的潜在诊断价值。  方法   选取云南大学附属医院口腔颌面外科2018年6月至2021年3月收治的无髁突骨折的颞下颌关节损伤患者36例，共72侧关节纳入研究。所有的患者锥形束CT结果均显示髁突及关节窝无骨折且伤后髁突表面骨质“完整”。患者伤前均无关节疾患，伤后均出现不同程度的关节区疼痛和张口受限及弹响，其中24例合并有面部及其他部位的骨折。通过MRI对纳入患者进行影像检查，并对结果进行分析。  结果   MRI检查显示有关节48侧关节发生不同程度损伤，发生率为66.7%。损伤类型为骨髓水肿12侧（25%），关节盘后区损伤撕裂27侧（56.25%），关节盘移位33侧（68.75%）以及关节腔积血、积液36侧（75%）。关节盘后区损伤撕裂，关节盘移位，关节腔积血（积液）与骨髓水肿的发生率相比较，前3者发病率明显高于骨髓水肿，差异有统计学意义（ P < 0.05）。  结论   MRI在无髁突骨折的颞颌关节即刻损伤后，能清楚的显示出关节软组织的损伤部位和类型。此外，在这些损伤中关节盘后区损伤撕裂，关节盘移位，关节腔积血（积液）与骨髓水肿的发生率相比较，前三者发生率明显高于骨髓水肿。MRI是无髁突骨折的颞颌关节即刻损伤后重要检查和评价手段。     

多囊卵巢综合征伴胰岛素抵抗对生育影响的研究进展

多囊卵巢综合征（PCOS）是育龄妇女常见的内分泌性疾病，跨越了妇女生命的全过程，以高胰岛素血症、高雄激素血症和（或）无排卵为特征，目前病因尚不明确，然而胰岛素抵抗（IR）是PCOS患者常见的代谢紊乱性疾病。由此产生的高胰岛素血症可导致激素水平改变、卵泡生长受限、子宫内膜容受性改变，增加流产率或导致不孕等，同时可增加妊娠合并症的发病率，甚至让患者产生焦虑、抑郁等心理问题，因此PCOS伴IR越来越受到人们的重视。阐述PCOS伴IR对生育影响的研究进展。     

小剂量阿托品对急性右冠状动脉梗塞介入治疗术中再灌注心律失常的影响

目的观察小剂量阿托品对急性右冠状动脉梗塞急诊冠状动脉(简称冠脉)介入治疗术中再灌注心律失常的影响。方法 128例冠脉造影显示急性右冠脉闭塞致心肌梗死(简称心梗)患者,分为阿托品组(66例)和对照组(62例),阿托品组冠脉开通前给予小剂量阿托品0.5 mg静脉注射,对照组不给予阿托品干预,观察两组再灌注心律失常发生情况。结果阿托品组发生再灌注心律失常27例,其中快速心律失常16例,缓慢心律失常11例,术后低血压13例,对照组发生再灌注心律失常47例,其中快速心律失常15例,缓慢心律失常32例,术后低血压24例,两组缓慢性心律失常和低血压发生率有显著差异(P<0.05),而两组快速心律失常发生率无统计学差异。结论对急性右冠脉心梗患者,急诊开通冠脉前,给予小剂量阿托品可以减少再灌注引起的缓慢性心律失常及低血压的发生率。     

miR-373通过P2X7R影响抑郁症小鼠行为的作用机制

  目的  探讨miR-373对抑郁症小鼠模型抑郁样行为，小胶质细胞激活和焦亡的影响。  方法  采用慢性不可预知应激构建抑郁症小鼠模型。蔗糖偏好，强迫游泳，尾部悬挂和社会实验评估小鼠的抑郁样行为。免疫荧光双染小胶质细胞标志物Iba-1和小胶质细胞活化标志物OX-42以评估小鼠海马层中小胶质细胞增殖和活化状态。TUNEL试剂盒检测小胶质细胞的凋亡。荧光定量PCR检测miR-373的表达水平。蛋白质印记检测P2X7R和细胞焦亡相关蛋白的表达水平。双荧光素酶报告基因实验验证miR-373和P2X7R的靶向关系。  结果  慢性不可预知应激处理的小鼠，蔗糖偏好度和社交时间显著下调，并且强迫游泳和尾部悬挂不动时间显著增加（P < 0.05）。miR-373在抑郁症模型小鼠中异常高表达，且能够缓解小鼠的抑郁样行为（P < 0.05）。miR-373靶向负调控小鼠海马层小胶质细胞中P2X7R的表达水平（P < 0.01）。miR-373抑制小鼠海马层中小胶质细胞增殖和激活（P < 0.01）。miR-373抑制小胶质细胞中Caspase-1，C-caspase-1，NLRP3，IL-1β和IL-18表达，并抑制小胶质细胞凋亡（P < 0.05）。  结论  miR-373通过靶向抑制P2X7R的表达，从而缓解抑郁症小鼠模型的抑郁样行为，并抑制其海马层中小胶质细胞活化和焦亡。     

奥沙利铂联合氟尿嘧啶和亚叶酸钙方案治疗70岁及以上转移性结直肠癌的疗效和安全性

目的 对比观察奥沙利铂联合氟尿嘧啶和亚叶酸钙方案(FOLFOX4)治疗70岁及以上转移性结直肠癌患者与70岁以下患者的不良反应和疗效.方法 61例转移性结直肠癌患者,其中≥70岁组28例,＜70岁组33例,两组患者均接受FOLFOX4方案化疗,14 d为1个周期,治疗期间观察不良反应,3个周期后评价疗效.结果 61例患者均可评价不良反应及疗效.主要不良反应为骨髓抑制、胃肠道反应及神经毒性,≥70岁组腹泻的发生率高于＜70岁组,但主要为1～2度不良反应.≥70岁组白细胞和中性粒细胞下降的发生率高于＜70岁组(92.8%比78.8%和39.3%比36.3%),但差异无统计学意义.≥70岁组神经系统毒性发生率为46.5%,＜70岁组为36.4%,均为1～2度,两组间差异无统计学意义.≥70岁组患者近期有效率为25%,疾病控制率为71.4%,中位疾病进展时间(TTP)为6个月,＜70岁组患者近期有效率24.2%,疾病控制率84.8%,中位TTP 7个月,两组有效率和疾病控制率差异无统计学意义,而＜70岁组患者的中位TTP比≥70岁组略长.结论FOLFOX4方案同样适用于≥70岁转移性结直肠癌患者,其耐受性较好且疗效肯定.

Abstract：

Objective To observe the safety and efficacy of FOLFOX4 regiment in elderly versus young patients with advanced colorectal cancer. Methods There were 61 patients enrolled in this study, with 28 elderly patients aged 70 years and over, 33 young patients aged less than 70 years.They suffered from advanced/recurrent colorectal cancer and received FOLFOX4 regiment (Oxaliplatin +CF+5-FU). Every 14 days were as a cycle, and the therapeutic safety and efficacy were evaluated after three cycles. Adverse events and response to treatment were compared between the elderly and young patients. Results The main adverse effects were myelosuppression, gastrointestinal disturbance and neurotoxicity. The incidence rate of diarrhea was significantly higher in elderly patients than in young patients, but the most of diarrhea were at grade Ⅰ - Ⅱ. The incidence rates of leucocyte decrease and neutrophil decrease were higher in elderly patients than in young patients (92. 8% vs. 78. 8%, 39.3% vs. 36.3%), but there were no statistically significant differences between them. The incidence rate of neurotoxicity was 46.5% in elderly patients and 36.4% in young patients (P＞0. 05). The recent efficacy rate was 25%, disease control rate was 71.4% and median time-to-progression (TTP) was 6 months in elderly patients and 24.2%, 84.8% and 7 months in young patients (all P＞0.05). Conclusions FOLFOX4 regiment is well-tolerated and effective in both young and elderly patients.     

多房性囊性肾瘤的影像学表现

<正> 多房性囊性肾瘤是一种较少见的肾脏囊性病变,国内外文献报道较少。笔者回顾性分析2例多房性囊性肾瘤的CT表现,同时复习相关文献,以总结其影像表现。1 临床资料例1:女,41岁,体检发现左肾病变,查体未见明显异常。实验室检查:血、尿常规及肝、肾功能均无异常。     

Innate immunity of surfactant protein A and D in urinary tract infection with uropathogenic Escherichia coli

Objective To investigate the role of surfactant protein (SP) - A and SP - D in urinary tract infection mouse model, and evaluate the effects of SP-A and SP-D absence on urinary tract infection. Methods SP-A and SP-D double knockout (SP-A/D KO) mice were made. SP-A/D KO and wild-type (WT) C57BL/6 female mice were used for this study. The expression of SP-A and SP-D in kidney was detected by immunohistochemistry (IHC). The levels of p - p38 and p38 protein in kidneys were measured by Western blotting. Uropathogenic Escherichia coli or buffer was delivered into the bladder of female mice. At 24 and 48 h after inoculation, CFU of Escherichia coli in the kidney and urine of the treated and control mice were measured. Histological, cellular and molecular analysis were performed by several methods of H/E staining, IHC and Western blotting. The effects of SP-A and SP-D on bacterial growth were studied in vitro. Results SP-A and SP-D in kidney were located in the proximal tubules and collecting tubules. Compared with WT mice, infected SP - A/D KO mice with UPEC had higher CFU in kidneys and urine at 24 h and 48 h, increased inflammatory cells infiltration in kidneys（P＜0.05）. Compared with WT mice, SP - A/D KO mice had higher p38 MAPK phosphorylation levels in kidneys（P＜0.05）. Growth of Escherichia coli was greatly inhibited by both SP-A and SP-D（P＜0.05）. Conclusions Both SP-A and SP-D are expressed in kidney. SP-A and SP-D can attenuate UTI induced by UPEC which may be through inhibiting bacterial growth and modulating renal inflammation.     

老年肺部感染患者病原菌分布及耐药性研究

目的分析老年肺部感染患者病原菌分布特点及耐药性,旨在为临床合理用药提供参考依据。方法对2011年12月-2012年12月158例老年肺部感染患者的痰标本进行细菌培养、鉴定、药物敏感试验,试验菌株均采用全自动微生物鉴定分析仪进行鉴定,药敏试验采用纸片扩散法(K-B),数据采用SPSS16.0统计软件进行分析。结果 158例老年肺部感染患者的痰标本检出144株病原菌,其中革兰阴性菌102株占70.83%,革兰阳性菌40株占27.78%,真菌2株占1.39%;革兰阴性杆菌对亚胺培南/西司他丁耐药率最低为1.96%,其次为美罗培南、哌拉西林/他唑巴坦,耐药率分别为3.92%、13.73%,革兰阳性球菌对青霉素G、红霉素、氧氟沙星的耐药率较高,分别为87.50%、80.00%、77.50%。结论及时了解病原菌的分布及耐药趋势有利于合理选择抗菌药物,制定有效治疗方案,不仅可降低老年患者感染的发生及病死率,而且能够减少耐药菌株的产生。     

颅颌面创伤多功能面套的研制和初步应用

目的：研制一种新型多功能面套,应用于颅颌面创伤患者,以达到快速、简便、通用、舒适、牢固和安全的对患者进行包扎.方法：42例患者包括额部、颏部、人中、面颊部、头顶部损伤及合并伤,使用颅颌面创伤多功能面套对其进行包扎治疗.结果：颅颌面创伤多功能面套对42例患者均一次性包扎成功,且提高了包扎的效果.结论：该多功能面套可快速、简便、通用、舒适、牢固和安全的对患者进行包扎,是一种新型的颅颌面创伤包扎面套.     

Quercetin对人气道平滑肌细胞增殖和迁移的影响及机制

目的 体外培养人气道平滑肌细胞(human airway smooth muscle cells,HASMCs),探讨槲皮素(Quercetin,Que)对血小板源性生长因子BB(PDGF-BB)刺激的HASMCs增殖和迁移的影响及其机制.方法体外培养HASMCs,分为六组；对照组、PdGF-BB组、Que与PDGF-BB联合干预组、Que组、U0126组、U0126与PDGF-BB联合干预组.四甲基偶氮唑蓝(MTT)微量比色法测定HASMCs增殖,transwell法观察细胞迁移,Western blot法检测ERK的磷酸化及Cyclin D1表达水平.结果 与对照组相比,PDGF-BB(20μg/L)显著诱导HASMCs增殖和迁移(P＜0.05),Que(20～80μmol/L)呈浓度依赖性抑制PDGF-BB诱导的HASMCs的增殖和迁移(P＜0.05).PDGF-BB组ERK磷酸化及Cyclin D1 表达水平较对照组明显增高(P＜0.05).Que(80μmol/L)及PDGF-BB干预组其表达量低于PDGF-BB组,此抑制作用与ERK特异性拮抗剂U0126作用相当(P＞0.05).结论 Que抑制PDGF-BB诱导的HASMCs的增殖和迁移,可能是通过调节ERK/Cyelin D1通路起作用.