X-刀治疗颅内肿瘤56例临床分析

目的探讨X-刀治疗颅内肿瘤的疗效及并发症。方法自2001年元月至2001年12月，共收治颅内肿瘤病人56例，其中男性30例，女性26例，年龄9—68岁，平均45．6岁。病变位于大脑半球深部者32例，鞍区16例，脑干肿瘤8例；肿瘤直径1—5cm。影像学或病理分类：脑转移瘤29例，脑胶质瘤12例，垂体瘤11例，脑膜瘤4例。全部病例均采用德国siemens直线加速器和Bmi。LAB X-刀治疗计划系统，进行立体定向分次放疗，5—8Gy／次，2—3次／周，共3-8次／1-3周，剂量范围相当于常规分割50～72Gy。结果全部56例患者中，有效率达85．7％（48／56）；颅内高压为最常见的副反应，占46.4％（26／56）。结论X-刀是治疗颅内肿瘤的一种安全有效的方法。     

活血补肾方联合左氧氟沙星治疗湿热瘀结型慢性盆腔炎效果分析

目的分析活血补肾方联合左氧氟沙星治疗湿热瘀结型慢性盆腔炎效果。方法选取医院2017年4月—2019年5月收治的湿热瘀结型慢性盆腔炎患者108例,采用随机数字法分为两组。对照组给予左氧氟沙星治疗,观察组给予活血补肾方联合左氧氟沙星治疗,分析两组患者治疗后的临床效果。结果两组治疗前中医证候积分组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后主证(小腹胀痛、腰骶胀痛、带下量多)积分、次证(神疲乏力、口腻或纳呆、小便黄、大便干燥)积分低于对照组(P<0.05)。两组治疗前C反应蛋白(CRP)、血红素氧和酶-1(HO-1)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后CRP、HO-1、GM-CSF水平低于对照组(P<0.05)。两组治疗前盆腔炎性包块直径组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后盆腔炎性包块直径(1.24±0.42)cm低于对照组(P<0.05)。观察组不良反应率(7.41%,4/54)与对照组(5.56%,3/54)比较,差异不具有统计学意义(P>0.05)。结论活血补肾方联合左氧氟沙星治疗湿热瘀结型慢性盆腔炎可调节CRP、HO-1、GM-CSF的表达水平,缩小盆腔炎性包块直径,改善症状积分,且不增加不良反应。     

ATP binding cassette G8 T400K polymorphism may affect the risk of gallstone disease among Chinese males

BACKGROUND: Supersaturation of bile with cholesterol is a primary step in the formation of cholesterol gallstones. ATP binding cassette (ABC) G5 and G8 play an important role in regulating sterol absorption and secretion. To investigate a possible association between transporter gene polymorphism and gallstone formation, we examined five common polymorphisms in the ABCG5 (Q604E) and ABCG8 (D19H, Y54C, T400K, A632V) genes in patients with gallstone disease (GS). METHODS: Study subjects included 287 patients with GS and 219 gallstone free controls (GSF). Polymorphisms were determined using PCR-RFLP analysis or the Taqman MGB assay. Plasma and biliary lipid levels were measured. RESULTS: 2 SNPs of ABCG8 gene (Y54C and T400K) showed strong linkage disequilibrium (D'=0.824, r2=0.579). Male carriers of the less frequent K allele of ABCG8 T400K had a 2.31-fold elevated risk [95% confidence interval (CI) 1.12 approximately 4.76, P=0.023] for gallstone disease compared to male with the common genotype after the adjustment for age, body mass index. Males with the K allele had lower plasma triglyceride (P=0.044) and biliary phospholipid (P=0.035) levels than TT homozygotes. No such association was found in female or other 4 SNPs. CONCLUSIONS: These findings indicate that the T400K polymorphism in ABCG8 may be associated with the incidence of gallstone disease in males.     

Postsecondary Pathways and Persistence for STEM Versus Non-STEM Majors: Among College Students with an Autism Spectrum Disorder

Little is known about postsecondary pathways and persistence among college students with an autism spectrum disorder (ASD). This study analyzed data from the National Longitudinal Transition Study-2, 2001–2009, a nationally representative sample of students in special education with an ASD who progressed from high school to postsecondary education. Findings suggest that most college students with an ASD enrolled in a 2-year community college at some point in the postsecondary careers (81 %). Those in science, technology, engineering and mathematics (STEM) fields were more likely to persist in a 2-year community college and were twice as likely to transfer from a 2-year community college to a 4-year university than their peers in the non-STEM fields. College persistence rates varied by gender, race, parent education level, and college pathway and major. Educational policy implications are discussed.     

mir-300 Promotes Self-Renewal and Inhibits the Differentiation of Glioma Stem-Like Cells

MicroRNAs (miRNAs) are small noncoding RNAs that have been critically implicated in several human cancers. miRNAs are thought to participate in various biological processes, including proliferation, cell cycle, apoptosis, and even the regulation of the stemness properties of cancer stem cells. In this study, we explore the potential role of miR-300 in glioma stem-like cells (GSLCs). We isolated GSLCs from glioma biopsy specimens and identified the stemness properties of the cells through neurosphere formation assays, multilineage differentiation ability analysis, and immunofluorescence analysis of glioma stem cell markers. We found that miR-300 is commonly upregulated in glioma tissues, and the expression of miR-300 was higher in GSLCs. The results of functional experiments demonstrated that miR-300 can enhance the self-renewal of GSLCs and reduce differentiation toward both astrocyte and neural fates. In addition, LZTS2 is a direct target of miR-300. In conclusion, our results demonstrate the critical role of miR-300 in GSLCs and its functions in LZTS2 inhibition and describe a new approach for the molecular regulation of tumor stem cells.     

Prognostic Factors of Patients with Spinal Chondrosarcoma: A Retrospective Analysis of 98 Consecutive Patients in a Single Center

Purpose

Chondrosarcoma (CHS) in the spine is relatively rare and minimal information has been published in the literature regarding this subject. The objective of our study was to discuss the factors that may affect outcomes of patients with spinal CHS.

Methods

Univariate and multivariate analyses were performed to identify prognostic factors for recurrence, distant metastasis, and survival of spinal CHS. T test, χ ² test and rank sum test were used to analyze a single factor for recurrence and metastasis, while survival rate was estimated using the Kaplan–Meier method. Factors with p values of ≤0.1 were subjected to multivariate analyses by binary logistic regression analyses or Cox regression analyses. p Values of ≤0.05 were considered statistically significant.

Results

A total of 98 patients with spinal CHS were included in the study. The mean follow-up period was 49.7 months (range 6–178). Recurrence was detected in 42 patients after initial surgery in our center, while distant metastasis and death occurred in 24 and 32 cases, respectively. The statistical analyses suggested that pathology grade III was closely related with distant metastasis which was an independent prognostic factor for overall survival. Total en bloc spondylectomy could significantly decrease the risk of recurrence, distant metastasis, and death of patients with spinal CHS.

Conclusions

Total en bloc spondylectomy could significantly decrease the risk of recurrence and distant metastasis, and meanwhile improve overall survival of spinal CHS. Distant metastasis which was closely associated with pathology grade III was an adverse prognostic factor for overall survival of spinal CHS.     

手术病人麻醉后恢复的特点

分析１９９５年８月至１９９６年１１月麻醉恢复室接收４３３例病人的情况，以期了解手术后麻醉恢复期护理的特点。其中男性４０．６％，女性５９．４％，平均年龄５４．１±１４．７岁（６～８２岁），平均停留时间４４ｍｉｎ（５～２６５ｍｉｎ），９８．８％的病人平稳恢复后送回病房，１．２％的病人转入ＳＩＣＵ。实施麻醉方法除６例为连续硬膜外麻醉或腰麻外，余为全麻或强化麻醉。根据Ｒａｍｓａｙ评分法，入室时９５％以上病人５～６分，出室时９２％的病人是４分以下，所有病人血压、心率无显著变化，没有给予任何血管活性药物。入室时６３．３％的病人自主呼吸已经恢复。由于麻醉药和肌肉松弛药对中枢和呼吸肌的残留抑制作用，术后早期病人最易出现缺氧。因此全麻术后必须认真监测病人呼吸功能恢复情况，提高吸入氧浓度，根据病情需要保留气管导管，或短时间的机械通气，提高吸入氧浓度，以保证病人呼吸道通畅，避免ＣＯ２的潴留，特别是缺氧的发生。从观察病例可以看出，全麻术后未能立即清醒，平均约４５ｍｉｎ后意识方能满意恢复。