芳香疗法和音乐干预对乳腺癌患者围手术期疼痛和焦虑的影响

目的：探讨芳香疗法和音乐干预对乳腺癌患者围手术期焦虑及疼痛反应的影响。方法：招募湖南省某综 合性三级甲等医院乳甲外科收治的100例接受乳腺癌根治术治疗的患者,将患者随机分为对照组、芳香治疗组、音 乐干预组及联合干预组,每组25例。对照组给予常规护理;在常规护理基础上,芳香治疗组及音乐干预组在手术前 60 min及术后麻醉苏醒拔出气管插管后立即给予芳香干预或音乐干预;联合干预组在常规护理基础上同时给予芳香及 音乐干预。对各组患者在术前30 min(T1)、术后麻醉苏醒拔除气管导管后30 min(T2)及拔管4 h(T3)3个时间点的焦虑、 疼痛进行评分并比较。结果：患者术后(T2,T3)疼痛程度明显高于术前(T1),与对照组比较,各干预组在T3时间点 疼痛程度明显减轻(P<0.05);患者术前焦虑状态最明显(T1),随着麻醉苏醒,患者焦虑状态逐渐减轻,与对照组比 较,各干预组在术后(T2,T3)焦虑程度明显降低(P<0.05)。结论：芳香疗法和音乐干预能减轻乳腺癌患者围手术期的 焦虑与疼痛,使患者在情绪体验及躯体反应两方面获得良好的改善。     

Segond骨折诊断及治疗

目的 探讨Segond骨折的临床特点和诊疗方法 .方法 2007年6月-2008年4月收治6例Segond骨折,男5例,女1例,平均年龄38岁.所有病例均行关节镜探查.其中中前交叉韧带完全断裂1例.前交叉韧带不全断裂3例,前交叉韧带挫伤2例,合并半月板损伤4例,合并腓骨头骨折与外侧副韧带损伤4例.其中1例行前交叉韧带重建术,4例行外侧副韧带修补,4例行半月板成型术.结果 6例患者术后均随访6～11个月,平均8个月.Lysholm术后评分平均为42分,所有病例均获得满意效果.结论 Segond骨折常合并有膝关节内组织结构损伤,早期治疗应早期发现,避免关节失稳的出现.     

Comparison of Efficacy Between Endoscopic Cyclophotocoagulation and Alternative Surgeries in Refractory Glaucoma: A Meta-analysis

Refractory glaucoma refers to uncontrolled intraocular pressure (IOP) despite anti-glaucoma medication and surgical treatment, which remains a challenge to be treated. The objective of this study is to evaluate and statistically compare the clinical efficacy between endoscopic cyclophotocoagulation (ECP) and alternative surgical techniques in the treatment of refractory glaucoma in this article, as a meta-analysis.Data sources are China Biomedical Database (Sinomed, online version), China National Knowledge Infrastructure (CNKI), Cqvip, Wanfang database, and PubMed.The randomized controlled trial (RCT) and case–control study literatures evaluating the clinical efficacy between ECP and other surgical techniques were searched electronically from public databases. The methodology quality of the retrieved articles was evaluated according to the RCT or case–control study criteria. The success rate of treatment, intraocular pressure (IOP) and visual acuity were statistically compared. RevMan 5.3 software was used for the meta-analysis.In total, 6 relevant control studies were selected in this study with a total sampling of 429 cases (429 eyes), including 204 eyes in the ECP group and 225 in the non-ECP group. Meta-analysis demonstrated that the clinical efficacy did not significantly differ between 2 groups (P > 0.05). Postoperative IOP was dramatically reduced in both groups. However, it was difficult to evaluate the combined influence of ECP and non-ECP therapies upon IOP reduction.In conclusion, ECP and non-ECP treatment yielded almost equivalent clinical efficacy in treating refractory glaucoma. The IOP-lowering degree, safety, and incidence of complications remain to be further elucidated by RCTs with a larger sample size.     

XIAP、TGF-β1和vimentin在乳腺癌中的表达及临床意义

目的探讨X染色体连锁的凋亡抑制蛋白(XIAP)、转化生长因子-β1(TGF-β1)和波形蛋白(vimentin)在乳腺癌中的表达情况及临床意义。方法选取82例乳腺癌患者的乳腺癌组织标本及其癌旁正常组织标本。采用免疫组织化学染色法检测不同组织中XIAP、TGF-β1和vimentin的阳性表达情况,分析乳腺癌组织中XIAP、TGF-β1和vimentin的阳性表达情况与患者临床特征的关系,并对乳腺癌组织中XIAP、TGF-β1和vimentin表达的相关性进行分析。结果 XIAP、TGF-β1、vimentin在乳腺癌组织中的阳性表达率均明显高于癌旁正常组织,差异均有统计学意义(P﹤0.01)。TNM分期为Ⅲ～Ⅳ期、有淋巴结转移乳腺癌患者乳腺癌组织中XIAP、TGF-β1和vimentin的阳性表达率均高于TNM分期为Ⅰ～Ⅱ期、无淋巴结转移的乳腺癌患者,差异均有统计学意义(P﹤0.05)。不同年龄、肿瘤直径、肿瘤分化程度乳腺癌患者乳腺癌组织中XIAP、TGF-β1和vimentin的阳性表达率比较,差异均无统计学意义(P﹥0.05)。Pearson相关性分析结果显示,乳腺癌组织中XIAP与TGF-β1的表达、XIAP与vimentin的表达、TGF-β1与vimentin的表达均呈明显正相关(r=0.543、0.584、0.657,P﹤0.01)。结论 XIAP、TGF-β1和vimentin在乳腺癌组织中的表达水平较高,可作为判断乳腺癌发生和淋巴结转移的参考指标。     

真性红细胞增多症并肠梗阻、抗磷脂综合征一例

静脉血栓栓塞性疾病是住院患者常见的并发症之一,具有发生率高、病死率高和住院费用增加等特点。本文报道1例67岁既往有真性红细胞增多症（PV）病史的男性,进食不当后出现腹胀、腹痛。增强CT显示小肠梗阻（SBO）、肠穿孔、阑尾炎和腹膜炎。经禁食、放置肠梗阻减压管、药物抗感染等非手术治疗后,肠梗阻症状改善且病灶局限化。但患者随后出现以左侧锁骨下静脉、颈内静脉和上肢静脉为主的血栓。笔者考虑肠梗阻导致的脓毒症和PV可能是静脉血栓形成的主要因素,给予普通肝素抗凝、羟基脲治疗PV。实验室化验血清抗心磷脂抗体、抗β2糖蛋白1抗体、狼疮抗凝物阳性。经积极的抗凝、糖皮质激素、羟氯喹和抗感染治疗,患者病情改善。出院后随访半年,患者大部分血栓消失。抗磷脂综合征（APS）和骨髓增生性肿瘤（MPN）均与血栓形成风险增加有关,但二者同时存在的报道并不多见。早期针对血栓的病因诊断及治疗对改善病程、预后至关重要。     

Temperature dependence of protein folding kinetics in living cells

We measure the stability and folding rate of a mutant of the enzyme phosphoglycerate kinase (PGK) inside bone tissue cells as a function of temperature from 38 to 48 °C. To facilitate measurement in individual living cells, we developed a rapid laser temperature stepping method capable of measuring complete thermal melts and kinetic traces in about two min. We find that this method yields improved thermal melts compared to heating a sample chamber or microscope stage. By comparing results for six cells with in vitro data, we show that the protein is stabilized by about 6 kJ/mole in the cytoplasm, but the temperature dependence of folding kinetics is similar to in vitro. The main difference is a slightly steeper temperature dependence of the folding rate in some cells that can be rationalized in terms of temperature-dependent crowding, local viscosity, or hydrophobicity. The observed rate coefficients can be fitted within measurement uncertainty by an effective two-state model, even though PGK folds by a multistate mechanism. We validate the effective two-state model with a three-state free energy landscape of PGK to illustrate that the effective fitting parameters can represent a more complex underlying free energy landscape.     

Optimized mouse model of embolic MCAO: From cerebral blood flow to neurological outcomes

The embolic middle cerebral artery occlusion (eMCAO) model mimics ischemic stroke due to large vessel occlusion in humans and is amenable to thrombolytic therapy with rtPA. However, two major obstacles, the difficulty of the eMCAO surgery and unpredictable occurrence of clot autolysis, had impeded its application in mice. In this study, we modified catheters to produce suitable fibrin-rich embolus and optimized the eMCAO model using cerebral blood flow (CBF) monitored by both laser Doppler flowmetry (LDF) and 2D laser speckle contrast imaging (LSCI) to confirm occlusion of MCA. The results showed that longer embolus resulted in higher mortality. There was a compensatory increase in MCA territory perfusion after eMCAO associated with decreased infarct volume; however, this was only partly dependent on recanalization as clot autolysis was only observed in ∼30% of mice. Cortical CBF monitoring with LSCI showed that the size of peri-core area at 3 h displayed the best correlation with infarct volume that is attributed to compensatory collateral blood flow. The peri-core area best predicted functional outcome after eMCAO. In summary, we developed a reliable eMCAO mouse model that better mimics embolic ischemic stroke in humans, which will increase the potential for successful translation of stroke neuroprotective therapies.     

Surface Modification of Biomedical Ti and Ti Alloys: A Review on Current Advances

Ti is widely used as a material for orthopedic implants. As rapid and effective osseointegration is a key factor for the successful application of implants, biologically inert Ti materials start to show inherent limitations, such as poor surface cell adhesion, bioactivity, and bone-growth-inducing capabilities. Surface modification can be an efficient and effective approach to addressing the biocompatibility, mechanical, and functionality issues of the various Ti implant materials. In this study, we have overviewed more than 140 papers to summarize the recent progress in the surface modification of Ti implants by physical and/or chemical modification approaches, aiming at optimizing their wear resistance, biocompatibility, and antimicrobial properties. As an advanced manufacturing technology for Ti and Ti alloys, additive manufacturing was particularly addressed in this review. We also provide an outlook for future research directions in this field as a contribution to the development of advanced Ti implants for biomedical applications.     

胃癌血清转化生长因子-β1和铁蛋白水平的临床研究

目的探讨转化生长因子(TGF-β1)和铁蛋白(SF)在胃癌血清中的水平及其临床意义.方法应用ELISA法对35例胃癌患者TGF-β1和SF水平进行测定,并同期检测24例健康人的血清TGF-β1和SF水平作对照.结果胃癌患者血清TGF-β1和SF水平均明显高于正常人(P＜0.01);分化较差组、浆膜浸润组及有淋巴结转移组均分别明显高于分化较好组、无浆膜漫润组及无淋巴结转移组(P＜0.05);胃癌组血清TGF-β1和SF水平呈正相关(P＜0.01).结论血清TGF-β1和SF可能在胃癌的浸润和转移过程中发挥某种相似作用.