Anti-Interleukin-6 Therapy Decreases Hip Synovitis and Bone Resorption and Increases Bone Formation Following Ischemic Osteonecrosis of the Femoral Head

Legg-Calvé-Perthes disease (LCPD) is a juvenile form of ischemic femoral head osteonecrosis, which produces chronic hip synovitis, permanent femoral head deformity, and premature osteoarthritis. Currently, there is no medical therapy for LCPD. Interleukin-6 (IL-6) is significantly elevated in the synovial fluid of patients with LCPD. We hypothesize that IL-6 elevation promotes chronic hip synovitis and impairs bone healing after ischemic osteonecrosis. We set out to test if anti-IL-6 therapy using tocilizumab can decrease hip synovitis and improve bone healing in the piglet model of LCPD. Fourteen piglets were surgically induced with ischemic osteonecrosis and assigned to two groups: the no treatment group (n = 7) and the tocilizumab group (15 to 20 mg/kg, biweekly intravenous injection, n = 7). All animals were euthanized 8 weeks after the induction of osteonecrosis. Hip synovium and femoral heads were assessed for hip synovitis and bone healing using histology, micro-CT, and histomorphometry. The mean hip synovitis score and the number of synovial macrophages and vessels were significantly lower in the tocilizumab group compared with the no treatment group (p < .0001, p = .01, and p < .01, respectively). Micro-CT analysis of the femoral heads showed a significantly higher bone volume in the tocilizumab group compared with the no treatment group (p = .02). The histologic assessment revealed a significantly lower number of osteoclasts per bone surface (p < .001) in the tocilizumab group compared with the no treatment group. Moreover, fluorochrome labeling showed a significantly higher percent of mineralizing bone surface (p < .01), bone formation rate per bone surface (p < .01), and mineral apposition rate (p = .04) in the tocilizumab group. Taken together, tocilizumab therapy decreased hip synovitis and osteoclastic bone resorption and increased new bone formation after ischemic osteonecrosis. This study provides preclinical evidence that tocilizumab decreases synovitis and improves bone healing in a large animal model of LCPD. © 2020 American Society for Bone and Mineral Research (ASBMR).     

三金排石汤辅助输尿管镜钬激光碎石术治疗输尿管结石临床研究

目的：观察三金排石汤辅助输尿管镜钬激光碎石术治疗输尿管结石的排石效果。方法：将115例输尿管结石患者,按随机数字表法分为治疗组58例与对照组57例。对照组给予输尿管镜钬激光碎石术治疗,治疗组在输尿管镜钬激光碎石术后加用三金排石汤治疗。观察2组治疗后排石效果、炎症因子[肿瘤坏死因子-α(TNF-α)、C-反应蛋白（CRP）]水平、应激反应指标[超氧化物歧化酶（SOD）、过氧化氢酶（CAT）]水平及并发症。结果：治疗组结石残余率为5.17%,低于对照组19.30%,2组比较,差异有统计学意义（P<0.05）;治疗组结石排尽率为94.83%,高于对照组80.70%,2组比较,差异有统计学意义（P<0.05）。治疗组结石排尽时间明显短于对照组、VAS评分明显低于对照组,差异均有统计学意义（P<0.05）。治疗前,2组TNF-α、CRP水平比较,差异无统计学意义（P>0.05）。治疗后,2组TNF-α、CRP水平较治疗前降低（P<0.05）;且治疗组TNF-α、CRP水平低于对照组（P<0.05）。治疗前,2组SOD、CAT水平比较,差异无统计学意义（P>...     

Giant hepatic extra-gastrointestinal stromal tumor treated with cytoreductive surgery and adjuvant systemic therapy: A case report and review of literature

BACKGROUNDPrimary extra-gastrointestinal stromal tumors (E-GIST) of the liver are rare. The clinical presentation may range from asymptomatic to bleeding or manifestations of mass effect. Oncologic surgery followed by adjuvant therapy with imatinib is the standard of care. However, under specific circumstances, a cytoreductive approach may represent a therapeutic option. We describe herein the case of an 84-year-old woman who presented with a tender, protruding epigastric mass. Abdominal computed tomography scan revealed a large, heterogeneous mass located across segments III, IV, V, and VIII of the liver. The initial approach was transarterial embolization of the tumor, which elicited no appreciable response. Considering the large size and central location of the tumor and the advanced age of the patient, non-anatomic complete resection was indicated. Due to substantial intraoperative bleeding and hemodynamic instability, only a near-complete resection could be achieved. Histopathology and immunohistochemical staining confirmed the diagnosis of primary E-GIST of the liver. Considering the risk/benefit ratio for therapeutic options, debulking surgery may represent a strategy to control pain and prolong survival.CASE SUMMARYHere, we present a case report of a patient diagnosed with E-GIST primary of the liver, which was indicated a cytoreductive surgery and adjuvant therapy with imatinib.CONCLUSIONE-GIST primary of the liver is a rare conditional, the treatment is with systemic therapy and total resection surgery. However, a cytoreductive surgery will be necessary when a complete resection is no possible.     

四川省新型冠状肺炎是否共病基础疾病患者的流行病学特征比较

目的 分析四川省新型冠状病毒肺炎患者的流行病学特征,比较是否共病基础疾病患者的流行病学特征差异。方法 对截至2020年3月1日传染病监测系统中报告的四川省确诊病例开展流行病学调查,描述疫情的总体流行特征,将患者分为合并及未合并基础疾病组,分析比较两组的流行病学特征。结果 共纳入确诊患者538例,其中合并基础疾病组175例。合并组前五位均为慢性基础疾病,分别为高血压、糖尿病、慢性肝病、慢性肺炎及慢阻肺和心脑血管疾病。与非基础疾病的患者相比,具有基础疾病的患者平均年龄更大（t = 2.823,P = 0.031）,出现肌痛、腹泻或其他胃肠道症状的比例更高（P＜0.05）,重症和危重症比例更高（Z = 2.682,P = 0.007）,平均住院时间更长（U = 5.532,P = 0.021）,病死率更高（χ2 = 6.258,P＜0.05）,但在性别、临床症状（发烧、干咳和肺炎）、发病到确诊时间、症状持续时间和病例来源无统计学差异（P＞0.05）。从职业分布来看,农民、家务及待业者占比最多,患基础性疾病的比例更高（P＜0.05）。结论 高血压病、糖尿病等慢性基础疾病可能为新型冠状病毒肺炎的易感因素,合并基础疾病的患者重症及危重症患者比例更高,平均住院时间更长。农民、家务及待业者二类职业人群应给与更多关注。     

一种快速简便的缺失突变方法

为了构建能表达稳定的、不易降解的ＴＭ－ＴＮＦ突变体（ＴＭ－ＴＮＦｍ）的基因，本文用改良的Ｓ－ＰＣＲ和ＯＥ－ＰＣＲ两种定位突变技术，成功地构建了缺失３６个碱基的ｐＢＳＫ－ＴＭ－ＴＮＦ突变重组体。与ＯＥ－ＰＣＲ技术（用两对引物进行两次ＰＣＲ反应）相比较，Ｓ－ＰＣＲ技术（用一对引物做一次ＰＣＲ反应）具有快速、经济、简便等优点，但其突变率较ＯＥ－ＰＣＲ低。     

考马斯亮蓝染色法检测人精子顶体反应的评价

为建立一种检测人精子顶体反应的简便实用的新技术，用３．５％高氯酸水溶液配制０．０５％考马斯亮蓝（Ｒ２５０）染色液浸染人精子３０ｍｉｎ，顶体完整者顶体区染成紫蓝色，顶体反应者则不染。对获能前后和钙离子载体Ａ２３１８７诱导顶体反应的精子进行染色并与经典的顶体反应检测技术ＰＳＡ法对照，两种方法检测顶体反应率无显著差异。方法学检验证明新技术结果可靠。本法操作简便、经济，普通显微镜即可检测，易于推广，克服了原有技术复杂昂贵的缺点，具有研究和临床诊断的良好价值。     

一种基于独立成分分析的功能磁共振数据处理方法

独立成分分析（ICA）是统计信号处理中的一项新技术，用来从混合信号的多维观测中提取具有统计独立性的成分。我们针对功能磁共振数据处理，采用先对相邻的两体元信号作ICA分离，然后与参考信号进行相关，把相关系数大于一定阈值的体元作为刺激引起兴奋的体元，从而实现刺激的功能定位。经实际脑功能磁共振数据试验，初步证明了方法的有效性。     

皖北地区血透患者中TTV感染的研究

目的 :研究皖北地区经输血传播病毒 (TTV)在血透患者中的感染。方法 :选TTVORF1的保守序列作内外引物 ,采用微板核酸杂交 -ELISA方法检测血透患者 6 0例及对照组血清标本中的TTV DNA。结果 :对照组和血透患者间TTV的阳性率差异显著 (P <0 0 5 ) ;TTV阳性和阴性的血透患者 ,在透析次数和透析时间方面有统计学意义 (P<0 0 5 )。结论 :皖北地区一般人群和血透患者中存在TTV感染 ,后者是TTV感染的高危人群。TTV可能与HBV ,HCV ,或HGV有类似的传播途径 ,主要经血液途径传播。