Conservative management of early endometrial adenocarcinoma with repeat curettage and hormone therapy under assistance of hysteroscopy and laparoscopy

We report a rare case of early-stage endometrial adenocarcinoma in a 22 year old nullipara with polycystic ovaries undergoing conservative treatment. Pretreatment evaluation including tumour grade, depth of myometrial invasion, tumour size, hormone receptor status and flow cytometric analysis indicated a favourable prognosis. The patient underwent repeat endometrial curettage and a 6 month period of therapy with megestrol acetate and tamoxifen. A combination contraceptive pill was then prescribed to ensure withdrawal of the menstrual cycle thereafter. Now, 1 year after the last curettage, there is no evidence of disease. During the treatment period, hysteroscopy allowed for a more precise approach in panoramically examining the tumour nest in the endometrial cavity, and the subsequent endometrial response to hormone therapy. Laparoscopy using bulldog clamps applied to the isthmic portion of the Fallopian tubes prevented i.p. spread of endometrial tissue from retrograde regurgitation during hysteroscopy. Laparoscopic ovarian electrocautery resulted in the reduction of abnormal hypervascularization on the surface of polycystic ovaries postoperatively but caused a peri-ovarian adhesion complication. It is interesting that this case posed a unique opportunity to demonstrate the tumour regression under the assistance of laparoscopy and hysteroscopy.      

Structural abnormalities of autosomal chromosomes in the male partner do not influence fertilization and early development of embryos after intracytoplasmic sperm injection

The objective of this study was to determine whether or not abnormalities in the autosomal structure of the male partner have any influence on fertilization and early embryo development after intracytoplasmic sperm injection (ICSI). Thirty-seven couples in whom the male partners were examined by the same andrologist were included in this study. Six couples (group I) in whom the male partner possessed autosomal structural abnormality underwent seven ICSI cycles. As a control group, 31 couples (group II) in which the male partner was karyotypically normal underwent 41 ICSI cycles. Although the normal fertilization rates seen in group I were significantly higher than those in group II (P < 0.05), there was no significant difference in the cleavage rates between the two groups. We did not perform the analysis of the female partner's chromosomes, but we surmise that structural autosomal abnormalities in the male partner do not adversely influence fertilization at ICSI and early development of embryos.      

孤独症谱系障碍儿童睡眠障碍的评估和干预

睡眠障碍是孤独症谱系障碍(ASD)儿童最常见的共患障碍之一,不仅与ASD儿童核心症状存在显著相关,还会影响患儿的功能水平、生活质量以及干预康复效果,给父母造成巨大养育压力和经济负担。国际上已将睡眠障碍,特别是失眠纳入到ASD的综合诊治之中,但国内相关工作开展滞后,儿科专业人员对ASD儿童睡眠障碍的诊治能力有待提升。 因此,本研究将介绍ASD儿童睡眠障碍的评估和干预方法,为临床和研究工作提供依据。     

基于胸痛中心急救流程在急性心肌梗死患者救治中的应用

目的探讨基于胸痛中心急救流程在急性心肌梗死(AMI)患者救治中的应用效果。 方法选取镇江市急救中心2017年8月至2021年8月接诊的94例AMI患者为研究对象,其中男性50例,女性44例;年龄42~81岁,平均(60.37±4.31)岁。根据就诊顺序分为对照组和研究组,每组各47例,对照组患者接受常规急救流程,研究组患者接受基于胸痛中心基础上的急救流程,比较两组患者急救各环节时间、不良心血管事件发生率及患者满意度。 结果研究组患者急救各环节时间较对照组更短,两组比较差异有统计学意义(P<0.05);研究组患者不良心血管事件发生率显著低于对照组(6.38%比23.40%),两组比较差异有统计学意义(P<0.05);研究组患者满意度显著高于对照组(93.62%比78.72%),两组比较差异有统计学意义(P<0.05)。 结论基于胸痛中心急救流程可有效缩短急救过程中各环节时间,最大限度降低不良心血管事件发生风险,患者满意度高,对提高AMI患者救治效果、改善预后具有积极意义。     

Mesenteric neovascularization during spring-mediated intestinal lengthening

BackgroundShort gut syndrome, a condition characterized by inadequate absorption of nutrients owing to decreased bowel length, has minimal avenues for treatment. We have proposed spring-mediated distraction enterogenesis to lengthen bowel in porcine jejunum as a treatment for short gut. We aim to evaluate the extent of mesenteric neovascularization in segments of lengthened bowel via spring-mediated enterogenesis.MethodsFemale juvenile Yucatan pigs underwent laparotomy and insertion of gelatin-encapsulated compressed nitinol springs, held in place with plication sutures, into the jejunum. At surgery and sacrifice, macroscopic mesenteric blood vessels were counted between the plication sites. Histologic samples of the mesentery were obtained to evaluate microscopic vasculature.ResultsA statistically significant increase in macroscopic mesenteric blood vessels was seen after intestinal lengthening (before: 1.9 ± 0.7 vessels, after: 4.7 ± 1.2 vessels, p = 0.001). A statistical significance is also seen in the density of arterioles (control: 3.0 ± 3.0 vessels/mm, spring: 7.0 ± 9.0 vessels/mm, p = 0.01) and venules (control: 4.0 ± 3.0 vessels/mm, spring: 8.0 ± 8.0 vessels/mm, p = 0.003).ConclusionIntestinal segments lengthened by intraluminal springs demonstrated total greater number of macroscopic vessels and microscopic blood vessels per length of mesentery as compared to control. This suggests local changes within the mesentery to recruit blood supply to growing intestine.Level of evidenceN/AType of studyTreatment study.     

Mechanical lengthening of porcine small intestine with decreased forces

Introductionshort bowel syndrome is marked by inadequate intestinal surface area to absorb nutrients. Current treatments are focused on medical management and surgical reconfiguration of the dilated intestine. We propose the use of spring-mediated distraction enterogenesis as a novel intervention to increase intestinal length. Given our previous success lengthening intestinal segments using springs with spring constant ~7 N/m that exerts 0.46 N or higher, we sought to determine the minimal force needed to lengthen porcine small intestinal segments, and to explore effects on intestine over time.MethodsJuvenile Yucatan pigs underwent laparotomy with enterotomy to introduce nitinol springs intraluminally (n = 21 springs). Bowel segments (control, spring-distracted) were retrieved on post-operative day (POD) 7 and 14, and lengths measured. Thickness of cross-sectional intestinal layers were measured using H&E, and submucosal collagen fiber orientation measured using trichrome stained sections.Resultsall pigs survived to POD7 and 14. Spring constants of at least 2 N/m exerting a minimum force of 0.10 N significantly lengthened intestinal segments (p <0.0001). The stronger the spring force, the greater the induced thickness of various intestinal layers at POD7 and 14. Collagen fiber orientation was also more disordered because of stronger springs.Conclusiona spring constant of approximately 2 N/m exerting 0.10 N and greater significantly lengthens intestinal segments and stimulates intestinal structural changes at POD7 and 14. This suggests a decreased force is capable of inducing spring-mediated distraction enterogenesis.     

自制IPS-Empress2铸瓷快速包埋材料物理机械性能表征

为降低IPS-Empress2铸瓷修复成本,研制了国产化包埋材料,以取代昂贵的进口专用包埋材料.对自制包埋材料的物理机械性能进行表征,与进口材料进行比较和统计分析,并用扫描电镜观察两种材料表面形貌的异同点.结果显示:自制包埋材料的凝固时间为9 min,烧结前密度为1.813 g/cm3,烧结后密度为1.402 g/cm3,开口孔隙率38.1%,凝固2 h后抗压强度和烧结后抗压强度分别为5.42 MPa和8.37 MPa,且耐火度在1000 ℃以上,高于铸造温度(920℃).与进口材料相比,自制包埋材料凝固时间更短,烧结前密度、凝固2h后抗压强度和烧结后抗压强度更高;开口孔隙率、烧结后密度和耐火度无统计学差异.扫描电镜观察显示两种材料结构相似,但自制材料的晶体尺寸略小于进口材料.可见自制包埋材料的主要物理机械性能指标接近或优于进口专用包埋材料,具有良好的临床应用前景.     

海绵中抗肿瘤抗病毒生物活性的生物碱研究进展

海绵中含有很多结构新颖且具有显著生物活性的生物碱。对近5年来具有抗肿瘤、抗病毒生物活性的生物碱加以概括。     

锌促进体外培养大鼠成骨细胞的增殖及分化

目的　研究锌对体外培养大鼠成骨细胞增殖和分化的影响。方法　从大鼠颅骨分离出成骨细胞,于 Ｄ Ｍ Ｅ Ｍ 培养基中进行传代培养。实验设置４ 个组,分别为对照组和１０ μｍｏｌ／ Ｌ、２５ μｍｏｌ／ Ｌ及５０ μｍｏｌ／ Ｌ Ｚｎ２ ＋ ３ 个剂量组,采用３ Ｈ Ｔｄ Ｒ 参入法确定成骨细胞在不同时点 Ｄ Ｎ Ａ 的合成状况,应用流式细胞仪技术分析细胞周期、３ Ｈ脯氨酸参入法测定胶原蛋白的合成;采用酶动力学和放免方法分别测定碱性磷酸酶活性和骨钙素含量。结果　３ 个锌剂量组细胞３ Ｈ Ｔｄ Ｒ 掺入量在各个时点均明显高于对照组;２５ μｍｏｌ／ Ｌ 及５０ μｍｏｌ／ Ｌ Ｚｎ２ ＋ 可以促进成骨细胞从 Ｇ０／ Ｇ１ 期向 Ｓ期转化。３ 个锌剂量组胶原蛋白、骨钙素的合成量、碱性磷酸酶活性均高于对照组。结论　锌能够促进体外培养大鼠成骨细胞的增殖及分化。     

锌激活体外培养大鼠成骨细胞肌醇磷脂信号转导系统

目的：　研究锌对体外培养大鼠成骨细胞肌醇磷脂信号转导系统的影响。方法：　从大鼠颅骨分离出成骨细胞,于 Ｄ Ｍ Ｅ Ｍ 培养基中进行传代培养。实验分为对照组、１０μｍｏｌ／ Ｌ、２５μｍｏｌ／ Ｌ 及５０μｍｏｌ／ Ｌ Ｚｎ２ ＋ 剂量组：分别测定了 Ｚｎ２ ＋ 对成骨细胞长期或短期作用后蛋白激酶 Ｃ（ Ｐ Ｋ Ｃ） 活性及三磷酸肌醇（ Ｉ Ｐ３） 含量的变化。根据被磷酸化多肽底物的量测定 Ｐ Ｋ Ｃ 活性,按照３ Ｈ ｍ ｙｏ 肌醇掺入及层析分离法测定 Ｉ Ｐ３ 含量。结果：　（１） 三个不同剂量的 Ｚｎ２ ＋ 作用于大鼠成骨细胞３ 天后, Ｉ Ｐ３ 含量及 Ｐ Ｋ Ｃ 活性均显著高于对照组;且随着 Ｚｎ２ ＋ 剂量的增加, Ｉ Ｐ３ 含量及 Ｐ Ｋ Ｃ 活性有相应增加的趋势;（２） 在短期实验中,２５μｍｏｌ／ Ｌ Ｚｎ２ ＋ 对成骨细胞的作用比较明显,仅作用１５ 分钟, Ｉ Ｐ３ 含量即明显提高,且在以后的各个作用时点均明显高于对照组,但时间效应曲线平坦;５０μｍ ｏｌ／ Ｌ Ｚｎ２ ＋ 组 Ｉ Ｐ３ 含量在各个时点略低于２５μｍｏｌ／ Ｌ Ｚｎ２ ＋组;１０μｍ ｏｌ／ Ｌ Ｚｎ２ ＋ 组略高于对照组。２５μｍｏｌ／ Ｌ Ｚｎ２ ＋ 、５０μｍ ｏｌ／ Ｌ Ｚｎ２ ＋ 组 Ｐ Ｋ