中药熏蒸与人工泪液联用及综合护理对干眼症的治疗效果

【摘要】 目的 探讨中药熏蒸结合西医人工泪液及综合护理对干眼症的治疗效果。方法 选取干眼症患者120例为研究对象,随机分为西医人工泪液治疗37例（A组）、中药熏蒸治疗39例（B组）、中药熏蒸结合人工泪液治疗44例（C组）,三组均行综合护理,连续治疗20天,并随访1个月,用分泌泪液指数、人工泪液使用频率、眼睛不适症状总数及VAS舒适度评价各组治疗后第20天和随访1个月的临床效果。结果 与治疗前相比,治疗第20天,A、B、C三组在泪液分泌指数、眼睛不适症状总数及VAS舒适度均显著改善（P＜0.05）。随访1个月,C组与A组相比,上述指标显著更优（均P＜0.05）;与B组相比,C组眼睛不适症状总数显著减少（P＜0.05）,两眼泪液指数显著增加（P＜0.05）;C组有效率显著高于A及B组（P＜0.05）。结论 在综合护理下,中药熏蒸结合西医人工泪液治疗干眼症效果明显优于单独中医和西医治疗效果,可有效提升患者生活质量。     

新生小鼠颅盖骨间充质干细胞原代培养模型的建立

目的:探索新生小鼠颅盖骨间充质干细胞原代培养的方法?方法:取新生小鼠颅盖骨,采用胶原酶消化获得间充质干细胞,观察细胞的形态及增殖情况,通过细胞周期分析细胞增殖能力,通过流式测定细胞表面标志来分析细胞纯度,对细胞进行成骨成脂诱导分化,并分别予茜素红及油红O染色定性,荧光定量PCR检测成骨标志基因Osteocalcin及成脂标志基因PPARγ?Fabp4表达情况?结果:培养出的纺锤形细胞均一性好?增殖能力强?流式测定细胞表面标志显示细胞纯度好,高表达CD29?CD44,几乎不表达CD34?CD45?诱导分化后分化率高,茜素红染色及油红O染色分别可见较多矿化结节及脂滴,荧光定量PCR显示随分化相关标志基因均明显增高?结论:本研究成功建立了新生小鼠颅盖骨间充质干细胞原代培养模型,为进一步研究间充质干细胞奠定基础?     

沙漠干热环境下猪腹部肠管火器伤后肝组织中NF-κB 、TNF-α的表达

目的探讨沙漠干热环境下猪腹部肠管火器伤后肝脏组织中核因子-κB(NF-κB)和肿瘤坏死因子-α(TNF-α)的表达及其与肝损伤的关系。方法健康长白仔猪42头随机等分为对照组和伤后1、2、4、8、12 h和24 h组,在沙漠干热环境下建立腹部肠管火器伤模型后,用免疫组化及图像分析法测定各组肝脏组织内NF-κB和TNF-α的表达,同时测定血清中ALT水平,在光镜下观察各组肝脏组织学变化。结果伤后各组肝内NF-κB、TNF-α表达明显高于对照组(P<0.05),NF-κB于伤后1 h和4 h出现2个高峰(P<0.05);TNF-α于伤后1h和8 h出现2个高峰(P<0.05);血清ALT水平在伤后明显升高,也于伤后1 h和8 h出现2个高峰(P<0.05);伤后1、2 h组出现逐渐加重的肝细胞水肿、变性,伤后4 h组开始出现逐渐加重的肝细胞点状坏死、灶状坏死和炎细胞浸润,对照组光镜下未见明显的损伤性变化;NF-κB与TNF-α的表达在2 h组和4 h组均有正相关关系(P<0.05)。结论沙漠干热环境下腹部肠管火器伤后肝内NF-κB、TNF-α表达一致性升高,二者在伤后早期表达密切相关,并与肝脏结构和功能损伤变化基本一致,提示NF-κB和TNF-α在沙漠干热环境下腹部肠管火器伤后肝损伤过程中起重要作用。     

基于MEBT／MEBO的ERK1／2和p38信号通路与糖尿病足免疫表达关系的研究

目的：观察烧伤皮肤再生医疗技术[湿润暴露疗法（MEBT）／湿润烧伤膏（MEBO）]对糖尿病足部创面组织细胞外信号调节激酶（ERK）1／2和p38信号通路分子及免疫表达的调控作用及关系,探讨MEBT／MEBO对糖尿病足溃疡的修复机制。方法糖尿病足患者40例予MEBT／MEBO干预治疗,留取治疗前后创面组织行免疫组化检测ERK1／2和p38信号通路关键分子ERK1／2、p38、促分裂原活化蛋白激酶（MAPKK6）、原癌基因（c‐myc）、Akt、活化复制因子2抗体（ATF2）及免疫因子IgA、IgM、IgG、C3c、C4c表达情况,并观察二者间关系。结果经MEBT／MEBO治疗后,39例患者足部创面面积有不同程度缩小,仅1例患者无明显变化,显效14例（35．00％）,有效25例（62．50％）,无效1例（2．50％）。治疗前后信号通路分子全阳性表达、免疫阳性表达（任一指标）及免疫阳性表达（具体指标）比较差异均有统计学意义（P＜0．05）,在创面信号通路分子表达阳性率升高的同时,免疫因子阳性表达率亦升高。治疗前创面组织可见免疫因子极少量分布,治疗后创面组织免疫因子IgA、IgM、IgG、C3c、C4c呈广泛、弥漫分布。治疗前创面组织可见信号分子极少量分布,治疗后创面组织信号通路分子ERK1／2、p38、MAPKK6、c‐myc、Akt、ATF2呈广泛、弥漫分布。结论MEBT／MEBO可能促进了糖尿病足创面ERK1／2和p38信号通路分子及免疫表达,ERK1／2和p38信号通路及其交互作用可能通过增加创面组织免疫表达而促进了糖尿病足创面的愈合。     

直接前入路与后外侧入路初次全髋关节置换术患者的临床疗效比较

目的 研究经直接前入路和后外侧入路初次全髋关节置换术（THA）患者的临床疗效。方法 选取2016年1月—2019年7月于安徽医科大学第二附属医院骨科行初次单侧全髋关节置换术285例患者的临床资料。其中采用直接前入路（DAA）患者100例作为DAA组,后外侧入路（PLA）患者185例作为PLA组。观察并分析两组患者失血量、手术时间等围手术期指标,VAS评分、Harris评分及髋关节活动（屈曲、后伸、内收、外展、内旋、外旋）等功能评价指标。结果 DAA组失血总量、隐性失血量、隐性失血量占比小于PLA组（P <0.05）,手术时间、直腿抬高时间短于PLA组（P <0.05）。两组患者不同时间点的Harris评分、VAS评分、ROM指标比较,经重复测量设计的方差分析,结果 ①不同时间点Harris评分、VAS评分、ROM指标有差异（P <0.05）;②两组患者Harris评分、VAS评分有差异（P <0.05）,ROM指标无差异（P >0.05）;③两组患者Harris评分、VAS评分变化趋势有差异（P <0.05）,ROM指标变化趋势比较无差异（P >0.05）。结论 采用DAA行初次单侧THA可有效降低围手术期的失血量、缩短手术时间、减少术后疼痛,有利于早期功能恢复。     

CAD/CAM技术Vita MarkⅡ全瓷嵌体充填治疗磨牙Ⅱ类洞缺损患者的效果

目的 探究计算机辅助设计/制造(CAD/CAM)技术Vita MarkⅡ全瓷嵌体充填治疗磨牙Ⅱ类洞缺损患者的效果。方法 选取我院2016年11月～2019年8月磨牙Ⅱ类洞缺损患者40例,随机数字表法分为对照组(n=20,20颗牙)与观察组(n=20,20颗牙)。对照组给予复合树脂嵌体修复治疗,观察组给予CAD/CAM技术Vita MarkⅡ全瓷嵌体充填治疗。修复3个月,评估两组修复成功率、牙周相关指标[牙菌斑指数(PIL)、龈沟出血指数(SBI)、牙龈指数(GI)]、微渗漏程度。结果 两组修复成功率无显著差异(P＞0.05);修复3个月观察组PIL、SBI、GI低于对照组(P＜0.05);观察组龈壁、轴壁微渗漏程度低于对照组(P＜0.05)。结论 CAD/CAM技术Vita MarkⅡ全瓷嵌体充填治疗磨牙Ⅱ类洞缺损患者,可保护牙周健康,降低龈壁、轴壁微渗漏程度。     

Elevated Expression of Transmembrane IL-15 in Immune Cells Correlates with the Development of Murine Lupus: a Potential Target for Immunotherapy Against SLE

Presentation in trans by the Interleukin-15 receptor α chain (IL-15Rα) has been suggested as the main mechanism for IL-15 anchoring to the cell surface, but it is also evident that IL-15 can exist as a transmembrane protein. We herein demonstrate that replacement of the first 41 residues of human IL-15 (hIL-15) with Ig κ chain leader sequence resulted in secretion of most of the recombinant hIL-15 expressed in transfectant cells, thus identifying the transmembrane region of IL-15. A fusion protein (hIL-15Rα-Fc) between the extracellular domain of hIL-15Rα and the Fc fragment of IgG1 was prepared and shown to be able to bind with transmembrane IL-15 (tmIL-15). The level of tmIL-15 expression in macrophages, activated T cells and B cells from 6-month-old BXSB male mice, an animal model for systemic lupus erythematosus (SLE), was significantly increased compared with that from BXSB females or young males. In addition, hIL-15Rα-Fc was able to block the T cell stimulating and anti-apoptotic effect of the tmIL-15-positive BXSB macrophages in vitro . Intravenous administration of hIL-15Rα-Fc reduced the titre of autoantibodies against dsDNA and also proteinuria in aged BXSB males, implying that neutralization of IL-15 activity in vivo may be an effective way of treating SLE.     

Impact of tension‐free vaginal tape procedure on dysfunctional voiding in women with stress urinary incontinence

Objectives: To determine the prevalence of dysfunctional voiding (DV) in female stress urinary incontinence (SUI) and its modification after tension‐free vaginal tape (TVT) procedure. Methods: Three hundred and sixty women with SUI were enrolled and underwent urodynamics from 2002 to 2008. DV was determined when non‐neurogenic detrusor‐sphincter dyssynergia occurred during voluntary voiding. It was further quantitatively analyzed using the tense/loose value, a parameter derived from external anal sphincter electromyogram. The distribution of other urodynamic variables was also evaluated. One hundred and fifty patients underwent the TVT procedure and forty of them were studied with urodynamics after surgery during follow up. Results: Overall, DV was diagnosed in ninety‐nine patients, with a prevalence of 27.5%. The functional profile length in SUI women with DV was significantly shorter than that in SUI women without DV (3.13 ± 0.76 vs 3.32 ± 0.65, P = 0.017). After the TVT procedure, the recovery of SUI between cases with and without DV showed no significant difference. The rate of DV state change after the surgery, namely from with to without DV or from without to with DV, significantly differed between the female patients with and without DV (66.7% vs 3.6%, P < 0.05) during follow up. The DV improved after the surgery in SUI women with DV. Conclusions: DV might represent a coexistent finding in women with SUI. The main difference of women with SUI and DV, as compared with those without DV, is a shortened functional profile length. In such cases, TVT procedure can improve DV along with the treatment of SUI.