改良斜轴位磁共振成像扫描在距腓前韧带损伤中的应用价值

目的  评估改良斜轴位磁共振成像（MRI）检查对慢性踝关节不稳患者距腓前韧带损伤诊断的可靠性及有效性。方法  选取2013年1月-2015年11月从该院预行踝关节镜检查的住院患者中招募研究对象。所有研究对象行踝关节常规轴位及改良斜轴位MRI检查,利用MRI图像评估距腓前韧带损伤,对比上述检查对韧带全长的显示效果,利用ICC指数评估观察者间一致性,以踝关节镜检查结果作为金标准,评估上述检查的敏感性、特异性、阴性预测值,阳性预测值、准确性。结果  招募91例研究对象。其中,男性49例,女性42例,平均（34.6±13.2）岁。常规轴位MRI显示,效果与改良斜轴位MRI的差异有统计学意义（观察者A：Z =-4.987,P =0.000;观察者B：Z =-4.084,P =0.000）,斜轴位MRI检查观察者间ICC指数为0.943,95%CI：0.902,0.987。共有60例患者经关节镜检查确诊为距腓前韧带损伤。改良斜轴位MRI检查的敏感性、特异性、阴性预测值、阳性预测值及准确度：观察者A分别为92%、97%、86%、98%和95%;观察者B分别为95%、94%、91%、97%和95%。结论  对于诊断距腓前韧带损伤,改良斜轴位MRI检查具有很好的观察者间一致性以及突出的诊断价值,可以较好地显示韧带全长,值得在临床推广应用。

     

Effect of esterified hyaluronic acid as middle ear packing in tympanoplasty for adhesive otitis media

Objectives: The goal of this study was to evaluate the effects of middle ear packing agents (MEPA) on post-operative hearing improvement and complications after tympanoplasty in patients with adhesive otitis media (OM).

Materials and methods: Patients with adhesive OM who underwent tympanoplasty surgery were enrolled in the study between January 2012 and January 2015. A total of 205 patients who received canal wall-down tympanoplasty with ossicular chain reconstruction were randomized into one of the three groups with different MEPA. Group 1 (n?=?72) received MeroGel as the MEPA, Group 2 (n?=?64) cartilage, and Group 3 (n?=?69) both. Air conduction (AC) and bone conduction (BC) thresholds at 0.5, 1, 2, and 4?kHz were measured, and air-bone gaps (ABG) were analyzed before and after the surgery for each patient.

Results: Mean pre- and post-operative ABG was 30.9?dB and 17.6?dB in Group 1, 31.4?dB and 21.9?dB in Group 2, and 32.2?dB and 19.1?dB in Group 3. The ABG closure was 13.3?±?7.5 in Group 1, 9.5?±?5.9 in Group 2, and 13.1?±?9.3 in Group 3. The improvement of ABG after surgery was statistically significant in all three groups (p?p?Conclusions: Tympanoplasty using esterified hyaluronic acid (i.e. MeroGel) or cartilage as the MEPA resulted in improved hearing for patients with conductive hearing loss due to adhesive OM. Using MeroGel as the MEPA appeared to achieve a better post-operative outcome than using cartilage.     

醒脑静对急性重度酒精中毒SOD、H_2O_2的影响

目的：观察醒脑静对急性重度酒精中毒H2O2、SOD的影响。方法：符合要求的急性重度酒精中毒患者按随机数字表法分为对照组30例和治疗组30例,对照组给予静脉滴注10%葡萄糖或生理盐水,肌注Vit B1和Vit B6,保护胃黏膜,纠正电解质紊乱等治疗基础上加用纳洛酮治疗;治疗组在对照组治疗基础上加用醒脑静治疗。比较两组患者治疗前后H2O2、SOD的变化。结果：治疗前,两组患者H2O2水平、SOD活力无显著差异（P〉0.05）;治疗后,两组患者H2O2、SOD差值比较有显著差异（P〈0.01）。结论：醒脑静可以降低急性重度酒精中毒患者的H2O2水平、升高急性重度酒精中毒患者的SOD活力,有利于清除氧自由基、保护机体免受损伤。醒脑静注射液可通过改善急性酒精中毒氧化应激损伤而发挥治疗作用。     

EB病毒感染对系统性红斑狼疮临床表现及Th1／Th2平衡的影响

目的：探讨系统性红斑狼疮（SLE）与EB病毒（EBV）感染的相关性及EBV感染对SLE患者Th1／Th2平衡的影响。方法：收集90例SLE患者（SLE组）及70侈4健康对照者（对照组）血液标本,用实时荧光定量PCR法测EBV—DNA特异性片段来检测EBV—DNA的阳性率,ELISA法检测血清中IFN—γ和IL-4的表达水平,四色流式细胞术检测Th1、Th2细胞数和Th1／Th2比值。结果：SLE组EBV—DNA阳性率明显高于对照组（P〈0．01）：SLE患者中,EBV—DNA阳性组比EBV-DNA阴性组具有更高的皮疹、关节炎和血液系统异常发生率以及更高的抗Rib—P抗体、抗Smith抗体、高免疫球蛋白血症阳性率（P〈0．05）,但两者在系统性红斑狼疮疾病活动指数（SLEDAI）评分方面差异无统计学意义（p〉0．05）;SLE患者中,EBV—DNA阳性组血清IL-4浓度和外周血Th2细胞数显著高于EBV—DNA阴性组和对照组（p〈0．01和P〈0．05）,Th1／Th2比值低于EBV—DNA阴性组和对照组（P〈0．05）。结论：EBV感染与SLE密切相关,EBV可能通过促进Th2型免疫反应来促进SLE的发病。     

血清斯钙素⁃1在稳定期慢性阻塞性肺病中的表达及意义

目的：探讨斯钙素?1（stanniocalcin?1,STC1）在稳定期慢性阻塞性肺病（chronic obstructive pulmonary disease,COPD）患者血清中的表达及意义。方法：收集55例稳定期COPD患者,根据肺功能和问卷评分进行相应分组,且以24例健康者作为对照。采用酶联免疫吸附法（ELISA）测定各研究对象的血清斯钙素?1表达情况,进行相关分析。结果：①与健康对照组相比,稳定期COPD患者血清斯钙素?1表达水平明显降低（P < 0.05）。②血清斯钙素?1在初筛COPD上具有一定价值（P=0.025,AUC=0.659）,最佳阈值为1 350 pg/mL（敏感度81.82%;特异度50.00%）。③血清斯钙素?1与稳定期COPD患者病情严重程度［包括GOLD分级、慢阻肺评估测试（COPD assessment test,CAT）评分、ABCD分组、肺功能］无明显相关性。结论：血清斯钙素?1在COPD中显著降低,可能对于COPD的诊治具有一定临床意义。     

氢化可的松和哌替啶治疗急性化脓性阑尾炎麻醉后寒战疗效评价

目的评价氢化可的松和哌替啶对急性化脓性阑尾炎蛛网膜下隙阻滞麻醉后寒战的治疗作用。方法急性化脓性阑尾炎蛛网膜下隙阻滞麻醉后寒战Wrench分级2级及以上的患者73例,随机分为氢化可的松（2．0mg／kg）组、哌替啶（0．05mg／kg）组和生理盐水（10m1）组。术中监测肛温（T）及常规麻醉监测指标。记录各组基础体温（T0）,寒战发生时（T1）,寒战后10min（T2）、30min（T3）、60min（T4）体温,对T1-T4时间点的寒战进行评分,并观察不良反应的发生情况。结果与对照组相比,哌替啶组和氢化可的松组患者麻醉后寒战缓解迅速,持续时间短,症状较轻（P〈0．05）;哌替啶组患者恶心、呕吐发生率较氢化可的松组高（P〈0．05）。结论哌替啶和氢化可的松均可用于麻醉后寒战治疗;氢化可的松较少引起恶心、呕吐等不良反应,更适用于急性化脓性阑尾炎麻醉后寒战的治疗。     

Pathological outcomes in men with prostate cancer who are eligible for active surveillance

Background

In order to prevent over treatment of prostate cancer and significant adverse effects after surgical intervention, active surveillance was suggested in low risk or very low risk patients. This study aimed to retrospectively analyze the adverse pathological results of candidates eligible for active surveillance.

醒脑静注射液对兔内毒素休克的血液流变学影响

目的探讨醒脑静注射液对兔内毒素休克时血液流变学的改变及可能机制。方法日本大耳白兔18只,随机分为正常对照组、LPS组、LPS+XNJ组,每组各6只。用耳缘静脉推注LPS复制兔内毒素休克模型,再推注醒脑静注射液治疗。于0h、1h2、h、3h取血检测血液流变学指标。结果 LPS组与正常组比较,各时间点全血粘度(ηb)、血浆粘度(ηp)、血沉(ESR)、全血还原粘度(ηre)、红细胞聚集指数(EAI)、血沉方程K值(ESRK)均显著增高(P<0.05);LPS+XNJ组与LPS组比较,ηb、ηp、ESR、ηre均降低(P<0.05),且随时间延长其下降更加明显。结论醒脑静注射液能改善内毒素休克兔的血液流变性。     

Two new furaldehyde compounds from the rhizomes of Gastrodia elata

Two new compounds 5-[4′-(4″-hydroxybenzyl)-3′-hydroxybenzyloxymethyl]-furan-2-carbaldehyde (1) and 5-[4′-(4″-hydroxybenzyl)-3′-hydroxybenzyl]-furan-2-carbal-dehyde (2), together with two known 5-(4-hydroxbenzyloxymethyl)-furan-2-carbaldehyde] (3) and 5-(hydroxymethyl)-2-furaldehyde (4), were isolated from the rhizome of Gastrodia elata. Their structures were elucidated by spectroscopic analysis and comparison of their spectral data with those reported previously. All compounds exhibited weak or no cytotoxicity against human colon carcinoma cell line (HT-29) and human chronic myelogenous leukemia cell line (K-562).