三维腹腔镜手术联合醋酸亮丙瑞林治疗盆腔深部浸润型子宫内膜异位症疗效观察

目的 探讨三维(3D)腹腔镜手术联合促性腺激素释放激素激动剂(GnRH-a)治疗盆腔深部浸润型子宫内膜异位症(DIE)的疗效.方法 选取医院2015年7月至2018年7月收治的行3D腹腔镜手术患者110例,分为观察组和对照组,各55例.观察组予皮下注射醋酸亮丙瑞林微球治疗,对照组予孕三烯酮治疗,均持续治疗6个月.结果 ...     

老年人群klotho G-395A、F352V与C370S基因多态性及组合与其血清klotho蛋白水平的相关性研究

目的:探讨重庆市汉族老年人群Klotho G-395A、F352V与C370S 3个位点的单核苷酸多态性(Single nucleotide polymorphism,SNP)及其组合与血清klotho蛋白水平的相关性。方法:随机选择汉族老年人390例,采用等位基因特异性引物PCR技术检测Klotho G-395A、F352V与C370S SNP,酶联免疫吸附试验(Enzyme-linked immunosorbent assay,ELISA)检测其血清klotho蛋白水平。结果:Klotho G-395A、F352V与C370S SNP各等位基因型携带者其血清klotho蛋白水平均无显著性差异(P>0.05)。基因组合分析研究发现Klotho G-395A、F352V与C370S SNP各组合等位基因型携带者其血清klotho蛋白水平差异性较大,其中Klotho G-395G+F352F+C370S携带者较Klotho G-395G+F352F+C370C携带者其血清klotho蛋白水平明显增高(P=0.056)。结论:Klotho G-395A、F352V与C370S SNP各等位基因型携带者其血清klotho蛋白水平无显著性差异,而组合等位基因型研究发现Klotho G-395G+F352F+C370S携带者较Klotho G-395G+F352F+C370C组合等位基因型携带者血清klotho蛋白水平增高有显著性趋势。     

不同处理时间50 Hz 3.6 mT正弦交变磁场对人脐带干细胞增殖与成骨性分化的研究

目的：研究50 Hz 3.6 mT不同处理时间的正弦交变电磁场（Sinusoidal electromagnetic field,SEMFs）对体外培养人脐带干细胞（Human umbilical cord stem cells,HUCSC）增殖与成骨性分化的影响。方法：体外分离培养HUCSC,传代后随机分为6组。用频率50 Hz,3.6 mT的SEMFs分别每天处理HUCSC 0.0（对照组）、 0.5、1.0、1.5、2.0 h和2.5 h,倒置相差显微镜观察细胞形态,MTT法测定细胞增殖,在磁场处理后的15 d 和17 d 分别用茜素红和vonkossa对钙化结节进行染色,在磁场处理后的第4天和第6天 PCR检测胶原Ⅰ（Collagen-Ⅰ）和骨形态发生蛋白（Bone morphogenetic protein-2,BMP-2）mRNA表达量的变化,在磁场处理后的10、12、14 d 和 16 d测定ALP活性。结果：1.0、1.5、2.0 h和2.5 h组促进HUCSC增殖;磁场处理后的7~9 d细胞出现钙化结节;在SEMFs处理后的第14天和第16天0.5 h组和1.0 h组碱性磷酸酶（Alkaline phosphatase,ALP）活性显著高于对照;SEMFs处理组能增加HUCSC钙化面积,其中尤以0.5 h和1.0 h最为明显;SEMFs能增加Collagen-Ⅰ和BMP-2 mRNA表达量,其中尤以0.5 h和1.0 h组作用最为明显。结论：50 Hz,3.6 mT 1.0、1.5、2.0 h和2.5 h促进HUCSC增殖,同时SEMFs组能促进体外培养HUCSC成骨性分化,尤以处理0.5 h和1.0 h促进成骨性分化最为明显。     

股骨近端髓内钉与动力髋螺钉在股骨粗隆部骨折治疗中临床疗效的对比分析

[目的]评价股骨近端髓内钉(PFNA)与动力髋螺钉(DHS)在股骨粗隆骨折治疗中的临床疗效.[方法]将应用PFNA(39例)与DHS(36例)治疗的75例患者,从术中情况、术后并发症以及术后髋关节功能的恢复情况对两种治疗方法的临床疗效进行比较分析.[结果]DHS的手术失血量高于PFNA(P＜0.05),同时其术后并发症也较PFNA明显增多(P＜0.05),髋关节功能Harris评分优秀率也低于PFNA治疗组(P＜0.05).[结论]PFNA在治疗上较DHS具有操作简单、创伤小、骨折固定牢固、并发症少及术后患者可早期离床负重等优点,是一种治疗股骨粗隆间骨折的理想方法,值得临床推广使用.     

补肾行气活血法对骨髓基质干细胞诱导成软骨细胞作用的影响

[目的]观察补肾行气活血法对诱导骨髓基质干细胞(BMSCs)成软骨细胞作用的影响.[方法]将传至第3代的BMSCs分为阴性对照组和治疗组,分别采用软骨细胞诱导培养基加体积分数为10%的空白对照血清和诱导培养基加体积分数10%的骨炎定含药血清培养诱导成软骨细胞,观察软骨细胞的生长状况及细胞表型特征.[结果]治疗组在细胞贴壁、生长形态及成软骨特性方面明显优于对照组,细胞表型的免疫组化染色均为阳性.[结论]以补肾行气活血法为组方依据的骨炎定含药血清既可促进BMSCs的增殖,又可促进诱导的软骨细胞分化.     

Individual and joint effects of borderline ankle-brachial index and high plasma total homocysteine on all-cause death in hypertensive adults

BACKGROUNDThe cardiovascular hazards of total homocysteine (tHcy) are long known. In addition, despite the acknowledgment on the importance of low ankle-brachial index (ABI) (< 0.9), borderline ABI (0.91-0.99) was once commonly overlooked. This study aims to explore the independent and joint effect of tHcy level and borderline ABI on all-cause death in hypertensive population.METHODSThis study included 10,538 participants from China H-type Hypertension Registry Study. ABI was described into two groups: normal ABI (1.00-1.40) and borderline ABI. tHcy level was also divided into two groups: < 15.02 and ≥ 15.02 μmo/L. Four groups were analyzed, using COX proportional hazard regression model, separately and pairwise to observe the independent and joint effect on all-cause death.RESULTSA total of 126 (1.2%) deaths were observed in the 1.7 years follow-up time. Borderline ABI has a higher predicted risk of death than normal ABI (HR = 1.87, 95%CI: 1.17-3.00) after adjusting for potential covariates. Compare with tHcy level < 15.02 μmo/L (low tHcy), those with tHcy ≥ 15.02 μmo/L (high tHcy) had higher risk to event outcome (HR = 1.99, 95% CI: 1.30-3.05). According to the cumulative hazard curve, group with borderline ABI and high tHcy level has significantly higher altitude and larger increasing rate over follow-up period compare to other groups. Among those with borderline ABI, participants with high tHcy had higher death risk than those with low tHcy, nevertheless, no significant different between borderline and normal ABI among those with low tHcy levels.CONCLUSIONSBorderline ABI and tHcy level both have independent predictive value on all-cause death. The combined group of borderline ABI and high tHcy has highest risk factor of outcomes, which suggested the mutual additive value of borderline ABI and tHcy. More attention should be given to the importance of borderline ABI in hypertensive population, especially with elevated tHcy level.

Homocysteine (Hcy) is a sulfur-containing, non-proteinogenic amino acid synthesized through the transmethylation of amino acid methionine from one-carbon metabolism. Elevated plasma total homocysteine (tHcy) level is associated with endothelial dysfunction, increased blood coagulation, and metabolic disturbance, promoting cardiovascular diseases, stroke, and coronary artery disease.^[1,2] Notably, patients with high Hcy levels and concomitant hypertension were suggested to be at particularly higher risk.^[3] Moreover, increasing studies have explored a positive association between advanced Hcy level with all-cause mortality. According to a recent dose-response meta-analysis, for each 5-μmol/L increment of tHcy levels, the risk for all-cause mortality increased by 33.6%.^[4]The ankle-brachial index (ABI) is an effective, well-established measure that is commonly used in the diagnosis of peripheral artery disease (PAD),^[5] meanwhile was well studied as an important indicator of atherosclerosis and CVD events.^[6] Although ankle-brachial index (ABI) ≤ 0.90 has been recognized as the threshold value for abnormal/low ABI, which was proven to increase the risk of all-cause mortality,^[7] a study from the American Heart Association has suggested ABI between 0.91 and 1.00 should be considered as “borderline area” in terms of cardiovascular risks,^[8] considering of prior probability and sensitivity of ABI calculation. Emerging studies have aimed to explore the predictive value of borderline ABI,^[9-11] however, controversy remains because of limited and inconsistent data. The current study aimed to explore the individual and joint effect of borderline ABI and tHcy on all-cause mortality among hypertensive adults. Although ABI level ≤ 0.90 has been and is going to remain significant in clinical practice, we believe broader concern should be placed on borderline ABI, especially for its value in risk differentiation and identification. To the best of our knowledge, there are no similar previous studies.     

特重型颅脑损伤84例救治探讨

目的 探讨特重型颅脑损伤救治的方法与效果.方法 对我科自1996年8月～2005年7月救治的84例特重型颅脑伤患者临床资料进行回顾性分析.结果 本组存活55例(65.48%).随访并经ADL统计,恢复良好30例(54.55%),中、重残21例(38.18%),植物生存4例(7.27%).结论 尽早明确诊断,及时开颅清除血肿、去大骨瓣充分减压是救治特重型颅脑伤的关键;颞肌敷贴、早期使用亚低温及钙离子阻滞剂等对脑的保护、损伤可逆脑细胞的修复和脑功能的恢复有良好的促进作用;脱水,止血,抗感染、营养脑神经、维持水电解质及酸碱平衡等亦是提高特重型颅脑伤患者的生存率的保证.     

吡格列酮对代谢综合征患者超敏C反应蛋白的影响

目的观察吡格列酮对糖耐量受损(IGT)合并代谢综合征(MS)患者超敏C反应蛋白(hsC-RP)的影响。方法对2005年1月至2007年12月厚街医院内科门诊50例新诊断IGT(7.8mmol/L≤餐后2h血糖<11.1mmol/L)合并MS患者,采用吡格列酮干预,比较治疗前和治疗12周后超敏C反应蛋白(hsC-RP)浓度变化。结果治疗前后空腹血糖、HbAlc、胰岛素、HOMA-IR、TG及hsC-RP水平均有明显降低(P<0.01),HDL-C明显升高(P<0.01)。结论吡格列酮改善胰岛索抵抗,降低hs-CRP浓度,改善MS患者的血管炎症反应。     

ICAM-1蛋白在慢性乙型肝炎肝衰竭肝组织中的表达

目的探讨肝组织细胞间粘附分子-1(ICAM-1)表达在慢性乙型肝炎肝衰竭组织中的作用。方法用免疫蛋白印迹(Western-blot)对12例慢性乙型肝炎和10例慢性乙型肝炎肝衰竭患者肝组织ICAM-1蛋白表达情况进行测定。结果在乙肝携带者组和乙型肝炎肝衰竭组都有ICAM-1蛋白的表达,而在乙型肝炎肝衰竭组肝组织ICAM-1蛋白呈显著表达,并且乙型肝炎肝衰竭组肝组织ICAM-1蛋白量与PTa呈正相关。结论肝细胞ICAM-1表达在慢性乙性肝炎肝衰竭肝细胞坏死中起重要作用。     

首诊精神分裂症和首诊强迫症患者静息态脑功能低频振幅分数的对比研究

目的 探讨首诊精神分裂症(schizophrenia,SZ)和首诊强迫症(obsessive-compulsive disorder,OCD)患者静息态脑功能低频振幅分数(fractional amplitude of low-frequency fluctuations,fALFF)的变化特征.材料与方法 招募22例...