外侧半月板后根部损伤不同缝合位置对膝关节生物力学的影响

目的对损伤的外侧半月板后根部进行不同位置的修复固定,比较不同缝合方式时膝胫股关节的生物力学结果,探讨外侧半月板后根部损伤最佳缝合术式。方法使用8例人体尸体膝关节,胫腓骨固定装置维持膝关节在0°位,在1 k N压缩载荷下,采用Tek-scan压力感测片收集膝关节外侧半月板后根部完整、外侧半月板后根部断裂、将外侧半月板后根部分别缝合至中心点、中心点偏后5 mm、中心点偏前5 mm、中心点偏外5 mm位置下的平均接触压力、峰值压力以及接触面积。结果在外侧间室,与完整状态相比半月板后根部损伤断裂后会导致平均接触压力和峰值压力明显增加(P0. 01),接触面积减少(P0. 05)。4种缝合固定方法均可减少平均压力和峰值接触压力,接触面积较根部断裂时均有增加。在半月板后根部中心点偏外5 mm缝合时,生物力学结果更接近完整膝关节(P0. 05)。比较缝合位点在根部中心点和中心点偏后5 mm时,平均接触压力影响差别微小,峰值接触压力、接触面积均无统计学差异(P0. 05)。在内侧间室,生物力学指标各组间均无统计学差异(P0. 05)。结论外侧半月板后根部发生撕裂后会导致膝关节外侧间室的平均接触压力、峰值压力以及接触面积相比正常膝关节发生显著改变;半月板缝合位置在原根部中心点偏外5 mm时,其生物力学功能更接近完整膝关节。     

数字病理扫描在颈动脉粥样硬化斑块组织学研究中的应用

目的颈动脉粥样硬化斑块的形成是脑血管病变的独立危险因素之一。对颈动脉内膜剥脱术(carotid endarterectomy,CEA)斑块进行充分的组织学判读和研究,将有助于全面把握CEA斑块的组织学表现,进而推进临床辅助诊断。方法本文我们将运用数字病理扫描仪对CEA斑块的切片经H&E染色后进行扫描,介绍数字病理扫描在CEA斑块组织学研究中的应用。结果经数字病理扫描所得的图片,有助于全面掌握和保存CEA斑块组织切片的全层面信息;在软件的帮助下有助于非常方便地测量斑块内各成分的大小;有助于精确评估斑块的狭窄程度。结论综上,数字病理成像应用于CEA斑块,结合MRI,有助于高效且准确地判读斑块组成和预测斑块稳定性,亦有助于人工智能的训练。     

Adoptive transfer of IFN-γ-induced M-MDSCs promotes immune tolerance to allografts through iNOS pathway

Inflammation Research - Efficient production of monocytic myeloid-derived suppressor cells (M-MDSCs) with stable immunosuppressive function is crucial for immunomodulatory cell therapy for many...     

维持性血液透析患者透析过程中血压变异性的相关探讨

研究终末期肾病患者维持性血液透析中血压变异性（BPV）及其影响因素。选择143例维持性血透患者,根据收缩压均数分为高收缩压血压变异性组（高SBPV组）、低收缩压血压变异性组（低SBPV组）;根据舒张压均数分为高舒张压血压变异性组（高DBPV组）、低舒张压血压变异性组（低DBPV组）。比较两组BPV与各指标的关系。高SBPV组和低SBPV组的年龄、糖尿病患病率、透析前收缩压（透前SBP）、超滤量、透析间期体质量增长率（IDWG%）、白蛋白（Alb）、尿素清除指数（Kt/V）有显著性差异（P＜0.05）。以SBPV为因变量,其余因素作为自变量进行多元线性回归分析,年龄、透前SBP、超滤量、血红蛋白（Hb）、血钙（Ca2+）是SBPV的独立影响因素并呈正相关。Alb是SBPV的独立影响因素并呈负相关。高DBPV组和低DBPV组的血管通路选择、超滤量、IDWG%有显著性差异（P＜0.05）。以DBPV为因变量,其余因素作为自变量进行多元线性回归分析,IDWG%、Alb、Kt/V是DBPV的独立影响因素,前者呈正相关,后两者呈负相关。高龄、高透前SBP、超滤量大、Alb低、高Ca2+是收缩压BPV的独立危险因素。IDWG%大、Alb低、Kt/V低是舒张压BPV的独立危险因素。临床中,控制透析前血压和透析间期体质量增长率,适当减少超滤量、增加血浆Alb,充分透析有助于降低透析中血压波动,进而改善透析患者预后,在老年人群尤应关注以上指标。     

Involvement of thromboxane A2 in interleukin-31-induced itch-associated response in mice

Background

Atopic dermatitis is a chronic and severe pruritic skin disease. Interlukin-31 (IL-31) has been recently demonstrated to be one of the key pruritogens in atopic dermatitis. However, the mechanisms underlying IL-31-induced itching remains unclear. In our previous study, we have shown that thromboxane (TX) A₂ is involved in itch-associated responses in mice with atopy-like skin diseases.

Regulation of cytochrome P450 gene expression by ketamine: a review

Introduction: Although used as an anesthetic drug for decades, ketamine appears to have garnered renewed interest due to its potential therapeutic uses in pain therapy, neurology, and psychiatry. Ketamine undergoes extensive oxidative metabolism by cytochrome P450 (CYP) enzymes. Considerable efforts have been expended to elucidate the ketamine-induced regulation of CYP gene expression. The safety profile of chronic ketamine administration is still unclear. Understanding how ketamine regulates CYP gene expression is clinically meaningful.

Areas covered: In this article, the authors provide a brief review of clinical applications of ketamine and its metabolism by CYP enzymes. We discuss the effects of ketamine on the regulation of CYP gene expression, exploring aspects of cytoskeletal remodeling, mitochondrial functions, and calcium homeostasis.

Expert opinion: Ketamine may inhibit CYP gene expression through inhibiting calcium signaling, decreasing ATP levels, producing excessive reactive oxygen species, and subsequently perturbing cytoskeletal dynamics. Further research is still needed to avoid possible ketamine–drug interactions during long-term use in the clinic.     

辅助用药临床使用情况的调查与研究

【摘要】 目的：调查我院2014-2016年辅助用药临床使用现状,为临床合理使用辅助用药提供参考。方法：结合我院近3年收集、上报的545例精神科药品不良反应的数据,对2014-2016年期间我院病区辅助用药的使用DDDs、金额排名及B/A值进行统计分析。结果：非注射剂辅助用药DDDs排名居前的是盐酸苯海索、盐酸普萘洛尔、二甲双胍等,主要用以对抗精神科用药引起的ADR为主;注射剂辅助用药金额排名居前的是奥拉西坦、参芎葡萄糖、赖氨酸等,主要以神经营养类、活血化瘀类为主。结论：我院病区非注射剂类辅助用药基本合理,但注射剂类辅助用药存在超适应症、过度治疗等现象,需进一步加强管理,确保患者用药的安全、有效、合理。     

Modeling Clinical Outcomes in Prostate Cancer: Application and Validation of the Discrete Event Simulation Approach

Objectives

Treatment landscape in prostate cancer has changed dramatically with the emergence of new medicines in the past few years. The traditional survival partition model (SPM) cannot accurately predict long-term clinical outcomes because it is limited by its ability to capture the key consequences associated with this changing treatment paradigm. The objective of this study was to introduce and validate a discrete-event simulation (DES) model for prostate cancer.