双解通圣汤联合西药治疗脾胃湿热型慢性非特异性唇炎临床研究

目的:观察双解通圣汤加减联合西药治疗脾胃湿热型慢性唇炎的临床疗效。方法:选择60例慢性唇炎患者,按照随机数字表法分为对照组和观察组各30例。对照组给予现代医学常规治疗,观察组在常规治疗基础上给予双解通圣汤加减,2组疗程均为3周。比较2组治疗前后症状体征评分,观察2组临床疗效、不良反应以及3个月随访观察治愈患者复发率的情况。结果:治疗后,2组皮损面积、充血水肿、糜烂流水、结痂面积、瘙痒灼热感及口唇活动度评分均较治疗前降低(P0.01),观察组5项评分均低于对照组(P0.01)。治疗3周后,观察组总有效率为96.67%,对照组为56.67%,2组比较,差异有统计学意义(P0.05)。2组均未见不良反应发生。治疗3周后,对治愈患者随访3个月,对照组复发3例,复发率为50%;观察组复发1例,复发率为5%。观察组复发率少于对照组(P0.05),差异有统计学意义。结论:在西药治疗基础上,采用双解通圣汤加减治疗脾胃湿热型慢性唇炎的疗效显著,安全性较好,复发率较低,提高了疗效持久性和稳定性。     

Endoscopic thyroidectomy by a modified anterior chest approach: A single institution`s 5-year experience

Endoscopic thyroidectomy embodies the features of both minimally invasive surgery and aesthetic surgery. However, none of the established approaches is minimally invasive and meanwhile maximally cosmetic. Here we applied a modified anterior chest approach to achieve excellent cosmesis with reduced physical invasion. Fifty-six patients with benign thyroid diseases accepted this procedure. A 10mm longitudinal incision was made about one-fourth of the distance from the xiphoid to the sternal notch. Bilateral transversal incisions (5mm and 10mm) were performed about one-third of the distance from the nipple to the sternoclavicular joint. The subfascial space was maintained with CO₂ insufflation. Endoscopic lobectomy or subtotal thyroidectomy was performed according to the diseases. Fifty-four of the 56 procedures were successfully performed endoscopically, including 41 unilateral lobectomies and 13 subtotal thyroidectomies. The mean operative time for uni- and bilateral procedures was 117.2 min and 184.5 min, respectively. Conversion occurred in two cases due to bleeding and malignant frozen section analysis, respectively. Postoperative complications included one temporary recurrent nerve palsy, one transient hypocalcemia, and one subcutaneous emphysema. 96.2%(50/52) of the patients were extremely satisfied or satisfied with the cosmetic effect. This procedure is more likely to be accepted by patients older than 30 years. Endoscopic thyroidectomy by the modified anterior chest approach is an effective procedure with both excellent aesthetic benefits and reduced physical injury.     

诱导化疗在局部中晚期口腔鳞癌序贯治疗中功能保留作用的研究

目的 探讨诱导化疗(DBF和TPF方案)在口腔癌序贯治疗中的作用,观察诱导化疗后患者口腔功能的差异.方法 回顾性分析2009年1月至2011年1月我科口腔鳞癌中晚期病例,共47例(UICC分期Ⅲ~Ⅳ期)口腔鳞癌患者,其中男35例,女12例.中位年龄55岁(29~72岁).试验组病例用TPF方案或DBF方案诱导化疗两个疗程,化疗结束后2~3周行影像学检查,根据影像学结果评价是否可行手术治疗.对照组病例直接行手术治疗,术后评估患者外观、口腔功能、发音、社会功能等.结果 47例患者中15例患者诱导化疗后行手术治疗.32例患者直接行手术治疗.两组患者相比较,诱导化疗组原发灶肿瘤平均值大小>直接手术组,两组原发灶肿瘤大小有统计学差异(P<0.05).两组患者口腔功能评估,外观、口腔功能、发音、社会功能无明显差别.结论 诱导化疗后肿瘤原发灶缩小,使患者获得手术机会,缩小手术范围,可使术后口腔功能与直接手术组功能相似.     

Silencing of miRNA-218 promotes migration and invasion of breast cancer via Slit2-Robo1 pathway

MiRNAs play an important role in regulating tumor migration and invasion, and abnormal expression of miRNAs occurs in various kinds of human cancers. In this essay, it is reported that the level of miRNA-218 decreases in metastatic breast cancer cells, moreover, miRNA-218 suppresses breast cancer cells migration and invasion through binding Robo1 (one of Slit receptors) to its 3′UTR. MiRNA-218 restoration suppresses Robo1 expression and inhibits breast cancer cells invasion and migration. What the results describe is that the function of Robo1 regulated by miRNA-218 may provide a new strategy for inhibiting migration and invasion of breast cancer cells.     

超声引导下微创旋切手术与传统开放手术治疗乳腺良性肿块的疗效对比

目的:对比分析超声引导下微创旋切手术与传统开放手术治疗乳腺良性肿块的临床疗效.方法:选取90例单侧乳腺单发良性肿块患者为研究对象,根据术式不同分为观察组(n=40)和对照组(n=50).观察组行超声引导下微创旋切手术,对照组行传统开放手术.对比分析两组患者围手术期指标、术后视觉模拟评分(VAS)、术后不良反应发生情况及患者治疗满意度.结果:观察组患者手术切口长度、术中出血量、手术时间、手术切口愈合时间均少于对照组(P<0.05);观察组患者术后1 d、3 d、5 d的VAS评分均低于对照组(P<0.05);观察组患者术后不良反应发生率为5.00％,低于对照组的22.00％(P<0.05);观察组患者治疗总满意度为95.00％,高于对照组的78.00％(P<0.05).结论:超声引导下微创旋切手术比传统手术在乳腺良性肿块的治疗中具有创伤小、疼痛感轻及不良反应少等优势.     

龙珠软膏外敷治疗下肢急性蜂窝组织炎30例疗效观察

目的:观察龙珠软膏外敷治疗急性蜂窝组织炎的临床疗效。方法:选取60例急性下肢蜂窝组织炎患者,随机分为两组:抗生素治疗(对照组)和抗生素加龙珠软膏外敷治疗(治疗组),每组各30例。在治疗过程中(14天为一疗程)加强观察,比较两组的治疗效果。结果:治疗组30例患者中27例取得显著效果,有效率为90%。对照组30例患者中21例取得显著效果,有效率为70%。两组有效率比较差异有统计学意义(P0.05)。结论:龙珠软膏外敷是有效治疗早期急性蜂窝组织炎重要的辅助治疗方法,早期使用可提高治愈率,减少局部组织化脓坏死,具有使用方便、经济、患者易于接受等优点。     

Sexual dimorphism in hepatic lipids is associated with the evolution of metabolic status in mice

Ectopic lipid accumulation in the liver is implicated in metabolic disease in an age‐ and sex‐dependent manner. The role of hepatic lipids has been well established within the scope of metabolic insults in mice, but has been insufficiently characterized under standard housing conditions, where age‐related metabolic alterations are known to occur. We studied a total of 10 male and 10 female mice longitudinally. At 3, 7 and 11 months of age, non‐invasive ¹H‐magnetic resonance spectroscopy (¹H‐MRS) was used to monitor hepatic lipid content (HLC) and fatty acid composition in vivo, and glucose homeostasis was assessed with glucose and insulin challenges. At the end of the study, hepatic lipids were comprehensively characterized by nuclear magnetic resonance (NMR) and liquid chromatography‐mass spectrometric analyses of liver tissue samples. In males, HLC increased from 1.4 ± 0.1% at 3 months to 2.9 ± 0.3% at 7 months (p < 0.01) and 2.7 ± 0.3% at 11 months (p < 0.05), in correlation with fasting insulin levels (p < 0.01, r = 0.51) and parameters from the insulin tolerance test (ITT; p < 0.001, r = –0.69 versus area under the curve; p < 0.01, r = –0.57 versus blood glucose drop at 1 h post‐ITT; p < 0.01, r = 0.55 versus blood glucose at 3 h post‐ITT). The metabolic performance of females remained the same throughout the study, and HLC was higher than that of males at 3 months (2.7 ± 0.2%, p < 0.01), but comparable at 7 months (2.2 ± 0.2%) and 11 months (2.2 ± 0.1%). Strong sexual dimorphism in bioactive lipid species, including diacylglycerols (higher in males, p < 0.0001), phosphatidylinositols (higher in females, p < 0.001) and omega‐3 polyunsaturated fatty acids (higher in females, p < 0.01), was found to be in good correlation with metabolic scores at 11 months. Therefore, in mice housed under standard conditions, sex‐specific composition of bioactive lipids is associated with metabolic protection in females, whose metabolic performance was independent of hepatic cytosolic lipid content.