不同干预措施治疗腕舟骨骨折的网状Meta分析

目的:采用网状Meta分析系统评价石膏固定、空心螺钉、Herbert螺钉、克氏针固定四种干预措施治疗腕舟骨骨折的疗效。方法:检索建库至2019年12月31日的PubMed、EMbase、Cochrane Library、Clinical Trial、中国学术期刊网络出版总库(CNKI)、中国生物医学文献数据库(CBMd...     

根除Hp对高原地区Hp相关性慢性胃炎病理变迁和溃疡转归的影响

目的:观察根除幽门螺杆菌(Hp)感染对高原地区Hp相关性慢性胃炎病理变迁和溃疡转归的短期影响。方法:对Hp阳性的37例慢性胃炎和30例溃疡患者均给予以洛赛克为中心加两种抗生素的三联一周疗法,停药一月后复查Hp并观察胃镜和病理组织学变化,与根除Hp治疗前进行对比分析,同时统计Hp根除组和未根除组溃疡的愈合率。结果:37例慢性胃炎中32例Hp被根除,30例溃疡中14例Hp被根除(2例未复查),平均Hp根除率70.77%;Hp根除前慢性胃炎组中有19例胃炎活动,治疗后16例Hp被根除,根除者胃炎活动完全消退,消退率100%,而3例Hp未根除者仅1例胃炎活动完全消退,消退率33.33%(P<0.05);28例溃疡在Hp根除治疗前均有胃炎活动的病理组织学改变,14例Hp根除者中,13例胃炎活动完全消退,消退率92.86%,14例Hp未根除者中,只有6例胃炎活动完全消退,消退率42.86%(P<0.05);所有的慢性胃炎和溃疡患者胃窦粘膜均有不同程度的萎缩、肠化和异型增生,两组Hp根除前后其上述病理组织学变化均无明显改善(P>0.05);Hp根除组溃疡全部愈合,愈合率达100%,未根除组只有8例愈合,愈合率为57.14%,两组比较Hp根除组溃疡愈合率显著高于未根除组(P<0.05)。结论:根除Hp感染可使绝大部分胃炎的活动性消退,并可明显提高溃疡的愈合率,而Hp根除后短时间内无慢性胃炎(萎缩、肠化、异型增生)逆转的病理组织学表现,需长期随访观察。     

高原地区Hp相关性胃癌前病变患者血清6种细胞因子水平的变化

目的:观察青海高原地区幽门螺杆菌(Hp)相关性胃癌前病变患者血清Th1/Th2细胞因子(IL-1β、IL-2、IL-4、IL-6、IL-8、TNF)水平变化,以探讨其在发病中的可能免疫致病机制。方法:应用放免法(RIA)测定25例慢性萎缩性胃炎(CAG)、17例肠化生(IM)、15例异型增生(Dys)患者血清IL-1β、IL-2、IL-4、IL-6、IL-8、TNF的含量。比较Hp感染与非感染胃癌前病变患者之间;Hp感染CAG炎症活动与非活动患者之间;Hp感染CAG、IM、Dys患者之间血清6种细胞因子含量的差别。结果:Hp感染与非感染胃癌前病变患者之间6种细胞因子含量均无显著性差别(P>0.05);Hp感染CAG炎症活动者血清IL-4含量显著低于非活动者(P<0.05);IM和Dys者均非常显著低于CAG(P<0.01),IL-2在Dys组显著高于CAG(P<0.05)。结论:本地区Hp相关性胃癌前病变中存在血清Th1/Th2失衡,表现为随着胃癌前病变的逐级加重,T淋巴细胞高表达IL-2伴随IL-4低表达现象。     

创伤性胫前皮肤缺损骨不连医源性因素分析及防治

目的探讨外伤性胫前皮肤缺损骨不连医源性因素、治疗方法及预防措施.方法对136例外伤性胫前皮肤缺损,进行回顾性研究,分析医源性因素,提出预防措施,随访治疗效果.采用7种局部转移皮瓣和6种游离皮瓣移植治疗皮肤缺损,骨不连、骨缺损均采用带血管的骨移植.结果136例中121例得到6～28个月随访,平均17个月.局部皮瓣转移全部成活,游离皮瓣移植中7例术后发生血管危象,经探查4例成活,3例失败,二期以带胫后血管的对侧小腿内侧皮瓣为受区血管蒂的皮瓣移植修复治愈.骨不连、骨缺损行骨移植后均在术后3个月愈合,骨髓炎治愈.结论医源性技术缺陷是外伤性胫前皮肤缺损骨不连的重要因素,针对各种不同的因素进行预防、合理治疗可获得满意效果.     

CXCR7在碱烧伤小鼠角膜组织中的表达

目的:研究基质细胞衍生因子-1(stromal cell-derived factor-1,SDF-1)的受体即人CXC趋化因子受体7(C-X-C chemokine receptor type 7,CXCR7)在碱烧伤小鼠角膜组织的表达,探讨CXCR7是否参与小鼠碱烧伤后角膜新生血管(corneal neovascularization,CNV)的形成。方法:采用在角膜鼻侧放置NaOH滤纸片40 s的方法构建BALB/c小鼠碱烧伤诱导CNV动物模型,通过real-time PCR、Western blotting法分别检测碱烧伤后3 d、7 d、14 d角膜组织中SDF-1、CXCR4、CXCR7和血管内皮生长因子(vascular endothelial growth factor,VEGF)的mRNA及蛋白的表达情况,免疫荧光法检测碱烧伤后14 d CXCR7蛋白的表达。结果:小鼠角膜新生血管在碱烧后14 d内持续生长。Real-time PCR结果显示,与正常对照组相比,碱烧伤后3d、7 d、14 d小鼠角膜组织中SDF-1、CXCR4、CXCR7及VEGF的mRNA表达均明显升高(P<0.05)。Western blotting结果显示,与正常组相比,碱烧伤后7 d组与14 d组中SDF-1、CXCR4、CXCR7及VEGF蛋白的相对表达量均升高(P<0.05),但7d组与14 d组差异无统计学意义。免疫荧光检测显示,正常小鼠角膜上皮层有CXCR7蛋白弱阳性蛋白表达;碱烧伤后14 d,角膜上皮层、基质层及新生血管CXCR7蛋白的表达升高。结论:CXCR7在碱烧伤后小鼠角膜组织中表达增加,提示其可能在碱烧伤后的CNV形成中发挥重要作用。     

Extract of the Chinese herbal formula Huo Luo Xiao LingDan inhibited adjuvant arthritis in rats

Ethnopharmacological relevance

The herbal formula Huo Luo Xiao Ling Dan (HLXL) and its modifications have been used in traditional Chinese medicine for about one hundred years to alleviate pain and inflammation.

Aim

To investigate the effects of HLXL on complete Freund's adjuvant (CFA)-induced multiple-joint arthritis in rats.

Materials and methods

Male Lewis rats, 190–210 g, were immunized subcutaneously at the base of the tail with 200 μl of heat-killed Mycobacterium tuberculosis in mineral oil (5 mg/ml). HLXL (2.30 and 4.60 g/kg) or vehicle control (n = 8 per group) was administered orally (i.g.) once a day between days 16 and 25 post-CFA injection. The rats were observed for signs of arthritis with arthritic changes (erythema, edema, induration) being scored on a scale of 0–4 of increasing severity using a standard scoring system. The maximum arthritis score per rat was 16. A plethysmometer was used to measure edema volume in each paw. Adverse effects of HLXL were monitored by closely observing the animals for unusual behavioral changes. Levels of tumor necrosis factor alpha (TNF-α) and interleukin-1 beta (IL-1β) in local tissue were measured by enzyme-linked immunosorbent assay on day 25 post-CFA.

Results

HLXL significantly decreased arthritis scores between days 23–25 in the 2.30 g/kg group and 21–25 in the 4.60 g/kg group (p < 0.05). It reduced paw edema on days 22 and 24 in the 2.30 g/kg group and on days 20, 22 and 24 in the 4.60 g/kg group compared to control (p < 0.05). Local tissue TNF-α and IL-1β levels on day 25 post-CFA injection were significantly (p < 0.05) lower in rats treated with HLXL than in control rats. No observable adverse effects were found.

Conclusion

The data suggest that HLXL produces significant anti-arthritic effects that may be mediated by suppressing pro-inflammatory cytokines, and it appears to be safe.     

Primary Breast Angiosarcoma: A Retrospective Study of 36 Cases from a Single Chinese Medical Institute with Clinicopathologic and Radiologic Correlations

The aim of this study was to present our experience with primary breast angiosarcoma (PBA) by describing a large series of cases with an emphasis on clinicopathologic and radiologic correlations. Thirty‐six cases of PBA diagnosed at our institution between 2006 and 2014 were retrospectively evaluated. All but one case occurred in women with a median age of 35.5 years. The majority of patients presented with a deeply located painless mass, whereas a minority manifested as diffuse enlargement or swelling of the breast. Magnetic resonance imaging showed poorly demarcated lesions with low signal intensity on T1‐weighted images, markedly high intensity on T2‐weighted images, and prolongation of enhancement upon dynamic study. Histologically, 19 cases (52.8%) were low grade, 12 cases (33.3%) were intermediate grade, and 5 cases (13.9%) were high grade. Follow‐up information was available for 27 patients and revealed local recurrence and/or metastasis in 16 patients (59.3%). Five patients (18.5%) died of the disease at a median interval of 20 months. Univariate analysis showed that tumor differentiation had effect on disease‐free survival (DFS) (p = 0.005) but failed to predict overall survival (OS) (p = 0.645). The treatment modality was related to OS (p = 0.042) but not DFS (p = 0.131). The Cox proportional hazards regression model suggested that tumor differentiation was an independent predictor of DFS (p = 0.015). We hypothesize that tumor differentiation may be used as a prognostic factor for this rare malignancy. Clinicopathologic and radiologic correlation may help pathologists to arrive at the correct diagnosis of PBA.     

加巴喷丁胶囊联合小计量泼尼松对带状疱疹神经痛患者免疫功能及疼痛物质的影响

目的 探讨加巴喷丁胶囊联合小剂量泼尼松治疗对带状疱疹患者清神经肽Y（NPY）、P物质（SP）及T细胞亚群的影响及近期临床疗效。方法 选择海南省人民医院2015年1月-2016年12月期间收治的带状疱疹患者128例,随机数表法分为对照组与观察组,每组各64例。其中对照组患者给予小剂量泼尼松治疗,观察组患者给予加巴喷丁胶囊联合小剂量泼尼松治疗。比较两组患者近期疗效,治疗前后患者视觉模拟尺评分（VAS）、T淋巴细胞亚群变化情况（CD3⁺和CD4⁺、CD8⁺、CD4⁺/CD8⁺）及NPY和SP水平。结果 经不同方案治疗后,观察组的总有效率为95.31%,对照组总有效率为85.94%,两组相比差异显著且具有统计意义（χ²=8.67,P < 0.05）。与治疗前相比,两组患者治疗后的VAS评分显著降低,同组治疗前后比较差异有统计学意义（P < 0.05）;治疗后,观察组VAS评分显著低于对照组,差异有统计学意义（P < 0.05）。与治疗前相比,两组患者治疗后T淋巴细胞亚群CD3⁺和CD4⁺、CD4⁺/CD8⁺明显增高,同组治疗前后比较差异有统计学意义（P < 0.05）;观察组治疗后T淋巴细胞亚群CD3⁺和CD4⁺、CD4⁺/CD8⁺较对照组增加更显著,差异有统计学意义（P < 0.05）。两组NPY和SP水平较治疗前均显著下降,同组治疗前后比较差异有统计学意义（P < 0.05）;治疗后,观察组NPY和SP水平均显著低于对照组,差异有统计学意义（P < 0.05）。结论 加巴喷丁胶囊联合小剂量泼尼松治疗对带状疱疹患者能够有效改善患者临床症状,缓轻患者的神经疼痛,改善患者机体免疫功能功能,降低外周血NPY、SP水平,值得临床推广和应用。