弹性弧形骨钻对小牛椎体骨质疏松模型PVP术中骨 水泥分布的影响

目的探讨自制弹性弧形骨钻在小牛椎体骨质疏松模型上行PVP术的可行性,并观察其对骨水泥分布的影响。方法采用乙二胺四乙酸二钠盐(EDTA-Na2)浸泡法制备小牛体外骨质疏松椎体,将40个骨质疏松椎体随机分为A、B两组,每组各20个椎体行椎体成形术,A组行常规直钻穿刺,B组采用自制弹性弧形骨钻穿刺,弧形方向朝向穿刺对侧,深度达到椎体中前三分之一终止,对两组穿刺骨钻及骨水泥是否达到或越过椎体矢状中线进行统计分析。结果 EDTA-Na2浸泡法脱钙9 d时成功制备出体外骨质疏松椎体,直钻穿刺组钻头达到或越过椎体矢状中线有7个椎体,骨水泥分布达到或越过椎体矢状中线11个;弹性弧形骨钻组穿刺钻头达到或越过椎体矢状中线有18个椎体,骨水泥分布达到或越过椎体矢状中线19个,两组骨钻穿刺效果及骨水泥分布上的差异有统计学意义(P0.05)。A组9个椎体发生骨水泥椎管内渗漏,B组4个椎体发生骨水泥椎管内渗漏,两组间在骨水泥渗漏上无显著性差异(P0.05)。结论采用自制弹性弧形骨钻在小牛骨质疏松模型上可以顺利实施PVP术,且能实现单侧椎弓根穿刺,骨水泥双侧分布的效果。     

数字化根管定位导板在微创牙髓治疗中应用研究进展

随着牙体牙髓治疗技术和理念的不断发展,微创牙髓治疗（minimally invasive endodontics,MIE）理念受到了广泛关注,MIE强调保留更多的牙体组织来提高患牙存留率。在各项数字化技术的联合应用下,MIE有了新思路、新方法。文章从现阶段的数字化根管定位导板在MIE的应用背景、数字化技术、制作方法、临床应用等方面展开综述。     

腹主动脉旁淋巴结切除在子宫内膜癌手术治疗中的意义

目的:探讨腹主动脉旁淋巴结切除对子宫内膜癌手术病理分期及预后的影响。方法:回顾性分析我院行系统性盆腔及腹主动脉旁淋巴结切除的68例子宫内膜癌患者的临床病理资料。结果:15例(22.1%)发生淋巴结转移的患者中,12例(17.6%)发生盆腔淋巴结转移,7例(10.3%)发生腹主动脉旁淋巴结转移,其中4例(5.9%)患者同时出现盆腔及腹主动脉旁淋巴结转移,3例(4.4%)为单纯腹主动脉旁淋巴结转移。临床分期与手术病理分期不符合率为22.1%。术后随访6～57个月,平均26个月,获访率100%,1例复发,1例复发并死亡。结论:系统性盆腔及腹主动脉旁淋巴结切除术不仅对进行准确的手术病理分期,指导术后辅助治疗有重要意义,而且能提供预后相关信息。     

抗PD-1单抗联合化疗及抗血管生成药物治疗晚期黑色素瘤的疗效和安全性

目的： 探讨抗PD-1单抗联合化疗及抗血管生成药物治疗晚期黑色素瘤的疗效和安全性。 方法： 收集2020年4月至2021年6月在北京大学肿瘤医院接受抗PD-1单抗联合化疗药物替莫唑胺±顺铂、白蛋白结合型紫杉醇及抗血管生成药物贝伐珠单抗治疗的14例（男6、女8例）不可切除的晚期黑色素瘤患者的临床资料。主要研究终点为无进展生存期（PFS）,次要终点为客观有效率（ORR）、疾病控制率（DCR）、总生存期（OS）及安全性数据（CTCAE 5.0标准）。 结果： 14例晚期黑色素瘤患者均纳入生存分析,中位随访时间为5.50个月（95% CI: 0~13.12个月）,中位PFS为7.43个月（95% CI: 3.07~11.79个月）,中位OS为13.50个月（95% CI: 5.19~21.81个月）,中位起效时间为1.5个月;ORR为28.6%（4例均为部分缓解）,DCR为85.7%;不良反应多为1~2级。结论： 抗PD-1单抗联合化疗及抗血管生成药物治疗在晚期黑色素患者中显示出初步的有效性及良好的安全性,此可能为晚期黑色素瘤的联合治疗策略提供了新思路。     

Seroprevalence of syphilis among women attending urban antenatal clinics in Burkina Faso, 1995-8. The DITRAME Study Group. DIminunation de la TRAnsmission Mère-Enfant

OBJECTIVES: To describe annual trends in syphilis seroprevalence and to identify risk factors of syphilis among pregnant women receiving antenatal care in Bobo-Dioulasso, Burkina Faso. METHODS: Women were recruited between January 1995 and July 1998 in three antenatal clinics where counselling and HIV testing services had been established in the context of a trial evaluating a short course of zidovudine to reduce mother to child transmission of HIV (ANRS 049 trial). Sociodemographic variables were collected during HIV pretest counselling sessions. Syphilis diagnosis was considered when serum was positive with both rapid plasma reagin and Treponema pallidum haemagglutination assay (TPHA) tests. RESULTS: Overall, 10,980 pregnant women were screened. Syphilis seroprevalence was 0.24% (95% confidence interval (CI): 0.15-0.35) without changes over time. HIV prevalence was 8.8% (CI: 8.3-9.3). In a multivariable analysis, having casual sex partners (odds ratio (OR) = 4.48; CI: 1.62-12.38), being HIV seropositive (OR = 2.62; CI: 1.02-6.74), and being illiterate (OR = 3.78; CI: 1.24-11.48) were independent risk factors for syphilis infection. CONCLUSIONS: This study suggests low syphilis seroprevalence in this city of Burkina Faso. Sexually transmitted disease programmes should be reinforced to offer free access to syphilis screening and treatment in order to eliminate this disease, in coordination with HIV prevention and care.     

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??Abstract??Objective??This study aimed to explore the relationship between the gene expression of FOXP3 and the pathogenesis of Hen?ch-Sch? nlein purpura in children during the acute phase. Methods??The mRNA expression of FOXP3 in the peripheral blood determined in 50 HSP children ??HSP group????34 KD children??KD group and 50 children who would receive tonsillectomy with normal physical examination??control group?? respectively. Results??Altogether 44 cases were included in the final statistical anaylsis??17 in HSP group??14 in KD group and 13 in control group. The mRNA expression of FOXP3 in patients with HSP was remarkably decreased compared to the healthy controls??and there was significant difference between the two groups ??P < 0.05??. The mRNA expression of FOXP3 in patients with KD was also decreased compared to the healthy controls??the difference showing statistical significance ??P < 0.05??.But no statistical difference was found in the mRNA expression of FOXP3 in patients with HSP and KD??P > 0.05??. Conclusion??The decrease of FOXP3 expression might be the indication of immune imsbalance of systematic vasculitis in children??not the specific manifestation of HSP.     

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??Clinicopathologic study of primary adenosquamous carcinoma of liver : a literature review of 47 cases WANG Dong??ZHU Ji-ye??HU Zhi-ping, et al. Department of Hepatobiliary Surgery, Peking University??People’s Hospital??Beijing 100044??China
Corresponding author: ZHU Ji-ye, E-mail??gandanwk@vip.sina.com
Abstract Objective To improve the diagnosis and treatment of one type of rare primary liver malignant tumor—adenosquamous carcinoma (ASC) of the liver. Methods A computer MEDLINE search found 47 histologically defined primary ASC cases reported in the literature including data from Peking University People’s Hospital between 1975 and 2007. The clinical features, imaging data, therapeutic strategies and prognosis of the cases were summarized retrospectively. Results Among the 47 cases, most of them could not be diagnosed with confirmation before operation. Some cases were found lymph node metastasis with or without intrahepatic metastasis early after operation. Forty-two cases were reported to have died of ASC at the time of study. The mean survival time of the cases was about 7.3 months. Multivariate analysis revealed that preoperative lymph node metastasis and pathologic stage were associated with poor outcome. Conclusion ASC of the liver is a type of rare primary liver malignant tumor with poor prognosis. It is difficult to differentiate it from other liver tumors before operation. The diagnosis and treatment of ASC should be intensified.     

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??Mesenteric angiographic selective location of jejunoileal vascular malformations with combined use of the guide wire LING Yue-xin*, TONG Sai-xiong, AI Zhi-long, et al. *Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China Corresponding auther: TONG Sai-xing, E-mial: sxtong@ zshospital.net Abstract Objective To study the intraoperative location of jejunoileal vascular malformations. Methods 16 cases of jejunoileal vascular malformation were diagnosed by mesenteric selective angiography. Subsequent superselective catheterization of a bleeding branch was performed. The guide wire was placed as a marker for intraoperative location. Results 9 cases of intestinal vascular malformation were located in the jejunum, 6 in the ileum, 1 in the jejunum and colon. At operation, the guide wire could easily be found and subsequent surgical resection performed successfully. Conclusion Placing the guide wire as a marker by angiographic techniques is quite useful in locating intraoperatively the exact bleeding site of jejunoileal vascular malformation.