兔侧后方入路髓核内注射TGF-β1预防软骨终板退变实验研究

目的探讨经侧后方入路髓核内注射转化生长因子-β1(transforming growth factor-β1,TGF-β1)预防椎间失稳后软骨终板退变的作用。方法选择6月龄日本大耳白兔36只,随机分为对照组和观察组各18只。两组均通过椎间失稳手术制备成腰5~6、腰6~7椎间失稳模型。观察组在术后立即经侧后方入路髓核内注射TGF-β1 25~30μl。于术后3个月、6个月各取8只动物,分别切取腰5~6、腰6~7椎间盘的软骨终板,对标本进行HE染色组织形态学观察及Mankin评分,测定Ⅱ型胶原,进行组间比较。结果术后3个月、6个月组织形态学显示观察组较对照组软骨终板退变明显减缓,Mankin评分显著低于对照组(P<0.01);观察组软骨终板内Ⅱ型胶原表达灰度值显著低于对照组(P<0.01)。结论髓核内注射TGF-β1对椎间失稳手术后软骨终板退变具有明显的预防作用。     

Evaluation of chemical interactions of maleic acid with sodium hypochlorite and chlorhexidine gluconate

Introduction

The elimination of microorganisms from the root canal system necessitates the use of combination of irrigating solutions to enhance their antimicrobial property. The combination of irrigants and their interaction sometimes could be detrimental to the outcome of the root canal therapy. The purposes of this study were (1) to evaluate the interaction between 7% maleic acid (MA) and 2% chlorhexidine gluconate solution (CHX) and to find out the availability of individual irrigant and (2) to determine the free available chlorine content when 7% MA was mixed with 2.5% sodium hypochlorite (NaOCl) solution.

Methods

Interaction between MA and CHX was assessed by high-performance liquid chromatography. Available chlorine content in NaOCl was evaluated by the standard iodine/thiosulfate titration method.

Results

It was observed that more than 90% free MA and CHX were available when MA was combined with CHX. It was also observed that there was no precipitate formation when 7% MA was mixed with 2% CHX. Available chlorine content decreased significantly in the MA/NaOCl mixture.

Conclusions

There were no adverse interactions or precipitate formation observed when MA was combined with CHX, but the available chlorine content was reduced when NaOCl was mixed with MA.     

A clinicopathological and molecular analysis of glioblastoma multiforme with long-term survival

The median survival time of patients with glioblastoma multiforme (GBM) is 12 months, and only 3-5% of patients survive longer than 3 years. We performed histomorphological and detailed molecular analyses of seven long-term survivors of GBM to identify any prognostic factors that potentially contribute to survival. Morphology and immunohistochemistry for p53, phosphatase and tensin homologue (PTEN) and epidermal growth factor receptor (EGFR) protein expression were investigated. EGFR amplification and 1p/19q deletion were assessed by fluorescent in situ hybridization. The O6-methylguanine-DNA methyltransferase (MGMT) gene methylation status was evaluated by performing methylation-specific polymerase chain reaction assays. All tumors were classical GBMs and no significant oligodendroglial differentiation was noted. The majority showed EGFR amplification (4/7), PTEN protein expression (6/7) and MGMT promoter methylation (5/6). Immunopositivity for p53 was noted in three of seven patients. Deletion of chromosome 1p/19q, either isolated or combined, was not identified in any of the se patients. All patients were treated by gross total resection followed by radiotherapy; six patients received additional temozolomide treatment. A relatively young age of onset (48 years), with a high MGMT promoter methylation and PTEN protein expression were favorable factors for long-term survival. The presence of EGFR amplification indicates that more than a single factor determines survival in GBM.     

Cannabis Induced Periodic Catatonia: A Case Report

Catatonia is a syndrome of specific motor abnormalities closely associated with disorders in mood, affect, thought and cognition. The principal signs of the disorder are mutism, immobility, negativism, posturing, stereotypy and echo phenomena. Catatonia is commonly seen in various psychiatric disorders, neurological disorders and certain medical conditions. It has also been reported in individuals with substance withdrawal. But we are presenting the case of a patient with cannabis dependence, who presented with symptoms of catatonia preceded by an increase in the amount of cannabis intake and resolution of the catatonia when he abstained from the substance. Literature review did not show any case revealing association between cannabis to catatonia.     

Validity of using UK primary care electronic health records to study migration and health: a population-based cohort study

BackgroundDespite international migrants comprising 15·6% of the English population, there are no large-scale studies of migrant health in UK primary care electronic health records (EHRs). Developing and validating a migration phenotype (a transparent reproducible algorithm based on EHRs to identify migrants) is necessary to determine the feasibility of using EHRs for migration health research. This study aims to develop and validate a migrant phenotype in Clinical Practice Research Datalink (CPRD), the largest UK primary care EHR.MethodsThis is a population-based cohort study of individuals of any age in CPRD between Jan 1, 2007, and Feb 29, 2016, with a diagnostic Read term indicating international migration. We describe completeness of recording of migration: percentage of individuals recorded as migrants over time. We also describe representativeness of the cohort (age, sex, and geographical origin) compared with data from the Office of National Statistics (ONS; country of birth and the 2011 English Census).Findings325 391 (3·4%) of 9,448,898 individuals in CPRD had at least one of 440 terms indicating international migration. The cohort was mostly female (53·7% [174 883/325 391] overall; 52·4% [55 734/106 462] in 2011), which is similar to ONS 2011 census data (51·7 [3 791 375/7 337 139]). The percentage of migrants per year increased from 1·2% (69 046/5 716 075) in 2007 to 2·8 (154 525/5 427 745) in 2013, following a similar trend to ONS migration data (11·7% [5 927 000/50 714 000] in 2007; 13·7% [7 285 000/53 164 000] in 2013). Proportions were significantly lower in CPRD (χ² test; p<0·0001). The highest percentages of migrants were in the 25–34-year-old band (4·6% [30 549/668 864] in CPRD; 25·9% [1 851 952/7 160 102] in ONS). Migrants were mostly born in Europe (35·4% [10 316/29 113] in CPRD; 36·5% [2 675 003/7 337 042] in ONS) or the Middle East and Asia (34·5% [10 037/29 113] in CPRD; 34·5% [2 529 137/7 337 042] in ONS).InterpretationWe created a cohort of international migrants in England that is broadly representative in terms of age, sex, and geographical region of origin. Future validation work should explore representativeness by ethnicity and deprivation. Potential reasons for undersampling compared with ONS data include insufficient recording and poor health-care access. Nonetheless, the large cohort size provides sufficient power to study a range of health-care analyses in this potentially underserved population.FundingWellcome Trust (approvals [CPRD ISAC 19_062R]; REC 09/H0810/16).