中药保留灌肠联合针刺治疗在结直肠癌术后的临床运用

目的 探寻中药保留灌肠联合针刺治疗在结直肠癌术后的临床运用前景。方法 选择2019年10月—2020年10月因原发性结直肠癌接收并进行根治性切除患者80例,采用随机数字表法随机分为治疗组和对照组,每组40例;试验组予以加味大承气汤保留灌肠联合针刺治疗,对照组予以同温生理盐水灌肠,比较两组患者首次肠鸣音出现时间、肠鸣音恢复正常时间、首次排气时间、首次排便的时间,同期监测患者血清胃动素和生长抑素水平变化。结果 治疗组首次肠鸣音出现时间、肠鸣音恢复正常时间、首次排气排便时间均早于对照组（P < 0.05）。两组患者术后均可见生长抑素水平升高。治疗组第7天的胃动素水平升高同时生长抑素表达降低,与对照组比较具有统计学差异（P < 0.05）。结论 中药保留灌肠联合针刺治疗,可在短期内促进胃肠道蠕动,恢复肠道功能,降低围手术期肠梗阻的发生,值得临床进一步研究与运用。     

Comparison of the effects of 10.6-μm infrared laser and traditional moxibustion in the treatment of knee osteoarthritis

Lasers in Medical Science - Based on two separate randomized controlled trials (RCTs) on traditional Chinese medicine (TCM) moxibustion and 10.6-μm infrared laser moxibustion in treating knee...     

Diagnostic value of dual detection of hepatocyte nuclear factor 1 beta (HNF-1β) and napsin A for diagnosing ovarian clear cell carcinoma

We evaluated the diagnostic value of hepatocyte nuclear factor 1 beta (HNF-1β) and napsin A for diagnosing ovarian clear cell carcinoma. Immunohistochemical EnVision was used to measure HNF-1β and napsin A expression in 38 cases of ovarian clear cell carcinoma, 30 cases of high-grade serous carcinoma, 22 cases of endometrioid adenocarcinoma, and 16 metastatic Krukenberg tumor cases. Then we found that HNF-1β appeared in all ovarian clear cell carcinoma and was less common in high-grade serous and endometrioid adenocarcinoma (P < 0.05). However, no significant difference in HNF-1β between clear cell carcinoma and metastatic Krukenberg tumor was found (P > 0.05). Napsin A was expressed in 97.4% of ovarian clear cell carcinoma, 6.7% high-grade serous carcinoma, 22.7% endometrioid adenocarcinoma, and 0% metastatic Krukenberg tumors. Napsin A in clear cell carcinoma was greater than that found in high-grade serous carcinoma, endometrioid adenocarcinoma, and metastatic Krukenberg tumor (P < 0.05). Sensitivity and specificity of HNF-1β and napsin A for diagnosing ovarian clear cell carcinoma was 100% and 54.4%, and 97.4% and 89.7%, respectively. Sensitivity and specificity of HNF-1β and napsin A for diagnosing ovarian clear cell carcinoma was 97.4% and 91.2%, respectively. So it is concluded that HNF-1β and napsin A are more sensitive than currently used markers for diagnosing ovarian clear cell carcinoma. Moreover, napsin A is more specific than HNF-1β. Combining HNF-1β and napsin A may distinguish clear cell carcinoma from high-grade serous carcinoma, endometrioid adenocarcinoma and metastatic Krukenberg tumors.     

普罗布考对2型糖尿病合并轻度认知功能障碍患者的疗效观察

目的 观察普罗布考对T2DM合并轻度认知功能障碍（MCI）患者改善的情况. 方法 根据蒙特利尔认知评估（MoCA）量表北京版结果选取糖尿病合并MCI （MoCA＜26分）患者88例,随机分为治疗组46例与对照组42例.干预6个月,比较治疗前后两组MoCA评分、β淀粉样蛋白40（Aβ1-40）和颈动脉内-中膜厚度（CIMT）的差异. 结果 两组完成随访人数分别为42例和40例.治疗后,治疗组Aβ1-40较对照组降低[135.05（35.32,221.23）vs174.15（85.13,327.77） pg/ml,P＜0.01],两组MoCA评分比较,差异无统计学意义（P＞0.05）.两组治疗前后临床参数自身差值（△=治疗前一治疗后）比较,差异均有统计学意义[△MoCA：-4.00（-5.00,-2.00）vs-1.00（-3.00,0.00）,P＜0.01;△Aβ1-40：68.61（-58.59,198.76）vs9.00（-110.65,106.67）pg/ml,P=0.02; △CIMT：0.05（-0.05,0.20） vs-0.05（-0.10,0.10） mm,P=0.02]. 结论 普罗布考可降低T2DM合并MCI患者Aβ1-40水平,改善认知功能.     

miR-552通过PTEN/AKT信号通路促进非小细胞肺癌A549细胞的恶性生物学行为

目的 探讨miR-552通过调控PTEN/AKT信号通路促进人非小细胞肺癌A549细胞的恶性生物学行为及其相关机制。方法 通过qRT-PCR检测人肺癌组织样本和人非小细胞肺癌A549细胞系中miR-552、PTEN mRNA的表达情况;通过Western blotting检测PTEN、AKT、p-AKT蛋白的表达情况;通过CCK-8检测miR-552表达对A549细胞增殖能力的影响;通过Transwell小室检测miR-552表达对A549细胞迁移和侵袭能力的影响;通过流式细胞术检测miR-552表达对A549细胞凋亡能力的影响。结果 miR-552在肺癌组织和A549细胞中的表达显著上调。过表达miR-552可显著促进A549细胞的增殖、迁移和侵袭,并抑制细胞凋亡,而抑制其表达则结果相反。与癌旁组织相比,肺癌组织中PTEN表达显著下调。过表达miR-552可下调PTEN蛋白表达,上调p-AKT蛋白表达,对AKT蛋白无影响,而抑制其表达则结果相反。结论 miR-552可能通过PTEN/AKT信号通路促进人非小细胞肺癌A549细胞的恶性生物学行为。     

血浆可溶性CD36与2型糖尿病及亚临床大血管病变的关系

目的 比较糖耐量正常人群、2型糖尿病及亚临床大血管病变患者血浆可溶性CD36（sCD36）的水平.方法 收集2型糖尿病患者196例及社区糖耐量正常人群135例,根据颈动脉超声分为糖尿病合并亚临床大血管病变组（SMDM组,118例）、单纯糖尿病组（DM组,78例）、亚临床大血管病变组（SMD组,42例）和对照组（NC组,93例）,比较4组sCD36水平及其他临床和理化参数.结果 SM组、DM组及SMDM组的sCD36水平显著高于NC组（P＜0.05）,糖尿病与亚临床大血管病变对sCD36水平有正交互作用（F =5.741,P＜0.05）.Logistic回归显示,血浆sCD36是单纯亚临床大血管病变（OR =2.444,95％ CI：1.449 ～4.125,P=0.001）及糖尿病患者合并亚临床大血管病变（OR=1.248,95％ CI：1.038～1.499,P=0.018）和发生2型糖尿病的危险因素（OR=1.206,95％ CI：1.026～1.418,P=0.024）.结论 血浆sCD36水平可能是2型糖尿病与亚临床大血管病变的风险标志物.     

Growth Differentiation Factor 7 promotes multiple-lineage differentiation in tenogenic cultures of mesenchymal stem cells

The repair of the tendon-bone interface, which is composed of tendon, fibrocartilage, and bony attachment, remains a clinical challenge. The application of mesenchymal stem cells (MSCs), collagen-rich extracellular matrix (ECMs), as well as growth factors, has the potential to regenerate this special multiple-tissue structure through the so-called biological augmentation. We present here an in vitro tendon regeneration model with C3H10T1/2 cells cultured on Collagen I matrix and evaluated the lineage determination effects of Growth Differentiation Factor 7 (GDF-7). We found that besides tenogenic effect, GDF-7 also stimulates the expression of osteoblastic as well as adipocytic genes. Our results indicate that GDF-7 might be a promising growth factor for regeneration of the tendon-bone interface due to its multiple-lineage stimulating effects. However, the side effect on adipogenic differentiation should be of concern, as it is a known risk factor for repair failures.     

Biomechanical comparison of tuberosity-based proximal humeral locking plate compared to standard proximal humeral locking plate in varus cantilever bending

PurposeIn a prior biomechanical study using a tuberosity-based proximal humeral locking plate (TBP) an improvement in greater tuberosity (GT) fixation strength with the TBP compared to a standard proximal humeral locking plate (PHLP) was demonstrated. The purpose of this study is to compare the TBP to the PHLP with a simulated calcar gap fracture under cyclic varus cantilever forces.MethodsSeven matched pairs of cadaveric humeri were studied and 11A2.3 proximal humerus fractures were created by a 1 cm gap osteotomy at the surgical neck. Matched pairs were randomized for fixation using either a PHLP or a TBP. The proximal articular aspect of the humerus was potted and secured to the base of a load frame. The shaft was subjected to cyclic varus cantilever loading with a roller positioned 8 cm from the osteotomy. Change in vertical displacement of the diaphyseal fragment was monitored and digital images were obtained. Failure was defined as vertical displacement greater than 20 mm. Specimens not exhibiting failure over the course of 10,000 cycles were then loaded to 20 mm of vertical displacement. Reactant forces of the specimens at these displacements were recorded.ResultsFour/seven TBP specimens and four/seven PHLP specimens survived 10,000 cycles. The average cycles to failure for TBP specimens was 7325 cycles and 5715 cycles for PHLP specimens (p = 0.525). For the specimens that survived 10,000 cycles, the decrease in calcar gap was superior in the TBP specimens (p = 0.018). A similar trend was seen when these specimens were loaded to failure where the percent calcar gap recovery was higher for the TBP at 74.71 ± 10.07% versus 53.22 ± 30.35% for the PHLP (p = 0.072). In specimens that were loaded to failure after survival of 10,000 cycles the average stiffness of the TBP construct was 20.51 N/mm, and 11.74 N/mm for the PHLP construct (p = 0.024).ConclusionIn addition to superior GT fixation shown in a prior study, the TBP construct demonstrates significantly greater stiffness at the neck fracture compared to the PHLP, when loaded to failure. In addition, there was a trend towards less collapse in this calcar gap model.     

Complications,readmissions, reoperations and patient-reported outcomes in patients with multiple sclerosis undergoing elective spine surgery - a propensity matched analysis

BACKGROUND CONTEXTMultiple sclerosis (MS) is an autoimmune, neurodegenerative disease that can lead to significant functional disability. Improving treatment regimens have extended life expectancy and led to an increase in the number of elective spine surgeries for degenerative conditions in the MS population. Recent literature has reported mixed results regarding the efficacy of elective spine surgery for patients with MS. There is also a paucity of literature comparing postoperative patient reported outcomes (PROs) and reoperation rates between patients with and without MS.PURPOSETo determine if patients with MS have worse PROs and higher complication, readmission and reoperation rates after elective spine surgery compared with patients without neurodegenerative conditions when adjusting for baseline covariates through propensity matching.STUDY DESIGN/SETTINGRetrospective review of prospectively collected data from the Quality Outcomes Database (QOD), a national, longitudinal, multicenter spine outcomes registry.PATIENT SAMPLEFor the lumbar cohort, 312 patients with MS and 46,738 patients without MS were included. The cervical myelopathy cohort included 91 patients with MS and 6,426 patients without MS. The cervical radiculopathy cohort consisted of 103 patients with MS and 13,751 patients without MS.OUTCOME MEASURES1) complication rates, 2) readmission rates, 3) reoperation rates, and 4) PROs at 3- and 12-months including ODI/NDI, NRS back/neck/arm/leg pain, mJOA scores and patient satisfaction ratings.METHODSData from the QOD was queried for patients with surgeries occurring between 04/2013–01/2019. Three surgical groups were included: 1) Elective lumbar surgery, 2) Elective cervical surgery for myelopathy, 3) Elective cervical surgery for radiculopathy. Patients with any neurodegenerative condition other than MS were excluded. Patients without MS were propensity matched against patients with MS in a 5 to 1 ratio without replacement based on ASA grade, arthrodesis, surgical approach, number of operated levels, age, and baseline ODI/NDI, NRS leg/arm pain, NRS back/neck pain, and EQ-5D. Multivariable regressions with cluster-robust standard errors were used to estimate average effect of how the outcome would change if the MS patient didn't have the disease. The mean difference was used for continuous outcomes and the risk difference was used for binary outcomes.RESULTSFor the lumbar cohort, no differences were found between the 2 groups at 3 or 12 months in any of the outcome measures. For the myelopathy cohort, patients with MS patients had a lower rate of reoperation at 12 months (risk difference=-0.036, p=.007) and worse 3-month mJOA scores (mean difference=-1.044, p=.004) compared with patients without MS. For the radiculopathy cohort, patients with MS had a lower rate of reoperation at 3 months (risk difference=-0.019, p=.018) and 12 months (risk difference=-0.029, p=.007) compared with those without MS.CONCLUSIONSPatients with MS had similar PROs compared with patients without MS when adjusting for baseline covariates through propensity matching, except for 3-month mJOA scores in the myelopathy cohort. Reoperation rates were found to be lower in patients with MS undergoing elective cervical surgery for both myelopathy and radiculopathy. These results suggest that when analyzed independently, a diagnosis of MS does not significantly impact complication, readmission and reoperation rates or PROs, and therefore should not represent a major contraindication to elective spine surgery. Surgical decisions in this patient population should be made based on careful consideration of patient factors including other comorbidities as well as baseline patient functional status.     

泪液及血清白介素及微量元素与白内障的关系研究

目的：研究及分析泪液及血清白介素及微量元素与白内障的关系,为白内障的防控、诊断及治疗提供依据。方法：选取2014－06／2015－04于本院进行治疗的67例白内障患者为观察组,并从于本院体检者中选取67例同龄健康人为对照组,然后将两组的泪液及血清白介素、微量元素进行检测及比较,并比较不同发病时间及分期白内障患者的上述检测指标,并采用logistic法分析泪液及血清检测指标与白内障的关系。结果：观察组的泪液及血清白介素均高于对照组,而微量元素则低于对照组,且不同疾病分期白内障患者的检测指标也存在明显差异（均P＜0．05）,而不同发病时间患者间则无明显差异（均P＞0．05）,经logistic法分析泪液及血清检测指标与白内障有密切的关系。结论：白内障患者的泪液及血清白介素及微量元素呈现异常的状态,并且不同疾病分期患者的差异也较为突出,检测指标与疾病的关系密切。