腰大肌及侧腹肌相关CT参数评价肝硬化肌少症

目的 观察腰大肌及侧腹肌相关CT参数评价肝硬化肌少症的价值。方法 采集210例临床诊断肝硬化患者腹部CT,获得L3水平骨骼肌总横截面积,计算相应骨骼肌指数（SMI）。根据SMI结果将患者分为肌少症组（n=105）与非肌少症组（n=105）,测量相同层面右侧腰大肌轴径及横径、右侧腹肌厚度,计算腰大肌轴径指数（APMI）、腰大肌横径指数（TPDI）及侧腹肌厚度指数（LWMI）;比较组间差异。以SMI结果为标准,绘制TPDI、APMI及LWMI鉴别肝硬化肌少症的受试者工作特征（ROC）曲线,计算曲线下面积（AUC）,并分析TPDI、APMI及LWMI与SMI的相关性及肌少症的影响因素。结果 组间体质量指数、胆固醇、NRS2002评分、APMI、TPDI和LWMI差异均有统计学意义（P均<0.05）。TPDI（r=0.71）、APMI（r=0.59）和LWMI（r=0.61）均与SMI呈正相关（P均<0.01）。APMI、TPDI及LWMI鉴别肝硬化肌少症的AUC分别为0.61、0.71及0.72（P均<0.05）。男性、三酰甘油为肌少症的危险因素,TPDI、LWMI为肌少症的保护因素（P均<0.05）。结论 腰大肌及侧腹肌相关CT参数可用于评估肝硬化肌少症,并有望成为临床评估肌少症的新方法。     

哈萨克族成人指骨长度的X线测量及其与身高的性别判别

目的 探讨新疆哈萨克族成人指骨长度与身高的依存关系。方法 随机选择健康哈萨克族成人200人（男100人,女100人）,进行双手后前位X线拍片,分别测量各节指骨长度和对应的身高。计算各节指骨长度的均值、标准差和标准误,并且从各节指骨长度推断身高的性别判别方程。结果 男性和女性各节指骨长度之间的差异有统计学意义（P＜0.01）。经相关分析建立了哈萨克族成人指骨长度推断身高的4个性别判别方程（Y₁＝0.780ZM₁＋3.146YM₂＋1.594YS₁＋0.618ZS₃＋0.045YX₁＋1.891ZX₁＋2.548ZX₃-135.324, Y₂＝0.3450ZM₁＋2.328YM₂＋1.814YS₁＋1.355ZS₃＋0.714YX₁＋1.461ZX₁＋1.580ZX₃-118.678, Y₃＝3.540SG＋0.859YM₂-1.882ZS₂＋0.640YZ₁-5.598YZ₂＋5.794ZZ₂＋0.807YZ₃＋0.695ZX₁-391.229, Y₄＝3.284SG＋0.313YM₂-1.595ZS₂＋1.113YZ₁-3.869YZ₂＋4.959ZZ₂＋5.244YZ₃＋0.353ZX₁-340.001）。 结论 所得性别判别式对法医学性别判别应用价值较大,为体质人类学和法医学提供了有关新疆哈萨克族人的解剖学资料。     

Zinc finger of the cerebellum 5 promotes colorectal cancer cell proliferation and cell cycle progression through enhanced CDK1/CDC25c signaling

IntroductionColorectal cancer (CRC), mostly caused by external or environmental factors, is the third most common and lethal cancer worldwide. Although a large number of investigations have been carried out to reveal the evolution of CRC, the underlying mechanisms of CRC remain unclear.Material and methodsExpression of zinc finger of the cerebellum 5 (ZIC5) in CRC tissues and cell models was measured by qRT-PCR and IHC. Cell transfection was carried out for ZIC5 overexpression or knockdown. The MTT assay was applied to examine the capacity of glioma cell proliferation. Wound healing assay and tumor invasion assay were used to test the capacity of glioma cell migration and invasion respectively. Cell cycle analysis and western blot were used to verify the apoptosis rates of CRC cells upon ZIC5 overexpression or downregulation. A further tumor Xenograft study was used to examine the effects of ZIC5 on tumor malignancy in vivo.ResultsCell models using HCT116 and SW620 cells were established to study the ZIC5 function upon ZIC5 overexpression of knockdown. Consistently, we discovered that ZIC5 also significantly increased in Chinese CRC patients. In addition, ZIC5 promoted CRC cell proliferation through increasing the proportion of cells maintained in the S phase. ZIC5 overexpression facilitated the capacity of CRC cell migration and invasion. Inhibition of ZIC5 mitigated such malignant effects.ConclusionsCollectively, investigations of the ZIC5 in CRC provided a new insight into CRC diagnosis, treatment, prognosis and next-step translational therapeutic developments from bench to clinic.     

Comparison of functional outcomes and health-related quality of life one year after treatment in patients with oral and oropharyngeal cancer treated with three different reconstruction methods

We evaluated the functional outcomes and health-related quality of life (HRQoL) of 117 patients (who had had primary operations for oral and oropharyngeal squamous cell carcinoma) using the University of Washington Quality of Life Questionnaire version 4 (UW- QOL V4), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire version 3 (EORTC QLQ-C30 v3) and Head and Neck version 1 (EORTC H&N35 v1). The patients were divided into groups according to the reconstruction techniques used: primary closure, submental island pedicled flap (SIPF), and radial forearm free flap (RFFF). Patients who had reconstruction with RFFF had better HRQoL as measured by swallowing, mastication, speaking, and overall score, than the primary closure group (p < 0.05). There was no significant difference (p > 0.05) between the RFFF and SIPF groups in overall QOL one year postoperatively. The HRQoL of the SIPF group was also better than that of the primary closure group in terms of mastication, speaking, and loss of appetite. Swallowing, mastication, and speaking are major factors that affect the HRQoL of patients one year after operation for oral and oropharyngeal cancer. Flap reconstruction can improve patients’ QoL postoperatively. They can regain their ability to speak and swallow through training, and the importance of this issue must be addressed postoperatively.     

A meta-analysis of the pros and cons of partial superficial parotidectomy versus superficial parotidectomy for the treatment of benign parotid neoplasms

ObjectivesSalivary gland tumors are predominantly benign and frequently localized in the parotid gland (P). The treatment consists primarily of surgical removal; however, the appropriate extent remains a subject of debate. In suitable tumors, superficial parotidectomy (SP) may be substituted for less invasive partial superficial parotidectomy (PSP) (I C). This systematic review analyzed the available literature, comparing PSP and SP with regards to several postoperative outcome parameters (O).Materials and methodsEstablished medical databanks were screened for articles evaluating outcomes of PSP compared with SP, published between 1955 and 2019. These data were assessed by pooled risk and odds ratios via meta-analysis.Results11 studies with 1272 patients were included. There was no significant difference in tumor recurrence between PSP and SP (primary outcome). Furthermore, no differences in the occurrence of permanent facial nerve paralysis (FNP), salivary fistula, great auricular nerve analgesia, or hematoma were observed between the groups. However, PSP displayed significantly reduced rates of transient FNP, Frey's syndrome, scar deformity, and xerostomia, as well as shorter surgical time, compared with SP (secondary outcomes).ConclusionBased on these data, PSP can be recommended as a surgical technique for the treatment of superficially located, small, benign parotid tumors.     

封闭负压引流治疗严重的口腔颌面部间隙感染的临床分析

目的:回顾性分析严重的口腔颌面部间隙感染患者的临床特点、治疗方法及治疗效果,探究合适的治疗策略。方法:回顾性分析2011年11月~2018年4月在我院颌面外科收治的咽旁间隙感染和纵隔感染患者共18例。其中男12例,女6例。年龄16~75岁,中位数年龄为54岁,应用封闭负压引流持续治疗。结果:重度口腔颌面部间隙感染患者12例,极重度口腔颌面部间隙感染患者6例,17例患者共有62个并发症,8例患者伴有系统性疾病,脓肿在入院后中位数6.125 h切开,植入封闭负压引流,多学科联合治疗,早期经验性抗生素对症支持治疗后,所有患者均好转,无死亡病例。结论:严重的口腔颌面部间隙感染须准确诊断,早期切开,多学科支持联合治疗,封闭负压引流植入后脓液引流效果好。     

微血管张力测定技术在血管内皮去除中的应用

目的通过建立离体小动脉血管内皮去除的研究方法,提高微血管测量技术研究数据的可信度。方法选取♂自发性高血压大鼠(SHR)和正常血压大鼠(WKY),测量血压后,获取肠系膜动脉环。采取机械(血管环围绕电极尖端旋转、推注气体)和药物(L-NAME和吲哚美辛)相结合的方式去除内皮。采用压力肌动图技术检测苯肾上腺素(PE)、乙酰胆碱(ACh)、硝普钠(SNP)对肠系膜动脉直径变化的影响。结果(1)SHR血压值高于WKY大鼠(P<0.01);(2)PE浓度依赖地收缩肠系膜动脉。内皮完整和内皮去除时,与WKY相比,SHR的收缩增强(P<0.05);(3)ACh、SNP能够浓度依赖地舒张肠系膜动脉。内皮完整时,与WKY相比,SHR的舒张减弱(P<0.01);内皮去除时,与WKY相比,SHR的舒张增强(P<0.01)。结论(1)成功建立离体微小动脉血管内皮去除的研究方法。(2)高血压大鼠存在明显的血管舒缩功能障碍。     

品管圈在提高某院PIVAS药品调配残留达标率的应用研究

目的:通过运用品管圈的质量管理方法,规范静脉用药集中调配操作,提高静脉用药调配中心(PIVAS)药品调配残留达标率,提高静脉输液调配质量。方法:首先建立品管圈,设立药品调配残留量限度标准,采用减重称量法、体积测量法测定药品调配残留量。然后通过现状把握、要因分析、对策拟定与实施、效果确认、标准化、检讨与改进等品管圈基本步骤提高药品调配残留达标率。结果:药品调配残留量检测方法可靠,对策实施有效,药品调配残留达标率由改善前的38.6%提升到改善后的83.70%(P<0.05),目标达成率106.87%。结论:药品调配残留量的测定方法成本费用低、操作简单,可有效测定药品调配残留达标率。应用品管圈质量管理方法可有效改善药品调配残留达标率,而且可以激发圈员学习的主动性和运用品管圈工具解决临床实际问题的能力。     

单双侧球囊灌注骨水泥椎体成形修复骨质疏松性椎体压缩骨折的系统评价

背景:经皮球囊灌注骨水泥椎体成形已被证实对骨质疏松性压缩骨折有效,但相关的随机对照试验存在样本量小和方法学上的缺陷,因此单侧入路或者双侧入路椎体后凸成形修复骨质疏松性压缩骨折孰优孰劣,仍存在争议。目的:使用系统评价的方法对经皮球囊灌注骨水泥椎体成形单侧入路与双侧入路方法进行分析,以期为椎体后凸成形入路及灌注骨水泥过程中的技术选择提供依据。方法:计算机检索Cochrane Library、PubMed、OVID、Embase、中国生物医学文献数据库、万方数据库、维普资讯等中英文数据库,手工检索9种国内相关杂志,检索日期均从创刊至2014年3月,收集单侧与双侧入路经皮球囊灌注骨水泥椎体后凸成形修复骨质疏松性椎体压缩骨折的随机对照试验,由2名系统评价员按纳入与排除标准选择试验、提取资料和质量评价后,并用RevMan 5.2软件进行Meta分析。结果与结论:最终纳入8个随机对照试验,共507例患者656个椎体。结果显示,骨水泥渗漏方面两组差异无显著性意义;术前目测类比评分[WMD=-0.05(P=0.58)]、短期随访(≤3个月)[WMD=-0.02(P=0.25)]与长期随访(≥12个月)[WMD=-0.08(P=0.64)],两组差异无显著性意义;Oswestry功能障碍指数(ODI)短期随访[WMD=-0.13(P=0.73)]和长期随访[WMD=-0.26(P=0.81)],两组差异无显著性意义;骨水泥用量和操作时间两组差异有显著性意义,单侧入路较双侧入路有优势;影像学结果中术前、术后后凸角及角度恢复值,差异均无显著性意义提示单侧和双侧入路经皮球囊灌注骨水泥椎体后凸成形修复骨质疏松性椎体压缩骨折,在目测类比评分、影像学结果、并发症方面无明显差异;但在手术时间和放射暴露时间上,单侧入路优于双侧入路。     

靶向超声造影剂在干细胞移植中的研究进展

近年来,干细胞移植技术在心肌梗死的治疗中应用越来越广泛。实验研究发现,靶向超声微泡技术能够有效增强心肌梗死区域局部血管的通透性、提高该区域内相关细胞因子的表达效率、增加梗死区新生血管的形成,从而促进干细胞靶向归巢、改善心功能,提高干细胞移植的成功率。因此,本文通过整理总结相关资料,对将超声联合微泡技术应用于干细胞移植治疗急性心肌梗死过程中的研究进展做一综述。