2型糖尿病患者颈动脉内膜-中层厚度与血液流变学指标的相关性分析

目的:探讨2型糖尿病患者颈动脉内膜-中层厚度(CIMT)与血液流变学指标的相关性。方法:选取88例糖尿病患者,检查CIMT后,分为血管病变组及无血管病变组,检测两组患者全血粘度、血浆粘度和红细胞压积、纤维蛋白原,对结果进行组间比较及CIMT与血流变指标的相关性分析。结果:血管病变组的CIMT、全血(低切、中切、高切)粘度、血浆粘度、红细胞压积、纤维蛋白原与无血管病变组比较差异有统计学意义(P<0.05);血管病变组CIMT与全血(中切、低切)粘度、血浆粘度、红细胞压积、纤维蛋白原呈显著正相关(P<0.01)。结论:糖尿病合并颈动脉血管病变患者常伴有血液流变学指标升高,血液流变学异常变化可能参与颈动脉血管病变的发生发展。     

血清胱抑素C和血尿β2-微球蛋白对2型糖尿病早期肾损害的诊断价值

目的探讨血清胱抑素C、血/尿β2-微球蛋白联合检测在2型糖尿病肾病中的应用价值。方法将120例2型糖尿病肾病患者按尿清蛋白排泄率分为A、B、C三组,用全自动生化分析仪检测血清胱抑素C,化学发光免疫分析仪检测血/尿β2-微球蛋白,对检测结果采用SAS统计软件进行统计学处理作对比分析。结果各期2型糖尿病肾病患者血清胱抑素C、血/尿β2-微球蛋白水平均明显升高,与对照组比较,有显著性差异(P<0.05或P<0.01);120例2型糖尿病肾病患者血清胱抑素C与血/尿β2-微球蛋白呈正相关(r为0.428,0.366;P<0.01,P<0.01)。结论血清胱抑素C、血/尿β2-微球蛋白联合检测在协助临床做好2型糖尿病肾病早预防、早发现、早治疗方面有其积极意义。     

卵母细胞成熟障碍4例与同期卵母细胞大部分不成熟患者比较分析

目的分析4例体外受精-胚胎移植（IVF—ET）患者共8个辅助助孕周期,全部73个卵母细胞均处于GV、MetaphaseI期的可能原因。并与同期13例IVF—ET患者比较分析,比较组患者〉50％卵母细胞处于GV、MetaphaseI期。方法回顾分析本中心12年辅助助孕工作中出现的4例患者共8个周期所获卵母细胞均处于GV、MI的临床及实验室资料,并与同期13例超过50％卵母细胞处于GV、MI患者的临床、实验室资料进行比较。结果4例患者73个卵母细胞均处于GV或MI期,经体外成熟培养,24,48,72h仍无极体排出,停滞于GV、MI期。同期13例患者大部分卵母细胞不成熟,但体外培养后部分卵母细胞可进一步成熟,并可受精,获得妊娠。结论细胞和遗传机制引起卵母细胞成熟障碍,现有体外成熟培养方法尚无法促其成熟,目前赠卵是该类患者获得妊娠可供选择的助孕方法。但对于在控制性超促排卵中,出现大部分卵母细胞不成熟的患者可以通过延长促超排时间,增大hCG注射日卵泡直径,体外成熟培养等方法获得成熟的卵母细胞,获得妊娠。     

舌静脉畸形的DSA分型及治疗—132例临床分析

目的:探讨舌静脉畸形(venous malformations,VM)的数字减影血管造影（digital substraction angiography, DSA）分型及治疗策略。方法:总结2016年2月—2019年2月收治的132例舌VM患者的DSA表现,根据影像学特征将其分为4型,Ⅰ型为无回流型、Ⅱ型为低回流型、Ⅲ型为高回流型、Ⅳ型为广泛型,依据分型选择不同的治疗方案。无回流型单纯采用平阳霉素进行硬化治疗,低回流型单纯采用聚桂醇泡沫硬化剂进行硬化治疗,高回流型采用无水乙醇结合聚桂醇泡沫硬化剂进行硬化治疗,广泛型先按高回流型进行硬化治疗后再结合整形手术切除。统计各组病例的治疗效果及不良反应。结果:本组132例病例获得12~41个月随访,平均15.8个月,所有患者术后舌VM明显缩小甚至消失。Ⅰ型8例,有效率100%;Ⅱ型17例,有效率100 %;Ⅲ型98 例,有效率90.8 %;Ⅳ型 9例,有效率77.8%。不良反应主要为组织溃烂、坏死,Ⅰ型0例;Ⅱ型1例,发生率5.88%; Ⅲ型16例,发生率16.33%;Ⅳ型7例,发生率77.78%。结论:基于DSA的舌VM分型对临床治疗具有重要指导意义。舌VM中大部分为Ⅲ型病例,Ⅰ型比例最小。经黏膜注射无水乙醇是治疗高回流型和广泛型舌VM的有效方法。     

Relapse-related factors of Le Fort I osteotomy in cleft lip and palate patients: A systematic review and meta-analysis

A systematic review search was based on the PICOS approach, as follows: population: cleft lip and palate patients; intervention: Le Fort I osteotomy; comparator: different surgical protocols; outcome: stability, recurrence or surgical complications; study designs: only case reports were excluded from the review. No restrictions were placed on language or year of publication. Risk of bias was analyzed, heterogeneity was assessed, and subgroup analysis was performed using a level of significance of 1% (p = 0.01).The search identified 248 citations, from which 29 studies were selected and a total of 797 patients enrolled. The level of agreement between the authors was considered excellent (k = 0.810 for study selection and k = 0.941 for study eligibility). Our results reported a mean maxillary advancement of 5.69 mm, a mean vertical downward/upward of 2.85/−2.02 mm and a mean clockwise rotation of 4.15°. Greater surgical relapse rates were reported for vertical downward movement (−1.13 mm, 39.6%), followed by clockwise rotation (−1.41°, 33.9%), sagittal (−0.99 mm, 17.4%) and vertical upward (0.11 mm, 5.4%) movements. No relevance was found regarding the type of cleft, the type of Le Fort I osteotomy, concomitant bone grafting, surgical overcorrection, postoperative rigid or elastic intermaxillary fixation, or retention splint.Study limitations were heterogeneity and the low number of high-quality studies. In spite of reported high relapse rates, Le Fort I osteotomy for maxillary reposition is the first-choice procedure for selected cleft lip and palate patients in whom extensive maxillary movements are not required, because of its safety and its three-dimensional movement versatility in one-step surgery. Otherwise, distraction osteogenesis should be considered as the gold standard treatment.     

手法复位石膏外固定联合盘龙七片治疗A3型桡骨远端骨折的早期疗效

目的探讨手法复位石膏外固定术联合口服盘龙七片治疗A3型桡骨远端骨折的早期疗效,为临床治疗提供参考。方法选取2018年6月至2020年1月于邳州医院治疗的A3型桡骨远端骨折患者100例,随机分为对照组(手法复位石膏外固定术,50例)和研究组(手法复位石膏外固定术联合口服盘龙七片,50例)。比较两组患者治疗前和治疗7 d血清IL-1、IL-6、TNF-α水平及治疗后4周Gartland-Werley腕关节评分,评价两组患者早期临床治疗效果。结果经过7 d治疗后,两组血清IL-1、IL-6、TNF-α水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05,P<0.01)。研究组患者拆除石膏后Gartland-Werley腕关节评分优良率高于对照组,差异有统计学意义(82.0%vs 48.0%,χ²=12.703,P<0.01)。结论手法复位石膏外固定术联合口服盘龙七片治疗A3型桡骨远端骨折,较之单纯手法复位石膏外固定能有效降低骨折炎性反应,缓解疼痛、肿胀。     

Development of calcium phosphate/calcium sulfate biphasic biomedical material with hyaluronic acid containing collagenase and simvastatin for vital pulp therapy

ObjectiveIn vital pulp therapy (VPT), a barrier is created with appropriate capping to protect the remaining pulp and thus maintain pulp vitality. Here, we evaluated the feasibility of a biphasic calcium phosphate cement (CPC)–calcium sulfate hemihydrate (CSH) biomaterial containing simvastatin (Sim) and collagenase (Col) for VPT.MethodsCombinations of varying CPC and CSH concentrations were analyzed for their handling properties and setting times, with their structures observed through scanning electron microscopy–energy dispersive X-ray spectrometry (SEM-EDS). Drug release patterns of simvastatin and collagenase combined with CPC–CSH (CPC–CSH–Sim–Col) were also analyzed, followed by biocompatibility and bioactivity tests on human dental pulp stem cells (hDPSCs) and in vivo animal study in canine models; the in vivo results were obtained through microcomputed tomography and histological analysis.ResultsThe results revealed that 70 wt% CPC (CPC7) with 30 wt% CSH (CSH3) exhibited optimal setting time and porous structure for clinical use. The cell viability and cytotoxicity analysis demonstrated that CPC7–CSH3 with or without simvastatin or collagenase did not injure hDPSCs. In vivo, the CPC7–CSH3–Sim–Col induced dentin bridge formation.SignificanceCPC7–CSH3–Sim–Col in this study has great potential as a VPT biomaterial to enhance the dentin bridge formation.