显微镜辅助经鼻蝶窦入路垂体瘤切除术的疗效及安全性评价

目的:研究显微镜辅助下经鼻蝶窦入路垂体瘤切除术的疗效和安全性。方法:回顾性分析垂体瘤患者病历资料,并根据手术方式不同分为接受显微镜辅助下经鼻蝶窦入路垂体瘤切除术的观察组和给予经口唇下-鼻中隔-蝶窦垂体瘤切除术的对照组,观察两组患者的术中应激程度、疗效相关指标以及并发症情况,并与已有研究进行比较。结果:1观察组患者的肾上腺素、去甲肾上腺素、肾素以及血管紧张素Ⅱ水平均以及手术时间、术中出血量、术后住院时间低于对照组,激素水平恢复正常例数、改善例数均明显增多,并发症例数少于对照组;2与已有研究相比,观察组患者的手术时间、术中出血量、术后住院时间以及激素水平恢复正常例数、改善例数、术后并发症例数的差异均无统计学意义。结论:显微镜辅助下经鼻蝶窦入路垂体瘤切除术有助于减小手术创伤、缓解应激状态,并且能够取得与神经内镜手术相当的手术疗效。     

Circulating prolactin and corticosterone concentrations during the development of migratory condition in the Dark-eyed Junco, Junco hyemalis

Endogenous plasma prolactin and baseline corticosterone concentrations were measured in Dark-eyed Juncos (Junco hyemalis, n=27) photostimulated into migratory condition to look at how these hormones may be linked to the development of migratory condition. In addition to the commonly used assay for corticosterone, a recombinant-derived European starling prolactin assay validated for Dark-eyed juncos was used to measure endogenous prolactin in order to detect small but significant changes in plasma prolactin levels. In response to transfer from short (10.5L:13.5D) to long (18L:6D) days, the birds increased in body mass, fat score, daily food intake, and nocturnal migratory locomotor activity (Zugunruhe). On short-days, both hormones were low (corticosterone mean=2.89ng/mL+/-0.48 SE; prolactin mean=6.43ng/mL+/-1.31 SE). But, within 14 days of photostimulation both hormones increased significantly (Day 14: corticosterone mean=5.71ng/mL+/-0.77 SE; prolactin mean=19.67ng/mL+/-2.81 SE), rising further by Day 48 (corticosterone mean=8.41ng/mL+/-0.72; prolactin mean=112.67ng/mL+/-9.18 SE). On Day 48, birds with the most fat (fat score=3) had significantly higher corticosterone levels than those with less fat (fat score=2). This pattern, albeit not statistically significant, was similar for prolactin. These results illustrate that, independent of the seasonal peak in prolactin associated with the onset of photorefractoriness, plasma prolactin levels can rise, in concert with corticosterone, as birds come into spring migratory condition, providing some support for earlier hypotheses that these two hormones play an integral role in the development of migratory condition. Whether similar changes in plasma prolactin occur with respect to autumn migration, as does baseline corticosterone, has yet to be determined.     

Periodontal risk assessment in a teaching hospital population in Saudi Arabia’s Eastern Province

ObjectiveWith this cross-sectional study, we aimed to evaluate factors associated with moderate and high risk of periodontal disease (PD) progression in the Saudi population.MethodsWe reviewed 281 patients’ clinical charts from predoctoral periodontal clinics at the dental teaching hospital in the College of Dentistry (COD) at Imam Abdulrahman Bin Faisal University (IAU) in Dammam, Saudi Arabia. After obtaining ethical approval, we determined the Periodontal Risk Assessment (PRA) of the included patients based on the modified criteria developed by Lang and Tonetti (2003). We used logistic regression on stratified data and divided the results into two categories (low-moderate and high risk) to assess the effect modifier for potential risk factors. We used SPSS version 22 for data analysis, and considered a P-value ≤ 0.05 to be statistically significant.ResultsOut of the 281 patients, 104 (37.0%) were male and 177 (63.0%) were female, with a mean age of 39.9 ± 14.0 years; 78.1% were Saudi nationals, 77% were married, and 44.6% were in the age group of 30 to 49. The PRA revealed 86 (30.5%) to represent high risk, 108 (38.3%) denoted moderate risk, and 88 (31.2%) signaled low risk for periodontitis. Logistic regression analysis showed that males were three times more likely to have high PRA (OR = 3.24) and to be married (OR = 2.77), as well as to be active smokers (OR = 8.87). The highest predictive factors of high PRA were 8 or more pockets ≥ 5 mm (OR = 29.0), those with active diabetes mellitus (DM; OR = 10.2), and those with 8 or more missing teeth (OR = 9.15).ConclusionSaudi males who are married and have residual periodontal pockets, are actively diabetic, and with missing teeth are at high risk of PD. Further research is needed with a larger sample size comparing the general population with and without PD.     

不同包装和贮藏条件下酸枣仁的质量比较

目的:确定酸枣仁适合的贮藏条件、包装材料和包装方式,为保障酸枣仁质量提供参考。方法:选用同一批酸枣仁样品,分别采取塑料编织袋包装、塑料袋包装、塑料袋真空包装、铝塑复合袋包装、铝塑复合袋真空包装和牛皮淋膜纸袋包装,贮藏在阴凉库(温度≤20℃、相对湿度为45%~75%)和药品稳定性试验箱[温度为(40±2)℃、相对湿度为(75±5)%]中,以性状及水分、黄曲霉毒素、酸枣仁皂苷A、斯皮诺素含量为考察指标,开展为期6个月的阴凉长期稳定性试验和加速稳定性试验研究。结果:6个月阴凉长期稳定性试验结果显示,不同包装条件下酸枣仁样品的性状以及水分、黄曲霉毒素、酸枣仁皂苷A含量均符合2015年版《中国药典》(一部)(后文简称"药典")酸枣仁项下规定;斯皮诺素含量均不符合药典的规定(不低于0.080%),但其中铝塑复合袋真空包装样品中斯皮诺素含量(0.079%)与药典要求接近。6个月加速稳定性试验结果显示,牛皮淋膜纸袋包装、塑料编织袋包装样品发霉严重,塑料袋包装、塑料袋真空包装样品表面颜色变暗,铝塑复合袋包装样品颜色稍变暗,但铝塑复合袋真空包装样品外观基本无变化;塑料编织袋包装、牛皮淋膜纸袋包装样品中水分含量超过了药典要求最高值(9.0%);仅在贮藏2个月时,编织塑料袋包装样品被检出黄曲霉毒素B1含量为8.64μg/kg,超出药典规定;各包装样品中酸枣仁皂苷A含量虽有下降,但均满足药典要求;仅塑料袋真空包装样品中斯皮诺素含量(0.084%)满足药典要求,其次属铝塑复合袋真空包装样品中含量(0.071%)相对较高。结论:酸枣仁以铝塑复合袋真空包装后置于阴凉干燥处为宜。     

NASA空间站航天员病症目录分析

目的对NASA空间站病症目录进行分析,为我国空间站医学保障设计和资源配置提供参考。方法对NASA空间探索任务病症清单(space medicine exploration medical condition list,SMEMCL)中的空间站病症进行应对优先情况汇总,并按照相应的标准进行分类及分级处理。结果按照应对优先等级划分,必须处理和酌情处理的病症占绝大多数(82.76%),属于不专项应对病症仅占很少部分。在对病症进行分类及分级后,可见分类中以临床病症占比例最大(82.72%);按照NASA病症分级标准(严重程度分级),属于轻中程度的病症最多(91.36%),极少部分属于严重病症。结论 NASA空间站病症目录详实全面,必须处理和酌情处理的轻中程度临床病症居多;在进行空间站航天员医学保障的设计和相关医学资源的配置时应重点考虑这部分病症,对其余病症适当兼顾。     

Total costs and clinical outcome of hematopoietic stem cell transplantation in adults with leukemia: comparison between reduced‐intensity and myeloablative conditioning

The total cost of hematopoietic stem cell transplantation (HSCT) as well as the financial impact of HSCT on the house holds of patients have been elusive. Between 2005 and 2012, we analyzed 191 HSCT in adult patients with leukemia with reduced‐intensity conditioning (RIC) regimen (n = 79) and with myeloablative conditioning (MAC) regimen (n = 112). The direct medical costs were calculated from healthcare claims obtained from the Seoul National University Hospital, and the direct non‐medical and the indirect costs were calculated from national statistics. The mean direct medical cost was $55 039, direct non‐medical cost was $6394, and indirect cost was $7503 from transplantation to one yr after transplantation in the RIC group and $72 916, $6993, and $9057 in the MAC group, respectively, based on the exchange rate of Korean won 1060 = US$1. The total costs for one yr were $68 938 and $88 967, constituting for 273% and 357% of the per capita income, respectively. The total costs, direct medical costs, and indirect costs showed statistically significant differences (p = 0.006, p = 0.007, and p = 0.017). No significant differences were found for leukemia‐free survival and overall survival. RIC‐HSCT provides lower costs within the first year of transplantation with comparable long‐term clinical outcomes.     

微电场通过活化黏着斑激酶信号通路促进缺氧条件下绒毛外滋养细胞的迁移/侵袭

摘要:目的：探讨微电场刺激及缺氧条件对黏着斑激酶（FAK）信号通路的作用及对人胎盘绒毛外滋养细胞系HTR-8/SVneo迁移/侵袭的影响。 方法：划痕实验分析绒毛外滋养细胞在缺氧条件下的迁移情况;western blot检测微电场刺激后绒毛外滋养细胞FAK Tyr397和pY576/577位点及其下游柱蛋白（paxillin）分子磷酸化水平,并检测微电场刺激5、10 h后HTR-8/SVneo细胞基质金属蛋白酶-2（MMP-2）的表达水平;2、5、10 μmol/L FAK抑制剂PF-573228处理HTR-8/SVneo细胞后观察细胞行为,并用western blot检测其MMP 2的表达水平。 结果：微电场刺激能改善缺氧条件下HTR-8/SVneo细胞的迁移速度;与对照组比较,缺氧条件下微电场刺激可促使FAK-Tyr397位点磷酸化水平及paxillin分子表达水平明显升高（P均<0.05）,而pY576/577位点则无明显改变;经微电场刺激5、10 h后,HTR-8/SVneo细胞MMP-2表达水平均升高（P均<0.05）;经FAK抑制剂处理后,HTR-8/SVneo细胞对微电场的应答反应明显受抑制,其MMP-2表达水平降低。 结论：微电场可能通过活化FAK信号通路促进缺氧培养绒毛外滋养细胞的迁移/侵袭。     

酒依赖患者病情观察及护理干预

通过对56例酒依赖患者进行病情观察,制定相应的护理措施并实施,可以帮助患者减轻戒断症状及并发症,安全度过戒断期,从心理及生理上缓解或消除对酒的依赖,提高患者生活质量。