颈椎后路单开门椎管成形术对脊髓型颈椎病患者疗效及预后

目的通过不同手术方法探究颈椎后路单开门椎管成形术对脊髓型颈椎病患者的临床治疗效果及远期预后情况。方法将患者随机分两组,锚钉悬吊固定组(AS组):采用颈椎后路单开门椎管成形术中的锚钉悬吊固定法;Arch钢板固定组(TP组):采用颈椎后路单开门椎管成形术中的Arch钢板固定法。每组各45例。通过两种方法分析AS组与TP组的神经功能、轴性症状、开门角度和门轴侧融合率的疗效及远期预后差异性。结果手术前AS组与TP组JOA评分无差异性,AS组与TP组手术后1年与手术前相比较JOA评分均明显升高;AS组与TP组相比较神经功能改善率无差异性;术后1年,TP组11例发生轴性症状,发生率为24.44%,AS组26例发生轴性症状,发生率为57.78%,经比较有明显差异。通过CT测量开门角度,术后1个月和1年,TP组与AS组相比较开门角度明显增大,两组术后1年与术后1个月相比较降低,但TP组仍大于AS组。结论在颈椎后路单开门椎管成形术中Arch钢板固定法优于锚钉悬吊固定法,对脊髓型颈椎病患者的治疗效果显著,且一年内远期预后整体效果好,Arch钢板固定法好于锚钉悬吊固定法。     

Applicability of Universal Thermal Climate Index (UTCI) in occupational heat stress assessment: a case study in brick industries

The present study aimed to investigate the applicability of Universal Thermal Climate Index (UTCI) as an innovative and science-based index in public health researches, in occupational heat stress assessment. All indoor and outdoor workers (200 people) of Brick industries of Shahroud, Iran participated in the research. First, the environmental variables such as air temperature, wet-bulb temperature, globe temperature, air velocity and relative humidity were measured; then UTCI and WBGT (wet-bulb globe temperature) indices were calculated. Simultaneously, physiological parameters including systolic and diastolic blood pressure, oral temperature, skin temperature, tympanic temperature and heart rate of workers were measured. UTCI and WBGT indices were 34.2 ± 2°C, 21.8 ± 1.8°C in the outdoor environments and 38.1 ± 4.4°C, 24.7 ± 3.3°C at the indoor environments, respectively. There were the weak inverse relationships between UTCI and WBGT indices at the outdoor environments and physiological responses such as systolic blood pressure, and diastolic blood pressure. However, there were no similar results for indoor environments. The significant relationships were found between UTCI and WBGT at both indoor and outdoor environments. Both UTCI and WBGT indices are suitable for assessing the occupational heat stress. Although, UTCI index seems more appropriate for heat stress assessment in the environments with low humidity and air velocity.     

DPD、MTHFR和TS表达水平与氟尿嘧啶类药物治疗消化道肿瘤疗效及预后关系的研究进展

消化道恶性肿瘤包括结直肠癌、胃癌和食管癌等。尽管使用了各种治疗方式，癌症患者仍然有复发和转移。绝大多数患者确诊时即为中晚期，因而化疗在癌症患者中发挥重要作用。作为5-FU抗癌活性中的三个关键酶，二氢嘧啶脱氢酶（DPD）、5,10-亚甲基四氢叶酸还原酶（MTHFR）、胸苷酸合成酶（TS）与消化道肿瘤的疗效、对化疗药物的敏感性及患者的预后有密切关系。     

胃肝样腺癌的诊治现状

目的了解胃肝样腺癌(GHA)的研究现状,以期为临床诊治提供参考。方法查阅近年来国内外关于GHA研究的相关文献并进行综述。结果 GHA是一种具有腺样分化和肝细胞分化的特殊类型胃癌,在所有胃癌中发生率≤1%。GHA的组织学形态与肝细胞癌相似,常伴有血清甲胎蛋白升高,极易出现淋巴结转移和肝转移。根治性手术及化疗是其最主要的治疗方法,但即使是根治性切除后仍常见复发和转移,且目前尚无针对GHA的标准化疗方案。结论 GHA是一种恶性度较高的特殊胃癌亚型,临床进展迅速,预后差。组织病理学结果是诊断GHA的金标准。GHA治疗以手术与化疗为主的综合治疗方式,基因分子特征及靶向治疗是未来的研究方向。     

Factors influencing ultra-endurance athletes food choices: an adapted food choice questionnaire

ABSTRACT

Inadequate nutritional intake has been reported during ultra-endurance training and competition. While substandard nutritional knowledge may contribute to inappropriate nutritional choices, the relationship between these variables is often weak. As such, this study investigated the importance of a range of factors to the food choices of ultra-endurance athletes. An existing food choices questionnaire was extended to reflect the main factors proposed to influence the food choices of these athletes. The questionnaire was pilot tested with endurance athletes, during which, it was refined and reassessed for internal consistency and test-retest reliability. Subsequently, 101 experienced ultra-endurance athletes completed the amended questionnaire. Athletes also documented dietary restrictions or strategies employed in preparation for competition. The factors rated as important by the majority of the athletes were “provides me with energy”, “do not cause me gastrointestinal discomfort” and, “are nutritious”. Despite the high importance of the provision of energy, only 38.2% of participants reported following a high carbohydrate diet in preparation for competition. In addition, given that nutritious foods are typically high in fibre, it is likely that this factor may conflict with the avoidance of gastrointestinal discomfort. The potential incompatibility of these factors may help explain the observed suboptimal nutritional intake.     

The potential of CD44 as a diagnostic and prognostic tool in oral cancer

The CD44 family of molecules exists as a wide range of isoforms ubiquitously expressed on the surface of mammalian cells. The variation in patterns of CD44 expression on cancer cells has been widely studied in relation to their behaviour, and further interest has recently arisen in CD44 as a marker of the subfraction tumour cells acting as cancer stem cells in several types of tumours. This review focuses on the patterns of CD44 expression on the stem cell fraction of oral squamous cell carcinoma and on the relationship of detectably different patterns of CD44 expression to the behaviour of tumours.     

Body mass index and the risk of infection - from underweight to obesity

BackgroundNutritional status is a well-known risk factor for metabolic and endocrine disorders. Recent studies suggest that dietary intake also affects immune function and as a consequence infection risk.AimsThis reviews aims to give an overview on the effect of body weight on infection rate at different periods of life.SourcesClinically relevant prospective, cross-sectional and case–control community-based studies are summarized.ContentIn children and adolescents underweight is a significant risk factor for infection especially in developing countries, probably reflecting malnutrition and poor hygienic standards. Data from industrialized countries suggest that infection rate is also increased in obese children and adolescents. Similarly, several studies suggest a U-shaped increased infection rate in both underweight and obese adults. In the latter, infections of the skin and respiratory tract as well as surgical-site infections have consistently been reported to be more common than in normal-weight participants. Paradoxically, mortality of critically ill patients was reduced in obesity in some studies.ImplicationsSeveral studies in children or adults suggest that both underweight and obesity are associated with increased infection risk. However, confounding factors such as malnutrition, hygienic status and underlying disease or co-morbidities might aggravate accurate assessment of the impact of body weight on infection risk.