成人后孟氏骨折与经尺骨近端骨折后脱位的鉴别与治疗

经典孟氏骨折的定义是尺骨骨折伴上尺桡关节脱位,如合并桡骨头后脱位,即肱桡关节后脱位时,称为后孟氏骨折。而对于不伴有上尺桡关节脱位者,不应笼统称为后孟氏骨折,可称为经尺骨近端骨折后脱位。对于伴有上尺桡关节脱位后孟氏骨折,临床相对少见,其冠突骨折通常粉碎,上尺桡关节遭到破坏,环状韧带及骨间膜损伤,治疗时在恢复骨性结构及处理外侧韧带复合体后,还须关注与处理上尺桡关节的稳定,预后疗效不确定。而经尺骨近端骨折后脱位临床相对多见,其冠突骨折块通常完整,环状韧带及骨间膜完好,在治疗上以恢复骨性结构为主,同时处理肘关节外侧韧带复合体,预后效果好。通过解剖基础、影像学特征、损伤特点、治疗方法及预后等方面鉴别和区分后孟氏骨折与经尺骨近端骨折后脱位。     

Long-term sero-positivity for IgG,sequelae of respiratory symptoms,and abundance of malformed sperms in a patient recovered from severe COVID-19

European Journal of Clinical Microbiology & Infectious Diseases - Patients with severe coronavirus disease in 2019 (COVID-19 pneumonia) may have many sequelae, which seriously affect their...     

经肛门内镜显微手术治疗直肠神经内分泌肿瘤

目的探讨经肛门内镜显微手术(TEM)直肠全层切除治疗直肠神经内分泌肿瘤的效果。方法回顾性分析北京协和医院2006年12月至2015年12月间74例采用TEM治疗的直肠神经内分泌肿瘤患者。收集患者的一般资料、肿瘤特点、手术情况、术后病理及随访结果。结果其中50例患者行原发病灶切除,24例患者因结肠镜下切除后标本切缘不清或阳性行二次手术。肿瘤直径平均(1.02±0.43)cm,距离肛缘(7.9±1.7)cm。平均手术时间(58.7±12.1)min,平均术中出血量(13.1±5.0)ml。所有标本基底和侧切缘均阴性。平均随访3.6年,无肿瘤复发。结论 TEM可以作为直径较小的中上段直肠神经内分泌肿瘤手术治疗的首选。     

35岁以下女性乳腺癌患者临床病理特征分析：附85例报告

目的：探讨35岁以下青年女性乳腺癌的临床病理特点。 方法：回顾性分析2005年2月—2010年11月85例35岁以下青年女性乳腺癌患者（观察组）的临床和病理资料,并与164例同期随机选取的中老年女性乳腺癌患者（对照组）资料比较。 结果：观察组85例青年乳腺癌患者的临床症状无特异性,误诊率为45.88%,平均（30.27±2.41）岁,平均病程（11.51±1.56）个月。与对照组比较,观察组肿瘤体积大、临床分期晚、组织学分级上分化差（均P<0.05）,但病理类型的构成差无统计学意义（P>0.05）。此外,观察组乳腺癌组织雌激素受体（ER）、孕激素受体（PR）表达水平低于对照组,但c-erbB-2蛋白表达水平高（均P<0.05）;腋窝淋巴结转移率与淋巴结转移数多均高于对照组（均P<0.05）。 结论：青年乳腺癌具有其独特的临床、病理学和分子生物学特征,早期诊断与治疗是提高生存率的有效手段。

     

Carvacrol effectively protects demyelination by suppressing transient receptor potential melastatin 7 (TRPM7) in Schwann cells

Anatomical Science International - Peripheral neurodegenerative processes are essential for regenerating damaged peripheral nerves mechanically or genetically. Abnormal neurodegenerative processes...     

2016年南通市放射工作人员外照射个人剂量监测结果

目的 了解南通市放射工作人员职业外照射的剂量水平及分布情况,评价放射工作人员职业危害及防护效果,为放射防护管理工作提供科学依据。方法 使用RGD-3D热释光剂量仪对放射工作人员进行外照射个人剂量当量H_P（10）监测,职业类别包括诊断放射学、介入放射学、核医学、牙科放射学、放射治疗、工业应用等,采用全国放射卫生信息平台个人监测管理系统进行数据汇总统计。结果 南通市放射工作人员外照射人均年有效剂量为0.273 mSv/a,所有监测人员的年有效剂量均小于年剂量限值20 mSv,集体有效剂量为0.570人·Sv,人均年有效剂量以介入放射学（0.375 mSv/a）稍高,其次为核医学（0.316 mSv/a）,人数最多的诊断放射学为0.271 mSv/a,其余职业类别年有效剂量值均在较低水平;不同地区放射工作人员平均年有效剂量相差不大,人均年有效剂量海安县（0.418 mSv/a）较其他地区稍高;二甲医院以下医疗单位监测剂量值（0.361 mSv/a）要高于二甲医院及以上医疗单位（0.182 mSv/a）和工业企业（0.143 mSv/a）。结论 2016年南通市放射工作人员年有效剂量均处于较低水平,我市放射工作人员的放射防护条件良好,工作环境安全。     

Hepatoprotective versus oncogenic functions of STAT3 in liver tumorigenesis

Aberrantly hyperactivated STAT3 has been found in human liver cancers as an oncogene; however, STAT3 has also been shown to exert hepatoprotective effects during liver injury. The balancing act that STAT3 plays between hepatoprotection and liver tumorigenesis remains poorly defined. In this study, the diethylnitrosamine (DEN)-induced liver tumor model and the chronic carbon tetrachloride (CCl(4))-induced liver fibrosis model were both used to investigate the role of STAT3 in liver tumorigenesis. Hepatocyte-specific STAT3 knockout mice were resistant to liver tumorigenesis induced by a single DEN injection, whose tumorigenesis was associated with minimal chronic liver inflammation, injury, and fibrosis. In contrast, long-term CCl(4) treatment resulted in severe hepatic oxidative damage, inflammation, and fibrosis but rarely induced liver tumor formation in wild-type mice. Despite the oncogenic function of STAT3 in DEN-induced liver tumor, hepatocyte-specific STAT3 knockout mice were more susceptible to liver tumorigenesis after 16 weeks of CCl(4) injection, which was associated with higher levels of liver injury, inflammation, fibrosis, and oxidative DNA damage compared with wild-type mice. These findings suggest that the hepatoprotective feature of STAT3 prevents hepatic damage and fibrosis under the condition of persistent inflammatory stress, consequently suppressing injury-driven liver tumor initiation. Once liver tumor cells have developed, STAT3 likely acts as an oncogenic factor to promote tumor growth.     

Is adjuvant chemotherapy necessary for patients with pathological complete response after neoadjuvant chemoradiotherapy and radical surgery in locally advanced rectal cancer? Long-term analysis of 40 ypCR patients at a single center

Objectives

According to practice guidelines, adjuvant chemotherapy (ACT) is required for all patients with locally advanced rectal cancer who have received neoadjuvant chemoradiotherapy (NCRT) and total mesorectal excision (TME). The objective of this study was to determine whether ACT is necessary for patients achieving pathological complete response (pCR) after NCRT followed by surgery.

Methods

By retrospectively reviewing a prospectively collected database in our single tertiary care center, 210 patients with locally advanced rectal cancer who underwent NCRT followed by TME were identified between February 2005 and August 2013. All patients achieving ypCR were enrolled in this study, in which who underwent ACT (chemo group) and who did not (non-chemo group) were compared in terms of local recurrence (LR) rate, 5-year disease-free survival (DFS) rate and overall survival (OS) rate.

Results

Forty consecutive patients with ypCR were enrolled, 19 (47.5 %) in chemo group and 21 (52.5 %) in non-chemo group. After a median follow-up of 57 months, five patients developed systemic recurrences, with the 5y-DFS rate of 83.5 %. No LR occurred in the two groups. The 5y-DFS rates for patients in chemo group and non-chemo group was 90.9 and 76.0 %, respectively, showing no statistically significant difference (p?=?0.142). Multivariate analysis showed that tumor grade was the only independent prognostic factor for 5y-DFS and 5y-OS.

Conclusions

Results of this study suggested that it may not be necessary for all rectal cancer patients with ypCR after NCRT and radical surgery to receive ACT. Prospective randomized trials are warranted to further determine the value of ACT for ypCR patients.