近肾腹主动脉瘤的腔内治疗技术进展

腹主动脉瘤腔内修复术目前已成为大部分肾下型腹主动脉瘤患者的首选治疗,但对于近端瘤颈较短的近肾腹主动脉瘤,需要涉及内脏分支重建,常规的腹主动脉瘤腔内修复术疗效并不满意。近年来,烟囱支架技术、开窗支架技术、分支支架技术、八爪鱼技术等创新性技术的使用为近肾腹主动脉瘤患者的腔内治疗提供了多种解决方案,本文回顾并总结当前腔内治疗技术的进展,以期对目前各种技术的应用难点加以分析思考。     

胰腺癌诊断筛查方式发展的回顾性分析

目的梳理胰腺癌诊断筛查方式的历史沿革,探究在中国人口基数大、经济处于发展中的背景下,如何实现胰腺癌的"早诊早治"。方法采用系统回顾的方法进行分析。计算机检索CNKI、VIP、WanFang Data、Web of Science、PubMed和EMbase数据库,同时由两名研究员独立检索百度搜索引擎,检索时限均从建库至2018年2月28日,搜集胰腺癌筛查方法及效果评价的相关报道,进行定性描述。结果共117篇文献纳入研究。国内对胰腺癌筛查方式的探索经历了萌芽、启蒙和成长三个阶段。现有筛查方式有临床表现、影像学方法、血清肿瘤标记物和分子生物学基因诊断四种,各有利弊。单一手段无法实现较高特异性和灵敏度,联合检测成为必然趋势。考虑到应用过程中的效益问题,在高危人群中进行筛查可以有效缩小人群范围,实现精准筛查。结论我国针对胰腺癌筛查方面的研究较国外有较大差距。筛查方法呈现多样性,联合检测是必然趋势。在高危人群中进行胰腺癌筛查将成为技术瓶颈下的突破口。     

神经导管修复周围神经损伤的研究进展

对神经导管在周围神经损伤的修复和再生的应用及研究进展作一综述。主要包括两方面内容：神经导管材料设计及导管内微环境构建。     

Clinicopathological features of primary diffuse large B‐cell lymphoma of the central nervous system – strong EZH2 expression implying diagnostic and therapeutic implication

Primary diffuse large B‐cell lymphoma of the central nervous system (CNS DLBCL) is a rare entity which is difficult to diagnose and treat. The histone methyltransferase EZH2 was reported to be involved in the tumorigenesis of systemic DLBCL but has not been implicated in primary CNS DLBCL. The clinicopathological features of 33 cases of primary CNS DLBCL and expression of EZH2 and Y641 mutation were assessed. The tumor cells of the majority cases resembled centroblasts, and intriguingly, three cases of rare anaplastic variant were observed. Immunophenotypically, 25/33 (75.8%) cases were non‐germinal center B‐cell‐like type. Several cases (10/33; 30.3%) co‐expressed BCL2 and MYC, 6/33 (18.2%) expressed both BCL6 and MYC, and 5/33 (15.2%) expressed BCL2, BCL6, and MYC. MYC expression alone and BCL2/MYC co‐expression were associated with poor prognosis. EZH2 was strongly expressed in all 33 cases independent of Y641 mutation and was significantly associated with the tumor proliferative index Ki67. However, no association was found between the level of EZH2 expression and outcomes of patients. In summary, the clinicopathological features including three rare anaplastic variant of primary CNS DLBCL are described. Strong expression of EZH2 in all the primary CNS DLBCL and association with high proliferative index provides further information for treatment and diagnosis of this distinctive entity.     

A facile technique to prepare biodegradable coaxial electrospun nanofibers for controlled release of bioactive agents.

A one-step, mild procedure based on coaxial electrospinning was developed for incorporation and controlled release of two model proteins, BSA and lysozyme, from biodegradable core-shell nanofibers with PCL as shell and protein-containing PEG as core. The thickness of the core and shell could be adjusted by the feed rate of the inner dope, which in turn affected the release profiles of the incorporated proteins. It was revealed that the released lysozyme maintained its structure and bioactivity. The current method may find wide applications for controlled release of proteins and tissue engineering.     

呼和浩特地区汉族正常(牙合)计算机辅助X线头影测量研究

以呼和浩特市180名中小学生为研究对象,运用计算机辅助X线头影测量系统,对其颅面、牙(牙合)22项硬组织指标进行了测量。提供了呼和浩特地区汉族正常验的X线头影正常值。结果表明,男女颅面结构差异以恒牙期显著,表现为颅面深度及高度的线距测量上,男性大于女性;颅面结构的深度、高度随生长发育而增大,侧貌凸度在恒牙初期以后减小显著。与国内其它地区对比,呼和浩特汉族人侧貌面形最凸,颅面深度及高度最大。上述结果为本地区错(牙合)畸形的诊治及审美标准提供了客观依据。     

Modulation of protein release from biodegradable core-shell structured fibers prepared by coaxial electrospinning

Biodegradable core-shell structured fibers with poly(epsilon-caprolactone) as shell and bovine serum albumin (BSA)-containing dextran as core were prepared by coaxial electrospinning for incorporation and controlled release of proteins. BSA loading percent in the fibers and its release rate could be conveniently varied by the feed rate of the inner dope during electrospinning. With the increase in the feed rate of the inner dope, there was an associated increase in the loading percent and accelerated release of BSA. Poly(ethylene glycol) (PEG) was added to the shell section of the fibers to further finely modulate the release behavior of BSA. It was revealed that the release rate of BSA increased with the PEG percent in the shell section. By varying the feed rate of the inner dope and PEG content, most of BSA could be released from the core-shell structured fibers within the period of time ranging from 1 week to more than 1 month. The effect of the feed rate of the inner dope and addition of PEG into the shell section on the fiber morphology was also examined by scanning electron microscope.     

苏州地区蒙特利尔认知量表的应用研究

目的调查苏州地区老年人的认知状况,探讨中文版MoCA量表在苏州地区的应用。方法采用中文版的MoCA、MMSE量表对≥60岁的社区老年人进行筛查,共计631例。结果筛查出痴呆组、MCI组和正常组MoCA平均得分分别为：（11.95±3.77）、（21.55±2.57）、（27.46±1.40）,3组之间存在明显差异（P〈0.01）。结论 MoCA量表在筛查不同认知状态方面具有较好的效果,各项指标在不同认知状态下存在明显差异,其中以注意、视觉网与执行能力、延迟回忆三项最为显著。     

Prediction of outcomes for symptomatic spinal cavernous malformation surgery: a multicenter prospective clinical study

Purpose

Clinical outcome of spinal cavernous malformation (SCM) varies because of its unclear natural history, and reliable prognostic prediction model for SCM patients is limited. The aim of the present study was to investigate potential factors that predict one-year neurological status in postoperative patients with SCM.

Methods

This was a multicenter prospective observational study in consecutive patients with SCMs. SCMs treated microsurgically between January 2015 and January 2021 were included. Outcome was defined as the American Spinal Injury Association Impairment Scale (AIS) grade at one year after operation. Multivariable analyses were used to construct the best predictive model for patient outcomes.

Results

We identified 268 eligible SCM patients. Neurological outcome had worsened from preoperative baseline in 51 patients (19.0%) at one year. In the multivariable logistic regression, the best predictive model for unfavorable outcome included symptom duration ≥ 26 months (95% CI 2.80–16.96, P < 0.001), size ≤ 5 mm (95% CI 1.43–13.50, P = 0.010), complete intramedullary (95% CI 1.69–8.14, P = 0.001), subarachnoid hemorrhage (95% CI 2.92–12.57, P < 0.001), AIS B (95% CI 1.91–40.93, P = 0.005) and AIS C (95% CI 1.12–14.54, P = 0.033).

Conclusions

Admission size of the lesion, morphology, symptom duration, AIS grade and the presence of subarachnoid hemorrhage were strong outcome predictors regarding prognostication of neurological outcome in postoperative patients with SCMs. A decision to surgically remove a symptomatic SCM should be justified by systematic analysis of all factors potentially affecting outcome.

     

组蛋白甲基转移酶EZH2和MLL2在弥漫大B细胞淋巴瘤中的最新研究进展

弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma,DLBCL）是最常见的非霍奇金淋巴瘤（non-hodgkin lymphoma）,并且是一组在临床表现、组织形态和预后等多方面具有很大异质性的恶性肿瘤,其发病机制错综复杂。近年来表观遗传学修饰在DLBCL的发生、发展中的重要作用是研究的热点。本文综述了近年来组蛋白甲基转移酶EZH2和MLL2在弥漫大B细胞淋巴瘤中的最新研究进展,为从表观遗传学的角度认识和治疗弥漫大B细胞淋巴瘤提供新认识。