海上训练与跳伞训练军训伤的流行病学调查

目的　研究空军的跳伞训练和海军的海上训练期间军训伤的流行病学特征 ,制定初步的预防措施 .方法　采用就诊登记和回顾性调查的方法调查了军训伤的发生情况 .结果　空军某部新兵军训伤的发生率为 16 .3% ,海军某部新兵为18.7% ,海军老兵为 5 .5 % .空军新兵和海军新兵的发生率无显著性差异 ,海军新兵和老兵之间的发生率有显著性差异 (P<0 .0 1) .海军新兵的发生高峰为开训后第 2个月 ,海军老兵的发生高峰为开训后第 1个月 ,空军新兵开训后第 2个月发生率较低 ,其余月份均维持较高水平 .海军的受伤部位以小腿和踝关节为主 ,分别占 42 .9%和 17.9% ;空军的受伤部位以踝关节和腰部为主 ,分别占 2 6 .9%和 2 3.9% .海军和空军均以急性创伤性损伤为主要类型 ,且均以关节扭伤为主要伤型 .结论　不同于基础训练的训练内容 ,军训伤的发生情况亦不同 .根据特殊训练的特殊性 ,要制定不同的预防措施     

经平坦部玻璃体切除联合滤过手术治疗无晶状体或人工晶状体眼的青光眼

目的探讨经平坦部玻璃体切除联合滤过手术治疗无晶状体或人工晶状体眼的青光眼的方法和疗效。方法对18例(18眼)无晶状体或人工晶状体眼的青光眼,进行上述手术治疗,术后观察视力、眼压、滤过泡形态、手术并发症等,随访6～12(平均7.3)mo。结果18眼中16眼(89%)术后视力维持不变或提高;最近一次随访,眼压在6～21mmHg者为14眼(78%),<6mmHg者1眼,>21mmHg者3眼。18眼中13眼(72%)形成滤过泡,5眼(28%)无明显滤过泡。术后前房少量积血2例,均在术后1wk内吸收,术后长期低眼压1例,此外无其它并发症发生。结论玻璃体切除联合滤过手术是治疗无晶状体或人工晶状体眼继发性青光眼的一种比较安全有效的方法,尤其适用于玻璃体脱入到前房的病例。     

超声乳化白内障摘除联合小梁切除术对眼表的影响

目的：采用Keratograph 5M眼表综合分析仪比较小梁切除术和超声乳化白内障摘除联合小梁切除术对眼表的影响。

方法：纳入原发性闭角型青光眼合并白内障患者62例62眼,按手术方式分为两组：小梁切除术组32例32眼,超声乳化白内障摘除联合小梁切除术组(青白联合手术组)30例30眼。运用Keratograph 5M评估术前,术后3d,1、 3mo的非侵入性首次泪膜破裂时间(NifBUT)、非侵入性平均泪膜破裂时间(NiaBUT)、泪河高度(TMH)和角膜荧光素染色评分(CFS)。

结果：术前两组患者眼表参数比较差异均无统计学意义(P>0.05)。术后3d青白联合手术组的NiaBUT、NifBUT、CFS、TMH最差,分别为10.13±1.48、12.59±1.96s、0.80±0.22分与0.31±0.02mm,变化幅度明显高于小梁切除组(均 P<0.05),术后1mo两组的各项指标均有所恢复,但直到术后3mo仍未完全恢复到术前水平。

结论：眼表综合分析仪可以客观、精确地用于评估抗青光眼手术后泪膜功能的变化。在术后3mo短期内超声乳化白内障摘除联合小梁切除术比单纯小梁切除术对眼表的影响更为严重,提示在此期间应加强对眼表的护理。     

球囊拉伤致家兔动脉粥样硬化斑块破裂及血栓形成

为建立动脉粥样硬化的兔模型并用药物触发造成斑块破裂及血栓形成，将60只雄性纯种新西兰兔随机平均分成三组：球囊损伤 高脂(1％胆固醇)组、高脂喂养组及普通饲料喂养组．喂养3个月后分别给予鲁塞尔蝰蛇毒和组胺药物触发以造成斑块破裂及血栓形成。结果发现，球囊损伤 高脂组与高脂喂养组均形成动脉粥样硬化斑块，其中球囊损伤 高脂组所形成的粥样斑块为具有较大脂质核的软斑块；药物触发后球囊损伤 高脂组存活的18只中有11只共15处发生斑块破裂及血栓形成；高脂喂养组中的19只经药物触发后仅5只共7处发生斑块破裂及血栓形成；普通饲料喂养组中未见斑块破裂及血栓形成。结果提示，在构建的动脉粥样硬化斑块的动物模型基础上，应用药物触发后能够造成斑块破裂及血栓形成。     

Novel oligopeptide nanoprobe for targeted cancer cell imaging

Here we designed and constructed a tryptophan-phenylalanine-phenylalanine-tryptophan (WFFW) tetrapeptide, which generated photostable and tunable fluorescence emission signals from 340 nm to 500 nm. The WFFW tetrapeptide could self-assemble into a spherical nanostructure with enhanced fluorescence intensity. Driven by π–π stacking and hydrogen bond interaction, WFFW co-assembled with arginine-glycine-aspartic acid (RGD) modified WFFW to form a cancer-targeted fluorescent nanoprobe, which could selectively image the cancer cells.

Co-assembly of WFFW tetrapeptide and RGDWFFW heptapeptide generated the photostable and fluorescence-tunable nanoprobe, which could selectively image the cancer cells.     

下体负压下VMCA ERP的改变及不同刺激模式的比较

目的:探讨坐位下体负压下人体大脑中动脉血流速度、人体事件相关电位的改变及不同刺激模式的比较. 方法: 15名健康青年男性在坐位下体负压-4.00,-6.67 kPa条件下,分别测试负压前、下体负压暴露0.5,1,2,3,4,5 min和卸压后1,3,5 min的大脑中动脉血流速度,P300波幅,P300潜时. 结果: 在-4.00 kPa下体负压作用4,5 min时,脑血流速度减慢(P＜0.05);P300波幅,P300潜时,反应时,跟踪误差与负压前对照无明显差别;在-6.67 kPa下体负压作用2,3 min时,脑血流速度减慢(P＜0.05),在4,5 min时显著减慢(P＜0.01),卸压后1 min尚未恢复(P＜0.05),随后恢复至对照水平;P300波幅显著降低,P300潜时显著延长;反应时延长,跟踪误差增大. Sternberg模式MEST=1诱发的事件相关电位对负压所致的脑缺血缺氧敏感. 结论: 坐位下体负压造成血液在下肢淤积,大脑中动脉血液速度减慢,引起大脑血供减少,为空中晕厥和立位耐力不良的医学鉴定提供了人体实验依据.     

Connexin 36 Mediates Orofacial Pain Hypersensitivity Through GluK2 and TRPA1

Trigeminal neuralgia is a debilitating condition, and the pain easily spreads to other parts of the face. Here, we established a mouse model of partial transection of the infraorbital nerve (pT-ION) and found that the Connexin 36 (Cx36) inhibitor mefloquine caused greater alleviation of pT-ION-induced cold allodynia compared to the reduction of mechanical allodynia. Mefloquine reversed the pT-ION-induced upregulation of Cx36, glutamate receptor ionotropic kainate 2 (GluK2), transient receptor potential ankyrin 1 (TRPA1), and phosphorylated extracellular signal regulated kinase (p-ERK) in the trigeminal ganglion. Cold allodynia but not mechanical allodynia induced by pT-ION or by virus-mediated overexpression of Cx36 in the trigeminal ganglion was reversed by the GluK2 antagonist NS102, and knocking down Cx36 expression in Nav1.8-expressing nociceptors by injecting virus into the orofacial skin area of Nav1.8-Cre mice attenuated cold allodynia but not mechanical allodynia. In conclusion, we show that Cx36 contributes greatly to the development of orofacial pain hypersensitivity through GluK2, TRPA1, and p-ERK signaling.Electronic supplementary materialThe online version of this article (10.1007/s12264-020-00594-4) contains supplementary material, which is available to authorized users.     

Preservation or Ligation of Splenic Vessels During Spleen-Preserving Distal Pancreatectomy: A Meta-Analysis

ABSTRACT

Purpose/aim: Spleen preservation distal pancreatectomy (SPDP) can be achieved by either splenic vessel preservation distal pancreatectomy (SVP-DP) or Warshaw technique (WT). Although studies comparing SVP-DP with WT have been reported, controversies exist. The aim of our study is to assess and compare the safety and feasibility of SVP-DP and WT. Materials and methods: Two authors searched the online database independently till April 30, 2017. Data extraction and quality assessment were performed independently by two authors. Short- and long-term outcomes of WT and SVP-DP were evaluated. Subgroup analysis was performed on laparoscopic surgery. Odds ratios (OR) with 95% confidence interval (CI) and mean difference (MD) with 95% CI were estimated. Results: A total of 664 patients from 11 retrospective cohort studies were included. Meta-analysis showed the WT group had a significantly higher incidence of splenic infarction (OR = 0.12; 95% CI: 0.07–0.20; p < 0.00001) and gastric/epigastric varices (OR = 0.11; 95% CI: 0.05–0.24; p < 0.00001). And more patients suffering from splenic infarction from WT group needed further splenectomy (OR = 0.13; 95% CI: 0.02–0.84; p = 0.03). While there was no difference between the two procedures in terms of pancreatic fistula (OR = 0.55; 95% CI: 0.25–1.19; p = 0.13), overall morbidity (OR = 0.87; 95% CI: 0.59–1.30; p = 0.50) and hospital stay (MD = ?0.45; 95% CI: ?1.73-0.82; p = 0.49). Conclusions: Due to relatively higher risk of postoperative splenic infarction, gastric/epigastric varices and Clavien–Dindo III–V complications, WT is not as safe as SVP-DP. However, well-conducted randomized clinical trials are still needed due to the limitations of current studies.     

急性心肌梗塞左心功能与胰岛素抵抗的关系

为探讨急性心肌梗塞恢复期患者左心功能与胰岛素抵抗的关系，对26例急性心肌梗塞恢复期患者和20例健康人进行口服葡萄糖耐量试验、胰岛素和C肽释放试验，并应用多普勒超声心动图仪探测急性心肌梗塞患者左心室收缩和舒张功能。结果发现左心室射血分数＜0.50的患者（LEF组）、左心室射血分数＞0．50的患者（NEF分数）和正常组空腹血糖浓度接近，而空腹胰岛素水平却LEF组＞NEF组＞正常组，胰岛素敏感性指数三组依次增大；LEF、NEF两组糖耐量受损与异常增高的胰岛素释放反应并存，LEF组胰岛素释放反应强度大于NEF组；某些收缩功能参数（主要是左心室射血分数）与多个胰岛素抵抗参数显著相关。提示急性心肌梗塞恢复期患者左心室收缩功能受损与胰岛素抵抗程度相关联。     

视网膜静脉阻塞的中医药治疗

视网膜静脉阻塞(retinal vein occlusion,RVO)是临床较常见的致盲性视网膜疾病。西医目前对RVO尚无十分满意的治疗方法。近年来大量的临床和实验研究显示,中医药在促进RVO患者出血的吸收、视力的恢复以及减少并发症等方面具有较好疗效。因此回顾性总结中医药在RVO的研究进展,对正确合理应用中医药治疗RVO并进一步提高治疗效果提供参考。