腹腔镜下完成宫颈癌保留神经平面广泛子宫切除术的疗效及可行性探讨

目的:探讨腹腔镜下完成宫颈癌保留神经平面广泛子宫切除术(NPSRH)的疗效及可行性。方法:选择2009年1月至2014年3月收治的94例宫颈癌患者(Ib1期~Ⅱa2期),其中接受开腹NPSRH50例患者作为对照组,术中未应用特殊器械;接受腹腔镜NPSRH44例作为观察组,术中利用盆腔的固有间隙,将输尿管下方自主神经平面做整体保留,术中同时应用血管钉对神经平面周围的血管进行止血。比较两组患者的各手术相关指标及术后近期膀胱功能的恢复情况。结果:观察组的手术时间为(314.9±68.6)min要多于对照组的(273.5±58.6)min,两组比较差异有统计学意义(P<0.05);失血量为(187.8±64.1)m L、输血者比例为6.8%(3/44)、术后住院时间分别为(9.1±2.0)d均明显低于对照组(474.6±67.3)m L、48%(24/50)、(11.3±3.1)d,差异均具有统计学意义(均P<0.05)。在拔尿管后,两组患者初次残余尿达标者的比例及导尿时间比较,差异均无统计学意义(均P>0.05)。结论:腹腔镜下完成NPSRH的疗效及保留神经的效果与开腹手术相当,但能明显减少患者术中的出血情况,且能促进患者的术后恢复。     

胆汁酸在胆汁淤积性肝损伤发病中的作用研究进展

胆汁酸由肝脏产生,是胆汁的主要成分之一。在胆汁分泌受阻时,血清和肝脏胆汁酸浓度上升,进而导致肝损害。尽管过去对于胆汁酸导致肝损害有过很多研究,但是其导致肝损害的分子机制目前仍存在争议。在本文中,我们总结了胆汁酸导致肝损伤发病机制的最新研究进展。在病理条件下,胆汁酸诱导肝细胞损害是通过处于应激条件下的肝细胞诱导炎症反应而发生的。本文主要聚焦胆汁酸如何诱导炎症因子的产生从而进一步诱导相关免疫细胞的聚集,以及基于对这些病理基础的认识,他们探讨了可能对胆汁淤积性肝损害有潜在治疗的新方法。     

Gestational exposure to low‐dose zearalenone disrupting offspring spermatogenesis might be through epigenetic modifications

Zearalenone (ZEA), a F‐2 mycotoxin produced by Fusarium, has been found to be an endocrine disruptor through oestrogen receptor signalling pathway to impair spermatogenesis. The disruption on reproductive systems by ZEA exposure might be transgenerational. In our previous report, we have found that low dose (lower than no‐observed effect level, NOEL) of ZEA impaired mouse spermatogenesis and decreased mouse semen quality. The purpose of the current investigation was to explore the impacts of low‐dose ZEA on spermatogenesis in the offspring after prenatal exposure and the underlying mechanisms. And it demonstrated that prenatal low‐dose ZEA exposure disrupted the meiosis process to inhibit the spermatogenesis in offspring and even to diminish the semen quality by the decrease in spermatozoa motility and concentration. The DNA methylation marker 5hmC was decreased, the histone methylation markers H3K9 and H3K27 were elevated, and oestrogen receptor alpha was reduced in the offspring testis after prenatal low‐dose ZEA exposure. The data suggest that the disruption in spermatogenesis by prenatal low‐dose ZEA exposure may be through the modifications on epigenetic pathways (DNA methylation and histone methylation) and the interactions with oestrogen receptor signalling pathway. Moreover, in the current study, the male offspring were indirectly exposed to low‐dose ZEA through placenta and the spermatogenesis in offspring was disrupted which suggested that the toxicity of ZEA on reproductive systems was very severe. Therefore, we strongly recommend that greater attention should be paid to this mycotoxin to minimize its adverse impact on human spermatogenesis.     

希氏束旁旁道CARTO3在常规X光指导下标测及射频消融

目的比较希氏束旁道CARTO3及常规X光指导下标测及消融方法。方法纳入12例希氏束旁道并进行射频消融治疗的患者。入选患者均进行了心内电生理检查,9例患者行常规X光透视下标测消融靶点并进行消融,3例患者应用CARTO3三维标测系统指导靶点标测及射频消融。对不同标测方法手术成功率、X线曝光时间及并发症进行比较。结果 9例常规标X光测患者中成功6例(66.7%),2例未成功,1例靶点距离希氏束过近,放弃消融,术中1例患者出现一过性完全性房室传导阻滞,X线曝光时间(36.2±13.4)min;CARTO3指导3例均成功(100.0%),X线曝光时间(14.2±7.8)min。与常规X光测患者比较,CARTO3三维标测系统指导靶点消融成功率更高,X线曝光时间更短,差异有统计学意义(P0.05)。结论与常规X光相比,CARTO3指导希氏束旁旁道消融可更精确指示希氏束及消融导管空间位置,缩短X光曝光时间,提高消融成功率。     

MACVIA-LR,Reference site of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) in Languedoc Roussillon

The Région Languedoc-Roussillon is the umbrella organisation for an interconnected and integrated project on AHA covering the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing. All sub-activities (A1: electronic pharmaceutical file, A2: falls prevention initiative, A3: frailty, B3: chronic respiratory diseases, chronic diseases with comorbidities, oral health and hepatitis virus C chronic infection, C2 and D4 active and independent living and handicap) are included in MACVIA-LR that has a strong political commitment and includes all stakeholders (public, private, patients, policy makers). It is one of the Reference Sites of the European Innovation Partnership on Active and Healthy Ageing built around chronic diseases, ageing and handicap. The framework of MACVIA-LR has the vision that the prevention and management of CDs is essential for AHA promotion and for the reduction of handicap. The main objective of MACVIA-LR is to develop innovative solutions for a network of Living Labs in order to improve the care of patients affected by CDs in the Languedoc-Roussillon area and to disseminate the innovation.     

基于分子网络研究四逆散抗抑郁症作用的潜在生物学机制

目的 基于分子网络研究四逆散治疗抑郁症的潜在生物学机制。方法 借助于中药系统药理学数据库和分析平台（TCMSP）数据库筛选四逆散的活性成分,筛选条件为口服利用率、药物相似性和血脑屏障透过率,并挖掘四逆散活性成分靶点和抑郁症的治疗靶点。利用韦恩图找到活性成分靶点和疾病靶点的交集靶点,对应相应成分定义为四逆散抗抑郁的有效成分。利用String在线数据库进行交集靶点蛋白质-蛋白质相互作用网络的预测,并利用DAVID数据库进行交集靶点KEGG信号通路的富集分析。最后使用Cytoscape 3.6软件进行活性成分-靶点网络及有效成分-靶点-信号通路的构建和拓扑分析。结果 筛选出了四逆散107个有效成分和28个重要的抗抑郁症靶点。四逆散抗抑郁症的重要靶点显著富集于神经活性配体-受体相互作用、5-羟色胺能突触、多巴胺能突触、逆行内源性大麻素信号传导、钙信号通路等10个信号通路中。结论 本研究从分子网络的角度初步揭示了四逆散治疗抑郁症的潜在作用机制,其主要的生物学机制可能与以神经活性配体-受体相互作用为中心的信号通路有关。     

维药小茴香抗肝纤维化作用及对TGF-β/smad信号转导通路的影响

目的探讨小茴香提取物抗肝纤维化的作用及其对TGF-β/smad信号转导通路和肝星状细胞活化的影响。方法选择44只SD大鼠给予40%四氯化碳(CCl4)橄榄油溶液4 ml/(kg·体重)皮下注射5周制备肝纤维化模型,成模后随机分成治疗组和模型对照组,同时取6只正常大鼠做空白对照。治疗组给予小茴香提取物灌胃,模型对照组给予生理盐水灌胃,4周末处死大鼠检测血清ALT、AST、HA、LN,肝石蜡切片行Masson染色和抗α平滑肌动蛋白(α-SMA)、TGF-β受体Ⅰ型(TGF-βRⅠ)、TGF-β1免疫组织化学染色,反转录实时荧光定量PCR分析肝组织TGF-β1、smad2 mRNA相对内参基因甘油醛-3-磷酸脱氢酶(GAPDH)的表达量。结果小茴香提取物治疗组血清ALT、AST、HA水平,肝组织内胶原纤维含量、α-SMA、TGF-βRⅠ、TGF-β1表达以及TGF-β1、smad2 mRNA相对表达量均明显低于模型对照组。结论小茴香提取物可通过抑制TGF-β/smad信号转导通路抑制肝星状细胞活化,从而减轻大鼠肝纤维化。     

Plasticity of language pathways in patients with low-grade glioma A diffusion tensor imaging study

Knowledge of the plasticity of language pathways in patients with low-grade glioma is important for neurosurgeons to achieve maximum resection while preserving neurological function. The current study sought to investigate changes in the ventral language pathways in patients with low-grade glioma located in regions likely to affect the dorsal language pathways. The results revealed no significant difference in fractional anisotropy values in the arcuate fasciculus between groups or between hemispheres. However, fractional anisotropy and lateralization index values in the left inferior longitudinal fasciculus and lateralization index values in the left inferior fronto-occpital fasciculus were higher in patients than in healthy subjects. These results indicate plasticity of language pathways in patients with low-grade glioma. The ventral language pathways may perform more functions in patients than in healthy subjects. As such, it is important to protect the ventral language pathways intraoperatively.