肝卵圆细胞对大鼠肝硬化组织TGFβ/smad信号传导的影响

【摘要】〓目的〓探讨肝卵圆细胞对TGFβ/smad信号传导通路影响的机制,并证明肝卵圆细胞对肝硬化的发展是否有阻止和逆转的作用。方法〓对肝卵圆细胞进行增殖、分离、培养后,移植于肝硬化大鼠肝脏组织,以未经移植的大鼠做对照,分别进行组织病理学和肝功能及蛋白表达水平的检测,分析ALB、AST、ALT、TGFβ1、TGFβRⅡ、Smad2、Smad4 、Smad7的情况。结果〓移植肝卵圆细胞的鼠肝硬化组织纤维化减少,肝功能明显改善(P<0.05),肝硬化组织TGFβ/smad信号通路中各蛋白表达量有差异。结论〓肝卵圆细胞刺激肝硬化细胞后TGFβ/smad信号通路中各蛋白的表达是不同的,肝卵圆细胞对肝硬化组织有阻止和逆转的作用。     

腹腔镜联合肾镜液电碎石仪在基层医院胆道结石手术的运用

【摘要】〓目的〓探讨与研究基层医院在胆道结石手术中运用腹腔镜联合肾镜液电碎石仪的可行性与实用性。方法〓选取我院于2013年1月至2014年1月在我院行手术治疗的胆囊结石合并肝内外胆管结石患者53例,均采用腹腔镜联合肾镜探查液电碎石仪治疗术式,通过观察患者手术时间、术中术后胆道出血、术后胆道结石残余、术后住院时间。结果〓53例患者均顺利完成手术,无中转开腹。术中35例采用液电碎石,每例碎石次数约3~10次,每次持续放电约2~3秒,其中2例较大者反复击打约15次。术中胆道出血者3例,没有出现难以控制的出血以及胆管穿透或胆管壁撕裂病例。术后平均住院时间7.1±2.6天,无腹腔感染病例。所有患者均得到术后半年随访,2例发现术后结石残余,经消化内镜取石。未发现胆总管狭窄病例。 结论〓腹腔镜联合肾镜液电碎石仪治疗胆道结石,在基层医院中有一定的可行性与实用性。     

血清F-PSA/T-PSA检测在前列腺疾病鉴别诊断中的应用

近年来,前列腺癌(PC a)在我国发病率呈上升趋势,迄今为止,前列腺特异性抗原(PSA)仍然是PC a最重要的肿瘤标志物,但它是前列腺组织特异性抗原[1],除了PC a,其他的一些前列腺疾病血清PSA也有不同程度的升高,另外血清中存在少量的游离PSA,计算F-PSA/T-PSA,进一步探讨了F-PSA/TPSA检测PC a的临床价值,报告如下。1对象和方法1.1对象PC a患者42例,年龄60~85(平均66.7)岁;良性前列腺增生(BPH)30例,年龄45~80(平均58.8)岁。均经临床和病理确诊。1.2方法采用电化学发光免疫分析法,试剂盒由罗氏诊断公司提供,批号04641655,仪器是罗氏…     

Spinal cord injury increases the risk of Type 2 diabetes: a population-based cohort study

Background contextPrevious studies on the risk and prevalence of diabetes among spinal cord injury (SCI) patients are limited and controversial.PurposeTo compare the risk and incidence rate (IR) of Type 2 diabetes in SCI and non-SCI patients.Study designThis is a population-based retrospective cohort study.Patient sampleData from Taiwan's National Health Insurance Research Database for the period 1997 to 2010 were analyzed. Patients aged 20 years and older newly identified with SCIs during this period were included in the SCI cohort. A non-SCI comparison cohort was randomly selected from National Health Insurance beneficiaries and matched with the SCI cohort based on age, sex, and index date.Outcome measuresBoth cohorts were followed until the first of the following occurred: the diagnosis of Type 2 diabetes (International Classification of Disease, Ninth Revision, Clinical Modification codes 250), withdrawal from the insurance system, the end of 2010, or death.MethodsA Cox proportional hazards regression analysis was used to estimate the risk of developing diabetes.ResultsTaiwan possesses an older SCI population, with a mean age of 51.6 years. The IR for diabetes in patients with and without SCIs was 22.1 per 10,000 person-years and 17.2 per 10,000 person-years, respectively. The adjusted hazard ratio (HR) for diabetes was 1.33 times higher in patients with SCIs than in those without SCIs. In patients with SCIs, men (adjusted HR=1.23, 95% confidence interval (CI)=1.04–1.44), older people (adjusted HR=4.26 in patients older than 65 years, 95% CI=3.16–5.74), patients with comorbidity (adjusted HR=1.36, 95% CI=1.14–1.62), and patients with a complete thoracic SCI (T-spine injury) (adjusted HR=2.13, 95% CI=0.95–4.79) were more likely to be diagnosed with diabetes than other patient subgroups.ConclusionsOur findings may facilitate the prioritizing of preventive health strategies and planning of long-term care for SCI patients.     

Self‐reported Internalizing and Externalizing Behaviours among Junior High School Students at 2 and 4 Years after the 921 Earthquake in Taiwan

We examined the impact of the 921 Taiwan Earthquake on internalizing and externalizing behaviours among junior high school students 2 and 4 years after the earthquake. This study was a secondary analysis using data extracted from the Taiwan Education Panel Survey and included 12111 students. The impact of the earthquake was assessed by the length of time to restore the home environment and whether a family member died or was severely injured in the earthquake. Generalized estimating equations showed that living in an urban area and a longer duration after the earthquake were associated with increased internalizing and externalizing behaviours. Boys reported more externalizing but fewer internalizing behaviours than girls. After adjustment for those variables, having a family member who had died or was severely injured was not significantly associated with increased internalizing and externalizing behaviours. However, a longer duration of time to restore the home environment was significantly associated with these behaviours. Regardless of the impact level of the disaster, adolescents had increased internalizing and externalizing behaviours from the seventh to ninth grades. Post‐disaster mental health services should continue monitoring and supporting children whose ordinary home living is affected by a natural disaster up to 4 years post‐disaster. Copyright © 2013 John Wiley & Sons, Ltd.     

Unilateral versus bilateral fixation for lumbar spinal fusion: a systemic review and meta-analysis

Purpose

The objective of this study was to systematically compare the efficacy and safety of unilateral fixation to bilateral fixation for the lumbar degenerative disease.

Study design

Systematic review and meta-analysis.

Methods

We searched databases including PubMed Central, MEDLINE (from 1966), EMBASE (from 1980), and Cochrane Central Register of Controlled Trials databases for randomized controlled trials or non-randomized controlled trials that compare unilateral fixation with bilateral fixation for the treatment for lumbar disease. Exclusion criteria were non-controlled studies, follow-up <6 months, combined anterior and posterior surgery, lumbar tumors, and non-English writing paper. Methodologic quality was assessed, relevant data were retrieved, and the appropriate meta-analysis was performed. Two review authors independently selected studies, extracted data, and assessed the risk of bias. The main end points included the rate of fusion, visual analogue scale (VAS), Oswestry disability index (ODI), intra-operative blood loss, operating time, and the rate of complications.

Results

A total of seven studies were included in the meta-analysis. Four relevant randomized controlled trials, one prospective study, and two retrospective studies involving 499 patients were identified. Patients in unilateral pedicle fixation group compared with bilateral pedicle screw fixation group on the fusion rate, VAS, ODI scores, and complication rate demonstrated no significant differences (P > 0.05, respectively). However, intra-operative blood loss and operating time in unilateral fixation group were significantly less than bilateral fixation group (P < 0.0001, respectively).

Conclusions

Unilateral fixation seems to be an effective, feasible, and safe procedure in one or two segmental disease when compare with bilateral instrumentation.     

异位胰腺误诊为胃肠间质瘤的临床分析

目的提高对异位胰腺与胃肠问质瘤的鉴别诊断水平。方法回顾性分析2007年1月至2013年6月于上海交通大学医学院附属仁济医院收治的14例术前诊断为胃肠间质瘤而术后病理证实为异位胰腺组织患者的临床资料及随访资料。结果本组病例男9例,女5例,年龄26,69岁。其中8例有上腹隐痛不适症状,2例为肠梗阻表现,4例为体检偶然发现。12例术前影像学检查及内镜检查均提示胃肠间质瘤。所有患者均行手术治疗,其中11例病变发生于胃,l例发生于十二指肠,2例发生于空肠;术后病理证实均为异位胰腺,其中10例以胰腺腺泡和胰腺导管混合存在为主要成分,同时含有平滑肌组织以及少量胃黏膜组织;3例以胰腺腺泡为主;1例以胰腺导管及平滑肌为主。随访时间为（26．5±5．1）月,均无复发和死亡者。结论异位胰腺缺乏特征性的临床表现和有效的术前辅助检查手段,易与胃肠间质瘤混淆。手术切除是治愈异位胰腺的唯一有效手段,而术后病理是鉴别两种疾病最可靠的诊断方法。     

Effects of helium-neon laser on levels of stress protein and arthritic histopathology in experimental osteoarthritis

OBJECTIVE: To investigate the effect of low-power laser therapy on levels of stress proteins (SPs) in experimental arthritis and their relation to the bioeffects on arthritic cartilage repair. DESIGN: A total of 42 rats with similar degrees of induced arthritis evaluated by means of bone scan were divided randomly into two groups. In the treated group, 21 rats received helium-neon laser treatment; in the control group, 21 rats received sham laser treatment. The changes in chondrocytes of SPs were measured by electrophoresis of proteins extracted from chondrocytes of arthritic cartilage at various time periods. The histopathologic changes and the presence of SP of arthritic cartilage were identified by hematoxylin and eosin stain and by immunostains of SP72 antibody individually from frozen sections of arthritic cartilage. RESULTS: SP density increased markedly in rats after laser treatment and was closely related to the repair of arthritic cartilage. Furthermore, the pathohistology of arthritic cartilage improved significantly with the decline of SP levels in the follow-up period. CONCLUSION: Helium-neon (632 nm) low-power laser can enhance SP production in arthritic chondrocytes. The extragenic production of SP is well correlated with the therapeutic effect of low-power laser in preserving chondrocytes and the repair of arthritic cartilage in rats.     

容积调强弧形放疗联合Xelox化疗方案应用于局部进展期直肠癌新辅助治疗的可行性研究

目的探讨容积调强弧形放疗（VMAT）联合Xelox化疗方案（卡培他滨加奥沙利铂）用于局部进展期直肠癌新辅助治疗的可行性。方法回顾性分析2011年4月至2013年4月中山大学肿瘤防治中心放射治疗科术前予以Xelox化疗方案同期联合VMAT的141例局部进展期直肠癌患者的临床资料,男95例、女46例,中位年龄56岁;临床分期：11a期18例、Ⅱb期11例、11C期4例、ma期1例、Illb期52例、mC期55例。全组放疗采用单弧VMAT技术,靶区剂量P11v1：50Gy／25次,刚2：46Gy／23次,1次／d,5次／周。放疗期间,全组均行Xelox方案同期化疗。结果全组141例患者均完成放疗计划,2例（1.4％）因3级腹泻中断放疗。放化疗期间,全组累计3级血液学及非血液学不良反应发生率分别为9．9％和16．3％,无4级不良反应。患者距放疗结束后中位时间54（34。86）d进行手术。手术凡切除率100％,低位直肠癌保肛率45．8％（33／72）;术后并发症发生率17．0％（24／141）;术后病理完全缓解（pCR）率32．6％（46／141）,原发肿瘤T分期、N分期及TNM分期的降期率分别为87．2％（123／141）、88．0％（95／108）和90．1％（127／141）。结论VMAT联合Xelox方案化疗应用于局部进展期直肠癌新辅助治疗安全可行,可获得较高pCR率及肿瘤降期率．且耐受性佳。