简介：摘要目的通过分析非M3型急性髓系白血病（AML）患者的临床和实验室资料，进一步阐明DNMT3A基因突变在非M3型AML患者预后中的意义及其影响AML发生发展的可能机制。方法采用R语言3.5.1版本RTCGAToolbox包下载癌症基因组图谱数据库180例非M3型AML患者临床及突变信息，数据为开放性数据。将患者按照突变状态进行分组，比较各组患者外周血白细胞计数、骨髓原始细胞比例、无事件生存期以及总体生存期有无差别。将患者按照年龄分为<60岁组和≥60岁组，使用Kaplan-Meier方法绘制生存曲线，并运用Log-rank检验进行<60岁和≥60岁患者、DNMT3A突变组及野生组患者生存率的比较。采用Cox比例风险模型进行DNMT3A突变和其伴随突变及年龄分层等因素对患者总体生存期的单因素和多因素分析。结果共纳入非M3型AML患者180例，DNMT3A突变组与野生组患者临床特征比较发现突变组白细胞计数显著高于野生组（Z=-2.606，P=0.009），且DNMT3A突变多见于中危患者。值得注意的是，DNMT3A突变常伴随FLT3（P=0.025）、NPM1（P<0.001）、IDH1（P=0.002）突变的发生，且DNMT3Awt/FLT3wt组无事件生存期显著高于DNMT3Amut/FLT3mut组（11.00个月vs 6.15个月，P=0.005），而与DNMT3Amut/FLT3wt、DNMT3Awt/FLT3mut组之间的差异无统计学意义。Cox多因素分析结果显示，高龄是AML患者总体生存的独立危险因素（HR=2.974，95%CI：1.966~4.500，P<0.001）；另外，DNMT3A R882突变是AML患者预后不良的独立预测因子（HR=1.937，95%CI：1.179~3.182，P=0.009）。结论高龄（≥60岁）和DNMT3A R882突变为预后不良的独立预测因子。DNMT3Amut/FLT3mut亚型与DNMT3Awt/FLT3wt、DNMT3Amut/FLT3wt、DNMT3Awt/FLT3mut相比，临床预后更差。

简介：摘要目的本研究从血清学及临床保护角度探讨单纯疱疹病毒1型(herpes simplex virus type 1，HSV-1)和HSV-2免疫交叉反应的特征，以期为控制及预防这两种病毒引起的疾病提供数据资料。方法HSV-1减毒株M3免疫小鼠，检测其诱导产生以中和抗体为指征的特异性免疫应答情况。免疫28 d后分别用HSV-1野毒株和HSV-2野毒株经不同途径对小鼠进行攻击感染，观察M3免疫小鼠抵御HSV-1/2病毒感染的情况。结果HSV-1减毒株M3免疫小鼠不能诱导产生特异性的抗HSV-2中和抗体，免疫28 d后接受不同途径的HSV-2攻击，病毒载量显著增加，但未出现明显的异常临床表现，同时组织病理损伤也仅表现为较轻微的炎性反应。HSV-1减毒株M3免疫小鼠能够诱导产生特异性的抗HSV-1中和抗体，并且在HSV-1野毒攻击后表现出明显的保护效果。结论HSV-1减毒株M3免疫小鼠后所诱导的免疫应答对HSV-1野毒株感染攻击表现出以中和抗体为特征的、可限制病毒在体内增殖的免疫保护作用，然而对HSV-2野毒株攻击则表现出不以抗体形式中和病毒而是以控制病毒的增长为主要模式的临床交叉免疫保护能力。

简介：摘要3M综合征是一种罕见的骨骼线性生长障碍的遗传病，其与许多其他原始身材矮小综合征不同，它是一种与生长相关的疾病。3M综合征主要由CUL7、CCDC8、OBSL1基因突变所引起的，且CUL7、CCDC8和OBSL1可能共属于同一个未知的潜在的分子或(和)细胞机制调控的生长发育的进程。现结合近几年国内外研究进展，阐述相关基因突变引起的3M综合征致病机制，旨在为研究3M综合征致病机制提供新的研究方向和研究基础。

简介：摘要ObjectiveTo demonstrate the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the ipsilesional dorsolateral prefrontal cortex (DLPFC) on neurological recovery in patients with subacute phase stroke.MethodsPatients with supratentorial hemispheric stroke who were hospitalized for intensive rehabilitation in the subacute phase were enrolled for this retrospective analysis. Two groups of patients were selected: the rTMS group who received high-frequency (20 Hz) rTMS ≥ 5 times over the ipsilesional DLPFC, and a control group who did not receive any rTMS. The patients were further divided into groups with right- or left-side brain lesions. Functional measurements for cognitive ability, mood, speech, and activities of daily living, which were assessed at baseline and at the 1-month follow-up as a routine clinical practice, were used for analyses.ResultsAmong 270 patients with available clinical data, 133 (women, 51; age, 61.0±13.8 years) met the inclusion criteria and were enrolled for analysis. There were no differences in demographic data and functional scores at baseline between the rTMS (n＝49) and control (n＝84) groups. The rTMS group showed a higher gain in the mini-mental status examination (MMSE) total score and subscores of all domains, forward digit span, and FIM-cognition than the control group (P<0.05). Among the patients with left hemispheric lesions (n＝57), the rTMS group showed better outcomes in cognition and depression through scores of total and " attention and concentration" subscores of MMSE, FIM-cognition, and the geriatric depression scale (P<0.05). Among the patients with right hemispheric lesions (n＝76), the rTMS group showed better outcomes in cognition through the MMSE total score and subscores of " attention and concentration，" " registration，" and " recall，" and scores of both forward and backward digit spans (P<0.05)．ConclusionsHigh-frequency rTMS over the ipsilesional DLPFC has beneficial effects on the recovery of cognition on both sides as well as mood in patients with left-sided hemispheric lesions.

简介：摘要目的探讨pT1N3M0期胃癌患者的临床病理特征及预后影响因素。方法回顾性分析2010—2019年河北医科大学第四医院外三科收治的110例术后病理分期为pT1N3M0期患者的临床病理特征及影响预后的危险因素。结果110例pT1N3M0期胃癌患者中pT1aN3aM0期27例(24.5%)，pT1aN3bM0期10例(9.1%)，pT1bN3aM0期45例(40.9%)，pT1bN3bM0期28例(25.5%)；病灶位于贲门-胃底51例(46.4%)，胃体-胃窦59例(53.6%)；病灶直径≥2 cm者40例(36.4%)，<2cm者70例(63.6%)；高～中分化腺癌59例(53.6%)，低～未分化腺癌51例(46.4%)。全组患者中有104例(94.5%)获得随访，2年总生存率(OS)为63.5%，2年无病生存率(DFS)为57.7%，其中各组2年OS分别为92.0%、50.0%、70.7%、30.8%，2年DFS分别为88.0%、41.7%、65.9%、23.1%，各组2年OS和DFS相比差异均有统计学意义(均P<0.05)。单因素分析显示，患者年龄、肿瘤直径、浸润深度T分期、组织学类型、淋巴结转移N分期、肿瘤标记物CA19-9、CA72-4表达水平、脉管瘤栓、神经受侵、Ki67阳性比例及Lauren分型均与pT1N3M0期胃癌患者的预后有关(均P<0.05)。多因素分析显示，肿瘤病灶直径≥2 cm(P＝0.003)、肿瘤组织类型差(P＝0.004)、淋巴结分期为N3b期(P＝0.000)、同时合并脉管瘤栓(P＝0.001)及神经受侵(P＝0.002)均是影响pT1N3M0期胃癌患者预后的独立危险因素。结论pT1N3M0期胃癌患者预后较差，淋巴结转移N分期为N3b期是影响预后的独立危险因素。

简介：摘要目的评估不同放疗方式对临床T2-3N0M0期食管鳞癌患者长期预后的影响，为此部分患者选择最佳治疗方案。方法收集2007－2012年在河北医科大学第四医院符合入组条件患者268例，将接受累及野照射的分为IFI组，接受选择性淋巴引流区照射分为ENI组。分析不同放疗方式构成比、预后影响因素及不良反应。结果患者中位生存期35.5个月(95%CI为30.12～40.88)，中位无瘤生存期23.5个月(95%CI为19.00～28.00)。依据多因素分析结果对两组患者进行1∶1配比后每组86例。PSM后患者多因素分析结果显示放疗方式为总生存影响因素(P＝0.038)，T分期、放疗方式为无瘤生存影响因素(P＝0.002、0.032)。两组≥2级不良反应相近(P＝0.819、0.756)，但联合化疗患者不良反应较大。结论ENI可延长临床T2-3N0M0期食管鳞癌患者生存，同时不增加严重不良反应发生率。

简介：摘要目的比较造口护肤粉联合3M液体敷料和氧气联合赛肤润在新生儿重度臀红中的治疗效果。方法选取2016年5月至2019年4月在新乡市第一人民医院接受治疗的重度臀红新生儿60例，按照随机数字表法分为观察组和对照组各30例。对照组采用氧气联合赛肤润治疗，观察组采用造口护肤粉联合3M液体敷料治疗。比较两组患儿症状改善情况及临床疗效。结果观察组患儿臀红好转时间、痊愈时间及处置所耗时长均短于对照组，临床疗效高于对照组，差异有统计学意义(P<0.05)。结论与氧气联合赛肤润治疗比较，采用造口护肤粉联合3M液体敷料治疗临床效果更加显著，操作方法简单，创面愈合时间较短，预后效果好。

简介：摘要本文报道腰髓H3K27M突变型弥漫性中线胶质瘤1例。患者，男15岁，因腰痛伴双下肢疼痛1个月余就诊。MR检查示T11~12水平腰髓内异常信号影，呈均匀稍长T1稍长T2信号，脂肪抑制T2WI呈稍高信号，增强扫描肿块未见明显强化，软脊膜增厚强化。首次术后病理示间变性星形细胞瘤IDH1/2野生型。4个月后肿瘤复发行二次手术，术后病理为胶质母细胞瘤H3K27M突变型弥漫中线胶质瘤，二次手术后3个月复查MRI示椎管内多发可疑转移灶。

简介：摘要N6-甲基腺嘌呤(N6-methyladenosine，m6A)，是高等真核生物mRNA最常见的修饰之一，主要发生在RRACH序列中的腺嘌呤上。N6-甲基腺苷甲基转移酶3(N6-methyladenosine methyltransferase，METTL3)是m6A甲基转移酶复合物的关键组成部分，可通过调控m6A修饰水平影响肿瘤的恶性表型。消化道肿瘤的发病率及死亡率在所有肿瘤中位居前列，研究发现，METTL3对多组织类型的消化道肿瘤的发生发展均具有重要的调控作用。本文综述了METTL3在消化道癌症中对肿瘤恶性表型的影响及分子机制，以期为消化道肿瘤相关研究提供新的思路。

简介：AbstractBackground:The human brain is the most complex organ in the body, and it is important to have a better understanding of how the protein composition in the brain regions contributes to the pathogenesis of associated neurological disorders.Methods:In this study, a comparative analysis of the frontal and temporal cortex proteomes was conducted by isobaric tags of relative and absolute quantification (iTRAQ) labeling and two-dimensional liquid chromatography-tandem mass spectrometry (2D LC-MS/MS). Brain protein was taken from relatively normal tissue that could not be avoided of damage during emergent surgery of the TBI (traumatic brain injury) patients admitted in Beijing Tiantan Hospital from 2014 to 2017. Eight cases were included. Four frontal lobes and 4 temporal lobes proteome were analyzed and the proteins were quantitated. Gene Ontology (GO), Ingenuity Pathway Analysis (IPA), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were used to analyze the biological function of identified proteins, unchanged proteins, and differentially expressed proteins (DEPs).Results:A total number of 2127 protein groups were identified in the frontal and temporal lobe proteomes. A total of 1709 proteins could be quantitated in both the frontal and temporal cortex. Among 90 DEPs, 14 proteins were screened highly expressed in the temporal cortex, including MAPT, SNCG, ATP5IF1, GAP43, HSPE1, STMN1, NDUFS6, LDHB, SNCB, NDUFA7, MRPS36, EPDR1, CISD1, and RALA. In addition, compared to proteins expressed in the frontal cortex, 14 proteins including EDC4, NIT2, VWF, ASTN1, TGM2, SSB, CLU, HBA1, STOM, CRP, LRG1, SAA2, S100A4, and VTN were a low expression in the temporal cortex. The biological process enrichment showed that unchanged proteins between the frontal and temporal cortex mainly take part in regulated exocytosis, axon guidance, and vesicle-mediated transport. The KEGG pathway analysis showed that unchanged proteins between the frontal and temporal cortex mainly take part in oxidative phosphorylation, carbon metabolism, Huntington's disease, and Parkinson's disease.Conclusions:The majority of proteins are unchanged between the frontal and temporal cortex, and unchanged proteins are closely related to its function. Among DEPs, MATP (tau) is upregulated in the temporal cortex, closely related to Alzheimer's disease (AD), and is one of the targets for the treatment of AD. CLU is downregulated in the temporal cortex which functions as an extracellular chaperone that prevents aggregation of non-native proteins. It was suggested that the temporal lobe may not be the "functional dumb area" of the traditional view, but could be involved in important neural metabolic circuits.

简介：AbstractBackground:Macrophages play an important role in renal ischemia reperfusion injury, but the functional changes of macrophages under hypoxia/reoxygenation and the related mechanism are unclear and need to be further clarified.Methods:The effects of hypoxia/reoxygenation on functional characteristics of RAW264.7 macrophages were analyzed through the protein expression detection of pro-inflammatory factors TNF-α and CD80, anti-inflammatory factors ARG-1 and CD206. The functional implications of C-X3-C motif chemokine receptor 1(CX3CR1) down-regulation in hypoxic macrophages were explored using small interfering RNA technology. Significance was assessed by the parametric t-test or nonparametric Mann-Whitney test for two group comparisons, and a one-way ANOVA or the Kruskal-Wallis test for multiple group comparisons.Results:Hypoxia/reoxygenation significantly increased the protein expression of M1-related pro-inflammatory factors TNF-α, CD80 and chemokine C-X3-C motif chemokine ligand 1 (CX3CL1)/CX3CR1 and inhibited the protein expression of M2-related anti-inflammatory factors ARG-1 and CD206 in a time-dependent manner in RAW264.7 cells. However, the silencing of CX3CR1 in RAW264.7 cells using specific CX3CR1-siRNA, significantly attenuated the increase in protein expression of TNF-α (P < 0.05) and CD80 (P < 0.01) and the inhibition of ARG-1 (P < 0.01) and CD206 (P < 0.01) induced by hypoxia/reoxygenation. In addition, we also found that hypoxia/reoxygenation could significantly enhance the migration (2.2-fold, P < 0.01) and adhesion capacity (1.5-fold, P < 0.01) of RAW264.7 macrophages compared with the control group, and CX3CR1-siRNA had an inhibitory role (40% and 20% reduction, respectively). For elucidating the mechanism, we showed that the phosphorylation levels of ERK (P < 0.01) and the p65 subunit of NF-κB (P < 0.01) of the RAW264.7 cells in the hypoxic/reoxygenation group were significantly increased, which could be attenuated by down-regulation of CX3CR1 expression (P < 0.01, both). ERK inhibitors also significantly blocked the effects of hypoxic/reoxygenation on the protein expression of M1-related pro-inflammatory factors TNF-α, CD80 and M2-related anti-inflammatory factors ARG-1 and CD206. Moreover, we found that conditioned medium from polarized M1 macrophages induced by hypoxia/reoxygenation, notably increased the degree of apoptosis of hypoxia/reoxygenation-induced TCMK-1 cells, and promoted the protein expression of pro-apoptotic proteins bax (P < 0.01) and cleaved-caspase 3 (P < 0.01) and inhibited the expression of anti-apoptotic protein bcl-2 (P < 0.01), but silencing CX3CR1 in macrophages had a protective role. Finally, we also found that the secretion of soluble CX3CL1 in RAW264.7 macrophages under hypoxia/reoxygenation was significantly increased.Conclusions:The findings suggest that hypoxia/reoxygenation could promote M1 polarization, cell migration, and adhesion of macrophages, and that polarized macrophages induce further apoptosis of hypoxic renal tubular epithelial cells by regulating of CX3CL1/CX3CR1 signaling pathway.

简介：摘要目的探讨集束化护理联合3M透明敷贴对新生儿留置胃管非计划性拔管概率的影响。方法随机将阜阳医院2017年7月至2018年9月留置胃管新生儿100例分为两组，对照组行常规护理，研究组行集束化护理联合3M透明敷贴干预，对比两组胃管留置时间、非计划拔管率及并发症发生率。结果研究组胃管留置时间长于对照组。而非计划拔管率和并发症发生率低于对照组，差异均有统计学意义(P<0.05)。结论新生儿留置胃管给予其集束化护理联合3M透明敷贴能够有效延长胃管留置时间，降低非计划拔管率和并发症发生率。

简介：摘要目的探讨伴H3K27M突变的脊髓弥漫性中线胶质瘤患者的临床特点和手术预后。方法回顾性分析2015年5月至2017年10月清华大学附属北京清华长庚医院神经外科收治的12例伴H3K27M突变的脊髓弥漫性中线胶质瘤患者的临床资料。其中，男8例，女4例；年龄为(28.4±11.9)岁(10～53岁)。呼吸困难2例，肢体无力7例，肢体和躯体感觉障碍6例，小便功能障碍2例。所有患者均接受手术治疗，术后均予替莫唑胺化疗，无一例行放疗。通过门诊和电话随访评估患者的生存预后。结果12例患者中，肿瘤大部切除8例，近全切除4例。术后病理学结果提示，7例为胶质母细胞瘤，3例为间变性星形细胞瘤，2例为间变性少突胶质星形细胞瘤。12例患者术后均发生肿瘤复发，肿瘤以沿脊髓侵袭为主，2例出现脑转移。术后随访30个月，12例患者均死亡，中位生存时间(上、下四分位数)为18.0(5.0，22.8)个月。结论伴H3K27M突变的脊髓弥漫性中线胶质瘤以儿童和青年人多见，临床表现多样，其手术疗效差，患者的生存预后不佳。

简介：摘要目的探讨伴H3 K27M突变的儿童弥漫性中线胶质瘤(DMG)的临床特点、治疗及预后。方法回顾性分析2017年7月至2020年3月首都医科大学附属北京儿童医院神经外科收治的10例DMG伴H3 K27M突变患儿的临床资料。10例患儿中，病变位于丘脑4例，脑干4例，脊髓2例，其中行开颅肿瘤切除术7例，脊髓肿瘤切除术2例，颅内病变活组织检查术1例。4例术后行放疗联合化疗，1例行单纯放疗，5例未行放疗或化疗。以肿瘤切除率>90%为近全切除，50%～90%为部分切除。术后随访至2020年7月或患儿死亡，随访患儿肿瘤有无进展、生存时间以及死亡原因。结果10例患儿的中位发病年龄为8.9(4.9～9.9)岁，颅内占位临床表现为头痛、恶心、呕吐、肢体无力、癫痫发作、意识障碍及脑神经麻痹；脊髓占位临床表现为进行性肢体无力。肿瘤近全切除4例，部分切除5例，活组织检查术1例。患儿术后症状改善6例，无改变4例；无一例出现中枢神经系统感染；1例在术后放疗期间出现脑积水。10例患儿的肿瘤病理学结果均为DMG伴H3 K27M突变(世界卫生组织肿瘤分级Ⅳ级)；免疫组织化学检测结果显示，少突胶质细胞转录因子2阳性比例为9/9，胶质纤维酸性蛋白阳性比例为10/10，突变型异柠檬酸脱氢酶1阳性比例为0/9，Ki-67≥40%的比例为8/10。10例患儿术后均得到有效随访；随访时间为1～23个月。至末次随访，2例患儿存活，8例患儿因肿瘤进展死亡，生存时间为1～23个月。结论初步观察发现，伴H3 K27M突变的儿童DMG临床表现多样，可选择手术、术后放疗和(或)化疗治疗，患儿的生存预后差。

简介：摘要目的探讨伴H3 K27M突变的儿童弥漫性中线胶质瘤(DMG)的临床特点、治疗及预后。方法回顾性分析2017年7月至2020年3月首都医科大学附属北京儿童医院神经外科收治的10例DMG伴H3 K27M突变患儿的临床资料。10例患儿中，病变位于丘脑4例，脑干4例，脊髓2例，其中行开颅肿瘤切除术7例，脊髓肿瘤切除术2例，颅内病变活组织检查术1例。4例术后行放疗联合化疗，1例行单纯放疗，5例未行放疗或化疗。以肿瘤切除率>90%为近全切除，50%～90%为部分切除。术后随访至2020年7月或患儿死亡，随访患儿肿瘤有无进展、生存时间以及死亡原因。结果10例患儿的中位发病年龄为8.9(4.9～9.9)岁，颅内占位临床表现为头痛、恶心、呕吐、肢体无力、癫痫发作、意识障碍及脑神经麻痹；脊髓占位临床表现为进行性肢体无力。肿瘤近全切除4例，部分切除5例，活组织检查术1例。患儿术后症状改善6例，无改变4例；无一例出现中枢神经系统感染；1例在术后放疗期间出现脑积水。10例患儿的肿瘤病理学结果均为DMG伴H3 K27M突变(世界卫生组织肿瘤分级Ⅳ级)；免疫组织化学检测结果显示，少突胶质细胞转录因子2阳性比例为9/9，胶质纤维酸性蛋白阳性比例为10/10，突变型异柠檬酸脱氢酶1阳性比例为0/9，Ki-67≥40%的比例为8/10。10例患儿术后均得到有效随访；随访时间为1～23个月。至末次随访，2例患儿存活，8例患儿因肿瘤进展死亡，生存时间为1～23个月。结论初步观察发现，伴H3 K27M突变的儿童DMG临床表现多样，可选择手术、术后放疗和(或)化疗治疗，患儿的生存预后差。

简介：AbstractBackground:Both bone marrow mesenchymal stem cell (BM-MSC) and transforming growth factor-β1 (TGF-β1) have a strong anti-inflammatory capacity in stroke. But their relationship has not been well addressed. In this study, we investigated how intravenous BM-MSC transplantation in rats effected the expression of TGF-β1 48 h post cerebral ischemia, and we analyzed the main cells that produce TGF-β1.Methods:We used a distal middle cerebral artery occlusion (dMCAO) model in twenty Sprague-Dawley (SD) rats. The rats were randomly divided into two groups: the ischemic control group and the postischemic BM-MSC transplantation group. One hour after the dMCAO model was established, the rats were injected in the tail vein with either 1 ml saline or 1 × 106 BM-MSCs suspended in 1 ml saline. ELISAs were used to detect TGF-β1 content in the brain infarct core area, striatum and the plasma at 48 h after cerebral infarction. Immunofluorescent staining of brain tissue sections for TGF-β1, Iba-1, CD68 and NeuN was performed to determine the number and the proportion of double stained cells and to detect possible TGF-β1 producing cells in the brain tissue.Results:Forty-eight hours after ischemia, the TGF-β1 content in the infarcted area of the BM-MSC transplantation group (23.94 ± 4.48 pg/ml) was significantly lower than it was in the ischemic control group (34.18 ± 4.32 pg/ml) (F = 13.534, P = 0.006). The TGF-β1 content in the rat plasma in the BM-MSC transplantation group (75.91 ± 12.53 pg/ml) was significantly lower than it was in the ischemic control group (131.18 ± 16.07 pg/ml) (F = 36.779, P = 0.0002), suggesting that after transplantation of BM-MSCs, TGF-β1 levels in the plasma decreased, but there was no significant change in the striatum area. Immunofluorescence staining showed that the total number of nucleated cells (1037.67 ± 222.16 cells/mm2) in the infarcted area after transplantation was significantly higher than that in the ischemic control group (391.67 ± 69.50 cells/mm2) (F = 92.421, P < 0.01); the number of TGF-β1+ cells after transplantation (35.00 ± 13.66 cells/mm2) was significantly reduced in comparison to that in the ischemic control group (72.33 ± 32.08 cells/mm2) (F = 37.680, P < 0.01). The number of TGF-β1+/Iba-1+ microglia cells in the transplantation group (3.67 ± 3.17 cells/mm2) was significantly reduced in comparison to that of the ischemic control group (13.67 ± 5.52 cells/mm2) (F = 29.641, P < 0.01). The proportion of TGF-β1+/Iba-1+ microglia cells out of all Iba-1+ microglia cells after transplantation (4.38 ± 3.18%) was significantly decreased compared with that in the ischemic control group (12.81 ± 4.86%) (F = 28.125, P < 0.01).Conclusions:Iba-1+ microglia is one of the main cell types that express TGF-β1. Intravenous transplantation of BM-MSCs does not cooperate with TGF-β1+ cells in immune-regulation, but reduces the TGF-β1 content in the infarcted area and in the plasma at 48 h after cerebral infarction.

简介：摘要目的探讨1M3S护理管理模式联合肝动脉化疗栓塞术（TACE）对原发性肝癌患者肠道微生态分布的影响。方法选取2017年1月至2020年1月在海安市人民医院住院治疗的原发性肝癌患者115例，以2017年1月至2018年12月收治的56例患者作为对照组，2019年1月至2020年1月收治的59例患者作为观察组。对照组采用常规术后护理，观察组采用1M3S护理管理模式进行术后护理。选取2017年1月至2020年1月在海安市人民医院体检的健康志愿者34人作为健康组。收集3组对象一般资料，测定血清内毒素（ET）、ALT和AST水平。收集粪便标本，采用16S rDNA测序法分析粪便菌群结构和组间物种相对丰度，并进行Alpha多样性分析。结果门水平上，3组的优势菌门均为拟杆菌门、变形菌门和厚壁菌门；介入手术后对照组ET、ALT和AST水平为（9.67±2.12） ng/L、（53.24±8.47） U/L、（55.48±8.15） U/L，观察组为（4.36±2.15） ng/L、（45.31±8.36） U/L、（47.25±8.21） U/L，显著低于对照组（t值为13.328、5.052、5.392，P<0.05）；介入手术后，与对照组比较，观察组厚壁菌门相对丰度百分比增加（t值为16.426，P<0.01），变形菌门相对丰度百分比降低（t值为8.462，P<0.001），毛螺菌科相对丰度百分比增加（t值为4.527，P<0.01）。结论肝动脉化疗栓塞术可影响原发性肝癌患者肠道细菌构成，导致变形菌门、毛螺菌科相对丰度降低，厚壁菌门相对丰度增加，1M3S护理管理模式不仅可降低体内内毒素水平、改善肝功能，还可减轻因介入手术所致的肠道菌群失衡。

简介：摘要目的探讨1M3S护理管理模式联合肝动脉化疗栓塞术（TACE）对原发性肝癌患者肠道微生态分布的影响。方法选取2017年1月至2020年1月在海安市人民医院住院治疗的原发性肝癌患者115例，以2017年1月至2018年12月收治的56例患者作为对照组，2019年1月至2020年1月收治的59例患者作为观察组。对照组采用常规术后护理，观察组采用1M3S护理管理模式进行术后护理。选取2017年1月至2020年1月在海安市人民医院体检的健康志愿者34人作为健康组。收集3组对象一般资料，测定血清内毒素（ET）、ALT和AST水平。收集粪便标本，采用16S rDNA测序法分析粪便菌群结构和组间物种相对丰度，并进行Alpha多样性分析。结果门水平上，3组的优势菌门均为拟杆菌门、变形菌门和厚壁菌门；介入手术后对照组ET、ALT和AST水平为（9.67±2.12） ng/L、（53.24±8.47） U/L、（55.48±8.15） U/L，观察组为（4.36±2.15） ng/L、（45.31±8.36） U/L、（47.25±8.21） U/L，显著低于对照组（t值为13.328、5.052、5.392，P<0.05）；介入手术后，与对照组比较，观察组厚壁菌门相对丰度百分比增加（t值为16.426，P<0.01），变形菌门相对丰度百分比降低（t值为8.462，P<0.001），毛螺菌科相对丰度百分比增加（t值为4.527，P<0.01）。结论肝动脉化疗栓塞术可影响原发性肝癌患者肠道细菌构成，导致变形菌门、毛螺菌科相对丰度降低，厚壁菌门相对丰度增加，1M3S护理管理模式不仅可降低体内内毒素水平、改善肝功能，还可减轻因介入手术所致的肠道菌群失衡。

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简介：摘要目的比较3种内固定方式治疗股骨远端Müller分型C2、C3型骨折的疗效。方法回顾性分析2013年2月至2017年2月期间宁波市第六医院创伤骨科收治的58例股骨远端Müller分型C2、C3型骨折患者资料。根据内固定方式不同分为3组：单切口锁定钢板组（A组）21例，男13例，女8例；年龄为（50.6±12.9）岁。双切口锁定钢板联合重建钢板组（B组）18例，男11例，女7例；年龄为（53.5±13.0）岁。单切口锁定钢板联合重建钢板组（C组）19例，男10例，女9例；年龄为（48.1±12.2）岁。比较3组患者的手术时间、术中出血量、术中C型臂透视次数、骨折愈合时间、术后并发症发生率、膝关节活动度及膝关节功能等。结果3组患者术前一般资料比较差异均无统计学意义（P>0.05），具有可比性。3组患者术中C型臂透视次数、随访时间及术后并发症发生率比较差异均无统计学意义（P>0.05）。但A组、C组患者的手术时间[（96.7±16.4）、（101.9±16.5）min]和术中出血量[（237.8±47.5）、（253.6±46.6）mL]显著少于B组患者[（114.9±20.1）min、（290.1±60.9）mL]，差异均有统计学意义（P<0.05）。B组、C组患者的骨折愈合时间[（6.9±1.6）、（6.6±1.7）个月]显著短于A组患者[（8.4±1.9）个月]，术后12个月膝关节活动度（91.7°±16.7°、90.9°±14.4°）显著大于A组患者（78.8°±14.4°），术后12个月膝关节功能恢复优良率[77.8%（14/18）、73.7%（14/19）]显著高于A组患者[57.1%（12/21）]，差异均有统计学意义（P<0.05）。结论采用股骨远端前外侧切口外侧应用锁定钢板、前侧附加重建钢板固定治疗股骨远端Müller分型C2、C3型骨折，固定坚强、对周围软组织损伤相对较小，兼具单切口锁定钢板和双切口内外侧锁定钢板固定的优点，术后患者膝关节功能恢复良好。