Objective To explore whether the polymorphism of transforming growth factor β1 (TGF β1) gene at 869T/C and 915G/C loci contributes to the genetic susceptibility to hypertension. Methods Assessed under the same criteria, all case control studies on relationship between the polymorphism of TGF β1 gene and hypertension were searched in both English and Chinese databases. All articles retrieved were screened and evaluated, and meta-analyses were conducted with RevMan 5.1 software. Results A total of 14 case control studies were included. The results of meta-analyses showed TGF β1 gene C allele was related to hypertension (OR=1.37, 95%CI 1.21 to 1.54). It was noted that individuals with CC genotype and TT genotype had a significant increased risk of hypertension (OR=1.43, 95%CI 1.27 to 1.60; OR=0.64, 95%CI 0.53 to 0.78, respectively). And there was no b evidence showing that TGF β1 915G/C genetic polymorphism was related to hypertension. The results from meta-analyses of the studies based on Chinese population on the two loci were in consistent with the outcomes of overall meta-analyses. Sensitivity analyses indicated the results were stable. And publication bias was not present, reflected by P values from Egger’s regression asymmetry test and Begg’s adjusted rank correction test. Conclusions 869T/C polymorphism of TGF β1 gene is associated with hypertension. C allele is potentially one of the genetic risk factors for hypertension. Present studies do not support a direct relationship between 915G/C polymorphism TGF β1 gene and hypertension.
Objective To explore the risk factors related to periprosthetic infection after breast augmentation, and to provide a basis for reducing the risk of postoperative infection. Methods A total of 1 056 female patients who underwent breast augmentation between January 2010 and January 2018 were analyzed retrospectively. The patients were 20 to 44 years old (mean, 31.6 years). The body mass index (BMI) was 19.0-31.1 kg/m2, with an average of 24.47 kg/m2. According to the periprosthetic infection standard of the United States Centers for Disease Control and Prevention (CDC), the patients were divided into infection group and non-infection group. Age, BMI, diabetes, previous history of immunosuppression, history of smoking, previous history of breast surgery, previous history of mastitis, combined with active dermatitis, surgical approach, the type and shape of breast prosthesis, implant in the different layers, combined with mastopexy, operation time, postoperative antibiotic time, postoperative breast crash, and postoperative potential infection surgery were analyzed by univariate analysis. The influencing factors of prosthetic infection were screened by logistic regression. Results Periprosthetic infection occurred in 60 cases after operation, and the infection rate was 5.68%. Among them, 11 cases were acute infection, 33 cases were subacute infection, 16 cases were delayed infection, and 20 cases were positive in bacterial culture. Postoperative breast crash occurred in 114 cases. Univariate analysis showed that diabetes, previous history of immunosuppression, history of smoking, previous history of mastitis, postoperative breast crash, postoperative potential infection surgery, and combined with breast suspension were the influencing factors of postoperative periprosthetic infection (P<0.05). Multivariate analysis showed that diabetes, history of smoking, and postoperative breast crash were the risk factors of periprosthetic infection (P<0.05). Conclusion Diabetes, smoking, and postoperative breast crash are the risk factors of periprosthetic infection after breast augmentation.
目的 通过观察盐酸氨基葡萄糖、依托芬那酯凝胶治疗颞下颌关节紊乱病（TMD）的临床疗效，探寻治疗老年TMD的有效治疗方法。 方法 对2008年7月－2011年12月收治的 35例老年TMD患者，予口服盐酸氨基葡萄糖胶囊750 mg，2次/d，依托芬那酯凝胶5 cm局部外涂，3～4次/d，治疗时间为6周，并对治疗前、后颞下颌关节疼痛程度和活动度进行临床疗效评价。 结果 经治疗，35例患者颞下颌关节疼痛缓解，关节活动度亦明显改善；依据疗效评定标准，治愈10例，显效16例，好转7例，无效2例，总有效率达94.3%；治疗过程中，4例出现轻度胃胀、恶心等不适，2例出现局部皮肤轻度瘙痒现象，无1例中途退出或失访。 结论 盐酸氨基葡萄糖联合依托芬那酯凝胶治疗老年TMD，能缓解关节症状，改善关节活动度，副作用少，值得临床推广运用。
睡眠过程中反复出现呼吸暂停造成的间歇低氧是阻塞性睡眠呼吸暂停低通气综合征( OSAHS) 的主要病理生理学特点, 它能够导致自主神经, 特别是交感神经兴奋性异常增高 , 后者可能是OSAHS合并心血管疾病包括高血压、充血性心力衰竭、心肌梗死以及心律失常的主要危险因素之一[2,3] 。现将慢性间歇低氧( chronic intermittent hypoxia,CIH) 所致交感神经异常兴奋的相关研究作一综述。
Objective To improve the knowledge of inflammatory bowel disease complicated with venous thromboembolism for better diagnosis and treatment. Methods One case of patient with ulcerative colitis complicated with a multiple vessel thromboembolism ( pulmonary arterial, deep vein of lower limb, and superior mesenteric vein) was analyzed, and related literatures were reviewed. Results The patient resulted in pulmonary thromboembolism ( PTE) recurrence because of irregular treatment. In addition to deep vein thrombosis of the lower extremity, a new discovery of the superior mesenteric vein embolism ( MVT) was diagnosed. The bleeding risk of heparin or lowmolecular weight heparin ( LMWH) for treatment is low, while that of warfarin is high. Conclusions Venous thromboembolism ( VTE) has a close relationship with inflammatory bowel disease ( IBD) such as ulcerative colitis. The symptomis not so typical that it is easy to misdiagnosis and missed diagnosis. It is noted that mesenteric venous thrombosis ( MVT) should be excluded in IBD patients suffering from VTE, if the source of embolus is not clear. Suitable treatment should be considered according to the risk stratification of VTE and risk-benefit ratio because of a high bleeding risk.
Objective To investigate the effectiveness of laparoscopic Y-shaped polypropylene mesh in the treatment of uterine and vaginal vault prolapse. Methods Between June 2010 and December 2012, 24 patients with uterine and vaginal vault prolapse were treated by laparoscopic pelvic reconstruction (vagina and uterus-sacral fixation) with Y-shaped polypropylene mesh. The age of patients was 35-60 years (mean, 48.6 years). The disease duration was 2-8 years (mean, 5 years). According to the pelvic organ prolapse quatitative (POP-Q) classification by International Continence Society (ICS), 16 cases were classified as uterine prolapsed degree II and 8 cases as degree III; 15 cases were classified as vaginal prolapse degree I, 7 cases as degree II, and 2 cases as degree III. All patients received postoperative follow-up regularly. Subjective evaluation was done based on prolapse quality of life questionnaire (P-QOL), and objective evaluation based on POP-Q classification. Results All the patients were operated successfully. The operation time was 22-68 minutes (mean, 33 minutes); the blood loss was 30-80 mL (mean, 51 mL); the indwelling urethral catheter remain was 3-7 days (mean, 4 days); and the hospitalization days were 4-9 days (mean, 6.8 days). Twenty-four patients were followed up 3-12 months (mean, 9 months), of whom, 2 were followed up less than 6 months. All patients had normal urination after withdrawal of urethral catheter, and the residual urine volume was in normal range. No patients had mesh erosion and discomfort during sex, vaginal and anal bearing down. The P-QOL scores at 3, 6, and 12 months after operation were significantly improved when compared with the preoperative value (P lt; 0.05); but there was no significant difference among 3, 6, and 12 months after operation (P gt; 0.05). The postoperative POP-Q classification was degree 0 in 19 cases and degree I in 3 cases, and the objective cure rate was 91.7%. No recurrence was found during follow-up. Conclusion Laparoscopic Y-shaped polypropylene mesh for treatment of uterine and vaginal vault prolapse is a safe and effective method, especially applicable to preserve the uterus, and higher requirements of sexual life of patients.
Objective To review the latest development in the research on the application of the electrostatic spinning technology in preparation of the nanometer high polymer scaffold. Methods The related articles published at home and abroad during the recent years were extensively reviewed and comprehensively analyzed. Results Micro/nano-structure and space topology on the surfaces of the scaffold materials, especially the weaving structure, were considered to have an important effect on the cell adhesion, proliferation, directional growth, and biological activation. The electrospun scaffold was reported to have a resemblance to the structure of the extracellular matrix and could be used as a promising scaffold for the tissue engineeringapplication. The electrospun scaffolds were applied to the cartilage, bone, blood vessel, heart, and nerve tissue engineering fields. Conclusion The nanostructured polymer scaffold can support the cell adhesion, proliferation, location, and differentiation，and this kind of scaffold has a considerable value in the tissue engineering field.
目的 采用低场MRI非增强扫描探讨强直性脊柱炎（AS）累及脊柱的MRI表现。 方法 从2010年3月－2013年3月间就诊的76例AS患者的MRI图像中选取19例脊柱受累者资料，对病变部位MRI图像进行分析，评价AS累及脊柱在低场MRI非增强扫描状态下的MRI表现特点。 结果 19例患者中颈椎病变3例，胸椎病变9例，腰椎病变7例；MRI表现为椎体终板炎17例、椎间盘炎13例、脊柱滑膜关节炎15例、椎旁韧带炎11例、韧带骨化和骨性强直9例。 结论 低场MRI非增强扫描能直观显示AS脊柱病变，主要表现为椎体终板炎、椎间盘炎、脊柱滑膜关节炎、椎旁韧带炎、韧带骨化和骨性强直，压脂T2WI序列对活动性炎性病变显示良好，T1WI、T2WI序列能较好显示结构性病变。
【摘要】 目的 研究降钙素基因相关肽（calcitonin gene related peptide， CRGP）在肝硬化门静脉高压症患者食管下段胃底静脉曲张中的作用。 方法 以2005年1月－2010年8月46例肝硬化门静脉高压症不同程度食管下段胃底静脉曲张患者作为研究对象，并按食管下段胃底静脉曲张严重程度分为轻度曲张组、中度曲张组、重度曲张组，以30例行胃肠疾病手术无肝病患者作为对照。术中水柱法测定门静脉压力；酶联免疫吸附法测定门静脉血中CGRP含量。 结果 对照组及轻、中、重度曲张组门静脉压力分别为（14.8±2.1）、（30.5±2.5）、（44.3±3.2）、（47.6±3.8） cm H2O（1 cm H2O=0.098 kPa）。门静脉血中CGRP的含量分别为（45.4±5.4）、（69.2±7.2）、（93.6±8.7）、（98.2±9.4） pg/mL。对照组门静脉压力及CGRP含量明显低于其他3组（Plt;0.05），在轻度曲张组明显低于中度和重度曲张组（Plt;0.05），中度和重度曲张组之间差异无统计学意义（Pgt;0.05）。 结论 CRGP在肝硬化门静脉高压症食管下段胃底静脉曲张的发生和发展中起重要作用，CGRP可作为反映食管静脉曲张程度的一种有用指标。【Abstract】 Objective To investigate the role of calcitonin gene related peptide (CRGP) in pathogenesis of esophageal varices in portal hypertension with cirrhosis. Methods from January 2005 to August 2010, 46 patients with portal hypertension and cirrhosis at different degrees of esophageal varices were divided into mild varicose group, moderate varicose group and severe varicose group according to the severity of esophageal varices. The patients who underwent gastrointestinal surgery without liver disease were as the control. Portal vein pressure was detected by mercury during the surgery. The expression of CGRP was assayed by enzyme-linked immunosorbent assay. Results The portal pressure was (14.8±2.1), (30.5±2.5), (44.3±3.2), and (47.6±3.8) cm H2O (1 cm H2O=0.098 kPa) in the control group and the mild, moderate and severe varicose group, respectively. Those CGRP content in the portal vein was (45.4±5.4), (69.2±7.2), (93.6±8.7), and (98.2±9.4) pg/mL, respectively. CGRP content and portal vein pressure were the lowest in control group, which were significantly lower than those in the other three groups (Plt;0.05); which were also significantly lower in mild varicose group than those in the moderate and severe esophageal varices group (Plt;0.05), while no statistic difference between moderate and severe esophageal varices group was found (Plt;0.05). Conclusion CGRP plays an important role in the occurrence and development of portal hypertension with cirrhosis concurrent esophageal varices, and it may serve as a useful indicator reflecting the degree of esophageal varices.
【Abstract】Objective To analysis the clinical characteristics, pathogenesis, diagnosis and treatment of acute acalculous cholecystitis.Methods Seventy-nine cases of acute acalculous cholecystitis from January 1996 to January 2003 were retrospectively reviewed.Results Of those 79 cases, 13 cases were treated nonoperatively and 66 cases were treated operatively. Twentythree cases were suppurative, 43 cases were gangrenous with perforation in 18 cases，which were proved by postoperative pathology. Seventysix cases were cured and 3 cases were dead. Conclusion Keeping vigilant alert, observing dynamically as well as appropriate operative intervention are effective to improve the prognosis of acute acalculous cholecystitis.