目的:探究经皮椎体成形术单侧穿刺入路在骨质疏松性椎体压缩骨折中的效果及对创伤反应的影响.方法:将2019年1月-2021年10月广元市第一人民医院收治的103例骨质疏松性椎体压缩骨折患者根据随机数字表法分为对照组(n=51)和观察组(n=52).观察组采用单侧穿刺入路经皮椎体成形术治疗,对照组进行双侧穿刺入路经皮椎体成形术治疗.比较两组的手术时间、术中骨水泥渗漏率、X线应用次数、手术前后的Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)评分、椎体参数及创伤应激指标[血清促肾上腺皮质激素(ACTH)、皮质醇(Cor)及前列腺素E2(PGE2)].结果:观察组手术时间显著短于对照组,X线应用次数显著少于对照组(P<0.05),两组术中骨水泥渗漏率比较,差异无统计学意义(P>0.05);术前两组ODI、VAS评分、椎体参数及创伤应激指标比较,差异均无统计学意义(P>0.05);术后1周及6个月,两组ODI、VAS评分、椎体参数均较术前显著改善(P<0.05),但两组比较,差异均无统计学意义(P>0.05);术后5 d,观察组的创伤应激指标均显著低于对照组(P<0.05).结论:单侧穿刺入路其在腰椎功能及疼痛程度改善方面与双侧穿刺入路无显著差异,但其缩短手术时间、减少X线应用次数及减轻创伤反应的作用相对更好,因此单侧穿刺入路在骨质疏松性椎体压缩骨折经皮椎体成形术中的应用价值相对更高.

目的 探讨在冠状动脉移植时应用"半兜状"自体心包片吻合技术治疗左冠状动脉开口较低且合并主动脉瓣病变的升主动脉瘤的临床效果.方法 回顾性分析我院心外二科2012年11月至2016年1月应用"半兜状"自体心包片吻合技术治疗7例左冠状动脉开口较低行Bentall术患者的临床资料,其中男5例、女2例,年龄(45.2±3.1)岁,术前主动脉CT血管造影(CTA)提示升主动脉瘤样扩张,直径(6.8±0.8) cm,合并主动脉瓣重度狭窄2例,余5例主动脉瓣中-重度关闭不全.手术在常规Bentall术式的基础上对左冠状动脉移植进行改良.应用自体心包片修剪成梭形,使之呈"半兜状"兜住左冠状动脉开口下缘,将左冠状动脉开口上缘与人工血管打孔处上缘直接缝合,完成左冠状动脉移植.结果 全组无死亡病例,体外循环时间(168.0±38.2)min,其中主动脉阻断时间(98.0±28.1) min.术后24h引流量(575.0±65.0) ml.出院前复查心电图及心肌酶学指标(血清肌钙蛋白I、肌酸激酶同工酶、肌酸激酶)均正常.出院随访左室舒张期末内径与术前差异有统计学意义[(5.4±0.5) cm vs. (7.0±0.6)cm, P<0.001].结论 本技术手术操作相对简单、吻合方便、吻合口张力较小、出血风险小、止血方便.冠状动脉吻合口无扭曲及牵拉,不影响冠状动脉血流.术后患者心功能恢复良好,取得了良好的早、中期效果.

BACKGROUND/AIMS:Alcohol abuse exerts deleterious effects on the internal organs of the body, and alcohol-related gastritis is a common disease for which prompt treatment is essential to prevent the condition from growing worse. However, the therapeutic methods have some adverse effects. Determining the pathogenic mechanisms of alcoholic gastritis is therefore essential.METHODS:The MTT assay was developed in order to determine the optimal concentration of alcohol needed to treat gastric mucosal cells. The effects of alcohol on the gastric mucosal cells were determined by qRT-PCR and western blot. The release of IL-1β and IL-18 were determined by ELISA assay. The immunofluorescence assay was used to detect caspase-1 activation levels, while immunohistochemical assay and HE staining were performed to identify the effectiveness of the caspase-1 inhibitor on alcoholic gastritis. The TUNEL assay was used to determine DNA fragmentation.RESULTS:Here, we clarified that ethanol treatment could cause cell DNA damage, activate caspase-1, and promote the generation and release of IL-1β and IL-18. In other words, ethanol could induce pyroptosis. Interestingly, a caspase-1 inhibitor could significantly suppress pyroptosis, decrease the release of inflammatory cytokines induced by ethanol, and cause no side effects in vivo and in vitro.CONCLUSION:Collectively, our results showed that pyroptosis is involved in the pathogenesis of alcohol-induced gastritis and that caspase-1 inhibitor Ac-yvad-cmk could effectively decrease the damage caused by alcohol, making it a potentially promising agent for the treatment of alcoholic gastritis.

In the development of cardiac surgery ,cardioplegic arrest perfusion has been used as the foremost method of myocardial protection until today.In the subsequent studies ,it's discovered that although the technique plays an important role in protecting myocardium ,it may cause serious adverse consequences such as myocardial edema ,energy metabolism dis-order,myocardial stunning and apoptosis.With the constant exploration of science , medical scientists put forward a new myocardial protection scheme-heart beating perfusion,which not only can avoid adverse consequences brought by the cardio-plegic arrest perfusion,but also has obvious advantages in the heart operation with hypertrophic myocardium.Heart beating perfusion has a good development prospect in the application of cardiac surgery.

Objective To analyze the high quality nursing combined with the effect of early rehabilitation on limb function and activity of daily living (ADL) of stroke patients. Methods 106 cases of stroke patients were randomly divided into treatment group and control group, treatment group with high quality nursing combined with early rehabilitation treatment, the control group with routine nursing method. Before and after treatment, simplified Fugl-Meyer, Barthe index and clinical neurological deficit score were used to evaluate their motor function, ADL and neurological function. Results After 4 weeks treatment, the treatment group simplified Fugl-Meyer, Barthe index, clinical neurological deficit scores were significantly improved compared with the control group (P<0.05). Conclusion High quality nursing combined with early rehabilitation can improve the limb function of stroke patients, improve the motor function and ADL, and promote the satisfaction of patients.

目的:2002-04 至 2015-12 期间我院心脏外科收治 6 例左心室近心尖部心脏肿物患者.探讨左心室肿物的临床特点、诊断和和外科治疗的手术效果. 方法:男4例,女2例,年龄34~58岁,平均年龄(42.2±6.7)岁.术前均有活动后心悸、气短临床表现,听诊发现心脏杂音 l 例,晕厥病史 1 例,脑栓塞病史 l 例,反复下肢动脉栓塞病史 1 例.心电图显示阵发性室性心动过速 1 例.所有患者术前均经超声心动图明确诊断,瘤体直径 1.5~3.8cm,显示肿物靠近左心室心尖部,2 例患者可见瘤蒂连于左心室侧壁心尖段.手术均在胸部正中切口、中低温体外循环下完成,根据超声心动图显示肿物位置及周围解剖关系选择不同的手术路径,其中 3 例患者采用右心房 - 房间隔入路,1 例患者通过主动脉切口入路,另 2 例患者采用左心尖切口.术中均完整显露并切除肿物,1 例患者肿物宽基底与室间隔紧密连接,切除肿物后行室间隔补片加固,1 例患者肿物包绕二尖瓣腱索和乳头肌导致二尖瓣关闭不全,术中切除肿物后二尖瓣成形效果不满意再行二尖瓣置换术.术后病理诊断:(左心室)黏液瘤 3 例,弹性纤维瘤 l 例,血管瘤 1 例,陈旧性血栓 1 例,均为良性肿物,术后无需放化疗治疗.

目的 观察探究髋关节置换患者血流变及血小板活化状态对深静脉血栓发生的影响.方法 选取2015年7月至2017年6月期间广元市第一人民医院的30例髋关节置换术后发生深静脉血栓患者为观察组,同时期未发生深静脉血栓的30例患者为对照组.检测2组患者术后1d、2d及3d的血流变及血小板活化状态指标,并比较2组的检测结果,同时采用Logistic分析上述指标与深静脉血栓发生的关系.结果 观察组术后1d、2d及3d的血流变及血小板活化状态指标均显著高于对照组,差异有统计学意义(P＜0.05),观察组术后1d、2d及3d的检测结果比较,差异无统计学意义(P＞0.05),而对照组术后3d的检测结果显著低于术后1d及2d,差异有统计学意义(P＜0.05),Logistic分析显示,上述指标均与深静脉血栓的发生有密切的关系.结论 髋关节置换患者血流变及血小板活化状态对深静脉血栓发生的影响较大,应注重对髋关节置换患者血流变及血小板活化状态的监测与改善.

目的:总结冠状动脉瘘合并冠状动脉瘤样扩张的外科手术疗效和相关经验教训,为该类患者选择手术方式提供依据,提高治疗效果. 方法:2002-04 至 2015-12 期间我院心脏外科收治 6 例冠状动脉瘘合并冠状动脉瘤样扩张的患者,男 4 例,女 2 例,年龄 24~62 岁.所有患者均出现活动后心悸、胸闷、气促、心前区疼痛等相关临床症状,查体可闻及心脏杂音.所有患者均接受超声心动图和冠状动脉造影检查.其中 5 例患者冠状动脉病变位于右冠状动脉,另 1 例位于左冠状动脉回旋支.冠状动脉瘘漏入右心室 3 例,左心房 1 例,左心室 1 例,冠状静脉窦 1 例.1 例患者合并房间隔缺损,1 例患者冠状动脉瘤内血栓形成,3 例患者合并其他冠状动脉狭窄.全组瘤样扩张的冠状动脉直径 1.8~4.0 cm.左心室射血分数为 48%~60%.冠状动脉瘘的处理采用体外循环下阻断主动脉,心脏停搏后纵行切开瘤样扩张的冠状动脉,在血管内用 7-0 prolene 线缝闭瘘口或者应用自体心包补片闭合瘘口.根据患者冠状动脉自身条件采用不同策略处理冠状动脉瘤样扩张:4 例患者切除部分瘤壁直接行血管成形术.1 例患者冠状动脉瘤内血栓形成,仔细剥离血栓并缝闭瘘口后,缝闭冠状动脉瘤入口和出口,远端行冠状动脉旁路移植.另 1 例患者瘤样扩张的冠状动脉病变较广泛,切除瘤样冠状动脉并远端行冠状动脉旁路移植术.术前造影显示冠状动脉狭窄者远端均行冠状动脉旁路移植.术后常规行抗血小板治疗.

This paper was designed to study metabolomic characters of the high-fat diet (HFD)-induced hyperlipidemia and the intervention effects of Mangiferin (MG). In this study, we aimed to investigate the intervention of MG on rats with hyperlipidemia induced by HFD and explore the possible mechanisms of hyperlipidemia. Urine metabolic profiles were analyzed using ultra-performance liquid chromatography/electrospray ionization quadruple time-of-flight mass spectrometry (UPLC-ESI-QTOF-MS) coupled with the principal component analysis (PCA) and partial least squares-discriminate analysis (PLS-DA) models, Heatmap and metabolism pathway analysis. PCA was applied to study the trajectory of the urinary metabolic phenotype of hyperlipidemia rat after administration of MG. The VIP-plot of orthogonal PLS-DA was used for discovering potential biomarkers to clarify the mechanism of MG. Biochemical analyses indicate that MG can alleviate the hyperlipidemia damage. Twenty significantly changed metabolites (potential biomarkers) were found to be reasonable in explaining the action mechanism of MG. The effectiveness of MG on hyperlipidemia is proved using the established metabolomic method and the regulated metabolic pathways involve the TCA cycle, taurine and hypotaurine metabolism, glyoxylate and dicarboxylate metabolism, glycine and serine and threonine metabolism, glycerophospholipid metabolism, primary bile acid biosynthesis etc. The results indicated that MG has a favourable protective effect on HFD-induced hyperlipidemia by adjusting the metabolic disorders. It also suggests that the metabolomic technology is a powerful approach for elucidation of the action mechanisms of MG.

PURPOSE To discuss the association between adiponectin (ADIPOQ) gene rs2241766 and rs1501299 polymorphisms and the risk of colorectal cancer, and to analyze the role of the interaction between these two loci and environmental factors in colorectal cancer pathogenesis. METHODS The case-control study was performed with a 1:1 match. A self-designed questionnaire was used to perform a face-to-face survey with 600 new primary colorectal cancer cases confirmed by histopathology as well as 600 cases of people receiving a physical examination at the same time. The general information, lifestyle, and diet habits, etc. were collected from two groups of study subjects. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to identify ADIPOQ rs2241766 and rs1501299 genotypes. RESULTS After adjusting for factors such as colorectal cancer family history, body-mass index (BMI), daily sedentary time, weekly red meat intake frequency, as well regular tea drinking, conditional logistic regression analysis indicated that rs2241766 TG+GG carriers had a higher risk of colorectal cancer than TT carriers (OR=1.433, 95% CI: 1.014-1.985); rs1501299 GT+TT carriers had a lower risk of colorectal cancer than GG carriers (OR=0.723, 95% CI: 0.531-0.902). Generalized multifactor dimensionality reduction analysis showed that ADIPOQ rs2241766 and rs1501299 could have interaction with red meat intake (p=0.001). CONCLUSION ADIPOQ rs2241766 and rs1501299 single nucleotide polymorphisms (SNPs) could be associated with colorectal pathogenesis and could have interactions with red meat intake. Both factors impact colorectal cancer occurrence.

PURPOSE:Vinegar has been reported to lower blood pressure, but its mechanism is unclear. This study explored whether vinegar plays antihypertensive effect by activating AMP-activated protein kinase (AMPK) pathway.METHODS:Male spontaneously hypertensive rats (SHRs) were assigned to vinegar, acetic acid, nifedipine, nifedipine + vinegar, or distilled water by oral gavage for 8 weeks. Blood and aortas were analyzed for biochemical indices and protein expression levels. Sv40-transformed aortic rat endothelia cell line (SVAREC) cells were treated with acetate at different doses for 24 h; protein expression levels were assessed.RESULTS:Vinegar and acetic acid decreased blood pressure in SHRs on weeks 6 and 8, and nifedipine + vinegar had a better effect on blood pressure control than vinegar or nifedipine alone. Vinegar and acetic acid could decrease serum renin and angiotensin-converting enzyme (ACE) activities, angiotensin II and aldosterone concentrations in SHRs. Vinegar and acetic acid also increased AMP/ATP ratios and expression levels of pAMPK, PPARγ coactivator-1α (PGC-1α), and PPARγ while inhibited angiotensin II type 1 receptor (AT1R) expression in SHRs. The changes in these protein expressions were also found in SVAREC cells treated with 200 or 400 μmol/L acetate. In the presence of AMPK inhibitor or PGC-1α small interfering RNA, the effects of acetate on their downstream protein expression in SVAREC cells were abolished, respectively.CONCLUSION:Vinegar activates AMPK by increasing AMP/ATP ratios, thereby increases PGC-1α and PPARγ expressions, and inhibits AT1R expression in SHRs. Acetic acid is responsible for the antihypertensive effects of vinegar. There is a joint effect between vinegar and nifedipine in blood pressure control.

Adipose-derived stem cells (ASCs) from subcutaneous and visceral adipose tissues have been studied individually. No studies have compared their abilities in treatment of heart failure. This study was designed to evaluate whether ASCs from the two sources could provide a long-term improvement of cardiac function in infarcted hearts. Rat subcutaneous and visceral adipose tissues were excised for isolation of ASCs. Morphology, yield, proliferation, surface markers, differentiation, and cytokine secretion of the subcutaneous ASCs (S-ASCs) and visceral ASCs (V-ASCs) were analyzed. Then a rat model of myocardial infarction (MI) was established by a coronary occlusion. Seven days after occlusion, S-ASCs ( n = 22), V-ASCs ( n = 22), and Dulbecco's modified Eagle medium (DMEM, n = 20) were injected into the infarct rim, respectively. Cardiac function was then monitored with MRI for up to 6 months. The hearts were then removed for histological assessments. The yield of V-ASCs per gram of the visceral adipose depot was significantly greater than that of S-ASCs in 1 g of the subcutaneous adipose depot. On the other hand, the S-ASCs showed a greater proliferation rate and colony-forming unit relative to the V-ASCs. In addition, the infarcted hearts treated with either S-ASCs or V-ASCs showed a significantly greater left ventricular ejection fraction (LVEF) than those treated with DMEM at 4 weeks and 6 months following the cell/DMEM transplantation. Moreover, the infarct sizes of both S-ASC- and V-ASC-treated hearts were significantly smaller than that in the DMEM-treated hearts. MRI showed the implanted ASCs at the end of 6 months of recovery. Despite the differences in cell yield, proliferation, and colony formation capacity, both S-ASCs and V-ASCs provide a long-lasting improvement of cardiac contractile function in infarcted hearts. We conclude that the subcutaneous and visceral adipose tissues are equally effective cell sources for cell therapy of heart failure.

Background: Diabetic encephalopathy is a common complication of diabetes, and it may be involved in altering intracellular calcium concentrations ([Ca2+]i) at its onset. The calcium sensing receptor (CaSR) is a G-protein coupled receptor, however, the functional involvement of CaSR in diabetic encephalopathy remains unclear. Methods: In this study, diabetic rats were modeled by STZ (50 mg/kg). At the end of 4, 8 and 12 weeks, the CaSR expression in hippocampus was analyzed by Western blot. In neonatal rat hippocampal neurons, the [Ca2+]i was detected by laser scanning confocal microscopy, the production of reactive oxygen species (ROS) in mitochondria, the level of NO and the mitochondrial transmembrane potential were measured by MitoSOX, DAF-FM and JC-1, respectively. Results: Our results showed in hippocampal neurons treated with high glucose, CaSR regulated [Ca2+]i through the PLC-IP3 pathway. CaSR expression was decreased and was involved in the changes in [Ca2+]i. Mitochondrial membrane potential, NO release and expression of p-eNOS decreased, while the production of ROS in mitochondria increased. Conclusion: Down-regulation of CaSR expression was accompanied by neuronal injury, calcium disturbance, increased ROS production and decreased release of NO. Up-regulation of CaSR expression attenuated these changes through a positive compensatory protective mechanism to inhibit and delay diabetic encephalopathy in rats.

We aimed to investigate the impact of maternal vitamin D deficiency during pregnancy on insulin resistance in male offspring and examine its mechanism.

目的 观察负载抗生素的骨移植物特性,比较不同骨移植物抗菌能力和成骨效果.方法 双侧胫骨近端慢性骨髓炎造模成功后,48只兔随机均分为4组接受治疗:A组:胫骨病灶清创并万古霉素皮下注射;B组:胫骨病灶清创并以预制的硫酸钙万古霉素颗粒填充清创后遗留的空腔;C组:胫骨病灶清创并以预制的磷酸钙万古霉素颗粒填充清创后遗留的空腔;D组:胫骨病灶清创并以预制的同种异体脱钙骨万古霉素颗粒填充清创后遗留的空腔.在胫骨病灶清创术后1、2、3个月末,每组各处死动物4只,解剖尸体并取胫骨纵剖两半行细菌学检查及病检.结果 B与C组及A与D组间细菌阳性率无统计学差异,而B、C组细菌阳性率低于A、D组.成骨能力:A组成骨比例低于其余各组,B、C、D组间成骨比例无统计学差异;2、3个月末成骨比例,A组＜B组、D组＜C组.结论 负载万古霉素的硫酸钙、磷酸钙治疗慢性骨髓炎效果满意;而吸附万古霉素的同种异体骨治疗慢性骨髓炎感染率较高,可能因万古霉素释放过快,感染灶内难以维持较长时间的抗生素有效浓度所致.磷酸钙万古霉素组能够在控制感染的同时促进新骨生成而修复缺损区.

Objective: To summarize the clinical experience of synchronous Cardiac Valve Operation plus Coronary Artery Bypass Grafting in the treatment of coronary heart disease combined with valvular heart disease. Methods: A retrospective study was carried out to review 41 cases of coronary artery disease combined with valvular heart disease that underwent synchronous CABG plus cardiac valve replacemem. The surgical technique complications and post-operative treatment were analyzed. Results: Early post-operative complication included: re-open in 4 cases(9.76%), LCOS in 6 cases(14.63%), IABP used in 2 cases(4.88%), renal insufficiency in 6 cases(14.63%), respiratory insufficiency in 7 cases(17.07%), complication of CNS in 1 case(2.44%), pleural effusion in 4 cases(9.77%) and death in 6 cases(13.63%). The others had favorable outcomes. Conclusion: Synchronous CABG combined with cardiac valve replacement showed a good early outcome in the treatment of patients with coronary artery disease combined with valvular heart disease. Preoperative improvement of heart function, perfect surgical technique, complete transmyocardial laser revascularization, effective myocardial protection, early application of IABP on the patients who was difficult to wean from pump could significantly improve the efficacy of CABG combined with cardiac valve replacement in the treatment of coronary heart disease combined with valvular heart disease.

目的：房间隔缺损和室间隔缺损是最为常见的先天性心脏病。近年来，随着介入封堵技术的发展与成熟，部分患者通过介入封堵治疗得到根治。但由于缺损过大或缺损边缘情况不佳等解剖学因素，导致部分患者介入治疗失败。封堵器脱落是先天性心脏病介入治疗术中一种严重并发症，严重威胁患者的生命安全。本文将探讨介入封堵治疗中封堵器脱落及并发症原因。

Objective To explore the operative procedures and notes of closure operation by local resection for double-cavity colonic stoma.Methods Retrospective analyses of clinical data were performed in 12 patients,who had undergone colostomy and closure operation from January 2009 to June 2012.Results The operative time was 1.5-2.0 hours.Primary healing was obtained in 10 patients(83.3%) after operation.Wound infection occurred in 2 patients(16.7%),both complicated by anastomotic fistula,and there was no intra-abdominal infection.The patients were followed up for 4-36 months,with a follow-up rate of 83.3%.No patients required colostomy once again,and no complications such as incisional hernia were seen(including 2 anastomotic fistula patients).Conclusion Double-cavity colostomy closure by local resection is a satisfactory choice for its safety,reliability and minor secondary damage.

[Objective]To explore the clinical efficacy of articular injection of sodium hyaluronate for the treat-ment of senile knee osteoarthritis .[Methods] Totally 120 elderly patients with knee osteoarthritis were randomly divided into treatment group and control group with 60 patients in each group .The control group was given only basic treatment including oral glucosamine hydrochloride capsules and physical therapy .The treatment group was given knee articular injection of sodium hyaluronate on the basis of basic treatment .One course were once a week for 5 weeks .The JOA scores ,joint function ,lower extremity muscle strength and gait were recorded and com-pared between two groups .The incidence of adverse effect was recorded .[Results] Compared with before treat-ment ,knee osteoarthritis JOA scores in two groups 1 month and 3 months after treatment were greatly improved , and there was significant difference( P <0 .01) .The improvement of knee osteoarthritis JOA score in the treat-ment group 1 month and 3 months after treatment was better than the control group ,and there was significant difference( P <0 .01) .The excellence rate and total effective rate in treatment group 6 months after treatment were obviously higher than those in control group ,and there was significant difference ( P < 0 .01) .Compared with the control group ,the overall incidence rate of lower extremity weakness and blood pressure elevation in treatment group during treatment was decreased obviously ,and there was significant difference( P<0 .01) .[Con-clusion]Compared with conventional basic therapy ,knee articular injection of sodium hyaluronate for the treat-ment of senile knee osteoarthritis is more effective ,and reduces the adverse reactions ,and the medication is safety . Therefore ,it is worthy of clinical promotion .

The adipocytokines, including adiponectin, are important factors in the regulation of insulin sensitivity and carbohydrate and lipid metabolism. It is proved that concentrations of adiponectin are decreased in obesity, an insulin resistant state. The current study is to address potential mechanisms regulating adiponectin secretion and expression in vivo. To observe the regulation of adiponectin by fasting-refeeding and -agonists, male Wistar rats were fasted for 18h and allowed to refeed with/without a 3-adrenergic receptor agonist infused into refeeding rats. We also investigated the effects of insulin clamp on adiponectin secretion and expression, including euglycemichyperinsulinemic clamp and hyperglycemichyperinsulinemic clamp. Plasma adiponectin levels were determined by radioimmunoassay. Using real-time PCR assays, we analyzed the expression of adiponectin genes in rat primary adipocytes. Refeeding of 18-h fasted rats increased plasma adiponectin concentration (approximate to 2-fold) and adipose tissue adiponectin expression (approximate to 3-fold), and these effects were mimicked by hyperinsulinemia in the absence of refeeding and completely blocked by administration of -agonists during refeeding. We conclude that (i) adiponectin secretion and expression are acutely regulated in vivo by nutritional status; (ii) in vivo, insulin and -agonists act directly at the adipocyte to regulate adiponectin secretion and expression.