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简介：AbstractThe main treatments for Parkinson’s disease (PD) currently include surgery, rehabilitation, and most commonly, drug therapy. However, the drugs that are currently used to treat PD provide only symptomatic relief and delayed disease progression but have no curative effect and cause many adverse reactions. When considering pathogenic factors and metabolic regulation, PD and type 2 diabetes have a high rate of comorbidity; this provides a theoretical basis for the treatment of PD with first-line antidiabetic drugs. Among these agents, metformin reduces neuronal damage in the brains of PD patients via neuroprotection and the inhibition of oxidative stress and inflammatory responses, thus providing a novel strategy for the clinical treatment of PD. Here, we present the current state of knowledge about the use of metformin to treat PD and discuss its clinical prospects.

简介：【摘要】回顾性分析 5例 Madelung’s病病人资料，探讨此病病因、临床表现及治疗方法。该病病因尚不清，常见于中年男性，肿块主要对称分布于头颈部及上躯干部，呈典型“牛颈”或“驼峰”样外观。手术切除为主要治疗方法。该病恶变率低、预后良好。

简介：AbstractObjective:To review indications and techniques for the endoscopic endonasal approach to the craniovertebral junction (CVJ), analyze postoperative outcomes, and discuss important technical considerations.Methods:A retrospective analysis was performed on all patients undergoing endonasal endoscopic approaches to the CVJ from May 2007 to June 2017. Demographic information, presenting symptoms, imaging results, treatment course, postoperative functional status, and follow-up were recorded.Results:There was a total of 30 patients in this series, with a mean follow-up of 11.7 months. The average age was 33.6 years (range, 5-75 years), with 18 females and 12 males. The majority of patients (n = 22, 73.3%) had Chiari malformation type 1 with basilar invagination and symptomatic cervicomedullary compression as the indication for surgery. Intraoperative cerebrospinal fluid leak (CSF) was noted in 3 cases of odontoid resection and a single case of skull base resection. There were no postoperative CSF leaks. Overall, 81% of patients resumed regular diet by post-operative day 2 (range, 0-8 days). Severe postoperative dysphagia occurred in two cases with one requiring gastrostomy tube placement and another utilizing total parenteral nutrition for support prior to eventual gastrostomy. On average, patients were extubated by postoperative day 0.93 (range 0-3 days), with 85% extubated by postoperative day 1. A tracheotomy was required in one patient.Conclusion:The endonasal endoscopic approach is a valuable technique for access to the CVJ with minimal disruption of respiratory and alimentary function.

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简介：AbstractPeyronie’s disease (PD) is a benign, progressive fibrotic disorder characterized by scar or plaques within the tunica albuginea (TA) of the penis. This study provides new insights into the pathogenesis of PD based on data from different studies regarding the roles of cytokines, cell signaling pathways, biochemical mechanisms, genetic factors responsible for fibrogenesis. A growing body of literature has shown that PD is a chronically impaired, localized, wound healing process within the TA and the Smith space. It is caused by the influence of different pathological stimuli, most often the effects of mechanical stress during sexual intercourse in genetically sensitive individuals with unusual anatomical TA features, imbalanced matrix metalloproteinase/tissue inhibitor of metalloproteinase (MMP/TIMP), and suppressed antioxidant systems during chronic inflammation. Other intracellular signal cascades are activated during fibrosis along with low expression levels of their negative regulators and transforming growth factor-β1 signaling. The development of multikinase agents with minimal side effects that can block several signal cell pathways would significantly improve fibrosis in PD tissues by acting on common downstream mediators.

简介：摘要目的分析非小细胞肺癌(NSCLC)患者人S100钙结合蛋白A8/钙粒蛋白A(S100A8)、S100A9、基质金属蛋白酶9(MMP-9)的表达及意义。方法将2017年1月至2020年1月于四川省眉山市人民医院就诊的16例NSCLC患者纳入NSCLC组进行回顾性研究，将同期20例肺部良性疾病患者作为良性组，另选同期20名健康受试者作为对照组。通过酶联免疫吸附法法测定3组血清S100A8、S100A9、MMP-9水平，经受试者工作特征曲线分析3项指标对NSCLC的诊断价值，并分析其与NSCLC病理特征的关系。结果NSCLC组血清S100A8、S100A9及MMP-9水平均>良性组>健康组，差异均有统计学意义(P值均<0.05)；绘制受试者工作特征曲线结果显示，血清S100A8、S100A9预测NSCLC的曲线下面积(AUC)分别为0.953、0.977，诊断价值高；血清MMP-9预测NSCLC的AUC为0.846，诊断价值中等；经Spearman等级相关分析法发现，S100A8、S100A9、MMP-9表达均与组织分化程度呈负相关(P值均<0.05)，与TNM分期呈正相关(P值均<0.05)；且MMP-9表达与有无淋巴转移相关(r＝0.811，P<0.05)。结论NSCLC患者血清中S100A8、S100A9及MMP-9水平均呈高表达，且与组织分化程度、TNM分期等病理特征密切相关，可作为诊断NSCLC及评估预后的潜在分子标志物。

简介：AbstractIntroduction:Erosive adenomatosis of the nipple is a rare benign lesion involving nipple which can be easily misdiagnosed as more ominous entities such as Pagets disease.Here we reported a case of erosive adenomatosis on the nipple masquerading as paget’s disease.Case presentation:A 21-year-old woman presented with a 6-year history of breast erythema involving her left nipple with tenderness and mild itching. The nipple appeared rough and thickened with areas of erosion and fissuring. Physical examination of other areas of breast as well as imaging studies including ultrasound and mammography showed no abnormalities. The histological examination reveal adiagnosis of erosive adenomatosis of nipple (EAN). The patient was treated by a simple surgical excision without complications and recurrence during 9-month follow-up.Discussion:In the early stage, it can mimic eczema, but in the later stage, more serious diagnosis such as Pagets disease should be differential. It is diagnosed by histopathological examination. Surgical excision is an optimal choice for treament with or without plastic reconstruction.Conclusion:EAN should be considered in the diagnosis of erythema and erosion lesions involving nipple. The gold standard for diagnosis is histopathological examination. A prompt and correct diagnosis of EAN can avoid both unnecessary over treatment and patients emotional stress.

简介：摘要：目的：观察分析内镜附件 7s管理效果。方法：我院自 2018年 1月起开始在内镜附件管理中采用 7s管理模式，将 2018年 1-12月期间的内镜附件管理情况作为观察组、 2017年 1-12月期间的内镜附件管理情况作为对照组，观察对比两组的内镜附件检查质量评分和拿取内镜附件用时，同时调查对比两组医护人员的满意度评分。结果：对比两组的内镜附件检查质量评分显示观察组明显高于对照组，差异具有统计学意义（ P＜ 0.05）。对比两组的拿取内镜附件用时显示观察组明显短于对照组，差异具有统计学意义（ P＜ 0.05）。对比两组医护人员的满意度评分显示观察组均明显高于对照组，差异具有统计学意义（ P＜ 0.05）。结论：在内镜附件管理中采用 7s管理模式的管理质量更高，值得推广。

简介：摘要目的探讨S100A8和S100A9在H.pylori相关胃炎中的表达及其临床意义。方法选择2018年10月至2019年5月在山西医科大学第一医院确诊的慢性胃炎患者101例。采用免疫组织化学法检测101例慢性胃炎患者胃黏膜组织中S100A8和S100A9的表达(以吸光度表示)，同时采用RT-PCR法检测其中48例患者胃黏膜组织S100A8和S100A9的mRNA表达，并结合H-E染色病理诊断和临床H.pylori感染资料进行分析。统计学方法采用Mann-Whitney U检验、Kruskal-Wallis H检验和Spearman秩相关。结果101例患者中，慢性萎缩性胃炎(CAG)59例(CAG组)，慢性非萎缩性胃炎(NAG)42例(NAG组)；H.pylori阳性59例(H.pylori阳性组)，H.pylori阴性42例(H.pylori阴性组)。CAG组S100A8和S100A9的表达水平与NAG组比较[分别为0.10(0.07，0.13)比0.09(0.06，0.10)和0.13(0.08，0.15)比0.09(0.07，0.10)]，以及H.pylori阳性组S100A8和S100A9的表达水平与H.pylori阴性组比较[分别为0.11(0.10，0.13)比0.07(0.06，0.08)和0.13(0.10，0.15)比0.07(0.07，0.08)]，差异均有统计学意义(U＝754.00、602.00、5.00、40.00，P均<0.01)。CAG组中H.pylori阳性患者(34例)S100A8和S100A9的表达水平与阴性患者(25例)比较[分别为0.13(0.11，0.14)比0.07(0.07，0.08)和0.15(0.14，0.16)比0.08(0.08，0.09)]，以及NAG组中H.pylori阳性患者(25例)的S100A8和S100A9的表达水平与阴性患者(17例)比较[分别为0.10(0.09，0.10)比0.06(0.05，0.07)和0.10(0.10，0.11)比0.07(0.06，0.07)] ，差异均有统计学意义(U＝1.00、0.00、0.00、0.00，P均<0.01)。CAG合并H.pylori感染者的S100A8和S100A9的表达水平最高，NAG无H.pylori感染者的S100A8和S100A9表达水平最低，差异均有统计学意义(H＝84.78、89.64，P均<0.01)。CAG患者(24例)S100A8和S100A9的mRNA表达水平与NAG患者(24例)比较[分别为0.12(0.06，1.31)比0.05(0.03，0.08)和0.19(0.03，0.43)比0.03(0.01，0.09)]，以及H.pylori阳性患者(24例)S100A8和S100A9的mRNA表达水平与阴性患者(24例)比较[分别为0.45(0.10，1.90)比0.05(0.03，0.08)和0.36(0.24，0.81)比0.03(0.01，0.04)]，差异均有统计学意义(U＝55.00、74.00、19.00、2.00，P均<0.05)。CAG合并H.pylori阳性患者(12例)S100A8和S100A9的mRNA表达水平与阴性患者(12例)比较[分别为0.85(0.27，2.28)比0.06(0.03，0.09)和0.39(0.25，0.87)比0.03(0.02，0.05)]，以及NAG合并H.pylori阳性患者(12例)S100A8和S100A9的mRNA表达水平与阴性患者(12例)比较[分别为0.09(0.05，0.28)比0.04(0.03，0.07)和0.20(0.09，0.65)比0.01(0.01，0.03)，差异均有统计学意义(U＝5.00、2.00、0.00、0.00，P均<0.01)。CAG合并H.pylori感染者S100A8和S100A9的mRNA表达水平最高，NAG无H.pylori感染者的S100A8和S100A9的mRNA表达水平最低，差异均有统计学意义(H＝20.43、24.15，P均<0.01)。S100A8和S100A9无论在蛋白质水平还是在mRNA水平的表达均呈正相关(r＝0.899和0.903，P均<0.01)。结论S100A8和S100A9可能参与H.pylori感染胃黏膜的致炎过程并促使胃黏膜上皮细胞增殖紊乱的发生，是H.pylori导致胃黏膜固有腺体减少和CAG发生的可能机制之一。S100A8和S100A9有望作为CAG诊断、随访生物标志物和治疗的潜在靶点。

简介：摘要目的观察S100A8、S100A9蛋白在比格犬健康及实验性牙周炎组织中的表达分布特点。方法将6只比格犬的一侧下颌第二磨牙通过拴线法诱导实验性牙周炎模型（结扎组），另一侧下颌第二磨牙保持口腔卫生（健康对照组），应用免疫组化法检测S100A8、S100A9在6只比格犬健康及实验性牙周炎组织中的表达；免疫细胞化学法检测两种蛋白亚基在人牙龈成纤维细胞（human gingival fibroblasts，hGF）（来自3例牙冠延长术切除的牙龈组织）、人牙周膜细胞（human periodontal ligament cells，hPDLC）（来自3例因正畸拔除的前磨牙或第三磨牙的牙周膜细胞）中的表达。结果实验性牙周炎诱导第12周，结扎组探诊深度[（3.86±0.14）mm]显著高于健康对照组[（2.11±0.28）mm，P<0.01]；比格犬健康牙周组织中S100A8、S100A9主要表达于牙龈上皮细胞、中性粒细胞，且在结合上皮处呈强阳性表达；实验性牙周炎组织中除牙龈上皮、中性粒细胞外，两种蛋白还诱导表达于牙龈成纤维细胞、牙周膜细胞、微血管内皮细胞及骨髓成纤维细胞；hGF及hPDLC中均可检测到S100A8、S100A9的表达。结论实验性牙周炎使S100A8、S100A9的表达范围更大，表达S100A8、S100A9的细胞类型更多。

简介：[ 摘要 ] 目的；评价 9S 管理在消毒供应中心的应用情况。方法； 我科 从 2019 年 3 月 -2020 年 3 月消毒供应中心 全面实施 9s 管理理念，在 6 个月、 1年后对实施 9S 管理 取得效果进行汇总评价 ， 9s 管理在消毒供应中心的推广是可行。 现将做法和实施细则汇 报如下。

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简介：【摘要】 目的 分析6s管理在物质管理中的应用价值。方法 抽选来自2017年4月至2018年4月期间我院未实施6s管理的物质管理作为对照组，将2018年5月至2019年5月期间我院采用实施6s管理的物质管理作为观察组 ，比较两组出现物品存放不合理例数、寻找物品消耗时间、清洁环境耗时、月盘点耗时。结果 观察组物品存放不合理例数显著低于对照组，差异具有统计学意义，P＜0.05；观察组寻找物品消耗时间、清洁环境耗时、月盘点耗时显著短于对照组，差异具有统计学意义，P＜0.05。结论 对物质管理中采用6s管理，能够避免不良事件，有助于物品核对，减少物品存放不合理例数，缩短寻找物品消耗时间、清洁环境耗时、月盘点耗时间，在临床上显示出卓越成效，值得进一步推广使用。

简介：【摘 要】目的：有针对性的探究在临床护理过程中应用6S管理所呈现出的应用价值和护理效果。方法：本次研究中所涉及的对象，是选自于我们医院在2018年10月到2020年6月时间范围之内所接收的80例住院患者，按照数字随机的方法对其进行分组，分为对照组和观察组，两组各有患者40例。针对对照组给予常规护理管理措施，而针对观察组给予6S管理模式，对两组患者进行相对应的护理管理之后，对其护理满意程度和治疗总有效率等相关情况进行分析对比。结果：通过对比能够显著看出，观察组患者的治疗总有效率以及护理满意程度等相关情况，要显著地优于对照组，（P＜0.05）。结论：针对临床住院患者来说，在对其进行护理过程中，结合患者的实际情况，有针对性的落实6s管理模式能够呈现出良好的治疗效果，这种护理方法有十分理想的临床应用价值，可以使患者的治疗总有效率和护理满意程度得到显著提升，改善其生活质量，因此这种方法值得在实践的过程中推行和应用。

简介：AbstractPurpose:To investigate the orthopedic injuries sustained while driving and using social media on cellular phones from an orthopedic resident's perspective.Methods:A total of 118 patients who presented with a history of road traffic accident secondary to social media usage and suffered from fractures were included in this cross-sectional study. These patients were reported from October 2018 to April 2019. We collected the data including the type of collision, type of social media usage during driving, location of injury, wearing of safety equipment's such as helmet and seat belt during driving.Results:The mean age of patients was (34.86 ± 12.73) (range 15-71) years. The common types of accident on the basis of collision of vehicles were: car versus motorbike 45 (38.1%), motorbike versus motorbike 28 (23.7%), and motorbike versus pedestrian 22 (18.6%). Most of the accidents (61, 51.7%) occurred due to mistake of motor-bikers. Out of them, 44 (37.3%) occurred on traffic signals, followed by 29 (24.6%) while driving on main roads. The common timing of accident was normal hours with frequency of 44 (37.3%), followed by 39 (33.1%) at late night. According to fracture type, closed injuries were 98 (83.1%) and open fractures were 20 (16.9%). The most common fracture was clavicular fracture (21, 22.5%) followed by soft tissue injury in 19 (16.1%) patients. The most common social media application usage during driving was Facebook 43 (36.4%), followed by Whatsapp 24 (20.3%), Google 19 (16.1%), and Instagram 15 (12.7%).Conclusion:This study provides evidence that social media usage while driving put the drivers and other road users' lives at high risk. The most common social media addiction while driving is Facebook and Whatsapp. So there is a need to make strict rules and penalties for using cell phone during driving so as to save the lives of drivers and other people using road.

简介：AbstractBackground:The prevalence rates of freezing of gait (FOG) in Parkinson’s disease (PD) vary widely, ranging from 14.0 to 55.1%. Our aim is to calculate the overall prevalence of FOG in all PD patients with different disease durations and severities.Methods:Using Medline/PubMed/Embase, we carried out a systematic literature search for studies reporting the PD and clinically relevant FOG.Results:After primary screening, a total of 35 studies were identified and further analyzed for inclusion into the analysis, and 29 studies fulfilled the quality criteria and included in this meta-analysis. The overall prevalence of FOG in PD was 39.9% (95% CI 35.3-44.5%). The FOG identified by the freezing of gait questionnaire item 3 may be more prevalent (43.8%, 95% CI 38.5-49.1%) than the FOG identified by the Unified Parkinson’s Disease Rating Scale item 14 (36.0%, 95% CI 29.0-43.1%). Disease duration and severity are both the clinical features associated with the FOG. The highest FOG prevalence rate in PD patients was seen in patients with disease durations ≥ 10 years, at 70.8%, followed that of PD patients with disease durations ≥ 5 years (53.3%), and PD patients with disease durations < 5 years (22.4%). FOG presented in 28.4% of PD patients with Hoehn and Yahr staging (H&Y) score ≤ 2.5, and in 68.4% of PD patients with H&Y score ≥ 2.5.Conclusion:This meta-analysis confirms that the prevalence of FOG in PD is considerable, and highlights the need for accurate identification of FOG in PD.

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简介：摘要目的探讨腹腔镜下诊治小儿Amyand′s疝的可行性及疗效。方法回顾性分析2013年1月至2018年12月泉州市第一医院收治的小儿嵌顿性腹股沟疝298例，其中Amyand′s疝14例，右侧13例，左侧1例；男13例，女1例，年龄2月至3岁(平均14个月)；于腹腔镜下还纳阑尾，并行疝囊高位结扎术及阑尾切除术。结果14例均于急诊完成腹腔镜手术，无中转开腹。其中3例合并对侧隐匿性斜疝，同期行疝囊高位结扎术。6例阑尾正常，仅行疝囊高位结扎术，手术时间10～20 min(平均15 min)，术后2～3 d(平均2.5 d)出院。8例合并急性阑尾炎，行阑尾切除＋疝囊高位结扎术，手术时间35～80 min(平均60 min)，术后5～10 d(平均7 d)出院。术后病理提示单纯性阑尾炎4例，化脓性阑尾炎3例，坏疽性阑尾炎1例。术后均无发现切口感染、阴囊感染。14例均随访至今，无斜疝复发，无医源性隐睾，无睾丸萎缩等并发症。保留阑尾的6例患儿，均未出现急性阑尾炎发作。结论小儿Amyand′s疝临床少见，术前诊断困难，腹腔镜可作为诊断及治疗的技术手段。

简介：摘要：目的 运用科学的管理方法对工作环境，药品摆放、储存及使用等工作流程进行管理，提高工作环境整体管理水平和工作效率，减少差错，保障患者用药安全。