中西医整合理念在肝癌诊治中的应用

随着肿瘤学科分支越来越细,其不足之处也逐渐显现.现代医学思维模式下,肝癌(hepatocellular carcinoma, HCC)的诊治也存在着过于细化,碎片化的趋势,这导致HCC诊治缺乏整体观.随着医学的发展,临床对HCC的治疗越来越强调个体化、整体化及整合理念的应用.本文从当今整合医学角度出发,把HCC的诊治过程视为一个有机的、具有中西医整合特征的全身性疾病,提出单纯消灭癌灶不等于治愈了HCC.同时指出,在临床实践中需要有机地运用基础临床整合、医学药学整合、中医西医整合、局部整体整合的思路对HCC进行重新的再认识,以期发现HCC诊治的新方法,新思路,建立新的HCC整合治疗医学观.

Dead trees as an indicator in tourism risk monitoring at primate ecotourism

Primate ecotourism has become an important conservation tool.Based around tourists observing primates in their natural habitat,it can provide multiple benefits(Lebrão et al.2021).Appropriate ecotourism can improve local residents’living conditions and economic level,heighten awareness about animal conservation,and increase funding for the latter(Stronza et al.2019).

Herbal medicine in the treatment of patients with type 2 Jiabetes mellitus

Introduction Type 2 diabetes mellitus (T2DM)is a type of metabolic disease caused by metabolic disorders in the endocrine system and characterized by hyperglycemia.Insufficient insulin secretion and insulin resistance are the basic pathologic characteristics of T2DM.

Radiological Analysis of Thoracolumbar Junctional Degenerative Kyphosis in Patients with Lumbar Degenerative Kyphosis

Background： Thoracolumbar junction （TLJ） is the transitional area between the lower thoracic spine and the upper lumbar spine. Vertebral compression fractures and proximal junctional kyphosis following spine surgery often occur in this area. Therefore, the study of development and mechanisms of thoracolumbar junctional degeneration is important for planning surgical management. This study aimed to review radiological parameters of thoracolumbar junctional degenerative kyphosis （TLJDK） in patients with lumbar degenerative kyphosis and to analyze compensatory mechanisms of sagittal balance. Methods： From January 2016 to March 2017, patients with lumbar degenerative kyphosis were enrolled in this radiographic study. Patients were divided into two groups according to thoracolumbar junctional angle （TLJA）： the non-TLJDK （NTLJDK） group （TLJA 〈10°） and the TLJDK group （TLJA≥10°）. Complete spinopelvic radiographic parameters were analyzed and compared between two groups. Pearson or Spearman correlation coefficients and independent two-sample t-test or Mann-Whitney U-test were used. Results： Atotal of 77 patients with symptomatic sagittal imbalance due to lumbar degenerative kyphosis were enrolled in this study. There were 34 patients in NTLJDK group （TLJA 〈10°） and 43 patients in TLJDK group （TLJA ≥10°）. The median angle of lumbar lordosis （LL） in the NTLJDK or TLJDK groups was 23.40° （18.50°, 29.48°） or 19.50° （13.30°, 24.55°）, respectively. The median TLJAs in all patients and both groups were -11.20° （-14.60°, -4.80°）, -3.70° （-7.53°, -1.73°）, and -14.30° （-17.45°, -13.00°）, respectively. In the NTLJDK group, LLwas correlated with thoracic kyphosis （TK; r = -0.400, P = 0.019）, sacral slope （SS; r = 0.681, P 〈 0.001）, and C7-sagittal vertical axis （r = -0.402, P = 0.018）. In the TLJDK group, LL was correlated with TK （r = -0.345, P = 0.024）, SS （r = 0.595, P 〈 0.001）, and pelvic tilt （r = -0.363, P = 0.017）. There were significant differences in LL, TLJA, TK, SS, and pelvic incidence （PI） between two groups. Conclusions：Although TLJDK is common in patients with lumbar degenerative kyphosis, it might be generated by special characteristics of morphology and biomechanics of the TLJ. To maintain sagittal balance, pelvis back tilt might be more important in patients with TLJDK, whereas thoracic curve changes might be more important in patients without TLJDK.

Roles of extra-cellular signal-regulated protein kinase 5 signaling pathway in the development of spinal cord injury

Background:In consideration of characteristics and functions,extra-cellular signal-regulated protein kinase 5(ERK5)signaling pathway could be a new target for spinal cord injury(SCI)treatment.Our study aimed to evaluate the roles of ERK5 signaling pathway in secondary damage of SCI.Methods:We randomly divided 70 healthy Wistar rats into five groups:ten in the blank group,15 in the sham surgery+BIX02188(sham+B)group,15 in the sham surgery+dimethyl sulfoxide(DMSO;sham+D)group,15 in the SCI+BIX02188(SCI+B)group,and 15 in the SCI+DMSO(SCI+D)group.BIX02188 is a specific inhibitor of the ERK5 signaling pathway.SCI was induced by the application of vascular clips(with the force of 30 g)to the dura on T10 level,while rats in the sham surgery group underwent only T9-T11 laminectomy.BIX02188 or DMSO was intra-thecally injected at 1,6,and 12 h after surgery or SCI.Spinal cord samples were taken for testing at 24 h after surgery or SCI.Results:Expression of phosphorylated-ERK5(p-ERK5)significantly increased after SCI.Application of BIX02188 indeed inhibited ERK5 signaling pathway and reduced the degree of spinal cord tissue injury,neutrophil infiltration and proinflammatory cytokine expression,nuclear factor-kB(NF-kB)activation and apoptosis(measured by TdT-mediated 20-deoxyuridine 50-triphosphate nickend labeling,expression of Fas-ligand,BCL2-associated X[Bax],and B-cell lymphoma-2[Bcl-2]).Double immunofluorescence revealed activation of ERK5 in neurons and microglia after SCI.Conclusion:ERK5 signaling pathway was activated in spinal neurons and microglia,contributing to secondary injury of SCI.Moreover,inhibition of ERK5 signaling pathway could alleviate the degree of SCI,which might be related to its regulation of infiltration of inflammatory cells and release of inflammatory cytokines,expression of NF-kB and cell apoptosis.