近十年夏科氏关节病的研究综述

目的 探讨夏科氏关节病的分期、发病机制、影像学检查、发病部位的临床表现及治疗方向。方法 分析夏科氏关节病的临床资料,检索2011年至2022年国内外发表的相关文献,逐一分析检索文献纳入研究,总结其临床表现、治疗方法及随访预后。结果 检索共获得302篇文献,最终纳入11篇。夏科氏关节病发病机制复杂,临床以糖尿病病史患者多累及足踝部病变为多见;脊髓损伤、脊髓痨多累及脊柱;梅毒感染好发于膝关节,其次是髋关节;脊髓空洞症神经病变多发生在肩部,其次是肘和腕关节。结论 夏科氏关节病患者的治疗原则是在控制原发病平稳的基础上,再进行病变部位的处理。

跟痛症的中医病因病机和治疗研究进展

跟痛症是以足底后跟部疼痛为主要特点的综合症候群,是骨科临床常见疾病之一。临床治疗相对棘手,且病因繁多复杂。中医学对其病因病机有其独特见解,在治疗方面较西医亦有独特优势。该病以肝肾亏虚、气滞血瘀为主,治疗上以调补肝肾、活血化瘀为基,兼以益气养血、祛风散寒、清热除湿、理气化痰等为辅,通过内治、外治及内外兼治等疗法,可有效缓解疼痛。

股骨近端大范围骨纤维结构不良合并病理性骨折1例

骨纤维结构不良(fibrous dysplasia of bone,FD)是一种非遗传性疾病,其特点是纤维和骨组织的肿瘤样增生,目前治疗主要以手术为主。本文报道了1例男性股骨近端大范围FD合并病理性骨折的病例,其FD侵袭范围涉及股骨头、股骨颈、股骨粗隆间及股骨小转子下部近端,经病灶刮除+同种异体腓骨条支撑植骨+打压植骨+锁定接骨板内固定术治疗后,患者下肢生理长度及颈干角恢复,在25个月的随访中,下肢功能活动恢复情况良好,未见患肢疼痛或FD复发。

中医药介导OPG/RANK/RANKL信号通路防治类风湿关节炎的研究进展

类风湿关节炎(rheumatoid arthritis,RA)是一种临床常见的以滑膜炎为主的自身免疫性疾病。炎性细胞因子和破骨细胞刺激滑膜组织增生、炎症反应、骨质破坏及关节功能障碍等,在RA的致病因素中占据关键位置。本文对中药单体及其提取物、中药复方及制剂、中药配伍,以及中医治疗通过调控骨保护蛋白(osteoprotegerin,OPG)/NF-κB受体激活因子(receptor activator of NF-κB,RANK)/NF-κB配体激活因子(receptor activator of NF-κB ligand,RANKL)信号通路干预RA的相关研究进行综述。结果表明,中药中的有效分子机制不同,但是可以起到调控信号通路的作用,刺激成骨细胞活性,抑制炎性细胞因子分泌,减少破骨细胞分化,从而防治RA,为中医药多靶点、多途径治疗RA提供理论依据。

慢性伤口治疗方法的研究进展

慢性伤口是一项医学难题,其发病率和并发症发生风险均较高,给全球数百万人的身心健康带来不同程度的影响。目前,对慢性伤口尚无标准统一的治疗方法,我国各级医疗机构对慢性伤口治疗方法的效果及成本了解也相对不足。本文对慢性伤口的一般治疗方法、辅助治疗方法、新型治疗方法,及中医药治疗方法进行综述,以期为一线临床医生治疗慢性伤口提供参考。

Effect of Glycyrrhiza uralensis Fisch polysaccharide on growth performance and immunologic function in mice in Ural City,Xinjiang

Objective:To discuss the effect of Glycyrrhiza uralensis(G.uralensis) Fisch polysaccharide on growth performance and immunologic function in mice in Ural City,Xinjiang and to provide important data supporting the application of Glycyrrhiza polysaccharide.Methods:A total of100 Kunming mice aged 3 weeks old were randomly divided into 5 groups with 20 mice in each group(10 were females and 10 were males).About 0.5 mL normal saline was given to the mice of control group every day and 0.5 mL G.uralensis Fisch polysaccharide was given to the mice of other groups at the concentration of 1,20,50 and 100 mg/mL respectively.The growth performance(average body weight,average daily feed intake and feed efficiency),immune organ indexes(spleen index and thymus index) and immunologic function(serum IL-2,CD4^+/CD8^+ and the activity of NK cells) of mice in each group were detected continuously.Results:The average body weight,feed efficiency,serum IL-2,CD4^+/CD8^+ and the activity of NK cells of mice were increased with the increase of administrated time after administrating G.uralensis Fisch polysaccharide and were reached up the largest level on Day 28.At the same time,each index was proportional to the given dose and was significantly higher than those of control group and reached up the largest level at the administrated dose of 100 mg/mL.After administrating G.uralensis Fisch polysaccharide,the spleen index and thymus index of mice were increased with the increase of administrated dose and the spleen index and thymus index of mice administrated with the dose of 100 mg/mL were maximum which was more than 1.51 times and 1.43 times of that in control group respectively and the comparative differences showed statistical significance(P<0.05).The average daily feed intake of mice in each group was increased with the passage of lime and at the same time,the comparison of average daily feed intake of mice in each group was not significantly different(P>0.05).Conclusions:G.uralensis Fisch polysaccharide can significantly improve the growth performance and immunologic function of mice and laid a research basis for the clinical application of G.uralensis Fisch polysaccharide.

Glycyrrhizinate reduces portal hypertension in isolated perfused rat livers with chronic hepatitis

AIM:To investigate the effects of diammonium glycyrrhizinate(Gly)on portal hypertension(PHT)in isolated portal perfused rat liver(IPPRL)with carbon tetrachloride(CCl4)-induced chronic hepatitis.METHODS:PHT model was replicated with CCl4 in rats for 84 d.Model was identified by measuring the ascetic amounts,hepatic function,portal pressure in vivo,splenic index,and pathological alterations.Inducible nitric oxide synthase(iNOS)in liver was assessed by immunohistochemistry.IPPRLs were performed at d0,d28,d56,and d84.After phenylephrine-induced constriction,Gly was geometrically used to reduce PHT.Gly action was expressed as median effective concentration(EC50)and area under the curve(AUC).Underlying mechanism was exploited by linear correlation between AUC values of Gly and existed iNOS in portal triads.RESULTS:PHT model was confirmed with ascites,splenomegaly,serum biomarkers of hepatic injury,and elevated portal pressure.Pathological findings had shown normal hepatic structure at d0,degenerations at d28,fibrosis at d56,cirrhosis at d84in PHT rats.Pseudo lobule ratios decreased and collagen ratios increased progressively along with PHT development.Gly does dose-dependently reduce PHT in IPPRLs with CCl4-induced chronic hepatitis.Gly potencies were increased gradually along with PHT development,characterized with its EC50at 2.80×10-10,3.03×10-11,3.77×10-11and 4.65×10-11mol/L at d0,d28,d56and d84,respectively.Existed iNOS was located at hepatocyte at d0,stellate cells at d28,stellate cells and macrophages at d56,and macrophages in portal triads at d84.Macrophages infiltrated more into portal triads and expressed more iNOS along with PHT development.AUC values of Gly were positively correlated with existed iNOS levels in portal triads.CONCLUSION:Gly reduces indirectly PHT in IPPRL with CCl4-induced chronic hepatitis.The underlying mechanisms may relate to rescue NO bioavailability from macrophage-derived peroxynitrite in portal triads.

中药组方联合连续血液灌流治疗百草枯中毒的疗效分析

目的观察中药组方联合连续血液灌流对百草枯(PQ)中毒患者的疗效。方法将108例PQ中毒患者分为对照组(常规药物和连续血液灌流治疗)和治疗组(在对照组基础上加中药组方),治疗24 h,两组均给予持续静脉-静脉血液滤过(CVVH)。两组均于治疗前及治疗3和7 d,检测血Lac、Presepsin、血尿素氮(BUN)、肌酸激酶(CK)和急性生理学和慢性健康状况评估Ⅱ(APACHEⅡ)评分的变化,于治疗前及治疗8及12 h检测血中PQ浓度,记录两组患者28 d生存情况。结果两组患者不同时间点Lac、Presepsin、BUN、CK、APACHEⅡ评分和PQ浓度有差异(P <0.05);对照组和治疗组Lac、Presepsin、BUN、CK、APACHEⅡ评分和PQ浓度有差异(P <0.05),治疗组与对照组比较,治疗后Lac、Presepsin、BUN、CK、APACHEⅡ评分和PQ浓度比较低,相对治疗效果好;对照组和治疗组Lac、Presepsin、BUN、CK、APACHEⅡ评分和PQ浓度变化趋势有差异(P <0.05)。治疗组28 d病死率(44.44%,24/54)低于对照组(66.67%,36/54)(P <0.05)。结论中药组方联合连续血液灌流能降低百草枯中毒患者Lac、Presepsin、BUN、CK和APACHEⅡ评分,提高患者生存率,疗效良好,值得临床推广应用。

Diagnostic value and safety of medical thoracoscopy for pleural effusion of different causes

BACKGROUND Pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic modalities.Medical thoracoscopy(MT)can be used for both diagnostic and therapeutic purposes,especially in patients with undiagnosed pleural effusion.AIM To assess the diagnostic efficacy and safety of MT in patients with pleural effusion of different causes.METHODS Between January 1,2012 and April 30,2021,patients with pleural effusion underwent MT in the Department of Respiratory Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University(Shaanxi,China).According to the discharge diagnosis,patients were divided into malignant pleural effusion(MPE),tuberculous pleural effusion(TBPE),and inflammatory pleural effusion(IPE)groups.General information,and tuberculosis-and effusion-related indices of the three groups were analyzed.The diagnostic yield,diagnostic accuracy,performance under thoracoscopy,and complications of patients were compared among the three groups.Then,the significant predictive factors for diagnosis between the MPE and TBPE groups were analyzed.RESULTS Of the 106 patients enrolled in this 10-year study,67 were male and 39 female,with mean age of 57.1±14.184 years.Among the 74 thoracoscopy-confirmed patients,41(38.7%)had MPE,21 had(19.8%)TBPE,and 32(30.2%)were undiagnosed.Overall diagnostic yield of MT was 69.8%(MPE:75.9%,TBPE:48.8%,and IPE:75.0%,with diagnostic accuracies of 100%,87.5%,and 75.0%,respectively).Under thoracoscopy,single or multiple pleural nodules were observed in 81.1%and pleural adhesions in 34.0%with pleural effusions.The most common complication was chest pain(41.5%),followed by chest tightness(11.3%)and fever(10.4%).Multivariate logistic regression analyses showed effusion appearance[odds ratio(OR):0.001,95%CI:0.000-0.204;P=0.010]and carcinoembryonic antigen(OR:0.243,95%CI:0.081-0.728;P=0.011)as significant for differentiating MPE and TBPE,with area under the receiver operating characteristic curve of 0.977(95%CI:0.953-1.000;P<0.001).CONCLUSION MT is an effective,safe,and minimally invasive procedure with high diagnostic yield for pleural effusion of different causes.

Near-net shape processing of spherical high Nb-TiAl alloy powder by gelcasting

Spherical Ti-45Al-8.5Nb-(W,B,Y)alloy powder prepared by an argon plasma process was near-net shape by gelcasting.In the non-aqueous system,methaerylate-2-hydroxy ethyl,toluene,benzoyl peroxide,and N,N-dimethylaniline were used as the monomer,solvent,initiator,and catalyst,respectively.To improve sintering and forming behaviors,many additives were included in the suspension.The concentrated suspension with a solid loading of 70vol%was prepared.The high Nb-TiAl powder was analyzed by electron microscopy and X-ray difraction.It was found that the green bodies had a smooth surface and homogeneous microstructure,exhibiting a bending strength as high as 50 MPa.After sintering at1480 C for 2 h in vacuum,uniform complex-shaped high Nb-TiAl parts were successfully produced.

Tailoring microstructure evolution and mechanical properties of a high-performance alloy steel through controlled thermal cycles of a direct laser depositing process

Direct laser deposition(DLD),as a popular metal additive manufacturing process,shows advantages of technical flexibility and high efficiency to gain a high-performance alloy steel component.However,during the processing of DLD,the deposited steel layer is affected by the subsequent layer depositing.The DLD block shows different microstructure and mechanical properties at the bottom,middle and top of the deposited parts.To date,there are few research works about the effects of inter-layer interval time and laser power on the microstructure evolution and mechanical properties of the deposited layers.In this study,the idle time and laser power layer by layer during DLD of 12CrNi2 steel were controlled to cause the deposited layers to maintain a high cooling rate,while the bottom deposited layer was subjected to a weak tempering effect.Results show that a high proportion of martensite is produced,which improves the strength of the deposited layer.Under the laser scanning strategy of laser power 2,500 W,scanning velocity 5 mm·s^(-1),powder feeding rate 11 g·min^(-1),overlap rate 50%,and a laser power difference of 50 W and a 2 min interval,the tensile strength of the deposited layer of 12CrNi2 steel is in the range of 873-1,022 MPa,and the elongation is in the range of 16.2%-18.9%.This study provides a method to reduce the tempering effect of the subsequent deposition layers on the bottom layers,which can increase the proportion of martensite in the low-alloy high-strength steel,so as to improve the yield strength of the alloy steel.

Synergistically Directed Assembly of Aromatic Stacks Based Metal-Organic Frameworks by Donor-Acceptor and Coordination Interactions

A synergistically directed assembly approach to distinctive metal-organic frameworks utilizing both donor-acceptor (D-A) interaction from aromatic systems and coordination interactions is presented.Based on such an approach,the coronene-tpt (tpt =2,4,6-tri(4-pyridyl)-1,3,5-triazine) stacks based coronene-MOF-1-4 have been successfully fabricated.Their structural discrepancies with coroneneabsent control products,1'-4',illustrate clearly the significance of coronene-tpt based D-A interactions in these architectures.All these coronene-MOFs contain varied coronene-tpt stacks as organic secondary building blocks (SBUs),which are closely interrelated with the coordination based framework structures.Moreover,porous coronene-MOF-1 and-2 exhibit high physicochemical stability and significant light hydrocarbons storage and separation performances.

Flat-head power-law, size-independent clustering, and scaling of coevolutionary scale-free networks

没有规模的拓扑学并且高聚类在一些真实网络共存，并且为种系统的尺寸保持不变。以前的模型一能给出与 selforganized 机制的尺寸无关的聚类就成功了生产幂定律度分布。总是忽略了，一些实验统计结果显示扁平头的幂定律行为。我们修改我们的最近的 coevolutionary 模型与节点的惰性的性质解释如此的现象在自我组织的给换新电线的过程保留相反的连接的小部分。弗拉塞德人幂定律并且尺寸无关的聚类被这修正作为新特征导致。另外，一种新可伸缩关系作为在节点状态生长和连接的适应变化之间的相互影响的结果被发现。