目的探讨自体腘绳肌腱植入治疗重度阴道前壁脱垂的安全性和中期疗效。方法本研究为单臂临床试验,2021年5月开始纳入有症状、要求手术治疗的以阴道前壁重度脱垂为主的盆腔器官脱垂(pelvic organ prolapse,POP)患者,经患者充分知情,自愿...目的探讨自体腘绳肌腱植入治疗重度阴道前壁脱垂的安全性和中期疗效。方法本研究为单臂临床试验,2021年5月开始纳入有症状、要求手术治疗的以阴道前壁重度脱垂为主的盆腔器官脱垂(pelvic organ prolapse,POP)患者,经患者充分知情,自愿选择自体腘绳肌腱添加修补,同时行双侧高位骶韧带悬吊。术后随访盆腔器官脱垂定量分度(pelvic organ prolapse quantification,POP-Q)、盆底不适调查表简表评分(Pelvic Floor Distress Inventory-Short Form 20,PFDI-20)、术后满意度评分、患者整体印象改善评分(Patient Global Impression of Improvement,PGI-I)。观察术后取腱侧下肢功能及术后并发症处理、再手术情况。结果取腱手术时间(19.7±8.3)min,盆底手术时间(122.1±37.8)min,术中出血量中位数70 ml(50~400 ml),无术中副损伤和术后病率。12例随访(26.4±2.5)月。Aa、Ba、C术前分别为3(-1~3)、5(2~10)、4(-1~10),术后24个月分别为-3(-3~3)、-3(-3~3)、-6(-6~3),差异有显著性(P<0.05)。12例术前、术后24个月PFDI-20评分分别为88.0(16.7~204.2)、8.3(0~32.3)分,差异有显著性(Z=-2.803,P=0.005);PGI-I问卷11例术后症状明显改善,1例有改善。术后6、24个月满意度评分分别为(4.8±0.4)分和(4.6±0.7)分。1例术后12个月自感阴道脱出物,阴道前壁及顶端脱垂Ⅲ度,复发率8.3%(1/12)。2例分别术后9 d、2周肺栓塞,Clavien-Dindo外科手术并发症分级分别为Ⅱ、Ⅲ级,分别门诊和住院治疗后痊愈。1例阴道顶端局部筋膜暴露,药物治疗好转。所有患者取腱部位切口愈合良好,肌力、下肢活动均正常。无因复发和筋膜条并发症再次手术。结论自体腘绳肌腱植入治疗重度阴道前壁脱垂手术安全,中期疗效满意。术前需向患者宣教下肢锻炼预防静脉血栓并发症。展开更多
O2 Soft magnetic material with high saturation magnetization(Ms)and high resistance(ρ)is vital to improve the power density and conversion efficient of modern electrical magnetic equipment.Yet,increasing Ms is always...O2 Soft magnetic material with high saturation magnetization(Ms)and high resistance(ρ)is vital to improve the power density and conversion efficient of modern electrical magnetic equipment.Yet,increasing Ms is always at the expense of high resistivity,such as soft magnetic alloys substitute for the ferrite.In this work,the superior comprehensive electromagnetic properties,namely the close association of high saturation magnetization and high resistivity,are combined in a new way in a newly Fe-N based magnetic materials.A high resistance oxide interface engineering was constructed between the conducting ferromagnetic phases in the process of spark plasma sintering(SPS)to achieve superior electromagnetic properties.The ZnO compositeγ’-Fe_(4) N bulk has a maximum resistivity of 220μcm and a Ms of up to 156.02 emu/g,while the TiO_(2)compositeγ’-Fe_(4) N bulk has a maximum resistivity of 379μcm and a Ms of 149.7 emu/g.The research findings offer valuable insights for the advancement of the next generation of soft magnetic materials,which hold significant potential for use in high-frequency,high-efficiency,and energy-saving power equipment applications.展开更多
文摘目的探讨自体腘绳肌腱植入治疗重度阴道前壁脱垂的安全性和中期疗效。方法本研究为单臂临床试验,2021年5月开始纳入有症状、要求手术治疗的以阴道前壁重度脱垂为主的盆腔器官脱垂(pelvic organ prolapse,POP)患者,经患者充分知情,自愿选择自体腘绳肌腱添加修补,同时行双侧高位骶韧带悬吊。术后随访盆腔器官脱垂定量分度(pelvic organ prolapse quantification,POP-Q)、盆底不适调查表简表评分(Pelvic Floor Distress Inventory-Short Form 20,PFDI-20)、术后满意度评分、患者整体印象改善评分(Patient Global Impression of Improvement,PGI-I)。观察术后取腱侧下肢功能及术后并发症处理、再手术情况。结果取腱手术时间(19.7±8.3)min,盆底手术时间(122.1±37.8)min,术中出血量中位数70 ml(50~400 ml),无术中副损伤和术后病率。12例随访(26.4±2.5)月。Aa、Ba、C术前分别为3(-1~3)、5(2~10)、4(-1~10),术后24个月分别为-3(-3~3)、-3(-3~3)、-6(-6~3),差异有显著性(P<0.05)。12例术前、术后24个月PFDI-20评分分别为88.0(16.7~204.2)、8.3(0~32.3)分,差异有显著性(Z=-2.803,P=0.005);PGI-I问卷11例术后症状明显改善,1例有改善。术后6、24个月满意度评分分别为(4.8±0.4)分和(4.6±0.7)分。1例术后12个月自感阴道脱出物,阴道前壁及顶端脱垂Ⅲ度,复发率8.3%(1/12)。2例分别术后9 d、2周肺栓塞,Clavien-Dindo外科手术并发症分级分别为Ⅱ、Ⅲ级,分别门诊和住院治疗后痊愈。1例阴道顶端局部筋膜暴露,药物治疗好转。所有患者取腱部位切口愈合良好,肌力、下肢活动均正常。无因复发和筋膜条并发症再次手术。结论自体腘绳肌腱植入治疗重度阴道前壁脱垂手术安全,中期疗效满意。术前需向患者宣教下肢锻炼预防静脉血栓并发症。
文摘目的探讨不同时间高浓度氧对肺泡Ⅱ型细胞(AECII)内质网自噬与肺泡表面活性物质产生功能之间的关系。方法将大鼠RLE-6TN细胞分为对照组(C组,21%O2常规培养72 h)、高氧H1、H2、H3、H4组(95%O2分别培养12、24、48、72 h)。实时荧光定量PCR法检测内质网自噬受体ATL3、CCPG1、FAM134B、RTN3、SEC62的mRNA水平,Western blot法检测内质网自噬相关蛋白ATL3、CCPG1、FAM134B、RTN3、SEC62的水平,ELISA法检测各组二棕榈酰卵磷脂(DPPC)水平。结果与C组相比,H1组ATL3、SEC62的mRNA水平、CCPG1的蛋白水平、DPPC产量下降(P<0.05),CCPG1、FAM134B、RTN3的mRNA水平、ATL3、FAM134B、RTN3、SEC62的蛋白水平显著下降(P均<0.01);H2组ATL3、CCPG1、FAM134B、RTN3、SEC62的mRNA水平、ATL3、CCPG1、FAM134B、RTN3、SEC62的蛋白水平差异无统计学意义(P均>0.05),DPPC产量增高(P<0.05);H3、H4组ATL3、CCPG1、FAM134B、RTN3、SEC62的mRNA水平、ATL3、CCPG1、FAM134B、RTN3、SEC62的蛋白水平、DPPC产量显著下降(P均<0.01)。与H1组相比,H2组CCPG1、FAM134B的mRNA水平、ATL3、RTN3的蛋白水平、DPPC产量显著增高(P<0.01),SEC62的蛋白水平增高(P<0.05);H3组ATL3、SEC62的蛋白水平显著下降(P<0.01),RTN3的mRNA水平、RTN3的蛋白水平下降(P<0.05);H4组ATL3的mRNA水平、CCPG1的蛋白水平下降(P<0.05)、RTN3的mRNA水平、ATL3、RTN3、SEC62的蛋白水平显著下降(P<0.01)。与H2组相比,H3组、H4组ATL3、CCPG1、FAM134B、RTN3的mRNA水平、ATL3、RTN3、SEC62的蛋白水平、DPPC产量显著下降(P均<0.01);H4组SEC62的mRNA水平下降(P<0.05);H3组CCPG1、FAM134B的蛋白水平下降(P<0.05);H4组CCPG1、FAM134B的蛋白水平显著下降(P<0.01);与H3组相比,H4组ATL3、RTN3、SEC62的蛋白水平显著下降(P<0.01);其余各组差异均无统计学意义(P均>0.05)。结论高氧12 h AECII内质网自噬水平、DPPC产量下降;高氧24 h AECII内质网自噬水平恢复到基础值,DPPC产量达到峰值,48 h后内质网自噬水平、DPPC产量再次下降,72 h后AECII内质网自噬水平、DPPC产量衰减仍保持较低水平,AECII内质网自噬与其功能密切相关。
基金supported by National Natural Science Foundation of China(No.52071294),National Key Research and Development Program(No.2022YFE0109800)Natural Science Foundation of Zhejiang Province(No.LY20E020015)Key Research and Development Program of Zhejiang Province(No.2021C01172).
文摘O2 Soft magnetic material with high saturation magnetization(Ms)and high resistance(ρ)is vital to improve the power density and conversion efficient of modern electrical magnetic equipment.Yet,increasing Ms is always at the expense of high resistivity,such as soft magnetic alloys substitute for the ferrite.In this work,the superior comprehensive electromagnetic properties,namely the close association of high saturation magnetization and high resistivity,are combined in a new way in a newly Fe-N based magnetic materials.A high resistance oxide interface engineering was constructed between the conducting ferromagnetic phases in the process of spark plasma sintering(SPS)to achieve superior electromagnetic properties.The ZnO compositeγ’-Fe_(4) N bulk has a maximum resistivity of 220μcm and a Ms of up to 156.02 emu/g,while the TiO_(2)compositeγ’-Fe_(4) N bulk has a maximum resistivity of 379μcm and a Ms of 149.7 emu/g.The research findings offer valuable insights for the advancement of the next generation of soft magnetic materials,which hold significant potential for use in high-frequency,high-efficiency,and energy-saving power equipment applications.
