Aberrant Activation of Cdc2/cyclin B1 Is Involved in Initiation of Cytoskeletal Pathology in Murine Niemann-Pick Disease Type C

Niemann-Pick disease type C（NPC） is a fatal, neurovisceral lipid storage disease, neuropathologically characterized by cytoplasmic sequestration of glycolipids in neurons, progressive neuronal loss, neurofibrillary tangles（NFTs） formation, and axonal spheroids（AS）. Cytoskeletal pathology including accumulation of hyperphosphorylated cytoskeletal proteins is a neuropathological hallmark of the mouse model of NPC（npc mice）. With a goal of elucidating the mechanisms underlying the lesion formation, we investigated the temporal and spatial characteristics of cytoskeletal lesions and the roles of cdc2, cdk4, and cdk5 in lesion formation in young npc mice. Cytoskeletal lesions were detectable in npc mice at three weeks of age. Importantly, concomitant activation of cdc2/cyclin B1 kinase and accumulation of a subsequently generated cohort of phospho-epitopes were detected. The activation of cdk4/cyclin D1 and cdk5/p25 kinases was observed during the fourth week of life in npc mice, and this activation contributed to the lesion formation. We concluded that the progression of cytoskeletal pathology in npc mice older than four weeks is accelerated by the cumulative effect of cdc2, cdk4, and cdk5 activation. Furthermore, cdc2/cyclin B1 may act as a key initial player one week earlier. Targeting cell cycle activation may be beneficial to slow down the NPC pathogenesis.

The Neuroprotective Effects of Cyclin-dependent Kinase-5 Inhibition in Mice with Niemann-Pick Disease Type C

In order to investigate the neuroprotective effects of cyclin-dependent kinase-5 （cdk-5） inhibition in mice with Niemarm-Pick disease type C （NPC） （npc^-/-）, recombinant adeno-associated virus （rAAV） carrying the small interfering RNA （siRNA） specific for cdk-5 gene was injected into 3-day-old npc^-/- mice intracerebroventricularly. The rAAV-GFP-injected age-matched npc^-/- mice and non-surgery age-matched npc^-/- mice were employed as controls （n=6-10/group）. From the 4th to 8th week after the treatment, mice were weighed, and evaluated for limb motor activity by using the coat hanger test once a week. Eight-week-old npc^-/- mice were sacrificed by decapitation, and brains were quickly dissected and halved sagittally. Immunohistochemistry, Western blotting, and HE staining were used to evaluate the neuropathology in npc^-/- mice. The results showed that rAAV-cdk-5-siRNA-GFP significantly reduced the number of axonal spheroids, delayed the death of Purkinje neurons, ameliorated motor defects in npc^-/- mice, and significantly attenuated the hyperphosphorylation oftau proteins. These data suggested that inhibition of cdk-5 activity has neuroprotective effect on neurons in NPC mice.

Evaluation of an attenuated vaccine candidate based on the genotype C of bovine parainfluenza virus type 3 in albino guinea pigs

Bovine parainfluenza virus type 3（BPIV3） is considered as one of the most important respiratory tract pathogens of both young and adult cattle, and widespread among cattle in the world. BPIV3 was first reported in China in 2008 and four strains of BPIV3 were isolated from Shandong Province, known as genotype C（BPIV3c）. Pathogen investigations had shown that BPIV3 c infection was very common among cattle in China. To date, BPIV3 can be classified into genotypes A, B and C based on genetic and phylogenetic analysis. Serological survey also demonstrates that BPIV3 infection is widespread in China, however, there is still no available vaccine for BPIV3 prevention in China nowadays. In the present study, the BPIV3 c strain SD0835 was continuously passaged on Madin-Darby bovine kidney（MDBK） cells for hundreds of times, and the pathogenicity of passage 209 was reduced in guinea pigs. The passage 209 of BPIV3 c strain SD0835 was used as a live vaccine candidate to immunize the guinea pigs. The vaccination results revealed that two vaccinations could induce excellent serum neutralizing antibody responses as well as proliferation of T lymphocytes. The vaccinated guinea pigs were well protected against challenge with a low passage of BPIV3 c strain SD0835. Additionally, the percentages of CD4~＋ and CD8~＋ T cell subsets of animals in vaccinated group increased after immunization; T cell subsets on day 2 after challenge in both groups decreased, and the decline of CD4~＋ and CD8~＋ T cell subsets levels of four guinea pigs in vaccinated group was relatively moderate, comparing with that of the control group. These data support further testing of the attenuated virus as an effective candidate vaccine.

USB3.1 Type C超声辅助钎焊焊接性研究

采用自制的SnXX无铅钎料代替生产中常用的SnBi钎料,并分别采用超声波辅助钎焊技术和常规钎焊技术实现USB3.1 Type C中的铜导线和铜端子的可靠焊接互连,以阐明新型超声辅助钎焊技术在数据线连接领域内的优越性。焊后PIN位焊点锡点饱满,PIN位的前端未见未融的锡膏,焊杯界面无过多的锡珠。焊点横截面宏观形貌呈圆滑过渡,界面结合良好并形成Cu_6Sn_5化合物,无宏观缺陷,良品率较高。

Histopathology of type C liver disease for determining hepatocellular carcinoma risk factors

AIM:To evaluate the histopathological findings of type C liver disease to determine risk factors for development of hepatocellular carcinoma(HCC).METHODS:We studied 232 patients,who underwent liver biopsy for type C chronic liver disease between 1992 and 2009,with sustained virological response(SVR)after interferon therapy.The patients were divided into two groups according to the F stage 0+1+2 group(n = 182)and F3+4 group(n = 50).We prospectively observed and compared the incidence of HCC of the patients with SVR in the F0+1+2 and F3+4 groups.Then,the background factors and liver histopathological findings,including the degree of fibrosis,F stage,inflammation,necrosis,bile duct obstruction,fat deposition,and degree of irregular regeneration(IR)of hepatocytes,were correlated with the risk of developing HCC.RESULTS:HCC developed in three of 182(1.6%)patients in the F0+1+2 group,and four of 50(8.0%)in the F3+4 group.The cumulative incidence of HCC in the former group was found to be significantly lower than in the F3+4 group(log rank test P = 0.0224).The presence of atypical hepatocytes among IR of hepatocytes in the F3+4 group resulted in a higher cumulative incidence of HCC,and was significantly correlated with risk of HCC development(RR = 20.748,95%CI:1.335-322.5,P = 0.0303).CONCLUSION:Atypical hepatocytes among the histopathological findings of type C liver disease may be an important risk factor for HCC development along with progression of liver fibrosis.

新IGC规范下的Type C型LNG/LPG运输船鞍座数值模拟研究

本文根据《国际散装运输液化气体船舶构造与设备(IGC)规范》中加速度计算公式的更新,对液化气LNG/LPG运输船支持鞍座考虑非线性接触模拟。采用某C型液化天然气运输船的相关数据,使用MSC.Patran/Nastran建立有限元模型,考虑运输船在静满载和动垂荡的状态下耦合液货的运动,对全船加载。分别将"临时杆单元"法和线性间隙单元法应用于工程实践中,通过对有限元结果计算精度与效率的分析,验证线性间隙单元方法的合理性和可靠性。为结构优化和强度分析提供重要依据和分析工具。

Type C Gen2对绞线的线缆设计

为了便于实际项目需要,设计了一种采用对绞线结构且带有E-Marker芯片的全功能USB Type-C高速电缆。采用polar SI 9000仿真软件对整条Type C线缆链路按产品实际制程的要求进行阻抗模拟仿真,得出Type C整条链路阻抗的曲线。实验结果表明, Type C整条链路阻抗一致性越好,其IMR、IRL性能就越好。采用一种新的线夹工艺,解决在Type C接头外模尺寸不变的情况下Type C Gen2 SI性能及可制造的问题。实验证明,通过这种新的线夹工艺,不但可以解决困扰Type C SI性能的串扰难点,还可以解决可制造问题。目前,采用该设计方案的Type C线缆已拿到USB协会的1M Type C Gen 2证书。

改善SMT过程工艺对提高Type C焊接质量的影响研究

为了提高新型的C型连接器的焊接质量,通过对焊接组装的SMT(表面贴装技术)过程工艺的流程改善,即:选择不同品牌的锡膏、选择不同角度印刷刮刀增加印刷电路板孔中的锡膏填充量、增大钢网开孔、增加焊接润湿面积、选择氮气回流焊炉等方法,提高了TYPE C的焊接质量,从而达到了客户的质量要求。希望能为从事本行业的同事提供参考。

Direct Decomposition of NO into N₂and O₂Over C-type Cubic Y₂O₃-Tb₄O₇-ZrO₂

Catalytic activities for direct NO decomposition were investigated over C-type cubic Y2O3–Tb4O7–ZrO2 prepared by a coprecipitation method. The NO decomposition activity was enhanced by partial substitution of the yttrium sites with terbium in a (Y0.97Zr0.03)2O3.03 catalyst, which shows high NO decomposition activity. Among the catalysts synthesized in this study, the (Y0.67Tb0.30Zr0.03)2O3.33 catalyst exhibited the highest NO decomposition activity;NO conversion to N2 was as high as 67% at 900℃ in the absence of O2 (NO/He atmosphere), and a relatively high conversion ratio was observed even in the presence of O2 or CO2, compared with those obtained over conventional direct NO decomposition catalysts. These results indicate that the C-type cubic Y2O3–Tb4O7–ZrO2 catalyst is a new potential candidate for direct NO decomposition.

Activin A receptor type 1C single nucleotide polymorphisms associated with esophageal squamous cell carcinoma risk in Chinese population

BACKGROUND Transforming growth factor-β(TGF-β)superfamily plays an important role in tumor progression and metastasis.Activin A receptor type 1C(ACVR1C)is a TGF-βtype I receptor that is involved in tumorigenesis through binding to dif-ferent ligands.AIM To evaluate the correlation between single nucleotide polymorphisms(SNPs)of ACVR1C and susceptibility to esophageal squamous cell carcinoma(ESCC)in Chinese Han population.METHODS In this hospital-based cohort study,1043 ESCC patients and 1143 healthy controls were enrolled.Five SNPs(rs4664229,rs4556933,rs77886248,rs77263459,rs6734630)of ACVR1C were assessed by the ligation detection reaction method.Hardy-Weinberg equilibrium test,genetic model analysis,stratified analysis,linkage disequi-librium test,and haplotype analysis were conducted.RESULTS Participants carrying ACVR1C rs4556933 GA mutant had significantly decreased risk of ESCC,and those with rs77886248 TA mutant were related with higher risk,especially in older male smokers.In the haplotype analysis,ACVR1C Trs4664229Ars4556933Trs77886248Crs77263459Ars6734630 increased risk of ESCC,while Trs4664229Grs4556933Trs77886248Crs77263459Ars6734630 was associated with lower susceptibility to ESCC.CONCLUSION ACVR1C rs4556933 and rs77886248 SNPs were associated with the susceptibility to ESCC,which could provide a potential target for early diagnosis and treatment of ESCC in Chinese Han population.

C反应蛋白/白蛋白比值对2型糖尿病合并急性心肌梗死患者远期不良心脑血管事件的预测价值研究

背景急性心肌梗死(AMI)是威胁全球公众健康的主要原因之一。虽然已有相应的再灌注治疗策略,但AMI相关的主要不良心脑血管事件(MACCEs)仍然是全世界人口死亡的原因之一。尤其合并糖尿病的AMI患者,因冠状动脉病变复杂,病变程度严重,尽早发现和判断该部分患者远期预后相对困难,因此寻找相对简便、易获得的实验室指标,有利于为2型糖尿病(T2DM)合并AMI患者经皮冠状动脉介入(PCI)术后MACCEs的预测提供依据。目的探讨血清C反应蛋白(CRP)/白蛋白(Alb)比值(CAR)对T2DM合并AMI患者PCI术后远期MACCEs的预测价值。方法纳入2014—2019年就诊于宁夏医科大学总医院心血管内科1683例T2DM合并AMI患者为研究对象,收集患者的一般临床资料与检查结果。对所有患者进行电话或门诊随访,以全因死亡、非致死性心肌梗死、再发不稳定型心绞痛、非致死性脑卒中、新发心力衰竭或心力衰竭加重再入院、再次血运重建作为MACCEs。根据患者随访期间是否发生MACCEs分为MACCEs组(508例)和非MACCEs组(1175例)。采用单因素及多因素Logistic回归分析探讨T2DM合并AMI患者MACCEs事件的影响因素。采用Kaplan-Meier法绘制患者的生存曲线,生存曲线的比较采用Log-rank检验。采用受试者工作特征(ROC)曲线分析CAR对T2DM合并AMI患者远期发生MACCEs的预测效能,使用净重分类改善指标(NRI)和综合判别指数(IDI)评价CAR对T2DM合并AMI患者预后评估的改善效果。结果1683例患者中508例(30.18%)患者发生MACCEs。多因素Logistic回归分析显示高血压病[OR(95%CI)=1.994(1.142~3.483)]、冠状动脉植入支架长度[OR(95%CI)=1.031(1.002~1.062)]、CRP[OR(95%CI)=0.950(0.915~0.986)]、Alb[OR(95%CI)=0.933(0.880~0.989)]及CAR[OR(95%CI)=5.582(1.705~18.277)]是T2DM合并AMI患者PCI术后发生MACCEs的影响因素(P<0.05)。根据CAR中位表达水平(0.86),将患者分为CAR<0.86组和CAR≥0.86组,Log-rank检验结果显示,CAR≥0.86组MACCEs发生率高于CAR<0.86组(52.68%与22.92%;χ^(2)=65.65,P<0.001)。ROC曲线显示CAR预测T2DM合并AMI患者发生MACCEs的ROC曲线下面积为0.728(95%CI=0.702~0.754),最佳截断值为0.576,灵敏度为0.617,特异度为0.747。在基线模型基础上,与CRP、Alb相比,CAR能明显改善对患者发生MACCEs的预测效果(NRI=0.377,IDI=0.166,C指数=0.690;P<0.05)。结论CAR是T2DM合并AMI患者PCI术后远期MACCEs发生风险的有效预测指标。

Thioredoxin Reductase Type C （NTRC） Orchestrates Enhanced Thermotolerance to Arabidopsis by Its Redox-Dependent Holdase Chaperone Function

Genevestigator analysis has indicated heat shock induction of transcripts for NADPH-thioredoxin reduc-tase, type C （NTRC） in the light. Here we show overexpression of NTRC in Arabidopsis （NTRC°E） resulting in enhanced tolerance to heat shock, whereas NTRC knockout mutant plants （ntrcl） exhibit a temperature sensitive phenotype. To investigate the underlying mechanism of this phenotype, we analyzed the protein＇s biochemical properties and protein structure. NTRC assembles into homopolymeric structures of varying complexity with functions as a disulfide reductase, a foldase chaperone, and as a holdase chaperone. The multiple functions of NTRC are closely correlated with protein structure.. Complexes of higher molecular weight （HMW） showed stronger activity as a holdase chaperone, while low molecular weight （LMW） species exhibited weaker holdase chaperone activity but stronger disulfide reductase and fol-dase chaperone activities. Heat shock converted LMW proteins into HMW complexes. Mutations of the two active site Cys residues of NTRC into Ser （C217/454S-NTRC） led to a complete inactivation of its disulfide reductase and foldase chaperone functions, but conferred only a slight decrease in its holdase chaperone function. The overexpression of the mutated C217/454S-NTRC provided Arabidopsis with a similar degree of thermotolerance compared with that of NTRC°E plants. However, after prolonged incubation under heat shock, NTRC°E plants tolerated the stress to a higher degree than C217/454S-NTRC°E plants. The results suggest that the heat shock-mediated holdase chaperone function of NTRC is responsible for the increased thermotolerance of Arabidopsis and the activity is significantly supported by NADPH.

Locking plate versus external fixation for type C distal radius fractures： A meta-analysis of randomized controlled trials

Purpose： Distal radial fracture is one of the most common fractures. Up to now, locking plates （LP） and external fixation （EF） are two conventional surgical approaches to type C radius fracture. Which method is superior has not yet reached a consensus. We try to assess the clinical effectiveness of the two in- terventions by this meta-analysis. Methods： We used network to search the PubMed, Embase, and Cochrane Medical Library of randomized controlled clinical trials about the type C distal radius fractures performed according to the search strategy mentioned in Cochrane Handbook 5.1.0 from Jan. 2005 to Jan. 2016. Patients in the experimental group were used LP, in the control group were included EF and other surgical approaches. Publication language was restricted to English. Studies that patient population and surgical indication did not define had been excluded. Studies must report at least one of the outcomes as follow： radial inclination, patmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The trials in which participants included children were excluded. We used Jadad study scores to appraise the study. Results： Seven studies included 162 patients （LP group） and 190 patients （EF group）. We compared the radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The radial inclination were revealed a difference favoring LP over EF [WMD = 1.84, 95% CI （0.17, 3.50）, p = 0.03] and the palmar tilt and ulnar variance was no significant difference between the two groups [（WMD = 3.61, 95% CI （0.00, 7.23）, p = 0.05; WMD = 0.05, 95% CI （-0.99,1.09）, p = 0.93]. The functional activities of range of flexion and extension and range of supination and pronation between the two groups was no difference [WMD = 10.04, 95% CI （-6.88, 26.96）, p = 0.24; WMD = 12.53, 95% CI （-9.99, 35.06）, p = 0.28]. Conclusion： Locking plate and external fixation is feasible to heal radius type C fracture. We found the small difference between the two groups on imaging examination. The locking plate has the advantage on maintaining reduction, however no significant difference regarding outcomes has been found be- tween the two groups.

Bilateral triceps tendon approach is flexible and efficient in the treatment of type C distal humerus fractures

Purpose:The purpose of this study was to assess and compare elbow range of motion,triceps extension strength and functional results of type C(AO/OTA)distal humerus fractures treated with bilateral triceps tendon(BTT)approach and olecranon osteotomy(00).At the same time,we are also trying to know whether BTT approach can provide sufficient vision for comminuted intra-articular fractures of the distal humerus,and whether it is convenient to convert to the treatment to total elbow arthroplasty(TEA)or 00.Methods:Patients treated with 00 and BTT approaches for type C distal humerus fractures between July 2014 and December 2017 were retrospectively reviewed.Inclusion criteria include:(1)patients'age were more than 18 years old,(2)follow-up was no less than 6 months,and(3)patients were diagnosed with type C fractures(based on the AO/OTA classification).Exclusion criteria include:(1)open fractures(Gustillo type 2 or type 3),(2)treated by other approaches,and(3)presented with combined injuries of ipsilateral upper extremities,such as ulnar nerve.Elbow range of motion and triceps extension strength testing were completely valuated,when the fractures had healed.Assessment of functional results using the Mayo elbow performance score and complications were conducted in final follow-up.The data were compared using the two tailed Student's t-test.All data were presented as mean±standard deviation.Results:Eighty-six patients of type C distal humerus fractures,treated by 00 and BTT approach were retrospectively reviewed between July 2014 and December 2017.Fifty-five distal humerus fractures(23 males and 32 females,mean age 52.7 years)treated by BTT approach or 00 were included in this study.There were 10 fractures of type Cl,16 type C2 and 29 type C3 according to the AO/OTA classification.Patients were divided into two surgical approach groups chosen by the operators:BTT group(28 patients)and 00 group(27 patients).And the mean follow-up time of all patients was 15.6 months(range,6-36 months).Three cases in BTT group were converted to TEA,and one converted to 00.Only one case in BTT group presented poor articular reduction with a step more than 2 mm.There were not significantly different in functional outcomes according to the Mayo elbow performance score,operation time and extension flexion motion are values between BTT group and 00 group(p>0.05).Complications and reoperation rate were also similar in the two groups.Triceps manual muscle testing were no significant difference in the two groups,even subdivided in elder patients(aged>60 years old).Conclusion:BTT is a safe approach to achieve similar functional result comparing with 00.BTT were not suitable for every case with severe comminuted pattern,but it avoids the potential complications related to 00,and has no complications concerning with triceps tendon.It is convenient for open reduction internal fixation and flexible to be converted to 00,as well as available to be converted to TEA in elder patients.

Different outer membrane c‐type cytochromes are involved in direct interspecies electron transfer to Geobacter or Methanosarcina species

Direct interspecies electron transfer(DIET)may be most important in methanogenic environments,but mechanistic studies of DIET to date have primarily focused on cocultures in which fumarate was the terminal electron acceptor.To better understand DIET with methanogens,the transcriptome of Geobacter metallireducens during DIET‐based growth with G.sulfurreducens reducing fumarate was compared with G.metallireducens grown in coculture with diverse Methanosarcina.The transcriptome of G.metallireducens cocultured with G.sulfurreducens was significantly different from those with Methanosarcina.Furthermore,the transcriptome of G.metallireducens grown with Methanosarcina barkeri,which lacks outer‐surface c‐type cytochromes,differed from those of G.metallireducens cocultured with M.acetivorans or M.subterranea,which have an outer‐surface c‐type cytochrome that serves as an electrical connect for DIET.Differences in G.metallireducens expression patterns for genes involved in extracellular electron transfer were particularly notable.Cocultures with c‐type cytochrome deletion mutant strains,ΔGmet_0930,ΔGmet_0557 andΔGmet_2896,never became established with G.sulfurreducens but adapted to grow with all three Methanosarcina.Two porin–cytochrome complexes,PccF and PccG,were important for DIET;however,PccG was more important for growth with Methanosarcina.Unlike cocultures with G.sulfurreducens and M.acetivorans,electrically conductive pili were not needed for growth with M.barkeri.Shewanella oneidensis,another electroactive microbe with abundant outer‐surface c‐type cytochromes,did not grow via DIET.The results demonstrate that the presence of outer‐surface c‐type cytochromes does not necessarily confer the capacity for DIET and emphasize the impact of the electron‐accepting partner on the physiology of the electron‐donating DIET partner.

基于可靠性的液化气体运输船新颖C型货物围护系统设计衡准

从结构可靠性分析方法入手,分析液化气体运输船新颖C型货物围护系统的载荷、抗力和模型的随机性。建立新颖C型货物围护系统的极限状态方程,参照国际船级社协会新编的《C型独立液货舱的屈服、屈曲和疲劳评估的有限元分析流程建议》(Recommendation No.174)的相关要求开展新颖构造货物围护系统有限元计算和可靠度分析方法研究,对新颖C型货物围护系统(双体罐和三体罐)进行应力分析和可靠性计算。采用可靠性的第一水准法构建新颖C型货物围护系统的设计衡准,并确定各分项系数,研究结果为制定符合可靠性标准的新颖C型货物围护系统规范和基于可靠性方法的结构强度准则提供参考。

通督调神针法治疗阴虚动风型脑梗死偏瘫疗效及对患者血清Hcy、CRP水平的影响

目的:探讨通督调神针法治疗阴虚动风型脑梗死偏瘫患者疗效及对患者血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)水平的影响。方法:选取脑梗死偏瘫患者76例,1∶1随机分为观察组(西医治疗+通督调神针法)与对照组(常规西医治疗)各38例。持续治疗1个月后,评估两组临床疗效,比较两组治疗前后中医证候积分、血清炎症因子(Hcy、CRP)水平、运动功能[Fugl-Meyer评定量表(FMA)]、平衡功能[Berg平衡量表(BBS)]和移动功能[功能性步态评价表(FGA)]变化情况,并记录两组不良事件发生率。结果:观察组总有效率更高(P<0.05);观察组治疗后中医证候积分降低程度比对照组更明显(P<0.05)。观察组治疗后FMA、FGA和BBS评分升高水平均比对照组更明显(P<0.05),观察组治疗后Hcy、CRP水平下降程度均比对照组更明显(P<0.05)。治疗期间两组均无不良事件发生。结论:阴虚动风型脑梗死偏瘫患者应用通督调神针法联合常规西医治疗具有较好的增益效果,可有效提高临床疗效,缓解患者临床症状,提高运动、平衡和移动能力,降低炎症反应。

解剖锁定钛板及桡侧阻挡钛板治疗桡骨远端C型骨折的疗效

目的探讨解剖锁定钛板及桡侧阻挡钛板治疗桡骨远端C型骨折的疗效。方法将40例桡骨远端C型骨折患者按照治疗方法不同分为观察组(采用解剖锁定钛板及桡侧阻挡钛板治疗,20例)和对照组(采用单纯桡骨远端解剖锁定钛板治疗,20例)。记录两组术中骨折复位情况、术中出血量、手术时间、骨折愈合情况、掌倾角、尺偏角及腕关节活动度。结果患者均获得随访,时间2.5~6个月。术中观察组骨折断端均固定良好,对位对线满意,无桡侧骨块移位;对照组9例骨折复位及固定满意,11例存在不同程度的桡侧骨块移位。术中出血量、手术时间两组比较差异均无统计学意义(P>0.05)。两组骨折均愈合,时间10~12周。末次随访时,两组掌倾角比较差异无统计学意义(P>0.05);尺偏角及腕关节掌屈、背伸活动度观察组均大于对照组(P<0.05)。结论解剖锁定钛板及桡侧阻挡钛板治疗桡骨远端C型骨折,术中骨折复位简单,同时能有效减少桡侧骨块移位,更利于患者腕关节功能恢复。

前外联合后内侧入路手术治疗伴冠状面半脱位的Wahlquist C型内侧胫骨平台骨折的效果分析

目的探究前外联合后内侧入路手术方案治疗伴冠状面半脱位的Wahlquist C型内侧胫骨平台骨折(mTPF)患者的疗效。方法前瞻性选取2020年8月至2022年8月江阴市人民医院收治的69例伴冠状面半脱位的Wahlquist C型mTPF患者,按照信封法将其分为对照组(n=34)和研究组(n=35)。对照组接受单一后侧倒“L”形入路手术方案,研究组接受前外联合后内侧入路手术方案。随访12个月,比较组间临床指标(手术时间、切口长度、术中失血量、术后引流量及住院时间);术前、术后1、3、6、12个月的疼痛[视觉模拟评分法(VAS)评分]情况;术前及术后1、3、6、12个月的膝关节功能[美国特种外科医院(HSS)评分];术后即刻、术后12个月的影像学资料(内翻角、后倾角、活动度);术后12个月的生活质量情况[世界卫生组织生存质量测定简表(WHOQOL-BREF)评分],并于末次随访时评估疗效,记录并发症情况。结果两组间手术时间、切口长度、术中失血量、术后引流量、住院时间比较,差异均无统计学意义(P>0.05)。研究组术后1、3、6个月的VAS评分分别为(3.45±0.56)、(3.01±0.34)、(2.56±0.38)分,均低于对照组[(3.88±0.61)、(3.37±0.33)、(2.98±0.42)分],差异均有统计学意义(P<0.05);术前及术后12个月,组间VAS评分比较,差异均无统计学意义(P>0.05)。术前及术后1、3、6、12个月,两组间HSS评分比较,差异均无统计学意义(P>0.05)。术后12个月,研究组内翻角、后倾角分别为(85.11±4.32)°、(5.03±0.35)°,均低于对照组[(88.98±3.16)°、(6.11±0.36)°],活动度为(113.26±13.66)°,高于对照组[(106.56±12.06)°],差异均有统计学意义(P<0.05)。术后12个月,两组间WHOQOL-BREF评分比较,差异均无统计学意义(P>0.05)。两组治疗优良率比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论采用前外联合后内侧入路手术方案治疗伴有冠状面半脱位的Wahlquist C型mTPF患者的疗效和安全性与单一后侧倒“L”形入路手术方案相当,但在术后影像学指标、疼痛程度方面有一定优势,临床应根据实际情况灵活选择。

达格列净对2型糖尿病病人肝脏脂肪含量及胱抑素C的影响

目的:比较使用达格列净+二甲双胍联合用药与单纯使用二甲双胍治疗对2型糖尿病病人肝脏脂肪含量(LFC)和胱抑素C(Cys C)水平的影响。方法:选取住院病人121例,按照治疗方案不同分为二甲双胍治疗组(甲组,n=51)和二甲双胍联合达格列净治疗组(乙组,n=70),所有病人均连续稳定使用上述治疗方案达半年以上,利用氢质子磁共振波谱法检测LFC,血清Cys C水平使用免疫比浊法进行检测,收集病人的一般人口学资料及实验室检测指标数据。分析不同实验室指标与LFC的关联,探讨不同治疗方式及其他实验指标对LFC和Cys C的影响。结果:2组病人的年龄、性别构成比、患病时长和体质量指数(BMI)的差异均无统计学意义(P>0.05);与甲组相比,乙组病人的LFC、血清Cys C水平、总胆固醇(TC)均明显降低(P<0.05~P<0.01),但三酰甘油(TG)和极低密度脂蛋白(VLDL)均升高(P<0.05);甲组的非酒精性脂肪肝(90.2%)比例高于乙组(30.0%)(P<0.01);相关分析结果发现,BMI、空腹血糖(FBG)和Cys C均与LFC存在关联(P<0.05~P<0.01)。以LFC为因变量,BMI、FBG、Cys C、病程、TC、TG和药物治疗作为自变量进行多元线性回归分析,发现与甲组相比,乙组可降低0.440个单位的LFC(P<0.01);同时以Cys C为因变量,BMI、FBG、LFC、病程、TC、TG和药物治疗作为自变量进行多元线性回归分析,与甲组相比,乙组联合用药能够降低0.689个单位的血清Cys C(P<0.01)。结论:二甲双胍联合达格列净能有效降低2型糖尿病病人LFC、血清Cys C水平,是LFC、血清Cys C的重要影响因素。