老年股骨转子间骨折治疗过程中氨甲环酸的应用

背景:研究显示,氨甲环酸可减少全髋及全膝关节置换患者失血量,降低输血率,且不影响凝血功能,不会使下肢深静脉血栓发生的风险增加。然而氨甲环酸应用于老年股骨转子间骨折手术中的研究较少,目前尚缺乏可靠的临床数据支持。目的:探讨氨甲环酸应用于老年人股骨转子间骨折行新型股骨近端髓内钉手术中的有效性及安全性。方法:纳入重庆市第九人民医院2021年1月至2022年4月期间收治的符合纳入标准的股骨转子间骨折患者共50例,将研究对象按照随机数表法分为2组,实验组将氨甲环酸1 g加入100 m L生理盐水,于术前15 min静脉滴注;对照组于术前15 min静脉滴注100 m L生理盐水。记录两组手术时间、术中失血量、术后引流量、输血情况;检测术前及术后第3天血红蛋白、红细胞压积、纤维蛋白水平;检测术后第3天及1,3,6周血栓情况。结果与结论:(1)两组患者手术时间、术前的血红蛋白、红细胞压积、术前及术后纤维蛋白等指标比较差异无显著性意义(P> 0.05),对照组术后的血红蛋白、红细胞压积明显低于实验组(P <0.05);(2)实验组术中失血量、术后引流量、隐性失血量、总失血量均少于对照组(P <0.05);(3)两组患者在血栓事件上比较差异无显著性意义(P> 0.05),而在输血事件上实验组明显低于对照组(P <0.05);(4)结果表明,在老年股骨转子间骨折行新型股骨近端髓内钉内固定的患者中应用氨甲环酸能够减少术中失血量、术后引流量及隐性失血量,降低围术期总失血量,减少输血率,增加术后血红蛋白及红细胞压积,而不会增加血栓栓塞事件形成的风险及对纤维蛋白的影响。

早期预见性护理干预在股骨TFNA手术中的应用观察

目的探讨早期预见性护理干预在股骨近端钉系统(TFNA)手术中的应用效果。方法选取股骨粗隆骨骨折行TFNA手术患者72例,随机分为观察组与对照组,各36例。对照组实施常规护理,观察组患者在常规护理基础上增加早期预见性护理干预,比较两组护理结果。结果观察组患者住院时间与并发症发生率明显低于对照组,满意度明显高于对照组(P<0.05);两组患者护理前SAS和SDS评分对比无明显差异(P>0.05),护理后两组患者SAS和SDS评分均降低,且观察组低于对照组(P<0.05);两组护理后Harris评分均升高,且观察组高于对照组(P<0.05);两组护理后VAS评分均降低,且观察组低于对照组(P<0.05)。结论对股骨TFNA手术患者在术中应用早期预见性护理,能够降低患者术后并发症发生率,减少住院时间,减轻患者焦虑、抑郁等不良情绪,减轻患者术后疼痛程度,提升髋关节功能,提高患者护理满意度。

早期预见性护理干预在股骨近端钉系统手术中的应用效果分析

目的:探讨早期预见性护理干预在股骨近端钉系统(TFNA)手术中的应用效果。方法:选取广东省清远市中医院2020年1月—2021年1月收治的72例股骨粗隆骨折行TFNA手术患者,根据护理方式不同将其分为观察组(n=36)与对照组(n=36)。对照组实施常规护理,观察组在常规护理基础上实施早期预见性护理干预。对比两组患者的住院时间、护理满意度、并发症发生率以及护理前后焦虑自评量表(SAS)和抑郁自评量表(SDS)评分情况。结果:观察组患者住院时间与并发症发生率低于对照组,满意度高于对照组,差异有统计学意义(P<0.05);护理后,两组患者SAS和SDS评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组患者护理前Harris评分与VAS评分对比,差异无统计学意义(P>0.05),两组患者护理后Harris评分均升高,且观察组高于对照组,差异有统计学意义(P<0.05);两组护理后V A S评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:对股骨TFNA手术患者在术中应用早期预见性护理,能够降低患者术后并发症发生率,减少住院时间,减轻患者焦虑、抑郁等不良情绪,减轻患者术后疼痛程度,提升髋关节功能,提高患者护理满意度,值得临床应用。

Tetrahedral framework nucleic acids enhance the chondrogenic potential of human umbilical cord mesenchymal stem cells via the PI3K/AKT axis

The field of regenerative medicine faces a notable challenge in terms of the regeneration of articular cartilage.Without proper treatment,it can lead to osteoarthritis.Based on the research findings,human umbilical cord mesenchymal stem cells(hUMSCs)are considered an excellent choice for regenerating cartilage.However,there is still a lack of suitable biomaterials to control their ability to self-renew and differentiate.To address this issue,in this study using tetrahedral framework nucleic acids(tFNAs)as a new method in an in vitro culture setting to manage the behaviour of hUMSCs was proposed.Then,the influence of tFNAs on hUMSC proliferation,migration and chondrogenic differentiation was explored by combining bioinformatics methods.In addition,a variety of molecular biology techniques have been used to investigate deep molecular mechanisms.Relevant results demonstrated that tFNAs can affect the transcriptome and multiple signalling pathways of hUMSCs,among which the PI3K/Akt pathway is significantly activated.Furthermore,tFNAs can regulate the expression levels of multiple proteins(GSK3β,RhoA and mTOR)downstream of the PI3K-Akt axis to further enhance cell proliferation,migration and hUMSC chondrogenic differentiation.tFNAs provide new insight into enhancing the chondrogenic potential of hUMSCs,which exhibits promising potential for future utilization within the domains of AC regeneration and clinical treatment.

A tetrahedral framework nucleic acid based multifunctional nanocapsule for tumor prophylactic mRNA vaccination

Synthetic antigen-encoding mRNA plays an increasingly significant role in tumor vaccine technology owing to its antigen-specific immune-activation. However, its immune efficacy is challenged by inferior delivery efficiency and demand for suitable adjuvants. Here, we develop a novel mRNA nanovaccine based on a multifunctional nanocapsule, which is a dual-adjuvant formulation composed of cytosine-phosphateguanine motifs loaded tetrahedral framework nucleic acid(CpG-tFNA) and an immunopeptide murine β-defensin 2(mDF2β). This m RNA nanovaccine successfully achieves intracellular delivery, antigen expression and presentation of dendritic cells, and proliferation of antigen-specific T cells. In a tumor prophylactic vaccination model, it exerts an excellent inhibitory effect on lymphoma occurrence through cellular immunity. This mRNA nanovaccine has promising prophylactic applications in tumors and many other diseases.

The protective effect of tetrahedral framework nucleic acids on periodontium under inflammatory conditions

Periodontitis is a common disease that causes periodontium defects and tooth loss.Controlling inflammation and tissue regeneration are two key strategies in the treatment of periodontitis.Tetrahedral framework nucleic acids can modulate multiple biological behaviors,and thus,their biological applications have been widely explored.In this study,we investigated the effect of tFNAs on periodontium under inflammatory conditions.Lipopolysaccharide and silk ligature were used to induce inflammation in vivo and in vitro.The results displayed that tFNAs decreased the release of pro-inflammatory cytokines and levels of cellular reactive oxygen species in periodontal ligament stem cells,which promoted osteogenic differentiation.Furthermore,animal experiments showed that tFNAs ameliorated the inflammation of the periodontium and protect periodontal tissue,especially reducing alveolar bone absorption by decreasing inflammatory infiltration and inhibiting osteoclast formation.These findings suggest that tFNAs can significantly improve the therapeutic effect of periodontitis and have the great potential significance in the field of periodontal tissue regeneration.

附睾睾丸活动与不动精子卵胞浆内注射治疗阻塞性无精子症效果分析

目的:对附睾、睾丸活动精子与不动精子ICSI的助孕效果进行比较分析。方法:收集2004年1月～2008年7月在福建省妇幼保健院辅助生殖技术研究室接受ICSI治疗的114例阻塞性无精症患者为研究对象,长方案进行超促排卵,ICSI常规操作,比较分析附睾、睾丸活动精子组与不动精子组ICSI后的妊娠结局。结果:114例阻塞性无精症患者120个周期ICSI助孕。获卵1415枚,平均获卵(11.79±6.15)枚,其中可注射的MⅡ成熟卵1187枚(83.88%),受精率75.82%,卵裂率88.22%;ET114周期,平均移植胚胎数2.01±0.34,种植率20.00%,周期临床妊娠率32.46%。6例双胎,双胎率16.22%,目前已出生32名健康婴儿,其中男婴14名,女婴18名,男女比例为0.78,尚有4例5胎继续妊娠中。睾丸活动精子组的受精率差异有统计学意义(P<0.01);卵裂率、种植率及妊娠率等指标两组间比较差异均无统计学意义(P>0.05)。结论:ICSI是治疗阻塞性无精症性不育的有效措施,取睾丸、附睾活动或HOST阳性精子卵胞浆内显微注射助孕效果一致。