目的 回顾性研究老年系统性红斑狼疮（SLE）患者合并感染的危险因素。 方法 选取1995年1月－2009年12月间在四川大学华西医院确诊为SLE，起病年龄为50周岁以上的158例患者，收集性别、临床表现、疾病活动度、实验室检查指标、合并症以及并发症等进行单因素分析或多因素非条件logistic回归分析。 结果 所纳入的158例患者中，合并感染53例（占33.5%），采用单因素分析显示疾病活动性（P=0.001）、低蛋白血症（P=0.030）、糖尿病（P=0.003）、肺间质病变（P=0.000）与老年SLE患者感染发生有关。经logistic回归分析显示，疾病活动性（OR=7.533，P=0.000）、肺间质病变（OR=19.762，P=0.000）、糖尿病（OR=6.862，P=0.025）是老年SLE患者感染发生的危险因素。 结论 积极控制老年SLE的疾病活动度，减少危险因素的发生是控制老年SLE患者并发感染的有效手段。
Acute kidney injury (AKI) is characterized by a sudden and rapid decline of renal function and associated with high morbidity and mortality. AKI can be caused by various factors, and ischemia-reperfusion injury (IRI) is one of the most common causes of AKI. An increasing number of studies found out that exosomes of mesenchymal stem cells (MSCs) could alleviate IRI-AKI by the adjustment of the immune response, the suppression of oxidative stress, the reduction of cell apoptosis, and the promotion of tissue regeneration. This article summarizes the effect and mechanism of MSC-derived exosomes in the treatment of renal ischemia-reperfusion injury, in order to provide useful information for the researches on this field.
Objective To study the effectiveness of transpedicular intervertebral bone graft and pedicle screws fixation in injured vertebrae for the treatment of thoracolumbar fractures. Methods Between February 2007 and January 2009, 25 patients with thoracolumbar fractures were treated by posterior short-segment fixation combined with transpedicular intervertabral bone graft and pedicle screw fixation in injured vertebrae. There were 18 males and 7 females with a mean ageof 46 years (range, 28-63 years). The injured vertebrae were located at T10 in 1 case, T11 in 2 cases, T12 in 8 cases, L1 in 6 cases, L2 in 6 cases, L3 in 1 case, and L4 in 1 case. According to Denis classification, there were 14 cases of burst fractures and 11 cases of compression fractures. Based on Frankel classifications, 2 cases were rated as grade A, 4 cases as grade B, 8 cases as grade C, 7 cases as grade D, and 4 cases as grade E. The time between injury and operation was 6 hours to 7 days (mean, 4.6 days). The X-ray film was taken to measure the relative height of fractured vertebrae and Cobb angle, and Frankel classification was conducted to evaluate the function recovery of the spinal cord. Results The operations were performed successfully, and incisions healed primarily. All the patients were followed up 12-25 months (mean, 16 months). CT and X-ray films showed good bone graft heal ing and no loosening or breakage of screws and rods. The relative height of fractured vertebrae were 56.8% ± 15.6% at preoperation, 91.2% ± 10.7% immediately after operation, and 89.6% ± 10.3% at 1 year after operation, showing significant differences between preoperation and postoperation (P lt; 0.01), while no significant difference between immediately after operation and 1 year after operation. The Cobb angles were (18.2 ± 2.6), (7.5 ± 1.4), and (8.7 ± 1.1)°, respectively, showing significant differences between preoperation and postoperation (P lt; 0.01), while no significant difference between immediately and 1 year after operation. At 1 year after operation, the neural function in 16 cases was improved 1-3 grades. ConclusionTreatment of thoracolumbar fractures with transpedicular intervertebral bone graft and pedicle screw fixation in injuredvertebrae has satisfactory effectiveness, which can reconstruct vertebral body height, increase the stabil ity of anterior and middle