In addition to its role as a sex hormone, estrogen aff ects the struc ture and function of many other systems such as the bone, the cardiovascular and the nervous system. Here, we review the most recent supporting evidence for es trogen as an important player in ocular fundus diseases, focusing particularly o n the effects of estrogen on these diseases and the underlying mechanisms. Base d on this, we also discuss the clinical applicability of estrogen in treating va rious agerelated disorders including agerelated macular degeneration and ret in al neurodegeneration. Our growing understanding of estrogenmediated action at a molecular level will provide insight into the controversies surrounding hormon e replacement therapy.
目的:探讨脑损伤患者凝血功能水平与颅脑损伤伤情转归的相关性。方法:收集70例颅脑损伤患者的临床资料,伤者抽取静脉血2 mL,进行凝血功能检测,分析结果与临床资料等分别采用SPSS 11.5软件进行χ2检验和logistic回归分析。结果:在13例凝血功能异常患者中有5例(38%)伤情加重(较入院时脑内血肿体积增大,迟发性血肿等),明显高于凝血功能正常而伤情加重者(12%,Plt;0.05);单因素和多因素logistic回归分析提示凝血功能异常时脑损伤伤情加重的危险因素。结论:脑创伤后凝血功能异常时颅脑损伤患者伤情加重的危险因素。
Objective To investigate the expression of presenilin-2(PS2) and glutathione S transferase π(GSTπ) and their role in the prognosis and therapy of infiltrating ductal breast carcinoma. Methods The expression of PS2 and GSTπ in tumor tissues from 210 patients with infiltrating ductal breast carcinoma confirmed by pathologic examination and treated with modified radical mastectomy was examined by using LSAB immunohistochemical method. Results The expression rate of PS2 was 49.5%(104/210) and the expression rate of GSTπ was 48.1%(101/210). The grade of the postoperative 5-year survival rate and 10-year survival rate in four groups of 210 patients, from high to low, was the group 1 (PS2 positive expression/GSTπ negative expression), the group 2 (PS2 positive expression/GSTπ positive expression), the group 3 (PS2 negative expression/GSTπ negative expression) and the group 4 (PS2 negative expression/GSTπ positive expression). Conclusion The prognosis of the group 1 is the best, the group 2 better, the group 3 good and the group 4 the worst. The results suggest that reasonable use of endocrinotherapy and chemotherapy in infiltrating ductal breast carcinoma is necessary.
Polycystic ovary syndrome (PCOS) is a complex and heterogeneous common endocrine disease, and periodontitis is a chronic infectious immune inflammatory disease caused by dental plaque. In recent years, a large number of studies have shown that PCOS and periodontitis may be related, but the pathological mechanism is still unclear. Therefore, this article reviews the correlation between PCOS and periodontitis and the possible biological mechanisms of their mutual influence, in order to provide a theoretical basis for the prevention and treatment of periodontal disease in patients with PCOS.
Objective To compare the effectiveness of intramedullary nailing fixation via suprapatellar approach and medial parapatellar approach in semi-extended position in the treatment of multiple tibial fractures.Methods The clinical data of 43 patients with multiple tibial fractures treated with intramedullary nailing fixation between July 2018 and December 2022 were retrospectively analyzed, including 23 patients treated with suprapatellar approach in semi-extended position (group A) and 20 patients with medial parapatellar approach in semi-extended position (group B). There was no significant difference in gender, age, cause of injury, time from injury to operation, AO/Orthopaedic Trauma Association (AO/OTA) classification, preoperative visual analogue scale (VAS) score, and range of motion (ROM) of the knee joint between the two groups (P>0.05). The operation time, intraoperative blood loss, incision length, intraoperative fluoroscopy frequency, and fracture healing time were recorded and compared. The VAS score and ROM of the knee joint were analyzed at 4, 8, and 12 weeks after operation, and the incidence of postoperative complications was observed; knee function was evaluated by Lysholm score at last follow-up. ResultsThe operations were successfully completed in both groups, and there was no complication such as nerve and blood vessel injury during operation, and all incisions healed by first intention. There was no significant difference in operation time, intraoperative blood loss, and intraoperative fluoroscopy frequency between the two groups (P>0.05), but the incision length in group B was significantly longer than that in group A (P<0.05). Patients in both groups were followed up 12-30 months, with an average of 21.1 months. The VAS score decreased and ROM increased gradually in both groups with time after operation, showing significant differences between different time points (P<0.05). The VAS score of group B was significantly lower than that of group A at 4 and 8 weeks after operation (P<0.05); there was no significant difference in VAS score and ROM between the two groups at other time points (P>0.05). There was no significant difference in fracture healing time between the two groups (P>0.05). During the follow-up, there was no complication such as internal fixator loosening, breakage, and loss of fracture reduction. At last follow-up, the Lysholm score in group B was significantly better than that in group A (P<0.05). Conclusion Both the suprapatellar approach and the medial parapatellar approach in semi-extended position can achieve satisfactory results in the treatment of multiple tibial fractures. The medial parapatellar approach has lower symptoms of early knee pain and better long-term function.
Objective To investigate the expressions of ubiquitin-proteasome markers，including E2-14K，MAFbx，MuRF-1，and nuclear factor-κB（NF- κB） p50，in diaphragm of COPD rats，and their relationship with IL-17 level in diaphragm and serum in order to elucidate the potential mechanism of diaphragm atrophy. Methods Thirty healthy adult male SD rats were randomly divided into a model group （n=18） and a normal control group （n=12）. The COPD rat model was established by instillation of lipopolysaccharide （LPS） and exposure to cigarette smoke for 28 days. The protein levels of E2-14K，MAFbx，MuRF-1，and NF-κB p50 in diaphragm were measured by Western blot. The concentration of IL-17 in serum and diaphragm was measured by ELISA. Results Western blot showed that the protein expressions of E2-14K，MAFbx，MuRF-1，and NF-κB p50 in diaphragm increased significantly in the COPD model group compared with the normal control group （0.96±0.12 vs. 0.53±0.09，0.99±0.10 vs. 0.53±0.08，0.95±0.08 vs. 0.51±0.16，1.11±0.10 vs. 0.64±0.50，respectively，Plt;0.01）. The IL-17 level in serum and diaphragm was significantly higher in the COPD group than the control group. The expression of NF-κB p50 was positively correlated with E2-14K，MAFbx，and MuRF-1 expressions （r=0.82，0.92，0.86，respectively，Plt;0.01）. Both in serum and diaphragm，IL-17 level was positively correlated with the percentage of neutrophils，levels of NF-κB p50，E2-14K，MAFbx，and MuRF-1 expressions（all Plt;0.01）. The IL-17 levels in serum and diaphragm were also positively correlated each other （r=0.84，Plt;0.01）. Conclusions The results show that the ubiquitin-proteasom pathway，the NF-κB pathway and IL-17 are up-regulated in diaphragm of COPD rats .These alterations may contribute to diaphragm atrophy in COPD.
Objective To discuss the optimal time for operation in patients with malignant middle cerebral artery (MCA) syndrome. Method The relation between effectiveness and operating time was analyzed in 47 patients to compare the effects of early and delayed operation by SPSS10.0. Results Among 27 patients undergoing early operation, 18 were cured or restored, 4 seriously disabled and 5 died. While among 20 patients undergoing delayed operation, only 9 were cured or restored, 4 seriously disabled and 7 died. The prognosis of delayed operation group was worse than that of early operation group. Conclusions Selecting the optimal time to operate may decrease the mortality and morbidity of MCA syndrome.
The human spine injury and various lumbar spine diseases caused by vibration have attracted extensive attention at home and abroad. To explore the biomechanical characteristics of different approaches for lumbar interbody fusion surgery combined with an interspinous internal fixator, device for intervertebral assisted motion (DIAM), finite element models of anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) are created by simulating clinical operation based on a three-dimensional finite element model of normal human whole lumbar spine. The fusion level is at L4–L5, and the DIAM is implanted between spinous process of L4 and L5. Transient dynamic analysis is conducted on the ALIF, TLIF and LLIF models, respectively, to compute and compare their stress responses to an axial cyclic load. The results show that compared with those in ALIF and TILF models, contact forces between endplate and cage are higher in LLIF model, where the von-Mises stress in endplate and DIAM is lower. This implies that the LLIF have a better biomechanical performance under vibration. After bony fusion between vertebrae, the endplate and DIAM stresses for all the three surgical models are decreased. It is expected that this study can provide references for selection of surgical approaches in the fusion surgery and vibration protection for the postsurgical lumbar spine.
Objective To explore the influencing factors of intraocular lens (IOL) position after cataract surgery and analyze the effect of ocular biological parameters on IOL centering under different axial length (AL). Methods Patients who underwent cataract phacoemulsification and IOL implantation at West China Hospital of Sichuan University between February and July 2024 were prospectively selected. According to the different AL values, the patients were divided into non-high myopia group (22.0 mm≤AL＜26.0 mm) and high myopia group (AL≥26.0 mm) to explore the influencing factors of IOL position after cataract surgery. Results This study included a total of 240 patients (240 eyes), with 120 cases (120 eyes) in both the non-high myopia group and the high myopia group. The preoperative lens tilt and decentration of the non-high myopia group and high myopia group were (4.41±1.07)°, (0.13±0.09) mm and (3.57±1.81)°, (0.20±0.10) mm, respectively. The results of multiple linear regression analysis showed that in the non-high myopia group, preoperative lens tilt (P<0.001) was the influencing factor of postoperative IOL tilt, while lens thickness (P=0.027) and preoperative lens decentration (P<0.001) were the influencing factors of postoperative IOL decentration. In the high myopia group, lens thickness (P=0.023) and preoperative lens tilt (P<0.001) were the influencing factors of postoperative IOL tilt, while anterior chamber depth (P=0.030), lens thickness (P=0.013), and preoperative lens decentration (P<0.001) were the influencing factors of postoperative IOL decentration. Conclusion Ophthalmologists can accurately predict the postoperative IOL position based on the patient’s degree of myopia (with a focus on identifying high myopia) and specific ocular biological parameters before surgery, thereby optimizing surgical plans and improving postoperative outcomes.
Objective To study the clinical anatomical basis of the liver hanging maneuver through research of applied anatomy. Methods Retrohepatic portions of the inferior vena cava of 21 cadaver were observed intracavitarily, and the numbers of short hepatic vein (SHV) opening were counted based on different possible pathway of the liver hanging maneuver and different width of retrohepatic tunnel (10 mm, 6 mm). Results The number of SHV was 0 to 3 (median=1) using standard pathway of the liver hanging maneuver in 6 mm retrohepatic tunnel, and the number of SHV was 0 to 2 (median=0) using EM pathway that was on the right border of retrohepatic portion of the inferior vena cava and 1 cm away from the inferior border of liver. There was a significant difference between the EM pathway and standard pathway, P=0.003.Conclusion The results show that setting up a retrohepatic tunnel through the liver hanging maneuver is feasible and safe.