目的:探讨后路椎弓根螺钉固定在地震伤胸腰椎骨折中的应用及优点。方法:对19例胸腰椎骨折的地震伤患者行后路椎弓根螺钉内固定术。结果:本组病例的手术时间70～115分钟,平均出血量约280mL,两例病员术中出血超过400mL进行输血,复位椎体前缘高度由术前平均57.5%恢复到术后平均93.6%,后突角由术前平均21°矫正到术后平均3°,术后3～7天转往外地继续治疗,Frankel分级平均提高0.4。结论:后路椎弓根螺钉固定具有省时、节约医疗资源、提高救治效率、减轻患者痛苦的优点,尤其适用于大批伤病员的紧急救治。
Objective To investigate the expression of miR-92a in breast cancer tissues and whether it can influence the migration and invasion ability of breast cancer cells through kruppel-like factor 4 (KLF4). Methods ① The expressions of miR-92a and KLF4 mRNA in cancer tissues and adjacent tissues were detected by qRT-PCR in 122 breast cancer patients who were operated in our hospital from May 2017 to October 2019. ② The expression of miR-92a in MCF-7 breast cancer cells was up-regulated or knocked out. Cell survival rate was detected by MTT assay, cell migration ability was detected by scratch assay, cell invasion ability was detected by Transwell assay, and the relative expression levels of KLF4, E-cadherin (E-cad), and N-cadherin (N-cad) proteins were detected by Western blotting. ③ The targeting relationship between miR-92a and KLF4 was detected by dual luciferase reporter gene assay. Results ① The relative expression levels of miR-92a and KLF4 mRNA in cancer tissues were higher than those in adjacent tissues (P<0.05). ② The up-regulation of miR-92a expression had no effect on the survival rate of MCF-7 breast cancer cells, but the migration and invasion ability of cells were enhanced (P<0.05). The knockdown of miR-92a expression decreased the survival rate of MCF-7 breast cancer cells and the ability of cell migration and invasion (P<0.05). ③ The miR-92a and KLF4 had a direct targeting relationship, up-regulation of miR-92a expression increased the relative expression levels of KLF4 and N-cad proteins, while decreased the relative expression level of E-cad protein (P<0.05). After knockout of miR-92a expression, the relative expression levels of KLF4 and N-cad proteins were decreased, while the relative expression level of E-cad protein was increased (P<0.05). Conclusion The miR-92a is highly expressed in breast cancer cells, and knockout of miR-92a expression can inhibit KLF4 signaling pathway and reduce the migration and invasion ability of breast cancer cells.
目的 探讨经伤椎椎弓根螺钉内固定治疗胸腰椎骨折的临床疗效。 方法 2008年5月－2010年12月，选择38例胸腰椎骨折患者，采用椎弓根螺钉固定伤椎及相邻上下椎体。其中男28例，女10例；年龄21～65岁，平均36.5岁。骨折部位：胸8 1例，胸9 2例，胸10 4例，胸11 8例，胸12 7例，腰1 10例，腰2 4例，腰3 2例。受伤至手术时间3～7 d，平均4.5 d。对患者手术前后椎体高度、矢状面后凸Cobb角、神经功能Frankel分级变化等指标进行测量并随访。 结果 术后患者切口均Ⅰ期愈合。38例获随访12～18个月，平均15个月。骨折均获得骨性融合，无钉棒断裂、无死亡或神经损伤加重患者。术后神经功能Frankel分级较术前有明显改善（P＜0.05）。术后X线片复查示伤椎高度恢复达90%以上，外形正常；CT复查示椎管内有效矢状径恢复满意，椎管前方无明显骨性压迫，伤椎椎体骨愈合良好。术后1、12个月时伤椎前、后缘高度及后凸Cobb角均较术前显著改善（P＜0.05）；术后12个月随访椎体高度无丢失。 结论 经伤椎椎弓根钉复位、减压、内固定治疗胸腰椎骨折具有创伤小、固定节段少、脊柱稳定性好、能有效矫正及预防脊柱后凸畸形等优点。
ObjectiveTo systematically investigate the registration status, methodology and reporting quality of the systematic review protocols for animal experiment registered on PROSPERO platform.MethodsSystematic review protocols of animal experiments registered on PROSPERO platform were searched up to December 31st, 2019. Two reviewers independently screened literature, extracted data, and performed a descriptive analysis of the methodological quality and reporting characteristics of the included studies.ResultsA total of 351 protocols from 50 countries were included, involving 22 diseases. The intervention measures were primarily "pharmaceutical chemicals". Only approximately 1/3 of the studies reported the search strategy from at least one database, approximately half of the studies were prepared to report heterogeneity analysis and publication bias, and only approximately 1/3 of the studies were prepared to report sensitivity analysis.ConclusionsThe quantity of systematic reviews of animal experiments registered on the PROSPERO platform is increasing annually, however, there are still some limitations in the methodology and reporting quality.
ObjectiveTo systematically review the relationship between frailty and risk of orthostatic hypotension.MethodsPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect studies on the association between frailty and orthostatic hypotension from inception to July 7th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsFive cross-sectional studies involving 8 671 patients were included. The results of meta-analysis showed that prefrailty (OR=1.04, 95%CI 0.99 to 1.09, P=0.11) and frailty (OR=1.02, 95%CI=0.92 to 1.13, P=0.70) were not associated with orthostatic hypotension. The results of subgroup analysis showed that differences of sample size (<500 or ≥500), using different frailty assessment tools (Fried scale, clinical frailty scale, and frailty index), different regions (Europe, Asia, and America) and different sources of studied subjects (hospitals and communities), the risk of orthostatic hypotension were not increased with frailty.ConclusionsCurrent evidence shows that frailty does not increase the risk of orthostatic hypotension. Due to limited quality and quantity of included studies, the above conclusions are needed to be validated by more high-quality studies.
ObjectiveTo systematically review the dose-response relationship between body mass index (BMI) and all-cause mortality in the elderly with frailty.MethodsPubMed, EMbase, Web of Science, CNKI, VIP, WanFang Data, and CBM databases were electronically searched to collect cohort studies on the association of BMI and mortality in frail adults from inception to November 2019. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies; Stata 15.0 software was then used to analyze the dose-response analysis of BMI and mortality by restricted cubic spline function and generalized least squares method.ResultsA total of 4 cohort studies involving 12 861 frail adults were included. Meta-analysis results showed that compared with normal BMI, the frail elderly who were overweight (HR=0.80, 95%CI 0.74 to 0.88, P<0.001) and obese (HR=0.89, 95%CI 0.79 to 1.00, P=0.047) had lower all-cause mortality. The results of dose-response meta-analysis showed that there was a non-linear relationship between BMI and all-cause mortality in the elderly with frailty (P value for nonlinearity was 0.035), for which the elderly with frailty had a BMI nadir of 27.5-31.9 kg/m2. For linear trends, and when BMI was less than 27.5 kg/m2, the risk of all-cause death was reduced by 4% for every 1 kg/m2 increase in BMI (RR=0.96, 95%CI 0.90 to 1.03, P=0.320), when BMI was greater than 27.5 kg/m2, the risk of all-cause death increased by 4% for every 1 kg/m2 increase in BMI (RR=1.04, 95%CI 1.03 to 1.05, P<0.001).ConclusionsThere is a paradox of obesity and a significant nonlinear relationship between BMI and all-cause mortality in the frailty elderly, with the lowest all-cause mortality in the frailty elderly at BMI 27.5-31.9 kg/m2. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.
Based on the PRISMA 2009 checklist, the study analyzed current status and reporting quality of systematic reviews of animal experiments, and consulted experts in relevant fields to form an initial entry pool of reporting checklists for systematic reviews of animal experiments in traditional Chinese medicine (PRISMA-ATCM). Then, the initial entry pool was improved through 2 rounds of Delphi expert consultation. Finally, the items were revised through the consensus meeting, and the final PRISMA-ATCM was formed. Of the 27 items on the PRISMA checklist, 12 were revised and expanded, specifically relating to TCM interventions and animal characteristics. The publication of the PRISMA-ATCM will improve the transparency and standardization of systematic reviews of animal experiments in Chinese medicine.