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前臂逆行岛状皮瓣修复虎口及拇指深度烧伤

Quality Assessment of Randomized Controlled Trials on Treatment of Sjogren’s Syndrome with Traditional Chinese Medicine

Objective　To investigate the current situation of randomized controlled trials (RCTs) on the treatment of Sjogren’s syndrome with Traditional Chinese Medicine (TCM), and to assess whether there is adequate evidence for clinical practice. Methods　Such databases as CNKI, VIP, CBM and PubMed were searched from their establishment date to June 2010 to collect the RCTs on the treatment of Sjogren’s syndrome with TCM according to the predefined inclusion criteria. And the quality was assessed by using the Jadad scale, the revised CONSORT statement and other self-defined indexes.Results　Among 19 included RCTs, 1 literature scored four points, 4 scored two points, 13 scored one point, and 1 scored zero point according to Jadad scale; no RCT performed the allocation concealment. According to the CONSORT criteria, 19 RCTs accounting for 100% reported the diagnostic criteria, implement of interventions and result, 11 RCTs applied the 2002 international diagnosis and classification criteria of Sjogren’s syndrome, 17 RCTs carried out positive control including one based on the standard treatment, and two RCTs applied only blank control without placebo control. All RCTs took the comprehensive efficacy assessment as the outcome index, but only 6 RCTs (31.6%) assessed both clinical efficacy and TCM syndrome efficacy. Among 6 RCTs (31.6%) describing the random sequence, no RCT reported the detailed methods. Except 1 RCT (5.3%) carried out the double blinding, all the others were non-blind trials. And only 1 RCT adopted analog. Conclusion　Currently, the methodology and reporting quality of studies on the treatment of Sjogren’s syndrome with TCM are not good enough to provide reliable evidence for clinical practice.

胰腺癌组织中 Beclin-1 mRNA 和 miR-216a 的表达及 VEGF 蛋白表达与 p-MAPK-ERK1/2信号通路的关系

目的 探讨腺癌、鳞癌、黏液性囊腺瘤、慢性胰腺炎和正常胰腺组织中胰腺癌相关基因的表达。 方法 回顾性收集 2012 年 1 月至 2017 年 4 月期间于湖北医药学院附属东风医院肝胆胰外科住院行手术治疗的 40 例胰腺疾病患者的术中标本，其中腺癌、鳞癌、黏液性囊腺瘤、慢性胰腺炎和正常胰腺组织各 8 例。采用实时荧光定量 PCR 和基因芯片法检测 5 组组织中 Beclin-1 mRNA 和 microRNA（miR）-216a 的表达。对以上组织行原代细胞培养，分为空白对照组和 PD98095 组（加入 PD98095 抑制剂），采用 Western blot 法检测细胞中血管内皮生长因子（VEGR）与磷酸化细胞外调节蛋白激酶 1/2（p-ERK1/2）的表达。 结果 与正常对照组比较，腺癌组和鳞癌组组织中 Beclin-1 mRNA 和 miR-216a 的表达水平较低（P<0.05），腺癌组、鳞癌组、黏液性囊腺瘤组和慢性胰腺炎组组织中 Beclin-1 mRNA 和 miR-216a 的表达水平比较差异无统计学意义（P>0.05）。与同类组织的空白对照组比较，腺癌组和鳞癌组加入 PD98095 后，细胞中 p-ERK1/2 和 VEGF 蛋白的表达水平下调（P<0.05），但黏液性囊腺瘤组、慢性胰腺炎组和正常对照组加入 PD98095 前后细胞中 p-ERK1/2 及 VEGF 蛋白的表达水平变化不大（P>0.05）。 结论 Beclin-1 mRNA、miR-216a 和 VEGF 蛋白的表达与胰腺癌的发生发展可能有关。

Clinical complications of high-intensity focused ultrasound for uterine fibroids: a meta-analysis of single rate

Objective To analysis the safety of high-intensity focused ultrasound (HIFU) in the treatment of uterine fibroids and provide references for clinical practice and prevention of complications of gynecological diseases. Methods Databases including PubMed, The Cochrane Library (Issue 2, 2016), EMbase, CBM, CNKI, and VIP were searched to collect studies concerning the complications of HIFU for uterine fibroids from March 1st 2005 to February 15th 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using R software. Results A total of twenty studies involving 2 405 patients were included. The results of meta-analysis showed that complications rate of gynecological system induced by HIFU was 6.63% (95%CI 3.58% to 12.28%); among them, the incidence of vaginal bleeding was 5.82% (95%CI 3.22% to 10.53%), and the incidence of abdominal pain was 10.02% (95%CI 4.77% to 21.05%). Conclusion The current evidence shows that there is a certain amount of complications of HIFU for uterine fibroids. Due to the limited quantity and quality of included studies, the above results are needed to be validated by more studies.

Significance of the expression of VEGF in postoperative portal venous thrombosis in patients with portal hypertension

ObjectiveTo investigate the significance of the expression of vascular endothelial growth factor (VEGF) in portal vein thrombosis after operation in patients with portal hypertension.MethodsThe serum of 146 patients with portal hypertension treated in Dongfeng Hospital Affiliated to Hubei Medicial College from January 2014 to December 2018 and the surgically removed splenic vein and spleen specimens were collected. The serum VEGF level was determined by enzyme-linked immunosorbent assay, and the expressions of VEGF in splenic vein and spleen tissues were detected by immunohistochemistry. According to whether portal vein thrombosis was formed after operation, the patients were divided into thrombosis group and non-thrombosis group, and the differences between the groups were compared.ResultsThe serum VEGF level in the thrombosis group was significantly higher than that in the non-thrombosis group (P<0.05). In splenic vein wall and spleen tissues, VEGF staining indexes in the thrombosis group were significantly higher than those in the non-thrombosis group (P<0.05).ConclusionsPostoperative portal vein thrombosis in patients with portal hypertension may be related to the serum VEGF level. The high expressions of VEGF in splenic vein wall and spleen suggest that VEGF may participate in the formation process of portal vein thrombosis.