中老年肩痛患者疼痛及肩关节功能恢复的影响因素分析

摘要 目的：探究分析中老年肩痛患者疼痛及肩关节功能恢复的影响因素分析。方法：采用便利抽样法,随机抽取2020年9月至2022年9月期间于我院门诊就诊的2010名中老年患者作为调查对象,对患者进行筛查、复查、确诊、随访等。并对所搜集信息进行疼痛及肩关节功能恢复单因素与多因素Logistic回归分析。结果：单因素分析显示,年龄（x²=15.274, P＜0.001）、性别（x²=10.401, P=0.001）、病程（x²=16.410, P＜0.001）和是否进行功能锻炼（x²=6.293, P=0.012）为影响中老年肩痛患者肩关节功能恢复的主要因素;年龄≥70岁（OR=1.292, 95%CI 0.953-1.750）、女性（OR=1.672, 95%CI 1.348-2.074）、病程＞1个月（OR=1.470, 95%CI 1.021-2.116）和未进行功能锻炼（OR=1.844, 95%CI 1.175-2.894）为影响中老年肩痛患者肩关节功能恢复的独立危险因素。结论：年龄≥70岁、女性、病程＞1个月和未进行功能锻炼为影响中老年肩痛患者肩关节功能恢复的独立危险因素,根据上述因素尽早快速甄别高风险患者,及早给予合理有效的康复治疗措施,可显著改善肩痛患者肩关节功能的预后。     

右美托咪定联合经皮穴位电刺激对混合痔剥扎术后患者肠胃功能及术后疼痛的影响

摘要 目的：探讨右美托咪定联合经皮穴位电刺激对混合痔剥扎术后患者肠胃功能及术后疼痛的影响。方法：选择2022年3月-2022年7月我院行混合痔剥扎术的患者60例,将60例患者随机分为对照组（30例）与观察组（30例）,对照组患者给予右美托咪定镇痛,观察组给予术前经皮穴位电刺激,时间为手术开始前2 min至手术结束,右美托咪定使用方法、剂量同对照组。对比两组患者术前、术后0.5 h、1 h、2 h、3 h的疼痛评分,对比两组患者的术后疼痛疗效,对比两组创面愈合时间、腐肉完全脱落时间、住院时间及胃肠功能恢复情况,对比两组术前、术后的血管活性肠肽、胃动素及胃泌素水平。结果：术前及术后3 h时,两组的疼痛评分对比无统计学意义（P>0.05）;术后0.5 h、1 h、2 h时,观察组的疼痛评分明显较对照组低（P<0.05）。观察组的术后疼痛有效率明显较对照组高,P<0.05。观察组的创面愈合时间、腐肉完全脱落时间及住院时间明显较对照组低（P<0.05）。观察组的肠鸣音恢复时间、术后恶心呕吐发生率及排气时间明显较对照组短（P<0.05）。术前,两组的血管活性肠肽、胃动素及胃泌素水平对比无统计学意义（P>0.05）;术后,两组血管活性肠肽、胃泌素水平升高,胃动素水平降低,且观察组变化幅度明显较对照组低（P<0.05）。结论：右美托咪定联合经皮穴位电刺激可改善混合痔剥扎术后患者肠胃功能及术后疼痛情况。     

不同容量胸段经椎间孔硬膜外注射阻滞范围的CT影像研究及诊断性阻滞的可行性分析

摘要 目的：探讨不同容量对胸段经椎间孔硬膜外注射（TFEI）药液扩散范围和镇痛效果的影响以及胸段TFEI用于诊断性阻滞的可行性。方法：选择2021年1月至2022年12月南京大学医学院附属鼓楼医院收治的胸段带状疱疹相关疼痛患者140例,随机分为4组,实施单次TFEI并分别注入不同容量含造影剂局麻药（A组：0.2 mL;B组：0.5 mL;C组：1.0 mL;D组：2 mL）,CT扫描并观察造影剂在硬膜外向头侧、尾侧及总扩散节段,造影剂在椎间孔、同侧椎旁间隙、同侧及对侧硬膜外间隙扩散情况,判断是否为选择性神经根阻滞。评估注射前、注射后30分钟及24小时视觉模拟评分（VAS）。结果：头侧和尾侧扩散节段以及总扩散节段数,D组最多,A组最少（P<0.05）;C组、D组造影剂扩散≥3个节段发生率明显高于B组（P<0.05）;C组、D组病例造影剂扩散至同侧椎旁间隙和对侧硬膜外间隙的发生率明显高于A组、B组（P<0.05）,仅A组37.1%的病例实现选择性神经根阻滞,其余各组均无选择性阻滞病例。注射后30分钟,C、D组VAS评分显著低于A、B组（P<0.05）;注射后24小时,D组VAS评分显著低于A、B组（P<0.05）。结论：胸段带状疱疹相关疼痛患者TFEI药液扩散范围随注射容量的增加而扩大,且在硬膜外倾向于头侧扩散,2 mL容量单次TFEI可阻滞3个以上的神经节段,获得良好的镇痛效果。胸段TFEI行诊断性阻滞的可行性较差。     

Human papillomavirus is associated with monoclonal gammopathies of unknown significance

When monoclonal gammopathies arise in persons without evidence of plasma cell malignancy or lymphoproliferative disease, the term monoclonal gammopathy of unknown significance (MGUS) can be used. MGUS is believed to be the preneoplastic phase of lymphoproliferative diseases because many of these patients eventually develop malignant disease, mainly multiple myeloma. We have previously identified human papillomavirus (HPV) in a chronic benign plasma cell tumor of the cervix and in the bone marrow of multiple-myeloma patients. In the following study, we expanded upon our initial observation by analyzing 14 patients with MGUS. Bone marrow biopsies of the patients were analyzed for HPV sequences using polymerase chain reaction (PCR) and in situ hybridization. Normal controls included 26 bone marrow specimens, 24 analyzed by PCR and two by in situ hybridization. A significant association was found to exist between HPV and MGUS (p=0.001). Among 14 patients iwth MGUS, HPV sequences have been identified in 10 of the bone marrow biopsies. These results suggest that HPV can reside in the bone marrow of a premalignant lymphoproliferative disease.     

Uptake of high-density lipoprotein by Y-organs of the crab,cancer antennarius. II. formal characterization of receptor-mediation with isolated membranes

Y-organs are the ecdysial glands of crustaceans, responsible for synthesis and secretion of ecdysteroid hormones. For this purpose, the glands acquire cholesterol as obligate precursor entirely from circulating high-density lipoprotein (HDL). A preceding study provided evidence for the mechanism of acquisition: Y-organs take up cholesterol bound to HDL by an energy-requiring process, receptor-mediated absorptive endocytosis. The present study characterized the receptors involved utilizing isolated Y-organ membranes. HDL binding was saturable and specific; a dissociation constant (K_d) of 1.08 × 10^?7 M and a binding maximum at equilibrium (B_max) of 70 μg HDL protein/mg membrane protein, were obtained. Binding was decreased by protease and was dependent upon calcium. Y-organs are regulated negatively by a peptide hormone from the eystalks, molt-inhibiting hormone (MIH). Y-organ membranes from de-eyestalked crabs (MIH absent) exhibited the same K_d value as membranes from intact crabs, but a B_max 17% higher. Thus, MIH activity apparently does not change the binding affinity of HDL, but decreases the number of binding sites. These results agree with our previous findings that MIH depresses ecdysteroid synthesis in part by inhibiting cholesterol uptake. Generally, Y-organ cells appear to contain receptors for HDL that are of high affinity and high binding capacity, similar to the characteristics reported for the binding of insect HDL (vitellogenin) to fat bodies and oocytes. © 1995 Wiley-Liss, Inc.     

Therapy of bovine ocular squamous-cell carcinoma with local doses of interleukin-2: 67% complete regressions after 20 months of follow-up

We have tested the therapeutic potency of peritumorally injected low doses of interleukin-2(IL-2). Seventy tumours of the bovine ocular squamous-cell carcinoma (BOSCC), 1–3 cm in diameter, were treated with 5000, 20 000 or 200 000 U IL-2 from Eurocetus (Chiron) to find the optimal dose for treatment. Injections were given peritumorally on Monday to Friday on 2 consecutive weeks. The size of the tumours was measured before treatment and 1, 3, 4, 9 and 20 months after treatment. After 9 months complete regression was observed in 89% of the tumours treated with 5000 U IL-2, 80% treated with 20 000 U and 67% treated with 200 000 U. After 20 months, there was complete regression of 35%, 31% and 67% of the tumours respectively. The 9-and 20-month results of the 200 000-U treatment are significantly better than those of the 5000-U and 20 000-U treatments taken together. This protocol may be useful to treat advanced inoperable tumours (e.g. of the nasopharynx or skin) of human patients.     

Interleukin-6 involvement in mesothelioma pathobiology: inhibition by interferon α immunotherapy

A role for interleukin-6 (IL-6) in malignant mesothelioma has been suggested by the clinically presenting symptoms of mesothelioma patients, which include fever, weight loss and thrombocytosis. A murine model of malignant mesothelioma was therefore used to examine the potential role of IL-6 in this cancer type and whether the effect of interferon (IFN) therapy on mesothelioma might be mediated, in part, by regulating IL-6 levels and/or IL-6-induced pathobiology. A panel of human and murine mesothelioma cell lines was assayed for endogenous IL-6 production in a bioassay, and for IL-6-mRNA expression. Four out of 5 human and 5 out of 15 murine mesothelioma cell lines produced moderate to high levels of bioactive IL-6 in vitro. This result was corroborated by mRNA detection. One of the representative murine cell lines, AB22, was chosen for further in vivo studies in the murine mesothelioma model. In AB22-inoculated mice detectable serum IL-6 levels were found to precede macroscopically detectable tumour growth, clinical signs (cachexia, abdominal distension, diarrhoea) and changes in the peripheral lymphoid organs (cell depletion and functional depression). Treatment with anti-IL-6 antibody curtailed the clinical symptoms (P<0.001), as did treatment with recombinant human (rhu) IFN (P<0.001). Neither anti-IL-6 antibody nor rhuIFN had a direct growth-inhibitory effect on the AB22 mesothelioma cell line in vitro, however, in vivo rhuIFN treatment of mice inoculated with AB22 cells attenuated both IL-6 mRNA expression in the tumours and serum IL-6 levels, ameliorated the depression of lymphocyte activities, and enhanced the number of tumour-infiltrating lymphocytes and macrophages. On the basis of these results it is suggested that IL-6 mediates some of these effects, directly or indirectly, and that a combination therapy of rhuIFN and anti-IL-6 antibody may be an improved palliative treatment for patients with malignant mesothelioma.     

损毁和刺激垂体对大鼠痛阈的影响

采用局限性损毁和刺激垂体的方法,以行为测痛为指标,观察大鼠垂体在痛觉调节中的作用以及地塞米松（Ｄｅｘ）对其影响。实验结果显示,损毁垂体中间叶（ＩＬ）及邻近的前叶（ＡＬ）,大鼠痛阈明显低于手术前的痛阈（Ｐ＜０．０１）。电刺激垂体的上述同样部位,大鼠痛阈明显高于手术基础值及自身假刺激值（Ｐ＜０．００１）。经Ｄｅｘ处理的动物,电刺激垂体不再引起痛阈升高。结果表明,大鼠垂体ＩＬ及靠近ＡＬ与痛调节有关,这种     

DNA strand scission and ADP-ribosyltransferase activity during murine erythroleukemia cell differentiation

The accumulation of DNA strand breaks and activation of ADP-ribosyltransferase (ADPRT) have recently been associated with cellular differentiation. Murine erythroleukemia (MEL) cells undergo erythropoietic differentiation when exposed to dimethyl sulfoxide (Me2SO) and several studies have suggested that DNA strand scission induced by this agent is a prerequisite for expression of the differentiated phenotype. Me2SO induction of MEL cells has also been associated with increases in ADPRT activity in one study, but not in another. We have monitored the effects of Me2SO on DNA strand breaks in preformed and replicating MEL cell DNA. The results clearly demonstrate that DNA fragmentation is not detectable during Me2SO induction of MEL differentiation, even in the presence of 3-aminobenzamide, an inhibitor of ADPRT. Further, these results are consistent with an absence of detectable changes in both endogenous and total potential ADPRT activity during Me2SO-induced MEL differentiation. These findings would argue against Me2SO induction of DNA strand scission and ADPRT in MEL cells undergoing differentiation.     

Heterogeneity of heparan sulfate proteoglycans synthesized by PYS-2 cells

Antibodies to the basement membrane proteoglycan produced by the EHS tumor were used to immunoprecipitate [35S]sulfate-labeled protoglycans produced by PYS-2 cells. The immunoprecipitated proteoglycans were subsequently fractionated by CsCl density gradient centrifugation and Sepharose CL-4B chromatography. The culture medium contained a low-density proteoglycan eluting from Sepharose CL-4B at Kav = 0.18, containing heparan sulfate side chains of Mr = 35-40,000. The medium also contained a high-density proteoglycan eluting from Sepharose CL-4B at Kav = 0.23, containing heparan sulfate side chains of Mr = 30,000. The corresponding proteoglycans of the cell layer were all smaller than those in the medium. Since the antibodies used to precipitate those proteoglycans were directed against the protein core, this suggests that these proteoglycans share common antigenic features, and may be derived from a common precursor which undergoes modification by the removal of protein segments and a portion of each heparan sulfate chain.