简介：摘要目的比较3D与2D腹腔镜根治术治疗胃癌的临床效果。方法抽取2018年6月至2020年6月安阳市第二人民医院收治的胃癌患者64例，按照患者入院先后顺序将其分为对照组(32例)和观察组(32例)，对照组采用2D腹腔镜根治术治疗，观察组采用3D腹腔镜根治术治疗，比较两组治疗效果。结果观察组患者的手术时间、术中出血量、淋巴结清扫数量、术后排气时间等指标值均优于对照组(P<0.05)；观察组患者中出血、感染、吻合口梗阻等不良反应发生率低于对照组(P<0.05)；观察组患者的C-反应蛋白、糖类抗原125指标值低于对照组，糖类抗原19-9、癌胚抗原水平高于对照组，两组患者的血清指标值比较差异有统计学意义(P<0.05)。结论在胃癌患者临床中采用3D腹腔镜根治术治疗，患者的手术指标值、血清指标值显著改善，不良反应发生率低。

简介：AbstractBackground:The human brain is the most complex organ in the body, and it is important to have a better understanding of how the protein composition in the brain regions contributes to the pathogenesis of associated neurological disorders.Methods:In this study, a comparative analysis of the frontal and temporal cortex proteomes was conducted by isobaric tags of relative and absolute quantification (iTRAQ) labeling and two-dimensional liquid chromatography-tandem mass spectrometry (2D LC-MS/MS). Brain protein was taken from relatively normal tissue that could not be avoided of damage during emergent surgery of the TBI (traumatic brain injury) patients admitted in Beijing Tiantan Hospital from 2014 to 2017. Eight cases were included. Four frontal lobes and 4 temporal lobes proteome were analyzed and the proteins were quantitated. Gene Ontology (GO), Ingenuity Pathway Analysis (IPA), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were used to analyze the biological function of identified proteins, unchanged proteins, and differentially expressed proteins (DEPs).Results:A total number of 2127 protein groups were identified in the frontal and temporal lobe proteomes. A total of 1709 proteins could be quantitated in both the frontal and temporal cortex. Among 90 DEPs, 14 proteins were screened highly expressed in the temporal cortex, including MAPT, SNCG, ATP5IF1, GAP43, HSPE1, STMN1, NDUFS6, LDHB, SNCB, NDUFA7, MRPS36, EPDR1, CISD1, and RALA. In addition, compared to proteins expressed in the frontal cortex, 14 proteins including EDC4, NIT2, VWF, ASTN1, TGM2, SSB, CLU, HBA1, STOM, CRP, LRG1, SAA2, S100A4, and VTN were a low expression in the temporal cortex. The biological process enrichment showed that unchanged proteins between the frontal and temporal cortex mainly take part in regulated exocytosis, axon guidance, and vesicle-mediated transport. The KEGG pathway analysis showed that unchanged proteins between the frontal and temporal cortex mainly take part in oxidative phosphorylation, carbon metabolism, Huntington's disease, and Parkinson's disease.Conclusions:The majority of proteins are unchanged between the frontal and temporal cortex, and unchanged proteins are closely related to its function. Among DEPs, MATP (tau) is upregulated in the temporal cortex, closely related to Alzheimer's disease (AD), and is one of the targets for the treatment of AD. CLU is downregulated in the temporal cortex which functions as an extracellular chaperone that prevents aggregation of non-native proteins. It was suggested that the temporal lobe may not be the "functional dumb area" of the traditional view, but could be involved in important neural metabolic circuits.

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简介：摘要目的观察含有Jumonji结构域的蛋白质2D(JMJD2D)在胃癌组织的表达并探讨其临床意义。方法收集2013年1月至2014年12月期间来自中国科学院大学附属肿瘤医院(浙江省肿瘤医院)手术治疗并经病理诊断证实的133例胃腺癌标本。采用免疫组织化学法检测133例胃癌组织及其配对的癌旁正常组织中JMJD2D的表达，应用SPSS-22统计软件分析其临床意义及与预后的关系，采用比例风险回归模型(proportional hazards model，Cox模型)多因素回归分析JMJD2D蛋白表达及其他病理参数对胃癌患者预后的预测价值。结果胃癌组织中JMJD2D的高表达率为75.9%(101/133)，显著高于癌旁正常胃组织(高表达率2.3%，3/133，χ2＝64.821，P<0.01)，差异有统计学意义。肿瘤组织中JMJD2D高表达与患者幽门螺杆菌感染状态(χ2＝22.163，P<0.01)、肿瘤分化程度(χ2＝7.022，P<0.05)、浸润深度(χ2＝5.061，P<0.05)、淋巴结转移状态(χ2＝14.123，P<0.01)、临床TNM分期(χ2＝23.194，P<0.01)显著相关，而与患者性别、肿瘤诊断时年龄、肿瘤部位和大小无相关(χ2＝0.072、1.451、2.562、1.383，P值均>0.05)。普兰-迈耶(Kaplan-Meier)生存分析显示，JMJD2D高表达的胃癌患者与正常/低表达患者中位生存时间分别为34个月和65个月，两者差异有统计学意义(P<0.05)。比例风险回归模型(proportional hazards model，Cox模型)多因素回归分析表明JMJD2D高表达是胃癌患者独立预后因素[危险比(HR)＝2.38，P<0.01]。结论JMJD2D在胃癌组织中高表达，且与胃癌进展及患者预后显著相关。

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简介：摘要近年来，臭氧在临床医学领域中得到了广泛应用。臭氧疗法马德里宣言2015年第2版对臭氧的治疗基础、基本原理、应用途径及适宜臭氧疗法治疗的病症等方面进行了详细的分析总结，本译文期望为今后的基础研究与临床应用提供参考。

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简介：摘要目的观察IGF2蛋白对小鼠早胚体外发育的影响。方法①体外培养：取野生型和IMP2基因敲除组小鼠受精卵，分别在含或不含IGF2的M16培养基中进行体外连续培养，观察各组发育至囊胚的数目和囊胚发育率；②胚胎移植：分别将4组早胚移植回代孕雌鼠，观察4组代孕雌鼠的产仔率和妊娠率。结果在体外培养实验中，对比无IGF2的囊胚形成率(29.4%)，野生型添加IGF2组的胚胎发育到囊胚率明显提高(65.8%)，差异具有统计学意义(P＝0.002)。IMP2基因敲除鼠无IGF2组和IGF2组几乎都不能发育到囊胚，差异无统计学意义(P＝0.060)。胚胎移植实验中，接受IGF2处理过的野生型胚胎的代孕母鼠平均每个雌性产下更多的幼崽，并且怀孕率也明显高于接受未处理过的对照胚胎的雌性，差异具有统计学意义(P<0.001)。结论IGF2可显著提高野生型小鼠囊胚形成率和胚胎发育能力，但对IMP2基因敲除小鼠胚胎无影响。

简介：摘要：蔡春江主任中医师，河北省人民医院中医科主任，研究生导师，第四批全国老中医药专家学术经验继承工作继承人，善用古方、经方、复方治疗内科常见病、多发病及疑难杂症，治疗慢性疲劳综合征经验丰富。笔者有幸侍诊于侧，获益匪浅，现将吾师治疗乏力医案 2则介绍如下，以供同道借鉴。

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简介：【摘要】2型糖尿病发病率高，非酒精性脂肪肝是常见的并发症之一。导师总结多年临床经验，基于“络病”理论研究T2DM合并NAFLD，提出本病病位在肝，与脾脏关系密切，湿痰瘀阻互结、痹阻肝络为其基本病机，立“疏肝健脾通络”之法，以柴苓调肝汤在临床中治疗本病，应用多年，取得较好疗效。

简介：摘要：《电子商务法》第38条第2款中的电子商务平台责任，立法一波三折，但实践却并未产生深刻改变，电子商务平台未尽到审核义务或安全保障义务，其承担的责任依旧是全有或全无的连带责任，最终还可向电子商务经营者追偿。在这种责任制度下，从利益角度出发，电子商务平台不具有履行审核义务和安全保障义务的积极性，平台责任规定也达不到目的。为激发电子商务平台积极性，倒逼电子商务经营者提供商品和服务的质量，应从审核义务、安全保障义务、追偿权三个方面层次化、动态化电子商务平台的“相对责任”。

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简介：AbstractBackground:Vitamin D deficiency has been reported to be associated with diabetic microvascular complications, but previous studies have only focused on the relationship between vitamin D and specific complications. Therefore, we aimed to explore the relationship between vitamin D level and diabetic microvascular complications in general, including diabetic retinopathy (DR), diabetic nephropathy (DN), and diabetic peripheral neuropathy (DPN).Methods:This was a cross-sectional study of 815 patients with type 2 diabetes mellitus (T2DM). Clinical information and laboratory results were collected from the medical records. The relationship between vitamin D and the three diabetic microvascular complications was investigated.Results:The serum 25-hydroxyvitamin D (25 [OH] D) level of patients with DPN and/or DN was significantly lower than that of T2DM patients without any microvascular complications (P < 0.01). Univariate analysis showed that the 25 (OH) D level was related to DPN and DN, but not DR. After adjustment, the 25 (OH) D level was confirmed to be an independent protective factor for DPN (odds ratio [OR]: 0.968, P = 0.004]) and DN (OR: 0.962, P = 0.006). The prevalence of DPN and DN increased significantly as the serum 25 (OH) D levels decreased. Furthermore, patients with both DPN and DN had the lowest concentration of serum 25 (OH) D (P < 0.001), and the prevalence of macroalbuminuria increased more abruptly than that of microalbuminuria across the 25 (OH) D tertiles. Among the patients with vitamin D insufficiency, those with DPN presented more comorbid macroalbuminuria than those without DPN (15.32% vs. 4.91%; P = 0.001).Conclusions:Vitamin D deficiency is independently associated with higher risk of DPN and DN, but not DR, in T2DM patients. Further, it may be a potential predictor for both the occurrence and severity of DPN and DN.

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简介：摘要：文章以课程标准和学生学情为依据，贯彻落实地理学科核心素养，对人教版高中地理选择性必修1“地球运动的地理意义（第2课时）”进行教学设计。运用了情境教学法、问题探究教学法、小组合作学习法等教学方法，以及数字星球系统等现代信息技术，联系乡土和生活实际，创设问题情境，设计了四个探究活动，注重培养学生的乡土意识和家国情怀，树立学习对生活有用的地理的意识。

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简介：摘要我国是胃癌大国，积极推行早期胃癌筛查刻不容缓。慢性萎缩性胃炎是胃癌演进过程中的重要节点，也是早期胃癌筛查的重要依据。近年来的临床实践证实，我国学者于2019年建立的新型胃癌筛查评分系统可通过定量评分的方法精准筛选出真正的胃癌高危人群，是预防胃癌发生的重要工具。