简介：Thenasogastrictube(NGT)hasbecomeafrequentlyuseddevicetoalleviategastrointestinalsymptoms.Nasogastrictubesyndrome(NTS)isanuncommonbutpotentiallylife-threateningcomplicationofanindwellingNGT.NTSischaracterizedbyacuteupperairwayobstructionduetobilateralvocalcordparalysis.Wereportacaseofa76-year-oldmanwithNTS,inducedbyanindwellinglongintestinaltube.Hewasadmittedtoourhospitalfortreatmentofsigmoidcoloncancer.Heunderwentsigmoidectomytoreleaseabowelobstruction,andhadalongintestinaltubeinsertedtodecompresstheintestinaltract.Hepresentedacutedyspneafollowingprolongedintestinalintubation,andbronchoscopyshowedbilateralvocalcordparalysis.TheNGTwasremovedimmediately,andtracheotomywasperformed.Thepatientwasfinallydischargedinafullyrecoveredstate.NTSbeconsideredinpatientscomplainingofacuteupperairwayobstruction,notonlywithaNGTinsertedbutalsowithalongintestinaltube.

简介：AbstractAs an innovative in vitro culture model, organoids have been established by cell sorting and subsequent culture in three-dimensional culture systems. Organoids can be derived from induced pluripotent stem cells or organ-restricted adult stem cells. Compared with traditional two-dimensional cell culture models and patient-derived xenograft models, organoids possess long-term genetic stability and can better retain the characteristics of source tissues or organs. These advantages have led to the increased use of ovarian and fallopian tube organoids in various fields of research, including cell differentiation and development, establishment of disease occurrence and progression models, tissue regeneration and reconstruction, individual drug screening, immune cell co-culture, and maternal-fetal medicine. This review briefly summarizes the recent progress in the application of ovarian and fallopian tube organoids in the field of obstetrics and gynecology.

简介：AbstractCilia are microtubule-based filamentous organelles that play a vital role in embryogenesis. Multiple signal transduction pathways are orchestrated by cilia, such as Hedgehog and planar cell polarity signals. Various studies, spanning over last 2 decades, have emphasized the role of cilia-mediated signaling cascades in regulating neural tube patterning and development. Moreover, the deficiency of certain ciliary genes have been reported to cause neural tube defects (NTDs), which are a set of disorders that occur due to perturbation of normal neural tube closure. However, the mechanisms underlying cilia dysfunction resulting NTDs remain unclear. Recent studies have highlighted the association of phosphoinositide signaling with cilia, thereby conferring novel insights into the function of cilia during neural tube development. Here, we have reviewed recent studies on cilia, focusing on the molecular mechanism underlying the involvement of cilia in neural tube development and the role of ciliary disruption in the development of NTDs.

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简介：INTRODUCTIONThecommonconstructionmethodoftissueengineeredarticularcartilageistoisolateandculturechondrocytes,transplantthemintothedegradablescaffoldmaterials,thentorepairthedefectofarticularcartilage.Wedesignedthisexperimenttoinvestigatethefeasibilityoftissueengineeredarticularcartilageconstructedbythetechniqueofcentrifugetubeculturewithoutscaffoldmaterials.

简介：AbstractImportance:A nasogastric tube is used commonly to decompress the stomach and provide enteral feeding in surgical and medical practice. Sometimes this safe and innocent-looking tube may lead to unexpected complications. We focus here on the possibility of spontaneous 'lariat loop’ knotting of the nasogastric tube when some resistance is felt on tube retrieval and describe a method of safe tube removal.Case presentation:We present a case of self-knotting of a nasogastric tube that was placed to decompress the stomach during the postoperative period after surgical repair of anorectal malformation in a 4-month-old boy.Conclusion:Self-knotting of the distal end of nasogastric tube is an unusual complication with catastrophic sequelae if not addressed properly. If any resistance is felt during nasogastric tube retrieval, self-knotting of the tube must be suspected.

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简介：Objective:Patientsundergoingtotalgastrectomyforcancerareatriskofmalnourishment.Theaimofthisselfcontrolledstudywastoexaminetheeffectofjejunostomytubefeeding(JTF)andotherfactorsonpostoperativeweightandtheincidenceofjejunostomy-relatedcomplicationsinpatientsundergoingtotalgastrectomyforcancer.Methods:Allconsecutivepatientswhounderwenttotalgastrectomyforgastriccancerwithjejunostomyplacementwereincludedfromaprospectivesingle-centerdatabase(2003–2014).Jejunostomy-relatedcomplicationsandpostoperativeweightchangeswereevaluatedupto12monthsaftersurgery.Multivariablelinearregressionanalysiswasperformedtoidentifyfactorsassociatedwithweightloss12monthsaftergastrectomy.Results:Of113patientsoperatedinthestudyperiod,65receivedJTFaftertotalgastrectomyforamediandurationof18d[interquartilerange(IQR),10–55d].Jejunostomy-relatedcomplicationsoccurredin11(17%)patients,includingskinleakage(n=3)andperitonealleakage(n=2),luxation(n=3),occlusion(n=2),infection(n=1)andtorsion(n=1).In2(3%)patients,areoperationwasneededduetojejunostomy-relatedcomplications.Themeanpreoperativeweightofpatientswas71.8kg(100%),andremainedstableduringJTF(73.9kg,103%,P=0.331).AfterJTFwasstopped,themeanweightofpatientsdecreasedto64.9kg(90%)at12monthsaftersurgery(P<0.001).Ahighpreoperativebodymassindex(BMI)(≥25kg/m~2)wasassociatedwithhighpostoperativeweightlosscomparedtopatientswithalowBMI(<25kg/m~2)(16.3%vs.8.6%,P=0.016).Conclusions:JTFcanpreventweightlossintheearlypostoperativephase.However,thisisattheprizeofpossiblecomplications.Asweightlossinthelongtermisnotprevented,routineJTFshouldbere-evaluatedandbalancedagainsttheselecteduseinpreoperativelymalnourishedpatients.SpecialattentionshouldbepaidtopatientswithahighpreoperativeBMI,whoareatriskofmorepostoperativeweightloss.

简介：AbstractObjectives:Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments. This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube dysfunction.Data sources:A total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English language. References of included studies were checked.Methods:A systematic review was undertaken. Outcomes assessed were: primary outcomes-subjective improvement in symptoms (ETDQ-7), audiometric improvement of hearing, improvement of negative middle ear pressure noticed in tympanometry, objective improvement of tympanic membrane retraction. Secondary outcomes were-the ability to auto-insufflate Eustachian tube i.e. Valsalva manoeuvre, improved quality of life, passive tubal opening, tubomanometry, swallowing test, reduction in mucosal inflammation of Eustachian tube orifice in the nose, complications from the procedure, the need for further procedures. Results are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous data.Results:Three studies were included. All included studies were small-scale case series (13-38 par-ticipants). Studies were conducted outside the UK. Subjective and objective improvement of Eustachian tube function was reported in all studies. But all included studies were at high risk of bias and subject to multiple limitations. No major complications were reported in either study.Conclusions:Based on current evidence, it is not possible to recommend the clinical use of either of these two interventions i.e. Laser or Microdebrider Eustachian tuboplasty. Lack of controlled studies was identified as a gap in the evidence. Future research should be directed toward designing randomised controlled trials. These trials should use strict standard methodology and reporting criteria. Future trials should make use of consensus statement document about Eustachian tube dysfunction definition, diagnostic methods, and outcome assessment criteria to design clinical trials.

简介：目的评价内窥镜下经x-tube腰椎板切除减压，髓核摘除术的初步临床效果。方法自2010年1月共收治13例腰椎间盘突出患者，其中L4／5节段7例，L5／S1节段6例，均行内窥镜下经x．tube腰椎板切除减压，髓核摘除术，按改良Macnab评分标准评价临床效果，同时记录手术时间，失血量及并发症。结果所有病例均得到随访，随访时间3-12个月，平均6个月。术后功能评定按改良Macnab评分分级：优10例，良3例，优良率100％。未发现手术并发症。手术时间45-105min，平均60rain，失血量10，95mL，平均30mL。结论METRx内窥镜辅助X-Tube下治疗腰椎间盘突出症，具有微创直视化、管道化特点，效果满意；应严格把握手术适应症，术中仔细操作．避免手术并发症发生。

简介：Objective:Todevelopasensitive,specificandsimplemethodfordetectionofextremelylownumbersofT.palliduminclinicalspecimens,asasignificantadditiontotheserologictestsforsyphilisdiagnosis.Methods:Double-tubenestedPCR(DN-PCR)andsingle-tubenestedPCR(SN-PCR)assayswereperformedtoamplifyspecificfragmentsoftheDNApolymeraseIgene(polA)ofT.pallidum.SensitivityandspecificityofthetwoPCRassaysweretested.EightysixwholebloodspecimensfrompersonswithsuspectedsyphilisweredetectedbythetwonestedPCRmethods.TheTPPAtestwasusedasacomparisonfordetectingsyphilisinserafromcorrespondingpatients.Results:OnlyspecificampliconscouldbeobtainedduringamplificationoftheT.pallidumpolAgeneandthedetectionlimitwasapproximately1organismwhenanalyzedongelbythetwoPCRmethods.Of86clinicalspecimens,62werepositivebyTPPA.Ofthese,54and51werepositivebytheDN-PCRandSN-PCR,respectively,whichdoesnotrepresentastatisticallysignificantdifferencebetweenthetwoPCRtests.Of24TPPA-negativespecimens,5werepositivebybothDN-PCRassayandSN-PCRassay.Conclusion:TheSN-polAPCRmethodisextremelysensitive,specificandeasytoperformfordetectinglownumbersofT.palliduminclinicalbloodspecimensasacomplementarytoserologyforsyphilisdiagnosis.

简介：经胸腔镜脊柱侧弯矫形术国内已经开展,通过微创方法腰椎内固定脊柱融合手术国内尚未报道.我们开展了2例经X-tube脊柱微创系统腰椎椎弓根螺钉内固定椎间融合手术,体会其优缺点.

简介：摘要目的比较QuantiFERON-TB Gold Plus（QFT-Plus）与QuantiFERON-TB Gold in tube（QFT-GIT）在肺结核辅助诊断中的筛查价值。方法筛检试验。前瞻性纳入2020年10—12月在广州市胸科医院住院的并进行QFT-GIT检测的患者作为研究对象，增加QFT-Plus检测，并收集这些患者的基本信息、临床表现、实验室检测结果和影像检查等资料。共纳入207例患者，分为结核组和非结核组。结核组共124例（包括94例确诊患者和30例临床诊断患者），其中男90例，女34例，年龄18~93岁，中位年龄57（36，66）岁。非结核组共83例（包括非结核分枝杆菌患者16例和其他肺部疾病患者67例），其中男49例，女34例，中位年龄60（51，68）岁。将确诊患者再分为低、中、高MTB荷菌量3级，和轻、中、重度肺结核3级。比较QFT-Plus与QFT-GIT检测结果，对比分析不同抗原管内γ-干扰素水平。各组间的差异采用Mann-Whitney U检验和Kruskal-Wallis H检验进行比较。结果QFT-Plus与QFT-GIT检测的结果的一致性较好（κ=0.786，95%CI：0.740~0.832），不一致率仅为8%，不一致的结果主要表现为QFT-GIT阴性/QFT-Plus阳性，占全部不一致的15/17。其中，QFT-GIT检测：敏感度为80.7%（95%CI：0.706~0.880）、特异度为76.3%（95%CI：0.649~0.850）、阳性预测值为79.8%（95%CI：0.697~0.873）、阴性预测值为77.3%（95%CI：0.659~0.859）；而QFT-Plus检测：敏感度为84.3%（95%CI：0.743~0.910）、特异度为78.8%（95%CI：0.679~0.868）、阳性预测值为80.5%（95%CI：0.703~0.879）、阴性预测值为82.9%（95%CI：0.721~0.902），均高于QFT-GIT检测结果。不同结核分枝杆菌荷菌量及疾病严重程度患者之间，抗原管检测的γ干扰素水平差异均有统计学意义（均P<0.05）。结论QFT-Plus检测和QFT-GIT检测之间有着较好的一致性，在肺结核的辅助诊断中有良好的应用价值；因为添加了结核特异性CD8细胞抗原，QFT-Plus检测有着更高的敏感度、更低的不确定性和更好的应用价值。本研究还发现，肺结核患者的荷菌量和疾病严重程度可能与γ-干扰素水平有一定相关性。