目的探究PROS1基因单核苷酸多态性(SNP)与包头地区汉族人群复发性流产(RSA)发生风险之间的相关性。方法选取RSA患者及对照人群各158例作为研究对象,测定蛋白S、蛋白C、抗凝血酶-Ⅲ活性;使用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术对PROS1基因rs13062355、rs6441600和rs12634349位点进行基因分型。采用非条件性Logistic回归分析PROS1基因三种SNP与RSA发生风险的相关性。结果RSA患者的蛋白S、抗凝血酶-Ⅲ活性下降(P<0.05);PROS1 SNP rs13062355在显性模型下与RSA发病风险相关:与携带TT基因型患者比较,携带CT+CC基因型的患者RSA发病风险下降(OR=0.398,95%CI:0.249~0.638)。SNP rs6441600、rs12634349与RSA的发病风险无关联。在PROS1 rs13062355、rs6441600、rs12634349构建的单体型中,单体型C-C-C在两组间差异有统计学意义(P<0.05);三阶交互模型rs13062355-rs6441600-rs12634349与RSA发病风险相关。结论PROS1 SNP rs13062355可能与包头地区汉族女性RSA患病风险相关;PROS1 rs13062355、rs6441600、rs12634349的单体型C-C-C降低了RSA发病风险;三阶模型rs13062355-rs6441600-rs12634349的交互作用在RSA的发生中具有协同效应。
目的比较双反牵引辅助微创闭合复位接骨板内固定术和切开复位接骨板内固定术治疗胫骨平台骨折的治疗效果。方法构建检索式分别检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方、维普及中国生物医学文献服务系统...
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目的比较双反牵引辅助微创闭合复位接骨板内固定术和切开复位接骨板内固定术治疗胫骨平台骨折的治疗效果。方法构建检索式分别检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方、维普及中国生物医学文献服务系统等数据库,收集双反牵引微创闭合复位和切开复位治疗胫骨平台骨折的文献,检索时间为建库至2024年4月。文献质量评价和数据提取由2位研究人员各自提取,对所提数据使用RevMan 5.3软件进行分析。结果本研究共纳入文献7篇,总纳入患者511例,其中微创组患者234例,切开组患者277例。结果显示,微创组在术中出血量[MD=-2.55,95%CI:-3.94~1.17,P<0.01]、住院时间[MD=-0.54,95%CI:-0.75~-0.33,P<0.01]、美国特种外科医院(The Hospital for Special Surgery,HSS)评分[MD=0.71,95%CI:0.50~0.91,P<0.01]、骨折愈合时间[MD=-0.39,95%CI:-0.70~-0.08,P=0.01]、并发症发生率[OR=0.30,95%CI:0.16~0.57,P<0.01]和切口并发症[OR=0.26,95%CI:0.10~0.68,P=0.006]优于切开组,2组在手术时间[MD=0.03,95%CI:-1.54~1.61,P>0.05]、术后负重时间[MD=-0.92,95%CI:-2.14~-0.30,P=0.14]、下肢深静脉血栓发生率[OR=0.78,95%CI:0.31~2.00,P=0.61]方面差异无统计学意义。结论双反牵引辅助微创闭合复位接骨板固定术治疗胫骨平台骨折治疗效果优于切开复位接骨板内固定术。
宫颈癌是全球范围内女性健康的重大威胁,其发病率在女性恶性肿瘤中位居第二位,位居女性妇科恶性肿瘤首位。每年大约有53万例宫颈癌新发病例,其中80%的患者发生在发展中国家,而中国是其中发病例数最多的国家之一。对于局部晚期宫颈癌,同步放化疗是基本治疗手段,但治疗后仍有约15%的患者出现复发,基于既往的治疗手段,一旦出现复发,后期的治疗措施十分有限。因宫颈癌早期临床症状不明显,大部分患者首次就诊即为中晚期,无法进行手术治疗,且宫颈癌是为数不多可以治愈的恶性肿瘤,因此首次治疗方案的确定显得尤为重要。传统的治疗手段包括手术、放疗、化疗等,但对于局部晚期宫颈癌患者的治愈率有一定局限。近年来,多项临床试验和研究发现,免疫治疗与靶向治疗在宫颈癌治疗中取得了显著效果,且免疫及靶向治疗具有更加精准、有效,并且副作用较小等优势,目前常用的检查点抑制剂包括细胞毒性T淋巴细胞相关抗原4 (CTLA-4)、程序性死亡受体1 (PD-1)及配体1 (PD-L1)等,血管内皮生长因子(VEGF)、EGFR抑制剂、HER2抑制剂等靶点药物也批准应用于各种晚期及复发宫颈癌患者中。本文就免疫治疗及靶向治疗以及相关检查点在局部晚期宫颈癌中的应用进展进行综述,为局部晚期宫颈癌患者提供更多的希望与可能。Cervical cancer is a major threat to women’s health worldwide, and its incidence ranks second among female malignant tumors and first among female gynecologic malignant tumors. There are about 530,000 new cases of cervical cancer every year, 80% of which occur in developing countries, and China is one of the countries with the highest number of cases. For locally advanced cervical cancer, simultaneous chemoradiotherapy is the basic treatment, but about 15% of patients still relapse after treatment. Based on the previous treatment methods, once relapse occurs, the later treatment measures are very limited. Because the early clinical symptoms of cervical cancer are not obvious, most patients are in the middle and late stages of the first visit, and can not be treated with surgery. Cervical cancer is one of the few malignant tumors that can be cured, so the determination of the first treatment plan is particularly important. Traditional treatment methods include surgery, radiotherapy, chemotherapy, etc., but there are certain limitations in the cure rate of patients with locally advanced cervical cancer. In recent years, a number of clinical trials and studies have found that immunotherapy and targeted therapy have achieved remarkable results in the treatment of cervical cancer, and immune and targeted therapy has more accurate, effective, and fewer side effects. Currently commonly used checkpoint inhibitors include cytotoxic T lymphocyt-asso
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