隐孢子虫基因组学研究进展

隐孢子虫为人兽共患性原虫,呈世界性分布,经水源和食物源途径传播,为人腹泻性疾病的一个重要致病因素.共有7个种(Cryptosporidium hominis, C.parvum, C.meleagridis, C.felis, C.canis, C.muris,C.suis,C.andersoni, C.baileyi)以及一个基因型(cervine genotype,skunk genotype)可以感染人类.而目前尚无有效的治疗性药物,因此研究隐孢子虫具有公共卫生重要性.     

SLIPA喉罩对无痛纤维支气管镜检查患者应激反应及血流动力学的影响

目的探讨流线型气道(streamlined liner of the pharynx airway,SLIPA)喉罩对无痛纤维支气管镜检查患者应激反应及血流动力学的影响。方法选择2015年1月-2017年1月收治的无痛纤维支气管镜检查患者124例为研究对象,采用前瞻性研究的方法,将患者随机分为干预组和对照组各62例。对照组使用内镜面罩,干预组使用SLIPA喉罩。比较两组患者应激反应、血流动力学、不良反应。结果纤维支气管镜插入后3min(T2)、取出纤维支气管镜后1min(T3),干预组患者血清肾上腺素(E)、去甲肾上腺素(NE)、多巴胺(DA)含量明显低于对照组[(0. 80±0. 16 vs 1. 25±0. 21,0. 72±0. 15 vs 0. 98±0. 24) mmol/L,(1. 36±0. 27 vs 1. 62±0. 27,1. 30±0. 16 vs 1. 48±0. 13) mmol/L,(1. 15±0. 22 vs 1. 58±0. 20,0. 98±0. 17 vs 1. 32±0. 21) mmol/L](t=13. 421,7. 234,5. 667,6. 875,11. 388,9. 909,P 0. 05,P 0. 01),心率(HR)、舒张压(SBP)、收缩压(DBP)均明显低于对照组[(78. 23±6. 65 vs 82. 10±6. 10,76. 32±8. 45 vs 76. 05±8. 32)次/min,(138. 12±8. 36 vs 146. 32±10. 20,135. 12±9. 20 vs 135. 24±11. 36) mm Hg,(82. 12±8. 45 vs 84. 45±7. 24,78. 15±8. 34 vs 79. 12±8. 35) mm Hg](t=3. 377,2. 127,10. 167,6. 420,6. 472,4. 962,P 0. 05,P 0. 01);干预组恶心呕吐、呛咳、咽痛不适等发生率明显低于对照组(3. 23%vs 12. 90%,4. 84%vs 27. 42%,1. 61%vs 11. 29%)(χ~2=3. 916,11. 685,4. 810,P 0. 05,P 0. 01)。结论 SLIPA喉罩有助于缓解无痛纤维支气管镜检查患者应激反应,维护血流动力学相对稳定,减少不良反应发生率。     

异甘草酸镁治疗自身免疫样药物性肝损伤的效果和安全性

目的探索异甘草酸镁治疗自身免疫样药物性肝损伤的临床疗效和安全性。方法选取首都医科大学附属北京佑安医院2016年7月-2019年1月住院的自身免疫样药物性肝损伤患者53例为观察组,另选不伴有自身免疫现象的药物性肝损伤患者50例为对照组。所有患者给予异甘草酸镁200 mg/d,治疗4周。观察治疗前后患者肝功能情况,观察治疗前后观察组患者的免疫学指标,记录两组患者的不良反应。治疗结束后每月随访肝功能,随访时间6个月。正态分布计量资料组间比较采用t检验,非正态分布的计量资料采用Mann-Whitney U检验,计数资料组间比较采用χ~2检验或Fisher精确概率检验。结果观察组治疗后与治疗前比较,ALT[35. 4(29. 2～42. 0) U/L vs 289. 0(226. 6～460. 3) U/L,Z=-8. 661,P 0. 001]、AST[46. 3(15. 6～183. 5) U/L vs306. 3(32. 2～589. 8) U/L,Z=-5. 271,P 0. 001]、GGT[77. 0(53. 2～183. 2) U/L vs 129. 0(77. 8～232. 5) U/L,Z=-3. 437,P=0. 001)]、ALP[83. 1(64. 9～83. 1U/L vs 119. 4 (104. 9～146. 9) U/L,Z=-3. 485,P 0. 001]和TBil[(27. 5±10. 3)μmol/L vs(59. 7±18. 6)μmol/L,t=6. 673,P 0. 001]水平均明显降低;对照组患者治疗后与治疗前比较,ALT[33. 1(14. 9～106. 4) U/L vs300. 6(206. 8～679. 5) U/L,Z=-8. 232,P 0. 001]、AST[44. 1(20. 8～151. 6) U/L vs 321. 7(36. 2～553. 2) U/L,Z=-3. 549,P 0. 001]、GGT[82. 7(50. 6～168. 5) U/L vs 133. 5 (72. 2～254. 2) U/L,Z=-2. 364,P=0. 018]、ALP[87. 6 (74. 3～139. 4) U/L vs128. 0(106. 3～201. 4) U/L,Z=-4. 303,P 0. 001]和TBil[(23. 8±10. 9)μmol/L vs (58. 3±19. 8)μmol/L,t=-8. 450,P 0. 001]水平也明显降低。但治疗后两组间比较差异均无统计学意义(P值均 0. 05)。治疗后观察组患者IgG水平由(15. 8±3. 2) g/L降至(14. 2±2. 0) g/L,治疗前Ig G水平升高(16 g/L)患者22例中18例(81. 8%)恢复正常。36例ANA阳性患者19例(52. 7%)阴转。两组患者均无严重不良反应。行肝穿病理检查患者中,观察组患者中性粒细胞和(或)嗜酸性粒细胞浸润(17/32,53. 1%)明显高于对照组(3/17,17. 5%)(χ~2=5. 785,P=0. 016)。结论异甘草酸镁用于治疗自身免疫样药物性肝损伤安全有效,是临床治疗的可选择方案。     

先天性肝纤维化伴血铜蓝蛋白降低1例

患者,男,22岁.因肝区隐痛不适2年来诊.无呕血、腹痛、黑便等症状.曾用保肝药物.既往史无殊,无毒物接触史和肝病家族史.查体体型瘦长.肝掌阴性,蜘蛛痣阴性,巩膜无黄染.心肺听诊未及异常.腹软,肝脾肋下未触及,移动性浊音阴性,下肢无水肿.     

穿孔素和颗粒酶B基因多态性与幼年特发性关节炎相关性分析

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非酒精性脂肪性肝病与血清维生素D及骨密度的关系

目的探讨非酒精性脂肪性肝病(NAFLD)与维生素D及骨密度的关系。方法选取2018年5月-2019年3月于大连大学附属中山医院住院及门诊就诊的NAFLD患者180例为NAFLD组,另选取年龄及性别相匹配的健康体检者180例为对照组。比较2组维生素D、骨密度、骨代谢生化标志物[β胶原降解产物(β-CTX)、Ⅰ型胶原氨基端延长肽(P1NP)、骨钙素(OC)]的差异。正态分布的计量资料2组间比较采用独立样本t检验,非正态分布采用Mann-Whitney U检验;计数资料2组间比较采用χ2检验。相关性采用Spearman秩相关分析;采用二项分类logistic回归分析NAFLD的相关危险因素。结果 NAFLD组25(OH) D[13. 06(10. 73～19. 77) ng/ml vs 19. 88(12. 56～22. 60) ng/ml,Z=-1. 37,P=0. 041]、L1-4骨密度[0. 87(0. 83～1. 05) g/cm2vs1. 05(0. 92～1. 21) g/cm2,Z=-2. 17,P=0. 034]、股骨颈骨密度[(0. 76±0. 21) g/cm2vs(0. 84±0. 51) g/cm2,t=2. 02,P=0. 015]、P1NP[45. 40(33. 35～58. 02) ng/ml vs 67. 39 (48. 09～87. 49) ng/ml,Z=-0. 83,P=0. 044]和OC[14. 79 (11. 64～18. 87) ng/ml vs17. 29(15. 16～21. 04) ng/ml,Z=-2. 09,P=0. 037]水平均明显低于对照组;β-CTX[354. 75(186. 32～526. 57) pg/ml vs 287. 67(164. 10～497. 76) pg/ml,Z=-1. 04,P=0. 027]水平明显高于对照组。NAFLD患者25(OH) D[(13. 51±3. 20) ng/ml vs(18. 86±3. 70) ng/ml,t=3. 02,P=0. 038]及L1-4骨密度[(0. 75±0. 24) g/cm2vs(1. 05±0. 31) g/cm2,t=2. 17,P=0. 035]、股骨颈骨密度[(0. 71±0. 18) g/cm2vs(0. 82±0. 21) g/cm2,t=2. 25,P=0. 042]在ALT2倍正常值上限(ULN)组明显低于≤2×ULN组; 25(OH) D、L1-4骨密度、股骨颈骨密度在CT诊断不同程度脂肪肝组间比较差异均无统计学意义(P值均 0. 05)。骨密度与HDL-C(r=0. 232,P 0. 05)呈正相关,与BMI(r=-0. 271,P 0. 05)、GLU(r=-0. 242,P 0. 05)、ALT(r=-0. 375,P 0. 05)、AST(r=-0. 312,P 0. 05)、LDL-C(r=-0. 247,P 0. 05)呈负相关。logistic回归分析结果显示,25(OH) D[比值比(OR)=1. 113,95%可信区间(95%CI):1. 023～1. 210,P=0. 013]、BMI(OR=0. 676,95%CI:0. 522～0. 877,P=0. 003)、GLU(OR=0. 350,95%CI:0. 139～0. 882,P=0. 026)是NAFLD的影响因素。结论 NAFLD患者血清维生素D及骨密度明显低于正常人,通过血清维生素D及骨密度的分析可进一步阐明NAFLD的骨代谢特征,对NAFLD并发骨质疏松症进行合理的早期筛查,以提高NAFLD患者的预后及生活质量。     

直接抗病毒药物治疗慢性丙型肝炎的效果及对肝硬度、APRI的影响

目的探讨目前直接抗病毒药物(DAA)治疗方案下,慢性丙型肝炎患者真实世界病毒应答情况及对肝硬度值和天门冬氨酸/血小板比值指数(APRI)的影响。方法连续性纳入2018年4月1日-2018年11月30日在天津市第三中心医院接受DAA治疗的慢性丙型肝炎患者,应用无干扰素方案的DAA治疗12～24周,评估治疗结束后第12周病毒学应答情况,对比基线及治疗结束后12周肝硬度值和APRI的变化。计量资料两组间比较采用Wilcoxon秩和检验。结果共纳入212例慢性丙型肝炎患者,其中肝硬化患者占35. 4%,基因1b、2a、3a、6a型分别占75. 0%、18. 4%、4. 2%及2. 4%。174例患者完成了DAA治疗疗程及治疗后12周随访。在DAA治疗结束和治疗结束后12周获得持续病毒学应答(SVR)的比例分别为98. 3%及95. 4%。基因1b型、2a型、3a型及6a型患者的SVR12分别为96. 3%、93. 1%、80. 0%及100%。治疗结束后12周肝硬度值较基线[9. 8(6. 9～16. 3) kPa vs 11. 4(7. 7～19. 1) kPa,Z=-2. 5,P=0. 012]及APRI[0. 34(0. 25～0. 64) vs 0. 76(0. 56～2. 25),Z=-6. 6,P 0. 001]均明显下降。根据基线是否存在肝硬化进行分组,结果显示治疗结束12周非肝硬化组患者肝硬度值较基线显著降低[7. 6(6. 6～10. 7) k Pa vs 8. 8(7. 2～13. 0) kPa,Z=-2. 7,P=0. 007];而肝硬化组患者治疗前后肝硬度值无明显差异[17. 4(12. 7～22. 1) k Pa vs 19. 8(12. 8～24. 9) kPa,Z=-1. 4,P=0. 152]。肝硬化组和非肝硬化组患者APRI在治疗后12周较基线均明显下降[0. 73 (0. 52～1. 34) vs1. 37(0. 80～2. 11),Z=-3. 4,P 0. 001; 0. 29(0. 21～0. 36) vs 0. 54(0. 31～0. 95),Z=-6. 8,P 0. 001]。结论在该真实世界研究中,应用DAA治疗的慢性丙型肝炎患者总体病毒学应答率较高,治疗结束后12周肝硬度及APRI明显改善。     

My Hobbies

Hi! My name is Chu Chenyao.I’m twelve years old.I live in Fenhu,a small town near Shanghai.I’m a student.I study at Luxu Experimental Primary School.I like English,but I cannot speak English very well.I like watching TV.I often watch TV at weekends.I like watching"Where are you going,Dad?"very much.I like reading,too.I read a nice storybook yesterday.What do you like?Tell me your hobbies please.     

3种预测工具评估住院高血压患者脑卒中风险

目的采用3种预测工具评估住院高血压患者脑卒中风险。方法选择高血压患者356例,采用脑卒中风险初筛量表、改良Framingham卒中风险评估量表(M-FSP)和汇集队列风险方程(PCE)评估脑卒中风险,并比较M-FSP和PCE在脑卒中风险评估应用中的一致性。结果脑卒中风险初筛量表评估男性脑卒中高危风险明显高于女性(28. 8%vs 17. 2%,P 0. 05);≥60岁脑卒中高危风险明显高于60岁(30. 1%vs 15. 3%,P 0. 01)。M-FSP评估患者10年脑卒中风险(12. 6±7. 1)%,男性脑卒中风险明显高于女性[(14. 5±9. 6)%vs (10. 1±8. 9)%,P 0. 01];≥60岁脑卒中风险明显高于60岁[(18. 8±12. 1)%vs (9. 4±7. 6)%,P 0. 01]。PCE评估患者10年脑卒中风险(13. 3±9. 2)%,男性脑卒中风险明显高于女性[(16. 5±11. 9)%vs (8. 9±7. 8)%,P 0. 01];≥60岁脑卒中风险明显高于60岁[(29. 9±19. 5)%vs (11. 2±9. 3)%,P 0. 01]。相关性分析显示,男性和女性的r值分别为0. 647和0. 609,≥60岁和60岁的r值分别为0. 577和0. 702(P 0. 01)。结论脑卒中风险初筛量表可以对个体脑卒中风险进行初筛和归类,M-FSP和PCE均能预测脑卒中发生风险。     

支气管镜局部灌注联合全身化疗 对耐多药肺结核患者血清炎性因子及免疫功能的影响

目的探讨支气管镜局部灌注联合全身化疗对耐多药肺结核患者血清炎性因子及免疫功能的影响。方法选择2013年10月-2015年10月收治的耐多药肺结核患者124例为研究对象,采用随机数字表法分为观察组和对照组各62例。对照组给予3DThZVAK+M/15DThZV+M标准化耐多药肺结核化疗方案,观察组联合应用支气管镜局部灌注治疗,比较两组痰菌转阴率、血清炎性因子、免疫功能、不良反应。结果治疗3个月、6个月,随访12个月,观察组痰菌转阴率明显高于对照组(59. 68%vs 35. 48%,74. 19%vs48. 39%,88. 71%vs 67. 74%),(χ~2=7. 725,8. 702,8. 002,P 0. 05);治疗6个月,观察组患者血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、降钙素原(PCT)含量降低值明显高于对照组[(17. 77±3. 12 vs 11. 00±1. 45) pg/m L、(45. 65±5. 42 vs 37. 96±4. 36) mg/L、(0. 31±0. 08 vs 0. 23±0. 05) ng/L](t=15. 494,8. 705,6. 677,P 0. 05,P 0. 01);免疫球蛋白Ig A、Ig G、Ig M增加值明显高于对照组[(0. 86±0. 15 vs 0. 48±0. 10)g/L、(4. 22±0. 56 vs 2. 12±0. 36) g/L、(0. 29±0. 08 vs 0. 14±0. 05) g/L](t=16. 597,24. 838,12. 520,P 0. 01);两组发热、咳血痰、肝功能损害等不良反应比较,无统计学意义(24. 19%vs 20. 97%)(χ~2=0. 185,P0. 05);随访2年,观察组复发率3. 23%明显低于对照组14. 52%(χ~2=4. 888,P 0. 05)。结论支气管镜局部灌注联合全身化疗有助于提高耐多药肺结核患者痰菌转阴率,减少复发率,可能与抑制患者炎症反应、改善免疫功能等因素有关。     

冠状动脉旁路移植术中应用罂粟碱对即时静脉桥血管影响的研究

目的:探讨冠状动脉旁路移植(OPCAB)术中应用罂粟碱处理静脉桥血管对围术期的影响。方法:选择2015年1月至2018年12月,在首都医科大学附属北京安贞医院心脏外科,单一手术组行OPCAB手术的患者251例作为罂粟碱组,其中男性150例,女性101例,平均年龄(67. 44±7. 49)岁,术中静脉桥血管排气液应用1. 5 mg/m L罂粟碱溶液。选择同期OPCAB手术的患者172例作为对照组,其中男性96例,女性76例,平均年龄(68. 91±7. 05)岁,术中静脉桥血管排气液为室温0. 9%氯化钠溶液。比较两组临床结果。结果:全部患者无围术期死亡。罂粟碱组术中平均流量(MGF)[(43. 91±8. 82) vs.(41. 21±6. 30) m L/min,t=2. 557,P=0. 011]高于对照组,搏动指数(PI)[(3. 03±0. 48) vs.(3. 57±0. 45),t=-7. 860,P=0. 000]、入ICU 30 min中心静脉压[(7. 42±2. 47) vs.(9. 04±3. 15) mm Hg,t=-2. 514,P=0. 032]、术后肾上腺素用量[(0. 07±0. 02) vs.(0. 08±0. 03)μg·kg~(-1)·min~(-1),t=-4. 934,P=0. 000]、去甲肾上腺素用量[(0. 07±0. 02) vs.(0. 06±0. 02)μg·kg~(-1)·min~(-1),t=2. 030,P=0. 044]、及Tn I值[(0. 48±0. 37) vs.(0. 68±0. 54) ng/min,t=-2. 820,P=0. 006]均少于对照组。结论:OPCAB术中应用罂粟碱对静脉桥血管予以处理,可以增加静脉桥血管即时平均血流量,减低搏动指数,减少围术期心肌损伤,此方法适于在OPCAB术中推广使用。     

高迁移率族蛋白B1/Toll样受体9途径在重症急性胰腺炎肠黏膜屏障损伤中的作用及机制分析

目的探讨高迁移率族蛋白B1(HMGB1)、Toll样受体(TLR) 9信号通路在重症急性胰腺炎(SAP)小鼠肠黏膜屏障损伤中的作用机制。方法将20只KM小鼠随机分为对照组和SAP组,每组10只。SAP组小鼠采用雨蛙素及脂多糖联合腹腔内注射建模,12 h后取材。HE染色观察小鼠胰腺病理学变化; ELISA检测小鼠血清二氨氧化酶(DAO)和内毒素核心抗体(Endo CAb)水平; TUNEL法检测小鼠小肠黏膜凋亡变化; Western Blot检测各组小鼠小肠HMGB1、TLR9、NF-κB蛋白水平的变化。计量资料2组间比较采用t检验。结果 SAP组小鼠均造模成功。SAP组小鼠血清DAO和EndoCAb水平明显高于对照组,差异有统计学意义(12. 172±1. 356 vs 4. 341±0. 521、32. 480±3. 054 vs 13. 281±2. 105,t值分别为16. 613、14. 725,P值分别为0. 001、0. 025); SAP组小鼠小肠黏膜细胞凋亡较对照组明显增加,差异有统计学意义(6. 25±2. 10 vs 19. 54±3. 63,t=11. 582,P 0. 05); SAP组小鼠小肠HMGB1、TLR9、NF-κB蛋白表达水平较对照组均明显升高,差异均有统计学意义(0. 590±0. 004 vs 0. 059±0. 035、0. 530±0. 043vs 0. 070±0. 023、0. 670±0. 059 vs 0. 170±0. 032,t值分别为47. 336、30. 565、23. 655,P值分别为0. 001、0. 034、0. 014)。结论 SAP小鼠小肠HMGB1表达水平升高,其可能通过激活下游TLR9信号通路,在SAP肠黏膜屏障损伤中发挥重要作用。     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

右归丸对膝骨关节炎模型鼠软骨组织凋亡和基质降解调控基因表达的影响

目的通过观察右归丸对膝骨关节炎(knee osteoarthritis,KOA)模型大鼠软骨组织凋亡和基质降解调控基因的影响,进一步揭示右归丸防治KOA的机制。方法采用数字表法将SD大鼠随机分为假手术对照组,KOA模型组,KOA+硫酸氨基葡萄糖组(硫酸氨基葡萄糖),KOA+右归丸(高、中、低剂量)组,每组10只。采用改良Hulth法制备大鼠KOA模型,分别予相应药物灌胃8周。HE染色法观察软骨组织的形态学变化,并进行Mankin评分;应用实时荧光定量PCR法检测各组大鼠软骨组织B淋巴细胞瘤分子-2 (Bcell lymphoma-2,Bcl-2)、B淋巴细胞瘤分子-2相关X蛋白(Bcl-2 associated X protein,Bax)和门冬氨酸特异性半胱氨酸蛋白酶-3 (aspartate-specific cysteine protease-3,caspase-3)基因的表达;应用免疫组化法检测各组软骨组织Ⅱ型胶原(collagenⅡ,COLⅡ)的表达。结果假手术组、KOA模型组、KOA+硫酸氨基葡萄糖组、KOA+右归丸高、中、低剂量组的Mankin评分别为0. 33±0. 073,4. 92±0. 539,2. 76±0. 317,3. 05±0. 253,4. 14±0. 159,4. 38±0. 621; COLⅡ评分分别为3. 45±0. 07,0. 39±0. 02,3. 53±0. 11,3. 87±0. 05,3. 15±0. 21,0. 41±0. 13; Bcl-2基因表达分别为2. 22±0. 08,1. 00±0. 08,1. 75±0. 05,1. 83±0. 11,1. 67±0. 03,1. 12±0. 09;Bax的基因表达分别为0. 23±0. 01,1. 00±0. 05,0. 33±0. 03,0. 28±0. 07,0. 42±0. 03,0. 75±0. 01; Caspase-3基因表达分别为0. 18±0. 01,1. 00±0. 03,0. 26±0. 05,0. 21±0. 02,0. 36±0. 02,0. 83±0. 07。与假手术组比较,KOA模型组大鼠软骨组织Mankin评分明显升高,软骨组织Bcl-2基因表达降低,COLⅡ蛋白表达明显降低,Bax和caspase-3基因表达显著升高(P<0. 01); KOA模型组关节软骨边缘严重破坏,软骨细胞排列紊乱。与KOA模型组相比,KOA+右归丸高剂量干预大鼠软骨组织Mankin评分明显降低,KOA+右归丸中、高剂量干预大鼠软骨组织Bax和caspase-3的基因表达均明显降低,Bcl-2基因表达和COL-Ⅱ的蛋白表达均明显升高(P<0. 05),KOA+右归丸高剂量组软骨结构趋于正常,软骨细胞分布仅偶见不均,关节软骨表面欠光滑。结论右归丸通过上调Bcl-2表达和下调Bax和caspase-3表达减缓COL-Ⅱ的降解,从而有效保护膝骨关节炎模型鼠关节软骨,延缓关节软骨退变。     

气管憩室纵隔瘘并纵隔脓肿1例

患者,男,52岁,农民,因咳嗽咳痰胸闷气喘发热5天,右胸痛3天于2013年3月27日入院.5天前受凉后咳嗽,咳中量灰黄色黏痰,痰有腥味,伴发热,呈稽留热,最高体温39.7℃.无牙龈肿痛,无咽痛,无咯血.3天前开始右胸痛,呈钝痛,伴纳差、吞咽困难.在当地医院按＂支气管炎＂抗感染治疗无效.3月26日在当地县医院行胸CT示气管憩室伴纵隔感染（图1）,求诊治入我院.病程中大小便正常.既往体健.入院体检：体温38.1℃,呼吸20次/分.神志清楚,精神萎靡.皮肤及浅表淋巴结无异常.口腔、咽颈部无异常.两肺呼吸音粗糙,无啰音.心腹无异常.     

棘球蚴感染长爪沙鼠诱发过敏反应的实验观察

[目的 ]观察棘球蚴感染长爪沙鼠诱发的过敏反应。 [方法 ]取 5 6只及 48只长爪沙鼠 ,分别腹腔接种感染细粒棘球蚴 E.g.及泡状棘球蚴 E.m.,3个月后分别用羊源新鲜囊液、羊源 E.g.粗制囊液抗原及沙鼠 E.m.抗原经腹腔注射攻击 ,观察其过敏反应。在攻击发敏前后 ,检测 Ig E抗体水平和嗜酸性粒细胞直接计数 (directeosinophilic leukocyte count,DEL C)。 [结果 ]沙鼠 E.g.和 E.m.感染率分别为 89.3%和 97.9%。各组过敏反应发生率最低为 6 2 .5 % ,最高为 10 0 %。过敏性休克发生率最低为 12 .5 % ,最高为 12 .7%。沙鼠感染 E.g.和 E.m.后 ,Ig E抗体和 DEL C水平逐渐增高 ,但攻击发敏后 Ig E抗体水平显著降低 ,DEL C显著增多。 [结论 ]E.g.和 E.m.感染沙鼠后 ,采用不同抗原攻击均可出现过敏反应或休克 ;不同抗原引起过敏反应的发生率和程度不同 ,但在感染E.g.与 E.m.沙鼠之间无显著性差异。