血清CA153、CEA和TPA联检在术前乳腺肿瘤鉴别诊断中的价值

目的:本文探讨血清CA153、CEA和TPA联检在术前乳腺肿瘤鉴别诊断中价值,以期为乳腺癌患者即时手术提供帮助.方法:采用放射免疫分析,检测乳腺肿瘤患者和健康人群血清CA153、CEA和TPA含量.结果:在CA153、CEA和TPA血清学检测中,术前乳腺癌组与乳腺良性肿瘤和健康人群组表达水平存在明显差异.术前乳腺癌组阳性率:CA153为63.8%,CEA为22.4%,TPA为62.1%;术前乳腺癌组联检阳性率:CA153和CEA为69.8%,CA153和TPA为87.1%,三者联检为90.5%;术前乳腺癌组检测特异性:CA153为77.9%,CA153和CEA联检为77.9%,CA153和TPA联检为71.9%,三者联检为73.4%.结论:当CA153、CEA和TPA三者联检时,术前乳腺癌组诊断阳性率显著提高,阳性组特异性无明显下降,值得临床推广应用.     

Activity in vitro of twelve antibiotics against clinical isolates of extended-spectrum beta-lactamase producing Escherichia coli

Twelve beta-lactam and non-beta-lactam antibiotics were evaluated against 115 clinical isolates of extended-spectrum beta-lactamase-producing (ESBLs) Escherichia coli using a broth microdilution test in accordance with the CLSI guidelines. Susceptibility was 100% with imipenem, ertapenem and amikacin, 95.7% with piperacillin-tazobactam, 91.3% with cefoxitin, 87% with tobramycin, 81.7% with amoxicillin-clavulanate, 80% with cefepime, 67.8% with ceftazidime, 27.8% with ciprofloxacin, 27% with levofloxacin and 13% with ceftriaxone. Ertapenem was the antibiotic with the lowest minimum inhibitory concentrations (MICs) for all isolates. There were no clinically relevant differences in the activity of the antibiotics in the presence of CTX-M-9 or SHV enzymes.     

Antinuclear Antibodies and Anti-DNA Antibodies in Scleroderma

Antinuclear antibodies (ANA), including anti-DNA antibodies, and rheumatoid factors (RAT, Waaler-Rose) were determined prospectively during a 3-year period in 40 patients with localized scleroderma (LS) compared with 77 patients with generalized scleroderma (GS). ANA were increased in 26% of patients with LS, and in 47% with GS, anti-DNA antibodies in 23% of patients with LS, and in 34% with GS. Thus, the anti-DNA antibody level was lower compared with the known level in systemic lupus erythematosus. Rheumatoid factors were present in 6-7% of patients with LS, and in 14-15% of patients with GS. Increased antinuclear antibodies were not associated with any specific type of localized scleroderma, nor with internal disorders, and no case of clinical overlap to discoid or systemic lupus erythematosus was observed. However, six patients with localized scleroderma and complaints of arthralgia all presented increased antibodies, and one patient showed overlap to rheumatoid arthritis. It is suggested that increased ANA and anti-DNA antibodies in localized scleroderma, associated with joint manifestations, represents a systemic component in this type of scleroderma, with activation of the immune system and similarities with generalized collagen diseases.     

Stronger nasal responsiveness to cold air in individuals with rhinitis and asthma, compared with rhinitis alone

BACKGROUND: We have previously proposed that, compared with rhinitis alone, the constellation of upper and lower airway allergic disease is a manifestation of a more severe form of a syndrome affecting the entire airway. If this is correct, not only the lower, but also the upper airways of patients with asthma and rhinitis should demonstrate more abnormalities compared with patients with rhinitis alone, including higher sensitivity to irritant factors. Objective To test the hypothesis that, a previously well-studied natural nasal stimulus, cold, dry air (CDA), produces a stronger response in subjects with allergic rhinitis (AR) and asthma compared with subjects with AR alone. METHODS: We performed nasal provocation with CDA on 24 individuals with asthma and rhinitis and 17 with rhinitis alone. Prior to and after the challenge, nasal symptoms were recorded using visual analogue scales and nasal lavages were performed to determine histamine and lysozyme levels. RESULTS: The two groups reacted differently to CDA: after the challenge, patients with rhinitis and asthma reported significantly higher scores for nasal congestion, rhinorrhea and lacrimation. Also in this group, significant increases in histamine and in lysozyme levels in nasal lavage fluids were induced by CDA. In subjects with rhinitis alone, CDA failed to increase histamine or lysozyme levels above baseline. The CDA-induced change from baseline in histamine was significantly higher in the patients with rhinitis and asthma, compared with the rhinitis-only group. CONCLUSION: Patients with AR and asthma have stronger nasal responsiveness to CDA compared with patients with rhinitis alone. This observation is consistent with the notion that compared with rhinitis alone, the presence of asthma and rhinitis signifies a higher degree of functional abnormality of the entire airway.     

肾组织中perlecan的表达及其与蛋白尿的关系

目的 观察基膜蛋白多糖（perlecan）在不同病理改变儿童原发性肾病综合征及阿霉素肾病大鼠的肾组织中表达变化，探讨其参与蛋白尿发生的机制。方法 应用免疫组化法检测阿霉素肾病大鼠在阿霉素注射后第7、14、28天时肾组织perlecan的表达变化，并与24h尿蛋白进行相关分析。在69例不同病理类型原发性肾病综合征和血尿患儿的肾组织，应用免疫组化法检测perlecan表达，并分别与尿蛋白肌酐比值及电镜下平均足突宽度（FPW）进行相关分析。结果 在阿霉素肾病大鼠中随着蛋白尿的加重，perlecan在肾小球内染色强度明显减低，且与24h尿蛋白呈显著负相关（P〈0．01）。Perlecan在正常肾组织中沿肾小球血管襻及肾小管基膜分布。肾小球perlecan的表达在MCD、FSGS中分别较正常对照或TBMN显著减低，而在MN中沿增宽的GBM分布，表达显著升高。在IgA肾病中，肾小球内可见perlecan沿血管襻及系膜区分布，蛋白尿组的肾小球中perlecan表达量较单纯血尿组显著减低（P〈0．05）。MCD肾小球中perlecan免疫组化指数与尿蛋白肌酐比值呈负相关，与FPW无显著相关。结论 Perlecan在肾小球内表达减低与阿霉素肾病大鼠及不同病理类型的儿童原发性肾病综合征的蛋白尿的发生有关。     

伴抑郁症状的精神分裂症临床分析

目的 了解精神分裂症的抑郁症状临床特征。方法 对76例件抑郁症状的精神分裂症,140例不伴抑郁症状的精神分裂症进行临床对照分析。结果 抑郁症状在精神分裂症中颇为普遍,抑郁症状与精神病性症状关系密切,抑郁症状与复发率、住院时间、自杀有关;与性别、年龄、精神疾病总痛程比较,差异均无显著性;加用与不加用抗抑郁剂比较,在治疗起效时间、症状改善时间方面的差异均有非常显著性(P<0.01)。结论 对伴抑郁症状的精神分裂患者治疗上加用抗抑郁剂是缩短疗程的有效途径。     

Cognitive functions and the state of nonspecific brain systems in panic disorders

A total of 93 patients with panic disorders and 36 healthy control subjects were studied. Clinical-neurological, psychometric, neuropsychological, and neurophysiological (auditory cognitive evoked potentials) investigations were performed. Patients with typical panic disorders were characterized by increased levels of anxiety and depression, along with impairments to cognitive functions in the form of decreases in short-term memory and attention, as compared with healthy subjects. Patients with atypical panic disorders differed from patients with typical panic disorders in having lower levels of anxiety, more severe depression, and more marked cognitive disorders. As compared with healthy subjects, patients with atypical panic disorders showed reductions in the amplitude of the P300 evoked potential wave, while patients with typical panic disorders showed increases. It is suggested that changes in the amplitude parameters of the P300 wave are associated with dysfunction of the limbic-reticular structures of the brain in patients with panic disorders.     

Facial expression recognition and emotional regulation in narcolepsy with cataplexy

Cataplexy is pathognomonic of narcolepsy with cataplexy, and defined by a transient loss of muscle tone triggered by strong emotions. Recent researches suggest abnormal amygdala function in narcolepsy with cataplexy. Emotion treatment and emotional regulation strategies are complex functions involving cortical and limbic structures, like the amygdala. As the amygdala has been shown to play a role in facial emotion recognition, we tested the hypothesis that patients with narcolepsy with cataplexy would have impaired recognition of facial emotional expressions compared with patients affected with central hypersomnia without cataplexy and healthy controls. We also aimed to determine whether cataplexy modulates emotional regulation strategies. Emotional intensity, arousal and valence ratings on Ekman faces displaying happiness, surprise, fear, anger, disgust, sadness and neutral expressions of 21 drug‐free patients with narcolepsy with cataplexy were compared with 23 drug‐free sex‐, age‐ and intellectual level‐matched adult patients with hypersomnia without cataplexy and 21 healthy controls. All participants underwent polysomnography recording and multiple sleep latency tests, and completed depression, anxiety and emotional regulation questionnaires. Performance of patients with narcolepsy with cataplexy did not differ from patients with hypersomnia without cataplexy or healthy controls on both intensity rating of each emotion on its prototypical label and mean ratings for valence and arousal. Moreover, patients with narcolepsy with cataplexy did not use different emotional regulation strategies. The level of depressive and anxious symptoms in narcolepsy with cataplexy did not differ from the other groups. Our results demonstrate that narcolepsy with cataplexy accurately perceives and discriminates facial emotions, and regulates emotions normally. The absence of alteration of perceived affective valence remains a major clinical interest in narcolepsy with cataplexy, and it supports the argument for optimal behaviour and social functioning in narcolepsy with cataplexy.     

Comparative study of pituitary and bacteria-derived human growth hormone by monoclonal antibodies

We have established hybridoma lines which secrete mouse monoclonal antibodies (Mabs) to human pituitary growth hormone, hGH. Using indirect competitive ELISA and indirect passive hemagglutination inhibition twelve different Mabs were characterized with regard to cross-reactivity with the hGH-related hormones, human chorionic somatomammotropin, hCS, and human prolactin, hPRL. The reactivity of these Mabs with pituitary hGH was compared to that with either bacterially-produced methionyl-hGH or to that of reduced and S-carboxymethylated hGH, which has an altered conformation. None of the Mabs reacted with hPRL. Four did not react with hCS whereas the others showed varying degree of cross-reactivity with hCS. All Mabs reacted more weakly with reduced and S-carboxymethylated hGH than with the native form of the hormone, which was not seen with conventional rabbit antisera to hGH. Thus in the case of hGH the Mabs are superior to conventional antisera in revealing small conformational differences. However the pituitary and bacterially-derived methionyl-hGH were indistinguishable as determined by the 12 Mabs.     

Immunolocalization of oestrogen and progesterone receptors in prostatic hyperplasia and carcinoma

Oestrogen receptors and progesterone receptors were immunolocalized in 19 patients with benign prostatic hyperplasia and in 26 patients with prostatic carcinoma. Immunohistochemistry was performed on tissue that had been fixed in 8% paraformaldehyde and then paraffin-embedded, using microwave irradiation for antigen retrieval. Oestrogen receptor expression was observed exclusively in the stromal cells of six out of 26 (23%) patients with prostatic carcinoma, but in none of the cells of patients with benign prostatic hyperplasia. Progesterone receptor expression was detected in 16 of 19 (84%) and 17 of 19 (89%) of the epithelial cells and stromal cells of patients with benign prostatic hyperplasia, respectively. In patients with prostatic carcinoma, progesterone receptor immunoreactivity was observed in 12 of 20 (46%) and 20 of 26 (77%) of the carcinoma and stromal cells of prostatic carcinoma, respectively. The ratio of epithelial cells with progesterone receptor immunoreactivity corresponded well with that of stromal cells with immunoreactivity in patients with benign prostatic hyperplasia. However, the ratio of stromal cells with progesterone receptor immunoreactivity was much higher than that in carcinoma cells in patients with prostatic carcinoma. Immunolocalization patterns or the ratio of the cells with progesterone receptor immunoreactivity did not significantly correlate with histological differentiation or patient's age in carcinoma cases. However, patients with advanced surgical stages of disease demonstrated a significantly smaller number of carcinoma and stromal cells with progesterone immunoreactivity in patients with prostatic carcinoma. These results suggest that oestrogens do not have a direct effect on the biological behaviour of benign prostatic hyperplasia and prostatic carcinoma, but that progesterone appears to play a role in the pathogenesis of benign prostatic hyperplasia and prostatic carcinoma.     

Autoimmune thrombocytopenia (AITP) and thyroid autoimmune disease (TAD): overlapping syndromes?

The pathogenesis of thrombocytopenia associated with TAD and the occurrence of overlapping traits between TAD and AITP are still a matter of debate. For this reason, we investigated for the presence and specificity of platelet and thyroid autoantibodies in 18 TAD patients with thrombocytopenia, 19 TAD patients without thrombocytopenia and in 22 patients with primary AITP without clinical signs of TAD. Platelet-associated IgG and/or specific circulating platelet autoantibodies were detected in 83% of patients with TAD and thrombocytopenia, in 10% of patients with TAD without thrombocytopenia and in 86% of patients with primary AITP. The reactivity of serum autoantibodies, assayed by MoAb immobilization of platelet antigens (MAIPA), was directed against platelet glycoproteins Ib and/or IIb/IIIa in 50% of the patients with TAD and thrombocytopenia, as in 46% of the patients with primary AITP. Thyroid autoantibodies were found in 89% of patients with TAD and thrombocytopenia, in 95% of patients with TAD without thrombocytopenia, and in 18% of patients with primary AITP. Thyrotropin (TSH) levels determined in three of four AITP patients with thyroid autoantibodies revealed a subclinical hyperthyroidism in one patient. The present study supports the autoimmune aetiology of thrombocytopenia associated with TAD, since the prevalence and specificity of platelet autoantibodies are similar in TAD and primary AITP. The results indicate also that there exists an overlap between thyroid and platelet autoimmunity with or without clinical manifestations.     

不同纬度的研究生创新能力与创新能力强度、学习动机强度之间的关系

目的:探讨不同纬度的创新能力与创新能力强度、学习动机强度之间的关系。方法:以某军医大学研究生为例,应用Williams创新能力倾向测量表、Eugene创新能力量表和学习动机评定量表进行调查。结果:1创新能力强度不同的研究生在冒险性、好奇性、想象力、挑战性(F=37.762,13.056,4.777,32.657;P=0.01)得分均有统计学差异,创新能力"很强"的研究生冒险性得分和挑战性得分均比其他研究生高、想象力得分高于创新能力"弱"的研究生而与创新能力"一般"、"强"的研究生无显著差别;2学习动机强度不同的研究生在冒险性、好奇性、想象力、挑战性(F=3.091,5.379,8.106,6.099;P=0.05)得分均有统计学差异。学习动机"中等"的研究生冒险性得分高于"较弱"的研究生,挑战性得分高于"较强"的研究生;学习动机"中等"和"较强"的研究生好奇性得分、想象力得分高于学习动机"较弱"的研究生。结论:研究生创新能力的等级强度与冒险性、想象力和挑战性3个维度(属性)基本正相关;学习动机中等的研究生创新能力各维度得分较高。     

Histochemical study of glycoconjugates in active and photoperiodically-regressed testis of hamster (Mesocricetus auratus)

The objective of the present study was to characterize glycoconjugates of hamster testis in gonadally-active and -inactive states by lectin histochemical methods. Thirteen HRP- or digoxigenin-labeled lectins were used in samples obtained from fertile and photoinhibited hamsters. In gonadally-active hamsters, spermatozoa tails were stained with Con-A, HPA, PNA, UEA-I, LTA, AAA, WGA and LFA and weakly with GNA and RCA-I. Spermatozoa acrosomes were labeled with HPA, SBA, WGA and PNA. Spermatid acrosomes were labeled with SBA, RCA-I, PNA, and WGA. Staining with GNA and Con-A was found in the Golgi phase and HPA staining was found in the Golgi phase and maturated spermatids. Cytoplasm of spermatocytes was labeled with Con-A, GNA, LTA, AAA, RCA-I, HPA, WGA and LFA, whereas spermatocyte membranes were stained with Con-A, LTA and AAA. Spermatogonia were strongly labeled with Con-A and moderately labeled with AAA, WGA and LFA. Sertoli cells were positive after staining with Con-A, AAA, WGA, and LFA. The lamina propria was positive after staining with UEA-I, LTA, AAA and LFA. Leydig cells showed strong labeling with SBA, Con-A, GNA, SNA and MAA, moderate labeling with WGA, weak labeling with RCA-I, AAA and LFA. In gonadally-inactive hamsters, spermatocytes showed increased staining with HPA, PNA and AAA, whereas staining with Con-A, GNA and LTA had disappeared. Spermatogonia showed an increased labeling with AAA and WGA, but labeling with Con-A and LFA had disappeared. Sertoli cells were strongly labeled with GNA. Con-A and GNA staining was decreased in Leydig cells of gonadally-inactive hamsters but PNA and HPA staining was increased. The lamina propria in regressed testes showed intense labeling with PNA. These results suggest that histological, morphological and hormonal changes occurring in hamster testis during exposure to a short photoperiod are reflected in altered patterns of expression and distribution of N- and O-linked glycans.     

Histochemical characterization of glycoproteins in the buccal epithelium of the catfish, Rita rita

Glycoproteins (GPs) elaborated by the buccal epithelium of the catfish, Rita rita, were analysed by a range of histochemical methods. These included methods for the characterization and simultaneous visualization of GPs with oxidizable vicinal diols, with O-acyl sugars, with O-sulphate esters and with sialic acid residues with and without O-acyl substitution at C7, C8 or C9. GPs elaborated at the surface of the buccal epithelium are primarily from two sources, the epithelial cells and the mucous goblet cells. They include GPs with O-sulphate esters, GPs with sialic acid residues without O-acyl substitution and GPs with oxidizable vicinal diols. Different classes of GPs have been associated with specific functions and are discussed in relation to their physiological significance, with special reference to their roles in lubrication, alteration in viscosity, trapping of food particles, buffering of fluids at the epithelial surface, prevention of proteoloytic damage to the epithelium, antimicrobial activity and defence against pathogens. The epithelium shows specialized modifications in the form of the buccal glands. These have been considered to increase the secretory surface that allows profuse secretion of mucus in a very short period of time. The secretions of these glands have been associated with multiple functions similar to those of saliva.     

Autoantibodies to Neurons and to the Cytoskeleton in Small Cell Carcinoma with Paraneoplastic Sensory Neuropathy

Autoantibodies to neurons and to the cytoskeleton were demonstrated in the serum of a patient with small cell carcinoma of the lung (SCCL) and paraneoplastic sensory neuropathy. The serum reacted by immunofluorescence with the nuclei of neurons, and with cytochalasin B-sensitive “stress fibres” of cultured cells. The serum also reacted by immunofluorescence with the nuclei of some cultured cell lines. Immunoblotting experiments with brain tissue, with SCCL, HeLa and other cultured cells showed that the serum reacted with 1–4 bands of 35–39 kDa apparent m.w. Two dimensional immunoblotting showed that these molecules had a neutral pI. Antibodies, affinity-purified by elution from the 35–39 kDa bands, gave staining of the nuclei of neurons and of cultured cells and immunoblotted the same 35–39 kDa antigens. These observations show that the anti-neuronal autoantibody reacts not only with neurons and with SCCL but also with some cultured cell lines. Molecular mimicry has been invoked as the basis for the reactivity of this autoantibody with exposed epitopes on SCCL and on neurons.     

Increased Prevalence of Anti-Third Generation Cyclic Citrullinated Peptide Antibodies in Patients With Rheumatoid Arthritis and CREST Syndrome

To investigate the prevalence of anti-third generation cyclic citrullinated peptide antibodies (anti-CCP3) in patients with systemic connective tissue diseases, we assembled a training set consisting of 115 patients with rheumatoid arthritis (RA), 52 with Calcinosis, Raynaud’s phenomenon, oesophageal dysmotility, sclerodactyly, telangiectasia (CREST) syndrome, 21 with scleroderma, 20 with ankylosing spondylitis, 18 with reactive arthritis, 25 with juvenile rheumatoid arthritis (RA), 51 with osteoarthritis, 26 with mixed connective tissue disease, 23 with primary Sjogren’s syndrome, 74 with systemic lupus erythematosus, 49 with Polymyaglia rheumatica, and 39 with polymyositis/dermatomyositis. The commercial enzyme-linked immunosorbent assay (ELISA) was used to detect anti-CCP antibodies, including anti-CCP2 (regular, second generation of CCP antigen) and anti-CCP3 (third generation of CCP antigen) in disease-related specimens and normal controls. These serum samples were also evaluated for anti-centomere antibodies by anti-centromere ELISA kit. The higher frequencies of anti-CCP3 and anti-CCP2 were detected in 75.6 and 70.4% patients with RA, respectively. At the same time, anti-CCP3 (not anti-CCP2) was significantly increased in samples isolated from patients with CREST syndrome. The clinical sensitivity of IgG anti-CCP3 for the patients with CREST syndrome was 29% (15 of 52) and the specificity was 96% (384 of 397), with the exception of the RA group. The anti-centromere antibodies were significantly higher in patients with CREST only. The results of our study suggest that compared to anti-CCP2 assay, the new anti-CCP3 assay can enhance the clinical sensitivity for diagnosis of RA and, as an associate marker combined with anti-centromoere, can distinguish CREST syndrome from other systemic connective tissue diseases, especially RA. The clinical specificity of anti-CCP3 was lower than anti-CCP2 assay in diagnosis of RA because of the crossreaction to the patients with CREST syndrome.     

Human immune response to cytomegalovirus structural polypeptides studied by immunoblotting

To define better the human immune response to individual structural proteins of human cytomegalovirus (HCMV), 55 human sera with different IgG and IgM titres were studied for their reactivity with HCMV structural polypeptides separated by SDS-PAGE and electrotransferred to nitrocellulose paper. The results obtained showed that antibody titres detected by immunoassay correlate with the intensity and the number of polypeptides reacting by immunoblotting (IB). The IB profiles of HCMV polypeptides reacting with different sera having the same antibody titres show considerable variation. Sera with high levels of IgG antibody and that are IgM-positive frequently react with 155, 149, 82.5, 74.5, 67, 57, 55, 38.5, and 28 kD polypeptides; all these sera react with 155, 67, 57, 55, 38.5 kD polypeptides. Sera with high levels of IgG antibody but that are IgM negative frequently react with all these polypeptides, with the exception of 149 and 74.5. Only 155 and 28 kD polypeptides were recognized by all sera of this group. The sera with moderate levels of IgG antibody preferentially recognize 155, 110, 82.5, 62, 55, 38.5 and 28 kD polypeptides. The sera with low levels of antibody reacted especially with 155 and 62 kD polypeptides. IgM antibody seems to recognize preferentially 155, 110, 67, 57, 55, 38.5 kD polypeptides.     

癫(癎)患者抗癫(癎)治疗时脑电图和发作诱因与再发关系

目的:探讨癫癎患者在药物治疗中脑电图、发作诱因与再发的关系,企为临床治疗提供参考指标。方法:分别对97例青少年癫癎患者行脑电图检查并追踪再发情况,比较脑电图、发作诱因与临床再发之间的关系。结果:97例患者中有49例脑电图正常,其中9例(18％)有癫癎再发,48例脑电图异常,其中38例(79％)有癫癎再发。此38例癫癎再发分别属于Ⅰ、Ⅱ、Ⅲ型异常脑电图,相应各有8、11、19例再发。脑电图正常而出现癫癎再发的9例中,有诱因者8例(89％),无诱因者1例(11％),脑电图异常而出现癫癎再发的38例中,有诱因者20例(53％),无诱因者18例(47％)。结论:青少年癫癎患者抗癫癎治疗时的脑电图表现与临床再发有相关性,其中有癎样放电者出现再发可能性最大。脑电图正常时出现再发常有诱因,而脑电图异常时出现再发常缺乏诱因。     

锁孔和锁钉杆过渡配合交锁髓内钉内固定骨折断端的生物稳定性

背景：随着交锁髓内钉的广泛使用,使骨折延迟愈合、交锁钉断裂等问题逐渐显露出来,在此情况下,一种锁孔和锁钉杆过渡配合交锁髓内钉应运而生。 目的：观察新设计的锁孔和锁钉杆直径过渡配合交锁髓内钉和传统交锁髓内钉固定骨折稳定性的比较。 方法：应用8具两侧股骨骨折标本,分别采用8根锁孔和锁钉杆直径过渡配合交锁髓内钉和传统交锁髓内钉固定骨折断端。实验组应用定制髓内钉远端瞄准微调装置配套安装器械锁钉,使用定制的直径   4.3 mm锁钉交锁固定;对照组应用常规的配套安装器械,常规的直径4.0 mm锁钉交锁固定,给予两组股骨固定标本,分别记录测量两组股骨骨折断端左右、前后、旋转移位情况,来进行骨折固定稳定性比较。 结果与结论：锁钉杆过渡配合髓内钉固定股骨中下段骨折,在10 N受力的情况下,股骨骨折断端平均有左右移位1.22 mm、前后移位1.2 mm、旋转移位0.33 mm;传统交锁髓内钉锁孔在10 N受力的情况下,股骨骨折断端平均有左右移位3.26 mm、前后移位3.37 mm、旋转移位2.15 mm,锁钉杆过渡配合髓内钉固定股骨骨折,骨折断端左右、前后、旋转移位明显小于传统交锁髓内钉,有显著性差异。说明锁孔和锁钉杆直径过渡配合交锁髓内钉置入内固定可明显提高骨折断端的稳定性。     

房颤伴室性早博与房颤伴差异性传导的量化鉴别方法研究

对于房颤伴室性早博与房颤伴差异性传导的临床诊断,目前还没有公认的标准,二者的准确鉴别一直是困扰医生的难题。本研究提出一种准确性高的计算方法,用于鉴别上述两类疾病。通过分析房颤伴室性早博与房颤伴差异性传导的临床特征,确定类代偿间期与联律间期的比值为鉴别特征参数。对待检测ECG信号作预处理,然后准确定位待检测ECG的每一个心动周期内QRS T特征波;在此基础上,识别宽大畸形QRS 波群,提取对应于类代偿间期与联律间期的两个相邻R R间期,计算它们的比值,将其与一个给定的鉴别阈值进行比较后作出判别。 算法验证数据来自MIT BIH心律失常数据库,10个记录中,含4 026心拍房颤伴室性早搏和949心拍房颤伴差异性传导,共计4 975心拍。 所提出方法在房颤伴室性早博与房颤伴差异性传导的混合数据中,鉴别房颤伴室性早搏的灵敏度和阳性预测率分别达到了9315%和9830%,优于传统方法。类代偿间期与联律间期的比值可以代替目前常用的类代偿间期,作为鉴别房颤伴室性早博与房颤伴差异性传导的特征参数,对提高诊断正确性具有指导作用。