初中生成就动机与自尊的相关研究

目的 探讨初中生成就动机和自尊之间的关系.方法 采用自尊量表和成就动机量表对莱初中的学生进行测查.结果 初中生的自尊和成就动机不存在性别差异;渴望成功和避免失败动机的差异非常显著,自尊是影响初中生成就动机的重要因素.结论 初中生的自尊和成就动机存在明显关联.     

脐形态学调查及其意义

目的：为临床脐整形美容术提供形态学依据。方法：随机观测男女性脐形态557例，男性269例，女性288例。对脐外形结构进行观察和统计。结果：脐外形男性以圆形、卵圆形居多，分别为42．4％和30．9％；女性卵圆形者、纵形者居多，分别为32．6％和31．9％；脐檐男性有者占54．3％，女性占23．6％；脐窝突起数1个或以上者男性占68．8％，女性占48．3％。结论：脐形态各型分布存在性别差异，有临床参考意义。     

64排螺旋CT冠脉成像效果与影响因素研究

目的 探讨64排螺旋CT冠脉成像中影响图像质量的各种因素及其影响程度以及评估冠脉狭窄的效果.方法 通过838例临床疑似冠心病患者的6_4排螺旋CT冠脉成像,并以其中218例在1周内进行的常规冠状动脉造影为标准,分析64排螺旋CT冠脉成像在评估冠脉狭窄的灵敏度、准确率、阳性预测值和阴性预测值.结果 心率、心率变化幅度、延迟时间设定、β受体阻滞剂、呼吸频率、屏气合作与否、造影剂注射总量与速度、图像重建时相、冠状动脉钙化、扫描参数、患者年龄性别、机器软硬件性能等是影响64排螺旋CT成像质量的因素.64排螺旋CT冠脉成像评估冠脉狭窄的准确率为95.9%,阳性与阴性预测值分别为92.3%、90.0%.结论 得到了影响64排螺旋CT冠脉成像的各种因素,分析了减少和消除这些因素影响的方法.在评估冠脉狭窄方面,64排螺旋CT冠脉成像基本能满足临床要求. Abstract： Objective To study the various factors that influence image quality of 64-slice spiral CT coronary artery imaging, their impact extent and the assessment effect of coronary artery stonnsis. Methods Through examination of 838 clinical coronary heart disease suspect patients, by 64-slice spiral CT coronary artery imaging, in which, 218 patients were also examined by conventional coronary angiagraphy in a week, we took the conventional coronary angiography as the standard, analyzed the 64-slice spiral CT coronary artery imaging in the assessment of coronary artery stenosis by sensitivity, accuracy, positive predictive value and negative predictive value. Results The factors which affect the image quality of 64-slice spiral CT coronary artery imaging include heart rate, heart rate change range, delay time setting, β-blocker, respiratory rate, breath-holding or not, total amount of contrast medium and the speed of injection, image reconstruction phase, coronary artery calcification, the scan parameters, age and sex of patients, machine     

家庭环境对高中生焦虑影响的访谈研究

目的 探讨家庭环境对高中生焦虑的影响.方法 随机抽取河北省定州中学108名高中学生进行焦虑访谈调查.结果 回到家心里感到踏实和安逸的占64.8%;家庭成员能使其缓解和放松的占59.3%;在家里比学校更快乐的占16.7%;认为有幸福快乐的家的占77.8%;满足现在的家庭环境的占57.4%;家庭环境影响其焦虑的占22.2%;经常跟父母谈自己想法和所做事情的占33.3%;心里话常跟父母说的占27.8%.结论 家庭环境在一定程度上影响高中生的焦虑水平,建议家长多了解孩子的焦虑情况并及时采取适当的措施.     

高中生完美主义研究

目的 研究高中生完美主义的现状.方法 采用自编青少年完美主义问卷对650名高中生进行调查.结果 ①高中生在完美主义的条理性和自省维度上存在显著的年级差异(t=2.56,P＜0.01).②在担心错误和条理性上有显著性别差异(t=2.15,P＜0.05;t=-3.08,P＜0.01).③高中生的完美主义可以聚类为健康型、障碍型和非完美型.结论 高中生的完美主义状况总体上较好.     

暴力犯罪者人格障碍研究

目的：研究暴力犯罪者的人格障碍。方法：随机抽取在重庆市女子监狱服刑的女性暴力罪犯204名，在重庆市监狱服刑的男性暴力罪犯294名，用人格诊断问卷（PDQ-R）、艾森克个性问卷（EPQ）进行测查。结果：男性在反社会型因子上得分高于女性（2±4／0±0，P=0．008）；女性在偏执型、分裂样、回避型因子上得分均高于男性（4±2／3±2、3±2／2±2、3±3／3±2，P=0．044、0．041、0．047）。结论：暴力犯罪者存在不同类型、不同程度的人格障碍。     

包头市综合医院医务人员人格特质调查

目的 比较分析包头市综合医院不同性别、民族、宗教信仰、婚姻状况、医院级别、岗位、科室的医护人员人格特质的差异.方法 在包头市21家二级以上综合医院中随机抽取出5家,对其中的1791名医护人员进行EPQ调查.结果 医生组N(情绪稳定性)因子分值低于护士组,已婚组E(外向-内向)因子分值低于未婚组,内系组(非手术科室)P和E分值均低于外系组(手术科室)(P＜0.05).不同性别、民族、宗教信仰、医院级别的医护人员人格特质未见明显差异(P＞0.05).结论 不同组群医务人员的人格特质存在不同程度的差异.     

护士长懈怠执行力的原因分析

目的 探讨护士长懈怠执行力的原因,是为了提高护理管理质量,为病人提供更加优质的护理服务.方法 采用问答式访谈法收集资料,通过举办培训班和年会的方法对三所二级甲等医院的护士长进行访谈.对访谈资料采用阅读、分析、分类、提炼、总结、归纳等6个步骤剖析护士长懈怠执行力的原因.结果 护士长懈怠执行力的原因包括6个方面即护士缺编.家庭支持塌陷的影响.工作环境关系紧张,缺乏激励机制,护理部对护士长的考核不逗硬.来自社会方面的压力.结论 高度关注护士长懈怠执行力的这一现象.为护士长切实解决工作中遇到的实际问题,从而挖掘和开发护士长的工作潜能,使她们在相应的工作岗位上发挥更好的护理管理作用,稳定护理管理队伍.     

自考生完美主义研究

目的 探讨自考生完美主义的现状.方法 采用自编完美主义问卷(SCPS)对742名自考生进行了调查.结果 ①自考生的完美主义可以聚类为健康型(40%)、障碍型(48%)和非完美型(12%).②自考生完美主义存在显著的文理科差异.结论 自考生的完美主义状况整体上偏低.     

Therapeutic gene editing strategies using CRISPR-Cas9 for theβ-hemoglobinopathies

With advancements in gene editing technologies,our ability to make precise and efficient modifications to the genome is increasing at a remarkable rate,paving the way for scientists and clinicians to uniquely treat a multitude of previously irremediable diseases.CRISPR-Cas9,short for clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9,is a gene editing platform with the ability to alter the nucleotide sequence of the genome in living cells.This technology is increasing the number and pace at which new gene editing treatments for genetic disorders are moving toward the clinic.Theβ-hemoglobinopathies are a group of monogenic diseases,which despite their high prevalence and chronic debilitating nature,continue to have few therapeutic options available.In this review,we will discuss our existing comprehension of the genetics and current state of treatment forβ-hemoglobinopathies,consider potential genome editing therapeutic strategies,and provide an overview of the current state of clinical trials using CRISPR-Cas9 gene editing.     

骨细胞凋亡在酒精性股骨头缺血性坏死中的作用

文章快速阅读：  文题释义：细胞凋亡：为维持细胞内环境稳定,由基因控制的细胞自主的有序的死亡。细胞凋亡与细胞坏死不同,细胞凋亡指细胞在一定生理或病理条件下遵循着自身的规律结束其生命的过程,不是一件被动的过程,而是主动过程,涉及一系列基因的激活、表达以及调控等的作用,不是在病理条件下自体损伤的一种现象,而是为更好地适应生存环境而主动争取的一种死亡过程。股骨头坏死及酒精性股骨头坏死：股骨头坏死又称股骨头无菌性坏死,或股骨头缺血性坏死,是由于多种原因导致的股骨头局部血运不良,从而引起骨细胞进一步缺血、坏死、骨小梁断裂、股骨头塌陷的一种病变。酒精性股骨头坏死就是因为大量酗酒而引起的一种股骨头坏死,是脂类代谢异常导致的结果。 背景：目前对酒精性股骨头缺血坏死仍缺乏行之有效的保髋疗法,病变晚期股骨头塌陷影响髋关节功能的患者只能选择人工髋关节置换。明确酒精性股骨头缺血坏死的发病机制,对股骨头缺血坏死保髋治疗有重要意义。 目的：综述近年来国内外有关骨细胞凋亡学说在酒精性股骨头缺血坏死发病机制中的研究进展,为探究酒精性股骨头缺血坏死的治疗方法提供理论依据。 方法：由第一作者应用计算机检索PubMed数据库及Embase数据库,在标题和全文中以“Osteonecrosis of Femoral Head and apoptosis”或“bone cell,apoptosis,gene,signal”或“osteonecrosis,alcohol”为检索词,纳入与骨细胞凋亡在酒精诱导股骨头缺血坏死发病机制中作用相关的研究文章。排除重复及较陈旧的文献。共40篇外文文献符合标准。 结果与结论：近年来,酒精性股骨头缺血坏死的发病机制学说中的骨细胞凋亡学说得到越来越多人的认同,逐步成为人们研究酒精性股骨头缺血坏死发病机制的焦点。骨细胞凋亡在酒精性股骨头缺血坏死的发病机制中发挥着重要的作用。p53、B细胞淋巴瘤家族、肿瘤坏死因子、半胱氨酸天冬氨酸蛋白水解酶等多种与骨细胞凋亡相关的基因是调控骨细胞凋亡的关键。但由于酒精性股骨头缺血坏死发病机制的复杂性,目前人们对酒精诱导骨细胞凋亡导致的股骨头缺血坏死在基因水平上的研究虽然取得了一定的进展但仍相对缺乏。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程 ORCID:0000-0001-5838-5618(黎金焕)     

Clinical Results of Auto-Iliac Cancellous Bone Grafts Combined with Implantation of Autologous Bone Marrow Cells for Osteonecrosis of the Femoral Head: A Minimum 5-Year Follow-Up

Purpose

There are no reports about bone graft and cell therapy for the osteonecrosis of femoral head (ONFH). We prospectively evaluated the clinical results of auto-iliac cancellous bone grafts combined with implantation of autologous bone marrow cells for ONFH.

Materials and Methods

Sixty-one hips in 52 patients with ONFH treated with bone graft and cell therapy were enrolled, and the average follow-up of the patients was 68 (60-88) months. Necrotic lesions were classified according to their size by the Steinberg method and location of necrosis.

Results

At the last follow-up, the percentage of excellent or good results was 80% (12/15 hips) in the small lesion group, 65% (17/26 hips) in the medium size group, and 28% (6/20 hips) in the large size group. The procedures were a clinical success in 4 of 5 hips (80%) of stage I, 23 of 35 hips (65.7%) of stage II, 7 of 18 hips (38.9%) of stage III, and 1 of 3 hips (33.3%) of stage IV grade, according to the Association Research Circulation Osseous grading system. Among the 20 cases with large sized necrotic lesions, 17 cases were laterally located and this group showed the worst outcomes, with 13 hips (76.5%) having bad or failed clinical results.

Conclusion

The results of the present study suggested that patients who have a large sized lesion or medium sized laterally located lesion would not be good candidates for the head preserving procedure. However, for medium sized lesions, this procedure generated clinical results comparable to those of other head preserving procedures.     

How barn owls (Tyto alba) visually follow moving voles (Microtus socialis) before attacking them

The present study focused on the movements that owls perform before they swoop down on their prey. The working hypothesis was that owl head movements reflect the capacity to efficiently follow visually and auditory a moving prey. To test this hypothesis, five tame barn owls (Tyto alba) were each exposed 10 times to a live vole in a laboratory setting that enabled us to simultaneously record the behavior of both owl and vole. Bi-dimensional analysis of the horizontal and vertical projections of movements revealed that owl head movements increased in amplitude parallel to the vole's direction of movement (sideways or away from/toward the owl). However, the owls also performed relatively large repetitive horizontal head movements when the voles were progressing in any direction, suggesting that these movements were critical for the owl to accurately locate the prey, independent of prey behavior. From the pattern of head movements we conclude that owls orient toward the prospective clash point, and then return to the target itself (the vole) — a pattern that fits an interception rather than a tracking mode of following a moving target. The large horizontal component of head movement in following live prey may indicate that barn owls either have a horizontally narrow fovea or that these movements serve in forming a motion parallax along with preserving image acuity on a horizontally wide fovea.     

The use of osteochondral allograft with bone marrow-derived mesenchymal cells and hinge joint distraction in the treatment of post-collapse stage of osteonecrosis of the femoral head

Osteonecrosis of the femoral head is an entity which occurs mainly in young and active patients aged between 20 and 50. The success of hip joint preserving treatments ranges from 15% to 50% depending on the stage and amount of osteonecrotic lesion. Total hip replacement is indicated in late post-collapse hips but it has unsatisfactory survival because of the wear and osteolysis in young and active patients. Osteochondral allografts have been reported in the treatment of large articular lesions with defects in underlying bone in knee, talus and shoulder. By combining osteoconductive properties of osteochondral allograft with osteogenic abilities of bone marrow-derived mesenchymal cells it has a potential to be an alternative to an autologous graft. The adjunct of hinged joint distraction should minimize stresses in subchondral bone to promote creeping substitution and prevent femoral head collapse. Unlike current treatment modalities, it would provide both structural support and allow bony and articular substitution.     

Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: Report of a case with osteochondroid differentiation

We report a case of an undifferentiated pancreatic carcinoma with osteoclast-like giant cells with focal osteochondroid differentiation in a 66-year-old man, who presented with painless jaundice, pruritis, and weight loss. Imaging studies revealed an inhomogeneous mass in the head of the pancreas. A pylorus preserving pancreaticoduodenectomy was performed. The resection specimen revealed a 9.5×4.2×3.2 cm³ solid neoplasm in the pancreatic head with direct extension into duodenum and common bile duct. Microscopy showed a cellular neoplasm composed of pleomorphic mononuclear cells (pancytokeratin, and EMA-positive; LCA, and CD68 negative) and osteoclast-like multinucleated giant cells (vimentin, LCA, and CD68-positive; pancytokeratin, and EMA-negative) consistent with OGTP. The tumor contained a focal area of osteochondroid differentiation. Evidence supports that the tumor giant cells are non-neoplastic and of histiocytic origin. Osteochondroid differentiation within undifferentiated carcinoma is unusual; its presence might suggest a sarcoma diagnosis on biopsy material.     

Real-time 3D-surface-guided head refixation useful for fractionated stereotactic radiotherapy

Accurate and precise head refixation in fractionated stereotactic radiotherapy has been achieved through alignment of real-time 3D-surface images with a reference surface image. The reference surface image is either a 3D optical surface image taken at simulation with the desired treatment position, or a CT/MRI-surface rendering in the treatment plan with corrections for patient motion during CT/MRI scans and partial volume effects. The real-time 3D surface images are rapidly captured by using a 3D video camera mounted on the ceiling of the treatment vault. Any facial expression such as mouth opening that affects surface shape and location can be avoided using a new facial monitoring technique. The image artifacts on the real-time surface can generally be removed by setting a threshold of jumps at the neighboring points while preserving detailed features of the surface of interest. Such a real-time surface image, registered in the treatment machine coordinate system, provides a reliable representation of the patient head position during the treatment. A fast automatic alignment between the real-time surface and the reference surface using a modified iterative-closest-point method leads to an efficient and robust surface-guided target refixation. Experimental and clinical results demonstrate the excellent efficacy of <2 min set-up time, the desired accuracy and precision of <1 mm in isocenter shifts, and <1 degree in rotation.     

髋关节表面置换改良杯的生物力学评价

髋关节表面置换术远期的松动率比全髋关节置换术高,且头杯的松动率较臼杯为高。但髋关节表面置换术具备一些全髋关节假体置换术所没有的优点,如:能保留健康的股骨颈,且尚有全髋关节假体置换术的余地。我们设计了新型的三翼头杯和杆栓杯,简称TC和BC。其中心杆使头杯与残存股骨颈一体化,使假体与残存骨质成为完整受力体系,均匀分散杯下应力。实验采用压力应变值和最大破坏扭矩来评价新头杯与传统头杯的力学稳定性。结果显示,TC综合力学性能最佳,有希望为临床提供一个较理想的头杯。     

Can local Erythropoietin administration enhance bone regeneration in osteonecrosis of femoral head?

Osteonecrosis of femoral head (ONFH) is a challenging disease. Regardless of underlying causes, the ultimate result in all cases is disruption of femoral head blood supply. Once the disease starts, it is progressive in 80% of cases. Since the majority of the affected individuals are young, every effort should be focused on preserving the patients own femoral head. These years, the role of angiogenic growth factors has been investigated with promising results in animal models of ONFH. Erythropoietin (EPO) is a well known hormone that has been used in treatment of chronic anemia for many years with few side effects. Considering the angiogenic properties of EPO, we hypothesize that local delivery of recombinant human EPO during core decompression will enhance bone regeneration in ONFH. In this way we also can avoid systemic side effects of EPO.     

富血小板血浆对股骨头坏死保髋术后凝血相关血液指标的影响

文题释义： 富血小板血浆：为自体血离心后分离所得的较高浓度血小板血浆，内含多种生长因子包括表皮生长因子、血管内皮生长因子、血小板衍生因子等。研究表明其具有促进股骨头坏死的骨形成和微血管形成的作用，是股骨头坏死的一种新型治疗方式。 保髋治疗：保髋是股骨头坏死以保全患者自身股骨头为原则的治疗方法，分为非手术保髋和手术保髋。非手术保髋主要包括保护性负重、药物治疗、中医特色治疗、物理治疗；手术保髋包括髋关节镜、外科脱位、髋臼周围截骨以及打压植骨支撑、富血小板血浆治疗等。 背景：研究发现富血小板血浆注射可改变股骨头坏死患者的凝血功能。 目的：探讨富血小板血浆注射疗法对股骨头坏死患者保髋术后凝血指标的影响，评估术后发生血管栓塞性疾病的危险因素。 方法：选择广州中医药大学第一附属医院2016年12月至2018年9月收治，采用股骨头钻孔减压、清除股骨头内死骨联合同种异体腓骨移植支撑治疗的股骨头坏死患者75例，按术中是否使用富血小板血浆注射治疗分为2组，其中富血小板血浆组42例(42髋)，对照组33例(35髋)不使用富血小板血浆，2组其余治疗方法一致。连续观察2组患者术前及术后凝血4项等血液学指标的变化。 结果与结论：①2组患者均连续随访3个月；②2组患者纤维蛋白酶原、D-二聚体水平均明显升高，但富血小板血浆组患者术后1周内纤维蛋白酶原、D-二聚体水平较对照组提升52.5%及47.0%，提示富血小板血浆可能导致术后高凝状态，血管栓塞风险可能较大；③2组凝血酶原时间、活化部分凝血活酶时间、国际标准化比值在数值上有明显差异，但无明显临床意义；④使用富血小板血浆对患者体内血小板水平基本无影响，对C-反应蛋白的变化亦无明显影响。 ORCID: 0000-0003-3043-7775(罗智鸿) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程     

胰头与十二指肠的血供关系及其临床意义

目的　了解胰头及十二指肠的血管走行,为在DPPHR术中如何保护十二指肠的血供及是否行Kocher操作提供更多的形态学资料。 方法　随机选取40具尸体,充分解剖暴露肠系膜上动脉、胃十二指肠动脉及胰十二指肠前后动脉弓,对供应十二指肠的动脉及伴行的静脉行径进行仔细观察和记录。 结果　在97.5%的标本中（n=39）, 胰十二指肠后动脉弓及伴行的静脉均位于胰后筋膜内;在90%的标本中（n=36）, 胰十二指肠下前动脉及伴行的静脉走行于胰十二指肠沟内,易于保留;在个别标本中（10%, n=4）, 没有完整的胰十二指肠前动脉弓;其中1例标本（2.5%,n=1）,没有完整的胰十二指肠后动脉弓,但供应十二指肠的动脉及其伴行静脉仍位于胰后筋膜内。 结论　DPPHR手术的关键在于保留胰十二指肠后动脉弓,同时尽可能地保留部分胰十二指肠前动脉弓,而Kocher操作有利于保护胰十二指肠后动脉弓;在个别标本中,没有完整的胰十二指肠前动脉弓,此时施行DPPHR可能伤及十二指肠血供,导致手术失败。