髂前下棘的解剖及其在骨盆骨折外固定中的应用

目的:对髂前下棘进行应用解剖学研究,为骨盆外固定钉直径的选择和微创置钉技术提供参考依据.方法:对22例44侧骨盆的髂前下棘进行观察测量,获取髂前下棘横、矢径,以及体表投影等数据,按性别分组进行统计学处理.所得数据应用于26例骨盆骨折外同定手术.结果:男性髂前下棘横、矢径分别为(12.23±1.91)mm和(20.09±2.43)mm;女性分别为(11.05±1.56)mm和(19.25±1.85)mm.男性髂前下棘在髂前上棘下方(29.49±7.66)mm,内侧(21.79±6.48)mm;在耻骨结节上方(51.70±9.31)mm,外侧(67.74±5.36)mm.女性髂前下棘在髂前上棘下方(23.74±8.89)mm,内侧(16.86±8.92)mm;在耻骨结节上方(43.93±9.04)mm,外侧(70.16±6.39)mm.依据本研究数据对26例骨盆骨折髋臼上方行外固定手术.有效的减少术中放射学暴露和手术时间.结论:根据解剖学测量数据进行固定钉选择和术中定位,使得髋臼上置钉外固定支架可迅速准确实施,适应骨盆骨折急诊处理的需要.     

Cell-free fetal DNA and intact fetal cells in maternal blood circulation: implications for first and second trimester non-invasive prenatal diagnosis

Both intact fetal cells as well as cell-free fetal DNA are present in the maternal circulation and can be recovered for non-invasive prenatal genetic diagnosis. Although methods for enrichment and isolation of rare intact fetal cells have been challenging, diagnosis of fetal chromosomal aneuploidy including trisomy 21 in first- and second-trimester pregnancies has been achieved with a 50-75% detection rate. Similarly, cell-free fetal DNA can be reliably recovered from maternal plasma and assessed by quantitative PCR to detect fetal trisomy 21 and paternally derived single gene mutations. Real-time PCR assays are robust in detecting low-level fetal DNA concentrations, with sensitivity of approximately 95-100% and specificity near 100%. Comparing intact fetal cell versus cell-free fetal DNA methods for non-invasive prenatal screening for fetal chromosomal aneuploidy reveals that the latter is at least four times more sensitive. These preliminary results do not support a relationship between frequency of intact fetal cells and concentration of cell-free fetal DNA. The above results imply that the concentration of fetal DNA in maternal plasma may not be dependent on circulating intact fetal cells but rather be a product of growth and cellular turnover during embryonic or fetal development.     

精子形成过程中内质网的形态研究——超薄切片和冷冻蚀刻复型膜的电镜观察

本文报道了对超薄切片和冷冻蚀刻技术制备的小白鼠、大白鼠睾丸精小管样品的观察结果。在透射电镜下高尔基期精子细胞内质网较少;头帽期精子细胞内质网增多,有泡状、管状,并互相吻合形成交错的网络;高尔基期和头帽期精子细胞的内质网包裹高尔基复合体,与头帽的形成有关。顶体期精子细胞内质网最丰富,参与精子尾部轴丝、密纤维的形成。此期还可见到环形片层——放射体结构;成熟期精子细胞内质网退化、消失。由此可见内质网的变化与精子顶体、轴丝和密纤维的形成有密切关系。     

骨髓神经组织定向干细胞的分离培养鉴定

目的:为临床中枢神经系统疾患的细胞移植及组织工程修复周围神经提供一种应用广泛、可来源于自体、无免疫排斥和伦理道德等问题的移植用种子细胞。方法:采用DMEM/F12(1∶1)无血清神经干细胞培养液,通过先贴壁、后悬浮的方法从大鼠骨髓中分离、培养单克隆生长的神经组织定向干细胞(neural tissue-committed stem cells,NTC-SCs),通过免疫细胞化学检测NTCSCs细胞球CXCR4和Nestin蛋白,以及细胞球自然分化后神经元β-TublinⅢ、MAP2ab以及神经胶质细胞CNPase、GFAP等蛋白的表达。结果:NTCSCs细胞球表达神经干细胞标志蛋白Nestin和组织定向干细胞标志蛋白CXCR4;NTCSCs细胞球在含15%胎牛血清的DMEM培养液中可自然分化,免疫荧光显示神经元和神经胶质蛋白β-TublinⅢ、MAP2ab、CNPase、GFAP等标志物阳性。结论:本研究提供了一种操作简便、成本低廉的NTCSCs的分离培养方法,NTCSCs作为种子细胞为脑、脊髓等神经系统疾患和创伤的修复和治疗提供了广阔的应用前景。     

北京市三所高校大学生SARS流行期的心理状态现况调查

目的 :了解SARS流行时期大学生在封闭式管理下的心理状况。方法 :采用症状自评量表、ZUNG氏焦虑自评量表、ZUNG氏抑郁自评量表和一般状况调查表 ,以分层整群抽样的方法 ,对北京市三所重点大学 62 80名在校本科大学生和研究生进行了心理状况自评问卷调查。结果 :症状自评量表的因子阳性检出率为 7 3 % ,各因子得分均明显低于既往北京市大学生调查结果 ;除恐怖因子和精神病性因子外 ,各因子得分均低于或接近国内常模 (t=2 17-5 3 65 ,P <0 0 5 )。焦虑症状阳性检出率为 9 5 % ,抑郁症状阳性检出率为 2 9 6%。结论 :北京市SARS流行期间大学生存在焦虑、抑郁症状 ;采取了有效的传染病防治和健康教育等措施后大学生群体的心理健康状况良好。     

Association of obesity with illness severity in hospitalized patients with COVID-19: A retrospective cohort study

BackgroundAlthough recent studies have shown an association between obesity and adverse coronavirus disease 2019 (COVID-19) patient outcomes, there is a paucity in large studies focusing on hospitalized patients. We aimed to analyze outcomes associated with obesity in a large cohort of hospitalized COVID-19 patients.MethodsWe performed a retrospective study at a tertiary care health system of adult patients with COVID-19 who were admitted between March 1 and April 30, 2020. Patients were stratified by body mass index (BMI) into obese (BMI ≥ 30 kg/m 2) and non-obese (BMI < 30 kg/m 2) cohorts. Primary outcomes were mortality, intensive care unit (ICU) admission, intubation, and 30-day readmission.ResultsA total of 1983 patients were included of whom 1031 (51.9%) had obesity and 952 (48.9%) did not have obesity. Patients with obesity were younger (P < 0.001), more likely to be female (P < 0.001) and African American (P < 0.001) compared to patients without obesity. Multivariable logistic models adjusting for differences in age, sex, race, medical comorbidities, and treatment modalities revealed no difference in 60-day mortality and 30-day readmission between obese and non-obese groups. In these models, patients with obesity had increased odds of ICU admission (adjusted OR, 1.37; 95% CI, 1.07?1.76; P = 0.012) and intubation (adjusted OR, 1.37; 95% CI, 1.04?1.80; P = 0.026).ConclusionsObesity in patients with COVID-19 is independently associated with increased risk for ICU admission and intubation. Recognizing that obesity impacts morbidity in this manner is crucial for appropriate management of COVID-19 patients.     

Adherence to COVID-19 Nutrition Guidelines Is Associated with Better Nutritional Management Behaviors of Hospitalized COVID-19 Patients

Good nutritional support is crucial for the immune system to fight against coronavirus disease 2019 (COVID-19). However, in the context of a pandemic with a highly transmissible coronavirus, implementation of nutrition practice may be difficult. A multicenter electronic survey involving 62 dieticians was conducted, in order to understand barriers associated with dieticians’ adherence to nutrition guidelines for hospitalized COVID-19 patients in Indonesia. 69% of dieticians felt under stress when performing nutrition care, and 90% took supplements to boost their own immunity against the coronavirus. The concerns related to clinical practice included a lack of clear guidelines (74%), a lack of access to medical records (55%), inadequate experience or knowledge (48%), and a lack of self-efficacy/confidence (29%) in performing nutritional care. Half (52%) of the dieticians had performed nutrition education/counseling, 47% had monitored a patient’s body weight, and 76% had monitored a patient’s dietary intake. An adjusted linear regression showed that guideline adherence independently predicted the dieticians’ nutrition care behaviors of nutrition counselling (ß: 0.24 (0.002, 0.08); p = 0.04), and monitoring of body weight (ß: 0.43 (0.04, 0.11); p = 0.001) and dietary intake (ß: 0.47(0.03, 0.10); p = 0.001) of COVID-19 patients. Overall, adherence to COVID-19 nutrition guidelines is associated with better nutritional management behaviors in hospitalized COVID-19 patients.     

玻璃体视网膜手术病因分析

目的：研究玻璃体视网膜手术的主要致病。方法：对449例玻璃体视网膜手术做回顾性分析,男243例,女206例,术前视力光感－0．2;平均病史11．6月,手术采用三切口闭合式玻璃体切割术,结果：449例诊断明确,与术前诊断符合率为80．6％,病因中视网膜血管性疾病114例,占25．39％,眼外伤85例,占18．93％,糖尿病视网膜病变82例,占18．26％,黄斑部病变41例,占9．13％,孔源性视网膜脱离39例,占8．69％,眼内炎25例,占5．57％,结论：玻璃体视网膜手术正走向成熟,其适应证逐渐扩展,已成为治疗眼后段疾病的重要手段。     

胸椎间盘突出症的外科治疗进展

胸椎间盘突出症在临床上较为少见,在所有椎间盘突出症中所占比例不足1％。近年来,随着对本病成像认识的不断深入及影像学诊断技术的不断发展,尤其是磁共振(MRI)检查应用的日益广泛,日前本病的诊断率有上升的趋势。 胸椎间盘突出症的临床表现较为复杂且缺乏特异性,临床上容易发生误诊或漏诊。一旦发病,脊髓压迫症状多呈进行性发展,且多伴有马尾神