TKA术中假体旋转力线控制的研究进展

近年来,全膝关节置换术(total knee arthroplasty, TKA)作为治疗严重膝关节疼痛、畸形、功能障碍的一种有效的临床术式,在国内外得到了广泛的开展。但其术后并发症的发生率也相对较高,对手术后远期效果和膝关节假体的长期生存率会产生较大的影响。随着对膝关节旋转力线的重视程度的提高和研究技术的发展,笔者查阅近几年有关控制旋转力线的文献,阐述其与术后功能的相关性,综合新技术在旋转控制方面的应用进展,以期为临床进一步研究提供参考。     

Activation status of CD56dim natural killer cells is associated with disease activity of patients with systemic lupus erythematosus

Clinical Rheumatology - Decreased natural killer (NK) cells have been reported in systemic lupus erythematosus (SLE) patients. However, the role of NK cells in the pathogenesis of SLE is not well...     

Ion Torrent ™ Genexus ™ Integrated Sequencer and ForeNGS Analysis Software—An automatic NGS-STR workflow from DNA to profile for forensic science

The Ion Torrent ™ Genexus ™ Sequencer (Genexus) is a highly integrated instrument that can automate library construction, templating, and sequencing in a single-instrument run. By programing the ForeNGS Analysis Software (FNAS), we bridged the gap between sequencing and genotyping without manual intervention. FNAS can automatically transfer sequencing output files from Genexus, analyze the repeat and flanking regions aligned to the GRCh38 assembly, name the alleles according to the ISFG guidelines, and generate user-friendly interactive profiles. Genexus and FNAS can accomplish the fully automatic DNA-to-Profile workflow in forensics. Based on our experiences, the optimal assay parameters on Genexus were validated as follows: 24 cycles of target amplification for library construction; 40 μL of library and 400 bp of template size for templating; 852 flows of dNTPs by order of Ion samba HID2 for sequencing; and 750,000 reads per sample at minimum for 16 samples multiplexed on a lane. By developmental validations of the Precision ID Globalfiler ™ NGS STR Panel v2, Genexus presented competitive performance at the optimal assay parameters qualified to detect commonly used forensic STR markers. It could produce repeatable and reproducible results, and human profiles could be easily separated from nonhuman profiles. Additionally, Genexus was sensitive enough to detect samples with 100 pg of input DNA, and it was suitable for various types of case samples, especially for low copy number samples and degraded samples. Moreover, minor contributors could be detected between the 4:1 and 1:4 mixtures with an analysis threshold of 50 × . The Genexus workflow is a robust and labor-effective solution enabling forensic scientists to obtain NGS-STR profiles within a single day and with only the need to prepare DNA extracts, then set up Genexus, and finally interpret profiles on FNAS.     

64层螺旋CT冠状动脉血管成像与冠状动脉造影对照研究

目的评价64层螺旋CT诊断冠状动脉粥样硬化性心脏病的临床应用价值。方法40例临床诊断或可疑冠心病患者行64层螺旋CT心电门控平扫及增强扫描,并以冠状动脉造影结果作为对照。得出64层螺旋CT冠状动脉CT血管成像(CTA)诊断冠状动脉狭窄的准确性、敏感性、特异性。结果64层螺旋CT冠状动脉血管成像用于诊断冠心病的敏感性为87.1%,特异性为67.5%,准确性为80.0%。结论①64层螺旋CT检查是一种无创、快捷的冠状动脉血管检查方法,对冠心病的诊断有较高的准确性。②与冠状动脉造影术相比,64层螺旋CT冠状动脉血管成像对冠状动脉血管狭窄程度判断仍有一定差异。     

Effects of dietary supplementation with vitamin E and selenium on rat hepatic stellate cell apoptosis

AIM: To evaluate the effects of dietary supplementation with vitamin E and selenium on proliferation and apoptosis of hepatic stellate cells (HSCs), in acute liver injury induced by CCl4, and to explore their role in the recovery from hepatic fibrosis phase. METHODS: An acute liver damage model of rats was established by intraperitoneal injection of carbon tetrachloride (0.3 mL/100 g body weight) twice a week, then the rats were killed at 6, 24, 48, and 72 h after the first and third injection, respectively. A liver fibrosis model was established by the same injection for 8 wk. Then three rats were killed at 3, 7,14, and 28 d after the last injection, respectively. The rats from the intervention group were fed with chow supplemented with vitamin E (250 mg/kg) and selenium (0.2 mg/kg), and the rats in the normal control group and pathological group were given standard chow. Livers were harvested and stained with hematoxylin and eosin, Sirius red. Activated HSCs were determined by α-smooth muscle actin immunohistochemistry staining. Apoptotic HSCs were determined by dual staining with the terminal deoxynucleotidyl transferase UTP nick end labeling (TUNEL) and α-smooth muscle actin immunohistochemistry. Serum alanine aminotransferase and aspartate aminotransferase were also analyzed. RESULTS: In the acute liver damage model, the degree of liver injury was more serious in the pathological group than in the intervention group. At each time point, the number of activated HSCs was less in the intervention group than in the pathological group, while the number of apoptotic HSCs was more in the intervention group than in the pathological group. In the liver fibrosis model, the degree of liver fibrosis was more serious in the pathological group than in the intervention group. At each time point, the number of activated HSCs was less in the intervention group than in the pathological group, and the number of apoptotic HSCs was more in the intervention group than in the pathological group. CONCLUSION: Vitamin E and selenium supplementation at the given level can inhibit CCl4-induced activation and proliferation of HSCs and promote the apoptosis of activated HSCs in acute damage phase. Vitamin E and selenium can also effectively decrease the degree of hepatic fibrosis and promote the recovery process.     

非酒精性脂肪性肝炎发病机制探讨

目的建立大鼠非酒精性脂肪性肝炎（NASH）动物模型,探讨脂质过氧化、一氧化氮（NO）和一氧化氮合酶（NOS）以及肿瘤坏死因子α（TNF-α）、转化生长因子-β（TGF-β）等细胞因子在NASH致病中的作用.方法通过持续16周的高脂肪、高胆固醇饮食,建立大鼠NASH模型,造模结束时检测模型组和正常组血清转氨酶,血清及肝组织丙二醛（MDA）、超氧化物歧化酶（SOD）、NO、NOS、谷胱甘肽（GSH）含量.免疫组化标记α平滑肌肌动蛋白（α-SMA）、KP-1、TNF-α、TGF-β.结果实验结束时,模型组动物体重、肝脏指数比正常组显著增高（P值分别＜0.05和0.01）.血清转氨酶较正常组显著升高（P＜0.01）.除血清NO显著升高外（P＜0.05）,MDA、SOD、NOS、GSH均与正常组差异无统计学意义（P＞0.05）;而肝匀浆中,MDA、NO较正常组显著升高（P值分别＜0.05和＜0.01）,SOD、NOS、GSH则较正常组显著下降（P值分别＜0.05和0.01）.模型组α-SMA、KP-1、TNF-α、TGF-β免疫组化显示阳性细胞较正常组显著增加（P值均＜0.01）.结论脂质过氧化损伤增强,抗氧化能力降低,以及TNF-α、TGF-β、NO等炎性介质活化,共同参与了NASH的发病,并预示NASH可发展为肝纤维化、肝硬化.     

T-Cell Immunoglobulin- and Mucin-Domain-Containing Molecule 3 Genetic Variants and HIV+ Non-Hodgkin Lymphomas

T cell immunoglobulin- and mucin-domain-containing molecule 3 (TIM-3) has been established as a negative regulatory molecule and plays a critical role in inflammatory diseases such as rheumatoid arthritis, hepatitis B and C, and human immunodeficiency virus (HIV)-related inflammation. Recent studies have shown that chronic inflammation may greatly affect the pathogenesis of non-Hodgkin lymphomas (NHL). The aim of this study was to investigate whether polymorphisms in the TIM-3 gene were associated with susceptibility to non-NHL and HIV-related NHL. Three polymorphisms in TIM-3 gene (?1516G/T, ?574G/T, and +4259T/G) were identified by polymerase chain reaction-restriction fragment length polymorphism in 434 NHL patients, 62 HIV-related NHL cases, and 512 healthy controls. Results showed that the prevalence of ?574GT genotype and +4259TG genotype were significantly increased in the NHL cases than in controls (odds ratio (OR)?=?2.72, 95 % confidence interval (CI)?=?1.50–4.92, p?=?0.0006 and OR?=?2.59, 95 % CI?=?1.49–4.49, p?=?0.0005, respectively). The ?1516G/T polymorphism did not reveal significant difference between patients and healthy controls. When analyzing the TIM-3 polymorphisms in HIV-related NHL patients, data showed that HIV+ NHL patients had higher prevalence of ?574GT or +4259TG genotypes than those cases without HIV infection (OR?=?3.48, 95 % CI?=?1.67–7.28, p?=?0.0005 and OR?=?2.92, 95 % CI?=?1.42–6.01, p?=?0.0026, respectively). These results suggested polymorphisms in TIM-3 gene could be new risk factors for NHL as well as HIV-related NHL and suggested a possible role of the inflammatory factor in these diseases.     

针灸治疗女性压力性尿失禁:随机对照研究特点分析

背景:众多文献对针灸治疗压力性尿失禁进行综述分析,但存在中外文献数据库检索不全面或没有针对性分析针灸对女性患者的单独疗效等局限性。目的:对针灸治疗压力性尿失禁临床研究各特点进行分析,为针灸临床提供参考。方法:检索从建库截止至2020-03-15 PubMed、EMbase、Cochrane Library、Clinical Evidence、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库(WanFang)及中国生物医学文献数据库(SinoMed)中以针灸为主要干预手段治疗压力性尿失禁的随机对照试验(RCT)文献,采用文献计量学方法对符合纳入标准的文献进行数据信息的提取,并运用Cochrane偏倚风险评估工具进行文献质量评价。从文献发表数量、诊断标准、治疗方法、腧穴选择与归经、治疗时长频次与疗程、疗效标准与结局指标、针刺操作方法特点、临床研究方法设计等方面进行统计,对针灸治疗压力性尿失禁进行定量分析。结果与结论:(1)共筛选出符合要求的115篇中英文文献,文献发表数量自2012年呈逐年增多并趋于稳定;(2)诊断标准和疗效标准的使用缺乏统一和规范;(3)治疗方法主要为针刺疗法单独使用或联合其他疗法(盆底肌训练和生物反馈等)、灸法单独使用或联合其他疗法、针灸结合或联合其他疗法,单独的针灸疗法以体针(毫针针刺)和电针居多;使用频次前10位的腧穴依次为关元、中极、三阴交、气海、肾俞、会阳、足三里、中髎、次髎、百会;选取的经脉以足太阳膀胱经、任脉、足少阳胆经、足少阴肾经等为主;(4)主客观指标相互结合,有效率为最常出现的结局指标;(5)针刺临床操作方法与治疗疗程不一;临床研究的方法学质量和报告质量普遍较低,高论证强度的研究稀少;(6)分析结果说明,针灸治疗压力性尿失禁疗法丰富多样,以局部选穴结合循经取穴为主;临床研究的设计与方法标准不一,有待于今后在临床中进一步规范与完善。     

常规消毒对ProTaper镍钛根管锉抗拉强度的影响

目的 探讨超声清洗时间和消毒灭菌频率对镍钛根管锉的抗拉性能的影响,以了解超声清洗和高温高压消毒灭菌法在镍钛根管锉灭菌中应用的安全性和可行性.方法 采用全新的ProTaper S2锉和F2锉各25支,分为5组:标准组(未处理)、对照组(未超声-高压灭菌)、A组(超声震荡50 min+高压灭菌5次)、B组(超声震荡100 min+高压灭菌10次)、C组(超声震荡150 min+高压灭菌15次),分别用万能测试仪对其进行抗拉伸强度的性能试验.结果 S2及F2的标准组之间的抗拉伸强度差异无统计学意义(P>0.05),提示样本间不存在差异性;经不同时间超声清洗及不同次数高温高压处理的S2镍钛锉抗拉伸强度测试结果显示:对照组、A组、B组、C组分别为(76.58±4.87)MPa、(71.00±5.39)MPa、(72.33±3.43)MPa、(66.81±4.08)MPa;F2镍钛锉抗拉伸强度结果分别为:(111.75±6.83)MPa、(110.46±3.88)MPa、(107.29±3.89)MPa、(94.53±6.61)MPa;A、B组与对照组的ProTaper S2锉和F2锉的抗拉强度差异均无统计学意义(P>0.05),即镍钛锉经超声震荡50 min+高压灭菌5次及超声震荡100 min+高压灭菌10次消毒后,其抗拉伸强度无明显影响;C组与对照组间差异存在统计学意义(P<0.05),即镍钛锉经超声震荡150 min+高压灭菌15次消毒后,对其抗拉伸强度有影响.结论 常规超声-高压灭菌消毒超过一定频率可能增加ProTaper系统镍钛根管锉折断可能性.     

In Silico identification of M. TB proteins with diagnostic potential

The development of a new tuberculosis (TB) vaccine has become one of the main objectives of the scientific community. Protein antigens have been widely explored as subunit TB vaccines, however lipid antigens could be equally important to be used or included in such a vaccine. The aim of this study was to demonstrate the potential of a liposome formulation composed of an extract of lipids from Mycobacterium smegmatis (Ms) as a TB vaccine candidate. We evaluated the immunogenicity of this formulation as well as the cross reactive response against antigens from Mycobacterium tuberculosis (MTb) in BALB/c mice. We determined the anti-liposome IgG response in sera from TB patients and from healthy subjects who displayed a positive (PPD+) or negative (PPD-) tuberculin skin test. A significant increase in anti-liposome IgG (p<0.05) was detected in animals immunized with Bacille Calmette-Guérin (BCG) compared with all groups, and in the group immunized with liposomes from Ms (LMs) compared to animals immunized with either LMs adjuvanted with aluminium (LMs-A) or the negative control group (phosphate buffered saline, PBS) respectively. With respect to the cross reactive response against a cocktail of cell wall antigens (CWA) from MTb, significantly higher IgG levels were observed in animals immunized with BCG and LMs compared to negative controls and either, aluminium-adjuvanted liposomes (LMs-A) or montanide (LMs-M) (p<0.05). Furthermore, the anti-liposome IgG response was significantly superior in sera from pulmonary TB patients compared to PPD+ and PPD- healthy subjects (p<0.001) suggesting the expression of these antigens in vivo during active MTb infection. The results obtained provide some evidence for the potential use of liposomes containing total lipid extracts of Ms as a TB vaccine candidate.