腹腔镜与开腹手术治疗急性阑尾炎穿孔的比较

目的：探讨腹腔镜治疗急性阑尾炎穿孔的效果和价值。方法回顾性分析2010年1月～2011年2月我院由同一组高年资医师完成的77例穿孔性阑尾炎手术的临床资料,其中腹腔镜阑尾切除术（laparoscopic appendectomy, LA）35例（LA组）,开腹阑尾切除术（open appendectomy, OA）42例（OA组）,比较2组手术时间、肠道功能恢复时间、切口感染率、腹腔脓肿发生率、住院时间、住院费用。结果2组手术时间无显著性差异[（64．1±18．1） min vs．（65．1±13．8） min,t＝0.275,P＝0．784];腹腔脓肿发生率无显著差异[2．9％（1/35） vs．4．8％（2/42）,χ2＝0．000,P＝1．000]。与OA组相比,LA组切口感染率显著降低[5．7％（2/35） vs．26．2％（11/42）,χ2＝5．704,P＝0．017];肠功能恢复时间明显缩短[（26．1±4．6）h vs．（36．1±11．9）h, t＝-4．684,P＝0．000）;住院时间明显缩短[（7．1±2．8）d vs．（9．2±4．8）d, t＝-2．283,P＝0．025];住院费用显著升高[（12．6±2．2）千元vs．（8．1±2．9）千元,t＝7．545,P＝0．000]。结论腹腔镜经验丰富的外科医生应用腹腔镜治疗穿孔性阑尾炎有显著优势,手术费用的增加是唯一缺点。     

施源器材料对192Ir后装源水中吸收剂量的影响

目的 应用3D打印支架联合人造金刚石探头测量施源器材料对高剂量率后装¹⁹²Ir源水中吸收剂量的影响。方法 将金刚石探头与塑料插植针分别固定在3D打印支架上,金刚石探头的中心轴与塑料插植针的中心轴在一个平面内相互垂直。采用模拟源尺测量实测驻留位置为248 mm,该驻留位置与逐点测量的最大响应位置吻合。测量材料有304不锈钢、聚亚苯基砜树脂（PPSU）材料、有机玻璃（PMMA）材料和3D打印聚乳酸（PLA）材质。测量水中不同厚度或不同填充率的材料对吸收剂量的衰减。结果 304不锈钢和PPSU材料厚度与相对剂量的线性拟合公式分别为y=-0.029 7x+1.000 3,y=-0.002 3x+1.010 2;拟合优度R²分别为0.925 3和0.722 2。10 mm以内PMMA材料对剂量的影响均<1.5%。3D打印材料填充率（%）与相对剂量的线性拟合公式为y=-0.000 4x+1.024 6,拟合优度R²为0.854 5。结论 施源器材料,尤其是高密度材料（如304不锈钢）和新型技术材料（如3D打印PLA）,对¹⁹²Ir后装源的吸收剂量影响需引起施源器开发人员和临床应用者的足够重视。     

Iguratimod dose dependently inhibits the expression of citrullinated proteins and peptidylarginine deiminases 2 and 4 in neutrophils from rheumatoid arthritis patients

Clinical Rheumatology - Anti-citrullinated protein antibodies (ACPAs) play an important role in rheumatoid arthritis (RA). Citrullinated proteins (CPs), which are produced by post-translational...     

Dynamic changes in gut microbiota under the influence of smoking and TNF-α-blocker in patients with ankylosing spondylitis

Clinical Rheumatology - This study aimed to investigate the relationship among smoking, TNF-α-blocker therapy, and the dynamic changes in gut microbiota in patients with ankylosing spondylitis...     

Metastatic Tumors of Unknown Origin: Ancillary Testing in Cytologic Specimens

The application of ancillary studies, such as immunostains, to cytopathology has improved the ability to make accurate diagnoses with precise subclassification. Even with these techniques, there are still aspiration and exfoliative cytology cases for which it remains difficult to definitively determine the source and/or subtype. This article focuses on the well-established and novel ancillary studies used in the modern era of cancer diagnoses in cytopathology, particularly in the diagnostic work-up of metastatic tumors without a known primary.     

2008-2012年长春疾控机构卫生技术人员动态分析

目的分析2008-2012年长春疾控机构卫生技术人员构成情况,为上级部门制定疾控卫生人力政策与规划,优化人力资源配置,加强疾控卫生人力队伍建设提供参考依据。方法利用国家卫生统计网络直报系统,对2008-2012年长春疾控机构卫生技术人员构成变化进行分析。结果 2008-2012年长春地区疾控卫生技术人员总数随着长春市人口的增长而减少,年龄构成趋于老龄化,学历以大专、中专及中技为主,职称以初级职称为主。结论长春地区疾控卫生技术人员从数量、年龄、学历、职称构成情况来看,均有所提高,但均未达到国家要求的水平,有待进一步调整。     

FGG在结直肠癌中的表达及意义

目的研究FGG蛋白在结直肠癌及其周围的癌旁组织的表达情况,探讨FGG在结直肠癌中的临床意义,以及评价作为该病肿瘤标志物的潜力。方法应用液质联用技术,分析结直肠癌中表达的差异蛋白情况,利用Western blot方法对其准确性进行验证。结果经质谱鉴定后得出FGG在结直肠癌中较正常组织中表达增高,Western blot结果与之吻合。结论可将FGG视为结直肠癌病情监测以及疗效预测中的潜在标志物之一。     

肾细胞癌组织中Notch信号途径蛋白表达水平的检测及其意义

目的：检测人肾细胞癌（RCC）组织中Notch信号途径相关蛋白的表达水平，探讨Notch信号途径分子与人RCC发生发展的关系。方法：手术方法获得6例经病理检查诊断为RCC组织标本，采用Western blotting法检测RCC组织和癌旁组织中Notch信号通路受体、配体蛋白表达水平。结果：与癌旁组织比较，RCC组织中Notch信号的受体Notch-1以及配体Jagged-1的表达水平均明显降低(P<0.05），受体Notch-2及配体Jagged-2表达水平均明显升高(P<0.05）。结论：RCC中Notch信号途径蛋白表达水平发生了明显的变化，Notch信号途径可能参与了RCC的发生发展过程。     

External validation of the clinical indications of computed tomography (CT) of the head in patients with low-energy geriatric hip fractures

IntroductionOn evaluation of the clinical indications of computed tomography (CT) scan of head in the patients with low-energy geriatric hip fractures, Maniar et al. identified physical evidence of head injury, new onset confusion, and Glasgow Coma Scale (GCS) < 15 as predictive risk factors for acute findings on CT scan. The goal of the present study was to validate these three criteria as predictive risk factors for a larger population in a wider geographical distribution.Patients and methodsPatients ≥65 years of age with low-energy hip fractures from 6 trauma centers in a wide geographical distribution in the United States were included in this study. In addition to the relevant patient demographic findings, the above mentioned three criteria and acute findings on head CT scan were gathered as categorical variables.ResultsIn total 799 patients from 6 centers were included in the study. There were 67 patients (8.3%) with positive acute findings on head CT scan. All of these patients (100%) had at least one criteria positive. There were 732 patients who had negative acute findings on head CT scan with 376 patients (51%) having at least one criteria positive and 356 patients (49%) having no criteria positive. Sensitivity of 100% and negative predictive value of 100% was observed to predict negative acute findings on head CT scan when all the three criteria were negative.ConclusionWith the observed 100% sensitivity and 100% negative predictive value, physical evidence of acute head injury, acute retrograde amnesia, and GCS < 15 can be recommended as a clinical decision guide for the selective use of head CT scans in geriatric patients with low energy hip fractures. All the patients with positive acute head CT findings can be predicted in the presence of at least one positive criterion. In addition, if these criteria are used as a pre-requisite to order the head CT, around 50% of the unnecessary head CT scans can be avoided.