幽门螺旋杆菌感染者的Th1/Th2和Treg细胞免疫应答及其相关性分析

目的：探讨幽门螺旋杆菌Hp感染胃部疾病患者Th1/Th2及Treg细胞表达量的变化及其相关性。方法：收集Hp感染无症状者，慢性浅表性胃炎、慢性萎缩性胃炎、肠的化生、不典型增生及胃癌患者的全血，利用胃黏膜尿素酶试验、ELISA和免疫印迹检测Hp的感染；采用流式细胞术检测Th1细胞、Th2细胞的表达水平，以及Treg细胞的表达。结果：在不同胃部疾病伴Hp感染者中，随着疾病的进展，Th1细胞的表达没有显著性变化，而Th2细胞的表达逐渐增加，Th1／Th2逐渐降低，而Treg细胞的表达逐渐增加．且Th1／Th2与Treg细胞的表达二者之间呈显著负相关。结论：在Hp感染者中，Th1／Th2及Treg细胞在调节HD感染的免疫应答中起重要作用，且与Treg细胞的表达增多呈显著负相关，与癌症的发生有一定的相关性。     

临床医学工程科如何开展科研工作

简要介绍了临床医学工程学科的发展史，强调了临床医学工程科开展科研工作的优势，列举了临床医学工程科科研项目的选题方向，并在科研活动中做好选题和过程管理，同时引入激励机制，促进我国的临床医学和临床医学工程的发展。     

做好医疗设备装备工作 提升医院核心竞争力

列举了医院核心竞争力的定义、要素,指出了医疗设备装备工作在提升医院核心竞争力方面的作用,讨论了医疗设备的装备原则、装备程序,最后提出只有充分发挥先进医疗设备的高级功能,才能起到提升医院核心竞争力的作用。     

临床医学工程学科建设

目前，我国医院临床医学工程学科的发展到了一个新的阶段，除了承担传统的采购、维修、管理等基础工作以外，在用医疗设备质量保证和功能开发、教学、科研、临床培训等成为医院临床医学工程科新开展的，更能体现学科发展时代特征的技术工作和任务，临床医学工程应该作为一个学科来建设和发展。     

注射用帕珠沙星治疗细菌性感染111例的临床随机对照研究

目的:评价国产注射用帕珠沙星治疗细菌性感染的疗效和安全性。方法:采用多中心、随机、单盲、平行对照试验设计。选择细菌性感染病人227例,其中呼吸系统感染113例,泌尿系统感染114例。所有病人随机分为试验组111例,给予帕珠沙星0.3g,iv,gtt,bid;对照组116例,给予左氧氟沙星0.2g,iv,gtt,bid;疗程均为7～10d。结果:2组人口学指标差异无统计学意义,资料具有可比性。临床综合疗效试验组和对照组的痊愈率分别为72.6%和67.8%,有效率分别为97.4%和91.5%(P>0.05)。细菌清除率分别为99%和98.0%(P>0.05)。试验组与对照组的不良反应发生率分别为12.0%和12.6%(P>0.05),主要表现为恶心、静脉炎等。结论:注射用帕珠沙星治疗呼吸系统和泌尿系统细菌性感染疗效好,使用安全。     

后巩膜收缩术治疗病理性近视黄斑劈裂

目的：评估后巩膜收缩术对病理性近视黄斑劈裂的治疗效果。方法：回顾性研究。选取2014年12月 至2017年04月在南京市第一医院眼科行后巩膜收缩术的病理性近视黄斑劈裂患者24例（45眼）,观察手术前后患者的最佳矫正视力、眼轴长度、屈光度、黄斑区视网膜劈裂高度的状况与手术并发症。对相关计量资料进行重复测量方差分析。结果：患者术前,术后1个月、3个月、6个月及12个月的黄斑区视网膜劈裂高度分别为（494±31）、（299±24）、（256±24）、（200±22）、（168±25）μm,术后各时间点与术前比较差异有统计学意义（均P<0.05）。患者术后1、3、6个月眼轴长度分别为（28.6±2.1）、（28.9±2.0）、（29.3±2.0）mm,与术前[（30.5±2.2）mm]相比差异有统计学意义（P<0.05）,术后12个月眼轴（29.8±2.1）mm,与术前相比差异无统计学意义（P>0.05）。患者术后1个月、3个月的屈光度分别为（-15.14±5.16）D、（-15.64±5.05）D,与术前[（-17.33±7.43）D]相比差异有统计学意义（P=0.013、0.048）,术后6、12个月的屈光度分别为（-15.96±4.97）D、（-17.05±5.10）D,与术前相比差异无统计学意义（P>0.05）。患者最佳矫正视力差异无统计学意义（P>0.05）。结论：针对病理性近视黄斑劈裂伴或不伴视网膜脱离的治疗,后巩膜收缩术的安全性和可行性较好。     

Local bone quality measurements correlates with maximum screw torque at the femoral diaphysis

BackgroundSuccessful fracture fixation depends critically on the stability of the screw-bone interface. Maximum achievable screw torque reflects the competence of this interface, but it cannot be quantified prior to screw stripping. Typically, the surgeon relies on the patients' bone mineral density and radiographs, along with experience and tactile feedback to assess whether sufficient compression can be generated by the screw and bone. However, the local bone quality would also critically influence the strength of the bone-screw interface. We investigated whether Reference Point Indentation can provide quantitative local bone quality measures that can inform subsequent screw-bone competence.MethodsWe examined the associations between the maximum screw torque that can be achieved using 3.5 mm, 4.5 mm, and 6.5 mm diameter stainless steel screws at the distal femoral metaphysis and mid-diaphysis from 20 cadavers, with the femoral neck bone mineral density and the local measures of bone quality using Reference Point Indentation.FindingsIndentation Distance Increase, a measure of bone's resistance to microfracture, correlated with the maximum screw stripping torque for the 3.5 mm (p < 0.01; R = 0.56) and 4.5 mm diameter stainless steel screws (p < 0.01; R = 0.57) at the femoral diaphysis. At the femoral metaphysis, femoral neck bone mineral density significantly correlated with the maximum screw stripping torque achieved by the 3.5 mm (p < 0.01; R = 0.61), 4.5 mm (p < 0.01; R = 0.51), and 6.5 mm diameter stainless steel screws (p < 0.01; R = 0.56).InterpretationReference Point Indentation can provide localized measurements of bone quality that may better inform surgeons of the competence of the bone-implant interface and improve effectiveness of fixation strategies particularly in patients with compromised bone quality.     

半结构性问询在儿童复发性头痛诊断中的运用

目的探讨半结构性问询在儿童复发性头痛诊断中的运用。方法对2007年10月至2010年10月门诊及病房诊治的90例复发性头痛病人进行半结构性问询、随访、全面的体格检查及神经系统检查并辅以必要的辅助检查。结果①90例复发性头痛患者中88例(97.8%)为原发性头痛,63例偏头痛,其中3例合并紧张性头痛,22例为可能的偏头痛,2例癔病性头痛;继发性头痛2例(2%),分别为颅内肿瘤1例、屈光不正1例;②疑诊为窦性头痛的复发性头痛患者经抗生素及中成药治疗鼻窦炎后头痛无缓解;③实验室检查中经颅多普勒超声检查显示的血管痉挛或扩张的部位与头痛部位无相关性,EEG检查多无明显异常。结论偏头痛是复发性头痛的常见原因;慢性鼻窦炎无急性发作不会导致窦性头痛。在复发性头痛诊断中应用结构性问询,并加强随访,既提高了诊断率,又避免了不必要的检查。     

In vitro cultivation of rat bone marrow mesenchymal stem cells and establishment of pEGFP/Ang-1 transfection method

ObjectiveTo obtain the bone marrow mesenchymal stem cells (BMSCs), complete phenotypic identification and successfully transfect rat BMSCs by recombinant plasmid pEGFP/Ang-1.MethodsBMSCs were isolated from bone marrow using density gradient centrifugation method and adherence screening method, and purified. Then the recombinant plasmid pEGFP/Ang-1 was used to transfect BMSCs and the positive clones were obtained by the screen of G418 and observed under light microscopy inversely. Green fluorescent exhibited by protein was enhanced to measure the change time of the expression amount of Ang-1.ResultsBMSCs cell lines were obtained successfully by adherence screening method and density gradient centrifugation. Ang-1 recombinant plasmid was transfected smoothly into rat BMSCs, which can express Ang-1 for 3 d and decreased after 7 d.ConclusionsAdherence screening method and density gradient centrifugation can be effective methods to obtain BMSCs with high purity and rapid proliferation. Besides, the expression of transfected recombinant plasmid pEGFP/Ang-1 in rat BMSCs is satisfactory.