乏脂肪的肌间梭形细胞脂肪瘤一例

患者男,25岁,发现左下肢包块半年余,至常熟市第二人民医院皮肤科就诊。半年前发现左下肢肿块,生长缓慢,未予重视。既往体健。皮肤科检查：左下肢可触及一约4.2 cm × 2.1 cm包块,质软、活动度差,轻度压痛,周围皮肤正常……     

数字建模分析倒退旋转法在腰椎椎体单侧穿刺椎体后凸成形术的适用性

目的:利用Mimics软件建立腰椎的3D模型,使用模拟穿刺来观察倒退旋转法在腰椎椎体单侧穿刺椎体后凸成形术的适用性及进针参数。方法:选取24例全腰椎螺旋CT扫描初次胸椎骨质疏松性骨折、腰椎无异常骨质破坏的影像学资料,其中男女各12例,应用Mimics软件对原始DICOM文件进行3D建模,分离出各节段椎体,直接导入3-matic软件后约束其椎体后壁进行标准化测量后以椎弓根中点作一垂直于中切面及椎体后壁的素描图,在素描图上进行模拟穿刺,记录穿刺针可活动范围的角度参数及距离参数,记录穿刺针在最大外倾角时落在椎体中切线前、中、后区的穿越点,并进行比较分析。结果:所有数据在左右两侧差异均无统计学意义(P0.05),不同节段数据在两性差异有统计学意义(P0.05),男女性L_1-L_5最大外倾角均逐渐增大,男性从(33.41±1.31)°到(56.53±4.71)°,女性从(28.58±2.55)°到(53.86±2.68)°,所有穿越点未落在前区,其中女性26.67%落在中区,男性3.33%落在中区,A、B、C分区在性别上差异有统计学意义(P0.05)。结论:倒退旋转法理论上均能满足椎体压缩性骨折对穿刺点的要求,其中男性及下腰椎更加适用倒退旋转法。最大外倾角的测定对倒退旋转法有指导性意义。     

产气肠杆菌连续分离株的耐药性及β-内酰胺类抗生素耐药机制的研究

目的 探讨临床连续分离的产气肠杆菌耐药性及耐碳青霉烯类药物菌株对β-内酰胺类药物耐药的主要机制。方法 用Vitek2-Compact仪对临床连续分离的240株产气肠杆菌进行鉴定和常规药敏试验,并筛选出耐碳青霉烯类药物的菌株;用琼脂稀释法测定其对碳青霉烯类药物的MIC值;用改良的三维试验方法分别检测耐药菌株的ESBLs与AmpC酶;改良Hodge试验法检测碳青霉烯酶;用PCR扩增法检测3种β-内酰胺酶的耐药基因;结果 240株产气肠杆菌对23种常用抗生素的耐药率在3.8%～100%之间,最高为头孢西丁(100%)、最低为亚胺培南(3.8%);筛选出10株耐碳青霉烯类产气肠杆菌;三维试验10株菌ESBLs 及AmpC酶均为阳性,Hodge试验阳性7株。PCR结果示,携带blaKPC基因7株;携带blaCTX-M基因7株,携带blaSHV基因2株;携带blaDHA基因6株,携带blaACT/MIR型ampC基因4株; 16SrRNA基因定量确定ampC基因的表达增加的3株。结论 产气肠杆菌对临床常用抗菌药物具有较高的耐药性,其主要耐药机制为产碳青霉烯酶、ESBLs与AmpC酶。     

Malignant melanoma of lingual gingiva with ipsilateral submandibular lymph node metastasis: a case report

Malignant melanoma is a neoplasm of epidermal melanocytes. It is one of the most biologically unpredictable and deadly of all human neoplasms. However, malignant melanoma in the oral cavity is a rare malignancy, accounting for 0.2% to 8% of all melanomas. It has a grave prognosis, with a 5 year survival of 10–20%. We present a case of malignant melanoma of lingual gingiva of left mandibular molars with ipsilateral submandibular lymph node metastasis. We performed peripheral osteotomy of primary lesion followed by modified radical neck dissection by sparing internal jugular vein and patient had received postoperative radiotherapy.     

携带乙型肝炎病毒产妇血清及乳汁HBV-DNA含量的研究

目的了解乙型肝炎血清学指标阳性母亲的血清与乳汁中HBV排泄率之间的关系,以及新生儿血清乙型肝炎病毒标志物(HBVM)表达的特点。方法选择携带乙型肝炎病毒产妇97例,采用电化学发光原理检测产妇及其新生儿血清学标志物;采用实时荧光定量PCR法测定产妇血清及其乳汁中HBV-DNA含量。结果携带乙型肝炎病毒产妇的乳汁中约10.0%存在潜在危险性;HBeAg阳性的血清和乳汁HBV-DNA阳性率明显高于阴性者,差异有统计学意义(P<0.05);HBeAg阳性母亲所生新生儿90.0%HBeAg也呈阳性,可能存在宫内感染。结论对产前HBVM阳性的孕妇有条件均应检测血清HBV-DNA,对血清HBV-DNA阳性的产妇需进一步检测乳汁及新生儿HBV-DNA来指导母乳喂养。     

六味地黄汤加味合黄豆苷元片治疗围绝经期综合征80例临床观察

[目的]评价六味地黄汤加味合黄豆苷元片治疗围绝经期综合征的疗效。[方法]将160例患者随机分为两组,治疗组80例,应用六味地黄汤加味治疗,同时口服黄豆苷元片;对照组用更年安片治疗,3个月为1个疗程,观察临床疗效并检测血清雌二醇(E₂)、促卵泡生成素(FSH)、促黄体生成素(LH)水平。[结果]治疗组对围绝经期综合征疗效显著,总有效率为93.8%,优于对照组(83.8%),两组比较有显著性差异(P<0.05);且六味地黄汤加味合黄豆苷元片能升调E₂水平,降低FSH、LH水平,治疗前后比较,有显著性差异(P<0.O5),与对照组比较,有显著性差异(P<0.O5)。[结论]六味地黄汤加味合黄豆苷元片治疗围绝经期综合征疗效明显,症状缓解率满意。     

In vitro characterization of polycaprolactone matrices generated in aqueous media

In this study, a novel process of dissolving polycaprolactone (PCL) matrices in glacial acetic acid was explored in which matrices spontaneously formed upon contact with water. Scanning electron microscopy analysis showed rough architecture and holes on the self-assembled matrix relative to matrices formed after dissolving in chloroform. Immersion in the gelatin solution reduced its roughness and number of micropores. Atomic force microscopy (AFM) analysis confirmed the increased roughness of the self-assembled matrices. The roughness of the matrices decreased after incubation in 1 N NaOH for 10 min. AFM analysis also revealed that the self-assembled matrix had a net positive surface charge, whereas chloroform–cast matrix had a negative surface charge. The surface charge of self-assembled matrix after immersion in gelatin changed to negative. However, incubation in NaOH did not affect the surface charge. The tensile properties were tested in both the dry state (25 °C) and the wet state (37 °C) by immersion in phosphate-buffered saline. Self-assembled matrix had lower elastic modulus, break stress and break strain than chloroform–cast matrix in both states. The elastic modulus in the wet condition was reduced by half in self-assembled matrix but tensile strain increased. Samples were further analyzed by ramp-hold test for assessing stress relaxation behavior. Both self-assembled and chloroform–cast matrices had similar trends in stress relaxation behavior. However, stress accumulation in self-assembled matrix was half that of chloroform–cast matrix. In vitro cell cultures were conducted using human foreskin fibroblast (HFF-1) in serum-free medium. Cytoskeletal actin staining showed cell adhesion and spreading on all matrices. Cell retention was significantly increased in self-assembled matrix compared to chloroform–cast matrix. Addition of gelatin improved the retention of seeded cells on the surface. In summary, PCL matrices generated using this novel technique show significant promise in biomedical applications.