中国妇女乳房乳晕乳头比例的测定及相关因素分析

目的为塑造自然、匀称而具有美感的乳房提供参考和依据。方法对45例22~45岁、对自己乳房满意且无乳房手术史的女性志愿者,分别测量体重、身高、乳头直径、乳晕直径、胸乳线(乳头至胸骨切迹连线距离)、乳房内侧半径(乳头至乳房下皱襞内侧止点连线距离)、乳房外侧半径(乳头至乳房下皱襞外侧止点连线距离)、乳房下半径(乳头至乳房下皱襞最低点连线距离)。以乳房外侧半径长度作为乳房大小参考指标,由此计算和确定乳房、乳晕、乳头之间的比例,并对可能影响其变化的年龄、体重、身高等因素进行研究分析。结果该组样本显示中国妇女乳房与乳晕之比约为3.7∶1.0,乳晕乳头之比约为3.4∶1.0。体重、体重指数与乳房大小、乳晕乳头比例之间呈正相关,具有显著的统计学意义;而年龄、身高的影响在该样本中并未显现。结论乳房与乳晕、乳头间具有一定的合适比例,体重和肥胖可能是影响该比例关系的因素。乳房、乳晕、乳头比例的确定对东方妇女的乳房整形和再造具有美学价值,可被用于手术中对乳房大小的理想化设计和预测。     

人工全髋置换术中拉钩对下肢深静脉血栓影响的研究

目的：通过对髂外动静脉及股动静脉与髋臼解剖学与临床的研究，探讨在全髋臼置换术中拉钩在髋放置位置对下肢深静脉血栓的影响。方法：通过解剖学研究56具成年骨盆标本中髂外动静脉及股动静脉来源及走行、与髋臼的关系进行测量分析；并通过临床观察22例（股骨颈骨折12例、股骨头缺血性坏死6例、类风湿性关节炎4例）在人工全髋置换术（THR）中拉钩放置安全区，经下肢静脉超声多普勒检查观察下肢深静脉血栓发病率。结果：在左侧3-5点间、右侧7-9点、左侧9点、右侧3点使用拉钩用力要适度，牵拉时间过长，会造成臀下血管、股动脉的牵拉过度或时间过长，易引起下肢深静脉血栓；通过临床22例THR拉钩放置安全区的观察，无一例下肢深静脉血栓，仅有2例轻度深静脉血流缓慢、但无明显的症状体征，经过口服活血通络中药后消失。结论：通过解剖学与临床观察研究，确定在THR中拉钩放置位置、深度是避免下肢深静脉血栓的重要因素。     

绝经后高血压危险因素的Meta分析

背景 流行病学研究表明,绝经后女性的高血压患病率高于老年男性。近年来,有关绝经后高血压的临床表现、病理特征、发病机制、治疗方法等受到越来越多的关注,但由于受到研究设计、样本量、人群特征、资源不足等因素的影响,其危险因素的研究结果不一致且缺乏全面报道。目的 运用系统评价方式探讨女性绝经后高血压的危险因素,为更好地预防和管理绝经后高血压提供循证证据。方法 于2022年1—5月,计算机检索中国知网、万方数据知识服务平台、中国生物医学文献服务系统、PubMed、EmBase、the Cochrane Library、Web of Science电子数据库,获取与绝经后高血压危险因素相关的队列及病例对照研究。检索时限为建库起至2022-05-20。由2名研究者独立根据纳入和排除标准筛选文献、提取资料,采用纽卡斯尔-渥太华量表（NOS）对所提取的文献进行偏倚风险评估,将得分≥6分（高质量）的文献纳入研究,最后采用RevMan 5.3对其进行Meta分析。结果 共纳入10篇文献,5篇为队列研究,5篇为病例对照研究,共涉及16个危险因素,总样本量为34 864,且均为高质量文献。Meta分析结果显示,...     

经皮锁定加压钢板固定胫骨多段骨折21例疗效分析

目的探讨经皮锁定加压钢板(locking compression plate,LCP)手术治疗胫骨多段骨折的临床疗效。方法将2010年6月~2011年12月收治的胫骨多段骨折患者,根据AO分类方法筛选出C2型骨折21例:左侧9例,右侧12例;男性14例,女性7例;年龄15~71岁,平均(44±2.1)岁。入选病例均采用微创经皮插入LCP钢板手术内固定治疗。结果随访8~15个月,术后3~4月骨折线变模糊,术后6~9月骨折处出现大量骨痂;膝关节屈曲为(147±3.2)°,伸直为(0±0.5)°;踝关节背伸(9±1.2)°,跖屈(43±2.1)°;Johner-Wruhs评分标准:优17例,良3例,可1例,差0例;优良率95.24%。结论经皮LCP钢板固定胫骨多段骨折安全、有效,是值得推广的手术方式。     

基于WNT16预防骨质疏松非椎体骨折的研究进展

随着我国老龄化程度加深,骨质疏松发病率持续升高,已经严重威胁我国国民健康。骨折作为骨质疏松最严重的并发症,是骨质疏松患者死亡的主要原因。近年来,关于骨质疏松骨折的研究有很多,但偏重于骨质疏松椎体骨折,而骨质疏松非椎体骨折的研究较少。目前,市场上预防骨质疏松的药物也往往针对椎体骨折,而骨质疏松非椎体骨折的可用药物较少。WNT信号通路在预防骨质疏松骨折方面的研究较多,WNT16作为WNT家族中新成员,是调控骨皮质的关键因子,骨质疏松非椎体骨折的关键原因在于骨皮质变薄,因此,WNT16可能是预防非椎体骨折的潜在靶标。本文主要通过总结近期关于WNT16在骨质疏松骨折上的研究,探讨WNT16在骨质疏松非椎体骨折的预防上所起的作用,为临床预防骨质疏松非椎体骨折提供参考,以及为骨质疏松非椎体骨折药物开发提供新思路。     

Trends of the internal phthalate exposure of young adults in Germany—Follow-up of a retrospective human biomonitoring study

The exposure of the general population to phthalates is of increasing public health concern. Variations in the internal exposure of the population are likely, because the amounts, distribution and application characters of the phthalate use change over time. Estimating the chronological sequences of the phthalate exposure, we performed a retrospective human biomonitoring study by investigating the metabolites of the five most prominent phthalates in urine. Therefore, 24 h-urine samples from the German Environmental Specimen Bank (ESB) collected from 240 subjects (predominantly students, age range 19–29 years, 120 females, 120 males) in the years 2002, 2004, 2006 and 2008 (60 individuals each), were analysed for the concentrations of mono-n-butyl phthalate (MnBP) as metabolite of di-n-butyl phthalate (DnBP), mono-iso-butyl phthalate (MiBP) as metabolite of di-iso-butyl phthalate (DiBP), mono-benzyl phthalate (MBzP) as metabolite of butylbenzyl phthalate (BBzP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), mono-(2-ethyl-5-carboxypentyl) phthalate (5cx-MEPP) and mono-(2-carboxymethyl hexyl) phthalate (2cx-MMHxP) as metabolites of di(2-ethylhexyl) phthalate (DEHP), monohydroxylated (OH-MiNP), monooxidated (oxo-MiNP) and monocarboxylated (cx-MiNP) mono-iso-nonylphthalates as metabolites of di-iso-nonyl phthalates (DiNP). Based on the urinary metabolite excretion, together with results of a previous study, which covered the years 1988–2003, we investigated the chronological sequences of the phthalate exposure over two decades. In more than 98% of the urine samples metabolites of all five phthalates were detectable indicating a ubiquitous exposure of people living in Germany to all five phthalates throughout the period investigated. The medians in samples from the different years investigated are 65.4 (2002), 38.5 (2004), 29.3 (2006) and 19.6 μg/l (2008) for MnBP, 31.4 (2002), 25.4 (2004), 31.8 (2006) and 25.5 μg/l (2008) for MiBP, 7.8 (2002), 6.3 (2004), 3.6 (2006) and 3.8 μg/l (2008) for MBzP, 7.0 (2002), 5.6 (2004), 4.1 (2006) and 3.3 μg/l (2008) for MEHP, 19.6 (2002), 16.2 (2004), 13.2 (2006) and 9.6 μg/l (2008) for 5OH-MEHP, 13.9 (2002), 11.8 (2004), 8.3 (2006) and 6.4 μg/l (2008) for 5oxo-MEHP, 18.7 (2002), 16.5 (2004), 13.8 (2006) and 10.2 μg/l (2008) for 5cx-MEPP, 7.2 (2002), 6.5 (2004), 5.1 (2006) and 4.6 μg/l (2008) for 2cx-MMHxP, 3.3 (2002), 2.8 (2004), 3.5 (2006) and 3.6 μg/l (2008) for OH-MiNP, 2.1 (2002), 2.1 (2004), 2.2 (2006) and 2.3 μg/l (2008) for oxo-MiNP and 4.1 (2002), 3.2 (2004), 4.1 (2006) and 3.6 μg/l (2008) for cx-MiNP. The investigation of the time series 1988–2008 indicates a decrease of the internal exposure to DnBP by the factor of 7–8 and to DEHP and BzBP by the factor of 2–3. In contrast, an increase of the internal exposure by the factor of 4 was observed for DiNP over the study period. The exposure to DiBP was found to be stable. In summary, we found decreases of the internal human exposure for legally restricted phthalates whereas the exposure to their substitutes increased. Future investigations should verify these trends. This is of increasing importance since the European Commission decided to require ban or authorization from 1.1.2015 for DEHP, DnBP, DiBP and BzBP according to REACh Annex XIV.