数字切片扫描仪产品主要性能指标的检验方法初探

数字切片扫描仪产品按照医疗器械进行管理,管理类别为Ⅱ类。本文依据日常检验工作要求,归纳总结出一套现实可行的,针对数字切片扫描仪产品主要性能指标的检验方法,以期规范和指导该类产品的检验。     

手术显微镜下MTA封闭年轻恒牙未闭合根尖孔临床效果观察

目的：观察根尖孔未完全闭合的年轻恒牙在手术显微镜下进行三氧化聚合物封闭根尖孔的临床疗效. 方法：选取我科2012年4月至2014年4月就诊的因龋病、外伤、畸形中央尖等致牙髓炎或根尖周炎使根尖孔未完全闭合的年轻恒牙12例27颗患牙.橡皮障隔湿后进行根管预备及彻底的冲洗,氢氧化钙封药-周至十日后,在手术显微镜下将调好的MTA 放至根尖处,垂压器充填根尖4-5mm ,封生理盐水棉球-周待硬固后热牙胶充填根管上部分,并完成冠部修复,定期观察疗效. 结果：所有病例2-3次完成充填,患者无不适,有瘘管着瘘管闭合,3-6个月复查X片示：根尖周暗影缩小或消失. 结论：手术显微镜下MTA 封闭年轻恒牙未闭合根尖孔临床效果明显,且疗程短,患者易接受.     

聚焦新媒体环境下的男性健康

本刊讯 日前,由辉瑞中国主办的辉瑞男科“朝阳工程”2014专题学术会议在京召开。北京大学第三陕院男科中心主任、中国性学会常务副理事长兼秘书长、中华医学会男科学分会候任主任委员姜辉教授,     

Loupe-assisted versus microscopic varicocelectomy： s there an intraoperative anatomic difference？

The aim of this study was to compare the intraoperative difference in anatomic details between Ioupe-assisted and microscopic varicocelectomy within the same spermatic cord. Between April 2011 and August 2011, 26 men with 33 sides containing grade 2-3 varicocele were enrolled in this study. First, one surgeon performed the open inguinal varicocelectomy under x 3.5 Ioupe magnification. The presumed vascular channels and lymphatics were isolated and marked without ligation. Another surgeon then microsurgically dissected and checked the same spermatic cord using an operating microscope to judge the results in terms of the ligation of the internal spermatic veins and the preservation of the arteries and lymphatics. There were significant differences in the average number of internal spermatic arteries （1.51 vs 0.97）, internal spermatic veins （5.70 vs 4.39） and lymphatics （3.52 vs 1.61） between the microscope and Ioupe-assisted procedures （P 〈 0.001, P 〈 0.001, P 〈 0.001, respectively）. Meanwhile, in varicocele repair with Ioupe magnification, an average of 1.30 β± 1.07 （43/33） internal spermatic veins per side were missed, among the overlooked veins, 1.12 ± 0.93 （37/33） were adhered to the preserved testicular artery, as well as 0.55 ± 0.79 lymphatics and 0.36 ± 0.55 arteries that were to be ligated. In conclusion, microscopic varicocelectomy could preserve more internal spermatic arteries and lymphatics and could ligate more veins than the Ioupe-assisted procedure. To some degree, Ioupe magnification is inadequate for the reliable identification and dissection of the tiny vessels of the spermatic cord, as most of the overlooked veins were adhered to the preserved testicular artery.     

显微镜与内镜下不同纵裂入路的结构显露特点及其解剖结构标志定位

目的探讨显微镜与内镜下不同纵裂入路的结构显露特点及解剖结构标志定位。方法成人尸头10具,分为A组和B组,每组5具,分别采用经前额纵裂入路和经纵裂胼胝体脉络膜裂入路联合室内孔入路,在显微镜和内镜下观察内部结构。结果显微镜与内镜下经前额纵裂入路微创并可充分显露和定位鞍区和第三脑室,有利于切除第三脑室前部和鞍区肿瘤,而经纵裂胼胝体脉络膜裂入路联合室内孔入路微创并可充分显露和定位第三脑室及侧脑室解剖结构,有利于第三脑室、房部、体部及侧脑室额角的手术操作。结论两种纵裂入路均可在显微镜、内镜下充分显露第三脑室等部分结构,组织创伤小,临床上可根据病变特点和手术需求选择合理的入路方式。     

原发性高血压患者WNK-SPAK激酶通路的表达及饮食干预的影响

目的：通过研究原发性高血压患者WNK1激酶（ with no lysine kinase 1）-STE20相关脯氨酸/丙氨酸丰富激酶（ Ste20-related proline/alanine-rich kinase,SPAK）信号通路的表达水平,以及低钠高钾饮食干预后表达水平的变化,探讨其在原发性高血压中的致病作用。方法：75名未经治疗的高血压患者经低钠高钾饮食干预1个月,通过Realtime PCR对干预前后外周血中的WNK1和SPAK的mRNA表达水平进行检测,并观察受试者血压、血尿生化指标变化。结果：高血压患者组外周血中WNK1和SPAK mRNA水平的表达较健康志愿者组明显升高,低钠高钾饮食干预后信号通路的表达则较基线期明显下降。统计学分析表明WNK1激酶的表达水平与血压之间存在相关性。结论：WNK1-SPAK激酶通路的表达异常可能参与原发性高血压的发病,饮食结构的变化可通过改变WNK1-SPAK-NCC信号通路的表达而调节血压。     

Heavy ion and X-ray irradiation alter the cytoskeleton and cytomechanics of cortical neurons

Heavy ion beams with high linear energy transfer exhibit more beneifcial physical and biological performance than conventional X-rays, thus improving the potential of this type of radiotherapy in the treatment of cancer. However, these two radiotherapy modalities both cause inevitable brain injury. The objective of this study was to evaluate the effects of heavy ion and X-ray irra-diation on the cytoskeleton and cytomechanical properties of rat cortical neurons, as well as to determine the potential mechanism of neuronal injury after irradiation. Cortical neurons from 30 new-born mice were irradiated with heavy ion beams at a single dose of 2 Gy and X-rays at a single dose of 4 Gy;subsequent evaluation of their effects were carried out at 24 hours after irradiation. An immunolfuorescence assay showed that after irradiation with both the heavy ion beam and X-rays, the number of primary neurons was signiifcantly decreased, and there was ev-idence of apoptosis. Radiation-induced neuronal injury was more apparent after X-irradiation. Under atomic force microscopy, the neuronal membrane appeared rough and neuronal rigidity had increased. These cell changes were more apparent following exposure to X-rays. Our ifnd-ings indicated that damage caused by heavy ion and X-ray irradiation resulted in the structural distortion and rearrangement of the cytoskeleton, and affected the cytomechanical properties of the cortical neurons. Moreover, this radiation injury to normal neurons was much severer after irradiation with X-rays than after heavy ion beam irradiation.     

活体肝移植后小肝综合征的研究进展

小肝综合征是活体肝移植术（LDLT）后的严重并发症,供体年龄、脂肪肝程度、受体术前疾病状态（MELD评分）、术后高门静脉灌注、流出道不畅及移植物大小和质量等均小肝综合征的发生起着重要作用。术前选择最佳的供体;术中行脾脏切除或脾动脉结扎或对门静脉限流,保证流出道的绝对通畅;术后及早发现并积极治疗能显著减少小肝综合征的发生。     

血细胞分析仪法及直接计数法和涂片染色法单核细胞分类计数的比较

目的 探讨三种单核细胞计数方法的准确性和可信性.方法 随机选取血细胞分析仪白细胞分类单核细胞＜15％、15％～ 20％、＞20％的标本,混匀后吸取20μl置单核细胞直接计数稀释液内计数,并按常规涂片,经瑞-吉染色后用显微镜人工分类,然后对三种方法结果进行比较.另外收集单核细胞比例高、中、低值标本各1份,用上述三种方法各计数30次.结果 血细胞分析仪白细胞分类单核细胞15％～ 20％、＞20％的标本与其他两种方法结果相关性差.三种方法的重复性比较,以低、中值标本以方法1及方法2较好,高值标本以方法3为优.结论 对单核细胞≥15％的标本,尤其散点图异常时必须经方法3（即涂片染色显微镜分类）再检查确认.     

三阶梯技术在筛查妊娠期妇女宫颈病变的临床应用

目的探讨三阶梯技术在诊断孕妇宫颈病变的临床价值和安全性。方法采用队列研究方法,选择2008年1月1日至2011年12月31日在密云县妇幼保健院产科门诊初次检查的孕10—32周、1年内未进行过宫颈液基薄层细胞学检查（TCT）的6649例孕妇,先行TCT筛查,对TCT结果异常者在知情同意后进行阴道镜检查和阴道镜指引下宫颈多点活检。结果①TCT筛查6649例孕妇,其中TCT结果异常154倒,发生率为2．32％;②114例孕妇的阴遭镜图像满意度为93．86％（107／114）,阴道镜拟诊慢性宫颈炎12例、鳞状上皮低度病变（LSIL）67例、鳞状上皮高度病变（HSIL）35例;③114例孕妇全部进行了宫颈活检,病理结果为宫颈炎及宫颈湿疣共48例,宫颈上皮内瘤样病变（CIN）136例、CINⅡ18例、CINⅢ10例、宫颈癌早浸2例;④与宫颈活检病理结果比较,阴道镜检查拟诊炎症和LSIL79例,其中71例与宫颈活检病理结果相同,符合率为89．87％（71／79）,79例拟诊炎症和LSIL患者中,无鳞状细胞癌（SCC）病例。拟诊为HSIL的35例孕妇中,20例活检病理结果为CINⅡ或CINⅢ,2例为早浸,符合率为57．14％（20／35）;⑤未发生与阴道镜检查和宫颈活检相关的不良事件。结论对1年内未进行宫颈细胞学筛查的孕妇进行TCT检查是必要的,对TCT结果异常者应进行阴道镜检查,阴道镜检查拟诊宫颈炎或LSIL可以随诊;对阴道镜检查下拟诊高级别宫颈病变的孕妇,应行阴道镜下宫颈活检以明确病理学诊断。