胎儿股骨次级骨化中心的MRI和组织学检测

目的:探讨用MRI检测骨化中心出现的时间、位置、形态等,和组织学进行对比性研究。方法:用FLASH2D梯度回波加脂肪抑制序列检测了胎龄6-8个月女性股骨远近端。同时与相应组织学H-E染色标本比较。结果:MRI检测结果:胎龄7个月 的81％股骨远端出现骨化中心征象,骨化中心始于偏心位。8个月 的股骨远端均出现骨化中心征象。胎龄7个月 、8个月 的股骨近端和6个月 股骨远近端均未出现骨化中心征象。H-E切片观测结果:证实了MRI检测阳性区有早期骨化中心征象。结论:MRI能检测出早期表达区,早于X线中所见,骨化中心见于骨组织尚未完全形成之前。     

内蒙古中学生神经衰弱患病情况调查

目的 :调查研究内蒙古不同民族中学生神经衰弱患病情况。方法 :采用随机整群抽样法 ,对内蒙古八所中学六个民族的中学生进行调查 ,以CCMD -2 -R中神经衰弱标准作最后医学诊断 ,所得数据进行卡方检验。结果 :总患病率为 2 3 5 % ,城市学生患病率高于乡村学生 ,高中生患病率高于初中生 ,均有显著差异 (P <0 0 5 ) ;男女生之间患病率无显著性差异。回族学生患病率最低 ,鄂伦春族学生患病率最高 ,汉族与回族学生之间患病率无显著差异 ,而与蒙古族、鄂温克族、鄂伦春族、达斡尔族之间患病率有显著差异(P <0 0 5 )。结论 :内蒙古中学生神经衰弱患病率较高 ,对来自于城市生、高中生应作为重点防治对象 ,关注少数民族学生的心理健康状况     

大脑中动脉供血区脑缺血后同侧丘脑继发性损害的MR实验研究

本文应用磁共振(magnetic resonance,MR)成像在体观察大脑中动脉(middle cerebral artery,MCA)供血区脑缺血后同侧丘脑的信号变化。结果显示:(1)通过MRA(magnetic resonance angiography)可以观测到单侧MCA的闭塞与血流再通,而供应丘脑的大脑后动脉信号无变化;(2)脑缺血后1d MR T2WI(T2weighted imaging)显示单侧MCA供血区原发病灶呈高信号,3d、7d时此原发病灶信号增高程度有所降低,至14d信号强度再次明显增高;(3)脑缺血后1d和3d时双侧丘脑T2信号无差别,7d和14d时脑缺血同侧丘脑T2信号减低,T2值降低;(4)MCA供血区脑缺血后原发病灶和同侧丘脑T2值的变化不同步。上述结果证实MR能够在活体显示MCA供血区脑缺血后同侧丘脑的继发性损害。     

Genetic alterations in primary and secondary hyperparathyroidism

Hyperparathyroidism refers to a term representing a wide spectrum of parathyroid disorders that are characterized by the increased production of parathyroid hormone. Hyperparathyroidism was once thought to be tare but is now more commonly recognized, aifecting 1 in 500 women over 40 years of age. Yet the interpretation of parathyroid pathology is still controversial and confusing. Over the past 10 years, genetic changes ( ret and menin genes) involved in the pathogenesis of MEN 2 and MEN 1 have been discovered in succession. Different mutations of the calcium-sensing receptor gene have been identified in neonatal severe hyperparathyroidism and familial hypocalciuric hypercal-cemia, respectively. The HRPT 2 gene responsible for the development of heredltaty hyperparathyroidism and jaw tumors has been localized on the 1q21–31 locus. Several genetic alterations have also been characterized in primary and secondary hyperparathyroidism. Different genetic alterations appear to involve the development of different types of hyperparathyroidism. These novel advances give us new insights into the pathogenesis of hyperparathyroidism and allow better differentiation between the different types of parathyroid disorders.     

DNA sequence analysis of the apocytochrome b gene of Podospora anserina: a new family of intronic open reading frame

Summary The 5,969 by (base pair) DNA sequence of the apocytochrome b mitochondrial (mt) gene of race A Podospora anserina was located in a 8.5 Kbp region. This gene contained a 2,499 by subgroup IB and a 1,306 by subgroup ID intron as well as a 990 bp subgroup IB intron which is present in race A but not race s. The large subgroup IB intron and the race A specific IB intron both contained potential alternate splice sites which brought their open reading frames into phase with their upstream exon sequences. All three introns were compared with regard to their secondary structures and open reading frames to the other 30 group I introns in Podospora anserina, as well as to other fungal introns. We detected a new family of intronic ORFs comprising seven P. anserina introns, several N. crassa introns, as well as the T4td bacteriophage intron. Sequence similarities to intron-encoded endonucleases were noteworthy. The DNA sequences reported here and in the accompanying paper complete the analysis of race s and race A mitochondrial DNA.     

303例闭经患者的病因学分析

目的分析统计女性闭经的病因。方法收集2016年1月至2019年6月云南省第一人民医院妇科门诊闭经患者303例,通过病史、查体、抽血查性激素六项、甲状腺功能、空腹血糖等指标、影像学评估及对原发性闭经患者行染色体检查,确定闭经原因并进行统计分析。结果303例患者中,原发性闭经36例(11.89%),继发性闭经267例(88.11%)。导致原发性闭经最常见的疾病为苗勒管发育不全综合征(Mayer-Rokitansky-Kuster-Hauser syndrome,MRKH综合征),36例患者中有7例是MRKH综合征患者,多囊卵巢综合征(polycystic ovarian syndrome,PCOS)是次要原因,有5例患者为PCOS。在继发性闭经中,Asherman综合征和PCOS是最主要的致病原因,分别占29.96%和29.59%。36例原发性闭经患者中,正常核型46,XX患者24例,占原发性闭经患者总数的66.67%。结论闭经患者最常见病因是PCOS和Asherman综合征。     

Micronutrients and Markers of Oxidative Stress and Inflammation Related to Cardiometabolic Health: Results from the EHES-LUX Study

Metabolic syndrome (MetS) characteristics include chronic inflammation and elevated oxidative stress. This study assessed associations between circulating concentrations of micronutrients/phytochemicals and inflammatory/oxidative stress markers with MetS and MetS components. Adults (N = 606) from the European Health Examination Survey in Luxembourg (2013–2015) were randomly selected. We performed a multivariable logistic regression model using the least absolute shrinkage and selection operator to identify MetS-associated variables. Participants with MetS had higher concentrations of C-reactive protein (CRP), 8-iso-prostaglandin F2α, leptin, insulin, and vitamins E/A, but lower concentrations of adiponectin, beta-carotene, and oxidized low-density lipoprotein. A one-unit increase in log-CRP was associated with 51% greater odds of MetS (OR = 1.51 (95% CI: 1.16, 1.98)). Adults with a one-unit increase in log-leptin were 3.1 times more likely to have MetS (3.10 (2.10, 4.72)). Women with a one-unit increase in vitamin A were associated with 3% increased odds of MetS (1.03 (1.01, 1.05)), while those with a one-unit increase in log-adiponectin were associated with 82% decreased odds (0.18 (0.07, 0.46)). Chronic inflammation best characterized adults with MetS, as CRP, adiponectin, and leptin were selected as the main MetS determinants. Micronutrients did not seem to affect MetS, except for vitamin A in women.     

基于医院信息化平台的护理荣誉无纸化管理的实践

目的借助医院现有的护理信息平台,实现护理荣誉无纸化管理。方法在护理信息平台上二次开发,整合平台数据库中的管理信息,构建护理荣誉表单系统,并通过"工号"字段进行关联,与其他数据表单交互取数。结果护理荣誉表单系统的应用,实现了护理荣誉无纸化管理;将护理集体荣誉进行量化处理,体现了护理荣誉使用中公平公正的原则;优化护理荣誉使用流程,在晋升评优等活动中实现"一键取数"。结论护理荣誉无纸化管理的应用,改变传统纸质版护理荣誉证书在存储及使用中存在的不足,提高护理管理工作效率。     

创伤后肺内炎性细胞凋亡与继发性坏死的观察及意义

目的 探讨严重创伤后肺内炎性细胞凋亡与继发性坏死在急性肺损伤发病机制中的地位和作用。方法 复制大鼠多发骨折合并休克模型,采用Annexin-V和PI双标法经流式细胞仪检测创伤后肺泡灌洗液中凋亡与坏死炎性细胞的数量变化,测定细胞分类计数及肺通透指数并作比较。结果伤后动物肺泡灌洗液中巨噬细胞数量减少,而白细胞数量增加。伤后凋亡炎性细胞数量增加,于伤后3h达到高峰。部分凋亡炎性细胞发生继发性坏死,其数量进行性升高并与肺通透指数变化显著相关（r=0.90,P<0.01）。结论 严重创伤后肺泡内炎性细胞发生凋亡,可能因为继发性坏死致炎性内容物外泄而引发急性肺损伤。     

差错反感文化在护士内部人身份认知与道德勇气间的中介作用

目的 探讨差错反感文化对护士内部人身份认知与道德勇气的影响及机制,为提高其道德勇气提供依据.方法 抽取湖南省湘西自治州7所二级医院的693名护士,采用一般资料调查表、差错反感文化量表、内部人身份认知量表及道德勇气量表进行调查.结果 护士的差错反感文化、内部人身份认知、道德勇气总分分别为(26.05±4.92)分、(27.99±3.15)分、(84.28±9.48)分.差错反感文化与道德勇气呈负相关,内部人身份认知与道德勇气呈正相关(均P＜0.01),差错反感文化在内部人身份认知与道德勇气间发挥部分中介作用,间接效应占总效应的15.74％.结论 护士的道德勇气总体水平较高,可以通过合理管理差错反感文化、增强内部人身份认知来提高护士道德勇气.