前踝骨折诊治分析5例

踝部骨折是最常见的关节内骨折,约占全身骨折的3.9%[1]。自1998年4月至2004年3月收治单纯前踝骨折5例,现报告如下。1临床资料本组5例,均为男性;年龄18～24岁;左侧3例,右侧2例。受伤至住院时间为2h～1d,均为训练时从高处跳下垂直暴力所致。按Lauge-Hansen分类系统踝关节骨折分为     

A study for accommodating the human crystalline lens by finite element simulation.

This paper constructs two finite element models of human crystalline lens and zonules based on published clinical data. Displacement and pressure were applied to study the mechanism of vision accommodation. The simulation results show that, in Model A, under the pull of the zonules, the thickness of the lens decreased linearly, and the lens diameter increased linearly. The optical power of the lens increased as the zonules displacement increased. Furthermore, the pressure had a remarkable influence on the shape of the lens and the optical power. The lens also became thinner and flatter as the pressure increased. The optical power increased when the pressure increased. In Model B, the lens became thicker and optical power increased as the equatorial zonules stretched. It is basically consistent with Schachar's hypothesis. The outcome of this paper proved that the analytical model presented in this paper can be used in the theoretical study of the accommodation mechanism of the lens.     

胃癌术后患者的不同营养治疗费用比较及其影响因素分析

目的:了解肠外营养(Parenteral Nutrition,PN)与肠内营养(Enteral Nutrition,EN)治疗临床应用和费用的现状及费用影响因素。方法:通过对87份胃癌手术患者的病例回顾性调查(PN EN 28份和PN59份),利用SPSS10．0进行临床疗效和费用的单因素比较,以及影响住院总费用的多因素分析。结果:2004年全部胃癌手术病例的营养治疗率为100％(单纯PN治疗率为69％,EN加PN的治疗率为31．0％);两组临床疗效无明显差异,但两组出院和入院自身状况比较,PN EN组略优于PN组;从住院日和各类人均费用指标来看,PN EN组明显高于PN组(有统计学差异);但其人日均EN药费为113．81元,明显低于本组或PN组的人日均PN药费(P=0．034);PN EN组和PN组病例进行了多因素分析,结果提示PN EN组和PN组影响住院总费用的首位因素均是PN药费。结论:胃癌患者术后EN的治疗率不足30％,多数适合EN治疗的患者并没有进行EN治疗;并且无论PN还是有限的EN治疗,均存在着相当程度的不规范治疗。目前影响临床营养合理用药的主要原因并不是医疗技术水平因素,更多的是非医疗技术水平以外的因素。要推动营养治疗的健康发展,单单依靠临床技术的教育和培养是远远不够的,如何制定合乎营养治疗实际情况的经济激励及医保支付和报销政策,以及实施临床营养治疗的监管措施,对于实现临床营养治疗的真正意义来说是至关重要的。     

肠外与肠内营养药临床应用的现状分析

目的:了解临床营养药的应用的现状和问题。方法:通过对临床医生、专家的问卷调查和定性访谈,对肠外营养(Parenteral Nutrition,PN)与肠内营养(Enteral Nutrition,EN)药的临床应用现况及其问题,以及营养药合理应用的主要因素进行了描述性分析。结果:营养支持已经广泛应用于临床各科室诸多疾病,但注重EN使用的医师仅占25．8%;究其原因,83．9%的医生认为对EN的新概念和技术进展了解不够,其次主要原因是医保具体支付政策和医院运营经济政策的问题。结论:为了控制临床住院费用,促进临床营养治疗的合理开展,不仅要制定其临床应用指南,普及教育,还要在技术层面制定相应的具体支付政策;舍此,医疗费用的宏观控制不仅很难操作,更无从谈起其合理性和科学性。     

运动依赖与性行为依赖

从运动依赖与性行为依赖的概念与表现症状入手,发现运动依赖与性行为依赖具有相同的形成机制.分析表明,性行为是一项特殊的运动项目,我们可以把对运动项目的研究成果推广应用到对性行为的研究上.性行为渴望的形成表明,个体产生的性行为渴望是后天培养的,而不是先天形成的.性行为频率的多少主要取决于个体在初始阶段进行性行为时的时间间隔.应该根据性行为依赖的形成机制,科学合理地调整性行为依赖程度.     

The effect of storage time in saline solution on the material properties of cortical bone tissue

BackgroundThe use of saline in preserving bone specimens may affect the mechanical properties of specimens. Yet, the reported effects varied and contradicted to each other, with a lack of investigating constitutive material parameters. Therefore, we quantified the effects of preservation time on the constitutive properties of cortical bone.MethodsWe collected 120 specimens from the mid-diaphysis of six male bovine femora, which were assigned to five groups, including fresh-frozen for 60 days (−20 °C), storage in saline for 3, 10, 36 and 60 days (25 °C). All specimens underwent quasi-static three-point bending tests with a loading rate of 0.02 mm/s. Using the optimization method combined with specimen-specific finite element models, the Young's modulus, tangent modulus, yield stress, effective plastic strain, yield strain, ultimate stress, and toughness were calculated.FindingsSaline preservation resulted in a significant decrease of Young's modulus, yield stress, ultimate stress and pre-yield toughness (P < 0.001), and a significant increase of effective plastic strain (P = 0.034). After 10 days of preservation, yield stress and pre-yield toughness decreased −14.9% and −21.4%, respectively, and they continued to decrease with longer preservation time. After 36 days of preservation, Young's modulus and ultimate stress decreased −19.2% and −17.3%, respectively, and continued to decrease with longer preservation time. Our data also showed changes of material properties collected after 3-day saline preservation, while the low statistical power must be considered for this group.InterpretationSaline preservation impacts on mechanical properties of cortical bone tissue and the effect is already observable after 3 days.     

DHA通过抑制PI3K通路和GLUT2表达而诱导NSCLC细胞毒性

目的:研究二氢青蒿素(dihydroartemisinin,DHA)诱导NSCLC细胞毒性的分子机制。方法:将不同浓度的DHA作用NSCLC细胞系A549和NCI-H1650细胞不同时间,运用MTT法、克隆形成实验、Annexin V染色和流式细胞术测定DHA对细胞活力、克隆形成能力和细胞凋亡的影响;同时测定DHA对细胞中葡萄糖水平、ATP和乳酸含量的影响;Western blot检测PI3K通路活性和GLUT2表达变化;通过细胞转染实现葡萄糖转运体2(GLUT2)和Rheb在A549和NCI-H1650细胞中高表达,测定和分析DHA作用下细胞活力、细胞凋亡、葡萄糖水平、ATP含量和PI3K通路活性的变化;分析葡萄糖缺乏对DHA诱导NSCLC细胞毒性的影响。结果:与对照组比较,DHA显著抑制A549和NCI-H1650细胞活力和克隆形成能力以及诱导细胞凋亡,同时降低ATP和乳酸含量以及抑制细胞对葡萄糖的摄取,具有时间和剂量依赖效应。Western blot结果显示,DHA能抑制PI3K通路活性和GLUT2的表达。上调GLUT2的表达和激活PI3K通路能减弱DHA对NSCLC细胞的毒性作用;葡萄糖缺乏能增强DHA对NSCLC细胞的毒性;相反,高浓度葡萄糖则抑制DHA对NSCLC细胞的毒性。结论:DHA能抑制NSCLC细胞活力和克隆形成,诱导细胞凋亡,该作用是通过降低PI3K活性和GLUT2的表达进而抑制细胞糖酵解代谢实现的。     

Solvent-assisted thermal reduction of microcrystalline graphene oxide with excellent microwave absorption performance

To prepare a new kind of electromagnetic wave absorber, and improve the processing technology and accessional value of natural microcrystalline graphite minerals (NMGMs), reduced microcrystalline graphene oxide (rGO-M), a novel absorber with high absorption, low reflection and a wide absorption band, was prepared from NMGMs using a solvent-assisted thermal reduction method. Moreover, the as-produced rGO-M with adjustable electrical resistivity can be easily transferred into well distributed bulk materials by freeze-drying technology. These unique structures and compositions make a great contribution to the impedance match, and cause strong conductive loss and various dipole polarization effects which greatly enhance the absorption. Meanwhile, the effective bandwidths below −5 dB and −10 dB are 11.7 GHz and 3.32 GHz respectively, and the reflection loss can reach −42.68 dB. The study will be beneficial to the development of carbon resources and carbon materials research. Besides, it can provide a scientific basis for the further improvement of the comprehensive utilization and the level of deep processing technology of NMGM resources.

Reduced microcrystalline graphene oxide (rGO-M), a novel absorber with high absorption, low reflection and a wide absorption band, was prepared from NMGMs using a solvent-assisted thermal reduction method.