彩色多普勒超声诊断宫内妊娠合并宫外妊娠的临床价值

目的:探讨彩色多普勒超声检查对宫内妊娠合并宫外妊娠的诊断价值。方法:回顾分析2010年1月至2013年12月收治的19例体外受精-胚胎移植术后临床诊断为宫内妊娠合并宫外妊娠患者的术前彩色多普勒超声图像特征,并随访其预后。结果:19例患者中,术前超声诊断为宫内妊娠合并宫外妊娠18例(合并宫角妊娠8例,合并输卵管妊娠10例),1例漏诊。19例患者均住院手术治疗并进行随访,其中13例宫内妊娠已分娩或继续妊娠,2例行手术终止妊娠(1例因胚胎枯萎行手术终止妊娠,1例因难免流产行手术终止妊娠),2例自然流产,2例失访。结论:彩色多普勒超声对诊断宫内妊娠合并宫外妊娠有重要价值,能够及早发现宫内妊娠合并宫外妊娠并指导临床处理。     

髋关节外展操干预对GrafⅡa型髋关节发育不良患儿的作用及安全性分析

目的研究髋关节外展操干预对GrafⅡa型髋关节发育不良(DDH)患儿的作用及安全性。方法选择2018年1月～9月我院接受治疗的GrafⅡa型DDH患儿134例作为观察对象,按照随机数字表法将患儿分为观察组和对照组,各67例。对照组予以常规健康指导。观察组给予髋关节外展操干预。比较两组髋关节角度、患儿家长对干预效果的满意度及干预安全性。结果两组干预后髋关节α角较干预前明显增大,β角较干预前明显减小(P0.05)。观察组干预后髋关节α角较对照组明显增大,β角较对照组明显减小(P0.05)。观察组患儿家长对干预效果的满意度高于对照组(P0.05)。两组干预安全性比较差异无统计学意义(P0.05)。结论应用髋关节外展操干预对GrafⅡa型DDH患儿的作用较好,且安全性较佳。     

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目的探寻肥胖与糖脂代谢异常的相关性及相应靶器官肝脏、心脏损害情况,以早期采取干预措施。方法选择2008年7月至2010年10月沈阳市儿童医院儿保门诊就诊的单纯性肥胖儿童516例为肥胖组,100名体检体重正常儿童为对照组。取空腹静脉血检测空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、谷丙转氨酶(ALT)、空腹胰岛素(FINS)等指标,计算胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能值(HOMA-β);对肥胖儿童行口服糖耐量试验(OGTT)和胰岛素释放试验。对所有入组者均进行肝脏和心脏超声检查。结果肥胖组收缩压、舒张压均高于对照组(P<0.05),肥胖组高血压检出率为12.0%(62/516)。肥胖组FBG、FINS、HOMA-IR及HOMA-β均高于对照组(P<0.05);TC、TG、LDL-C均高于对照组,而HDL-C低于对照组,差异均有统计学意义(P<0.05)。轻、中、重度肥胖组脂肪肝发生率差异有统计学意义(P<0.001),且随肥胖程度加重,脂肪肝发生率明显增加(χ2=12.97,P<0.001)。肥胖组心包外脂肪增厚268例,平均厚度(3.372±0.098)mm,与对照组比较差异有统计...     

蛋氨酸合酶基因A275 6G位点多态性与非综合征型唇腭裂的关联性研究

Objective To study the association of the A2756G polymorphism of the methionine synthase (MS) gene with nonsyndromie cleft lip with or without cleft palate (NSCL/P) in Chinese. Methods Ninety-seven NSCL/P case-parent triads were selected as the case group. One hundred and four healthy subjects and their biological parents were selected as control group. For all subjects the A2756G polymorphism of the MS gene was examined by PCR-RFLP method. Results There was no statistical difference in genotype and allele frequencies for MS A2756G variants among family members between case group and control group. The GG genotype was not detected in the offsprings and mothers. The odds ratio and confidence interval of genotype AG in offspring, father and mother were 1.78(0.74-4.34), 0.80(0. 36-1.79) and 1.26(0. 54-2.93) respectively. The odds ratio and confidence interval of allele G in offspring, father and mother were 1.70(0.78-3.73), 0. 88(0. 49-1. 75) , and 1.23(0.59-2.60) respectively. The G allele did not increase the risk of NSCL/P. Transmission disequilibrium test (TDT) analysis yielded no evidence of linkage disequilibrium (χ2=0.034,P>0. 05). The results of haplotype-based haplotype relative risk (HHRR) analysis (χ2=0.03,P>0.05) and family-based association tests (FBAT) (Z=0. 186, P> 0.05) failed to show association between the MS A2756G variant and the risk of NSCL/P. Conclusion The A2756G polymorphism of the MS gene was not associated with NSCL/P in Chinese in the present study.     

骨形态发生蛋白2对成牙骨质细胞中硬化蛋白表达调控机理的研究

目的 探索成牙骨质细胞OCCM-30中骨形态发生蛋白2（BMP2）对硬化蛋白（SOST）表达的调控机制。方法 用2种质量浓度的BMP2（50、100 ng·mL^-1）处理成牙骨质OCCM-30细胞3、5、7 d,相同体积的PBS液为对照组,采用实时荧光定量聚合酶链反应（RT-PCR）、免疫印迹法检测SOST mRNA和蛋白的表达情况。将OCCM-30细胞分为5组：空白对照组、BMP2组、BMP2+dorsomorphin组、BMP2+SB202190组、BMP2+PD98059组,根据分组分别加入100 ng·mL^-1的BMP2和相应的试剂共培养,于3、5 d时检测SOST mRNA和蛋白的表达情况。结果 100 ng·mL^-1 BMP2对SOST表达的上调作用强于50 ng·mL^-1 BMP2,且有时间依赖性（P<0.05）。BMP2+dorsomorphin组、BMP2+ SB202190组、BMP2+ PD98059组的SOST mRNA水平和蛋白质水平均降低,其中BMP2+dorsomorphin组降低最明显（P<0.05）。结论 成牙骨质细胞中BMP2主要是通过Smad信号通路介导上调SOST的表达。     

胎儿生长受限仔鼠脂肪组织中葡萄糖转运蛋白4的表达和细胞转位变化

Objective To investigate the effects of fetal growth restriction (FGR) on the expressions and translocation of glucose transporter 4 (GLUT4) in adipose tissue of male offsprings and its relationship with insulin resistance in FGR. Methods Male 8-week-old offspring from maternal with protein-malnutrition or normal diet were studied. The weight of rats at 8 weeks of age were obtained and insulin resistance index (IRI) was examined at 4 weeks and 8 weeks of age. Perinephric fat pads were harvested to measure the expression of GLUT4 mRNA by fluorescent quantitative RT-PCR and the GLUT4 protein level and insulin-stimulated transloeation were assessed by Western blot. Results Birth weight of FGR animals were significantly lower than that of control (t=6.399, P<0.01), but surpassed the control at 8 weeks with increased fasting IRI(P<0.05). The GLUT4 mRNA expression in adipose tissue of FGR rats (0.36± 0.04) was lower than that of control (1.01±0.11) (t=2.854, P<0.05). Declined total GLUT4 protein concentration(913.47±87.32) was also noted in the FGR group compared with the controls (1248.30± 131.52) (t=2.617, P<0.05). After administration of insulin, plasma membrane associated-GLUT4 concentration significantly increased to 897.03±102.87, which was equal to 2.12 times of the basal level (423.05±41.26) in control rats(t=4.759, P<0.01). However, insulin-responsive GLUT4 transloeation was markedly blunted in FGR rats(525.12±54.96) compared with controls, only increased to 1.38 times of the basal level (379.57±38.71)(t=2.083, P<0.05). Conclusions Decreased GLUT4 expression and insulin-stimulated translocation in adipose tissue of the male FGR offspring might be caused by exposure to protein malnutrition during pregnancy, which may disturb the uptake and utilization of glucose and subsequently be related to diabetes mellitus in later life.     

荧光定量PCR在小儿肺炎支原体感染早期诊断中的临床应用

目的 探讨荧光定量PCR检测在肺炎支原体感染的早期诊断价值及临床意义.方法 分别用咽拭子荧光定量PCR法和明胶颗粒凝集法检测122例下呼吸道感染患儿肺炎支原体感染情况并对两种检测方法进行比较.结果 与明胶颗粒凝集法相比,荧光定量PCR法有较高的敏感性(86.7%)和特异性(91.3%).在首次滴度＜1:160的110例患儿中,荧光定量PCR法检测阳性病例与第二次血清滴度呈4倍以上升高的病例符合率为90.9%.两种方法均在检测6岁以上儿童时阳性率最高;在婴幼儿组,荧光定量PCR法阳性率高于明胶颗粒凝集法,但差异无显著性(X2=2.29,P＞0.05).结论 荧光定量PCR法敏感度高,特异性强,操作简单,可以准确定量,可作为早期快速诊断儿童(尤其3岁以下患儿)肺炎支原体感染的方法.     

荧光探针PCR检测肺炎支原体的临床应用研究

目的 探讨荧光探针PCR(FP-PCR)检测肺炎支原体DNA(MP-DNA)的临床应用价值.方法 563例疑似MP感染患儿为实验组,用FP-PCR检测MP-DNA,选取60例复查MP-DNA.同时应用颗粒凝集法检测肺炎支原体抗体(MP-Ab),1～2周后复查MP-Ab.同期选取20例无呼吸道感染者为对照组.结果 MP-DNA和MP-Ab的阳性率分别为34.99%、35.52%,两者差异无显著性(χ2=0.31,P>0.05),两种方法 一致率为97.69%.在疾病早期MP-DNA阳性率为30.48%,MP-Ab阳性率为10.16%,MP-DNA阳性检出率明显高于MP-Ab,差异有显著性(χ2=74.46,P<0.05).FP-PCR法敏感度及特异度分别是96.00%和98.62%.MP-DNA复查结果 与首次检查结果 及临床诊断一致.结论 FP-PCR法敏感性高,特异性强,方便快捷,稳定性好,适于临床应用,尤其适于MP早期诊断;且对MP既往感染有鉴别诊断意义.     

某市农村社区健康老年人主观幸福度评定的相关因素分析

目的探讨重庆市农村社区老年人主观幸福度及其影响因素。方法采用多级分层随机抽样方法,以纽芬兰大学幸福度量表(MUNSH)作为评定工具,对重庆市588名60岁及以上农村社区健康老年人主观幸福度进行调查。并采用多元回归分析方法分析影响老年人主观幸福度的相关因素。结果在588名健康老人中,MUNSH总分6～48分,平均(33.78±8.16)分,其中大于24分500例(85.03%);正性情感分(5.99±2.33),负性情感分(1.93±2.32),正性体验分(8.81±3.43),负性体验分(3.11±2.77)。MUNSH评分显示,低文化、无配偶、独居、亲子关系不良、经济收入低、有慢性病、生活能力差、认知水平高、社会支持低的老年人主观幸福度较低,差异有统计学意义(P<0.05)。认知水平、精神质、婚姻、社会支持、掩饰性、神经质、文化、亲子关系、内外向进入回归方程,决定系数R2=38.2%。结论农村社区健康老年人幸福度以正性情感占优势;影响老年人幸福度得分的主要因素包括认知水平、性格特征及家庭因素;提高老年人幸福度,应从这几个方面综合考虑。     

多普勒血流频谱法估测肺出血新生儿肺动脉压的研究

目的　研究肺出血新生儿心脏收缩功能和肺动脉压力变化及临床影响因素。方法　用M型二维超声多普勒和脉冲多普勒方法分别测定28例肺出血新生儿和28例非肺出血新生儿(含17例正常新生儿)心脏收缩功能及主肺动脉血流速度频谱,以肺动脉血流峰速时间/右室射血时间(TPV/RVET)比值反映肺动脉压力,分析肺出血新生儿心脏收缩功能和肺动脉压力变化及临床影响因素。结果　肺出血新生儿TPV/RVET比值(0.253±0.041)明显低于正常对照组(0.329±0.058)和非肺出血组(0.301±0.022)(P＜0.01);肺出血新生儿恢复期该比值(0.294±0.033)升高,肺出血死亡组TPV/RVET比值(0.219±0.022)和缩短分数［FS(31±5)%］明显低于存活新生儿(0.270±0.031,TPV/RVET39±7,FS)(P＜0.01);TPV(52±12)ms明显低于存活新生儿(44±8)(P＜0.05)。早产儿肺出血组TPV明显缩短(P＜0.01)。肺出血组TPV/RVET比值与动脉血pH值高度相关(r=0.84,P＜0.01)。结论　肺出血新生儿伴有肺动脉压力升高,严重者心脏收缩功能降低,导致心力衰竭,致新生儿死亡。