强直性脊柱炎的临床,CT,ECT诊断与比较

报告１１０例强直性脊柱炎（ＡＳ）的临床、Ｘ线平片及ＣＴ表现，并与其中２４例发射计算机体层（ＥＣＴ）全身骨显像及骨与邻近软组织核素比值进行了对照分析。结果表明，骶髂关节和髋关节骨与邻近软组织核素比值高者，临床上均有明显的下背疼痛和僵硬（Ｐ＜０．０５），核素比值与Ｘ线平片及ＣＴ显示骨的侵蚀和硬化呈正相关（ｒ＝０．５３～０．６６，Ｐ＜０．０５；ｒ＝０．４０～０．５３，Ｐ＜０．０５），与强直呈负相关（ｒ＝－０．４２～－０．４７，Ｐ＜０．０５）。随着骨侵蚀和硬化的增加，骨与软组织核素比值亦相应升高，而强直加重时比值反而减小。ＥＣＴ骨与软组织核素比值测定不仅能预示ＡＳ的活动，而且可以确定病变的部位和范围尤其对全身有多处病变者其敏感性和检出率明显高于ＣＴ及Ｘ线平片。作者认为ＥＣＴ骨与软组织核素比值测定对ＡＳ的早期诊断是一个有价值的检查方法。     

心肌血管紧张素Ⅱ在运动和高血压性心肌肥大时肌球蛋白重链变化中的作用

运动和高血压心肌肥大的细胞表型改变明显不同，心肌局部血管紧张素Ⅱ（ＡｎｇⅡ）参与运动和高血压心肌肥大形成。为了解心肌局部ＡｎｇⅡ是否参与两种不同心肌肥大细胞表型变化调节，本实验对正常和自发性高血压大鼠（ＳＨＲ）运动后心肌ＡｎｇⅡ与肌球蛋白重链（ＭＨＣ）异型变化进行相关分析，结果表明正常安静大鼠心肌ＡｎｇⅡ与ａ－和β－ＭＨＣ变化无明显相关性（ｒ＝０．１７４７：０．１７３２，Ｐ＞０．０５），但经过１２周游泳训练运动后，心肌ａ－ＭＨＣ增加，ＡｎｇⅡ含量升高，两者呈正相关（ｒ＝０．７７２３，Ｐ＜０．０５）。ＳＨＲ心肌ＡｎｇⅡ和β－ＭＨＣ比ＷＫＹ高８８．０２％和４６．８９％，两者呈正相关（ｒ＝０．８７０５，Ｐ＜０．０５），ＳＨＲ心肌ＡｎｇⅡ与ａ－ＭＨＣ呈负相关（ｒ＝－０．８６２２，Ｐ＜０．０５），ＷＫＹ心肌ＡｎｇⅡ与ａ－和β－ＭＨＣ之间无明显相关性（ｒ＝０．２９３５；０．０２６３，Ｐ＞０．０５）。ＳＨＲ经１０周游泳运动后，心肌ＡｎｇⅡ含量下降，β－ＭＨＣ向ａ－ＭＨＣ逆转，ＡｎｇⅡ与ａ－／β－ＭＨＣ呈正相关（ｒ＝０．７９３４：Ｐ＜０．０５）。以上结果提示心肌局部ＡｎｇⅡ在运动性心肌肥大中可能具有对ａ－ＭＨＣ表达上调作用?     

肾综合征出血热患者血清及尿液中TNF与SIL－2R的动态研究

采用双抗体夹心ＥＬＩＳＡ法，对３０例肾综合征出血热（ＨＦＲＳ）患者９６份血清及９６份尿液中肿瘤坏死因子（ＴＮＦ）及可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）水平进行了动态检测。结果显示：ＨＦＲＳ患者各期尿液及血清ＴＮＦ与ＳＩＬ－２Ｒ水平均高于正常对照组（Ｐ＜０．０１），且与临床病程密切相关，尿液与血清变化水平有密切的正相关性（γ＝０．５７５２，Ｐ＜０．００１；γ＝０．５４２７，Ｐ＜０．０１），尿液中含量与尿蛋白含量呈正相关（γ＝０．３４２５，Ｐ＜０．０１；γ＝０．４４８５，Ｐ＜０．０１），血、尿中ＴＮＦ与血、尿中ＳＩＬ－２Ｒ的变化呈正相关（γ＝０．６４２５，Ｐ＜０．０１，γ＝０．６５９６，Ｐ＜０．０１）。提示：ＴＮＦ及ＳＩＬ－２Ｒ是参与ＨＦＲＳ发病机理的重要介质。     

白质疏松病人局部脑血流变化的初步研究

为探讨白质疏松（ＬＡ）病人ＬＡ区域和皮质部位的局部脑血流（ｒＣＢＦ）变化及与痴呆的关系，对２４例伴有ＬＡ〔ＬＡ（＋）〕、２５例无ＬＡ〔ＬＡ（－）〕的皮质下多发性脑梗塞病人及１０例正常对照者行脑血流ＳＰＥＣＴ显像，并与智能评分进行相关分析。结果：ＬＡ（＋）组与正常组相比，额叶、颞叶、顶叶、ＬＡ区域ｒＣＢＦ显著降低（ｔ＝２１２～２５４，Ｐ＜００５）；与ＬＡ（－）组相比，额叶和顶叶皮质、ＬＡ区域ｒＣＢＦ显著减少（ｔ＝２１１～２６０，Ｐ＜００５）；ＬＡ（＋）组长谷川智能评分与额叶皮质、ＬＡ区域ｒＣＢＦ变化呈显著正相关（ｒ＝０７６５，Ｐ＜００１和ｒ＝０４３９，Ｐ＜００５）。结果表明，伴ＬＡ的多发性脑梗塞病人，ＬＡ区和皮质区域存在广泛血流灌注不足，持续的低灌注状态可引起脑功能低下，并与痴呆的程度有一定关系；脑血流ＳＰＥＣＴ显像具有独特优势和价值。     

不同海拔高度健康人超氧化物歧化酶和丙二醛的测定

对不同海拔高反的西安市（海拔３４０ｍ）、西宁市（２２６０ｍ）、茶卡镇（３１００ｍ）和甘德地区（４０８０ｍ）共１０８９例健康人进行了红细胞——超氧化物歧化酶（ＳＯＤ）和血清丙二醛（ＭＤＡ）测定。结果表明：随着海拔高度的升高和大气压、大气氧分压的降低，血清ＭＤＡ明显增加（Ｐ＜０．０１），红细胞ＳＯＤ显著降低（Ｐ＜０．０１）。相关分析表明：ＭＤＡ与大气氧分压呈明显负相关（ｒ＝－０．９７９，Ｐ＜０．０５），ＳＯＤ与大气氧分压呈明显正相关（ｒ＝０．９８４，Ｐ＜０．０５）。本文对长期生活在高原低氧环境下居民ＭＤＡ升高和ＳＯＤ降低的原因进行了探讨。     

医高专496名学员口腔卫生状况调查

调查本校４９６名学员口腔卫生状况，结果：软垢、牙石、龈炎的检出率分别为８３．９％，６６．７％，９０．９％，牙石、龈炎检出率男女间差异非常显著（Ｐ＜０．０１）；其中以轻度者居多；口腔卫生指数、牙龈指数分别为１．１，０．９，男女间差异非常显著（Ｐ＜０．０１）；软垢、牙石与龈炎间呈正相关关系（ｒ＝０．５４４６，Ｐ＜０．０１，ｒ＝０．５７１３，Ｐ＜０．０１）。说明口腔卫生保健十分必要。     

99m Tc－M IBI心肌灌注断层显像对实验性心肌梗塞的评价

目的：评价９９ｍ锝一甲氧基异丁基异腈（９９ｍＴｃ－ＭＩＢＩ）ＳＰＥＣＴ显像对心肌梗塞范围的估测及硝酸甘油介入后对存活心肌检测的价值。材料和方法：７条杂种犬通过结扎冠状动脉造成心肌梗塞模型，分别在实验第一天及实验第七天行９９ｍＴｃ－ＭＩＢＩＳＰＥＣＴ静息显像及硝酸甘油介入９９ｍＴｃ－ＭＩＢＩ心肌显像。用圆周剖面法定量分析短轴６个断面心肌缺损面积大小。结果：末次显像缺损面积与病理梗塞面积有良好相关性（ｒ＝０．８６和ｒ＝０．８７分别为硝酸甘油介入前后心肌缺损面积与病理梗塞面积的相关系数），末次显像与首次显像相比缺损面积明显缩小（Ｐ＜０．０５），硝酸甘油介入后心肌显像的平均缺损面积在首次和末次显像均明显减小（Ｐ＜０．０１），且缺损区的平均计数在硝酸甘油介入后均明显增高（Ｐ＜０．０５）。结论：９９ｍＴｃ－ＭＩＢＩ心肌断层显像是了解急性心肌梗塞范围的较好手段及硝酸甘油介入９９ｍＴｃ－ＭＩＢＩＳＰＥＣＴ显像可以提高检测低灌注区残存的存活心肌。     

血清层粘连蛋白、透明质酸及Ⅳ型胶原与肝纤维化不同组织学分级的关系

目的：探讨慢性肝炎血清检测指标层粘连蛋白（ Ｌ Ｎ） 、透明质酸（ Ｈ Ａ） 及Ⅳ型胶原（ Ⅳ－ Ｃ） 的临床意义及其与肝纤维化分期间的关系。方法：对１５２ 例各型肝病患者急性肝炎,慢性肝炎轻度、中度、重度及肝硬化与正常对照血清 Ｌ Ｎ、 Ｈ Ａ 及Ⅳ－ Ｃ 进行了测定,其中１０８ 例行肝脏穿刺,肝组织石蜡切片,常规 Ｈ Ｅ、网纤维及弹力纤维染色,肝纤维化病理诊断分五期（ Ｓ０ － Ｓ４） ,统计三者血清值。结果：慢性肝炎中、重度及肝硬化三者血清与对照组有显著性差异（ Ｐ＜ ０ ．０５） ,且呈现递增趋势,各病理组织学纤维化分期与血清指标成显著正相关（ｒ＝ ０ ．９８３ , Ｐ＜ ０ ．０１ ;ｒ＝ ０ ．９８０ , Ｐ＜ ０ ．０１ ;ｒ＝ ０ ．９９０ , Ｐ＜ ０ ．０１） 。结论：纤维化血清学指标有较好的临床诊断价值,血清学诊断慢性肝炎肝纤维化程度的具体数据范围可以确定,并可估计相对应病理组织学分期。     

Changes of Cerebral OxygenSaturation under Lower Body Negative Presure

观察了１２名被试者在下体负压作用下脑氧饱和度（ＳｒＯ２）的变化，并作了分析。结果表明：（１）下体负压作用下，ＳｒＯ２呈现显著下降的趋势；（２）在负压终止的时刻，不同状态组之间ＳｒＯ２的变化量差别显著；（３）下体负压作用下ＳａＯ２保持不变，ＳｒＯ２的改变与眶上动脉血流改变的百分数显著相关（ｒ＝０．５９～０．８６，Ｐ＜０．０５或０．０１）。以上结果提示下体负压作用下ＳｒＯ２的改变与脑血流的下降有关，而且用ＳｒＯ２探测晕厥前状态及晕厥是可能的。作者据此推测ＳｒＯ２的监测能够在Ｇ－ＬＯＣ的研究中得到应用。     

吴氏太极拳对老年人外周血NK细胞活性的影响

对８名多年练习吴氏太极拳的老人练拳前后外周血ＮＫ细胞活性和ＮＫ细胞数量进行了动态观察，同时观察了白细胞介素２（ＩＬ－２）及皮质醇的变化。通过它们与ＮＫ活性的相关分析讨论了吴氏太极拳练习影响ＮＫ活性的机理。研究结果显示，练拳后即刻ＮＫ活性升高６７．２９±３２．６１％（Ｐ＜０．０５），ＮＫ细胞数升高４７．８±１４．６９％（Ｐ＜０．０５）。ＩＬ－２活性升高４０．８８±１１．３０％（Ｐ＜０．０１），血浆皮质醇则下降１５．８２±４．０５‰（Ｐ＜０．０５），运动后２小时各项指标都有相当程度的恢复，ＮＫ活性虽高于安静值但差异无显著性意义。相关分析显示，ＮＫ活性的变化与ＮＫ细胞数的变化有一定程度的相关（ｒ＝０．７３，Ｐ＜０．０５，Ｃ．Ｖ＝０．３３），与ＩＬ－２活性呈高度相关（ｒ＝０．９６，Ｐ＜０．００１，Ｃ．Ｖ＝０．０４２），与皮质醇的变化也呈高度负相关（ｒ＝－０．９７，Ｐ＜０．００１，Ｃ．Ｖ＝０．０４９）。     

Physiologic and pathologic calcifications and ossifications in the face and neck

The aim was to give a systematic presentation of physiologic and pathologic calcifications and ossifications in the face and neck with a special emphasis on clinical relevance. In a sometimes subacute setting one should recognize specific calcifications which often lead to important diagnoses such as fungal sinusitis or sclerosing labyrinthitis. In a more chronic situation intraocular calcifications in small children are pathognomonic for retinoblastoma. Juxtatumoral sclerosis of the laryngeal cartilage in laryngopharyngeal carcinoma is usually caused by tumor infiltration of the cartilage resulting in a higher tumor stage and, this way, has a major impact on the therapeutical strategy. Calcified lymph nodes are mainly unspecific but can be the result of tuberculosis or metastases of thyroid cancer. Cross-sectional imaging methods, most of all computed tomography, are ideally suited to reveal head and neck calcifications and ossifications, especially those which are clinically relevant.     

Head and neck infection and inflammation

This article discusses the imaging manifestations of infectious and inflammatory conditions of the head and neck. Special attention is paid to the sites, routes of spread, and complications of neck infections. Because the clinical signs and symptoms and the complications of these conditions are often determined by the precise anatomic site involved, anatomic considerations are stressed. Familiarity with the fascial layers, spaces of the neck, and the contents of each space is helpful for this discussion. The fascial layers of the neck are important barriers to infection, and once infection is established, the fascial layers play a part in directing its spread.     

幽门螺杆菌分泌与重组表达的VacA蛋白的分离纯化及其致细胞空泡效应与凋亡的对比研究

目的：分离纯化幽门螺杆菌分泌和重组表达的细胞空泡毒素抗原（ VacA）蛋白,并评价其致细胞空泡效应及致细胞凋亡效应。方法分别从幽门螺杆菌ATCC26695菌株培养上清和重组表达VacA蛋白的pQE30-VacA-E．coliM15基因工程菌中分离纯化VacA蛋白,经酸化后,以不同终浓度（5,10 ng／ml）分别与人胃腺癌AGS细胞共孵24 h,观察致空泡效应,并通过流式细胞术检测细胞凋亡。结果成功分离纯化出幽门螺杆菌分泌和重组表达的VacA蛋白;幽门螺杆菌分泌的VacA蛋白能显著引起AGS细胞的空泡样改变及凋亡（P＜0．01）,而重组表达的VacA蛋白致细胞空泡样改变及凋亡不显著（ P＞0．05）。结论幽门螺杆菌分泌的VacA蛋白有良好的空泡毒性及致凋亡效应,而重组表达的VacA蛋白无致空泡及凋亡效应,幽门螺杆菌分泌的VacA蛋白可用于VacA作用机制的研究。     

化学和生物学融合对国际武器公约履约的影响

化学武器公约（ CWC）和生物武器公约（ BWC）是为禁止生产、发展、储存和使用化学武器和生物武器而制定的国际公约。近年来,科学技术快速发展,知识交叉渗透,学科之间出现整合和融合,促进了科技进步和经济发展。其中化学和生物学融合在有力促进制药、健康卫生、绿色化学和环境保护等产业进步的同时,也对化学和生物武器公约的履约产生了重要的影响。该文综述了与化学武器和生物武器公约相关的化学和生物学融合进展,并分析其对公约履约的影响。     

Oxygen uptake and ventilation during rowing and running in females and males

This study evaluated if the ventilatory response to exercise is impaired by the cramp position of rowing. Maximal oxygen uptake (VO2max), maximal expiratory volume (VEmax), and maximal heart rate (HRmax) during rowing and running were compared in 55 males (age, mean +/- SD, 21 +/- 3 years; height 176 +/- 5 cm; body mass 72 +/- 6 kg) and 18 females (age 20 +/- 2 years; height 164 +/- 5 cm; body mass 61 +/- 4 kg). VEmax was larger during rowing than during running (males, 157 +/- 16 vs. 147 +/- 13 L min(-1); 114 +/- 9 vs. 105 +/- 11 L min(-1), P<0.01). Also VO2max was larger during rowing than during running (males, 4.5 +/- 0.5 vs. 4.3 +/- 0.4 L min(-1); females, 3.3 +/- 0.4 vs. 3.2 +/- 0.4 L min(-1), P<0.01). However, HRmax was lower during rowing than during running (males, 194 +/- 8 vs. 198 +/- 11 beats min(-1); females, 192 +/- 6 vs. 196 +/- 8 beats min(-1), P<0.05). VEmax was correlated to body mass and fat-free mass, as was VO2max. Thus, the oxygen pulse (VO2max/HRmax) was larger during rowing than during running, while the ventilatory equivalent for oxygen (VEmax/VO2max) was similar. We showed that bending the body during rowing does not seem to impair ventilation either in males or in females. The results indicate that VEmax and VO2max relate to body size and fat-free mass for both females and males. The findings indicate that the involvement of more muscles, the entrainment, and the body position during rowing facilitates ventilation and venous return and lowers maximal heart rate.     

Coracoclavicular and coracoacromial ligament calcification and ossification

Thirty-six patients with calcification or ossification at or around the coracoclavicular and coracoacromial regions were analyzed with regard to type, location, and configuration of the deposits and related clinical history. Calcification or ossification in the coracoclavicular region resulted largely from trauma (36%) or renal failure (28%). Trauma patients may develop punctate calcification or ossification but do not develop the tumoral type of calcification. About 5% of the renal failure patients had coracoclavicular ligament calcifications, one-half of which were of the tumoral type. Renal failure patients may have punctate or tumoral calcifications but do not develop ossification.     

CLIP相关技术的研究进展

在真核生物基因表达的转录后调节中,RNA结合蛋白（ RBP）起着关键作用,很多RBP的异常与人类疾病的发生密切相关。自2000年的RNA免疫沉淀和芯片分析方法（ RNA immunoprecipitation with differential display or microarray analysis , RIP-ChIP）出现以来,人们开始就RBP与RNA相互作用进行了系统而广泛的研究。经过改良和发展,基于体内实时紫外交联免疫沉淀法（ ultraviolet crosslinking and immunoprecipitation , CLIP ）、交联免疫沉淀cDNA文库高通量测序法（ high-throughput sequencing of CLIP cDNA library , HITS-CLIP）、光催化核糖核苷增强交联和免疫沉淀法（ photoactivatable-ribonucleoside-enhanced crosslinking and immunprecipitation , PAR-CLIP）以及提高个别核苷酸分辨率交联和免疫共沉淀法（ individual nucleotide resolution CLIP , iCLIP）等RIP-ChIP衍生方法相继产生,使用这些方法,可以解析RBP的RNA识别特异性,而且通过与高通量测序技术结合,可以实现转录组尺度的RBP的靶序列的鉴定,分辨率也得到极大提高。该文就RNA与蛋白的相互作用的基本原理及其研究进展、相关技术存在的问题以及发展趋势进行简要综述。     

Cross-sectional and longitudinal comparisons of self-reported and device-assessed physical activity and sedentary behaviour

ObjectivesTo examine the longitudinal associations and differences between self-reported and device-assessed physical activity (PA) and sedentary behaviour (SB), using a multifaceted statistical approach.DesignLongitudinal measurement burst.MethodsIn total, 52 university students (78% female) aged 18–38 years (mean = 21.94 ± 4.57 years) participated. The study consisted of three blocks of six days of measurement, during which participants wore an accelerometer on their wrist for the entire block, and self-reported their PA over the 6 days at the end of each block.ResultsMeaningful latent differences between methods were observed for moderate PA and SB across all three assessment periods, such that participants underreported the time spent in each activity. Bland–Altman plots revealed a positive mean difference for vigorous PA, with over-reporting increasing as mean levels increased. Negative mean differences were observed for all other intensities. Underreporting of moderate PA increased as the mean level increased, whereas for light PA and SB, underreporting decreased at high levels. Repeated measures correlations revealed a meaningful association for vigorous PA only, suggesting that as self-reported minutes increase so too do device-measured minutes.ConclusionsWe found evidence of cross-sectional and longitudinal differences and weak associations between self-reported and device-assessed PA and SB. Future work is needed to enhance the quality of self-reported methods to assess PA and SB (e.g., face and content validity), and consider improvements to the processing of device-based data.     

Old and dangerous: Prison and dementia

Older prisoners are the fastest growing group of prisoners in many countries. The purpose of this study is to explore the phenomenon of detention of persons suffering from dementia. Medline searches were conducted for relevant articles, chapters and books published until August 2016. Search terms included dementia, elderly, prison and criminal. Publications found through this indexed search were reviewed for further relevant references. As results, there is a lack of data about elderly with dementia in prisons. Given the rise in the average age, it is reasonable to hypothesize that the number of older prisoners is growing. Moreover, some elderly are imprisoned with a concomitant cognitive impairment or psychiatric disorder while others will develop such diseases once incarcerated. At the present time, legal and social systems seem unprepared to handle the phenomenon of dementia in prison. As proposal, health assessments for older first time offenders should become a practice inside the correctional facilities and include an evaluation for specific health issues, such as psychiatric comorbidity and cognitive impairment.