磷酸钙骨水泥临床应用类型选择及微结构观察

根据磷酸钙骨水泥（CPBCs)的基本性能选择符合临床适用的类型,并观察适用类型CPBC固化体超微结构。制备五种CPBCs粉末,即磷酸八钙－沉淀性羟基磷灰石（OCP－PHA）、磷酸八钙－羟基磷灰石（OCP－HA）、磷酸八钙（OCP）、缺钙性羟基磷灰石（CDHA）、羟基磷灰石（HA).调和液为去离子水和0．25M Na2HPO4/NaH2OPO4等摩尔浓度缓冲液。采用Gillmore双针法测定凝结时间,采用TS－14单颗粒压缩强度自动测量仪－Ⅱ测定压缩强度,按照Ginebra临床应用标准选择适用类型,并用扫描电镜观察适用类型CPBC固化体浸泡仿生液体前后的超微结构。结果表明：5种CPBCs中以OCP－PHA型和CDHA型CPBCs的凝结时间和压缩强度符合Ginebra临床应用标准。SEM观察两种CPBCs固化体为多孔结构,并随浸泡仿生液体中时间的延长而溶解或溶合。OCP－PHA型和CDHA型CPBCs适合于非承重骨的修复,其固化体为多孔结构,利于纤维组织长入及纤维血管化。     

宽恕类型及其影响因素(综述)

宽恕是一个包括认知、情感、行为成分的复杂心理现象，受害者忽视或压抑了由激惹而产生的愤怒或报复的心情，以同情、仁慈和关爱对待冒犯者。从不同的角度出发可将宽恕分为不同的类型。影响宽恕的因素可从受害者、冒犯事件和冒犯者三个方面加以探讨。宽恕有助于个体做出亲社会行为，有利于改善人际关系。宽恕研究目前尚不成熟，需要进行更深入的研究和探讨。     

The Anatomical Society’s Core Anatomy Syllabus for Dental Undergraduates

The Anatomical Society has developed a series of learning outcomes in consultation with dentists, dental educators and anatomists delivering anatomical content to undergraduate dental students. A modified Delphi methodology was adopted to select experts within the field that would recommend core anatomical content in undergraduate dental programmes throughout the UK. Utilising the extensive learning outcomes from two UK Dental Schools, and neuroanatomy learning outcomes that remained outside the Anatomical Society's Core Gross Anatomy Syllabus for Medical Students, a modified Delphi technique was utilised to develop dental anatomical learning outcomes relevant to dental graduates. The Delphi panel consisted of 62 individuals (n = 62) from a wide pool of educators associated with the majority of undergraduate dental schools in the UK, representing a broad spectrum of UK Higher Education Institutions. The output from this study was 147 anatomical learning outcomes deemed to be applicable to all dental undergraduate programmes in the UK. The new recommended core anatomy syllabus for dental undergraduates, grouped into body regions, offers a comprehensive anatomical framework with which to scaffold clinical practice. The syllabus, presented as a set of learning outcomes, may be used in a variety of pedagogic situations, including where anatomy teaching exists within an integrated dental curriculum (both horizontally in the basic sciences part of the curriculum and vertically within the clinical years).     

The Distribution of Muscles Fibers and Their Types in the Female Rat Urethra: Cytoarchitecture and Three‐Dimensional Reconstruction

An attempt to explore urethral cytoarchitecture including the distribution of smooth muscles and fast and slow striated muscles of adult female Sprague Dawley rat—a popular model in studying lower urinary tract function. Histological and immunohistochemical stainings were carried out to investigate the distribution of urethral muscle fibers and motor end plates. The urethral sphincter was furthermore three‐dimensionally reconstructed from serial histological sections. The mucosa at the distal urethra was significantly thicker than that of other segments. A prominent inner longitudinal and outer circular layer of smooth muscles covered the proximal end of urethra. Thick circular smooth muscles of the bladder neck region (urethral portion) decreased significantly distalward and longitudinal smooth muscles became 2‐ to 3‐fold thicker in the rest of the urethra. An additional layer of striated muscles appeared externally after neck region (urethra) and in association with motor end plates ran throughout the remaining urethra as the striated sphincter layer. Most striated muscles were fast fibers while relatively fewer slow fibers often concentrated at the periphery. A pair of extraneous striated muscles, resembling the human urethrovaginal sphincter muscles, connected both sides of mainly the distal vagina to the dorsal striated muscles in the wall of the middle urethra. The tension provided by this pair of muscles, and in conjunction with the striated sphincter of the urethral wall, was likely to function to suspend the middle urethra and facilitates its closure. Comprehensive morphological data of urethral sphincter offers solid basis for researchers conducting studies on dysfunction of bladder outlet. Anat Rec, 296:1640–1649, 2013. © 2013 Wiley Periodicals, Inc.     

DR全脊柱成像技术应用探讨

目的探讨DR全脊柱成像技术在脊柱侧弯畸形诊断及测量中的价值,研究不同检查方法对成像质量及测量精度的影响.方法利用PHILIPS公司Digital Diagnost DR系统和具有全脊柱拼接功能的SUN后处理工作站,对分次所摄的脊柱正位、侧位、左、右侧屈位影像进行拼接处理后作必要的测量,并打印成像.结果经上述处理后的全脊柱正位、侧位及左、右侧屈位均能将颈、胸、腰、骶椎完整联接,显示在1张14·17的X光片上,其测量的数据真实可靠.结论 DR全脊柱成像技术克服了以往颈、胸、腰、骶椎单独成像后测量上的误差,为临床手术提供了更精确的数据.     

An Individual,Community-Based Treatment for Obese Children and Their Families: The Solution-Focused Approach

BackgroundThis study evaluates an individual, community-based treatment for obese children and their families. In this program, a treatment team applied solution-focused techniques to develop a custom-made treatment plan in collaboration with the participants. The treatment plan consisted of community-based lifestyle activities.Methods559 obese children with an average BMI z-score of 2.76 ± 0.54 took part in the 12-month study, and 372 children with an average BMI z-score of 2.75 ± 0.52 took part in the 24-month study. At the start of the study, ethnicity and special school needs were recorded. Before, after 12 months, and after 24 months of the treatment, body weight and height were measured. The effect of the treatment on body weight was evaluated using BMI z-scores.Results291 children (52%) completed 12 months of treatment, whereas 22 children (4%) were dismissed earlier due to a good response. After 12 months, the children showed a significant decrease in BMI z-score by 0.16 (95% confidence interval (CI) 0.11-0.20; p ℋ 0.005). After 24 months, 103 children (28%) were participating in the program, with a significant decrease in BMI z-score of 0.15 (95% CI 0.07-0.22; p ℋ 0.005). 50 children (13%) were dismissed before the end of the second year due to significant weight loss (standard deviation z-score reduction −0.38; 95% CI 0.30-0.46; p ℋ 0.005; with an average treatment duration of 12.9 ± 6.4 months). There was a negative correlation of age and reduction in BMI z-score: children younger than 6 years showed a decrease in BMI z-score of 0.45 (95% CI 0.26-0.65) and 0.31 (95% CI 0.11-0.53) after 12 and after 24 months, respectively.ConclusionsChildren showed a significant decrease in BMI z-score after the treatment. We found a negative correlation of age and weight loss. Special attention to patients with a high risk of drop-out might further improve these results. We advise a referral to obesity treatment as early as possible since a ‘wait and see’ policy might have adverse results in obese children.Key Words: Obesity, Obesity therapy, Children, Solution-focused therapy, Community-based treatment     

Psychoanalysis And Homosexuality: Keeping The Discussion Moving

This paper contributes to the debate following the British Psychoanalytic Council's 2012 conference, ‘Homosexuality and Psychoanalysis: Moving On’ and their Position Statement on Homosexuality. After two world wars psychoanalysts, concerned to establish the credentials of their discipline, sought a more settled definition of sexual ‘normality’ than that of Freud, which ‘naturalized’ a heterosexual view of gender difference. Extending one aspect of Freud's thinking, homosexuality became accepted as evidence of a developmental retreat, even as a fixation at the oral stage of relating. As an identity founded on rejection of the reproductive ‘reality’ of the body, it was seen as a borderline condition. An individual who did not regard it as a problem to be cured was understood to be maintaining a perverse denial of their pathology. Same sex object‐choice was narcissistic and led to the formation of unstable patterns of relating. In this paper I hope to show that psychoanalysis has in the past developed a theoretical bias that has distorted its view of the experience of lesbians and gay men and, in detecting and questioning this bias, we have an opportunity to make our discipline more open and responsive to the complex society we live in.     

核酸适配子及其治疗应用

核酸适配子(aptamer)是从大容量的组合化学库中筛选出的短的寡核苷酸。与抗体类似,它与靶分子结合具有高特异性和高亲和力。大多数核酸适配子与靶分子结合后对靶分子有抑制作用。适配子可广泛用于抗凝血、抗病毒、抗增殖、抗炎等方面。特异针对人VEGF165的核酸适配子已在美国被批准上市。     

血清D-二聚体在不同类型主动脉夹层诊断中的应用

目的 探讨不同类型主动脉夹层患者血清D-二聚体(D-dimer)水平及其诊断价值.方法 选取2018年1月至2020年1月在我院就诊且临床确诊为主动脉夹层的患者62例,根据检查分型结果分为Stanford A型30例(A组)和Stanford B型32例(B组).分别于患者入院后1、6、12、24、72 h及14 d检测患者血清D-dimer水平,分析其与不同类型主动脉夹层的相关性.结果 A组患者在入院后1、6、12、24、72h及14 d时检测血清D-二聚体水平均显著高于B组患者,差异均具有统计学意义(P＜0.05).A组治疗后11例死亡,19例生存;B组治疗后12例死亡,20例生存.A组死亡及生存患者血清D-二聚体水平均显著高于B组,且A组、B组死亡患者血清D-二聚体水平均显著高于生存患者,差异均具有统计学意义(P＜0.05).血清D-二聚体对Stanford A型主动脉夹层诊断的截断值为1 258.4μg/L,ROC曲线下面积AUC为0.92,灵敏度为73.46％,特异性为89.68％.D-二聚体对Stanford B型主动脉夹层诊断的截断值为989.7μg/L,ROC曲线下面积AUC为0.89,灵敏度为70.27％,特异性为88.47％.结论 D-二聚体在Stanford A型和Stanford B型主动脉夹层患者不同时期血清水平均不同,整体呈现Stanford A型高于Stanford B型.通过检测患者血清D-二聚体水平可辅助判断主动脉夹层分型,对临床诊疗具有重要应用价值.     

DNA Antibody Idiotypes: An Analysis of Their Clinical Connections and Origins

Approximately thirty common DNA antibody idiotypes have been described on hybridoma derived or affinity purified DNA-binding antibodies. There are associations between some idiotypes and the clinical manifestations of systemic lupus erythematosus although none are sufficiently firm to be clinically useful in identifying subsets of SLE or in assessing disease activity in individual patients. The expression of these idiotypes is not confined to DNA antibodies in SLE. They may be found in the serum from patients with a range of autoimmune rheumatic disorders, infectious diseases and blood dyscrasias. In most cases the antigen binding specificity of the antibody bearing the idiotype is unknown. The precise relationship between the various idiotypes is becoming better understood with increasing availability of genetic and structural data. DNA antibody idiotype manipulation may provide a potential new therapeutic modality in SLE.     

Existing and Training Induced Differences in Aerobic Fitness: Their Relationship to Physiological Response Patterns During Different Types of Stress

Aerobic fitness has been associated with various desirable psychological and physiological characteristies. Recently, attenuation of physiological reactivity during stressful situations was added to this list, although comparison of the stress responses of sportsmen and sedentary subjects has yielded equivocal results. The present study examined cardiovascular patterns rather than single variables, and tried to clarify these matters. Tasks were used that were known to increase blood pressure through different combinations of changes in cardiac output and vascular resistance. Autonomic nervous system dynamics underlying these response patterns were studied using preejection period as an index of β-adrenergic activity, and respiratory sinus arrhythmia as an index of vagal activity. Pre-existing differences in aerobic fitness in a sample of sedentary subjects were related to their responses during the stressful tasks and the recovery periods afterwards. This approach prevented confounding of the relationship between fitness and stress-reactivity with the psychological effects of regular exercise. Furthermore, it excluded the bias in psychological makeup that is introduced when subjects spontaneously engaged in sports are compared to non-exercising persons. To rule out a third (hereditary?) factor underlying both stress-reactivity and fitness, physiological responses before and after a seven-week training program were compared to those of subjects in a waiting list control group. Substantial individual differences in aerobic fitness were found in spite of the fact that all subjects reported low levels of habitual activity. During two active coping tasks, diastolic blood pressure reactivity and vagal withdrawal were negatively related to these pre-existing differences in fitness. No such relation was seen during a cold pressor test or during recovery from the tasks. Neither β-adrenergic cardiac reactivity nor heart rate responses were related to fitness, but the absolute heart rate during the tasks was lower in the more fit subjects. Seven weeks of training were not effective in changing either reactivity or recovery of any of the variables. The discrepancy between cross-sectional and longitudinal results in the present study suggests that training of longer duration is necessary to induce the psychological or physiological changes underlying reduced reactivity. The latter may include changes in cardiac vagal/sympathetic balance or in adrenoceptor sensitivity. Alternatively, both psychological and physiological determinants of stress-reactivity may be related to aerobic fitness at a dispositional level.     

TLR与足细胞损伤

TLRs是一类重要的模式识别受体家族,主要调节天然免疫反应.研究发现在肾脏固有细胞及间质细胞都有TLR表达,其介导的炎症反应参与了许多肾脏疾病的发生.多种足细胞标志蛋白的发现加快了足细胞表面分子的研究进程.目前已发现足细胞表面有TLR的表达,且TLR的表达与足细胞的损伤有关.文章综述了已经发现的TLR成员及其与足细胞损...     

血清游离脂肪酸浓度和hs-CRP在老年DM2中的应用

目的:通过血清游离脂肪酸浓度(FFA)和超敏C反应蛋白(hs-CRP)水平的变化特征,探索血清FFA和hs-CRP与老年2型糖尿病(DM2)的关系。方法:应用免疫比浊法和生化法测定156名老年DM2患者和75名无DM2的健康对照组的FFA、hs-CRP、GLU、TG、TC、HDL-C和LDL-C的浓度,将测得的数据进行DM2组和健康对照组的对比分析。结果:DM2组患者血清FFA、hs-CRP、TG和LDL-C均比健康对照组高,差异有统计学意义(其中FFA和hs-CRP P<0.01,TG和LDL-C P<0.05);HDL-C低于健康对照组,差异有统计学意义(P<0.05);两组TC比较无统计学意义。结论:老年DM2患者血清FFA和ha-CRP浓度升高,FFA是反映糖代谢及脂代谢的灵敏指标。此外,可能参与患者代谢异常的发生、发展起重要作用。