非小细胞肺癌螺旋CT表现特征与血清可溶性Fas和FasL关系的研究

目的探讨非小细胞肺癌(NSCLC)螺旋CT(spiral CT,SCT)表现特征与病人血清中可溶性Fas(soluble Fas,sFas)和FasL(soluble FasL,sFasL)之间的关系。方法对32例经SCT扫描的并经病理证实的非小细胞肺癌进行回顾性分析,采用双抗体夹心酶联免疫吸附法(ELISA)检测其血清中sFas和sFasL水平,并将非小细胞肺癌的CT表现特征与检测结果进行对照分析。结果病人血清中sFas和sFasL检测水平与肿瘤的类型、大小无统计学意义(P>0.05);与有无纵隔淋巴结肿大,是否累及胸膜或心包膜,肿瘤是否有毛刺、结节和分叶,是否存在胸腔积液和肺不张等均有统计学差异(P<0.05)。结论SCT的表现特征在一定程度上可反映肺癌病人血清中sFas和sFasL的水平。     

虎纹蜘蛛毒素-I对全脑缺血再灌注大鼠海马神经元Fas凋亡通路的抑制作用

目的:探讨虎纹蜘蛛毒素-I(HWTX-I)与由Fas分子启动的死亡信号转导通路之间的关系及可能的神经保护作用分子机制。方法:48只SD大鼠随机分为假手术组、生理盐水组及用药组三组,每组16只,采用改良的Pulsinelli"四血管阻断法"并结合蛛网膜下腔置管术构建全脑缺血再灌注损伤大鼠模型。免疫组织化学法检测海马组织CA1区Fas、FasL、FADD蛋白水平表达,RT-PCR法检测海马组织死亡信号转导通路相关因子Fas、FasL、FADD核酸水平表达。结果:免疫组化法检测结果显示,生理盐水组、用药组Fas、FasL和FADD蛋白表达高于假手术组,差异均有统计学意义(P<0.05,P<0.01),用药组Fas、FasL和FADD蛋白表达低于生理盐水组,差异均有统计学意义(P<0.05,P<0.01);RT-PCR检测结果显示,假手术组Fas、FasL、FADDmRNA表达低于生理盐水组和用药组,差异均有统计学意义(P<0.05,P<0.01),用药组Fas、FasL、FADDmRNA表达均低于生理盐水组,差异均有统计学意义(P<0.05,P<0.01)。结论:HWTX-I蛛网膜下腔用药对全脑缺血再灌注损伤大鼠海马组织具有一定的神经保护作用,其机制可能是通过抑制Fas分子启动的死亡信号转导通路激活而发挥作用。     

同步放化疗对非小细胞肺癌患者Fas水平的影响

目的 用酶联免疫吸附试验研究非小细胞肺癌患者同步放化疗对血清可溶性Fas的影响及其与预后的关系。方法 对60例患者比较治疗前、治疗后1个月血清Fas水平变化,并设正常对照组。比较治疗有效组(完全缓解+部分缓解,50例)与无效组(无变化+进展,10例) 治疗前Fas水平变化。以2年生存为观察指标,观察血清Fas水平对生存时间的影响。结果 非小细胞肺癌患者治疗前血清Fas水平明显高于正常对照组(8.55±0.63) ng/L和(6.03±0.55) ng/L(t=18.63,P<0.01),治疗后1个月明显低于治疗前(7.24±0.52) ng/L和(8.55±0.63) ng/L(t=12.44,P<0.01)。治疗有效组疗前血清Fas水平明显低于无效组的(8.02±0.43)ng/L和(8.97±0.42)ng/L(t=8.67,P<0.01)。生存满2年者(26例)治疗前Fas水平明显低于生存不足2年者(34例)(t=645.88,P<0.05)。结论 同步放化疗可降低非小细胞肺癌患者血清可溶性Fas水平,治疗前后Fas水平变化有可能成为判断非小细胞肺癌患者预后的观察指标。     

2型糖尿病患者血清内脂素水平与足背动脉内膜中膜厚度的关系

目的探讨血清内脂素与2型糖尿病患者足背动脉粥样硬化病变程度的关系。方法收集109例2型糖尿病患者临床资料,以35例正常体检者作对照组。根据足背动脉内膜中膜厚度(IMT)将109例2型糖尿病患者,分为动脉粥样硬化组(AS)66例和非动脉粥样硬化组(NAS)43例。分别测定血清内脂素水平及糖、脂等代谢指标。结果 AS组患者的IMT显著高于对照组及NAS组患者(P均<0.01);AS组患者的血清内脂素显著高于NAS组及对照组患者(P均<0.01)。内脂素与IMT、腰围、腰臀比、三酰甘油、空腹胰岛素、胰岛素抵抗指数呈正相关(均P<0.01),与高密度脂蛋白呈负相关(P<0.01)。多元回归分析显示,三酰甘油、内脂素水平是影响血管IMT的主要因素。结论血管IMT作为反映早期动脉粥样硬化的客观指标,其与内脂素具有明显的相关性。     

血液透析患者外周血淋巴细胞Fas/FasL的表达及其意义

为探讨外周血淋巴细胞Fas/FasL的表达与血液透析(血透 )患者免疫功能损伤的关系 ,用酶联免疫夹心法检测 4 0例血透患者血浆可溶性Fas、FasL(sFas、sFasL) ,用流式细胞术检测CD3+ 细胞Fas抗原的表达。结果发现 ,血透患者CD3+ Fas表达率显著高于正常对照 (P <0 0 1) ;透析后Fas表达明显降低 (P <0 0 1) ,但FasL表达率仍高于正常对照(P <0 0 5 ) ;血浆sFas水平比对照组明显减低 (P<0 0 1) ,透析后虽有所增加 ,但仍低于对照组 (P <0 0 5 )。相关分析发现sFas与CD3+ Fas细胞百分比以及尿素氮、肌酐呈显著负相关。提示Fas/FasL表达率增高可促使外周血淋巴细胞凋亡 ,并与血透患者免疫功能低下的发生、发展相关。     

老年2型糖尿病合并血管并发症患者C反应蛋白与游离脂肪酸水平分析

 目的 研究老年2型糖尿病及合并血管并发症患者C反应蛋白(CRP)和游离脂肪酸(FFA)的变化及相关性,探讨C反应蛋白和游离脂肪酸在老年糖尿病合并血管并发症发生中的作用.方法 检测2型糖尿病伴血管并发症组102例,无血管并发症组142例,正常对照组62例血清C反应蛋白与游离脂肪酸水平,分析其差异与相关性.结果 伴血管并发症组和无血管并发症组的血清CRP、FFA与正常对照组比较均差异显著(P＜0.05).伴血管并发症组CRP与FFA呈正相关,相关系数r=0.582(P＜0.05); FFA和CRP基本无关,相关系数分别为r=0.126和r=0.198(P>0.05).结论 老年2型糖尿病伴血管并发症患者血清中CRP和FFA浓度升高,且高于无血管并发症患者,CRP与FFA水平更具有一致性,血清CRP与FFA检查可用于监测老年2型糖尿病有无血管并发症.     

多囊卵巢综合征患者血清C反应蛋白与单核细胞趋化因子蛋白-1的相关性

 目的 探讨多囊卵巢综合征(PCOS)患者血清中C反应蛋白(CRP)与单核细胞趋化因子蛋白-1(MCP-1)的相关性.方法 60例PCS患者和60例对照者根据体重指数(BMI)分为PCOS肥胖组及非肥胖组各30例、肥胖及非肥胖对照组各30例,分别应用ELISA方法及速率散射比浊法检测血清中MCP-1及CRP水平,应用化学发光法检测血清泌乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)和睾酮(T),应用放射免疫方法检测血清雄烯二酮(A)水平;应用化学方法检测血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)及低密度脂蛋白-胆固醇(LDL-C);同时检测空腹血糖和空腹胰岛素.结果 (1)非肥胖PCOS组血清CRP及MCP-1水平均明显高于非肥胖对照组(P＜0.05);(2)Pearson相关分析显示,血清MCP-1与BMI(r=0.381,P=0.000)、CRP(r=0.219,P=0.027)、稳态模型的胰岛素抵抗指数(HOMA-IR)(r=0.265,P=0.007)及TG(r=0.439,P=0.000)呈正相关;CRP与BMI(r=0.477,P=0.000)、TG(r=0.214,P=0.032)及HOMA-IR(r=0.617,P=0.000)呈正相关,与HDL-C(r=-0.209,P=0.035)呈负相关.结论 PCOS是一种慢性炎症性疾病;肥胖及胰岛素抵抗加重了PCOS患者的慢性炎症状态;PCOS患者血清中MCP-1与CRP具有协同性;MCP-1及CRP可能共同参与了PCOS患者的心血管疾病的发生.     

丁苯肽对急性脑梗死患者血清TNFα-、CRP和神经功能缺损程度评分的影响

目的观察丁苯肽对急性脑梗死的早期治疗作用。方法80例急性脑梗死患者随机分为丁苯肽治疗组及常规对照组各40例,分别采集患者治疗前和治疗后第14天外周血标本,测定血清肿瘤坏死因子(TNFα-)和C-反应蛋白(CRP)水平,同时对患者治疗前及治疗后第7、14天进行神经功能缺损程度评分。结果治疗组和对照组第14天血清TNFα-、CRP水平较治疗前降低(P<0.01),且治疗组较对照组显著降低(P<0.01);第7、14天神经功能缺损程度评分治疗组较对照组有明显改善(P<0.01)。结论丁苯肽对急性脑梗死的早期有显著治疗作用。     

烫伤大鼠肠、肺组织白细胞介素-18的表达及其对脏器的影响

目的：探讨大鼠严重烫伤后肠，肺组织IL－18（白细胞介素－18，Interleukin-18)和相关介质的动态表达规律及其对脏器的影响。方法：采用大鼠30％体表面积Ⅲ度烫伤延迟复苏模型，肠，肺组织IL－18，IFN－γ，FasL(Fas配体，Fas Ligand)mRNA含量采用逆转录聚合酶链式反应检测。ELISA法测定IFN－γ含量；同时检测肠，肺功能指标。结果：肠、肺组织IL－18，IFN－γ，FasLmRNA表达较伤前显著升高，烫伤后8小时达高峰，且一直持续至伤后24小时，给予SDD（选择性消化道脱污染selective decontamination of the digestive tract)预后治疗后，不同程度抑制了IL－18，IFN－γ，FasLmRNA的表达。严重烫伤后，出现广泛的脏器功能损害，预防性SDD处理可不同程度地保护脏器。相关分析表明，循环内毒素与肠，肺IL－8，IFN－γ，FasL诱生有关，而后者与器官功能损害密切相关。结论：肠，肺组织IL－8，IFN－γ，FasLmRNA的表达在烫伤早期即显著增多，并呈逐渐升高的趋势，后者对脏器功能具有重要影响。     

绝经后妇女颈动脉彩色多普勒与血管内皮功能相关性研究

目的:应用高分辨率彩色多普勒超声观察绝经后妇女颈动脉及血管内皮功能,并探讨两者的关系。方法:对37例绝经后妇女,观察其颈动脉内中膜厚度(intema-media thickness,IMT)、粥样斑块,及反应性充血时和舌下含服硝酸甘油后肱动脉内径的变化,并对它们进行相关性分析。结果:绝经后妇女IMT较对照组明显增厚(P<0.01),且斑块发生率较对照组明显升高(P<0.01)。反应性充血时肱动脉内径的扩张程度与对照组相比在统计学上有显著性差异(P<0.01)。舌下含服硝酸甘油后肱动脉内径的变化两组间有显著性差异(P<0.01)。颈动脉IMT、斑块发生率与反应性充血时和舌下含化硝酸甘油后动脉内径变化呈显著负相关(r=0.213,P<0.05;r=0.231,P<0.05)。结论:绝经后妇女存在血管内皮依赖性及非依赖性舒张功能的损伤,从而引起血管壁内中膜增厚及斑块形成。因此绝经后妇女血管内皮功能损伤促进了动脉粥样硬化的发生,从而导致了绝经后妇女心血管疾病发生率的剧增。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.