儿童气管的解剖学观测和临床应用

目的研究支气管镜操作术的成功率和安全性。方法通过44例儿童尸体观测气管的解剖长度、临床长度和气管的横径、矢状径,并与儿童身高和上部量进行相关分析,另外分析临床资料85例,其中58例在使用支气管镜前做了气管横径、矢状和长度的预测。结果两性儿童的身高和上部量与气管的解剖长度、临床长度、气管内径之间密切相关。结论只要先测量儿童的身高和上部量就可根据他们之间的回归方程计算出气管的长度和内径大小,为临床准确选用气管镜型号和插管的深度提供可靠的依据,从而保证了气管插管的一次性成功率和安全性。     

CD44介导的透明质酸对单核细胞黏附和迁移的作用

目的研究透明质酸（HA）在单核细胞中的分布,HA受体CD44和细胞问黏附分子-1（ICAM-1）在单核细胞中的表达以及HA及其受体对单核细胞黏附和迁移的影响.方法用Percoll非连续密度梯度离心法分离狗外周血单核细胞,然后用免疫荧光染色法标记单核细胞的HA、CD44和ICAM-1.通过用透明质酸酶（HAase）消化细胞表面的HA、在培养皿底面和细胞培养池膜上涂布HA和在培养液中添加HA,观察细胞表面的HA、底物HA和游离HA对细胞黏附和迁移的影响.以抗体阻断剂抑制CD44或ICAM-1,研究HA受体的介导作用.结果单核细胞表面和细胞内存在HA,并表达CD44和ICAM-1.消化细胞表面HA后,黏附和迁移的单核细胞数减少.在培养皿底面和细胞培养池膜上铺HA,黏附和迁移的细胞数增加.培养液中加入HA,黏附和迁移的细胞数减少.阻断CD44后,HA底物上黏附和迁移的细胞数减少,而阻断ICAM-1后黏附和迁移的单核细胞数无明显变化.结论单核细胞内外分布有HA.单核细胞表面的HA和底物HA促进细胞的黏附和迁移,但游离HA阻碍单核细胞的黏附和迁移.CD44介导HA对单核细胞黏附和迁移的作用.     

膝关节矢状断层影像解剖学

目的 为膝关节疾患的影像学诊断提供矢状断层解剖学基础。方法 用成年男尸右膝部标本5例(新鲜3，福尔马林固定2)，按解剖骨性标志画线，其中1例标本先行矢状位MRI扫描，所有标本冻硬后，切制矢状断层解剖标本，每例切5个断层，皆观察其内侧面。结果 观察了构成膝关节的主要结构，交叉韧带、半月板及其周围软组织的形态特征、位置、毗邻及其在连续断层的变化规律，并匹配同一断层之MRI。测量股骨内、外侧髁关节软骨厚为2．3mm和2．4mm，胫骨内、外侧髁关节软骨厚为2．5mm和2．6mm，髌骨关节软骨厚为5．3mm，前交叉韧带长36．1mm，前、后交叉韧带中部矢状径为6．32mm和6．51mm，内、外侧半月板矢状径为42．4mm和33．2mm，内侧半月板前、后部厚度为5．1mm和5．8mm，外侧半月板为6．5mm和7．1mm。结论 膝关节的矢状断层解剖各结构形态、位置及变化规律，对骨科及影像学诊断和治疗有重要的价值。     

Public health reforms and development of health service in the Dakovo sub-district and administrative county in the period 1850-1899

In the long-lasting struggle for national identity and modernization of Croatia, the Parliament of the Kingdom of Croatia and Slavonia has passed many laws and regulations from 1874 on, affecting thus the health care and the development of the public health system. The aim of those laws was to establish and achieve the same level of public health care that had already been instituted in some other countries of the Austro-Hungarian Empire. In order to clarify the consequences of these reforms for the development of the health care system on the county and district levels of Slavonia, we collected data on the town of Dakovo as a market center, home of the diocese, and seat of the sub-district and administrative county. The data were divided into several categories in order to examine (1) the reorganization of health care in the Kingdom of Croatia and Slavonia from 1848 to 1894; (2) the development of health care in the Dakovo sub-district and Dakovo administrative county; (3) number, structure, and distribution of medical practitioners from 1807 to 1899; (4) hospitals from 1859 to 1900; and (5) selected indicators of health and living condition and health needs of the county inhabitants in the period 1850-1900. The analysis of historical material showed that new regulations of health care initiated the process of "medicalization" that was understood as a part of European modernization in the field of state medicine and health care administration. It brought more accurate knowledge of the main causes of illnesses, deaths and disabilities but did not significantly improve health and health conditions in the Dakovo County at the entrance of the 20th century.     

中医表型组学的数据特征与研究方法展望

人类表型组学构建了跨尺度组学数据的关联,对精准医学的实现具有重要价值。中医学与表型组学都关注人体复杂系统中各种表型的变化规律,二者的理念与技术可以相互促进和补充,中医表型组学研究将有助于实现中西医融合协同发展和促进。本研究首先总结了现有中医特色表型的数据特征、表型收集和量化的方法,随后从大数据和人工智能角度简述中医表型的数据处理、跨尺度关联和精细调控机制的手段,最后提出了现存的挑战与未来的研究方向,以期为中医表型组学研究者提供参考。     

The prenatal development of the human femur

The study reported here is the result of a detailed investigation of the changes in shape of the femur with growth and torsion, the type, rate and character of ossification, and the onset, subsequent course, and general features of remodeling. Forty pairs of femurs, from a series of embryos and fetuses ranging from 26 to 342 mm in crown-rump length, were measured, radiographed, and sectioned for microscopic study. A primary bony collar was present before the end of the embryonic period, and in a 27 mm embryo it extended for about one-fifth of the length of the femur. Erosion of the collar was evident at 34 mm. and invasion and destruction of calcified cartilage were occurring by 37 mm. Cartilage canals first appeared in the proximal epiphysis at 57 mm and in the distal epiphysis at 61 mm. Along with the progression of endochondral ossification proximally and distally and the establishment of growth zones, periosteal bone formation also proceeded in both directions, and, until 275 mm, extended about 1 mm beyond the zones of cartilage destruction. After 275 mm, the extents of periosteal and endochondral ossification were the same and at term occupied almost four-fifths of the length of the femur. Trabeculation of the bony collar was first noted at 37 mm. Fusion of endochondral trabeculae with the inner aspect of the periosteal shell began by 61 mm. A central marrow cavity free of trabeculae was present at 86 mm and thereafter. Evidence of reconstruction appeared in both proximal and distal ends by 92 mm, and was consistently present in both ends in all specimens of 111 mm and larger.     

儿童气管镜应用解剖学

目的：研究气管镜操作术的成功率和安全性。方法：观测儿童尸体气管的解剖长度、临床长度和气管的横径、矢状径，并与儿童身高和上部量进行相关分析，另外分析临床资料85例，其中58例在使用支气管镜前做了气管横径、矢状和长度的预测。结果：两性儿童的身高和上部量与气管的解剖长度、临床长度、气管内径之间密切相关。结论：测量儿童的身高和上部量就可根据他们之间的回归方程计算出气管的长度和内径大小，为临床准确选用气管镜型号和插管的深度提供可靠的依据。以保证一次性成功率和安全性。     

Advances in synthesis of calcium phosphate crystals with controlled size and shape

Calcium phosphate (CaP) materials have a wide range of applications, including biomaterials, adsorbents, chemical engineering materials, catalysts and catalyst supports and mechanical reinforcements. The size and shape of CaP crystals and aggregates play critical roles in their applications. The main inorganic building blocks of human bones and teeth are nanocrystalline CaPs; recently, much progress has been made in the application of CaP nanocrystals and their composites for clinical repair of damaged bone and tooth. For example, CaPs with special micro- and nanostructures can better imitate the biomimetic features of human bone and tooth, and this offers significantly enhanced biological performances. Therefore, the design of CaP nano-/microcrystals, and the shape and hierarchical structures of CaPs, have great potential to revolutionize the field of hard tissue engineering, starting from bone/tooth repair and augmentation to controlled drug delivery devices. Previously, a number of reviews have reported the synthesis and properties of CaP materials, especially for hydroxyapatite (HAp). However, most of them mainly focused on the characterizations and physicochemical and biological properties of HAp particles. There are few reviews about the control of particle size and size distribution of CaPs, and in particular the control of nano-/microstructures on bulk CaP ceramic surfaces, which is a big challenge technically and may have great potential in tissue engineering applications. This review summarizes the current state of the art for the synthesis of CaP crystals with controlled sizes from the nano- to the macroscale, and the diverse shapes including the zero-dimensional shapes of particles and spheres, the one-dimensional shapes of rods, fibers, wires and whiskers, the two-dimensional shapes of sheets, disks, plates, belts, ribbons and flakes and the three-dimensional (3-D) shapes of porous, hollow, and biomimetic structures similar to biological bone and tooth. In addition, this review will also summarize studies on the controlled formation of nano-/microstructures on the surface of bulk ceramics, and the preparation of macroscopical bone grafts with 3-D architecture nano-/microstructured surfaces. Moreover, the possible directions of future research and development in this field, such as the detailed mechanisms behind the size and shape control in various strategies, the importance of theoretical simulation, self-assembly, biomineralization and sacrificial precursor strategies in the fabrication of biomimetic bone-like and enamel-like CaP materials are proposed.     

Anatomy of the pancreas and Langerhans islets in snakes and lizards

The pancreas of snakes (18 species) was comparatively examined and classified into five major types, based on structure of the lobes and ducts, spatial relationships with the spleen and the gall bladder, and the disposition of islet cells. These types trend toward fusion of the pancreatic lobes and compaction of the pancreas--a progression that coincides with the phylogeny of the snakes. The more primitive pancreas of lizards (17 species) also was surveyed; that of Varanus is of special interest because its structure is intermediate between the extended, tri-lobate pancreas of lizards and the compact pancreas of snakes and may represent a transitional link in the evolution of this organ. Islet tissue is always confined to the dorsal lobe and is concentrated in its distal region adjacent to the spleen. In primitive snakes and in Varanus, a large islet mass is sequestered within a distinct juxtasplenic "islet body" distanced from the dorsal lobe and connected to it by a slender stalk. In some of the most advanced snake species, numerous islets of endocrine cells are found within the spleen. The occurrence and formation of these intrasplenic islets is described in detail. The anatomic "affinity" between spleen and the islet region of the pancreas is discussed. A hypothesis for the development of the pancreas from embryonal placodes on the mid-gut is presented; it proposes that the exocrine and the endocrine components derive from different progenitor cells, and that the endocrine progenitors are located in the center of the dorsal placode. The hypothesis combines embryological and evolutionary views about the origin of the pancreas, and offers a rationale for differences in its structure and in the disposition of the islets.     

Comparative angioarchitectural formation seen in microvascular cast specimens of the fungiform papillae in the weaning period and adult rat tongue

The purpose of this study was an attempt to identify the functional and comparative angioarchitectural differences between the sexes, and the developmental processes seen in microvascular cast specimens (MVCS) of the formation of the fungiform papillae (FuP) geometrically and regularly distributed on the anterodorsal surface in the weaning period and in the adult rat tongue. The basic microvascular structure seen in the MVCS of FuP of both the weaning and adult rat tongue consisted of several ascending (As. b) and descending branches (Ds. b) and a loop structure (L. st), and the cylindrical network structure of the L. st made up of the open-hole formation of the C form of the upper and lower microvascular structures. In the lateral view, the MVCS of FuP has a bamboo basket-like shape, and by means of the three-dimensional expansion of the surface area, effectively plays an assistant functional role in receiving the taste of foods and liquids. There were obviously no sex and morphological differences in the developmental process as to shape, but there was some difference between the weaning period and the adult rat in size in the MVCS of FuP.     

The microbiological and immunological characteristics of disbiotic disturbances of the biotopes of the mucose membranes of the respiratory and urogenital tracts

The study consisted in comparison of the microecology and the parameters of the humoral immunity of the biotopes of the respiratory and urogenital tracts under normal conditions and in inflammatory processes caused by bacterial agents. The study revealed significant changes in the microbiocenosis of the respiratory and urogenital tracts, caused by decline of indigenous microflora and increase of the content of conditionally pathogenic microorganisms. These changes depended on the degree of the infectious process severity. Measurement of the humoral immunity parameters revealed a significant correlation between the content of conditionally pathogenic microorganisms and the levels of M and A immunoglobulins, as well as secretory IgA and free secretory component (sc) in the vaginal secretions of patients with non-specific inflammatory diseases of the genital tract, as well as G and A immunoglobulins, secretory IgA, and sc in the saliva of patients with chronic inflammatory diseases of the respiratory tract.     

传统中药对成骨细胞及骨钙素合成的影响

背景：成骨细胞体外培养及其中药干预是研究和开发中药治疗骨质疏松症的重要手段之一。 目的：观察中药对成骨细胞增殖、分化及对骨钙素合成的影响。 方法：收集不同类别中药载药血清对体外成骨细胞及骨钙素分泌影响的相关研究,进行实验数据分析,从细胞分子生物学水平认识传统中药影响成骨细胞合成骨钙素的作用。 结果与结论：部分单味中药和中药复方有促进成骨细胞增殖、分化及骨钙素的合成作用,并且不同中药成分对成骨细胞增殖和分化的促进作用及提高骨钙素表达水平不同,与这种中药载药血清浓度在一定范畴内呈正相关。通过对成骨细胞体外培养方法的筛选,找出促进细胞增殖和分化的药物及适宜剂量,对研制治疗骨质疏松症的药物具有积极促进作用。     

基于有限元模型的踝关节生物力学分析*

背景：有限元力学分析在生物力学领域广泛应用。 目的：采用大型有限元软件ANSYS对踝关节三维有限元数字模型进行生物力学分析,探讨踝关节各组成骨的应力分布规律及其发生形变、位移情况。 方法：把经MIMICS、Geomagic和ANSYS处理后生成的踝关节三维数字模型导入软件ANSYS中,经过约束条件、施加载荷、求解试算等阶段,对其各组成骨进行有限元分析。 结果与结论：①静止直立位时,踝关节各组成骨最大应力区集中在内踝与距骨相关节处、胫骨远端关节面髁间线前部、胫骨中下段前缘皮质区及距骨滑车外侧部;最小应力区集中在外踝、胫骨远端内侧皮质区、距骨头、距骨颈;最大位移发生在距骨头,位移自下而上逐步减小;最小位移发生在胫骨、腓骨中下段1/3处。②高空坠落时,最大应力区集中在胫骨中下段前缘皮质区、距骨滑车前外侧、内踝内侧皮质区以及胫骨远端关节面髁间线前部。其中胫骨中下段应力集中区随着压力的增加,稍向内侧移位。距骨滑车外侧部最大应力集中区位置无明显变化,范围逐渐加大。最小应力区集中在外踝、胫骨远端关节面外侧部、距骨头、内踝的外侧皮质;随着压力不断加大,内踝外侧皮质的小应力蓝色区域范围逐渐减小;外踝逐渐出现应力稍大的淡蓝色区域,提示所受应力加大。最大位移发生的部位自距骨头向上,经距骨颈、胫距关节面到胫腓骨中下段逐渐减小,到胫腓骨中下段时减到最小。     

Pathophysiologic characteristics of the reactive toxic stage of acute suppurative peritonitis and ways to enhance the effectiveness of intensive therapy

The oxygen regimen, circulation, and metabolism were studied in 95 patients in the reactive-toxic stage of diffuse purulent peritonitis. The results of cluster analysis made it possible to determine the clinical and pathophysiological features of the phases of the disease. The phase of compensation was characterized by disorders of mass exchange of plasma water which led to increased index of transcapillary exchange and increased excess of lactate. These parameters of tissue metabolism were grouped into one cluster together with the oxygen regimen value and mean arterial pressure. The other cluster was formed of the values of oxygen consumption and the values of oxygen systemic and vascular tissue transport and the hemodynamic parameters. In the phase of decompensation the homeostasis parameters were grouped into another 2 clusters. The first contained the indices of transcapillary exchange of oxygen and water, the other--those of the intensity of blood oxygen transport function and metabolism. Surgical treatment and inclusion of the sympatholytic agent ornid and the beta-adrenergic agonist alupent in the complex of intensive therapy from the stages of preoperative and anesthesiological management brought homeostasis to a level characteristic of the phase of compensation, as a result of which fatal outcomes were absolutely excluded.     

The relationship between the metabolic syndrome and energy-utilization deficit in the pathogenesis of obesity-induced osteoarthritis

We propose that the pathogenesis of obesity-induced osteoarthritis may be explained by the metabolic changes in the striated muscle induced by the interaction of insulin resistance and systemic inflammation in obese individuals with metabolic syndrome being osteoarthritis the latest consequence by the physiological changes seen in the metabolic syndrome. Increased levels of TH1 cytokines are produced by activated macrophages in the presence of an acute or chronic infectious disease and suppress the sensitivity of insulin receptors on the membrane of muscle cell and adipocytes. Both cells are activated by inflammatory cytokines and contribute to enhance acute inflammation and to maintain a state of chronic, low-grade inflammation in apparently healthy obese individuals. The increased number of macrophage in the adipose tissue of obese individuals acts as an amplifier of inflammation. Patients with osteoarthritis and metabolic syndrome frequently are complaining about hotness and recurrent edema of feet and hands. It is probable that hyperinsulinemia in the presence of insulin resistance and inflammation, induce vasodilation through the TNF mediated-iNOS overexpression. Patients with metabolic syndrome express clinically the consequence of a poor uptake, storage and energy expenditure by the muscle and any other insulin dependent tissue and the consequence of high insulin plasma levels are vasodilation and increased protein synthesis. The fatigue and muscle weakness induced by insulin resistance and inflammation in obese patients with metabolic syndrome increase the frequency and the intensity of traumatic events of peripheral or axial joints that result in stretch and breaking of tenoperiosteal junction and abrasive damage of cartilage and therefore in these patients with metabolic syndrome and pro-inflammatory state the reparative process of cartilage and periarticular tissues would be severely modified by the growth factor activity in presence of high levels of insulin.     

The biological significance of immunity

The classical definition of immunity as the resistance of the body to disease, views the immune system in simple mechanistic terms. In this brief overview, possible reasons and consequences of the presence of an effective immune system across a range of invertebrate and vertebrate animals are considered. Topics discussed include the forces favouring the development of immunity, such as the acquisition of the colonial habit and terrestrial mode of life by many primitive animals, the constant threats of microbial and macrobial invasion, and the need to eliminate somatic mutations. The consequences of immunity in terms of the development of autoimmunity and hypersensitivity reactions, as well as the interaction of the immune system with the brain, the neuroendocrine organs and environmental factors, are also examined. Finally, the possibilities that the delicate balance maintained between many parasites and the immune systems of their hosts results in the spread of disease, and may also determine the maintenance of sexual reproduction and the choice of mate, are discussed.     

犬小肠缺血再灌注后血中NO和SOD与小肠粘膜凋亡相关基因表达的改变

研究犬小肠缺血再灌注后氧自由基和c-fos、增殖性细胞核抗原（PCNA）及Bax的表达改变及其相关性。于阻断小肠动脉前及再灌注0、30、及60min采集伴行静脉血液标本及小肠组织进行各项指标检测。结果显示，再灌注0min，N烽SOD的血中浓度明显下降，c-fos、PCNA和Bax在小肠粘膜上皮及小肠腺的表达明显增强。再灌注30min，NO和SOD浓度降至最低、c-fos、PCNA和Bax的表达达最高峰。至再灌注60min，NO和SOD有所升高，而三种基因的表达则显著减少。NO和SOD的改变与三种基因表达的相关性分析显示出它们之间密切的相关关系。犬小肠缺血再灌注可造成氧自由基的增多和c-fos、PCNA和Bax的表达增加，可能与损伤后的修复重建等有关，氧自由基的增多与相关基因的表达有密切关系。     

血管细胞在体力学微环境简析

在脉搏血压和血流作用下血管承受的弹性应力、黏性剪切应力以及管壁基质的力学特性构成血管细胞的在体力学微环境,这些力学刺激参与调控管壁细胞的生物学响应,诱导血管组织的重建和病变。虽然目前有大量关于血管力学生物学的实验研究,但是体外实验中施加的力学刺激与血管生理和病理条件的定量相关性仍缺乏必要的讨论。总结血管细胞在体力学微环境的量化评估方法,聚焦生理位置和老化对管壁力学行为的影响。探讨细胞力学微环境的生理和病理特性,以及对当前血管力学生物学研究的启示。