应用Ilizarov技术治疗手腕部瘢痕挛缩畸形临床观察

目的 观察Ilizarov技术治疗手腕部瘢痕挛缩畸形的临床效果。 方法 2017年4月~2020年1月,应用Ilizarov技术治疗7例手腕部瘢痕挛缩畸形患者,男3例,女4例;年龄12~52岁,平均24岁;左手部2例,左腕关节1例,右腕关节4例;创面感染致瘢痕增生2例,开水烫伤致瘢痕增生1例,火焰烧伤致瘢痕增生4例。瘢痕形成6月~34年,平均7年。根据Mayo评分法评估手腕部功能,术前患者手腕部功能可5例,差2例。 结果 腕关节畸形均获得矫正,以腕关节中立位为0°测量,腕关节掌屈可达到55~70°,背伸可达0~55°,无明显疼痛及麻木感,手指活动灵活。患者均无针道感染、肢端感觉麻木等并发症。术后随访5月~24月（平均15月）,末次随访时评估手腕部功能,良4例、可3例,较术前显著改善。 结论 应用Ilizarov技术治疗手腕部瘢痕挛缩畸形安全有效,可为烧伤后肢体功能重建提供一种新的疗法。     

蒙娜丽莎之谜

<正>500多年前,意大利人达芬奇创作出历史上最负盛名的肖像画杰作《蒙娜丽莎》。19世纪中叶,"她"正式入驻世界上最著名的艺术博物馆——法国的卢浮宫,刚开始被该馆收藏,"她"的知名度还不是很高,后来到了1911年,该馆的一个油漆     

个体人格类型与气味偏好的关系

目的：探讨气味偏好与个体人格之间的初步关系。为在行为层面上研究人格提供新的路径。方法：以艾森克的现代人格理论模型为框架，采用人格问卷和实验结合的方法进行研究，通过实验法在控制的条件下得到个体的气味偏好数据，通过人格问卷得到同一群体的人格各维度分值。结果：不同人格特征的个体在气味偏好上存在显著差异。结论：气味偏好和人格之间存在一定的联系。     

肾结核病灶中淋巴细胞趋化因子的表达

目的:探讨淋巴细胞趋化因子在正常肾脏和肾结核中的表达以及淋巴细胞趋化因子和浸润CD4 、D8 T细胞在肾脏结核病灶中的分布特点.方法:6例正常肾脏和10例肾结核病变组织,经匀浆后,采用RT-PCR法扩增人淋巴细胞趋化因子(hLptn)的含编码区序列的cDNA;扩增cDNA的克隆至pGM-T Easy T载体,测序;应用免疫组织化学方法检测正常肾脏和肾结核中的hLptn的表达和结核病灶中的CD4、CD8分子的表达.结果:正常肾脏和肾结核组织均表达hLptn mRNA,应用RT-PCR法克隆的cDNA序列与GenBank中U23772的序列一致;hLptn在正常的肾小球、肾小管中和结核病变中残存的肾小球、肾小管中均有表达;结核病变中有散在的CD4和CD8分子阳性细胞,与hLptn的分布无重叠.结论:淋巴细胞趋化因子在肾脏的肾小球和肾小管中呈结构性表达,肾结核肉芽肿中淋巴细胞的募集可能非依赖于hLptn的作用.     

GKT测谎模式研究

犯罪知识测试（Guilty Knowledge Test，简称GKT），是Lykken在1959年引入的一种测谎测试程序。本文就GKT测试的认知原理一定向反应有关理论的发展及其与GKT测试的关系进行了介绍，并以此为起点，对GKT测谎研究的四种范式进行了分析与探讨，最后指出GKT测谎模式还存在的问题、相关的扩展性研究以及发展趋势。     

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敬告作者

本刊编辑部自2011年6月起不再向论著类作者提供纸质单行本,如有需要者可向本刊索取文稿的电子版数据(PDF格式),或登录本刊网站(http://www.cjcep.com)自行下载。     

非实验因素对人体核磁共振代谢组学检测结果的影响

代谢组学被认为是未来诊断疾病和评价患者机能状况的有力手段,但目前的研究结果表明,很多非实验因素,如饮食、运动、环境以及个体差异等均会影响临床实验结果,为保证不同核磁共振(Nuclear magnetic resonance,NMR)实验数据之间的可比性,很有必要在实验设计和数据分析过程中对这些因素进行合理的控制.     

腺病毒介导的肝癌靶向SEA-CD80基因治疗及免疫学机制的初步研究

目的: 观察肝癌靶向性葡萄球菌肠毒素A (SEA)/CD80基因重组腺病毒载体对肝癌的疗效,并对其免疫学机制进行初步研究.方法: 利用AdEasy腺病毒系统分别构建并制备甲胎蛋白(AFP)启动子和增强子Ⅰ调控的SEA和/或CD80基因重组腺病毒载体, 然后采用瘤体内直接注射的方式对小鼠皮下移植性肝癌进行治疗, 采用RT-PCR和Western blot方法检测腺病毒注射部位的SEA和CD80 mRNA和蛋白的表达情况; 采用ELISpot方法和LDH释放实验分别检测脾脏淋巴细胞中肝癌特异性IFN-γ分泌细胞的频数和细胞毒性T细胞(CTLs)对Hepa1-6细胞的特异杀伤活性; 通过观察荷瘤小鼠经治疗后肿瘤体积的变化及生存时间, 评价重组腺病毒对肝癌的治疗作用.结果: 我们构建的腺病毒能够使SEA和/或CD80 mRNA和蛋白靶向地在肝癌组织中表达; 与空载体组和PBS对照组相比, 双基因组和单基因组分泌IFN-γ的T细胞数量均明显增多, CTL对Hepa1-6细胞的特异性杀伤作用均明显增强, 荷瘤小鼠肿瘤体积明显减小, 生存期明显延长; 双基因组的疗效和对免疫系统的激活作用明显高于单基因组; CD80 和SEA的组之间、空载体和PBS组之间无明显差异.结论: 我们制备的肝癌靶向性重组腺病毒对肝癌有良好的治疗作用, 联合基因治疗优于单个基因治疗.     

太行山猕猴距骨的性别判别分析

太行山猕猴主要分布在太行山南坡中条山南端,是我国黄河以北分布最集中、数量最多、面积最大的猕猴自然分布种群。在形态、行为、遗传、食性、骨学方面均具有其特殊性。踝关节的距骨作为最坚固的骨骼之一,在国内有关该部位的研究报道较少。本研究主要对太行山猕猴距骨进行测量统计分析,找出两性间差异较大的变量,建立判别函数,为太行山猕猴的基础研究和生物学研究积累资料。     

基于UML的医院信息系统建模

系统分析是系统开发的关键,软件建模技术使系统开发走向成熟。UML是一种标准建模语言,适用于是面向对象技术来描述的任何系统。使用UML建模方式,将客户变化的需求映射到模型中,能大大提高系统的扩展性和开发效率。本文介绍了UML的内容、特点,并通过对医院信息系统HIS功能的分析,应用常用的用例图、类图、活动图、状态图、时序图、合作图等方法,很好地解决了系统开发的建模问题。     

Description of the banding patterns of human chromosomes by acridine orange reverse banding (RFA) and comparison with the Paris banding diagram

A reference diagram is presented which is comparable to the Paris banding diagram but which was based primarily on chromosomes studied by acridine orange reverse banding. Comparison with the Paris Conference (1971) banding diagram was made. Bands were combined in 13 instances and subdivided in 10 cases. The number of bands was found to depend primarily upon the length and quality of the chromosomes. No major differences between the present diagram and the Paris banding diagram were observed. Moreover, the results with acriding orange reverse banding were comparable to those previously reported with Giemsa R banding. In addition, sequential Q banding and R banding were carried out in the same cells. No significant differences in resolution of bands were observed when these two techniques were compared.     

Vector (butterfly) diagrams for osteoarthritic gait: a preliminary report

This paper describes briefly a simple three-dimensional vector diagram display combining all the force components of gait in one diagram. The locus of the centre of pressure of the feet on the ground is fully illustrated. This provides a useful reference for the consideration of the position of the centre of body mass over one foot or the other. In the case of some pathological gaits, the lateral displacement can be substantial. The traditional two-dimensional diagram fails to show some of these effects.     

The phase diagram of the monoolein/water system: metastability and equilibrium aspects

Interest in the liquid crystal structure, transport and membrane protein crystallizing properties of the monoolein/water system has grown in the recent past. Monoolein is also an important homolog in a series of monoacylglycerols used to decipher how lipid molecular structure relates to liquid crystal phase behavior--information needed for rational design applications and for understanding the origin of membrane lipid diversity. To make intelligent use of the monoolein/water system, a reliable and detailed temperature-composition phase diagram is needed. The phase diagram of Briggs et al. (J Phys II France 1996;6:723-51) was constructed for this purpose. However, we have established that the liquid crystal phases in the latter below ca. 20 degrees C are metastable. By implementing a sub-zero degree (degrees C) sample incubation prior to data collection in the heating direction, we can reset the system into the lamellar crystal phase which we assume represents equilibrium behavior. We have re-examined the low-temperature part of the phase diagram and characterized structurally the new 'equilibrium' phases by static and time-resolved low- and wide-angle X-ray diffraction and by differential scanning calorimetry. A more complete phase diagram that incorporates the new equilibrium behavior at low temperatures is reported.     

Success-failure diagram for defibrillation

A new method for presenting defibrillation threshold data (current, voltage or energy) is presented in the form of a success-failure diagram, the y-axis of which is the shock strength employed. A vertical line divides the successful shocks from the unsuccessful shocks for each shock strength. The diagram shows clearly how many shocks have been given at each strength and how the success for defibrillation increases with increasing shock strength.     

Application of influence diagrams to prostate intensity-modulated radiation therapy plan selection

The purpose is to incorporate clinically relevant factors such as patient-specific and dosimetric information as well as data from clinical trials in the decision-making process for the selection of prostate intensity-modulated radiation therapy (IMRT) plans. The approach is to incorporate the decision theoretic concept of an influence diagram into the solution of the multiobjective optimization inverse planning problem. A set of candidate IMRT plans was obtained by varying the importance factors for the planning target volume (PTV) and the organ-at-risk (OAR) in combination with simulated annealing to explore a large part of the solution space. The Pareto set for the PTV and OAR was analysed to demonstrate how the selection of the weighting factors influenced which part of the solution space was explored. An influence diagram based on a Bayesian network with 18 nodes was designed to model the decision process for plan selection. The model possessed nodes for clinical laboratory results, tumour grading, staging information, patient-specific information, dosimetric information, complications and survival statistics from clinical studies. A utility node was utilized for the decision-making process. The influence diagram successfully ranked the plans based on the available information. Sensitivity analyses were used to judge the reasonableness of the diagram and the results. In conclusion, influence diagrams lend themselves well to modelling the decision processes for IMRT plan selection. They provide an excellent means to incorporate the probabilistic nature of data and beliefs into one model. They also provide a means for introducing evidence-based medicine, in the form of results of clinical trials, into the decision-making process.     

生物伯德图用于血压稳定性的分析和计算

本文用生物伯德图分析了血压稳定性。按照经典的控制理论,讨论了生物系统的稳定性,提出了血压控制的数学模型。根据生物特点,建立了生物伯德图的表达式。作为系统稳定性的指标,增益裕量和相位裕量可以用作图法求得,也可以用计算机求解。实验结果与理论分析能很好地符合。     

血细胞分析仪异常散点图对血液病的辅助诊断价值

目的 通过分析血细胞分析仪异常散点图的细胞群分布形态及特征,探讨其对血细胞分析中白细胞,特别是幼稚细胞分类的辅助诊断价值.方法 通过观察130例的血细胞分析散点图,统计分析其形态特征、仪器警示信息、血涂片染色镜检等特点,总结血细胞分析仪警示信息和临床诊断的关系.结果 采用静脉血标本分析时,警示信息与临床诊断符合率较高,可根据异常散点图的表现和警示信息对血液异常细胞进行人工镜检分类;而采用指血分析时,警示信息与临床诊断符合性较差,参考价值较低.结论 认真观察血细胞分析仪的异常散点图及显微镜复检是诊断血液病类型的重要措施,有助于筛查或辅助诊断血液疾病,正确判断白血病类型.     

Toward complete and accurate reporting of studies of diagnostic accuracy. The STARD initiative

Our objective was to improve the accuracy and completeness of reporting of studies of diagnostic accuracy, to allow readers to assess the potential for bias in the study, and to evaluate its generalizability. The Standards for Reporting of Diagnostic Accuracy Steering Committee searched the literature to identify publications on the appropriate conduct and reporting of diagnostic studies and extracted potential items into an extensive list. Researchers, editors, and members of professional organizations shortened this list during a 2-day consensus meeting with the goal of developing a checklist and a generic flow diagram for studies of diagnostic accuracy. The search for published guidelines regarding diagnostic research yielded 33 previously published checklists, from which we extracted a list of 75 potential items. At the consensus meeting, participants shortened the list to a 25-item checklist, using evidence whenever available. A prototypical flow diagram provides information about the method of patient recruitment, the order of test execution, and the numbers of patients undergoing the test under evaluation, the reference standard, or both. Evaluation of research depends on complete and accurate reporting. If medical journals adopt the checklist and the flow diagram, the quality of reporting of studies of diagnostic accuracy should improve, to the advantage of clinicians, researchers, reviewers, journals, and the public.