高原胎盘的病理形态学研究

目的：研究高原胎盘的组织形态及超微结构。方法：对３２００ｍ以上的高原胎盘２６例及１３００ｍ以下的喀会及西安胎盘５０例进行比较观察。结果：（１）高原新生儿体重均数绝对值２９１５．３８ｇ，较对照组少３７４．４２ｇ，较对照组少３７４．４２ｇ（Ｐ〈０．０１）；（２）高原胎盘重量均数绝对值４８５．１２ｇ，明显低于对照组５８３。６８ｇ（Ｐ〈０．０１）；（３）组织学检查中，高原组具有合体细胞结节、血管合体膜、血     

高原胎盘的病理形态学研究

目的：研究高原胎盘的组织形态及超微结构变化，探讨形态变化对孕妇和胎儿的影响。方法：对３２００ｍ以上原高胎盘２６例与１３００ｍ以下的喀什及西安地区胎盘５０例进行比较观察。结果：①高原新生儿体重均数绝对值２９１５．３８ｇ，较对照组少３７４．４２ｇ（Ｐ＜０．０１）；②高原胎盘重量均数绝对值４８５．１２ｇ，明显低于对照组５８３．６８ｇ（Ｐ＜０．０１）；③组织学检查：具有合体细胞结节、血管合体膜、血管增多、朗罕氏细胞、绒毛纤维素样坏死等绒毛均高于对照组（Ｐ＜０．０１）；④超微结构观察：高原胎盘绒毛的合体细胞及朗罕氏细胞增生明显，粗面内质网高度扩张，滋养叶基底膜明显增厚，可达正常的几倍至十几倍。结论：高原缺氧能引起高原妊娠胎盘组织形态及结构改变，致使婴儿体重减轻。     

中度高原地区不同孕周胎盘绒毛超微结构观察

本文通过对２７例中度高原的西宁地区３９～４２孕周胎盘绒毛超微结构的观察，并与南京平原组相应孕周胎盘作比较。结果提示：西宁地区胎盘绒毛滋养细胞和间质在４０孕周已有改变。４１孕周合体细胞表面微绒毛减少，粗面内质网扩张空泡变，饮液泡减少，细胞滋养细胞增生，易见中间型细胞。间质滋养层基底膜持续增厚及胶原纤维增多、血管内皮细胞皱缩，管腔狭窄等一系列老化的形态学改变与平原组４２孕周（过期妊娠）胎盘相同。表明高原西宁地区胎盘提前发生老化，并认为可能与高原低压氧等自然环境有关，据此提出，西宁地区应在４０孕周时实施计划分娩，以降低围产儿死亡率及并发症。     

不同海拔高原地区健康成人右心Tei指数研究

目的:探讨不同海拔高原地区健康成人右心Tei指数。方法:应用多普勒超声心动图对高原地区(海拔3 800m)健康世居、移居成人右房室内径、主肺动脉内径及右心Tei指数测定,并与西宁地区(海拔2 260m)相对照。结果:高原地区世居成人右房室内径、主肺动脉内径及右心Tei指数与西宁地区(海拔2 260m)健康成人比较,无统计学差异,但高原移居健康成人右房室内径、主肺动脉内径及右心Tei指数均高于西宁地区世居健康成人,西宁地区世居健康人群与移居健康人群右心各项参数无统计学差异。结论:高原地区移居健康成人右心Tei指数高于世居健康成人。     

高原缺氧环境对世居藏族和移居汉族胎儿生长发育的影响

目的:通过比较高原世居藏族产妇与移居汉族产妇胎盘重量、新生儿体重和胎盘系数,了解高原环境对世居藏族和移居汉族胎儿生长发育的影响。方法:收集、检测和比较生活在海拔3480m高原的世居藏族和移居汉族初产妇分娩的胎盘重量、新生儿体重及胎盘系数,并与平原汉族新生儿出生体重比较;比较移居高原汉族初产妇和经产妇分娩的胎盘重量、新生儿体重及胎盘系数。结果:移居汉族初产妇新生儿低体重出生率显著高于世居藏族(P<0.01);世居藏族初产妇胎盘重量与移居汉族初产妇无显著差别(P>0.05)、新生儿体重高于汉族,差异有显著性(P<0.01);移居汉族初产妇胎盘系数显著高于世居藏族(P<0.05)。移居汉族初产妇胎盘重量和胎盘系数显著高于移居汉族经产妇(P<0.01),二者新生儿出生体重差别无显著性(P>0.05);藏族新生儿体重与平原汉族新生儿出生体重无显著差别(P>0.05);结论:移居汉族产妇,尤其是初产妇,在高原分娩的新生儿体重低于世居藏族和平原汉族,胎盘系数显著高于世居藏族,说明高原环境影响移居汉族胎儿宫内的生长发育。因此,有必要进一步探索高原环境对移居汉族胎儿生长发育的影响机制,以利于加强移居者围产期保健,降低高原缺氧环境对移居者胎儿生长发育的不良影响。     

高原缺氧对正常人血浆心钠素的影响

目的 :心钠素是近年来发现从心脏分泌的一种新激素 ,具有强大的利尿、排钠、扩张血管作用。本文观察高原缺氧对人体心钠素含量水平的影响。方法 :血液标本分别取自三个不同海拔地区正常人的空腹静脉血 ,北京地区 (海拔 31m) ;青海省西宁市地区 (海拔 2 2 6 0m) ;青海省果洛州 (海拔 3719m) ;用直接放免法测定血浆中心钠素的含量。结果 :低海拔组 (北京地区 )正常人血浆心钠素含量明显低于中等海拔组 (西宁地区 )及高海拔组 (果洛地区 )正常人 ;其 (P <0 .0 0 1)。结论 :不同海拔高度对正常人体血浆心钠素水平有一定的影响 ,缺氧可能是不同海拔正常人血浆心钠素水平发生的主要原因     

高原缺氧环境成年男性精子质量分析

目的：了解长期高原缺氧暴露对成年男性精子功能的影响。方法：以38名驻海拔3 300 m和36名驻海拔5 000 m以上的健康成年男性青年为高原组1和高原组2,以生活在海拔1 300 m的35名同龄成年男性为对照组。行精液常规检测与血常规检查。结果：高原组的精子密度明显低于对照组（P〈0.05）,精子活率在高原组2与对照组有显著差异（P〈0.05）;高原组中血红蛋白浓度与精子数量和活率成正比。结论：虽然人体有一定的代偿功能,但长期驻留高原缺氧环境对成年男性的精子功能有负面影响。     

高原汽车兵血清Hcy、叶酸和维生素B12的测定及相关性研究

目的 了解高原汽车兵血清同型半胱氨酸(Hcy)水平和营养状况,为合理补充营养提供依据.方法 采用S-腺苷酶法和酶促间接化学发光法,对36名在海拔3700 m以上高原生活9个月的汽车兵和40名在海拔1500 m平原生活的汽车兵进行了血清Hcy、叶酸和维生素B12含量的测定.结果 高原组血清Hcy含量明显高于平原组(P＜0.05),而血清叶酸和维生素B12的含量明显低于平原组(P＜0.05).结论 高原汽车兵血清Hcy明显偏高,营养不够合理,有必要进行营养干预.     

西宁地区与平原地区中重度颅脑外伤后认知功能障碍的比较分析

目的:分析西宁地区与平原地区颅脑外伤后认知功能障碍的特点。方法:采用简易智力状况检查量表(MMSE)评定颅脑外伤后认知功能状态,对比分析西宁地区(海拔2 260m)61例及平原地区上海(海拔4m)67例脑外伤患者的认知功能状况。结果:西宁地区中重度颅脑外伤患者的MMSE总分、记忆力、回忆得分明显低于平原地区(P<0.05);在定向、计算、复述、命名方面得分相比无明显差异(P>0.05)。结论:西宁地区急性颅脑外伤患者认知功能障碍的特点较平原地区有其相对的特殊性,高原缺氧可能是重要的影响因素。     

亚高原地区大、小鼠生化指标正常参考值实验研究

目的 探讨亚高原地区SD大鼠和KM小鼠血液生化指标变化规律,确立参考值.方法 将2w龄SD大鼠和KM小鼠各60只,按饲养地区分为亚高原组(海拔1890 m)和平原组(海拔540 m),分别于4、6、10 w龄时检测血液生化指标,比较两组肝功能、肾功能、血脂及血糖的差异.结果 取得亚高原地区不同周龄、不同性别SD大鼠和KM小鼠的血液生化指标均值.亚高原组的肝功能指标普遍高于平原组,以谷丙转氨酶、谷草转氨酶、白蛋白的改变为主(P＜0.05);亚高原组肾功能指标也高于平原组(P＜0.05),特别是习服时间越长,改变越明显;亚高原组血脂指标高于平原组(P＜0.05);除平原组雄性KM小鼠血糖(GLU)高于亚高原组(P＜0.05)外,其余亚高原组大、小鼠GLU均高于平原组(P＜0.05).结论 建立了亚高原地区不同周龄、不同性别SD大鼠和KM小鼠的血液生化指标数据库,为该地区生物医学研究奠定了基础,也为亚高原地区KM小鼠和SD大鼠标准化鉴定和质量控制提供了可靠依据.     

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.