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。     

术中三维C型臂实时透视导航辅助颈椎椎弓根螺钉的植入

可以准确引导颈椎椎弓根螺钉的植入.     

Modelling of metastatic cure after radionuclide therapy: influence of tumor distribution, cross-irradiation, and variable activity concentration

The objective was to study the influence of tumor number and size, cross-irradiation from normal tissue, and of variable activity concentration on metastatic cure after radionuclide therapy. A model to calculate the metastatic cure probability (MCP) was developed, in which it was assumed that the tumor response was an exponential function of the absorbed dose. All calculations were performed for monoenergetic electron emitters with different energies (10-1000 keV). The influence of tumor size and number of tumors were investigated with different log uniform distributions; the basic tumor distribution consisted of tumors with 1, 10, ..., 10(11) cells. The influence of cross-irradiation was assessed by calculating MCP for various tumor-to-normal tissue activity concentration ratios (TNC). The influence of variable activity concentration between tumors was calculated by assuming that the activity concentration in tumors was an inverse power law function of tumor mass. The required activity concentration (C0.9) and absorbed dose (D0.9) to obtain MCP=0.9 was calculated in the different models. The C0.9 and D0.9 needed to obtain MCP were very high; more than 25 MBq/g and 80 Gy, respectively. The lowest C0.9 and D0.9 for equal activity concentration in the different tumor sizes were obtained for electron energies less than 80 keV. For higher energies the low absorbed energy fraction in small tumors will increase the required C0.9 and D0.9 markedly. Cross-irradiation from normal cells surrounding the tumor will cause sterilization of the smallest tumors and decrease the required C0.9 and D0.9 for higher electron energies. Assuming that the activity concentration decreased with increased tumor mass caused a marked increase in C0.9 and D0.9 in favor of higher electron energies. With the MCP model we demonstrated significant influence of the number of tumors, their size, TNC and variable activity concentration on MCP. The results are valuable when evaluating optimal choices for radionuclides for internal-emitter therapy.     

Immunotypes ofChlamydia trachomatis isolated from genital tract specimens in Tahiti

The distribution ofChlamydia trachomatis immunotypes (serovars) in Tahiti was studied by immunotyping of local isolates using monoclonal antibodies in the micro-immunofluorescence test. From 115 isolates obtained from the genital tracts of patients attending a sexually transmitted diseases clinic and other gynecological consultations, eight immunotypes were identified: E (51.3 %), F (16.5 %), G (13 %), H (5.2 %), J (6.9 %), D (3.5 %), K (1.7 %) and I (0.9 %). In addition, an isolate with mixed immunotypes, EJ (0.9 %), was observed. This distribution was compared with those in different geographical areas.     

Refractive error among urban preschool children in Xuzhou,China

The prevalence of refractive errors in urban preschool children in Xuzhou, China remains unknown. Children attending twelve randomly selected kindergartens participated in this study. Visual acuity, ocular alignment, cover-uncover test, cycloplegic refraction, slit-lamp and funduscopy were performed under a standardized testing environment. Cycloplegic streak retinoscopy was performed for all subjects. The mean spherical equivalent (SE) refractive error was the main outcome measure. Emmetropia was defined as refractive status between +1.75 diopters (D) and -0.75D. Myopia, hyperopia, astigmatism and anisometropia were defined as SE < -0.50D, SE > +2.0 D, cylindrical error > 1.0 D and SE difference ≥ 1 D between fellow eyes, respectively. Out of 2349 eligible children, 2255 (96%) children completed a refractive examination. Of the 2255 children, the mean SE of right eyes was +1.14 ± 0.95 diopters (D). Mean SE of the right eyes did not decline with age (r = -0.01; P = 0.56). The majority (86.6%) of children were emmetropia. The prevalence of myopia and hyperopia was 0.9% and 14.3%, respectively. The mean astigmatism for the right eyes was 0.87 ± 0.62 D. The prevalence of With-the-rule, against the rule and oblique astigmatism was 93.8%, 4.7% and 1.5%, respectively. The mean anisometropia between two eyes was 0.14 ± 0.38 D. The most common type of refractive error was hyperopia (14.3%), followed by astigmatism (8.8%), anisometropia (3.2%), and myopia (0.9%). The refractive status in this population of urban Xuzhou preschool children was stable and there was no evidence of a myopic refractive shift over this age range in our cross-sectional study.     

不同密度梯度离心处理后精子形态的变化

目的研究不同密度梯度法处理后精子形态的变化。方法收集55份男性精液标本,每份精液按不同处理方法分4组,A组为对照直接加生理盐水洗涤离心,B组由40%、80%两层梯度液处理精液,C组由40%、60%、80%三层梯度液处理精液,D组由40%、55%、70%、80%四层梯度液处理精液,处理后均行精子形态改良巴氏染色分析。结果 C组与D组可以显著降低精子的畸形率,差异有统计学意义（P〈0.0125）,其中D组最为显著。结论梯度液层次多对畸形精子的分离效果较好。     

Genetic variability of wild-type measles viruses, circulating in the Russian Federation during the implementation of the National Measles Elimination Program, 2003–2007

Genetic characterization of wild-type measles viruses (MVs) is an important component of laboratory surveillance of measles. In this study, a phylogenetic analysis was performed of the nucleoprotein gene sequences of 228 MVs isolated in the Russian Federation between 2003 and 2007. Five genotypes, D4, D5, D6, D8, and H1, were detected. From 1999 through the first 6 months of 2003, the most prevalent genotype in the European part of Russia was D4. All genotype D4-type viruses were closely related to each other (with overall sequence diversity of ≤0.9%), suggesting the presence of a single endemic MV strain. After 2003, viruses with closely related sequences within genotype D6 (≤0.9% sequence diversity) were prevalent. During this time, there was a low level of indigenous transmission of genotype D6, and genotype D6 viruses were imported from neighbouring countries, which led to the identification of two lineages of genotype D6, i.e. D6a and D6b. Lineage D6a was closely related to viruses isolated in Turkey, Kazakhstan, and Uzbekistan, whereas lineage D6b was linked to a large outbreak in Ukraine in 2005–2006. Genotypes H1, D5 and D8 were associated with sporadic cases and clusters of transmission linked to importations. Enhanced vaccination interrupted the transmission of the previous endemic lineage D4 in 2003 and of lineage D6a in 2005, although an accumulation of susceptible individuals in the population allowed for prolonged circulation of lineage D6b. These data on MV genotype distribution, in conjunction with the epidemiological data for measles, show considerable progress in measles control and suggest that regional elimination is possible.     

High prevalence of dual or triple infection of hepatitis B, C, and delta viruses among patients with chronic liver disease in Mongolia

Mongolia is known for its high endemicity for hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis delta virus (HDV) infections among apparently healthy individuals. However, there are little or no data on the prevalence and genotype distribution of HBV, HCV, and HDV among patients with chronic liver disease in Mongolia. Therefore, serum samples obtained in 2004 from 207 patients (age, mean+/-standard deviation, 51.0+/-11.9 years) including those with chronic hepatitis (n=90), liver cirrhosis (n=41), and hepatocellular carcinoma (n=76) were tested for serological and molecular markers of HBV, HCV, and HDV infections. Of the 207 patients, 144 (69.6%), 106 (51.2%), and 117 (56.5%) tested positive for hepatitis B surface antigen (HBsAg) and/or HBV DNA, HCV RNA, and HDV RNA, respectively. Collectively, 172 patients (83.1%) were viremic for one or more of these viruses, including dual viremia of HBV/HDV (26.6%) or HBV/HCV (7.7%) and triple HBV/HCV/HDV viremia (30.0%). Of note, triple ongoing infection was significantly more frequent among patients with hepatocellular carcinoma than among those with chronic hepatitis (63.2% vs. 14.4%, P<0.0001). One hundred sixty patients (77.3%) had a history of blood transfusion and/or surgery. The distribution of HBV genotypes among the 116 HBV-viremic patients was: A (0.9%), B (0.9%), C (6.0%), D (88.8%), and C plus D (3.4%). All 117 HDV isolates were classified into genotype I. The 106 HCV RNA-positive samples were typed as genotype 1b (92.5%), 2a (0.9%), or 1b plus 2a (6.6%); mixed infection of two distinct HCV genotypes was found exclusively in the patients with hepatocellular carcinoma.     

Noncontact common-path Fourier domain optical coherence tomography method for in vitro intraocular lens power measurement

We propose a novel common-path Fourier domain optical coherence tomography (CP-FD-OCT) method for noncontact, accurate, and objective in vitro measurement of the dioptric power of intraocular lenses (IOLs) implants. The CP-FD-OCT method principle of operation is based on simple two-dimensional scanning common-path Fourier domain optical coherence tomography. By reconstructing the anterior and posterior IOL surfaces, the radii of the two surfaces, and thus the IOL dioptric power are determined. The CP-FD-OCT design provides high accuracy of IOL surface reconstruction. The axial position detection accuracy is calibrated at 1.22 μm in balanced saline solution used for simulation of in situ conditions. The lateral sampling rate is controlled by the step size of linear scanning systems. IOL samples with labeled dioptric power in the low-power (5D), mid-power (20D and 22D), and high-power (36D) ranges under in situ conditions are tested. We obtained a mean power of 4.95/20.11/22.09/36.25 D with high levels of repeatability estimated by a standard deviation of 0.10/0.18/0.2/0.58 D and a relative error of 2/0.9/0.9/1.6%, based on five measurements for each IOL respectively. The new CP-FD-OCT method provides an independent source of IOL power measurement data as well as information for evaluating other optical properties of IOLs such as refractive index, central thickness, and aberrations.     

The effects of 17 beta-oestradiol plus dydrogesterone compared with conjugated equine oestrogens plus medroxyprogesterone acetate on lipids, apolipoproteins and lipoprotein(a)

OBJECTIVE: To compare the effects of 17 beta-oestradiol plus dydrogesterone with conjugated equine oestrogens plus medroxyprogesterone acetate on serum lipids, apolipoproteins and lipoprotein(a) in postmenopausal women. METHODS: A multi-centre, prospective, randomised, double-blind, comparative one-year study in 362 healthy postmenopausal women aged 39-74 years with an intact uterus. Fasting blood samples were taken at baseline and after 28 and 52 weeks of treatment. Participants received daily oral treatment with continuous combined 1 mg micronised 17 beta-oestradiol/5 mg dydrogesterone (E/D: n=180) or 0.625 mg conjugated equine oestrogens/5 mg medroxyprogesterone acetate (CEE/MPA: n=182). RESULTS: Significant differences between the two groups after 52 weeks were observed for total cholesterol (E/D: -1.7%; CEE/MPA: -7.3%), LDL-cholesterol (E/D: -4.5%; CEE/MPA: -11.3%), HDL-cholesterol (E/D: +15.3%; CEE/MPA: +7.5%), triglycerides (E/D: +9.8%; CEE/MPA: +16.6%), VLDL-triglycerides (E/D: -3.3%; CEE/MPA: +10.0%), lipoprotein(a) (E/D: 0.0%; CEE/MPA: -25.2%) and for the ratio apolipoprotein B/LDL-cholesterol (E/D: +0.9%; CEE/MPA +5.9%). CONCLUSIONS: E/D and CEE/MPA differ in their anti-atherogenic effects on lipids and lipoproteins. This however can not easily be translated to differences in clinical cardiovascular outcomes.     

Analysis of hepatitis B surface antigen mutations in Mongolia: Molecular epidemiology and implications for mass vaccination

Summary. Although the potential significance of hepatitis B surface antigen (HBsAg) mutants for failure of immunization has been studied in some endemic countries, whether the “a” determinant variants are responsible for vaccine failure in Mongolia remains unknown. Fifty-nine HBsAg-positive children (age: 8.8 ± 0.9 years) who had been observed during the nationwide survey of vaccinated cohorts conducted in 2004 were subjected to molecular analyses of hepatitis B virus (HBV). Partial S gene sequences encoding amino acids (aa) 40–171 of HBsAg were determined in 57 children (96.6%) who had detectable HBV DNA. Phylogenetic analysis of the S gene sequences revealed that genotype D accounted for 93.0% and genotype A for 5.3%. Only one child (1.7%) had HBVs of genotypes A and D. HBsAg mutations were found in 17 (29.8%) children ranging from 1 to 4 aa per subject (mean ± SD, 1.6 ± 0.9 aa). Pro127Thr and Thr118Ala were the most common substitutions, which occurred in 6 (10.5%) and 3 (5.3%) subjects, respectively; none had Gly145Arg. There were no significant associations in the prevalence of HBsAg mutations with age, sex, residential area, or vaccination status against hepatitis B. Analysis of the deduced amino acid sequence of the entire preS1/preS2/S gene revealed that eight genotype D isolates and one genotype A isolate were quite similar to previously-reported wild-type isolates, suggesting that they are essentially wild-type, but not vaccine-induced mutants. In conclusion, the results demonstrate that hepatitis B surface gene mutants do not play a significant role in vaccination failure in Mongolia.