广东东莞地区中老年非暴力性骨折107例及无骨折求诊者392例超声骨密度测定

目的:应用超声骨密度/骨质量测量仪对东莞地区中老年非暴力性骨折患者进行检测,探讨各参数的变化规律及临床意义,并确立骨折的骨密度阈值。方法:①实验对象:选择2003-09/2006-08在东莞石龙人民医院进行超声骨密度测定的非暴力性骨折东莞地区中老年患者107例,男30例,女77例;同期同龄进行超声骨密度测定的无骨折求诊者392例,作为对照组,男83例,女309例。②实验分组:根据年龄分为3个时期:46～60岁为老年前期、61～75岁为老年期、76岁以上为高龄期,以及相应男女组及骨折与非骨折组。③实验方法:采用法国DMS公司UBIS5000型超声骨密度/骨质量测量仪对中老年非暴力性骨折者、无骨折就诊者进行超声骨密度测量。④实验评估:比较两组男女及不同年龄段超声振幅衰减平均值、超声传播速度、骨硬度指数、T值(代表患者测量值如超声振幅衰减平均值和20岁正常人的测量值之间的差异)、Z值(代表患者测量值如超声振幅衰减平均值和同龄正常人的测量值之间的差异)。结果:两组499例患者全部进入结果分析。①总体比较:男、女性骨折组与非骨折组比较,除超声传播速度差别无统计学意义外(P>0.05),其余指标(超声振幅衰减、骨硬度指数、T值、Z值)非骨折组高于骨折组(P<0.01)。②分年龄组比较:老年前期组与总体一致,老年组、高龄组主要指标无统计学意义。应用方差分析对女性骨折组各年龄组之间进行比较,除骨硬度指数外(P<0.05),其余指标差异无显著性;男性骨折组各年龄组之间比较得出与女性一样结果。③男性与女性骨折组比较:除T值男性组高于女性组外(P<0.01),其余指标(超声振幅衰减、超声传播速度、骨硬度指数、Z值)差异均无统计学意义。结论:①中老年人群骨质下降至一定程度(相应测量参数为骨折阈值)时容易发生脆性骨折。②致脆性骨折的骨质量条件与性别、年龄因素无明显相关性。③东莞地区步入老年期后不论男女骨质疏松现象相当普遍,是否会出现骨折关键在于有否外力作用,对其预防性诊断很有价值。     

许旺细胞增殖和分化过程中的信号通路

目的:探讨许旺细胞增殖和分化过程中细胞内各种信号通路及其关联性。资料来源:应用计算机检索Medline 1994-01/2006-12和Embase 1994-01/2006-12期间的有关许旺细胞增殖和分化相关的信号通路的文献,检索词“Schwann cell;proliferation;differentiation;signal transduction”,并限定文章语言种类为英文。资料选择:选取与许旺细胞增殖和分化相关的有关信号通路的文献,进行初审,删除与信号通路不相关的研究,然后查找余下的文献全文。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索54篇与许旺细胞增殖和分化相关的有关信号通路的文献研究,纳入30篇文章。14篇有关许旺细胞增殖,12篇许旺细胞分化,4篇是其他的相关信号通路。资料综合:许旺细胞的分化和基因表达是通过各种细胞外信号来调控的,多种信号通路相互联系。来自于受体酪氨酸激酶,丝裂原活化蛋白激酶,磷酯酰肌醇-3激酶通路的信号在许旺细胞增殖和分化过程中都有很重要的作用,它们之间的平衡决定了细胞最后的功能。而细胞内膜受体G蛋白偶联的环磷腺苷浓度促进了细胞的各种功能,也参与调节了其他信号通路。结论:许旺细胞增殖和分化过程是多种信号通路相互联系完成的,阐明不同信号通路之间的关系以及它们的交互作用对于揭示许旺细胞的生物学功能有重要的意义。     

An evaluation of the improved Technicon Chem 1 system

The improved selective multitest analyser Technicon Chem 1 was evaluated according to the ECCLS guidelines in our laboratory. Twenty two routine parameters were examined. The trial also included a clinical evaluation. About 50,000 measurements were performed during six weeks. The following conclusions can be drawn: 1. The changes made in the system (mainly software) led to genuine improvements. 2. The precision of the system can be rated as good. With a few exceptions (alkaline phosphatase, lactate dehydrogenase, creatine kinase, albumin and total bilirubin) all between-day coefficients of variation are lower than 3%. 3. Excellent agreement was found between the results obtained from the Chem 1 and from the comparison methods. 4. No drift was observed. Once calibrated the Chem 1 can be used for at least fifteen days without renewed calibration, except for the analysis of sodium, potassium and calcium. 5. No carry-over was observed, either specimen-related, or reagent-related. 6. Though not all methods were examined in detail, in general the linearity was found to agree with the manufacturer's claims. 7. The influence of interfering substances proved to be moderate. 8. The practicability of the system was good. A more complete judgement is given in the Discussion Section.     

Measurement of total serum protein by near-infrared reflectance spectroscopy

This study describes the measurement of total protein in serum by near-infrared reflectance spectroscopy. With an algorithm, generated by the calibration procedure, the protein content of serum samples was calculated from absorbance data at various wavelengths in the near-infrared. A good correlation (r = 0.993) was found between near-infrared reflectance spectroscopy measurement of serum protein and analysis by the biuret reaction.     

The influence of the label on the quality of a solid-phase immunoassay: evaluation of a commercial ELISA kit for serum ferritin

A new Enzyme Linked Immuno Sorbent Assay (ELISA) kit for the determination of serum ferritin has been compared with another ferritin kit based on the Immuno Radio-Metric Assay (IRMA) approach, both assays containing similar antibodies. Based on these studies, we found the within-run precision of the ELISA (and IRMA) to have coefficients of variation of 4-10% and 2-6% respectively, over a concentration range of 12-600 micrograms/l. The between-run precision for the same concentration range exhibited a CV range of 9-13% and 7-11% respectively. The sensitivities were found to be 1.4 micrograms/l and 0.9 microgram/l. The mean recovery was 103% for the ELISA procedure. It was found that, using the serum dilution technique, the linearity reached to 1000 micrograms/l. In the ELISA procedure no influence from the so-called "high dose hook effect" was observed. While EDTA-plasma produced 6% lower values than serum in the ELISA technique, no interference from albumin, gamma-globulins and mild haemolysis was observed. Stability problems with the ELISA kit were not encountered. A comparative analysis of multiple specimens demonstrated nearly identical values with r = 0.994 and y = 0.87 x1.01. The quality and ease of operation of the ELISA approach compared with other techniques are discussed. In conclusion it is possible to replace a radio-label in an immunoassay with an enzyme-label with the same degree of reliability and other parameters of quality control exhibited by radioimmunoassays.     

Computed tomography in the evaluation of Brown syndrome of the superior oblique tendon sheath

Computed tomographic (CT) findings in 4 patients with superior oblique tendon sheath syndrome (congenital or acquired Brown syndrome) are described. When the inferior oblique muscle moves the eye upward, the superior oblique muscle normally relaxes, while its tendon lengthens and slides freely through the trochlea. In Brown syndrome this process is somehow restricted, which is most apparent during attempts at elevation when the eye is adducted, resulting in an apparent inferior oblique "palsy" (pseudopalsy). Brown syndrome is the most common cause of an apparent isolated limitation of the inferior oblique muscle. CT is a valuable tool in understanding the pathophysiology and management of acquired Brown syndrome, showing thickening and inflammatory changes of the reflected portion of the superior oblique tendon.