葛洪形神思想新诠

葛洪在老庄思想基础上构建了独特的形神理论,认为形以神为本,神视形为终。形神养生重视贵德尚善、笃志至信,心身协养、动静结合。从其形神思想获得灵感,认为发扬医学人道主义理念、深化治未病理念、挖掘身心医学的传统文化基础应作为心身医学构建的重要内容。     

附睾管三维重建及解剖

目的 以人附睾组织为研究对象,进行附睾管三维重建,明确附睾管解剖学及组织学特点。 方法 对1例人附睾连续组织切片,Leica Aperio AT2数字扫描,Photoshop CC 2018配准,VGStudio MAX V3.0三维立体合成,Materialise Magics V22.0后期修饰。另1例用于电子显微镜观察。结合切片及三维重建,分析附睾管的组织学特点。 结果 获得7 μm厚的横断面人附睾石蜡切片4331张,矢状面切片543张;人附睾管存在明显的区域性分布,附睾头、体和尾部可分别划分为7个、9个和4个亚区,亚区间有组织间隔;不同亚区内附睾管排列无序,但附睾管管径及其上皮结构存在差异,且体、尾部各亚区间为单根附睾管连接。 结论 利用连续组织切片的方法能成功三维重建人附睾管。揭示人附睾管具有明显的空间区域性,不同亚区组织存在差异。     

椎板切除神经根损伤后聚羧甲基葡萄糖胺产品抗瘢痕粘连的效果

目的探索聚羧甲基葡萄糖胺产品防止神经损伤后瘢痕粘连形成的效果。方法 48只雄性Sprague-Dawley大鼠分为A、B两组。大鼠切除L4-5椎板,暴露并损伤右侧神经根。A组术区涂抹生理盐水,B组涂抹聚羧甲基葡萄糖胺产品。术后第1(A1、B1)、2(A2、B2)、4周(A3、B3)对各组神经根周围粘连行Rydell评分;HE染色、Masson染色观察,行粘连组织学Nussbaum评分;检测血常规和肝、肾功能。结果各组Rydell评分:A1组Ⅰ级、A2组Ⅱ级、A3组Ⅲ级,B1组0级、B2组0级、B3组Ⅱ级。HE染色示B组较A组神经根周围粘连速度慢且瘢痕生长疏松。Masson染色示B组较A组神经根周围瘢痕组织网稀疏散在,且随时间延长其致密程度加深不明显。组织学Nussbaum评分示,同时段A、B组间比较均有显著性差异(P0.05)。各组大鼠血常规及肝、肾功能均在正常参考值范围内。结论聚羧甲基葡萄糖胺产品能有效防止椎板切除术后神经根周围及硬膜外瘢痕粘连形成,无毒副作用。     

In vitro and in vivo proliferation,differentiation and migration of cardiac endothelial progenitor cells (SCA1+/CD31+ side‐population cells)

To cite this article: Liang SX, Khachigian LM, Ahmadi Z, Yang M, Liu S, Chong BH. In vitro and in vivo proliferation, differentiation and migration of cardiac endothelial progenitor cells (SCA1⁺/CD31⁺ side‐population cells). J Thromb Haemost 2011; 9 : 1628–37. Summary. Background: Side‐population (SP) cells are a select population identified by a capacity to efflux Hoechst dye and are enriched for stem/progenitor cell activity. Previous studies suggested that cardiac SP (CSP) cells could be divided into SCA1⁺/CD31^? and SCA1⁺/CD31⁺ CSP cells. SCA1⁺/CD31^? CSP cells have been shown to be cardiac stem/progenitor cells. However, SCA1⁺/CD31⁺ CSP cells have not been fully characterized. Objective: The aim of the present study was to characterize SCA1⁺/CD31⁺ CSP cells in the adult mouse heart, and investigate their abilities to proliferate, differentiate, vascularize and migrate in vitro and in vivo. Results: Using fluorescence‐activated cell sorting (FACS), RT‐PCR, and assays of cell proliferation, differentiation and migration, and a murine model of myocardial infarction (MI), we showed that SCA1⁺/CD31⁺ CSP cells express stem cell and endothelial‐specific genes, and reside in the blood vessels. These cells were able to proliferate, differentiate, migrate and vascularize in vitro and in vivo. After MI, SDF‐1α and CXCR4 were up‐regulated in the damaged myocardium and on SCA1⁺/CD31⁺ CSP cells, respectively. Our results further showed that SDF‐1α induced migration of these cells in vitro. Importantly, we found that SCA1⁺/CD31⁺ CSP cells could migrate into the ischemic region from the non‐ischemic area within the myocardium and form a vascular tube‐like structure after MI. Conclusions: Based on the gene expression profile, localization of SCA1⁺/CD31⁺ CSP cells, and their ability to proliferate, differentiate, migrate and vascularize in vitro and in vivo, we postulate that SCA1⁺/CD31⁺ CSP cells may represent endothelial progenitor cells in the mouse heart.     

影像引导下经皮穿刺注射甲基泼尼松龙及注射型硫酸钙治疗单房性骨囊肿

目的 探讨在影像引导下经皮双针注射甲基泼尼松龙及注射型硫酸钙治疗单房性骨囊肿的方法与疗效.方法 回顾性分析2006年10月至2010年8月治疗的单房性骨囊肿患者37例,男26例,女11例;年龄8～22岁,平均13.2岁.股骨近端病变5例,患者均有大腿近端酸痛、跛行等症状;肱骨近端病变32例,其中16例有上臂近端酸痛等症状,余16例无症状.术前均行X线、CT与MR检查.在"C"型臂X线机透视下将两枚穿刺针分别穿入囊腔内的近端与远端,欧乃派克造影确认两针相通,生理盐水反复冲洗后,注入甲基泼尼松龙120 mg及可注射型硫酸钙,直至囊腔完全充填.根据改良Neer X线评级标准对骨囊肿愈合进行评估.结果 术后住院1～3d,平均2.3d.术后每个月摄片复查,如连续2个月骨囊腔面积较前不再缩小则再次注射.37例患者中,6例注射2次,31例注射1次.注射后囊肿均愈合.改良Neer X线评级标准对骨囊肿愈合进行评估:术后3个月时随访37例,其中Ⅱ级6例,Ⅲ级8例,Ⅳ级23例;术后6个月时随访31例,其中Ⅱ级2例,Ⅲ级4例,Ⅳ级25例;术后24个月时随访26例,其中Ⅲ级3例,Ⅳ级23例;术后36个月时随访19例,均为Ⅳ级.结论 影像引导下经皮穿刺注射甲基泼尼松龙及注射型硫酸钙治疗单房性骨囊肿,具有创伤小、并发症少、术后恢复快等优点.

Abstract：

Objective To investigate the methods and therapeutic effects of image-guided percutaneous needle iniection of methylprednisolone and injectable calcium sulfate for simple bone cysts.Methods Thirty-seven patients with simple bone cysts from 0ctober 2006 to August 2010 were analysed retrospectively in our hospital,including 26 males and 11 females with the average age of 13.2 years(range,8-22 years).Five cases of proximal femus lesions,with proximal thigh pain,limp and other symptoms.Thirty-two cases of proximal humeral lesions,16 patients had proximal pain and other symptoms of upper arm,the other 16 cases were asymptomatic.Preoperative AP and lateral X-ray.CT and MRl were taken.Under the C-arm X-ray monitor.two needles were inserted into the proximal and distal of cysts respectively,Omnipaque contrast was iniected to confirm the two needles is interlinked,then repeated rinsing with normal saline,then 120 mg methylprednisolone and iniectable calcium sulfate were injected,till the cysts were full up.Patients after treatment were assessed according to modified Neer X-ray criteria.Resuits The average hospitalization was 2.3 days (range.1-3 days).X-ray was reviewed every month,additional injection was performed if bone cysts stopped decreasing for 2 consecutive months,iniection 2 times in 6 eases,and 31 cases were injected only once.After 3 months follow.up 37 cases,according to modified Neer X-ray criteria,6 eases regarded as grade Ⅱ,8 as grade Ⅲ,23 as grade Ⅳ;after 6 months,31 patients were followed up,including 2 cases as grade Ⅱ,4 cases as grade Ⅲ,25 as grade Ⅳ;after 24 months of follow-up 26 cases,3 as grade Ⅲ,23 as grade Ⅳ;after 36 months follow-up,19 cases were all grade Ⅳ.Conclusion Imaging-guided percutaneous iniection of methylprednisolone and inieetable calcium sulfate for simple bone cysts has demonstrated,with less trauma,lower complications incidence and quicker recovery.     

基于聚合模糊数的多参数监护仪故障树研究

针对多参数监护仪急救医疗设备故障率高,故障现象与故障原因对应复杂,且设备技术图纸缺乏、维修力量薄弱、厂家或第三方维修成本高等因素导致的维修困境,本文提出了基于聚合模糊数的多参数监护仪故障树故障诊断模型。首先,通过分析多参数监护仪的结构组成,建立故障树模型;其次,针对其故障数据缺乏和专家评价主观性的特点,采用聚合模糊数确定底事件故障率,并进行了底事件关键重要度分析;最后,采用Bland-Altman分析确定了本实验研究结果与验证实验结果一致性达到96.88%,证明了本文方法的有效性。本文的研究方法通过结合专家评价法和聚合模糊数弥补了故障数据缺乏和专家评价主观性的不足,适用于过程诊断中故障确定及事前潜在风险识别,为系统可靠性分析及故障诊断提供了思路。