用电子自旋共振成像观测氮氧自由基的透皮特性

在自行研制的电子自旋共振成像(Electron spin resonance imaging, ESRI)系统上建立了活体皮肤电子自旋共振成像的实验模型.观测了氮氧自由基化合物2,2,6,6-四甲基哌啶-1-氧(2,2,6,6-tetramethyl-1-piperidinyloxy,TEMPO)穿透小鼠皮肤组织的动态过程和浓度分布情况.成像结果显示TEMPO化合物对不同方法处理后的皮肤组织的透皮特性有明显差别.TEMPO水溶液难以穿透皮肤,而溶解在二甲基亚枫(Dimethyl sulfoxide,DMSO)中的脂溶性TEMPO溶液可以渗入并穿透皮肤.皮肤表层的角质蛋白对TEMPO有明显的阻隔性, 而且化合物渗入或透过皮肤组织的量具有较强的时间依赖性.本研究结果提示ESRI技术为动态研究某些特殊结构化合物的透皮特性提供了科学有效的分析手段.     

前路椎体次全切在治疗颈椎后纵韧带骨化中的应用

目的：探讨颈前路椎体次全切治疗颈椎后纵韧带骨化的手术减压范围。方法：采用前路椎体次全切植骨融合术治疗颈椎后纵韧带骨化56例，其中完全切除骨化者47例，用“漂浮法”处理者9例，并针对不同个体及病变特点采用不同的减压范围。结果：54例获得3个月-6a随访，平均28个月。植骨均于术后3-5个月内获得骨性融合。JOA评分由术前8．5分提高到术后14．1，平均改善率74％，优良率80．2％。结论：行椎体次全切术治疗颈椎后纵韧带骨化时应针对不同个体及病变特点采用不同的足够的减压范围，可以减少并发症，并获得较佳的疗效。     

Die Wertigkeit der Adenosintriphosphatase Reaktion zur Diagnostik von essentiellen Paraproteinämien

Zusammenfassung Bei 26 Fällen mit essentieller Paraproteinämie wurde die cytochemische Aktivität der Adenosintriphosphatase (ATPase) in den Plasmazellen des Knochenmarks untersucht. 15 Fälle zeigten eine erniedrigte und 11 Patienten eine normale ATPase-Aktivität. Die Untersuchungen zeigen, daß die Erniedrigung der ATPase für die Diagnostik des Plasmocytoms nicht spezifisch ist.Herrn Prof. Dr. W. Hoffmeister, Mannheim, zum 65. Geburtstag.     

大鼠蓝斑内P物质、神经降压肽和生长抑素样神经元的上行投射

本实验采用HRP逆行追踪与免疫细胞化学相结合的方法,对大鼠蓝斑内P物质(SP)、神经降压肽(NT)、生长抑素(SOM)三种肽能投射神经元的纤维联系及其局部关系进行了探讨。结果证实:1.HRP注射至丘脑或尾壳核后,大鼠蓝斑内均可见到双标记神经元。2.存在SP样和NT样蓝斑—丘脑纤维,前者终止于丘脑腹后核和板内核,后者终止于丘脑板内核。3.蓝斑至尾壳核的投射呈SOM样免疫反应。4.蓝斑内三种肽能投射的起始和终止部位有所不同,其中SP样和NT样神经元主要位于蓝斑后部背侧区,其纤维终于丘脑;而SOM样投射神经元则见于蓝斑前部背侧区,纤维终止于尾壳核。上述肽能通路均为双侧性,而以同侧占优势。5.蓝斑内三种肽能单标记神经元中以NT样免疫反应阳性胞体最为丰富。以上结果表明;蓝斑上行性投射中除含去甲肾上腺素纤维外,还含有SP样、NT样和SOM样纤维,并存在一定的局部定位投射关系。     

Obliterative muscularization of the small bowel submucosa in Crohn disease: a possible mechanism of small bowel obstruction

CONTEXT: The pathology of small bowel obstruction in Crohn disease has not been studied extensively. Stricture formation has been attributed mainly to fibrosis, although muscularization of the submucosa has been discussed previously. OBJECTIVE: To identify additional pathologic changes in Crohn disease that could be involved in the formation of strictures. DESIGN: We reviewed 50 ileal resections from patients with Crohn disease. The histopathologic slides were reviewed initially without knowledge of the macroscopic or clinical findings. We identified an unusual muscular proliferation that we refer to as obliterative muscularization of the submucosa, defined as a thick and continuous muscle layer from the mucosal base to the muscularis propria that is at least 1 cm in length. Subsequently, histopathologic findings were correlated with macroscopic and clinical findings. RESULTS: Obliterative muscularization of the submucosa was present in 14 specimens, and in 11 of these 14 it was topographically restricted to strictures. Submucosal fibrosis was observed in sections from adjacent regions. Obliterative muscularization of the submucosa, including thick-walled vessels and hyperplastic nerves but not prominent scarring, was more common in specimens with strictures; the difference was statistically significant (P <.001). CONCLUSIONS: Obliterative muscularization of the submucosa may be pathogenetically involved in the formation of strictures either directly by causing a sustained spasm, or indirectly by minimizing the vasoprotective role of the submucosa, impairing repair and enhancing scarring.     

Genetic basis for individual variations in pain perception and the development of a chronic pain condition

Pain sensitivity varies substantially among humans. A significantpart of the human population develops chronic pain conditionsthat are characterized by heightened pain sensitivity. We identifiedthree genetic variants (haplotypes) of the gene encoding catecholamine-O-methyltransferase(COMT) that we designated as low pain sensitivity (LPS), averagepain sensitivity (APS) and high pain sensitivity (HPS). We showthat these haplotypes encompass 96% of the human population,and five combinations of these haplotypes are strongly associated(P=0.0004) with variation in the sensitivity to experimentalpain. The presence of even a single LPS haplotype diminishes,by as much as 2.3 times, the risk of developing myogenous temporomandibularjoint disorder (TMD), a common musculoskeletal pain condition.The LPS haplotype produces much higher levels of COMT enzymaticactivity when compared with the APS or HPS haplotypes. Inhibitionof COMT in the rat results in a profound increase in pain sensitivity.Thus, COMT activity substantially influences pain sensitivity,and the three major haplotypes determine COMT activity in humansthat inversely correlates with pain sensitivity and the riskof developing TMD.     

Adaptation of cancellous bone to aging and immobilization in growing rats.

Two-and-half-month-old female rats were subjected to right hindlimb immobilization or served as controls for 0, 1, 2, 8, 14, and 20 weeks. The right hindlimb was immobilized by bandaging it against the abdomen, thus unloading it. Cancellous bone histomorphometry was performed on microradiographs and double-fluorescent labeled 20 microns sections of the distal femoral metaphyses. Primary spongiosa bone loss occurred rapidly by 2 weeks, and secondary spongiosa bone loss occurred rapidly by 8 weeks of immobilization, and then equilibrated at 60% less bone mass than age-related controls. The negative bone balance induced by immobilization was caused by transient increase in bone resorption, decrease in bone formation, and longitudinal bone growth. The dynamic data of secondary spongiosa cancellous bone showed that percent eroded perimeter was transiently elevated by 55 to 82% between 1 and 8 weeks, percent labeled perimeter was transiently depressed by 32% to 50% between 1 and 14 weeks, mineral apposition rate was depressed by 23% and 19% at 1 and 2 weeks, and bone formation rate-bone area referent was transiently depressed by 35% and 59% at 1 and 2 weeks. All the above parameters were at age-related control levels by 20 weeks of immobilization. However, bone formation rate-tissue area referent was depressed (-65%) throughout the study. Immobilization depressed completely longitudinal bone growth by 2 weeks and remained so. Only 0.65 mm of new metaphysis was generated in the immobilized versus 2.1 mm in controls during the study period. The immobilization induced an early cancellous bone loss which equilibrated at a new steady state with less bone and a normal (age-related control) bone turnover rate. When these findings were compared to an earlier study of 9-month-old virgin females subjected to right hindlimb immobilization up to 26 weeks, we found the adaptive responses of the cancellous bone were identical except that they occurred earlier and equilibrated sooner in younger rats.     

遗尿儿童和青少年情绪和行为问题及相关因素研究

目的 调查河南省儿童青少年遗尿症的情绪和行为问题的现况及其影响因素。 方法 从2019年10月—2020年3月,采用分层随机整群抽样方法抽取河南某县5所中小学校,采用一般资料调查表、长处和困难问卷及儿童睡眠调查表进行调查,对影响遗尿患儿情绪和行为的因素进行单因素、多因素分析。 结果 实际发放问卷4 500份,回收4 120份,有效问卷3 912份,有效回收率为94.95%。调查结果显示有7.82%儿童患有遗尿症。遗尿组的情绪症状、多动和困难总分得分明显高于正常组(P＜0.001),两组品行问题、同伴交往和社会行为得分的比较差异无统计学意义(P＞0.05)。Pearson相关分析结果显示,遗尿儿童和青少年的困难总分与打鼾、夜间呼吸问题、嗜睡、注意力缺陷、睡眠总分均存在正相关关系(P＜0.05)。多元线性回归结果显示睡眠呼吸紊乱、照顾者文化程度低、便秘、学习成绩较差是遗尿患儿情绪和行为问题的影响因素。 结论 遗尿患儿情绪和行为问题的检出率高,影响因素是睡眠呼吸紊乱、照顾者文化程度低、孩子学习成绩差、便秘,应引起关注。     

新型冠状病毒肺炎患者焦虑和抑郁状况研究

目的 了解新型冠状病毒肺炎患者焦虑、抑郁现况,探索新型冠状病毒肺炎患者的护理干预模式。方法 选取解放军总医院第五医学中心2020年1月23日—2月10日收治的新型冠状病毒肺炎患者为研究对象。运用焦虑自评量表（SAS）和抑郁自评量表（SDS）统计患者焦虑和抑郁得分情况。制定相应护理干预措施并评估疗效。结果 共收治40例新冠肺炎患者。10例（25.00%）患者出现焦虑,SAS平均得分（42.94±8.33）分。14例（35.00%）患者出现抑郁,SDS平均得分（46.41±13.37）分。患者焦虑与抑郁得分均高于常模,差异有统计学意义（P<0.05）。女性患者焦虑得分高于男性,差异有统计学意义（P=0.02）。不同年龄、文化程度组患者焦虑和抑郁得分比较,差异均无统计学意义（均P>0.05）。护理干预后,SAS量表平均得分（37.94±5.67）分,SDS量表平均得分（39.93±8.55）分,均较干预前降低,差异有统计学意义（均P<0.05）。结论 新型冠状病毒肺炎患者焦虑和抑郁高于普通人群,通过有效的护理干预可降低患者的焦虑和抑郁,长期的护理干预需要持续进行。     

婴儿饮食行为量表的编制与评价

目的 旨在编制一套具有高信效度的本土化婴儿饮食行为量表,以早期识别、预防婴儿饮食行为的发生。方法 对281名6~11月龄婴儿进行初始问卷调查。运用因子分析、区分度分析、Cronbach's α系数及Spearman相关分析筛选条目,形成试用问卷。对935名6~11月龄婴儿行试用问卷调查,筛选条目并形成正式量表。运用折半信度、重测信度、探索性因子分析和验证性因子分析等方法评价量表的信效度。结果 1)形成包含6个维度、33个条目的婴儿饮食行为量表,Cronbach's α系数为0.910,折半信度为0.927,重测信度为0.693,与各维度的相关系数为0.266~0.752。验证性因子分析示χ²/df=3.180,GFI=0.831,CFI=0.842,RFI=0.766,RMSEA=0.068。2)婴儿体格生长与出生体重、食物种类与进食能力、喂养人行为和食物响应相关(P<0.05)。父母文化水平和家庭收入对婴儿饮食行为影响显著(P<0.05)。结论 婴儿饮食行为量表具有良好的信效度,可客观反映6~11月龄婴儿的饮食行为问题,是我国本土化婴儿饮食行为评估的科学可信工具。