慢性乙型肝炎患者的HDV感染

作者对69例经病理确诊为慢性乙型肝炎患者,检测了肝内δ抗原(ABC免疫组化法)和血清δ抗体(ELISA法),结果57例肝组织有 7例检出δ抗原,39例血清中 7例检出δ抗体,无 1例 δ抗原和抗体同时阳性。HDV 标志的总检出率为20.3％(14/69)。CPH和CAH之间的HDVM检出率无显著性差异。HDV感染与无HDV感染者之间,HBV复制标志无差异。HDV 感染者蛋白质代谢紊乱程度较重。发现3例肝内δ抗原和血清HB-DNA均为阳性,显示重叠HDV感染,对HBV复制未见明显抑制。     

HMG-CoA还原酶抑制剂对X综合征血管内皮功能的影响

目的 :通过应用HMG -CoA还原酶抑制剂 (普伐他汀 )对x综合浆内征患者的血管内皮功能的影响 ,观察微血管病变引起的心肌缺血的改善作用。方法 :严格筛选 17例临床表现为胸痛并已作冠脉造影正常的患者服用普伐他汀 10mg。每晚睡前服 1次 ,疗程 3个月 ,用药前后进行血浆内皮素 (ET)的检测及活动平板运动试验 ,比较用药前后各项指标的变化情况。结果 :血浆ET水平较治疗前明显降低 (P <0 .0 1) ,运动出现心绞痛ST段改变的时间明显延长 (P <0 .0 5 ) ;ST段恢复时间显著缩短 (P <0 .0 5 )运动后 4分时相各导联运动诱发的ST段缺血型下降之和 (∑ST)明显减少。结论 :HMG -CoA还原酶抑制剂 (普伐他汀 )可显著改善X综合征患者的血管内皮功能异常 ,减轻心肌缺血 ,对X综合征有治疗作用     

乳腺癌围手术期中西医结合临床路径观察

目的：评估乳腺癌围手术期临床路径实施对住院天数、住院费用及医疗品质的影响。方法：制订乳腺癌围手术期中西医结合临床路径表,选择2006年至2009年可手术的乳腺癌病人153例随机分为两组,临床路径组75例按路径表实施诊疗过程,对照组78例按普通诊疗方法治疗,比较两组间的治疗效果。结果：实施临床路径可降低住院日平均费用（P〈0.05）,缩短住院天数（P〈0.01）。结论：乳腺癌临床路径可降低住院费用,缩短住院天数,值得推广应用。     

Decorin inhibits MMP13 gene expression in human chondrocytes: an in vitro study

目的 体外原代细胞培养人正常关节软骨细胞,观察不同浓度的外源性核心蛋白聚糖(decorin,DCN)对软骨细胞基质金属蛋白酶13(matrix metalloproteases 13,MMP13)表达的影响.方法 采用胰蛋白酶和Ⅱ型胶原酶结合消化法分离培养人透明软骨细胞,观察体外培养的软骨细胞形态,阿尔新蓝染色和Ⅱ型胶原免疫组化鉴定透明软骨细胞,从基因水平(实时定量PCR)检测不同浓度的外源性DCN(对照组:0,A组:2.5μg/ml,B组:25 μg/ml,C组:250 μg/ml)作用下透明软骨细胞对MMP13、X型胶原(Collagen X)表达的影响.结果 ①正常透明软骨细胞培养呈多角型,扁平状,换液培养5d时,细胞呈多边形、星形等,排列紧密呈“铺石板”样.②本法分离培养的原代透明软骨细胞的阿尔新蓝染色和Ⅱ型胶原免疫组化均为阳性.③随着外源性DCN浓度(0～250μg/ml)的不断增大,Collagen X的表达明显降低(P＜0.01),且成剂量依赖关系(A:0.78±0.03,B:0.71±0.04,C:0.63±0.01),MMP13的表达则在DCN高浓度组(250 μg/ml)时明显降低(0.85±0.02,P＜0.01).结论 外源性DCN抑制透明软骨细胞的Collagen X的表达且成剂量依赖关系,高浓度(250μg/ml)对MMP13的表达起明显抑制作用.表明外源性DCN可能通过抑制透明软骨细胞肥大化抑制软骨细胞MMP13的表达.     

首发精神障碍家庭照顾者经历的系统评价

目的：系统评价首发精神障碍家庭照顾者的经历,为患者早期康复及照顾者心理健康问题的干预提供循证依据。方法：计算机检索The Cochrane Library、Ovid、PubMed、Embase、Web of Science、CBM、CNKI、VIP和WANFANG DATE数据库,检索时限均从建库至2021年7月31日,使用“JBI循证卫生保健中心质性研究质量评价标准”评价符合纳入标准的文献,并采用汇集性整合法对研究结果进行整合。结果：纳入12篇文献,提炼出60个研究结果,整理成8个类别,得出3个整合结果。分别是多维度的挑战、成长或缺如的角色结局、急需的社会支持。结论：亟需提高全民心理健康素质及去精神障碍疾病污名化,营造患者及家属无障碍化就医环境;关注家庭照顾者早期心理健康的干预,满足其社会支持的需要,提高该类人群应激应对能力,促进照顾者心理康复。     

Study on Toughening and Temperature Sensitivity of Polyurethane Cement (PUC)

Polyurethane cement (PUC) is now commonly used in the reinforcement of old bridges, which exhibit various issues such as poor toughness, temperature-sensitive mechanical properties, and brittle failure. These problems can lead to the failure of the reinforcement effect of the PUC on old bridges in certain operating environments, leading to the collapse of such reinforced bridges. In order to alleviate these shortcomings, in this study, the toughness of PUC is improved by adding polyvinyl alcohol (PVA) fiber, carbon fiber, and steel fiber. In addition, we study the change law of the flexural strength of PUC between −40 °C and +40 °C. The control parameters evaluated are fiber type, fiber volume ratio, and temperature. A series of flexural tests and scanning electron microscope (SEM) test results show that the flexural strength first increases and then decreases with the increase in the volume-doping ratio of the three fibers. The optimum volume-mixing ratios of polyvinyl alcohol (PVA) fiber, carbon fiber, and steel fiber are 0.3%, 0.04% and 1%, respectively. Excessive addition of fiber will affect the operability and will adversely affect the mechanical properties. The flexural strength of both fiber-reinforced and control samples decreases with increasing temperature. Using the flexural test results, a two-factor (fiber content, temperature) BP neural network flexural strength prediction model is established. It is verified that the model is effective and accurate, and the experimental value and the predicted value are in good agreement.     

The frequency of assessment tools in arthroscopic training: a systematic review

BackgroundMultiple assessment tools are used in arthroscopic training and play an important role in feedback. However, it is not fully recognized as to the standard way to apply these tools. Our study aimed to investigate the use of assessment tools in arthroscopic training and determine whether there is an optimal way to apply various assessment tools in arthroscopic training.MethodsA search was performed using PubMed, Embase and Cochrane Library electronic databases for articles published in English from January 2000 to July 2021. Eligible for inclusion were primary research articles related to using assessment tools for the evaluation of arthroscopic skills and training environments. Studies that focussed only on therapeutic cases, did not report outcome measures of technical skills, or did not mention arthroscopic skills training were excluded.ResultsA total of 28 studies were included for review. Multiple assessment tools were used in arthroscopic training. The most common objective metric was completion time, reported in 21 studies. Technical parameters based on simulator or external equipment, such as instrument path length, hand movement, visual parameters and injury, were also widely used. Subjective assessment tools included checklists and global rating scales (GRS). Among these, the most commonly used GRS was the Arthroscopic Surgical Skill Evaluation Tool (ASSET). Most of the studies combined objective metrics and subjective assessment scales in the evaluation of arthroscopic skill trainingConclusionsOverall, both subjective and objective assessment tools can be used as feedback for basic arthroscopic skill training, but there are still differences in the frequency of application in different contexts. Despite this, combined use of subjective and objective assessment tools can be applied to more situations and skills and can be the optimal way for assessment.Level of EvidenceLevel III, systematic review of level I to III studies.

Key messages

• Both subjective and objective assessment tools can be used as feedback for basic arthroscopic skill training.
• Combined use of subjective and objective assessment tools can be applied to more situations and skills and can be the optimal way for assessment.

     

Microstructure and Phase Evolution of Ti-Al-C-Nb Composites Prepared by In Situ Selective Laser Forming

In the present work, a novel Ti-Al-C-Nb composite was prepared using in situ selective laser forming (ISLF). The formation mechanism of the Ti-Al-C-Nb bulks, which were synthesized using elemental titanium, aluminum, and carbon (graphite) powders via ISLF techniques, was investigated. The results showed that the Ti₃Al and TiC phases were the dominant synthesis products during the chemical reactions, and these occurred during the ISLF process. The size of the fine nanoscale crystal TiC grains could reach 157 nm at an energy level of 60 J/mm³. The porous structure of the ISLF specimens was disclosed, and an open porosity of 20–44% was determined via the scanning speed and the laser power. Both the high dynamic viscosity and the reactions of the raw powders led to the generation of a considerable number of pores, whereas the specimen processed using 45 W and 100 mm/s possessed the lowest degree of open porosity.     

First-Principles Study of Silicon–Tin Alloys as a High-Temperature Thermoelectric Material

Silicon–germanium (SiGe) alloys have sparked a great deal of attention due to their exceptional high-temperature thermoelectric properties. Significant effort has been expended in the quest for high-temperature thermoelectric materials. Combining density functional theory and electron–phonon coupling theory, it was discovered that silicon–tin (SiSn) alloys have remarkable high-temperature thermoelectric performance. SiSn alloys have a figure of merit above 2.0 at 800 K, resulting from their high conduction band convergence and low lattice thermal conductivity. Further evaluations reveal that Si_0.75Sn_0.25 is the best choice for developing the optimum ratio as a thermoelectric material. These findings will provide a basis for further studies on SiSn alloys as a potential new class of high-performance thermoelectric materials.     

超声生物显微镜对慢性低眼压诊断和治疗的动态监测

目的:一组以UBM诊断为基础的慢性低眼压患者,经眼压、裂隙灯显微镜、眼底检查、UBM3~6mo的动态监测,了解低眼压的恢复情况,不同治疗方法的效果,说明UBM在低眼压诊断和治疗中的作用。方法:慢性低眼压45眼(眼压≤8mmHg),平均眼压为5.59(2~8)mmHg,病史超过1mo。所有患者均进行常规眼科检查,包括视力、裂隙灯、眼压检查、前房角镜、间接检眼镜、UBM检查,治疗分为药物组和手术组,于治疗后1wk;1,3和6mo进行随访检查。结果:经UBM检查有24眼(53%)为钝伤性低眼压,主要为睫状体脉络膜脱离;16眼(36%)为各种内眼手术后所致的低眼压;1例(0.04%)患者为风湿性心脏病继发双眼葡萄膜炎。基线眼压与治疗后随访眼压比较,均存在显著性差异(P<0.01)。末次眼压和基线眼压之间无相关性,而和病史及发病年龄均呈强的负相关性。42眼(93%)UBM检查有形态学结构改变,睫状体异常占87%。药物组和手术组的基线眼压分别为5.91和4.95mmHg,存在显著性差异(P<0.05),药物组病史明显长于手术组,而手术组发病年龄明显低于药物组,随访的末次眼压分别为10.42和11.25mmHg,无显著性差异。结论:经治疗两组眼压均有显著提高,手术组的患者病情明显重于药物组,治疗前眼压低,发病年龄小,但治疗后眼压效果相似。UBM无论在低眼压的诊断,还是治疗后监测中均有非常重要的作用。