输送链的结构与齿形探讨(三)——修正齿形链传动特性及完善齿形修正设计

本文讨论用“包络一轨迹”法设计的修正齿形链的传动特性,并提出了完善齿形修正设计的方法,基本上实现消除链传动申的“多边形效应”。     

消化道肿瘤免疫相关不良事件的临床分析

目的探讨消化系统恶性肿瘤中免疫检查点抑制剂(immune checkpoint inhibitors, ICIs）导致免疫相关不良事件(immune-related adverse events, irAEs)的特征及危险因素。方法 回顾性分析2019年4月至2021年10月北京大学肿瘤医院诊治的95例接受ICIs治疗的消化系统恶性肿瘤患者的临床资料和irAEs发生情况。irAEs、内分泌irAEs危险因素分析采用二元Logistic回归分析。结果 95例患者共应用ICIs治疗458例次,中位应用3例次(范围：1~33例次）。irAEs的发生率为55.8%,3~4级irAEs发生率为9.5%。最常见的irAEs为皮肤irAEs(27.4%）和内分泌irAEs(22.1%）。内分泌irAEs中甲状腺功能减退最常见(16.8%）,肾上腺皮质功能减退(2.1%）和垂体炎(1.1%）少见。多数irAEs发生于免疫治疗初期,78.2%发生于12周内。过敏反应、皮肤irAEs最早发生,中位发生时间分别为2周(范围：0.9～3.1周）和3.8周(范围：0.9～17.9周）,内分泌irAEs中位发生时间为6.9周(范围：3.0～52.1周）。多因素分析显示,女性(OR=5.197, 95%CI：1.166～23.154, P=0.031)和微卫星高度不稳定(microsatellite instability-high,MSI-H） (OR=35.048, 95%CI：2.756～445.787, P=0.006)是内分泌irAEs发生风险增加的独立危险因素,免疫治疗联合化学药物治疗(OR=0.107, 95%CI：0.021～0.412, P=0.001）是内分泌irAEs的独立保护性因素。结论在消化系统恶性肿瘤中应用ICIs具有较好的安全性。女性和MSI-H患者出现内分泌irAEs风险增加,联合化学药物治疗可能降低内分泌irAEs发生风险。     

妊娠糖尿病患者孕晚期血清LRG1、CCL2水平与产后血糖转归的相关性分析

目的 探究妊娠糖尿病（GDM）患者孕晚期血清富亮氨酸α2-糖蛋白1(LRG1）、趋化因子配体2(CCL2）水平与产后血糖转归的相关性。方法 选取2019年6月—2021年6月衡水市人民医院收治的98例GDM孕晚期患者为研究对象,根据患者产后6周的口服葡萄糖耐量试验（OGTT）结果分为异常组42例和恢复组56例。收集两组患者的基线资料,采用酶联免疫吸附试验（ELISA）检测血清LRG1、CCL2水平;采用Pearson法分析血清LRG1、CCL2水平与产后血糖及胰岛素指标的相关性;采用多因素一般Logistic回归分析影响产后血糖异常的因素。结果 异常组患者孕前体质量指数（BMI）高于恢复组（P<0.05）;异常组患者孕晚期及产后血清LRG1、CCL2水平均高于恢复组,且恢复组产后血清LRG1、CCL2水平低于孕晚期（P<0.05）;异常组患者孕晚期及产后甘油三酯（TG）、空腹血糖（FPG）、餐后1 h血糖（1 hPG）、餐后2 h血糖（2 hPG）、空腹胰岛素（FINS）及胰岛素抵抗指数（HOMA-IR）均高于恢复组（P<0.05）,异常组患者产后FPG、FINS、H...     

轮匝肌切除术联合睫毛外翻褥式缝合对先天性下睑内翻的矫治效果

目的 探究轮匝肌切除术联合睫毛外翻褥式缝合对先天性下睑内翻的矫治效果。方法 选取2019年1月—2022年1月南通大学附属医院眼科收治的82例先天性下睑内翻患儿,采用随机数字表法分为切除术组和缝线组,每组41例,切除术组采用轮匝肌切除术联合睫毛外翻褥式缝合治疗,缝线组采用传统缝线法治疗。术后2个月,比较两组的临床疗效、角膜散光值、最佳矫正视力及泪膜破裂时间。结果 切除术组治疗有效率为98.75%,高于缝线组90.00%(P <0.05)。切除术组治疗前后柱镜度数、泪膜破裂时间的差值均高于缝线组（P <0.05）;两组治疗前后轴位、最佳矫正视力的差值比较,差异无统计学意义（P>0.05）。结论 轮匝肌切除术联合睫毛外翻褥式缝合应用于先天性下睑内翻患儿的治疗中,更有助于提升临床疗效,保护视力且安全性良好。     

分析膝关节镜引导微创复位内固定术对胫骨平台骨折(FTP)患者术后骨折愈合时间及关节功能恢复的影响

目的：分析胫骨平台骨折患者应用膝关节镜引导微创复位内固定术的有效性,以及对术后骨折愈合时间及关节功能恢复的影响。方法：选入我院于2016年1月到2021年12月期间收治的胫骨平台骨折患者120例,以抽签法的形式将其分：60例切开组,60例关节镜组。切开组行常规切开复位固定手术治疗,关节镜组行膝关节镜引导微创复位内固定术治疗,对比两组患者膝关节功能恢复效果、不同时间段两组疼痛评分、两组骨折愈合时间,术后下床活动时间,手术中出血量,切口长度,两组患者治疗效果、不良反应。结果：①关节镜组膝关节恢复总优良率91.67%高于切开组66.67%,具有统计学意义（X2=11.3684,P<0.001）。②手术结束当天,关节镜组疼痛评分为：（8.95±0.76）,切开组（8.86±0.68）,经过对比组间无差异（T=0.6835,P=0.4956）;两组疼痛程度评分无差异（P>0.05）;手术后第四周、十二周的关节镜组疼痛评分分别为（4.42±0.55）、（1.09±0.27）,低于切开组的（6.03±0.58）、（2.40±0.55）,组间存有差异（X2=15.0621,P<0.001;X2=16.5615,P<0.001）。③ 关节镜组骨折愈合时间（3.20±0.30）月,术后下床活动时间（3.65±1.47）d,手术中出血量（79.06±6.65）ml,切口长度(7.20±2.98)cm均优于切开组（5.60±0.77）月,（7.20±2.29）d、（99.67±7.42）ml、(15.44±4.71）cm,组间具有差异（T=22.4961;P<0.001;T=10.1051;P<0.001;T=16.0223;P<0.001;T=11.4517;P<0.001）。④ 关节镜组出现的不良反应3.33%低于切开组25.00%,组间具有差异（X2=11.5820,P<0.001）。结论：治疗胫骨平台骨折采用膝关节镜引导微创复位内固定术,可以提高整体治疗效果,缩短骨折愈合时间,有助于关节功能恢复,值得在临床上推广和应用。     

婚姻质量与人格特质的相关分析

目的　探究夫妻人格特质与婚姻质量的相关以及夫妻间人格特质的相关性 ,为婚姻咨询提供帮助。方法　用 OL-SON婚姻质量问卷 ( ENRICH)和艾森克人格问卷 ( EPQ) ,对 1 0 0对夫妻进行测试和调查。结果　精神质特质、神经质特质与婚姻质量总分存在极显著负相关 ( P<0 .0 0 1 ) ,掩饰维度与婚姻质量总分存在极显著正相关 ( P<0 .0 0 1 ) ,精神质和神经质均与婚姻质量的 8个因子存在极显著负相关 ( P<0 .0 0 1 ) ,丈夫的神经质与妻子精神质特质间存在显著性正相关 ( P<0 .0 1 ) ,与妻子的掩饰维度存在显著性负相关 ( P<0 .0 5 )。结论　婚姻质量与人格关系极为密切。     

Preparation and characterization of porous beta-tricalcium phosphate/collagen composites with an integrated structure

Porous beta-tricalcium phosphate (TCP)/collagen composites with different beta-TCP/collagen weight ratio were prepared. The influences of the preparation conditions on the microstructure of porous composite and the joint status of beta-TCP particles with collagen fibrils were characterized by X-ray diffractometer, scanning electron microscopy and transmission electron microscopy. The results showed: (1) an acid treatment could effectively disassemble collagen fibrils; (2) in the resulting porous composites, beta-TCP particles homogenously existed on the skeleton of the collagen fibril network and bonded tightly to both the fibrils and themselves. The tight bonding formation could be due to the reaction between Ca ions in the particles and carboxyl groups in collagen polypeptide chains and due to the reprecipitation of partially dissolved beta-TCP during synthesis. The tight bonding between beta-TCP particles and collagen fibrils in the composites demonstrated an integrated structure, which was reproducible when beta-TCP/collagen ratio ranged from 2 to 4. Such integrated structure would make significant contributions in reliably tailoring properties of the porous composites by varying beta-TCP content. In addition, the porous composites had large porosity (approximately 95%) and appropriate pore size (approximately 100 microm), showed no negative impact in cytotoxicity assay and complete bone tissue regeneration after 12 weeks in animal test.     

Survey of the Distribution of a Newly Characterized Receptor for Advanced Glycation End Products in Tissues

Advanced glycation end products (AGEs), the final products of nonenzymatic glycation and oxidation of proteins, are found in the plasma and accumulate in the tissues during aging and at an accelerated rate in diabetes. A novel integral membrane protein, termed receptor for AGE (RAGE), forms a central part of the cell surface binding site for AGEs. Using monospecific, polyclonal antibody raised to human recombinant and bovine RAGE, immunostaining of bovine tissues showed RAGE in the vasculature, endothelium, and smooth muscle cells and in mononuclear cells in the tissues. Consistent with these data, RAGE antigen and mRNA were identified in cultured bovine endothelium, vascular smooth muscle, and monocyte-derived macrophages. RAGE antigen was also visualized in bovine cardiac myocytes as well as in cultures of neonatal rat cardiac myocytes and in neural tissue where motor neurons, peripheral nerves, and a population of cortical neurons were positive. In situ hybridization confirmed the presence of RAGE mRNA in the tissues, and studies with rat PC12 pheochromocytes indicated that they provide a neuronal-related cell culture model for examining RAGE expression. Pathological studies of human atherosclerotic plaques showed infiltration of RAGE-expressing cells in the expanded intima. These results indicate that RAGE is present in multiple tissues and suggest the potential relevance of AGE-RAGE interactions for modulating properties of the vasculature as well as neural and cardiac function, prominent areas of involvement in diabetes and in the normal aging process.     

Early embryonic expression patterns of the mouse Flamingo and Prickle orthologues.

The Drosophila melanogaster proteins Flamingo and Prickle act in the planar cell polarity (PCP) pathway, which is required for acquisition of epithelial polarity in the wing, eye, and epidermis. In mammals, PCP signaling has been shown to regulate cell movements and polarity in a variety of tissues. Here, we show that the murine Flamingo orthologues Celsr1-3 and the Prickle orthologues Prickle1, Prickle2, and Testin have dynamic patterns of expression during pregastrulation and gastrulation stages. Celsr1 is expressed in the anterior visceral endoderm and nascent mesoderm, Celsr2 and Celsr3 mark the prospective neuroectoderm, Prickle1 is expressed in the primitive streak and mesoderm, Prickle2 in the node, and Testin in the anterior visceral endoderm, the extraembryonic ectoderm, primitive streak, and mesoderm. Analysis of a gene-trap mutation in Testin indicates that this gene is not required for embryogenesis; therefore, other Prickle homologues may compensate for its function during development.