凝血酶原时间与肝促凝血活酶试验在慢性乙型病毒性肝炎纤维化分期的诊断价值

判断凝血酶原时间（PT）与肝促凝血活酶试验（HPT）诊断慢性乙型病毒性肝炎患者肝纤维化分期的作用.选取72名经肝活检病理证实的慢性乙型病毒性肝炎患者,检测不同肝纤维化分期血浆PT及HPT（分别以秒、活动度、率及国际标准化比率计）,并通过ROC曲线分析两者诊断肝纤维化、早期肝硬化的价值.慢性乙型病毒性肝炎患者S0-S3期PT组间无差异,只有S4期明显升高或降低,且与S0、S1、S2、S3期比较有显著性差异（P＜0.01）.而HPTS0-S2组间无显著性差异外,其它两两比较均有显著性差异（P＜0.01）.通过ROC曲线分析,PTs及HPTs诊断S4的阈值为14.05秒、19.75秒时,敏感度及特异度分别为0.889、0.814;0.889、0.907.PTA及HPTA的诊断阈值为85.5%、70.5%时,诊断S4期的敏感度及特异度分别为0.889、0.814;0.889、0.907.因此,HPT、PT在肝纤维化分期的诊断中有一定的作用,且前者优于后者.     

Changes in Alcohol Consumption,Eating Behaviors,and Body Weight during Quarantine Measures: Analysis of the CoCo-Fakt Study

IntroductionPublic health measures enacted to reduce COVID-19 transmission have affected individuals'' lifestyles, mental health, and psychological well-being. To date, little is known how stay-at-home orders have influenced the eating behaviors, weight development, and alcohol consumption of quarantined persons. The CoCo-Fakt cohort study analyzed these parameters and their association with psychological distress and coping strategies.MethodsAn online survey was conducted of all persons who tested positive for SARS-CoV-2 (infected persons [IP]) between December 12, 2020, and January 6, 2021, as well as their close contacts (contact persons [CP]) registered by the public health department of Cologne. 8,075 of 33,699 individuals were included in the analysis. In addition to demographic data, psychological distress, and coping strategies, information on changes in body weight, eating, and drinking behaviors was collected.ResultsIP lost 1.2 ± 4.4 kg during the quarantine period, and CP gained 1.6 ± 4.1 kg. The reasons given by IP for weight change were mainly loss of taste and feeling sick, whereas CP were more likely than IP to eat out of boredom. Higher psychological burden and lower coping strategies were associated with both weight gain and loss. Of the 30.8% of participants who changed their alcohol consumption during the quarantine period, CP in particular drank more alcohol (IP 15.2%; CP 47.7%). Significantly less alcohol was consumed by individuals with higher coping scores.ConclusionIn this short but psychologically stressful period of stay-at-home orders, changes in eating and drinking behavior as well as weight development are evident, mainly in high-risk contacts. To avoid possible long-term sequelae, health authorities should take these findings into account during the quarantine period; in particular, general practitioners should consider these findings during follow-up.     

Additive effect of latanoprost and dorzolamide in patients with elevated intraocular pressure

Purpose : To evaluate the additive ocular hypotensive effect of latanoprost and dorzolamide in combination, on intraocular pressure reduction in patients with elevated intraocular pressure (IOP). Methods : Thirty patients with ocular hypertension or early capsular or primary open-angle glaucoma and elevated IOP were randomly assigned to two parallel treatment groups. The treatment period was twenty days. Fifteen patients (Group 1) received latanoprost once daily during the first ten days and, in addition, dorzolamide three times daily during the second ten days. Fifteen patients (Group 2) received dorzolamide three times daily during the first ten days and, in addition latanoprost, once daily during the second ten days. IOP was measured and conjunctival hyperemia was evaluated. Results : In Group 1, the mean IOP on day 0 was 26.8 mmHg; on day 10, 18.7 mmHg; and on day 20, 15.9 mmHg. In Group 2, the mean IOP on day 0 was 26.3 mmHg; on day 10, 21.2 mmHg; and on day 20, 16.1 mmHg. Both groups had clinically significant IOP- lowering effect on day 10 as compared with baseline day (30.2% and 19.4% respectively) (p < 0.01). When dorzolamide was added to latanoprost, the additional IOP reduction was 2.8 mmHg (15%) (p<0.01) compared with 5.1 mmHg (24.1%) (p<0.01when latanoprost was added to dorzolamide. No local serious adverse reactions were observed. A mild but statistically significant increase in conjunctival hyperemia was seen in latanoprost applied patients. Conclusions : The results showed that latanoprost and dorzolamide can be combined successfully to reduce IOP with their additive effects.     

Small incision extracapsular cataract surgery with manual phacotrisection

PURPOSE: To evaluate the safety and efficacy of small incision extracapsular cataract extraction (ECCE) using the manual phacotrisection technique. SETTING: Department of Ophthalmology, Turgut Ozal Medical Center, In?nüUniversity, Malatya, Turkey. METHODS: Fifty-nine eyes of 54 patients had small incision ECCE by the manual phacotrisection technique. Mean follow-up was 10 months. After capsulorhexis and hydrodissection were performed, the endonucleus was prolapsed into the anterior chamber and trisected using an anteriorly positioned triangular trisector and posteriorly placed solid vectis. Pieces were extracted with a forceps through a small incision. RESULTS: Postoperatively, best spectacle-corrected visual acuity of 20/40 or better was achieved in 48 eyes (83%) and of 20/25 or better in 28 eyes (47%). The most frequent intraoperative complication was posterior capsule rupture (n = 5). Of eyes that developed posterior capsule rupture, 3 had vitreous loss and 2 had implantation of an anterior chamber intraocular lens (IOL). In 44 eyes, the IOL was implanted in the bag and in 12 eyes, in the ciliary sulcus. The most significant postoperative complication was transient corneal edema, which developed in 32 eyes (54%). No permanent complications (e.g., corneal endothelial decompensation) occurred in any case. CONCLUSIONS: Manual phacotrisection has several advantages such as nucleus safety, less dependence on assistant personnel, the elimination of the phaco machine, and cost effectiveness.     

人工智能技术在辅助耳鼻咽喉科医师了解过敏性鼻炎患者需求中的应用

利用人工智能技术分析近年中国互联网用户对于过敏性鼻炎（allergic rhinitis,AR）的网上检索信息,以帮助耳鼻咽喉科医师更好地了解AR患者的实际需求,从而在临床实践中更加合理地对患者进行管理。     

人心肌肌钙蛋白IcDNA的克隆及分泌表达

克隆人心肌肌钙蛋白I(cTnI)基因全序列，并进行分泌表达。从人心肌组织提取总RNA，经逆转录得到cDNA第一链，以此为模板，PCR扩增目的条带，重新设计上游引物，用相同PCR程序完成点突变；突变后PCR产物克隆入Pfd5载体，并用PCR、SpeI XhoI双酶切、载体测序等方法鉴定；用ITPG诱导cTnI的表达。PCR扩增出630bp左右条带，Pfd5—cTnI融合表达载体用PCR、SpeI Xho1双酶切均可见630bp左右条带，测序结果与预期序列一致；诱导后培养基及细胞周质均检测到cTnI蛋白免疫原活性。人心肌肌钙蛋白I得到成功表达。     

Über den Einfluß von Extrakten aus dem endokrinen Drüsensystem auf die Entwicklung des Mäusecarcinoms

Zusammenfassung Die Untersuchungen am transplantablen Mäusekrebs ergaben, daß die Extrakte der Leber, der Milz, des Pankreas, des zentralen Nervensystems und das Insulin in systematischen Gaben das Angehen des Krebses, das Tempo seines Wachstums und schließlich die Bildung von Metastasen hemmend zu beeinflussen vermochten.In einem geringerem Maße wird das Carcinomwachstum auch durch die Extrakte des Knochenmarkes, der Nebenschilddrüse, des Eierstockes und des Corpus luteum gehemmt.Nebenniere, Hypophysenhinterlappen, Glandula pinealis und Thymus vermögen das Carcinomwachstum nicht zu beeinflussen, hingengen üben die Extrakte der Nebennierenrinde, der Schilddrüse und des Hypophysenvorderlappens eine fördernde Wirkung aus.Die verschiedene Kombination der hemmenden Substanzen ergab, daß die Hemmung dann am allerstärksten war, wenn die Extrakte des Knochenmarkes, der Milz, der Leber, des Pankreas und der Parathyreoidea gleichzeitig gegeben wurden.Jene Organe, deren Extrakte auf Grund unserer Untersuchungen das Carcinomwachstum hemmend beeinflussen, vermögen gleichzeitig die Zuckerassimilationsfähigkeit des Organismus zu erhöhen, die glykolysierende Tätigkeit der Zellen zu dämpfen und den Cholesteringehalt des Blutserums zu senken. Hingegen erhöhen sie den Lipoidgehalt des Blutes, sie arbeiten der Senkung, der Oberflächenspannung entgegen, sie erleichtern die Sauerstoffversorgung der Zellen, der Wassergehalt der Zellen wird durch sie beeinflußt, sie verschieben das Säurebasengleichgewicht in die Säurerichtung, der Kaliumgehalt des Blutes wird durch sie herabgesetzt, sie erhöhen den Calciumgehalt im Blute, der Schwefelhaushalt wird durch sie beeinflußt, und schließlich bedingen sie eine vagotonische Einstellung des vegetativen Nervensystems. Mit einem Worte vermögen sie die Vorbedingungen des Krebses, alle Faktoren des carcinomatösen Milieus in einer ungünstigen Richtung zu beeinflussen.Die Wirkungen der fördernden endokrinen Organe sind den erwähnten gerade entgegengesetzt, also sie wirken auf jene Eigenschaften des Organismus, die in ihrer Gemeinschaft das carcinomatöse Milieu bilden, fördernd ein.Eine derartige experimentelle Beeinflussung des Organismus durch das endokrine System und die Wirkung desselben auf die Entwicklung des carcinomatösen Gewebes macht es wahrscheinlich, daß unter den ätiologischen Faktoren der Krebsbildung die Zustandsänderung dieses Systems eine wichtige Rolle spielt.     

Einzelreferate und Buchbesprechungen

Ohne Zusammenfassung     

人工心瓣材料和不同浓度细菌与皮下软组织感染的关系

目的 通过动物实验，评价人工心瓣材料和不同浓度细菌与皮下软组织感染的关系。方法 将4种浓度分别为10^4CFU/ml、10^6CFU／ml、10^8CFU／ml、10^10CFU／ml的表皮葡萄球菌等量注入日本长耳白兔单侧皮下软组织切口，以对侧无菌切口为对照，或同时在皮下软组织放入不同人工心瓣材料涤纶、热解碳、聚四乙烯，观察皮下软组织切口感染与植入不同人工心瓣材料和污染细菌浓度的关系。结果 表皮葡萄球菌引起兔皮下软组织感染最少需要10^8CFU细菌，当涤纶、热解碳、聚四乙烯存在时，分别只需要10^4CFU、10^6CFU、10^CFU细菌，差异有显著性（P＜0．05）。结论 在皮下软组织在人工心瓣材料时，较少的污染细菌可导致感染，材料不同，引起感染所需的细菌量不同。     

Response of the xenograft endothelium in the concordant xenotransplantation

Objective: To investigate the response of the xenograft endothelium in the concordant hamster to rat cardiac xenotransplantation and the mechanism of acute vascular rejection. Methods: The animals were divided into 5 groups randomly: control group,CsA group, splenectomy group, D0 splenectomy+CsA group and D3 splenectomy+CsA group. Hamster heart was heterotopicaly transplanted to rat abdominal cavity. The graft survival was monitored by palpation of the rat abdominal wall. The histological and ultrastructural changes of the xenogafts were investigated. NF-κB and P-selectin expression in the xenograft were detected. Hene Oxigenase-1 and Bcl-2 expression were also detected in the xenografts of different groups. Results: The mean survival time of the xenografts in control group, CsA group, splenectomy group, D0 splenectomy+CsA group and D3 splenectomy+CsA group was 3.4±0.55, 3.8±0.45, 6.4±1.52, 30 and 7.4±1.14 days. The rejected graft showed typical acute vascular rejection in control group, CsA group,splenectomy group and D3 splenectomy+CsA group. Endothelial cells of the rejected xenograft showed dramatic assembly of ribosomes and expansion of the rough endoplasmic reticulum. However, the endothelium of the long-term survived grafts in D0 splenectomy+CsA group showed normal architecture. NF-κB and P-selectin expression were detected in the rejected xenografts. HO-1 expression was observed in the long-term survived xenografts in D0 splenectomy+CsA group. Conclusion: The endothelial cells of the xenograft might be activated during the acute vascular rejection. Expression of HO-1 might inhibit the upregulation of NF-κB and adhesion molecular which decreases the activation of the endothelium of the graft.