国际脊髓损伤脊柱损伤基础数据集

收集脊柱损伤的信息对于脊髓损伤患者的诊断和治疗非常重要,设立脊髓损伤患者脊柱损伤基础数据集是为了规范脊柱损伤相关信息的收集方式和报告内容,学习并使用国际脊髓损伤脊柱损伤基础数据集,有助于规范和统一我国脊髓损伤患者脊柱损伤信息的收集,为相关治疗提供依据。本文将介绍国际脊髓损伤脊柱损伤基础数据集的研发过程,数据元素的内容以及数据编码的应用实例。     

机械力学对体外骨髓间充质干细胞的影响

目的:分析力学刺激体外骨髓间充质干细胞所产生增殖分化等生物学效应的影响及其力化学信号转导途径。资料来源:因特网上检索PubMed数据库中2000-01/2006-06期间有关力学刺激对骨髓干细胞作用效应进展的英文文章,检索词“stem cel1,marrow mesenchymal stem cells,mechanical stimulation,stress”,同时检索CNKI中国知网医学文献数据库2000-01/2006-06期间的相关文章,检索词为“干细胞、骨髓间充质干细胞、机械刺激、应力”。资料选择:对资料进行筛选,选取相关文章查找全文。纳入标准:①骨髓间充质干细胞相关生物学特性。②体外细胞加载的应力分类及相应力学装置的特点。③应力对细胞影响的研究。④能获取文章的全文。排除标准:①较陈旧的文献。②重复研究。资料提炼:共收集关于86篇体外骨髓干细胞及力学干预的相关文献。其中30篇符合纳入标准。资料综合:①骨髓干细胞具有高度增殖及多向分化能力,可通过体外培养、干预作为细胞组织工程的理想种子细胞。②力学刺激是体外调节细胞生物学效应的重要途径,其中力学分类有:流体切应力、静止压应力、张应力、离心力以及单个细胞的吸吮力等,介绍各种力以及相应的力学装置的特点。③骨髓干细胞加载各种应力干预后产生的生物学效应,以及细胞应力学刺激的机制、信号转导途径。结论:力学刺激可影响骨髓间充质干细胞生物学特性,在适当的力学刺激条件下,促进细胞的增殖与分化,为骨组织工程提供新的技术手段,同时也为临床应用牵拉成骨的骨再生过程提供理论依据。     

经皮椎体注入骨水泥治疗老年脊椎骨质疏松压缩性骨折

目的:观察经皮椎体内注入骨水泥(聚甲基丙烯酸甲酯)治疗脊椎骨质疏松压缩性骨折的疗效。方法:自2005-06/2006-06吉林大学中日联谊医院骨科及大庆龙南医院骨科对35例40个椎体的骨质疏松压缩性骨折患者使用经皮椎体内注射骨水泥,行椎体成形术。成形材料:美国KYPHON公司生产的骨水泥,生产准许号:(GB/T19001-2000和YY/T0287-1996)。结果:35例患者均参加随访6个月。术后均未出现骨水泥外漏、脊髓或马尾神经损伤等并发症。35例患者中5例出现穿刺部位局部疼痛,服用镇痛药物后均缓解。疼痛完全消失25例,占71.4%;明显缓解8例,占22.6%;轻度缓解2例,占6.0%;无缓解0例。15例患者在术后72h内均能下床活动。术后未再发生压缩性骨折及疼痛。结论:经皮椎体注入骨水泥可以有效改善椎体骨质疏松压缩性骨折患者疼痛症状,随访6个月未出现充填剂不良性宿主反应,临床疗效较好。     

血管紧张素原基因5’端启动子区A-20C和A-6G单核苷酸多态性与蒙古族人群原发性高血压的相关性

目的:分析血管紧张素原基因启动子区A-20C和A-6G单核苷酸多态性与蒙古族人群原发性高血压的相关性。方法:实验于2005-08/2006-01在北京华大实验室完成。选取对象均为生活在内蒙古乌拉特后旗的蒙古族牧民,三代血亲内无其他民族。采用基因测序技术对内蒙古蒙古族人群中107例原发性高血压患者和108例正常对照者进行A-20C和A-6G基因分型,观察高血压组和正常对照组不同基因型的分布和等位基因频率的差异。结果:①两组受试者在性别、年龄及吸烟、饮酒、体质量指数和临床化验检查指标有较好的匹配(P均>0.05)。②两组血管紧张素原基因A-20C位点AA,AC,CC基因型频率比较差异无显著性意义(高血压组分别为0.51,0.29,0.20;正常对照组分别为0.49,0.28,0.23,χ2=0.395,P=0.529)。A,C等位基因频率比较差异无显著性意义(高血压组分别为0.65,0.35;正常对照组分别为0.63,0.37,χ2=0.015,P=0.904)。③两组血管紧张素原基因A-6G位点AA,AG,GG基因型频率比较差异无显著性意义(高血压组分别为0.50,0.33,0.17;正常对照组分别为0.55,0.34,0.11,χ2=1.924,P=0.165)。A,G等位基因频率比较差异无显著性意义(高血压组分别为0.66,0.34;正常对照组分别为0.72,0.28,χ2=1.728,P=0.189)。④高血压组协同存在血管紧张素原基因A-20C基因型CC时,血管紧张素原基因A-6G基因型GG频率稍高于正常对照组,但差异无显著性意义(χ2=2.395,P=0.122,OR=7.52,95%CI0.014～1.250),高血压组G等位基因明显高于正常对照组(分别为0.37,0.22,χ2=4.658,P=0.034),携带该等位基因的蒙古族人群发生原发性高血压的相对危险度升高(OR=2.80,95%CI1.087～7.271)。结论:血管紧张素原基因A-20C和A-6G单核苷酸多态性与蒙古族人群原发性高血压相关,并可能具有协同作用。     

Localization of matrix metalloproteinases (MMPs‐2, 8, 9 and 20) in normal and carious dentine

Background: Dentine matrix metalloproteinases (MMPs) may participate in the destruction of dentine following demineralization by bacterial acids. This study investigated the localization of MMPs in carious dentine. Methods: Frozen sections of dentine caries were prepared without demineralization and immersed in monoclonal antibody against MMP‐2, ‐8, ‐9 and ‐20. The sections were labelled by IgG conjugated with gold colloidal particles, and observed under FE‐SEM. Labelling indexes (number of gold particles/μm²) of outer and inner carious dentine, respectively, with and without bacterial infection, were compared with that of normal dentine. Results: MMP‐2 was distributed in both carious and normal dentine; the level of MMP‐2 showed no significant difference among the outer caries, inner caries, and normal dentine. The labelling indexes of MMP‐8 and MMP‐9 both significantly decreased at the inner carious dentine compared with the level of normal dentine, but intensified again at the outer caries region. The labelling index of MMP‐20 was the highest at normal dentine. Conclusions: The localization of MMPs was visibly detected using immunogold labelling. The localization of MMP‐2 showed no significant difference among the three regions, while MMP‐8 and MMP‐9 showed significant reduction at the inner caries layer, and MMP‐20 reduced toward the outer caries.     

REVIEW ARTICLE: Paediatric nasopharyngeal rhabdomyosarcoma: A case series and literature review

Rhabdomyosarcoma (RMS) is the most common soft tissue tumour in children, with the head and neck region accounting for 35–40% of cases. Nasopharyngeal RMSs tend to grow rapidly and invade adjacent structures. Both the Intergroup Rhabdomyosarcoma Studies and the European Studies have established that the ideal management of this disease is multimodal, using a combination of surgery, chemotherapy and radiotherapy. This case series examines the role of radiotherapy in the management of paediatric nasopharyngeal RMSs, with particular reference to long-term morbidity and disease-free survival. The cases of five children with nasopharyngeal RMS were reviewed and a systematic review of the literature contained in the PubMed databases was conducted to establish 24 individually detailed cases. Management in all patients was multimodal, using a combination of chemotherapy, radiotherapy as well as surgery. External beam radiotherapy is an integral component of treatment for nasopharyngeal RMSs. With more patients surviving for longer periods, more long-term sequelae of radiotherapy have been reported. Complications include sensorineural deafness, endocrine manifestations following radiation of the pituitary gland, cranial nerve palsies, second malignancies within the radiation field, cataract formation, retinopathy and growth disturbance. Morbidity from radiotherapy may be considerable and depends on the field and dose of radiation. Current advances in radiotherapy are aimed at improving the rate of tumour control and reducing such complications. Recent improvements in imaging and conformal techniques have the potential to reduce the morbidity associated with radiotherapy in this cohort.     

HIV prevalence among female sex workers,drug users and men who have sex with men in Brazil: A Systematic Review and Meta-analysis

Background  

The Brazilian response towards AIDS epidemic is well known, but the absence of a systematic review of vulnerable populations ─ men who have sex with men (MSM), female sex workers (FSW), and drug users (DU) remains a main gap in the available literature. Our goal was to conduct a systematic review and meta-analysis of studies assessing HIV prevalence among MSM, FSW and DU, calculating a combined pooled prevalence and summarizing factors associated the pooled prevalence for each group.     

Disability Adjusted Life Years and minimal disease: application of a preference-based relevance criterion to rank enteric pathogens

Background

Burden of disease estimates, which combine mortality and morbidity into a single measure, are used increasingly for priority setting in disease control, prevention and surveillance. However, because there is no clear exclusion criterion for highly prevalent minimal disease in burden of disease studies its application may be restricted. The aim of this study was to apply a newly developed relevance criterion based on preferences of a population panel, and to compare burden of disease estimates of five foodborne pathogens calculated with and without application of this criterion.

Methods

Preferences for twenty health states associated with foodborne disease were obtained from a population panel (n = 107) with the Visual Analogue Scale and the Time Trade-off (TTO) technique. The TTO preferences were used to derive the relevance criterion: if at least 50% of a panel of judges is willing to trade-off time in order to be restored to full health the health state is regarded as relevant, i.e. TTO median is greater than 0. Subsequently, the burden of disease of each of the five foodborne pathogens was calculated both with and without the relevance criterion.

Results

The panel ranked the health states consistently. Of the twenty health states, three did not meet the preference-based relevance criterion. Application of the relevance criterion reduced the burden of disease estimate of all five foodborne pathogens. The reduction was especially significant for norovirus and rotavirus, decreasing with 94% and 78% respectively.

Conclusion

Individual preferences elicited with the TTO from a population panel can be used to empirically derive a relevance criterion for burden of disease estimates. Application of this preference-based relevance criterion results in considerable changes in ranking of foodborne pathogens.