间歇性外斜视眼位控制力评分综述

在间歇性外斜视患者的管理中,眼位控制力至关重要,它是评价手术时机的重要参考指标及监测和判断病情发展严重程度的必要指标之一。因此,眼位控制能力的量化成为间歇性外斜视评估中的重要环节。本文旨在对间歇性外斜视患者眼位控制力评估方法做一综述,帮助临床医生对间歇性外斜视患者制定合理的治疗方案。     

补骨脂对体外黑素细胞黏附和迁移的作用

目的 :研究补骨脂对黑素细胞黏附和迁移的影响。方法 :用补骨脂处理黑素细胞 ,检测其黏附于牛血清纤维结合素和通过微孔滤膜的细胞数量并与生姜和未经药物处理的黑素细胞比较。结果 :补骨脂可显著促进黑素细胞黏附于牛血清纤维结合素和通过微孔滤膜并呈剂量依赖关系 ,但当补骨脂浓度超过 0.2mg·L^-1时这种作用未见增加。补骨脂浓度在 0.01mg·L^-1时 ,黑素细胞黏附并无显著增加 ,但对迁移的影响已可见统计学差异 (P <0.01)。生姜则不具有这样的作用。结论 :在体外 ,补骨脂能明显促进黑素细胞的黏附和迁移 ,这至少可以部分解释应用补骨脂治疗白癜风是有效的。     

The PRB-dependent FOXO1/IGFBP-1 axis is essential for progestin to inhibit endometrial epithelial growth

Progestin inhibits the growth of normal and cancerous endometria via the progesterone receptor (PR), but the distinct functions and signalings of PR subtypes have not been fully understood. The aim of the present study was to dissect the key pathways of progestin to inhibit endometrial epithelial growth. Immortalized endometrial epithelial cells (EM-E6/E7/TERT) with stable PRA or PRB expression were established and used for the experiments. In vitro growth inhibition by progestin was mainly observed in EM-E6/E7/TERT cells with PRB rather than those with PRA. RT-PCR assay confirmed that FOXO1, a key gene for progestin action, was up-regulated by progestin in a PRB-dependent manner. cDNA microarray analysis identified IGFBP-1, which contains FOXO1 binding sites on its promoter, to be induced by medroxyprogesterone acetate (MPA) in EM-E6/E7/TERT cells with PRB but not with PRA. siRNA knockdown of FOXO1 disturbed the induction of IGFBP-1 by MPA, while IGFBP-1 knockdown showed no effect on MPA-induced FOXO1 expression, indicating that FOXO1 is an upstream regulator of IGFBP-1. Luciferase reporter assays showed that MPA activated the IGFBP-1 promoter, which was cancelled by FOXO1 knockdown. Chromatin immunoprecipitation assay confirmed the in vivo binding of FOXO1 to the core promoter of IGFBP-1. IGFBP-1 knockdown significantly attenuated the growth inhibitory effects of MPA. The FOXO1/IGFBP-1 axis is essential for PRB-dependent growth inhibition of endometrial epithelial cells, offering a potential therapeutic clue to enhance the progestin effect.     

综合评价医院工作的指标加权百分位次累加法

本文提出了综合评价医院工作的一种方法——指标加权百分位次累加法。本方法分五个步骤:1.建立评价指标体系;2.制定评价标准值;3.对指标值进行标准化;4.根据指标重要程度赋予相应权重;5.进行综合评价。并通过实际资料对本方法进行了验证。     

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.

     

HACCP原理在中小冷冻饮品生产企业中的应用

通过前期的基线调查,对浦东新区7家未实施HACCP计划的中小冷冻饮品生产企业的状况有了充分的认识,在此基础上,我们与企业共同制订了HACCP计划,确定了关键控制点,并在实际运行中进行纠偏和验证。事实说明各企业的生产过程卫生状况明显改善,提高了产品的安全性。     

褪黑素缺乏影响脊柱侧弯的研究进展

脊柱侧弯是一种常见的脊柱畸形,可能会增加发生背痛的风险,导致肩部不平衡和胸部畸形,甚至影响到患者的心肺功能或对神经造成不可逆的损伤。褪黑素可以改善骨代谢平衡和增加骨密度,目前关于褪黑素干预骨代谢有许多假说,对于褪黑素缺乏是否会导致脊柱侧弯的发生仍存在争议。血清褪黑素水平较低的脊柱侧弯患者,使用褪黑素进行补充,或许在一定程度上能防止脊柱侧弯的发展,并存在一定的治疗效果。本文综述了近年来关于褪黑素缺乏与脊柱侧弯的关系的相关研究,以期为脊柱侧弯的治疗提供参考。     

脑脱髓鞘假瘤MRI与临床病理对照研究(3例报告并文献复习)

目的探讨脑脱髓鞘假瘤的磁共振影像学特征与临床病理的关系。方法搜集经病理证实的脑脱髓鞘假瘤3例,结合文献复习其MR形态及信号特点,并与病理及临床症状对照。结果本组3例(男2例,女1例)患者发病年龄24～68岁,发病前无明确的前驱感染史或诱因,3例患者中,其中2例为单发,1例位于双额叶,1例位于右颞叶,另1例为颅内多发病灶,MRI T2WI呈稍低信号,T1WI呈低信号为主,增强后呈半环形或斑片状强化,其中1例合并出血性改变,病理上表现为典型脱髓鞘、炎性浸润及反应性细胞增多,多数可见具有核分裂状的肥胖型胶质细胞。结论颅内炎性脱髓鞘假瘤的MRI影像学表现具有一定的特点,增强扫描及扩散加权技术有助于脱髓鞘假瘤的诊断及鉴别诊断。     

HSV1-TK/GCV系统对人肺腺癌细胞A549生物学特性的影响

目的　观察转TK基因肺癌细胞对丙氧鸟苷 (GCV)的敏感性及TK GCV系统杀灭肿瘤细胞机制。方法　观察转TK基因、转空载体A5 49细胞 (下分别简称A5 49 TK、A5 49 pLXSN)和A5 49细胞形态学改变、生长增殖特性。GCV对 3种细胞生长抑制 (MTT法 )。电镜、流式细胞仪观察A5 49 TK、A5 49细胞经 5 0μmol LGCV作用 3d后细胞凋亡。 结果　转基因细胞变为不规则 ,呈多角型 ,透亮度下降 ,体外增殖能力下降 ,A5 49 TK ,A5 49 pLXSN ,A5 493种细胞倍增时间分别为 42 .3 5、41.75、3 6.18h。依据IC5 0 ,A5 49 TK细胞对GCV敏感性比A5 49细胞提高 46倍 ,电镜发现A5 49 TK细胞有凋亡小体 ,核呈半月征等 ,流式细胞仪发现A5 49 TK、A5 49细胞亚G0 G1 期分别为 ( 12 .2 1± 1.76) %、( 1.3 2± 0 .47) % ,两者比较P <0 .0 1。结论　A5 49 TK细胞获得了对GCV敏感性 ,TK GCV杀灭肿瘤细胞与诱导凋亡有关。