Risk Factors and Outcomes for Preoperative Asymptomatic Pulmonary Embolism in Patients Aged 60 Years and Over with Hip Fracture

ObjectiveTo investigate the risk factors for, and outcomes of, preoperative asymptomatic pulmonary embolism (PE) in patients ≥60 years old following delayed operation for hip fracture.MethodsFrom March 2017 to December 2018, 90 patients aged ≥60 years with hip fracture who suffered a delay in surgery were recruited to this prospective study following admission to our hospital. Computed tomography pulmonary angiography (CTPA) was used to detect preoperative asymptomatic PE and calculated its incidence. Time from injury to admission, baseline characteristics, medical comorbidities, and blood biomarker levels were evaluated as potential risk factors. Logistic regression analysis was used to identify risk factors. Mortality and major bleeding events were recorded and compared between individuals with PE and without. Data were analyzed by t‐test, Mann–Whitney U test, χ ² test, Fisher''s exact test, and logistic regression analysis.ResultsThe incidence of preoperative asymptomatic PE was 18.9% (17/90 patients). In the univariate analysis, the risk factors for preoperative asymptomatic PE were male sex, hypertension, cerebrovascular accident, smoking, plasma D‐dimer level, potassium level, urea level, creatinine level, and cysteine level. Multivariate logistic regression analysis showed that the risk of preoperative asymptomatic PE was higher in patients with hypertension (odds ratio [OR] = 10.048; 95% confidence interval [CI], 1.118–90.333), cerebrovascular accident (OR = 20.135; 95% CI, 1.875–216.164), smoking (OR = 48.741; 95% CI, 4.155–571.788), high plasma D‐dimer levels (OR = 1.200; 95% CI, 1.062–157.300), and high plasma potassium levels (OR = 12.928; 95% CI, 1.062–157.300). All patients were followed up for 21.0 months (range, 2 to 36 months). Mortality within the first year postoperatively was higher in patients with PE (29.41% vs 9.59%, P = 0.046).ConclusionsIn view of the high incidence of preoperative asymptomatic PE and the inferior prognosis in individuals with PE, routine CTPA examination for preoperative asymptomatic PE could be useful for patients aged ≥60 years with hip fracture for whom surgery is delayed.     

椎间盘退变的腰椎活动节段力学模型

椎间盘是人体组织中最早发生退行性改变的部位。本文报告采用三维有限元方法建立的椎间盘退变腰椎活动节段的力学模型,着重分析其在直立时的应力分布与载荷传递情况。模型共有388个节点,组成293个单元,所得结构较为合理可靠。作者认为,本模型具有其独特的优点。可望用于进一步的研究。     

褐云玛瑙螺中枢内支配大触角肌肉神经元的分布

实验用荧光素Ｂｂ逆行追踪方法，研究了褐云玛瑙螺支配大触角肌肉活动的神经元在中枢的分布，结果表明，Ｂｂ标记神经元大多分布于同侧脑节，少量分布于侧脑节，同侧口球节，足节和侧节，Ｂｂ标记神经元大多为中小型神经元，个别属于大型神经元。     

Primary study of iontophoresis of zinc ion in treatment of retinitis pigmentosa

We report here the preliminary effects of zinc iontophoresis in treatment of 26 Rp patients who had decreased zinc serum level or abnormal ratio of serum copper to zinc. Through more than 20 to 30 times of therapy, the vision of 15.38% eyes increased more than "3 lines", 4% eyes increased more than 5 degrees in the visual field, 13.46% eyes improved in dark adaptation threshold (greater than 1.0), the visual functions of the rest eyes were slightly improved or unimproved. The fundus didn't change before & after treatment. There were no changes of ERG in 8 eyes of 4 cases. In addition, the advantages and disadvantages between Zn iontophoresis and Zn compound taken orally, the improvement of vision by direct electric current therapy, the relationship between the metabolism of Zn element and Vit A and influence of Zn over the mechanism of dark adaptation were also briefly discussed.     

Rsa I与Sma I多态性寡核苷酸阵列检测法的建立及其与血栓性疾病的相关性研究

目的 建立血管性血友病因子（vWF)基因Rsa I、Sma I多态性寡核苷酸阵列检测方法,对基因芯片在单核苷酸多态性（SNP）检测上的应用进行探讨;研究两位点多态性与血栓性疾病的发生有无相关关系。方法 设计、合成两组寡核苷酸探针,使用3甲氧基氨基丙基硅烷、戊二醛等化学物质,实现探针与固相支持物玻片的连接。 应用不对称PCR方法扩增Rsa I、Sma I多态性片段,在扩增体系中掺入荧光标记dUTP,获得被测片段的单链标记产物。对核酸杂交反应的温度、动力学和离子浓度 变化进行研究,获得最佳的杂交鉴别条件。对20名正常人,酶切法确定多态性基因型,再用寡核苷酸阵列法检测,以验证该方法的准确性。使用该方法对50例血栓病人进行检测,探讨血栓性疾病的发生与vWF基因Rsa I、Sma I多态性的关系。结果 寡核苷酸阵列法和酶切法对20例标本检测的符合率为1005;血栓病人与正常人Rsa I、Sma I两位点多态性的基因型GG、GA、AA和CC、CT、TT分别为4．0％、12．0％、84．0％和24．0％、44．0％、32．0％,正常人分别为1．4％、11．8％、86．8％和8．8％、57．4％、33．8％,血栓病人等位基因频率G、A和C、T分别为10．0％、90．0％和46．0％、54．0％,正常人分别为7．4％、92．6％和37．5％、62．5％,血栓病人与正常人之间两位点多态性的基因型和等位基因频率的差异均无显著意义（P＞0．05）。结论 成功建立vWF基因 Rsa I、Sma I多态性寡核苷酸阵列检测方法,为基因芯片技术在SNP检测上的应用提供依据。未获明确证据表明Rsa I、Sma I多态性与血栓的发生有关。     

胸水细胞端粒酶活性检测对良恶性胸腔积液的鉴别诊断价值

目的：探讨胸水细胞端粒酶活性对良、恶性胸腔积液的鉴别诊断价值。方法：用改良的PCR-ELISA法检测37例恶性、32例良性胸水细胞端粒酶活性,并与胸水细胞学、癌胚抗原（CEA）诊断结果进行比较。结果：37例恶性胸腔积液中有26例端粒酶活性阳性（26/37）,阳性率为70.27%,高于良性胸腔积液中端粒酶海性表达（2/32,P＜0.01);端粒酶活性检测诊断恶性胸水敏感性为70.27%,特异性为93.75%,与胸水细胞学诊断符合率为54.05%;其敏感性高于胸水CEA诊断结果（敏感性为51.35%)。结论：胸水细胞端粒酶活性检测作为细胞学检查的辅助手段能提高恶性胸水的诊断率,有助于良、恶性胸腔积液的鉴别诊断。     

加热对人肝癌耐药细胞模型-7721/Adm细胞内药物浓度的影响

目的 探讨比较43℃加热前后人肝癌细胞－7721（以下简称7721细胞）和耐药人肝癌细胞模型－7721／Adm(以下简称7721／Adm细胞）细胞内阿霉素（ADM）药物浓度的变化。方法 以体外培养的人肝癌细胞－7721和作自行培养建立的人肝癌细胞模型－7721／Adm为研究对象,采用水浴加温法、流式细胞荧光技术观察阿霉素化热前后7721和7721／Adm细胞胞内阿霉素（ADM）浓度的变化。结果 加热后7721组提高30．8％,HCC－7721／Adm组提高51％。结论 加热可明显提高这两种细胞内的阿霉素浓度,从而提高这两种细胞的化疗敏感性,为临床克服多药耐药问题提供了重要依据。     

前列腺素E1对脑缺血再灌注损伤的治疗作用

目的 研究前列腺素E1对脑缺血再灌注损伤的治疗作用。方法 采用线栓法制备大鼠脑缺血再灌注模型,进行神经症状评分,分别计算脑含水量、脑梗塞体积。结果 大脑中动脉阻断1h再灌注24h,前列腺素E1各剂量组能显著降低脑缺血再灌注大鼠的脑梗塞体积、脑含水量,改善大鼠神经功能缺损症状,降低行为评分。结论 前列腺素E1对脑缺血再灌注损伤有保护作用。     

P~(53)蛋白在口腔扁平苔藓癌变诊断中的意义

目的 :探索口腔粘膜扁平苔藓 (OLP) P53蛋白的表达及其在癌变诊断中的应用价值。方法 :采用 S- P免疫组化方法 ,观察在 2 5例 OLP、2 0例鳞癌 (OSCC)中 P53蛋白的表达。结果 :1 P53蛋白的阳性表达在 OLP早期已出现 ,各组间 P53阳性表达率间有显著性差异。2在 OSCC中其阳性表达率高达 80 % ,随着细胞异常增生程度的增高而增高。结论 :1在 OSCC的形成过程中 ,抑癌基因 P53的失活可能参与调节作用 ;2 P53蛋白作为判断 OLP癌变的辅助性参考指标 ,具有一定的可行性