早期慢性肾病患者血管内皮功能及肾脏病理相关性研究

目的：研究早期慢性肾病患者的血管内皮功能损害程度及其与肾脏病理损伤的关系。方法：60例研究对象分为3组：A组为20例正常对照组;B组为20例早期慢性肾病患者血压正常组;C组为20例早期慢性肾病患者肾性高血压组。对各组患者应用高频超声检测肱动脉充血前后管径变化率,评价早期慢性肾病患者血管内皮功能损害程度。对病例组行超声引导下穿刺活检,并对肾组织损伤程度行半定量积分,分析血管内皮功能与年龄、血压、肾脏病理损伤的关系。结果：①C组血流介导的血管舒张功能（Flow-mediated dilation,FMD）低于A组和B组（P＜0.05）,A组与B组之间FMD无差异性（P＞0.05）;②FMD与收缩压、肾小球损伤积分、肾间质损伤积分有相关性（P＜0.05）,与年龄、舒张压无相关性（P＞0.05）。结论：①肾性高血压患者在肾功能损害之前已经存在血管内皮功能的异常;②血管内皮功能紊乱对肾脏的病理损伤有一定的促进作用;③高频超声早期检测慢性肾病患者的血管内皮功能有重要的临床意义。     

Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter,prospective, double blind,placebo controlled,randomized trial

Background  

The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%), non-union (5-21%) and early osteo-arthritis (up to 32%) which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences.     

不同标准空腹血糖受损人群葡萄糖负荷后血糖代谢特征

目的：分析两种标准空腹血糖受损人群葡萄糖负荷后血糖代谢特点。方法：对3828名40岁以上居民进行流行病学调查,对空腹血糖≥5.6mmol/L者行75g葡萄糖负荷试验,据不同空腹血糖受损诊断标准分析负荷后2h血糖代谢情况。结果：在以空腹血糖为6.1mmol/L为切点诊断的245例空腹血糖受损（IFG）人群中,糖耐量减低（IGT）的患病率为41.22%,女性（25.71%）高于男性（15.51%）;2型糖尿病（T2DM）患病率为20.82%,女性（11.84%）高于男性（8.98%）。在以空腹血糖为5.6mmol/L为切点诊断的627例空腹血糖受损人群中,糖耐量减低的患病率为37.00%,女性（23.76%）高于男性（13.23%）;2型糖尿病患病率为13.88%,女性（9.52%）高于男性（4.63%）。结论：以空腹血糖为5.6mmol/L和6.1mmol/L为切点诊断的空腹血糖受损人群葡萄糖负荷后2h血糖代谢异常率分别为50.88%和62.04%,患病率女性均高于男性。     

泌尿生殖道支原体感染情况及耐药性分析

目的:探讨泌尿生殖道支原体感染及耐药情况,为临床治疗提供合理、科学的抗生素用药依据.方法:应用支原体培养鉴定药敏试剂盒检测从患者中分离培养的支原体对10种抗生素的药敏情况,并对结果进行分析.结果:2 137例患者中1 163例支原体阳性,阳性率为54.42%;其中女性标本中阳性率为59.58%、男性标本中阳性率为38.78%,女性感染率明显高于男性,Uu、Mh、Uu+Mh阳性率分别为41.18%(880/2137)、3.88%(83/2137)、9.36%(200/2137),以Uu感染率最高,对Uu敏感率最高的抗生素为强力霉素,耐药率最高者为环丙沙星.结论:泌尿生殖道支原体的感染相当普遍,以Uu阳性率最高,女性高于男性,其耐药性已相当严重,应引起临床重视.     

Human milk as a carrier of biochemical messages

Not only does breast milk provides an ideal nutrient composition for the newborn, but it also contains a variety of substances that may actively influence growth and development of the infant and stimulate neonatal protection against gastrointestinal diseases. Hormones, growth factors, cytokines and even whole cells are present in breast milk and act to establish biochemical and immunological communication between mother and child. In addition, milk nutrients such as nucleotides, glutamine and lactoferrin have been shown to influence gastrointestinal development and host defense. The unique properties of milk as a mediator of biochemical messages will be presented and the clinical significance of breastfeeding in the prevention of neonatal gastrointestinal diseases will be discussed.     

Dose-response effect of fetal cocaine exposure on newborn neurologic function

BACKGROUND: Studies of fetal cocaine exposure and newborn neurologic function have obtained conflicting results. Although some studies identify abnormalities, others find no differences between cocaine-exposed and cocaine-unexposed infants. To determine the effects of prenatal cocaine exposure on intrauterine growth and neurologic function in infants, we prospectively evaluated 253 infants shortly after birth. METHODS: Women who delivered a live singleton >36 weeks by dates were eligible for enrollment. Maternal exclusionary criteria were known parenteral drug use, alcoholism, and acquired immunodeficiency syndrome; infant exclusionary criteria were Apgar scores 相似文献   

鼻种植相关的切牙管三维重建的影像学研究

目的:明确切牙管区的解剖结构,为鼻缺失后种植体支持的赝复体修复提供依据,以明确种植钉植入部位及方向。方法:对60例正常咬合人群的上颌骨进行64排螺旋CT扫描和三维重建,观察切牙管开口的形状及周围骨质形态,并在中切牙之间的矢状位截面上测量切牙管的长度、鼻腔和口腔开口的纵径、与鼻底平面所成角度及与牙槽骨前壁的距离。结果:研究得出了切牙管口腔开口的形态、平均长度、口腔和鼻腔开口的矢状径、切牙管口腔开口和鼻腔开口距牙槽骨前壁的距离、切牙管前壁与鼻底平面的交角∠α、上前牙牙槽突与鼻底平面的交角∠β。结论:切牙管与牙槽骨前壁之间可植入直径5mm以内的种植体1枚,方向由后上方向前下方,与鼻底所成的角度介于∠α与∠β之间;双侧中切牙之间水平向可植入长度<5mm的种植体1枚。     

Hutchinson-Gilford progeria syndrome: oral and craniofacial phenotypes

Objective:  Hutchinson-Gilford progeria syndrome (HGPS) is a rare early-onset accelerated senescence syndrome. In HGPS, a recently identified de novo dominant mutation of the lamin A gene ( LMNA ) produces abnormal lamin A, resulting in compromised nuclear membrane integrity. Clinical features include sclerotic skin, cardiovascular and bone abnormalities, and marked growth retardation. Craniofacial features include 'bird-like' facies, alopecia, craniofacial disproportion, and dental crowding. Our prospective study describes dental, oral soft tissue, and craniofacial bone features in HGPS.
Methods:  Fifteen patients with confirmed p.G608G LMNA mutation (1–17 years, seven males, eight females) received comprehensive oral evaluations. Anomalies of oral soft tissue, gnathic bones, and dentition were identified.
Results:  Radiographic findings included hypodontia ( n  = 7), dysmorphic teeth ( n  = 5), steep mandibular angles ( n  = 11), and thin basal bone ( n  = 11). Soft tissue findings included ogival palatal arch ( n  = 8), median sagittal palatal fissure ( n  = 7), and ankyloglossia ( n  = 7). Calculated dental ages (9 months to 11 years 2 months) were significantly lower than chronological ages (1 year 6 months to 17 years 8 months) ( P  = 0.002). Eleven children manifested a shorter mandibular body, anterior/posterior cranial base and ramus, but a larger gonial angle, compared to age/gender/race norms.
Conclusion:  Novel oral-craniofacial phenotypes and quantification of previously reported features are presented. Our findings expand the HGPS phenotype and provide additional insight into the complex pathogenesis of HGPS.     

脑缺氧是影响严重颅脑创伤患者短期预后的独立危险因素(英文)

Background:Brain hypoxia(BH)can aggravate outcome after severe traumatic brain injury(TBI).Whether BH or reduced brain oxygen(Pbto2)is an independent outcome predictor or a marker of disease severity is not fully elucidated.Objective To analyze the relationship between Pbto2,intracranial pressure(ICP),and cerebral perfusion pressure(CPP)and to examine whether BH correlates with worse outcome independently of ICP and CPP.Methods We studied103patients monitored     

多重PCR法检测金黄色葡萄球菌耐药基因及致病毒素基因

目的：了解金黄色葡萄球菌（简称金葡菌）耐药基因及所携带致病毒素基因PVL与TSST-1的特点。方法：应用多重PCR法检测mecA基因、TSST-1基因及Py￡基因。结果：84株金 葡球经多重PCR法对其mecA基因进行检测．检出率为58．3％（49／84）。PVL基因阳性菌株的分离率为23．8％（20／84）,州￡阳性的MRSA为13株（13／49,26．5％）,PyL阳性的MSSA为7株（7／35,20．O％）,差异无统计学意义（P〉0．05）;未检出TSST-1基因。结论：金葡菌的耐药性呈上升趋势,且金葡菌可产生多种毒素,在分离金葡菌的同时,应加强其耐药基因及毒素基因的检测。