经颅多普勒超声在儿童颅内压增高性疾病中的应用

经颅多普勒超声(transcranial doppler ultrasonography,TCD)是一种非侵入性评价颅内动脉的检测手段,自上世纪80年代问世以来,已被广泛性应用于临床工作的各个领域.由于其操作简便、重复性好,可以对患者进行床旁连续、动态观察,尤其适用于监测危重症患者.颅内压增高是儿童致病致死的再要原因之一,它可使脑血流灌注下降,造成脑功能障碍等严重后果,因此颅内压监测有重要临床意义.TCD作为一种无创性监测工具,可根据其血流速度、相关参数及血流频谱的变化对颅内压增高患者脑血流动力学进行动态监测与评估,从而达到监测颅内压改变的目的.本文着重阐述TCD在几种常见的儿童颅内高压性疾病中的应用进展.     

Changes of TGF-β2, MMP-2, and TIMP-2 levels in the vitreous of patients with high myopia

Purpose

To investigate the concentrations of transforming growth factor (TGF)-β2, matrix metalloproteinase (MMP)-2, and tissue inhibitor of metalloproteinase (TIMP)-2 in the vitreous of patients with high myopia.

Methods

Twenty-six patients with high myopia (HM) who received vitrectomy for macular retinoschisis or macular hole were enrolled in this prospective study. Twenty-six patients with idiopathic macular hole or macular epiretinal membrane were chosen as a control group. Vitreous samples were obtained during the vitrectomy surgery. The levels of TGF-β2、MMP-2、TIMP-2 in the vitreous samples were measured by enzyme-linked immunosorbent assay. The MMP activity was determined by a fluorometric assay.

Results

There was no significant difference in the vitreous level of TGF-β2 between HM (1.64?±?0.38 ng/ml) and the control group (1.56?±?0.32 ng/ml, p?=?0.56). The vitreous levels of MMP-2 in HM (32.40?±?14.90 ng/ml) were significantly higher than in the control group (21.42?±?6.74 ng/ml, p?MMP-2/TIMP-2 was significantly elevated in the vitreous samples from HM (0.61?±?0.19), compared to the control group (0.48?±?0.11, p?p?Conclusions The elevated MMP/TIMP ratio and MMP activity may play a role in the pathogenesis of human high myopia. Large prospective studies are needed to further investigate the effect of MMPs in the pathogenesis of human high myopia.     

TREX1基因变异致Aicardi-Goutières综合征1例报告

目的 总结TREX 1基因变异致Aicardi-Goutières综合征(AGS)的临床及基因特征.方法 回顾分析1例新生儿期起病的AGS综合征患儿的临床资料.结果 女性患儿于生后第2天起发热、喂养困难、呼吸困难;特殊面容,头型尖、头围小(30 cm)、眼距宽、眼裂窄、鼻梁低平、上唇短小、短下颌,四肢肌张力低,原始反射...     

中医穴位按摩联合生物电刺激乳房护理在产后乳腺疏通中的应用效果

目的 探讨中医穴位按摩联合生物电刺激乳房护理在产后乳腺疏通中的应用效果。方法 选取2019年1月至2020年6月肇庆市端州区妇幼保健院保健科收治的产后出现乳房胀痛需要乳腺疏通的468例产妇作为研究对象,并按照随机数字表法分成对照组和观察组,各234例。对照组采用常规按摩手法,观察组采用中医穴位按摩护理手法,两组产妇在乳房疏通按摩过程中,均辅助低频脉冲生物电刺激。护理干预3 d后,比较两组产妇乳腺疏通效果及护理疗效评价。结果 护理干预前,两组产妇的乳房胀痛程度评分比较,差异无统计学意义（P>0.05）;护理干预3 d后,观察组的乳房胀痛程度评分低于对照组,两组产妇的乳房胀痛程度评分也均低于本组干预前,差异有统计学意义（P<0.05）。观察组干预3 d后的护理总有效率高于对照组,差异有统计学意义（P<0.05）。结论 中医穴位按摩与生物电刺激相结合方式,能够大大提高产妇产后乳腺管疏通度,护理效果值得肯定。     

Structure Characterization and Impact Effect of Al-Cu Graded Materials Prepared by Tape Casting

With the need of developing new materials, exploring new phenomenon, and discovering new mechanisms under extreme conditions, the response of materials to high-pressure compression attract more attention. However, the high-pressure state deviating from the Hugoniot line is difficult to realize by conventional experiments. Gas gun launching graded materials could reach the state. In our work, the corresponding Al-Cu composites and graded materials are prepared by tape casting and hot-pressing sintering. The microstructure and the acoustic impedance of the corresponding Al-Cu composites are analyzed to explain the impact behavior of Al-Cu graded materials. Computed tomographic testing and three-dimension surface profilometry machine results demonstrated well-graded structure and parallelism of the graded material. Al-Cu GMs with good parallelism are used to impact the Al-LiF target at 2.3 km/s using a two-stage light-gas gun, with an initial shock impact of 20.6 GPa and ramping until 27.2 GPa, deviating from the Hugoniot line.     

计算机辅助鼻额区域影像解剖学研究

OBJECTIVE: To evaluate the value of Advantage Windows 3.1 (AW 3.1) software for anatomical study of nasofrontal region, and to study the CT characteristics of nasofrontal region which related to the frontal sinus surgery. METHODS: Eighty patients underwent axial consecutive computed tomography scans and these data were studied with AW 3.1 software which provided reconstructional imaging of continuous coronal, sagittal, axial sections. Some related structures of nasofrontal region were studied and measured. RESULTS: AW 3.1 software could identify and measure the following structures accurately: The diameter of frontal sinus was (22.5 +/- 8.6) mm in height, (16.3 +/- 6.8) mm in depth, (23.8 +/- 9.8) mm in breadth. The diameter of frontal sinus ostium: the anterior-posterior diameter was (7.3 +/- 1.7) mm, the transverse diameter was (8.5 +/- 1.9) mm. The width of nasal beak of frontal bone(5.9 +/- 1.4 ) mm. The distance of frontal sinus ostium to the floor of columella nasi and the corresponding angle to the nasal floor were (60.8 +/- 4.2) mm and (70.1 +/- 4.7) degrees. The superior attachment sites of the uncinate process were as follows: lamina papyracea 41%, posteromedial wall of agger nasi cell 11%, middle turbinate 19%, anterior skull base 16%, superior bifurcation 13%. The cells could impinge on the frontal recess to cause obstruction (terminal recess 38.8%, anterior ethmoid cell 27.6%, agger nasi cells 24.5%). The accessory cells could impinge on the frontal sinus (perifrontal cells 32.7%, superaorbital cells 38.8%, intersinus septal cells 32.0%). There was significant difference between two groups of characteristics of nasofrontal region. CONCLUSIONS: AW 3.1 software is a helpful and powerful new tool for anatomical study of nasofrontal region and for preoperative evaluation. The structures of nasofrontal region are complex and various, frontal sinusitis almost always results from the obstruction of frontal sinus outflow tract. These results of anatomical study of nasofrontal region are helpful in directing the functional endoscopic surgery in frontal sinus.     

永存原始玻璃体增生症与先天性纤维血管瞳孔膜临床特征的比较

目的：分析永存原始玻璃体增生症(PHPV)和先天性纤维血管瞳孔膜(CFPM)的临床特征异同。

方法：回顾性分析2006-03/2021-12在空军军医大学西京医院眼科接受手术治疗的PHPV(PHPV组)和CFPM患儿(CFPM组)的眼部生物测量参数、临床表现、病变的形态学特点。

结果：纳入PHPV患儿56例61眼,CFPM患儿24例25眼; PHPV和CFPM的发病年龄相似、无性别差异,均以单眼患病为主,其占比分别为91%和96%。PHPV合并白内障患眼可有多种并发症和眼发育异常,CFPM主要为不同程度的瞳孔区堵塞及形态异常。PHPV组和CFPM组单眼患病患儿患眼前房深度(ACD)均小于对侧眼,手术年龄≤24月龄患儿患眼眼轴长度(AL)均小于对侧眼(P<0.05); PHPV组单眼患病患儿患眼角膜直径(CD)小于对侧眼、眼压高于对侧眼(均P<0.05); CFPM组单眼患病患儿患眼与对侧眼CD、IOP比较均无显著差异(P>0.05)。PHPV组患儿患眼ACD小于CFPM组患眼(P<0.05)。术中发现PHPV纤维血管膜组织位于晶状体后、玻璃体腔内,而CFPM纤维血管膜位于虹膜与晶状体前囊膜之间,很少累及晶状体。

结论：PHPV和CFPM有非常相似的临床特点,提示PHPV和CFPM可能是永存胚胎血管(PFV)的不同表现形式,但PHPV病变范围更广、病情更复杂。     

DCC基因转染对卵巢癌细胞HO-8910生长及化疗药物敏感性的影响

结直肠癌缺失(deleted in colorectal carcinoma, DCC)基因是于1990年确定并命名的重要的肿瘤抑癌基因,定位于人染色体18q21.3.DCC蛋白具有跨膜分子特征,其胞外部分氨基酸排序与神经细胞黏附分子相似.细胞黏附分子介导细胞间、细胞与基质间的相互作用,促进细胞与细胞间的黏附,是维持细胞生长的重要条件之一.有研究表明,良性卵巢肿瘤组织中DCC基因的表达缺失率为20%,恶性卵巢肿瘤组织中DCC基因的表达缺失率为56%,两者比较差异有显著意义.在临床分期晚、组织分化差、盆腹腔有转移的卵巢恶性肿瘤中DCC基因表达缺失率更高.     

体内成熟与体外成熟的卵母细胞纺锤体位置及其与胚胎发育的关系

目的研究体内成熟与体外成熟卵母细胞的纺锤体位置及其与胚胎发育的关系。方法对134个体内成熟卵母细胞在卵母细胞胞质内单精子注射法（ICSI）操作时用纺锤体实时观察仪进行纺锤体位置的观察,体内成熟卵母细胞来自单纯因男性不育而进行ICSI治疗的患者15例（体内成熟组）。另外对45个体外成熟的卵母细胞观察纺锤体位置,体外成熟卵母细胞来自因多囊卵巢综合征致不孕而进行治疗的患者5例（体外成熟组）。纺锤体的位置按照其与第一极体之间的角度不同分为Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ级。并观察两组成熟卵母细胞的受精及其胚胎发育情况。结果体内成熟组和体外成熟组患者的卵母细胞中可观察到纺锤体的分别占83．6％（112／134）和82．2％（37／45）。体内成熟组患者卵母细胞纺锤体的位置Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ级分别为22．4％、55．2％、3．O％、3．O％、16．4％,体外成熟组则分别为17．8％、51．1％、8．9％、4．4％、17．8％,两组各级间分别比较,差异均无统计学意义（P〉0．05）。在体内成熟组卵母细胞中,纺锤体离第一极体较近（Ⅰ级）者受精率较高（93．3％）,显著高于其他各级（分别为73．0％、2／4、1／4、63．6％,P〈0．05）。结论体内成熟与体外成熟卵母细胞间纺锤体位置未见显著差异;纺锤体的位置与卵母细胞受精率有一定相关性。