Relative Skeletal Maturation and Population Ancestry in Nonobese Children and Adolescents

More rapid skeletal maturation in African‐American (AA) children is recognized and generally attributed to an increased prevalence of obesity. The objective of the present study was to evaluate the effects of population ancestry on relative skeletal maturation in healthy, non‐obese children and adolescents, accounting for body composition and sexual maturation. To do this, we leveraged a multiethnic, mixed‐longitudinal study with annual assessments for up to 7 years (The Bone Mineral Density in Childhood Study and its ancillary cohort) conducted at five US clinical centers. Participants included 1592 children, skeletally immature (45% females, 19% AA) who were aged 5 to 17 years at study entry. The primary outcome measure was relative skeletal maturation as assessed by hand‐wrist radiograph. Additional covariates measured included anthropometrics, body composition by dual‐energy X‐ray absorptiometry (DXA), and Tanner stage of sexual maturation. Using mixed effects longitudinal models, without covariates, advancement in relative skeletal maturation was noted in self‐reported AA girls (～0.33 years, p < 0.001) and boys (～0.43 years, p < 0.001). Boys and girls of all ancestry groups showed independent positive associations of height, lean mass, fat mass, and puberty with relative skeletal maturation. The effect of ancestry was attenuated but persistent after accounting for covariates: for girls, 0.19 years (ancestry by self‐report, p = 0.02) or 0.29 years (ancestry by admixture, p = 0.004); and for boys, 0.20 years (ancestry by self‐report, p = 0.004), or 0.29 years (ancestry by admixture, p = 0.004). In summary, we conclude that advancement in relative skeletal maturation was associated with AA ancestry in healthy, non‐obese children, independent of growth, body composition, and puberty. Further research into the mechanisms underlying this observation may provide insights into the regulation of skeletal maturation. © 2016 American Society for Bone and Mineral Research.     

手术治疗老年Stanford A型急性主动脉夹层的近期和远期疗效分析

目的:探讨外科手术治疗老年Stanford A型急性主动脉夹层(AAD)的近远期疗效。方法:回顾性分析2008年6月—2017年3月郑州大学第二附属医院心血管外科应用手术治疗的196例Stanford A型AAD患者资料,患者均采用全麻、深低温停循环加单侧选择性脑灌注技术进行外科手术治疗,其中33例患者年龄≥60岁(老年组),163例患者年龄60岁(年轻组),比较两组患者的临床资料和预后情况。结果:与年轻组比较,老年组男性患者比例低(45.5%vs.73.0%,P=0.000),De Bakey II型主动脉夹层发病率高(21.2%vs.6.7%,P=0.009);升主动脉置换+全弓置换+象鼻支架术应用比例低于年轻组(9.1%vs.28.2%,P=0.021)升主动脉置换+全弓置换+象鼻支架术应用比例减少(9.1%vs.28.2%,P=0.021),但单纯升主动脉置换比例增加(21.2%vs.2.5%,P=0.000),平均体外循环时间、主动脉阻断时间、手术时间均缩短(215.70 min vs.252.98 min,P=0.000;121.12 min vs.134.00 min,P=0.008;489.15 min vs.533.52 min,P=0.004);术后ICU停留时间延长(235.27 h vs.163.55 h,P=0.011),术后肾功能不全(21.2%vs.6.7%,P=0.009)、感染发生率(30.3%vs.9.8%,P=0.002)升高;术后生存率差异无统计学意义(P=0.1466)。全组病例分析显示,体外循环时间是AAD患者手术后院内死亡的危险因素(OR=0.987,95%CI=0.977~0.997,P=0.011),而年龄(OR=1.790,95%CI=0.651~4.921,P=0.259)与其他因素并非手术后院内死亡的危险因素。结论:对于老年AAD患者,根据夹层累及范围选择恰当的手术方式可以取得较满意的预后,术中尽可能缩短体外循环时间有助于提高手术疗效。     

蛛网膜下腔出血患者迟发性脑血管痉挛相关因素的临床分析

目的 探讨动脉瘤性蛛网膜下腔出血(SAH)患者迟发性脑血管痉挛(DCVs)的临床影响因素. 方法 回顾性分析南方医科大学珠江医院神经外科自2005年1月至2008年12月收治的74例动脉瘤性SAH患者的临床资料,判定DCVS,统计分析其影响因素. 结果年龄、出血次数、吸烟史、Hunt-Hess分级、Fisher分级、白细胞计数峰值与DCVS的发生具有明显相关性,其中年龄、出血次数、Hunt-Hess分级、Fisher分级是DCVS发生的独立影响因素. 结论 低年龄、出血2次以上及Hunt-Hess分级或Fisher分级Ⅲ级以上患者更易发生DCVS,临床上对此类患者应加强监测、及早发现和处理.     

异体软组织修复材料在口腔颌面部缺损中的应用

目的 探讨异体软组织修复材料(异体脱细胞真皮基住)在口腔颌面外科应用的可行性。方法 选择口腔粘膜组织缺损患者46例，在创面上采用异体脱细胞真皮基质覆盖，并对修复后创面情况和组织病理进行观察。结果 所有口腔粘膜创面愈合良好，无1例出现排斥反应。经4～6月后组织学观察，异体脱细胞真皮基质处所生成的组织与正常粘膜组织不易区分。结论 异体脱细胞真皮基质可以作为口腔粘膜缺损的修复材料推广使用。     

Murine leukemia inhibitory factor enhances retroviral-vector infection efficiency of hematopoietic progenitors

We have investigated the in vitro effects of the cytokine leukemia inhibitory factor (LIF) on normal murine hematopoietic progenitors by measuring recovery and retroviral vector infection efficiency of 13-day posttransplant, spleen-colony-forming cell (CFU-S 13) in short-term culture. Up to a twofold increase in CFU-S13 recovery was observed, from 9.7 x 10(-5) cells in untreated controls to 17.8 to 19.5 x 10(-5) cells, depending on the concentration of LIF. Histologic analysis of spleen colonies from control and LIF-treated marrows demonstrated that there was no detectable alteration in the differentiative potential of CFU-S13. The efficiency of CFU-S13 infection was increased from 15% in untreated controls to 84% to 91% in LIF-treated marrows. Analysis of proviral integration sites in spleen colonies indicated that some CFU- S13 precursors were infected in the LIF-treated marrows.     

Copy number changes of the microcephalin 1 gene (MCPH1) in patients with autism spectrum disorders

Autism spectrum disorder (ASD) represents a set of neurodevelopmental disorders with a strong genetic aetiology. Chromosomal rearrangements have been detected in 5–10% of the patients with ASD, and recent applications of array comparative genomic hybridisation (aCGH) are identifying further candidate regions and genes. In this study, we present four patients who implicate microcephalin 1 ( MCPH1) in band 8p23.1 as an ASD susceptibility gene. Patient 1 was a girl with a syndromic form of autistic disorder satisfying the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Oligonucleotide aCGH (oaCGH) showed that she had a classic inv dup del(8)(qter-> p23.1::p23.1-> p21.2) containing at least three candidate genes; MCPH1 and DLGAP2 within the 6.9-Mb terminal deletion and NEF3 within the concomitant 14.1-Mb duplication. Three further patients with MCPH1 copy number changes were found using single-nucleotide polymorphism (SNP) array analysis in a cohort of 54 families with ASD patients. Our results show that ASD can be a component of the classical inv dup del(8) phenotype and identify changes in copy number of MCPH1 as a susceptibility factor for ASD in the distal short arm of chromosome 8.     

浅低温体外循环围术期血清炎症介质的变化

目的 探讨浅低温体外循环围术期炎症介质的释放规律。方法 按入选标准筛选先天性心脏病患者24例，均采用浅低温体外循环心脏直视术，用酶联免疫吸附法测定患者术前（T1）、CPB30min（T2）、CPB结束后2h（T3）、12h（T4）、24h（T5）各时间点血清IL-6、IL-8、IL-10的浓度。结果 所有患者血清IL-6、IL-8、IL-10浓度在CPB开始后均升高（P〈0，01），于术后2h（T3）逐渐达高峰，术后12h（T4）逐渐下降，术后24h（T5）虽仍高于术前（T1）水平，但较高峰时（T3）已明显下降。结论 浅低温CPB术后患者血清IL-6、IL-8、IL-10浓度逐渐升高．术后2h达高峰．并于24h内恢复接近正常水平。     

自体骨髓单个核细胞移植治疗缺血性心脏病临床疗效观察

目的 研究经冠状动脉内移植骨髓单个核细胞治疗缺血性心力衰竭的可行性和疗效。方法 缺血性心力衰竭病人20例，抽取骨髓用密度梯度离心法分离出骨髓单个核细胞，经外周动脉穿刺插管，将自体骨髓单个核细胞注入冠脉。比较病人的临床症状，NYHY分级和治疗后由于心血管事件造成的再住院情况。结果 病人自觉症状改善，心功能提高，ECT检查显示在缺血区有血管新生。结论 自体骨髓单个核细胞移植是安全有效的。