胸骨舌骨肌皮瓣的局部解剖学研究

目的 为采用带蒂胸骨舌骨肌皮瓣修复气管瘘口提供解剖学参考资料。方法 在30侧成人尸体标本上观测了胸骨舌骨肌的形态、血供和神经支配。结果 肌长85.1±10.3mm;该肌有2～5支甲状腺上动脉分支供应,外径约为0.7mm,其中大部分(61.0％)从肌的外侧入肌,且在舌骨体下缘35.4±12.1mm处较为恒定;舌下神经袢(颈袢)约发出2支分布该肌,其上支在舌骨体下缘35.7±13.6mm处从胸骨舌骨肌的外侧入肌。结论 制备该肌皮瓣的蒂部应在舌骨体下缘40mm的范围内,亦可采用该肌的两端为蒂作翻转肌皮瓣修复管瘘口。     

Recovery of duck hepatitis A virus 3 from a stable full-length infectious cDNA clone

Recently, duck hepatitis A virus 3 (DHAV-3) with genetically distinct characteristics from DHAV-1 and DHAV-2 was recognized in South Korea and China. In this short communication, we successfully constructed a stable full-length infectious cDNA clone derived from DHAV-3 by solving instability of cloned full-length cDNA in Escherichia coli (E. coli). The cDNA fragments amplified from the genome of DHAV-3 were assembled and inserted into a low-copy-number plasmid. Finally, a full-length cDNA clone containing an engineered SacII site that served as a genetic marker was obtained. The cDNA clone showed stable by serial passages in E. coli when propagated at 25°C under low level of antibiotic selection. BHK-21 cells were transfected with transcribed RNA from the full-length cDNA clone; infectious viral particles were rescued, showing its fatality to 10-day-old duck embryos. The results indicated that the constructed full-length cDNA clone of DHAV-3 is infectious. By various virological assays, our results indicated that the rescued virus exhibited similar biological properties with the parental virus. Animal experiments revealed that the rescued virus retained the high pathogenicity to 1-day-old ducklings and could induce a fatal hepatitis indistinguishable from its parental virus. Our present studies provide a useful tool for future research on genomic functions and molecular pathogenesis of DHAV-3.     

The distribution of HLA-A, -B, and -DRB1 alleles and haplotypes in inhabitants of Guizhou Province of China

The present study was aimed to analyze the frequencies of human leukocyte antigen (HLA)-A,-B,and-DRB1 alleles and A-B-DRB1,A-B,A-DRB1 and B-DRB1 haplotypes in inhabitants of Guizhou province,China.All samples were typed in the HLA-A,-B,and-DRB1 loci using the polymerase chain reaction-reverse sequence specific oligonucleotide probe (PCR-rSSOP) method and HLA polymorphisms were analyzed.A total of 18 HLA-A,31 HLA-B,and 13 HLA-DRB1 alleles were found in the Guizhou population.The first two frequent alleles in the HLA-A,-B,and-DRB1 loci were A11(30.72%) and A02(30.65%),B40(16.27%) and B46(16.27%),and DRB109(15.91%) and DRB115(13.51%),respectively.The most common haplotype was A02-B46DRB109(5.59%) in A-B-DRB1,A02-B46(11.73%) in A-B,B46-DRB109(7.49%) in B-DRB1,and A02DRB109(8.08%) in A-DRB1.Some haplotypes with strong linkage disequilibrium (LD) were found not only in the common haplotypes,such as A33-B58,B30-DRB107,and B33-DRB103,but also in the rare haplotypes,such as A01-B37,B37-DRB110,and A01-DRB110.Guizhou inhabitants shared some characteristics of the Southern Chinese population but also had their own unique features.Overall,HLA polymorphism in Guizhou population was more consistent with that of Chengdu population than that of other populations in China.     

碱性成纤维细胞生长因子对体外培养人羊膜间充质干细胞增殖的影响

目的观察不同浓度碱性成纤维细胞生长因子（bFGF）对体外培养人羊膜间充质干细胞（HAMSCs）增殖的影响,以探索体外培养HAMSCs的最适条件。方法分离、培养HAMSCs,选取第3代细胞进行鉴定及检测。实验组将bFGF分为0.1、0.5、1、5、10、20、40、80ng/ml共8个浓度组;阴性对照组只加HAMSCs,不加bFGF;空白对照组只加培养基。各组孵育48h后加入Am-Blue试剂,继续孵育,待培养基由靛青蓝色开始变成粉红色时取出用酶标仪测量各组的吸光度（OD）,重复3次实验。结果 0.5、1、5、10、20、40、80ng/ml浓度组与对照组相比,差异均有统计学意义（P〈0.05）;10ng/ml组与0.5、1、5ng/ml组相比,差异均有统计学意义（P〈0.05）;10ng/ml组与40、80ng/ml组相比,差异无统计学意义（P=0.067）,表明bFGF促增殖作用最强的最小浓度为10ng/ml。结论 bFGF能够促进HAMSCs增殖,且促增殖作用最强的最小浓度为10ng/ml。     

沙盘模拟在产科专科培训的应用初探

目的探讨沙盘模拟培训在产科专科培训应用中的可行性和有效性。 方法培训班以沙盘模拟形式对学员进行产科急危重症与助产技术培训，采用"沙盘推演—学员操作—导师点评—导师演示"的培训模式，内容包括子痫、产后出血、肩难产、阴道助产和新生儿窒息复苏。选取200名学员为研究对象，并随机分成5个团队，培训前后对学员进行理论知识和操作技能考核，根据考核标准由导师组进行打分，并对每个团队的抢救流程进行考核评分。同时培训前后发放调查问卷对培训课程进行反馈。 结果经培训后，学员的理论考核成绩(91.1±14.5)分较培训前(75.6±24.0)分明显提高，差异有统计学意义(P<0.05)。各操作模块考核前后成绩分别为：子痫(73.7±5.6)分与(90.6±3.9)分，产后出血(71.2±8.7)分与(88.9±4.8)分，阴道助产(70.1±7.9)分与(90.0±4.8)分，肩难产(74.6±5.7)分与(91.5±2.3)分，新生儿窒息(73.2±4.7)分与(91.2±2.5)分，培训后成绩明显提高，差异有统计学意义(P<0.05)。团队考核的Topsis分析结果显示，团队3在多项指标上都是最优秀的，综合排名第一名，尤其是方案设计。团队5在临床技能表现突出，在团队配合和患者沟通方面做得也比较好。团队2和团队4各项指标都表现不足。 结论团队3大部分成员来自三甲医院，经常参加产科模拟培训班，因此总体素质较高，而团队2和团队4来自基层医院的成员居多，接受培训的次数较少，因此成绩偏弱，尤其在流程、沟通和团队配合等方面，还需要加强培训。沙盘模拟培训作为一种新型的体验式培训模式，具有创新性、互动性、趣味性，并具有实战性，在产科急危重症专科培训中具有较大的发展前景。     

慢性牙周炎患者血清生化指标分析

目的通过分析牙周炎患者和牙周健康者的血糖、血脂、血清钙水平,探讨血清生化指标的异常是否对牙周炎的发生发展起促进作用。方法研究对象225人均无全身系统性疾病,病例组为慢性牙周炎患者145人,以临床附着丧失（CAL）<3 mm或CAL≥3 mm分为轻度组和中、重度组,对照组为牙周健康者80人,空腹抽取静脉血,检测血糖、血脂和血清钙水平,用SPSS 12.0统计软件包对血清学指标进行统计分析。结果病例组和对照组血脂和血清钙水平无显著差异（P>0.05）,病例组血糖、低密度脂蛋白高于临界值者和高密度脂蛋白、血清钙低于临界值者比例明显高于对照组（P<0.05）,轻度组血糖、甘油三酯、低密度脂蛋白水平明显低于中、重度组（P<0.05。结论血糖、血脂升高,血清钙降低可能增加宿主对牙周炎的易感性和促进牙周炎的发展。     

Endovascular Treatment of Autogenous Radiocephalic Fistulas with the “Eighth Note” Deformity for Hemodialysis

The purpose of this paper is to describe a unique “eighth note” deformity of the autogenous radiocephalic fistula for hemodialysis and to retrospectively evaluate the efficacy and safety of its endovascular treatment. Over 3 years, a total of 808 patients and 558 autogenous radiocephalic fistulas were treated for vascular access dysfunction or thrombosis. These included 14 fistulas in 14 patients (9 men, 5 women; mean age, 58.2 ± 2.8 years; range 27–79 years) whose fistulograms before treatment resembled a musical note, the eighth note. Endovascular treatment sought to remodel the deformed vascular access to a classic radiocephalic fistula and increase the number of cannulation sites available for hemodialysis. The technical and clinical success rates were each 92.8% (13/14). Fistula remodeling was successful in 13 patients. The postintervention primary patency was 100% at 90 days, 91.7 ± 0.8% at 120 days, 78.6 ± 13.9% at 180 days, 62.9 ± 17.9% at 360 days, 31.4 ± 24.0% at 540 days, and 0% at 720 days. The postintervention secondary patency was 100% at 90 days, 100% at 120 days, 100% at 180 days, 85.7 ± 13.2% at 360 days, and 85.7 ± 13.2% at 720 days. No major complications were noted. Minor complications were found in 71.4% of patients, all of which resolved spontaneously. In conclusion, endovascular treatment of fistulas with the eighth note deformity can effectively increase the number of available cannulation sites, facilitate fistula maturation, and facilitate thromboaspiration after fistula thrombosis.     

Evidence of Coulomb blockade behavior in a quasi-zero-dimensional quantum well on TiO2 surface

Line defects on the surface of rutile TiO₂(110) form in pairs separated by 1.2 nm creating a quantum well. The well is effectively closed by the presence of two charged structures at both ends separated by a distance in the 10–20 nm range. As expected for quantum confinement a long period oscillatory feature of the local density of states is observed and attributed to the formation of discrete quantum states inside the system. It is at first glance surprising that the lowest energy quantum state of the well can be observed at room temperature. The properties of the quantum state cannot be explained in an independent-electron, band-like theory. Instead, electron-electron correlation must be included to give a satisfactory picture of the spatial distribution of the charge density. Theory predicts charging energies of 1.30 eV and 1.14 eV for quantum well lengths of 14 nm and 16 nm, respectively, in good agreement with a classical calculation and the size dependence of the capacitance. This observation opens up the possibility of experimentally imaging the transition from a Coulomb blockade localized in a zero-dimensional system to an independent-particle or band-like behavior in an extended one-dimensional system.     

Zacopride对血管紧张素Ⅱ诱发的心肌纤维化的影响

目的:研究内向整流钾通道(IK1)激动剂扎考必利(zacopride,Zac)对血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)诱导的心脏成纤维细胞(cardiac fibroblasts,CFb)细胞活力和凋亡的影响,探讨其抑制心肌纤维化的机制。方法:以组织块消化和差速贴壁法原代分离培养SD乳鼠心室成纤维细胞,用AngⅡ诱导细胞建立细胞活化模型。将分离培养的CFb随机分为空白对照组、AngⅡ模型组、Zac干预组、Zac+Ba Cl2干预组、Zac+氯喹干预组和AngⅡ+卡托普利阳性对照组。CCK-8法检测Zac对CFb活力的影响;ELISA法测定CFb上清液中Ⅰ、Ⅲ型胶原含量;流式细胞术检测细胞凋亡率;Western blot检测心肌内向整流钾通道蛋白Kir2.1表达的变化。结果:与空白对照组比较,AngⅡ模型组CFb活力及胶原合成显著增加,Kir2.1的表达降低(P0.05);与AngⅡ模型组比较,Zac干预组CFb活力及胶原合成显著降低,凋亡率显著升高,Kir2.1的表达明显上调(P0.05);IK1阻断剂Ba Cl2和氯喹可阻断Zac对IK1通道的激动效应,明显逆转Zac的抗心肌纤维化作用。结论:Zac可明显抑制AngⅡ诱发的心肌纤维化,其机制可能与激动心肌内向整流钾通道,进而抑制成纤维细胞活力并诱导其凋亡有关。