小鼠输尿管梗阻后肾脏间质病变及抗细胞间粘附分子1单克隆抗体的治疗作用

利用单侧输尿管梗阻制备小鼠肾间质病变模型，观察了肾间质中细胞间粘附分子－１（ＩＣＡＭ－１）及Ｍａｃ－１阳性细胞的变化，并利用抗小鼠ＩＣＡＭ－１单克隆抗体对此模型进行了治疗。结果发现在单侧输尿管梗阻后第一天，梗阻侧肾间质小血管附近及近端肾小管上即有ＩＣＡＭ－１及ＩＣＡＭ－１ｍＲＮＡ的表达，第３～５天达高峰，第７天时开始下降。与此同时，肾间质内Ｍａｃ－１阳性的巨噬细胞也于梗阻后第３天开始出现，第７天达高峰。经抗ＩＣＡＭ－１单克隆抗体治疗后，ＩＣＡＭ－１及Ｍａｃ－１的表达均延迟出现并明显减弱，肾间质病理改变亦有所减轻。     

外周血甲胎蛋白mRNA和白蛋白mRNA在评估肝癌微小转移中的比较研究

目的　探讨肝病患者外周血甲胎蛋白mRNA(AFPmRNA)和白蛋白mRNA(ALBmRNA) ,作为肝癌微小转移标志物的特异性。方法　提取患者和健康志愿者的外周血单个核细胞总RNA ,进行RT PCR ,扩增产物再进行Southern杂交。结果　原发性肝癌 (HCC)组外周血AFPmRNA的检出率为 4 1.4 % ,对照组为 0 % ,差异显著 (P <0 .0 5 ) ;HCC组外周血ALBmRNA的检出率为4 4 .8% ,对照组为 2 9.2 % ,二者差异无统计学意义 (P >0 .0 5 )。结论　作为肝癌微小转移的标志物 ,外周血AFPmRNA的特异性高于ALBmRNA     

Novel and Novel De Novo Mutations in NTRK1 Associated With Congenital Insensitivity to Pain With Anhidrosis: A Case Report

Congenital insensitivity to pain with anhidrosis (CIPA) is a very rare autosomal recessively inherited disorder. The main clinical features of the disorder consist of absence of reactions to noxious stimuli and inability to sweat under any conditions.In this case report, a 3-year-old Chinese boy diagnosed with CIPA presented with the core features of CIPA, including insensitivity to noxious stimuli, self-mutilation, inability to sweat, and developmental delay. Clinical and genetic analyses were conducted on the affected boy.Sequencing analysis revealed an inherited novel mutation, c.1635G>C, and a novel de novo mutation, c.2197G>A, in the NTRK1 gene. In silico studies suggested that the mutations described are detrimental to the function of the protein encoded by the NTRK1 gene.The two novel mutations described here widen the genetic spectrum of CIPA, and this knowledge will benefit studies addressing this disease and pain medicine in the future.     

原发性高血压遗传度的研究

对５１４例原发性高血压家族史进行Ｆａｌｃｏｎｅｒ法遗传度研究，结果表明，高血压组一级亲属现患率为１８．７９％较对照组（５％）高约４倍，男先证者父亲高血压现患率高于其母亲的现患率，而女性先证者则相反。旧Ｆａｌｃｏｎｅｒ方法进行性别分层计算，高血压遗传度估计为７１．７４±２．９７％。研究表明原发性高血压的分布有明显家族聚集性，其遗传倾向有明显的性别差异。     

卵巢性索间质肿瘤的低场MR诊断

目的 探讨卵巢性索间质肿瘤(OSCST)的低场MRI表现,提高对该病的诊断水平.方法 回顾性分析经手术病理证实的13例OSCST的临床、MR影像资料.结果 8例实性肿块,6例卵泡膜细胞瘤,2例纤维瘤,T1WI呈等低信号,T2WI低信号中夹杂条索状、片絮状高信号,5例轻度强化、1例明显强化、1例纤维瘤不强化.5例颗粒细胞瘤,表现囊实性肿块,囊壁及分隔粗厚、光滑,T1WI呈等信号,T2WI呈稍高信号;囊性部分呈长T1、长T2信号;肿块实质、囊壁及分隔明显强化.本组正确诊断10例(76.9%),误诊阔韧带肌瘤2例、胃肠间质瘤1例.结论 OSCST在低场MRI上表现具有一定特征性,对该病具有一定的诊断价值.     

A 4 year prospective study to determine risk factors for severe community acquired pneumonia in children in southern China

Background

Pneumonia is the major cause of death under 5 years. With high CAP numbers in China and growing access to PICUs, factors associated with severe CAP need to be determined to optimize care.

Objective

To prospectively determine PICU CAP admission features and outcomes.

Methods

A 4 year prospective study of CAP aged 1 month to <14 years admitted to PICU, Children's Hospital Affiliated to Soochow University, China. All were managed in a standard manner. Clinical, laboratory, and imaging findings were collected systematically. All received antibiotics.

Results

Eight hundred ten (7%) of 10,836 CAP hospital admissions needed PICU. Seven hundred seven (87%) were enrolled. PICU CAP children were young (76% ≤ 12 months) and 33% had co‐morbid conditions; 21% congenital heart disease.21% required mechanical ventilation. The average length of PICU stay was 5 days (range, 3–27). The case fatality rate was 5.8%. Viruses were detected in 38%, RSV 24%; bacteria in 23%, Streptococcus pneumoniae 7%, Haemophilus influenza b 4%, Mycoplasma 11%. On single factor analysis, PICU admission respiratory rate >70/min, grunting/groaning, head nodding, cyanosis, and anemia were associated with respiratory failure and with fatality. On multivariate analysis only presence of congenital heart disease, Trisomy 21 and immunodeficiency correlated with fatality; not microbe nor PICU findings.

Conclusions

Young age and underlying congenital heart disease were associated factors for PICU support in CAP in China. Early referral if altered sensorium, high respiratory rate, head nodding, grunting and anemia, and universal access to conjugated vaccines may decrease morbidity and mortality. Pediatr Pulmonol. 2013; 48:390–397. © 2012 Wiley Periodicals, Inc.

     

Synthesis of manganese-oxide and palladium nanoparticles co-decorated polypyrrole/graphene oxide (MnO2@Pd@PPy/GO) nanocomposites for anti-cancer treatment

Design and fabrication of novel multifunctional nanomaterials as novel “theranostic nanoagents”with high efficiency and low side effects is important for cancer treatment. Herein, we synthesized manganese-oxide and palladium nanoparticle-co-decorated polypyrrole/graphene oxide (MnO₂@Pd@PPy/GO) nanocomposites, which could be used as a novel “theranostic nanoagent” for cancer treatment. Various spectroscopic and microscopic characterizations of the synthesized MnO₂@Pd@PPy/GO nanocomposites suggest that the nanocomposites are assembled sequentially by graphene oxide, polypyrrole, palladium nanoparticles and manganese-oxide nanoplates. Further research revealed that the nanocomposites had excellent photothermal conversion performance (reached near 50 °C after 10 min of irradiation), pH responsive enzymatic-like catalytic activity and enhanced magnetic resonance imaging (MRI) performance (r₁ = 7.74 mM⁻¹ s⁻¹ at pH 5.0 and glutathione (GSH)). Cell experiments also testified that combined cancer treatment (the viability of cancer cells is 30%) with photothermal therapy (PTT, the viability of cancer cells is 91% only with irradiation) and chemodynamic therapy (CDT, the viability of cancer cells is 74.7% only with nanocomposites) guided by MRI was achieved when the as-prepared nanocomposites were employed as theranostic nanoagents. This work could provide some new ideas for the controllable synthesis and application of multicomponent nanomaterials.

Manganese-oxide and palladium nanoparticle-co-decorated polypyrrole/graphene oxide (MnO₂@Pd@PPy/GO) nanoenzyme composites were synthesized, and could be as a novel “theranostic nanoagent” for cancer treatment due to excellent performance.     

坐姿下不同组织压力性损伤生物力学研究

目的 探讨坐姿下臀部压力性损伤易发部位以及不同软组织的生物力学响应,为有效预防深层组织压力性损伤提供参考。 方法 基于臀部 CT 扫描数据,建立坐位臀部有限元模型,包括骨骼、肌肉、脂肪和皮肤组织及坐垫模型,利用生死单元模拟组织损伤。 对比实验坐垫界面压力测量数据与有限元模拟结果,验证模型有效性。 模拟坐位力学状态,研究软组织的应力、应变情况,分析不同软组织中的压应力及超出极限值后可能造成的损伤情况。结果 通过对比坐垫模型仿真结果与实验界面压力测量结果,证明模型有效。 坐位时坐骨结节下方软组织区域出现应力集中现象。 其中,臀大肌组织中的横向压应力峰值约为 38 kPa,剪切应力峰值约为 3. 4 MPa;而脂肪组织中的最大压应力与剪切应力峰值分别为 22 kPa 与 4. 5 MPa,均未出现在坐骨结节正下方。 结论 软组织受到一定时间和大小的压力载荷作用,可能出现深层组织损伤。 当保持坐姿一定时间后,应及时变换体位,以降低压力性损伤出现的概率。 研究结果为预防压力性损伤提供生物力学依据,具有重要的临床研究价值。     

甲状腺相关眼病患者复视的手术治疗

目的探讨甲状腺相关眼病患者下直肌肥大引起复视的手术治疗时机及效果，并观察下直肌组织病理学改变。方法 对11例因下直肌肥大致复视的甲状腺相关眼病患者行下直肌退后术，术中取下直肌标本行组织病理学检查，术后观察疗效。结果 所有患者术后向下注视及水平注视复视症状消失，眼位基本正常。病理学检查见肌纤维僵硬，肌细胞退变，数目变少，肌内膜，肌束膜及肌外膜大量结缔组织增生，眼外肌增在。结论 甲状腺相关眼病患者下直肌大量纤维结缔组织的增生，肌纤维的变性导致的舒缩功能的降低，可导致复视；行下直肌退后术可消除复视。     

女性失眠患者相关影响因素的研究

目的 探讨影响女性失眠的相关危险因素。方法 采用病例一对照研究和流行病学方法调查女性患者的睡眠情况，其中对照组354例，急性失眠组89例及慢性失眠组356例，并采用多元Logistic回归模型分析影响失眠的因素。结果 焦虑（OR=1．978，P=0．024）、抑郁（OR=2．097，P=0．014）与急性失眠显著相关；焦虑（OR=2．592，P=0．000）、抑郁（OR=3．673，P=0．000）、打鼾（OR=1．637，P=0．006）、饮酒（OR=3．105，P=0．046）与慢性失眠显著相关。结论 女性失眠与焦虑、抑郁、打鼾及饮酒有关。