外源性硫化氢对双侧卵巢摘除骨质疏松模型大鼠骨代谢的影响

背景:外源性硫化氢(H2S)对成骨细胞的形成和分化有重要的影响,成骨细胞是骨质疏松疾病发生发展的重要功能细胞,而外源性H2S对骨质疏松水平及相关激素的影响尚未见研究.目的:探讨内源性H2S浓度与骨质疏松的相关性,以及补充外源性H2S对骨代谢临床随访常用生化、激素指标的影响.方法:纳入60只大鼠,随机分为3组(n=20)...     

Syphilitic uveitis in HIV-positive patients: report of a case series, treatment outcomes, and comprehensive review of the literature

AIM: To report the clinical characteristics, treatment and outcomes of active syphilitic uveitis in human immunodeficiency virus (HIV) positive patients and compare them with the previously published data. METHODS: Retrospective analysis of the case series from an infectious disease center in southern China was conducted. Comprehensive review of previously published cases of HIV positive syphilitic uveitis was conducted using the PubMed and Web of Science databases and the references listed in the identified articles. RESULTS: Twelve HIV positive patients with active syphilitic uveitis were collected. All were male, with age of 36.3y (range 27 to 53y). Five (41.7%) had a history of syphilis, and three of them had received anti-syphilis treatment. Ocular manifestations included corneal epithelial defect (13%), complicated cataract (17.4%), vitreous opacity (82.6%), optic disc edema (26.1%), macular edema (30.4%), neuro-retinitis (43.5%), and retinal hemorrhage (26.1%). After standardized syphilitic treatment, intraocular inflammation was reduced and vision improved in all cases. The literature review summarizes 105 previously reported cases of HIV positive syphilitic uveitis. High serum rapid plasma regain (RPR) titers may be associated with severe uveitis and poor vision. Treatment with penicillin, ceftriaxone sodium, or penicillin plus benzylpenicillin instead of using benzylpenicillin alone can significantly improve best-corrected visual acuity (BCVA) in HIV positive ocular syphilis patients. CONCLUSION: For HIV positive syphilitic uveitis patients, prompt diagnosis and appropriate treatment and follow-up are paramount. In our series, the clinical manifestations are diverse. Syphilis patients treated by penicillin G or long-acting penicillin before may still develop syphilitic uveitis. Patients who relapse after long-term penicillin treatment can still benefit from penicillin G.     

糖尿病足发病风险筛查和评估的最佳证据总结

目的 总结糖尿病足发病风险筛查和评估的最佳证据。方法 检索国内外相关数据库和专业团体网站中有关糖尿病足发病风险筛查和评估的证据,包括指南、证据总结、推荐实践和系统评价。检索时限为建库至2020年1月5日。应用临床指南研究与评价系统、系统评价评估工具、JBI证据预分级及证据推荐级别系统对文献进行质量评价和证据等级评定。结果 共纳入9篇文献,包括5篇指南、1篇证据总结、1篇推荐实践和2篇系统评价。从全面采集健康史,周围神经病变的风险筛查和评估,末梢血管病变的风险筛查和评估,足部皮肤检查,足部压力的测量、足部畸形和鞋类的检查,风险分层系统的应用,风险筛查和评估的频率7个方面总结21条最佳证据。结论 最佳证据总结为临床开展规范化的糖尿病足发病风险筛查和评估提供了循证依据,医护人员应结合临床环境与患者特点,合理地应用证据。     

Prophylactic juxtapapillary laser photocoagulation in pediatric morning glory syndrome

AIM: To determine the anatomic and visual outcomes of prophylactic juxtapapillary laser photocoagulation treatment alone in the prevention of retinal detachment (RD) in a cohort of pediatric patients diagnosed with morning glory syndrome (MGS). METHODS: A total of 24 eyes of 22 consecutive patients aged 0-15y diagnosed with MGS treated with prophylactic juxtapapillary laser photocoagulation alone were reviewed. Data including demographics, ocular examination, anatomic and visual outcomes, following treatment and complications were collected. RESULTS: Two patients had bilateral laser treatment and 20 had monocular laser treatment. The age at treatment of 13 (59.1%) patients was less than 12mo. The presenting symptoms included strabismus (6/22, 27.3%), decreased vision (2/22, 9.1%), and routine fundus screening (14/22, 63.6%). Fifteen (68.2%) patients underwent cranial magnetic resonance imaging (MRI) examinations, and 3 of those 15 (20.0%) had abnormal findings in the nervous system. Based on preoperative wide-field fundus photography and B-scan echography, all (100.0%) eyes had no obvious RD. On postoperative 1mo and 6mo and the following follow-ups, the anatomic outcomes of all eyes remained stable. The mean follow-up duration was 27.7±17.5mo. No severe complications were found. Preoperative visual acuity acquired from 2 (9.1%) patients ranged from light perception to 20/200. Postoperative acuity acquired from 11 (50.0%) patients ranged from light perception to 20/125. CONCLUSION: The preliminary anatomic and visual outcomes of prophylactic juxtapapillary laser treatment alone in pediatric MGS patients are relatively stable in a short-term follow-up. Further long-term clinical observation will be needed to confirm its efficacy and safety.     

The effect of folic acid on genetic damage induced by ethanol in human lymphoblast cell line

目的:探讨叶酸(folic acid,FA)对乙醇(ethanol,EtOH)诱发的人成淋巴细胞遗传损伤的影响.方法:人成淋巴细胞株GM12593培养在含有不同FA浓度(20、200、2 000 nmol/L)的RPMI-1640培养基中,并同时在每种FA浓度的培养体系中分别加入0.09％、0.36％和1.34％ (V/V)的EtOH,8 d后用细胞松弛素B(cytochalasin B,CB)处理28 h,胞质阻断微核细胞组分析(cytokinesis-block micronucleus cytome assay,CBMN Cyt)比较不同培养条件下的细胞遗传损伤,包括微核化双核细胞(micronucleated binueleated cell,MNed BNC)、核芽(nuclear bud,BUD)、核质桥(nucleoplasmic bridges,NPB)的频率差异.结果:乙醇在受试细胞中诱发MNed BNC、BUD和NBP频率显著升高(P＜0.01);2 000 nmol/L的叶酸能显著降低由乙醇诱发的MNed BNC、BUD和NBP频率(P＜0.01).结论:乙醇对细胞遗传物质具有损伤效应,叶酸对乙醇的遗传毒性具有防护效应.     

抗击严重急性呼吸综合征的医生与护士心理状态的比较与分析

为分析抗击严重急性呼吸综合征(SARS)的医生与护士的心理状态和差异,在SARS暴发的3个月中共收集了来自多家SARS定点医院的1532份医生和护士的心理健康问卷,应用时勘心理量表与Zung自评抑郁量表进行分析比较。发现无论处于一线还是二线,医生的一般心理健康得分要高于护士,自评抑郁量表得分低于护士,且护士的自评抑郁量表得分要高于常模组。逐步相关回归分析显示,抑郁量表得分同压力源,如“社会对医护人员的支持不够”,“治疗条件和生活环境不好”,“缺乏家庭亲人的支持和交流”等有关,同参加体育锻炼的程度,文化程度呈负相关。医生的心理状态和抑郁状态好于护士。提示应针对不同原因给予干预,同时应对于发现的相关因素予以改善。     

宠物医院X射线诊断放射防护研究进展

我国宠物医院快速发展, X射线诊断应用也随之增多, 其工作人员和同室协助人员的防护问题值得关注。本文从国际上宠物医院的X射线诊断放射防护相关管理和研究进展出发, 结合我国宠物医院X射线诊断的现状、存在的问题以及各部门的管理规定, 从中总结出我国宠物医院放射防护中政府部门、宠物医院、放射工作人员以及同室协助人员可能出现的典型问题, 并提出当前我国宠物医院放射防护工作的重点, 有助于为政府决策提供科学建议, 规范完善宠物医院的各项放射防护工作。     

刘沈林教授中医治疗结肠息肉经验撷粹

随着内镜技术的发展,结肠息肉的诊断率越来越高,镜下切除术后易复发,而中医药治疗结肠息肉效果显著,文章意在总结刘沈林教授多年来临证中运用中医药治疗结肠息肉的经验,与读者共飨,并附医案1则以佐证.     

磁共振电影成像估价心肌功能

采用磁共振电影成像（Ｃｉｎｅ－ＭＲＩ）估价９例正常人和１３例左心室陈旧心肌梗塞患者的左心室功能状况。其方法是应用小角度翻转角、短ＴＲ和信号聚焦的梯度场成像序列，通过观察左心室各段肌壁运动状态和测量肌壁厚度的变化以判断各段肌壁的运动功能。结果提示，Ｃｉｎｅ－ＭＲＩ无论对心肌壁运动状态的定性还是运动功能的定量均有一定的价值。