胎盘组织中解脲脲原体感染的检测与分型

应用扩增解脲脲原体（Ｕｕ）ＭＢ抗原基因的ＰＣＲ方法与培养法对照检测了３２例新鲜胎盘组织,结果ＰＣＲ扩增阳性８例,其中属于生物Ⅰ型Ｕｕ５例,生物Ⅱ型３例,ＰＣＲ扩增阳性的新生儿出生时体重平均比扩增阴性的新生儿低０６２ｋｇ,且以感染Ｕｕ生物Ⅰ型者更为显著,培养法检出Ｕｕ阳性５例。结果提示胎盘组织中Ｕｕ检出率,ＰＣＲ法显著高于培养法,感染胎盘的Ｕｕ可引起新生儿体重降低,可能与Ｕｕ生物Ⅰ型有关。     

成人斯蒂尔病109例临床分析

目的探讨成人斯蒂尔病的发病、临床特点及治疗、预后转归情况.方法回顾性分析109例成人斯蒂尔病患者的临床资料.结果成人斯蒂尔病长期临床控制者为26.60%,周期性反复发作者为62.38%,演变为类风湿关节炎者为5.50%,平均时间为5.2年,演变为淋巴瘤者为0.92%,死亡4.59%.结论成人斯蒂尔病大部分为周期性反复发作型,血清学无特异性检查,血清铁蛋白的测定有助于本病的诊断.患者累及关节以腕关节最常见.小部分患者最终演变为典型的类风湿关节炎.非甾体类消炎药对大部分患者无效,需用激素,甚至免疫抑制剂控制病情.     

Hysteroscopic removal of foreign bodies and its method of monitoring

Objective To evaluate transcervical removal of foreign bodies(TCRF)and to estimate the effectiveness of its monitoring methods.Methods One hundred and thirteen women were identified as having residual intrauterine devices(IUD),residual pregnancy products,unabsorbed strings and broken hooks,which were not removed during routine curettage of IUD removal.All patients were monitored using B ultrasonography while TCRF was performed.Four cases were monitored by laparoscopy simultaneously.One case was monitored by laparoscopic ultrasonography.Results Foreign bodies of one hundred and nine patients were taken out by TCRF.Uterine bleeding, amenorrhoea,discharge,abdominal pain,mlcturition and hematuria disappeared postoperatively.Fetal bones embedded into intramural uterin in four cases were not removed completely.Of these four,one became pregnant 4 months later after TCR and term delivered.One case encountered uterine perforation that was sutured by laparoscopy.Conclusions TCRF is safe and efficient.Sufficient cervical canal distension,selection of equipment and methods to be used is important for successful TCRF.As a non-invasive and effective monitoring method,B ultrasonography is the first choice to monitor for TCRF.For patients with high risk factors for uterine perforation,laparoscopic monitoring should be done simultaneously.Laparoscopic ultrasonography monitoring has both the advantages of B ultrasonography and laparoscopy monitoring,but is invasive and expensive.     

2型糖尿病患者LP(a)水平与代谢综合征的关系

目的研究2型糖尿病患者LP(a)水平与伴发的代谢综合征组分相关性。方法采用横断面研究对上海地区1040例2型糖尿病患者进行了LP(a)水平的调查，同时采用Spearman单因素相关、Partial偏相关分析LP(a)与代谢综合征各组分的相关性，同时根据患者伴发代谢综合征组分数目分组，并对组间LP(a)水平进行统计分析。结果2型糖尿病患者LP(a)水平与尿微量白蛋白排泄率、血尿酸、空腹血糖及低密度脂蛋白胆固醇呈显著正相关性，而与胰岛素敏感指数呈显著负相关，但与肥胖、血压等无明显关联。同时LP(a)水平随着伴发代谢综合征组分数目的增加而明显升高。结论LP(a)水平与代谢综合征关系密切；监测2型糖尿病患者LP(a)水平有助于了解2型糖尿病患者伴发代谢综合征的情况；降低LP(a)水平有利于预防2型糖尿病患者慢性并发症的发生。     

Cryo-EM structure of DNA-bound Smc5/6 reveals DNA clamping enabled by multi-subunit conformational changes

Structural maintenance of chromosomes (SMC) complexes are essential for chromatin organization and functions throughout the cell cycle. The cohesin and condensin SMCs fold and tether DNA, while Smc5/6 directly promotes DNA replication and repair. The functions of SMCs rely on their abilities to engage DNA, but how Smc5/6 binds and translocates on DNA remains largely unknown. Here, we present a 3.8 Å cryogenic electron microscopy (cryo-EM) structure of DNA-bound Saccharomyces cerevisiae Smc5/6 complex containing five of its core subunits, including Smc5, Smc6, and the Nse1-3-4 subcomplex. Intricate interactions among these subunits support the formation of a clamp that encircles the DNA double helix. The positively charged inner surface of the clamp contacts DNA in a nonsequence-specific manner involving numerous DNA binding residues from four subunits. The DNA duplex is held up by Smc5 and 6 head regions and positioned between their coiled-coil arm regions, reflecting an engaged-head and open-arm configuration. The Nse3 subunit secures the DNA from above, while the hook-shaped Nse4 kleisin forms a scaffold connecting DNA and all other subunits. The Smc5/6 DNA clamp shares similarities with DNA-clamps formed by other SMCs but also exhibits differences that reflect its unique functions. Mapping cross-linking mass spectrometry data derived from DNA-free Smc5/6 to the DNA-bound Smc5/6 structure identifies multi-subunit conformational changes that enable DNA capture. Finally, mutational data from cells reveal distinct DNA binding contributions from each subunit to Smc5/6 chromatin association and cell fitness. In summary, our integrative study illuminates how a unique SMC complex engages DNA in supporting genome regulation.

Structural maintenance of chromosomes (SMC) complexes are essential genome regulators in both prokaryotes and eukaryotes. In eukaryotes, the cohesin and condensin SMC complexes organize DNA, while the Smc5/6 complex (referred to as Smc5/6) directly regulates DNA replication and repair (1). At the structural level, SMC complexes share similarities while possessing unique attributes (1). Each complex contains a pair of SMC subunits and a set of non-SMC subunits. The SMC subunits define the tripartite filamentous architecture of the complex: their approximal 50-nm long coiled coil arm region connects their dimerized hinge and adenosine triphosphatase (ATPase) head regions (1). A non-SMC kleisin subunit uses its N- and C-terminal domains to link the head of one SMC to the head-proximal arm region (neck) of another SMC, forming a trimeric SMC-kleisin structure. In cohesin and condensin, two large U-shaped HEAT (Huntington, elongation factor 3, PR65/A, TOR) repeat HAWK (HEAT proteins associated with kleisins) subunits attach to the middle region of the kleisin. By contrast, the Smc5/6 kleisin (Nse4) binds to smaller WH (winged helix)-containing KITE (kleisin interacting tandem WH elements) subunits (Nse1 and Nse3) (2).SMC-mediated functions depend on interactions with DNA. Recent cryogenic electron microscopy (cryo-EM) structures of DNA-bound cohesin and condensin revealed that their HAWK subunits and the SMC head-neck regions form a clamp to enclose a single DNA double helix (3–7). DNA clamping can be critical for cohesin and condensin to extrude DNA loops for chromatin folding (5, 7–9). DNA loop extrusion additionally requires arm bending at a region called the elbow, which is found in both cohesin and condensin (5, 7–9). By contrast, a lack of arm bending in Smc5/6 was suggested by negative stain EM and cross-linking mass spectrometry (CLMS) data (10–14). Since Smc5/6 does not contain HAWK proteins nor shows arm-bending, it has remained unclear how Smc5/6 engages DNA to accomplish its multiple functions.Here we address the molecular mechanisms by which this unique SMC complex binds DNA using an integrative approach, coupling a cryo-EM-based structural characterization with CLMS analyses and functional investigation. Our atomic structure of a DNA-bound Saccharomyces cerevisiae Smc5/6 complex reveals that the head-neck Smc5-6 regions and the Nse1-3-4 subcomplex together form a clamp entrapping the DNA helix. The structure further reveals protein subunit folds and association, as well as how the subunits collaborate to entrap DNA. Comparison of CLMS analyses of DNA-free Smc5/6 with the structure of the DNA-bound Smc5/6 unveils large scale, multi-subunit conformational changes that enable Smc5/6 to encircle DNA. Finally, our mutational data suggest distinct contributions from each of the DNA binding regions to Smc5/6 chromatin association and cellular fitness. Comparison of our findings with those of other SMCs reveals that diverse SMC complexes use a similar DNA clamping strategy despite structural differences, and that Smc5/6 possesses unique features distinct from cohesin, condensin, and prokaryotic SMCs. Our work lays the foundation for an in-depth understanding of how Smc5/6 fulfills unique roles in genome protection.     

新型冠状病毒肺炎后潜水员适潜性评估

新型冠状病毒肺炎（COVID?19）自2019年底爆发以来,对人类生命健康造成了极其严重的危害。作为一种呼吸系统疾病,COVID?19对全身几乎所有器官都会产生影响,其中最主要的受累器官为肺和心脏。随着COVID?19 “康复”患者数量不断增加,越来越多的证据表明,因COVID?19而住院治疗得到“康复”的患者中有相当大比例的人群存在着后遗症,主要表现为呼吸系统和心血管系统的症状。对于潜水员,COVID-19后运动耐受、心肺功能的恢复对于其适潜性具有重要的影响。一些组织和机构对于潜水员COVID-19后的适潜性评估,发布了指南。本文对COVID-19后呼吸和心血管后遗症以及相关的适潜性评估方案进行简要介绍,并基于已有的相关要求和我国实际,初步提出我国潜水员COVID-19后的适潜性评估要求。     

基于复杂系统中因果关系的单细胞病理学

肿瘤是由肿瘤细胞和周围的微环境组成的复杂生态系统。在病理学上,肿瘤中细胞各异、分布和生理功能千差万别,并且受自身、周围环境和治疗的调节,自成复杂系统。单细胞分析技术为病理学复杂系统的研究提供了更多的信息。利用复杂系统中的因果判定方法,可以揭示单细胞的复杂的调节作用,以及不同类型的肿瘤细胞与患者治疗方案、治疗效果、疾病复发和生存时间的因果关系。     

双入路小切口坏死组织清除术联合持续灌注引流治疗感染性坏死性胰腺炎的临床疗效

目的:探讨双入路小切口坏死组织清除术联合持续灌注引流治疗感染性坏死性胰腺炎（INP）的临床疗效。方法:采用回顾性描述性研究方法。收集2016年4月至2019年7月陆军军医大学大坪医院收治的20例INP病人的临床资料;男11例,女9例;年龄为（42 ±9）岁。20例病人均行双入路小切口坏死组织清除术,联合术后...     

Human influenza A (H5N1) cases, urban areas of People's Republic of China, 2005-2006

We investigated potential sources of infection for 6 confirmed influenza A (H5N1) patients who resided in urban areas of People's Republic of China. None had known exposure to sick poultry or poultry that died from illness, but all had visited wet poultry markets before illness.