Association of Vitamin D in Different Trimester with Hemoglobin during Pregnancy

The association between vitamin D and hemoglobin has been suggested. Vitamin D can affect erythropoiesis by the induction of erythroid progenitor cell proliferation and enhance iron absorption by regulating the iron-hepcidin-ferroportin axis in monocytes. However, this relationship in pregnant women is scarce. The purpose of this study was to investigate the association between plasma vitamin D levels with hemoglobin concentration in pregnant women considering each trimester and iron supplementation. The data were obtained from Zhoushan Pregnant Women Cohort, collected from 2011 to 2018. Plasma 25(OH)D was measured in each trimester using liquid chromatography–tandem mass spectrometry. Generalized estimating equations and multiple linear regressions were performed. Finally, 2962 pregnant women and 4419 observations in the first trimester were included in this study. Plasma 25(OH)D in first trimester (T1) (β = 0.06, p = 0.0177), second trimester (T2) (β = 0.15, p < 0.0001), and third trimester (T3) (β = 0.12, p = 0.0006) were positively associated with Hb. Association between plasma 25(OH)D levels in T1 and Hb concentration was positively associated with gestational age (β = 0.005, p = 0.0421). Pregnant women with VD deficiency in T1 (OR = 1.42, 95% CI: 1.07–1.88) or T2 (OR = 1.94, 95% CI: 1.30–2.89) presented an increased risk of anemia, compared with women without VD deficiency. Moreover, the significant relationship between VD and Hb was only observed among women with iron supplementation during pregnancy. Plasma 25(OH)D levels in each trimester were positively associated with Hb concentration. Iron supplementation might be an important factor affecting the relationship between VD and Hb.     

Generative Design and Integrated 3D Printing Manufacture of Cross Joints

The integrated process of design and fabrication is invariably of particular interest and important to improve the quality and reduce the production cycle for structural joints, which are key components for connecting members and transferring loads in structural systems. In this work, using the generative design method, a pioneering idea was successfully realized to attain a reasonable configuration of the cross joints, which was then consecutively manufactured using 3D printing technology. Firstly, the initial model and generation conditions of a cross joint were constructed by the machine learning-based generative design algorithm, and hundreds of models were automatically generated. Then, based on the design objective and cost index of the cross joint, three representative joints were selected for further numerical analysis to verify the advantages of generative design. Finally, 3D printing was utilized to produce generative joints; the influences of printing parameters on the quality of 3D printing are further discussed in this paper. The results show that the cross joints from the generative design method have varied and innovative configurations and the best static behaviors. 3D printing technology can enhance the accuracy of cross joint fabrication. It is viable to utilize the integrated process of generative design and 3D printing to design and manufacture cross joints.     

达芬奇机器人与开放性手术在肿瘤直径大于1 cm甲状腺癌中的对照研究

目的探讨达芬奇机器人下甲状腺全切＋中央区＋颈侧区淋巴结清扫治疗肿瘤直径>1 cm乳头状甲状腺癌的可行性、有效性及安全性。 方法回顾性分析2014年2月至2018年6月在解放军第九六〇医院甲状腺乳腺外科接受达芬奇机器人腋乳入路甲状腺全切＋中央区＋单侧颈侧区淋巴结清扫术的81例乳头状非微小癌患者(机器人组)的临床资料,与同期接受传统开放手术的87例乳头状非微小癌患者(开放组)进行比较。采用统计学检验比较两组的手术时间、清扫中央区和单侧颈侧区淋巴结数目、术中出血量、住院时间、术后引流量、术后美容效果及手术并发症发生率等。 结果所有患者均顺利完成手术。与开放组相比,机器人组的手术时间及术后引流量多于开放组,术后美容效果更佳(P<0.05);清扫中央区和单侧颈侧区淋巴结数目、术中出血量、术后引流量、并发症发生率等方面差异无统计学意义(P>0.05)。 结论对于有选择性的肿瘤直径>1 cm的乳头状甲状腺癌患者,达芬奇机器人腋乳入路与传统开放手术行甲状腺全切＋中央区＋单侧颈侧区淋巴结清扫治疗安全性和治疗效果相似且术后美容效果更佳。     

低分子肝素对慢性阻塞性肺疾病急性加重期疗效初探

目的:分子肝素在慢性阻塞性肺疾病急性加重期(AECOPD)抗凝治疗中的应用价值。方法:将92例AECOPD患者随机分成对照组和治疗组,每组各46例。治疗组患者在对照组常规治疗基础上予低分子肝素4 000 U皮下注射,每天2次,治疗7 d。观察治疗前后患者肺功能指标FEV1及FEV1/FVC%,血气分析指标Pa O2、Pa CO2,血超敏C-反应蛋白(hs-CRP)和血D-二聚体水平的变化情况。结果:两组FEV1、FEV1/FVC%、Pa O2、Pa CO2、hs-CRP和血D-二聚体水平治疗前后比较,治疗组优于对照组(P<0.05)。结论:低分子肝素治疗AECOPD效果明显。     

大肠癌及癌旁组织中TAG-72抗原及两种凝集素PNA和DBA受体的表达

应用肿瘤相关糖蛋白７２抗原（ＴＡＧ－７２）的单抗７２－４５及两种凝集素ＰＮＡ和ＤＢＡ对不同组织分型的大肠癌及癌旁组织进行了研究。结果表明：大肠癌中ＴＡＧ－７２抗原及ＰＮＡ受体的表达阳性率分别为８５．３％和８９．３％，ＤＢＡ受体呈阴性；在癌旁组织中三者的表达阳性率分别为５０％、５３．３％和６３．３％；在正常大肠粘膜中ＴＡＧ－７２抗原及ＰＮＡ受体均呈阴性，而ＤＢＡ受体全部呈阳性。由此认为７２－４５单抗和ＰＮＡ可做为大肠癌的有效标记物，有助于大肠癌的诊断和预后。     

初级卫生保健试点县妇幼保健投入产出分析

  目的  分析2000 — 2017年京沪妇女保健财力资源适宜程度及孕产妇死亡率的变化趋势,明确2地差异,探讨妇女保健财力资源适宜程度。  方法  收集1995 — 2017年涉及京沪妇女保健财力投入政府主导问题（202篇）、投入总量问题（205篇）和投入增长问题（122篇）文献,综合投入政府主导适宜程度、投入总量适宜程度、增长适宜程度等3个指标,计算财力资源的适宜程度。运用Spearman相关、线性回归等分析妇女保健财力资源适宜程度与孕产妇死亡率的关系。  结果  北京妇女保健财力资源适宜程度从2000年的28.40 %升至2017年的42.60 %,上海则由22.60 %升至69.40 %,北京和上海的回归方程均有统计学意义（上海P < 0.01,北京P < 0.05）。  结论  京沪2地妇女保健财力资源适宜程度逐年提高,上海财力资源在孕产妇死亡率下降中作用更大,但财力投入稳定增长仍是薄弱环节;适宜的妇女保健体系应“政府负责、投入适宜、稳定增长”;验证了量化妇女保健财力资源适宜程度的可行性。     

鲁迅与解剖学研究述略

鲁迅在《我怎么做起小说来》一文中写道,"但我的来做小说,也并非自以为有做小说的才能……大约所仰仗的全在先前看过的百来篇外国作品和一点医学上的知识,此外的准备,一点也没有"[1].可见,鲁迅青年时期接受的医学教育,与之精神与艺术有着深刻的渊源.而鲁迅所说的"医学上的知识"中,对其影响最大的莫过于 "解剖学的知识".在鲁迅...     

葫芦巴碱调节肾移植术后代谢紊乱的应用前景

肾移植术后易发生糖、脂质等代谢紊乱,导致移植肾功能障碍及长期存活率降低。葫芦巴碱是一种具有多种生物活性的天然生物碱,具有改善糖、脂质等代谢紊乱的作用,可减轻肾脏的炎症反应、氧化应激及细胞凋亡,从而保护肾功能。因此,葫芦巴碱可能是调节肾移植术后代谢紊乱的潜在药物。本文对葫芦巴碱与糖代谢紊乱、脂质代谢紊乱、其他代谢紊乱及葫芦巴碱在肾移植中的应用前景进行综述,旨在为改善肾移植术后代谢紊乱、提高肾移植受者及移植肾的长期存活率提供参考。