福州市生活饮用水及其水源水有机提取物的体内遗传毒性研究

目的：探讨福州市生活饮用水及其水源水的体内遗传毒性。方法：随机选择福州市5个区县（市）各1家水厂,采集水源水和出厂水各200 L,经XAD-2树脂柱收集其中的有机物,采用小鼠骨髓细胞微核试验和精子畸形试验检测其遗传毒性。结果：长乐市、平潭县水厂出厂水和水源水及福清市水厂出厂水具有致突变性;各出厂水有机提取物的致突变性基本高于同厂水源水。结论：福州市部分生活饮用水水源水和出厂水受到一定程度的有机物污染。     

微创小梁切除术联合微创晶状体超声乳化吸出术治疗新生血管性青光眼

目的方法结果结论探讨微创小梁切除术联合微创晶状体超声乳化吸出术治疗新生血管性青光眼的临床效果。2007年12月至2009年1月于我院住院治疗的新生血管性青光眼16例16眼,手术方法为先通过两个0.7毫米的透明角膜穿刺口完成微创晶状体超声乳化吸出术,再于上方结膜切口下切除2m中层角巩膜条带,周边虹膜切除及前房成形后球结膜连续缝合。观察记录手术前后眼压、前房、视力变化及滤过泡情况。随访时间6-12个月,术眼手术后眼压均低于21mmHg,滤过泡形成良好,虹膜新生血管大多消褪,全部眼球得以保留,其中11例视力保持不变,5例不同程度提高。微创小梁切除术联合微创晶状体超声乳化吸出术是治疗新生血管性青光眼的一种有效方法mm×2.5m。     

儿童急性淋巴细胞白血病雌激素受体α与β的表达及临床意义

[摘要] 目的：研究雌激素受体（ER）α与β在儿童急性淋巴细胞白血病（ALL）中的表达水平及与临床疗效的关系。方法：先采用白细胞免疫标记技术APAAP法对30例儿童急性淋巴细胞白血病（ALL）患儿进行免疫学分型,然后采用免疫组织化学SP法检测30例儿童急性淋巴细胞白血病患儿骨髓单个核细胞ERα与ERβ的表达;对照组为15例非恶性血液病患儿。结果：30例初诊组中ERα、ERβ阳性表达率分别为65.7%和70.7%,明显高于对照组（P<0.05）;ERα阳性表达者与阴性表达者之间缓解率无显著差异（P>0.05）,ERβ阳性表达者缓解率明显高于ERβ阴性表达者,两者比较有显著差异（P<0.05）;在缓解组与未缓解组之间ERα阳性表达率无显著差异（P>0.05）,在缓解组与未缓解组之间ERβ阳性表达率有显著差异（P<0.05）。在ALL-B和ALL-T中ERα、ERβ表达均无统计学意义。结论：儿童急性淋巴细胞白血病可能有一定的激素依赖性,ERβ在儿童急性淋巴细胞白血病发生、发展、预后评估上发挥重要角色。     

Pusher curving technique for preventing tilt of femoral Günther Tulip inferior vena cava filter: in vitro study

Objective To determine whether the adjustment of the pusher of GTF was useful to decrease the degree of tilting of the femoral Ginther Tulip filter (GTF) in an in vitro caval model. Methods The caval model was constructed by placement of a 25 mm × 100 mm and two 10 mm ×200 mm Dacron graft inside a transparent bifurcate glass tube. The study consisted of two groups: left straight group (GLS) (n =100) and left curved group (GLC) (n = 100). In the GLC, a 10° to 20° angle was curved on the introducer.The distance (DCH) between the caval right wall and the hook was measured. The degree of tilting (DT) was classified into 5 grades and recorded. Before and after the GTF being released, the angle (ACM1, 2)between the axis of IVC and the metal mount, the distance (DCM1) between the caval right wall and the metal mount, the angle (ACF) between the axis of IVC and the axis of the filter and the diameter of IVC (DIVC) were measured. The data were analyzed with Chi-Square test, t test, rank sum test and Pearson correlation test. Results The degree of GTF tilting in each group revealed a divergent tendency. In group LC, the apex of the filter tended to be grade Ⅲ compared in group LS (x2 value 37. 491 ,P ＜0.01).The differences of most variables between GLS and GLC were considered as statistical significance(16. 60° vs.3.05°, 20.60° vs. 3.50°, -3.90°vs. -0.40°, 2.98 mm vs. 10.40 mm, - 10.95° vs. -0.485°,13. 17 mm vs. 10.06 mm, - 1.70° vs. 0.70°, t or Z values - 12. 187, - 12. 188, -8.545, -51.834,-11. 395,9. 562, -3. 596, P ＜ 0. 01). There exist significant positive correlation between ACM1 and ACF,ACM1 - ACM2 and DCH1 - DCH2 in each group, respectively(r values 0. 978,0. 344,0. 879,0. 627 ,P ＜0. 01),while significant negative associations are detected between DCH1 and ACF in each group , ACP and ACF in group LC(r values -0.974, -0.322, -0.702,P＜0.01). Conclusion The technique of adjusting the orientation of filter pusher had minimized the incidence and extent of GTF filter tilting in vitro.     

不同体位短臂离心机暴露时心血管及前庭功能的改变

目的 通过观察和比较不同体位下短臂离心机暴露所引起的心血管及前庭功能反应,进一步明确短臂离心机暴露下体位因素对心血管和前庭功能的影响. 方法 10名健康男性,依次进行75°、45°、15°后倾体位的短臂离心机暴露,且每体位先后进行2 G、3 G(足水平)人工重力暴露;采用便携式无创逐跳血压监测仪(Portapres)全程监测,并记录受试者血压、心率,通过Beatscope分析软件计算心脏泵血功能和总外周阻力;同时进行前庭功能评价,比较不同体位短臂离心机暴露对心血管、前庭系统的影响. 结果 2 G、3 G短臂离心机分别暴露时,15°体位下6名受试者出现严重运动病症状被迫终止试验;75°和45°两种体位下受试者血压、心率较基础值增高(F=2.79～16.44,P<0.05);心输出量则无显著变化.3 G暴露75°和45°两种体位时,每搏量显著降低(F=2.25、8.35,P<0.05).3 G暴露45°体位时总外周阻力较基础值增高(F=2.61,P<0.05);相同G值短臂离心机暴露时,75°体位下心血管功能变化较45°体位差异无统计学意义,而前庭功能评分则随着体位角度的减小而逐渐增高,15°体位下评分较45°和75°体位增高,差异有统计学意义(P<0.05). 结论 短臂离心机暴露时,45°和75°两种体位对心血管功能的影响无统计学意义,但不同体位对前庭功能的影响却差异较大.暴露体位越趋近于坐位,引起的运动病程度越重. Abstract： Objective To investigate the changes of human cardiovascular and vestibular functions when exposed to the artificiaI gravity generated by short-arm centrifuge with different body positions.Methods Ten healthy male volunteers were exposed to the artificial gravity at three different body positions:foot towards to the radial direction off the rotation center respectively with 75°,45°and 15°back tilting.Each position underwent on short-arm centrifuge with two sessions that were at 2 G and 3 G (at foot level) respectively.Beat-by-beat arterial blood pressure (BP) and heart rate (HR) were measured before and during the experiment by means of Portapres and calculated parameters,such as stroke volume (SV),cardiac output (CO) and total peripheral resistance (TPR),were obtained by Beatscope software.A subjective scoring was taken for assessing vestibular sensations. Results Six of 10 subjects with 15°posture were terminated both in 2 G and 3 G exposure due to their serious motion sickness symptoms.Comparing to the measurements before exposure,subjects with 45°and 75°posture showed significant increased BP and HR (F=2.79 to 16.44,P<0.05) but SV (F=2.25 or 8.35,P<0.05) while CO had no obvious change.Comparing to the measurements before exposure,subjects with 3 G (45°posture) showed significant incleased TPR (F=2.61,P<0.05).3 G exposure resulted in higher HR than that in 2 G.No significant changes of BP,HR,CO,SV and TPR were found between 45°and 75°postures under same exposure.The scores of vestibular assessment showed increased tendency with the decreased tilt angle.Significantly higher scores were got for 15°posture exposures comparing to others and indicated stronger vestibular stimuli.Conclusions The results suggested that the smaller tilted angle posture would result in mole serious vestibular symptoms.     

结晶型硫化镍诱发细胞恶性转化过程中基因组总体DNA甲基化的改变

Objective To observe the effect of crystalline NiS on genome DNA methylation profile in in vitro cultured cells.Methods 16HBE Cells were treated with crystalline NiS at 0.25,0.50,1.00 and 2.00 μg/cm2 for 24 h and three times at total.DAC treatment was given at 3 μmol/L for 72 h.5-mC immunofluorescence and SssI emthyltrasferase assay methods were applied to investigate if the hypomethylation of genome DNA involved.Results The results of 5-mC immunofluorescence showed that the fluorescence intensity of NiS-treated cells were decreased in some degree, and transformed cells were decreased dramatically.By the SssI methylase assay, an average of (81.9 ± 7.3 )% methylated CpG were found in negative control cells.By contrast, ( 77.9 ± 6.2) %, ( 75.3 ± 6.8 ) %, ( 59.5 ± 4.9 ) %, ( 67.4 ±5.1 ) % methylated CpG were observed in cells treated with NiS for three times at dosage of 0.25,0.50,1.00and 2.00 μg/cm2 which were abbreviated as NiS0.25, NiS0.50, NiS1.00, NiS2.00 respectively.The ANOVA analysis results showed that there was a significant difference in the 5 groups above ( F = 124.95,P ＜0.01 ).The results of Dunnett-t test showed that the methylated CpG of both group NiS1.00 and NiS2.00were significantly decreased compared with the negative control group(t values were 7.64,4.89 respectively,P ＜0.01 ).For methylated CpG, (46.2 ±4.1 ) % and (43.6% ±4.3)% were observed in NiS-transformed cells (NSTC1 and NSTC2) which were dramatically decreased compared with the negative control group(t values were 12.79,13.56 respectively, P ＜ 0.01 ).Conclusion Genomic DNA methylation levels were decreased during NiS induced malignant transformation.     

Ⅰ期临床试验生物样本管理的差错分析及应对措施探讨

目的 提高Ⅰ期临床试验的生物样本管理质量.方法 根据原国家食品药品监督管理总局《药物临床试验数据现场核查要点》和医院体系文件,收集医院2017年1月至2020年12月的Ⅰ期临床试验的质控检查和现场核查报告中的样本管理差错,分析各类差错类型的典型案例,并提出相应纠正措施.结果 共纳入253份Ⅰ期临床试验报告.其中,发生样...     

血β-羟丁酸诊断2 型糖尿病酮症酸中毒阈值的建立

目的探索建立血β-羟丁酸（βOHB）诊断2 型糖尿病酮症酸中毒（DKA）的阈值及βOHB水平与DKA严重程度的关系。
方法对急症科收治的2 型糖尿病患者的血βOHB与[HCO3
-]进行相关分析,同时利用回归方程计算出[HCO3
-]为18.0、15.0、
10.0 mmol/L 时的βOHB值,并以与[HCO3
-]为18.0 mmol/L 对应的βOHB值作为DKA诊断的阈值,并结合临床评估其诊断性
能。结果血βOHB水平与[HCO3
-]浓度具有良好的相关性,R2=0.7023,P<0.001。[HCO3
-]为18.0、15.0和10.0 mmol/L时的βOHB
值分别为3.0、4.70和7.5 mmol/L,并与DKA病情严重程度相符;结合血糖浓度≥13.9 mmol/L,当血βOHB≥3.0 mmol/L时,诊断
DKA的灵敏度为99.0%,特异性为86.0%,总有效性为92.81%。结论血βOHB≥3.0 mmol/L 可作为DKA诊断的阈值,并且
βOHB可作为DKA病情严重程度的判断指标。
     

有/无填充物微创玻璃体切割术治疗增生性糖尿病视网膜病变合并牵拉性视网膜脱离的疗效比较

目的　比较有／无填充物的微创玻璃体切割术治疗增生性糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＰＤＲ）合并牵拉性视网膜脱离的疗效。方法　回顾性分析２０１０年１月至２０１３年１月我院收治的ＰＤＲ合并牵拉性视网膜脱离患者的临床资料,所有患者均采用微创玻璃体切割术治疗,根据术中是否进行玻璃体填充分为无填充物组（Ａ组）和有填充物组（Ｂ组）。术后随访３个月以上,比较两组患者的一般资料（包括性别、年龄、血糖、糖尿病病程等）、手术前后眼压、视力以及术后并发症等。结果　本研究共入组８０例（８０眼）患者,其中Ａ组患者４２例,Ｂ组患者３８例。２组患者术前、术后７ｄ、术后１个月的眼压比较,差异均无统计学意义（均为Ｐ＞０．０５）。２组患者术前、术后３个月的视力比较,差异均无统计学意义（均为Ｐ＞０. ０５）,而Ａ组术后１个月时的视力高于Ｂ组,差异有统计学意义（Ｐ＜０．０５）。术后Ａ组２例患者出现低眼压,１例出现玻璃体积血;Ｂ组２例患者出现玻璃体积血,２例出现晶状体混浊,１例出现低眼压;２组患者术后并发症发生率差异无统计学意义（χ２ ＝０．８０２,Ｐ＝０．３７）。结论　ＰＤＲ合并牵拉性视网膜脱离患者采用微创玻璃体手术治疗可取得较好的疗效,且无填充物患者术后视力恢复更快。     

应用OCT研究高度近视视网膜神经纤维层厚度及影响因素

目的 研究高度近视患者视网膜视神经纤维层(RNFL)变异情况及其与屈光度、年龄、性别和眼别的关系。 方法 选择高度近视172眼,应用光学相干断层成像术(OCT)检测全周和各象限RNFL的厚度,使用多元线性回归分析全周及4个象限的平均厚度与屈光度、年龄、性别和眼别的。 结果 高度近视172只眼RNFL平均厚度分别为全周(112.523±12.053)μm、上方(134.942±21.016)μm、下方(135.488±25.058)μm、颞侧(112.198±27.145)μm,鼻侧(68.3895±17.554)μm;高度近视RNFL全周平均厚度与屈光度的偏相关系数为-1.225,与性别的偏相关系数为5.415,与年龄的偏相关系数为-0.117。RNFL上方平均厚度与年龄的偏相关系数为-0.623,与眼别的偏相关系数为4.780。RNFL下方平均厚度与性别的偏相关系数为6.632。RNFL颞侧平均厚度与性别的偏相关系数为10.048,与屈光度的偏相关系数为4.264。RNFL鼻侧平均厚度与眼别的偏相关系数为-6.905。 结论 年龄、性别、屈光度是高度近视患者RNFL平均厚度的影响因素,眼别是RNFL上方和颞方平均厚度的影响因素,RNFL厚度影响因素的研究为高度近视合并青光眼的早期诊断和随诊提供依据,对加强高度近视患者病情进展的监测和健康宣教有重要意义。