甲状腺乳头状癌核内包涵体及核的形态结构定量分析

目的:定量揭示甲状腺乳头状癌核内包涵体及核的几何形态结构特点,为甲状腺乳头状癌的病理诊断提供定量诊断参数。方法:取甲状腺乳头状癌100例,常规切片、HE染色,在40倍物镜下采集核内包涵体及核的图像,用Image-Pro Plus测试包涵体及核的面积、周长、长轴、短轴、形状因子PE（Form PE）、形状因子AR（Form AR）、规化形状因子（RFF）、轴比、核内包涵体的面积密度以及包涵体与核质的面积比。结果:（1）甲状腺乳头状癌核内包涵体的面积约为（13.575±9.045） μm2（95%CI 13.339~13.810）,其在核内的面积密度约为25.761%±10.683%（95%CI 25.483~26.039）;其周长约为（12.720±4.275） μm（95%CI 12.609~12.831）,长轴（4.547±1.466） μm（95%CI 4.509~4.585）,短轴（3.482±1.178） μm （95%CI 3.451~3.512）;其轴比约为0.772±0.121（95%CI 0.769~0.775）,Form PE、Form AR和RFF约等于1;其与核质的面积比约为0.380±0.237（95%CI 0.374~0.386）,其面积、周长、长轴和短轴的变异系数为66.6%、33.6%、32.2%、33.8%。（2）具有核内包涵体的癌细胞,其核的面积、周长、长轴和短轴及其相应变异系数显著大于没有核内包涵体的细胞核（P<0.05）。（3）核内包涵体、含有核内包涵体的核及没有核内包涵体的核,其面积、周长、长轴和短轴的频数分布均呈正偏态分布。结论:（1）甲状腺乳头状癌核内包涵体形状大致呈圆形;约为核面积的1/4,核周长、长轴和短轴的1/2;其面积、周长、长轴和短轴的变异程度均较大。（2）具有包涵体的癌细胞,其核的异型性明显,诊断阅片时应重点观察。（3）包涵体及核的上述尺寸参数的频数分布均呈正偏态分布。     

人工心脏圆盘泵的流动特性研究

人工心脏（血泵）一直存在泵体对血细胞剪切力过大和流速过快容易引起溶血的问题。为了研究人体正常血压情况下,血泵内部剪切力和速度场的分布情况,选择圆盘泵叶轮代替传统离心泵叶轮,对两种模型进行数值计算,分析不同叶轮内部剪切力和速度场的分布规律。研究表明传统离心泵内部流速高,叶片表面剪切力大,对血细胞的伤害大。圆盘泵相比传统离心泵,剪切力更小,流场速度分布均匀,流速更小。和传统离心泵相比,不同转速下圆盘泵能降低溶血的发生率。圆盘泵叶片数为6片时,抗溶血性能更好。研究结果为血泵的优化提供理论依据。     

全髋关节置换术治疗成人发育性髋关节发育不良的难点及处理策略

发育性髋关节发育不良（developmental dysplasia of the hip, DDH）是成人继发性髋关节骨关节炎的最常见病因之一,早期干预不及时或治疗不当常引起髋关节严重畸形,晚期致残率较高。全髋关节置换术（total hip arthroplasty, THA）是治疗晚期成人DDH较有效的方法,但是由于髋臼和股骨近端解剖形态病理性异常使THA手术难度较大。本文就DDH的分型、手术难点及处理策略等结合近年来相关文献报道进行综述,以期为THA治疗成人DDH提供一定的理论依据。     

钻孔减压结合自体松质骨及同种异体骨植骨治疗股骨头坏死的短期疗效观察

目的 对ARCO Ⅱa期至Ⅲa期股骨头坏死（osteonecrosis of the femoral head, ONFH）且接受大通道钻孔减压、病灶清除,并经减压通道行股骨头内自体松质骨、同种异体颗粒骨打压植骨、同种异体腓骨条植骨治疗的患者进行短期临床疗效分析。方法 2018年1月至2020年12月,四川省骨科医院纳入47例（59髋）股骨头坏死患者。其中,男39例,女8例;年龄29 ～ 51岁,平均37.2岁;ARCO Ⅱa期16髋,ARCO Ⅱb期21髋,ARCO Ⅱc期13髋,ARCO Ⅲa期9髋;酒精性ONFH 46髋（酒精组）,激素性ONFH 13髋（激素组）。术后门诊随访,复查X线片（双髋正位及蛙式位片）,观察股骨头形态及骨整合情况,记录患髋Harris评分。结果 本组47例（59髋）随访24 ～ 36个月,平均随访30个月。术后所有患者疼痛明显缓解,部分患者疼痛消失（包括Ⅱa期14髋,Ⅱb期13髋,Ⅱc期4髋）。6例（9髋）患者病情进展股骨头发生塌陷,其中Ⅱb期1髋,Ⅱc期3髋,Ⅲa期5髋。按病因分,酒精性坏死塌陷6髋,塌陷率13%;激素性坏死塌陷3髋,塌陷率23.1%。酒精组和激素组末次随访时Harris评分与术前比较,差异均有统计学意义（P＜0.05）;酒精组术后Harris评分（82.7±5.6）分显著高于激素组（78.3±8.3）分,差异具有统计学意义（P＜0.05）。不同ARCO分期患者术后髋关节功能均得到一定程度改善,其中Ⅱa及Ⅱb期优良率78.4%,Ⅱc、Ⅲa期优良率50%（P＜0.05）。结论 针对ARCO Ⅱa期至Ⅲa期股骨头坏死的患者,采用大直径通道减压、清除死骨,同时植入自体松质骨和同种异体颗粒骨混合物,最后配合同种异体腓骨条加强支撑,短期可有效防止坏死股骨头的塌陷并减轻疼痛、改善患功能。     

Anemia and malnutrition in children at public schools in Osasco,São Paulo,Brazil

The authors studied a sample of students entering the first grade in the Osasco public school system in order to determine both the prevalence of anemia and nutritional status. Osasco is part of the Greater S o Paulo Metropolitan Area. Diagnosis of anemia was made through the hemoglobin concentration of blood from digital puncture. World Health Organization (WHO) levels were used to define anemia. Nutritional Status assessment. was made through weight/age and height/age indices, using Z score distribution and the National Center for Health Statistics (NCHS) reference levels. Prevalence of anemia was 51%. Prevalence levels varied according to the schools' geographic location: 56.9% in peripheral neighborhoods and 41.7% in central areas. Children with illiterate parents had a higher prevalence of this condition. Risk of anemia was higher for children who were over eight years of age when entering the first grade. Acute malnutrition was not found. Prevalence was higher than expected and points to the urgent need to establish an anemia control program for schoolchildren in this population.     

Plasma apolipoprotein B-48, hepatic apolipoprotein B mRNA editing and apolipoprotein B mRNA editing catalytic subunit-1 mRNA levels are altered in zinc-deficient rats.

Apolipoprotein B (apoB) exists as two major isoforms and serves as an obligatory component of lipid-rich plasma lipoprotein particles. Apolipoprotein B mRNA editing is a zinc-dependent, site-specific cytidine deamination that determines whether the apoB-100 or apoB-48 isoform is synthesized. The objective of this work was to examine whether dietary zinc levels affect apoB mRNA editing in vivo. Adult male Sprague-Dawley rats were randomly assigned to zinc-deficient (ZD, <0.5 mg Zn/kg diet), zinc-adequate (ZA, 30 mg Zn/kg diet) or zinc-replenished (ZDA, ZD rats fed the ZA diet for last 2 d) dietary groups for 18 d. The ratio of plasma apolipoprotein B-48 (apoB-48) to total apoB was significantly lower in zinc-deficient compared with zinc-adequate rats. Primer extension analysis indicated a modest but significant reduction in hepatic apoB mRNA editing in ZD rats compared with that of the ZA group. In ZDA rats, hepatic apoB mRNA editing and the percentage of plasma apoB-48 to total apoB were not different from ZA rats. The mRNA abundance of hepatic apobec-1 (apoB mRNA editing catalytic subunit 1) was significantly lower in ZD and ZDA rats than in ZA rats. In summary, the plasma ratio of apoB-48 to total apoB protein as well as hepatic apoB mRNA editing and hepatic apobec-1 mRNA levels were reduced in rats consuming a zinc-deficient diet. These data suggest that one or more components of apoB metabolism may be influenced by dietary zinc status.     

睡眠呼吸暂停综合征患者夜间睡眠呼吸参数的变化及护理对策(英文)

目的：探讨睡眠呼吸暂停综合征（ＳＡＳ）患者夜间睡眠呼吸参数的变化及相应护理对策。方法：对１６例ＳＡＳ住院患者在治疗前、睡眠姿势训练、气道持续正压（ＣＰＡＰ）呼吸机治疗三种状态下,进行整夜多导睡眠仪监测。结果：在ＳＡＳ整夜呼吸紊乱中,零点以后其危险因素大大增加,出现严重低氧血症,血压升高,心律失常,尤其是呼吸暂停时间延长,次数增加。而侧卧位可显著地改善低氧血症,最低血氧饱和度（ＳａＯ２）从（６２±１９）％升高至（８３±１１）％（Ｐ＜０．０１）,ＣＰＡＰ呼吸机治疗能使呼吸调节障碍得到明显的恢复,呼吸暂停由（４４．３±２２．６）次降至（０．２５±０．５４）次（Ｐ＜０．０１）。结论：护理上应密切观察病情变化,特别是零点以后应加强巡视,除观察呼吸运动外还应警惕脑血管病及心脏疾病的发生,对不具备ＣＰＡＰ呼吸机治疗条件者宜采取睡眠时督促取侧卧位。对ＳＡＳ患者进行健康教育也是减少危险因素的重要护理措施。     

保存时间及温度对血清标本补体C_3和CH50测定结果的影响

目的 了解保存时间及温度对补体活性的影响。方法:用单向琼脂扩散法和非离心单管法对不同温度和时间下标本的C_3含量及CH50进行测定。结果与结论:血清补体C_5含量在室温下24h、4C下4dC、-10C和-20C下8d内无显著变化;CH50在室温下12h、4C下24h,-10C和-20C下8d内CH50无明显变化。     

中国林蛙卵油和卵渣中微量元素的测定

目的：为中国林蛙油和卵渣应用提供科学依据。方法：采用等离子光谱和分光光度计法测定中国林蛙卵油和卵渣中的微量元素。结果：卵油和卵渣中均含 Ｚｎ, Ｍ ｎ, Ｃｕ, Ｆｅ 等 ９ 种人体必需微量元素,且 Ｚｎ／ Ｃｕ 比值较小。结论：卵油可能具有抗衰老及防治冠心病和高血压等作用。     

良性增生前列腺组织中鸟氨酸脱羧酶基因表达的研究

为探讨鸟氨酸脱羧酶（ＯＤＣ）基因表达与前列腺良性增生的关系,采用Ｎｏｒｔｈｅｒｎ印迹和ＲＮＡ斑点杂交技术,测定分析了正常人（１０例）和良性前列腺增生症（ＢＰＨ）病人（１５例）前列腺组织中ＯＤＣｍＲＮＡ的丰度。结果显示,良性增生前列腺组织中ＯＤＣｍＲＮＡ丰度较正常前列腺组织显著升高。经密度扫描测定结果显示,Ｎｏｒｔｈｅｒｎ印迹分析中ＢＰＨ前列腺组织中ＯＤＣｍＲＮＡ丰度约为对照组的６～２０倍,斑点杂交为５倍以上。提示ＯＤＣ基因表达增强在良性前列腺增生症形成中起重要作用