白细胞介素-9在胃癌前病变中的表达及意义

目的观察白细胞介素-9(IL-9)在胃良性病变、胃癌前病变及胃癌中的表达及临床意义。方法回顾性分析12例胃良性病变、38例胃癌前病变、46例胃癌患者的临床病理资料。采用免疫组化法检测上述标本中IL-9的表达水平,分析其与临床病理资料的关系。结果胃良性病变组、胃癌前病变组、胃癌组中IL-9表达差异有统计学意义(P0.01),且胃癌前病变中IL-9表达显著高于胃癌组(P0.01)。胃癌前病变组幽门螺旋杆菌(Hp)(+)患者IL-9表达显著高于Hp(-)患者,且组织炎症、萎缩、肠化程度越高,IL-9表达随之增加,差异具有统计学意义(P0.05)。结论 IL-9在胃癌前病变组织中高表达并与临床病理资料密切相关,推测IL-9及其介导的免疫反应参与胃癌前病变的发生及进展。     

比较注射冲洗与辅助超声荡洗对根管清洁效果的系统评价

目的 系统比较单独使用注射冲洗与辅助超声荡洗在根管预备过程中的根管清洁效果。方法 电子检索PubMed、Embase、Web of Science、Cochrane Library、ProQuest Dissertation and Theses,以及中文科技期刊数据库、中国期刊全文数据库、万方数据库和中国生物医学文献数据库,检索时间为1985年1月1日-2014年3月1日,同时对中文口腔医学杂志进行手工检索,对全部纳入文献的参考文献进行追索,收集辅助超声荡洗能否提高注射冲洗质量的临床随机对照试验（RCT）和临床对照试验（CCT）。使用Cochrane协作网推荐的标准对纳入文献进行偏倚风险评价并提取数据,采用RevMan 5.2软件进行统计分析。结果 最终纳入9篇文献,7篇为低度风险,2篇为中度风险。Meta分析结果：组织学方法显示辅助超声荡洗能显著提高根管根尖区主侧支根管碎屑和玷污层的清洁程度,与仅使用注射冲洗相比,其差异有统计学意义（P<0.01）,但细菌培养法（P=0.26）及聚合酶链反应（PCR）检测法（0.99）均显示辅助超声荡洗的根管抗菌效果与仅使用注射冲洗无明显差异。结论 辅助超声荡洗对根管根尖区碎屑和玷污层的清洁效果明显优于单独使用注射冲洗,但两者的根管抗菌效果没有明显差异。     

真皮替代物在创面和瘢痕修复中的临床应用

【摘要】 烧伤、创伤、瘢痕及肿物切除术等造成的严重真皮缺失容易引起瘢痕畸形。真皮替代物能减少创面愈合过程中异常瘢痕的形成,同时有效降低瘢痕切除修复术后病理性瘢痕的发生。本文介绍常用真皮替代物和其在创面愈合及瘢痕切除术后修复中的临床应用。     

肺滑膜肉瘤的诊治现状

目的探讨提高肺滑膜肉瘤诊断、治愈率的方法。方法选择1例肺滑膜肉瘤患者,同时结合2012年10月中国期刊全文数据库收录发表的80例资料较为完整的肺原发性滑膜肉瘤患者进行回顾性研究,分析其主要临床表现、影像学特点,根据病理学、免疫组化特点及分子生物学对其进行诊断及鉴别诊断,以减少误诊。结果81例肺原发性滑膜肉瘤患者中,男40例,女41例。主要临床表现有胸痛、呼吸困难、咯血及咳嗽。个别病例无任何不适。全部病例均进行手术治疗。术前均未确诊,最终依赖病理、免疫组化支持诊断。结论肺原发性滑膜肉瘤临床表现不一,影像学检查具有相对特征表现,易与其他肺部肿瘤或炎性反应混淆;确诊需依靠病理、免疫组化和融合基因检测。手术切除是主要的治疗方法,切除不完全者预后差。     

童年期不良经历与青春发动时相提前的关联及其性别差异的研究

目的 探讨童年期不良经历与青春发动时相提前的关联及其可能的性别差异。方法 以安徽省某九年一贯制小学3～5年级自愿参加的男女生为研究对象, 进行问卷调查、体格和第二性征发育(男生睾丸容积和女生乳房)检查。问卷调查主要包括童年期不良经历和视频时间、体力活动情况。青春发动时相提前的判定标准按“中国儿童青春期发育研究协作组”建立的中国儿童青少年青春期发育里程碑事件年龄界值。结果 共调查1 744名8.2～12.2岁学生, 其中男生957人, 女生787人。男生青春发动时相提前检出率为7.5%, 女生为14.6%, 差异有统计学意义(χ²=11.671, P<0.001)。报告家庭不良事件的男生, 其青春发动时相提前检出率较高;报告躯体虐待经历的女生, 其青春发动时相提前检出率也较高。多因素logistic回归分析表明, 家庭不良事件是男生青春发动时相提前的危险因素(OR=2.531, 95%CI:1.276～5.020), 躯体虐待经历是女生青春发动时相提前的危险因素(OR=2.453, 95%CI:1.588～3.788)。结论 躯体虐待和家庭不良事件均与青春发育提前有关, 但该关联的本质及其性别差异尚需纵向研究进一步阐明。     

Interactions between Environmental Lead Exposure and Sociodemographic Factors on Cognitive Development

A total of 375 children who lived in Port Pirie, South Australia, and surrounding towns were followed from birth to ages 11-13 y. Possible interactions between lifetime average blood lead concentration and sociodemographic factors (including gender, parents' occupational prestige [as a surrogate of socioeconomic status], quality of home environment, and maternal intelligence quotient) on children's intelligence quotients were examined. Although no statistically significant interaction between blood lead concentration and any of these covariates was found, the results suggested that—after adjustment for a wide range of covariates—children from socially disadvantaged backgrounds (adjusted regression coefficient = -9.6 intelligence quotient points per log unit of blood lead concentration; 95% confidence interval = -2.5, -17.7) were more sensitive to the effects of lead than those of a higher socioeconomic status (adjusted regression coefficient = -2.9; 95% confidence interval = 3.8, -9.6). In addition, girls (adjusted regression coefficient = -7.4; 95% confidence interval = -1.7, -13.1) were more sensitive to the effects of lead than boys (adjusted regression coefficient = -2.6; 95% confidence interval = 2.9, -8.0). These results were basically consistent with our findings observed at ages 2 y, 4 y, and 7 y.     

Spatial patterns and socioecological drivers of dengue fever transmission in Queensland, Australia

Background: Understanding how socioecological factors affect the transmission of dengue fever (DF) may help to develop an early warning system of DF.Objectives: We examined the impact of socioecological factors on the transmission of DF and assessed potential predictors of locally acquired and overseas-acquired cases of DF in Queensland, Australia.Methods: We obtained data from Queensland Health on the numbers of notified DF cases by local government area (LGA) in Queensland for the period 1 January 2002 through 31 December 2005. Data on weather and the socioeconomic index were obtained from the Australian Bureau of Meteorology and the Australian Bureau of Statistics, respectively. A Bayesian spatial conditional autoregressive model was fitted at the LGA level to quantify the relationship between DF and socioecological factors.Results: Our estimates suggest an increase in locally acquired DF of 6% [95% credible interval (CI): 2%, 11%] and 61% (95% CI: 2%, 241%) in association with a 1-mm increase in average monthly rainfall and a 1°C increase in average monthly maximum temperature between 2002 and 2005, respectively. By contrast, overseas-acquired DF cases increased by 1% (95% CI: 0%, 3%) and by 1% (95% CI: 0%, 2%) in association with a 1-mm increase in average monthly rainfall and a 1-unit increase in average socioeconomic index, respectively.Conclusions: Socioecological factors appear to influence the transmission of DF in Queensland, but the drivers of locally acquired and overseas-acquired DF may differ. DF risk is spatially clustered with different patterns for locally acquired and overseas-acquired cases.