趋化因子诱饵受体D6在心肌梗死后心肌重塑中的作用及机制研究

目的:研究急性心肌梗死(AMI)后患者体内趋化因子诱饵受体D6的水平变化过程以及D6在心肌梗死后影响心肌重塑的可能机制。方法:将35例AMI患者根据心肌梗死后72 h血清趋化因子CCL2的检测水平分为h CCL2high组(n=18)和h CCL2low组(n=17),流式细胞术分析外周血中CD14++CD16-炎症单核细胞比例,Q-PCR测定外周血单核细胞趋化因子诱饵受体D6 mRNA的表达,3周后超声心动图测定心脏功能。将30只AMI雄性BLAB/C小白鼠根据血清CCL2的检测水平分为m CCL2high组(n=17)和m CCL2low组(n=13),流式细胞术分析小鼠外周血中CD11b+单核细胞比例;梗死心肌冰冻切片后免疫荧光染色D6阳性细胞,Q-PCR测定心肌梗死后3 d时间梗死区D6 mRNA的表达。3周后通过小动物超声检测小鼠心脏功能。结果:h CCL2high组患者外周血中CD14++CD16-炎症单核细胞比例显著高于h CCL2low组(P<0.001),其单核细胞D6受体的表达明显低于h CCL2low组(P<0.001),但单核细胞D6的表达与患者LVEF%未见明显相关性(P=0.16)。急性心肌梗死小鼠m CCL2high组外周血中CD11b+单核细胞细胞比例显著高于m CCL2low组(P<0.001),梗死心肌组织D6 mRNA表达显著低于m CCL2low组(P<0.001),小鼠梗死心肌免疫荧光可见D6表达于CD11b阳性单核细胞和CD31阳性内皮细胞。3周后小鼠心脏超声示LVEF%与梗死区D6的表达呈正相关(P=0.01)。结论:急性心肌梗死后梗死区组织可表达趋化因子诱饵受体D6,梗死区D6的高表达可抑制心肌梗死后的炎症浸润。梗死区趋化因子诱饵受体D6通过特异性结合CCL2减少心肌梗死后心肌局部的炎症浸润进而减轻心肌梗死后的心肌重塑。     

上海交通大学医学院“211工程”三期重点学科建设探索

重点学科是“211工程”建设核心,重点学科项目的建设成效对“211工程”总体绩效具有重要影响.为了提升“211工程”重点学科建设水平,某医学院对第三期“211工程”重点学科建设项目的管理模式进行探索,通过对“211工程”三期重点学科建设和管理实践的分析,探讨新的管理模式给“211工程”重点学科建设所带来的变化,为完善和促进“211工程”重点学科建设提供有益启示和借鉴.     

医院影像归档及通讯系统无线传输的结构分析

目的:设计一套能进行无线传输的影像储存与通信系统,作为有线网络的补充。方法:使用无线路由器、交换机和带有无线网卡的笔记本电脑,搭建一套无线图像文字传输设备。结果:数据速率可达600 Mbps、频率达到5 Hz,在多重安全保护下进行类似蜂窝状覆盖的IEEE 802.11n标准的无线传输结构符合医院影像归档及传输系统(PACS)的要求,使医疗信息资源达到充分的共享。结论:在IEEE 802.11n无线局域网PACS系统体系结构下,基本实现了影像的无线传输和实时显示,便于临床医生在全院范围内实时查看患者的影像资料,以及该系统在未来医院中发展的重要作用。     

Interleukin-10 promoter polymorphisms are associated with the mode and sequel of HBeAg seroconversion in patients with chronic hepatitis B virus infection.

BACKGROUND: The influence of interleukin-10 (IL-10) gene promoter polymorphisms on the mode and sequel of HBeAg seroconversion (a favorable event usually) in patients with chronic Hepatitis B virus (HBV) infection has not been clarified. PATIENTS AND METHODS: IL-10 genotyping and haplotype analyses of 340 HBsAg carriers and 100 volunteers with self-limiting HBV infection from southern China, a high prevalent area of HBV were performed according to the single nucleotide polymorphisms in its promoter (-1,082, -819 and -592) using a competitively differentiated PCR. RESULTS: High-producer genotype (GG at -1,082) or haplotype (GCC) was rarely found in patients from southern China (<1%). Intermediate-producer haplotype (ACC) was closely associated with chronic liver disease (P=0.004); compared with this, low-producer genotype (AA at -592) and haplotype (ATA) were closely associated with asymptomatic carriers (P=0.035 and 0.035). Intermediate-producer genotype (AC at -592) and haplotype (ACC) were closely associated with covert seroconversion of HBeAg (P=0.0086 and 0.0013) and progressive sequel after HBeAg seroconversion (P=0.013 and 0.0008), while, low-producer genotype (AA at -592) and haplotype (ATA) were closely associated with overt seroconversion of HBeAg (P=0.0023 and 0.0061) and silent sequel after HBeAg seroconversion (P=0.0009 and 0.001). CONCLUSIONS: IL-10 gene promoter polymorphisms significantly influence the mode and sequel of HBeAg seroconversion in patients with chronic HBV infection.     

皮质激素辅助治疗结核性脑膜炎的研究现状

结核性脑膜炎（tuberculous meningitis，TBM）以血脑屏障紊乱、颅内压升高和脑水肿为特征，是人型结核分枝杆菌感染最严重的类型。未经治疗死亡率达100%，治疗后死亡率约为10%，生存者中约80%有严重的神经系统后遗症。随着新增病例的不断增多，世界卫生组织（World Health Organiza-tion，WHO）在2007年的结核防治报告中提出：“要让所有结核患者都有机会得到有效的治疗。”目前尚没有明确针对TBM最佳治疗方案的临床指南。临床上主要参考肺结核的治疗方案。     

Lip morphology estimation models based on three-dimensional images in a modern adult population from China

International Journal of Legal Medicine - Lips are the main part of the lower facial soft tissue and are vital to forensic facial approximation (FFA). Facial soft tissue thickness (FSTT) and linear...     

神经元树突非典型运输途径的微结构和功能的研究进展

细胞中蛋白质的合成和运输是复杂而严格调控的过程,在结构高度特异化的神经元细胞更是如此。神经元树突中存在着不同于其他细胞的独立于胞体运输途径的非典型运输途径,其构成主要有树突mRNA、树突内质网（dER）和树突“外驻”高尔基体(Golgi outposts)。关于这
些细胞微结构的形态分布,其非典型运输的功能以及相关病理学研究近几年有重要的进展。     

Duration of SARS‐CoV‐2 RNA shedding and factors associated with prolonged viral shedding in patients with COVID‐19

To investigate the factors associated with the duration of severe acute respiratory syndrome coronavirus 2 RNA shedding in patients with coronavirus disease 2019 (COVID‐19). A retrospective cohort of COVID‐19 patients admitted to a designated hospital in Beijing was analyzed to study the factors affecting the duration of viral shedding. The median duration of viral shedding was 11 days (IQR, 8‐14.3 days) as measured from illness onset. Univariate regression analysis showed that disease severity, corticosteroid therapy, fever (temperature>38.5°C), and time from onset to hospitalization were associated with prolonged duration of viral shedding (P < .05). Multivariate regression analysis showed that fever (temperature>38.5°C) (OR, 5.1, 95%CI: 1.5‐18.1), corticosteroid therapy (OR, 6.3, 95%CI: 1.5‐27.8), and time from onset to hospitalization (OR, 1.8, 95%CI: 1.19‐2.7) were associated with increased odds of prolonged duration of viral shedding. Corticosteroid treatment, fever (temperature>38.5°C), and longer time from onset to hospitalization were associated with prolonged viral shedding in COVID‐19 patients.     

分阶段延续护理模式在COPD稳定期患者中的应用

目的探讨分阶段延续护理模式在COPD稳定期患者中的应用效果。方法采用便利抽样法,选取2019年5月—2020年4月成都市第三人民医院收治的220例COPD患者为研究对象,将2019年5—10月收治的110例患者纳入对照组,2019年11月—2020年4月收治的110例患者纳入观察组。对照组采用常规护理,观察组采用分阶段延续护理模式。干预前后采用自我护理能力测定量表(ES-CA)和简明健康测量量表(SF-36)评估两组患者的自我护理能力和生活质量。结果干预后观察组患者的ES-CA总分为(110.62±12.09)分,高于对照组的(102.87±11.54)分,差异有统计学意义(t=4.863,P<0.01)。干预后观察组患者的SF-36量表各维度得分均高于对照组,差异均有统计学意义(P<0.01)。结论应用分阶段延续护理模式可以充分调动患者的积极性,有效地提高患者的自我护理能力和生活质量。