CT定量分析急性呼吸窘迫综合征模型兔肺复张呼气末正压通气最佳压力

目的 以CT定量评估不同肺复张呼气末正压(PEEP)通气治疗急性呼吸窘迫综合征(ARDS)模型兔,并确定最佳PEEP.方法 纳入10只成年大耳兔,建立ARDS兔模型.采用压力控制通气进行肺复张,分别于4、8、12、16、20、24及28 cmH2O PEEP下行肺部CT扫描,并按CT值将肺分为不通气区(-100～100...     

Fas ligand is expressed in normal skin and in some cutaneous malignancies

Fas, a cell surface receptor and member of the tumour necrosis factor receptor superfamily, induces apoptosis upon oligomerization by its ligand (Fas ligand: FasL). Detailed studies have revealed that Fas is broadly expressed in normal human tissues, but relatively little is known about the range of cell types capable of expressing FasL. The aim of this study was to determine the in vivo patterns of expression of Fas and FasL in human skin tissues. Immunohistochemistry was performed using paraffin-embedded samples of normal and neoplastic skin tissues. In normal skin, FasL was expressed in the epidermis, sebaceous glands, sweat glands and outer root sheath of the hair. In squamous cell carcinomas (SCC), all cases analysed expressed FasL at high levels, whereas 60% of basal cell carcinomas (BCC) were positive for FasL. Expression of Fas in normal skin was observed in the basal and spinous layers of the epidermis, the outer root sheath of the hair, and the sebaceous glands. Expression of Fas was observed in all the SCC tested and none of the BCC tested. Expression of FasL by normal cells and tumour cells in skin tissue, demonstrated for the first time in the present study, may provide an important clue to understanding skin physiology, and immune evasion of skin tumours.     

人体成分监测仪在血液透析患者干体重评估中的意义

目的：研究人体成分监测仪（BCM）在血液透析患者干体重评估中的意义。方法选择126例在我院血液透析中心透析的患者作为病例组,选择40例在我院体检中心体检健康的志愿者作为对照组,两组分别行BCM监测。记录测得的总体液量（TBW）、细胞外液（ECW）、细胞内液（ICW）、水负荷（OH）,记录患者透析脱水量、上机前血压以及对照组血压。利用ROC曲线分析OH值评估干体重的准确性,Logistic回归分析影响OH值的因素。结果（1）OH值与脱水量呈正相关（r＝0.462,P＜0.001）。（2）OH值评估干体重ROC曲线下面积（AUC）为0.877,当取3.30 L临界值时,灵敏度为0.909,特异性为0.833。（3）ECW、SBP是影响OH值的关键因素（P＜0.05）,且影响程度ECW＞SBP。结论 BCM可客观地监测透析患者体内多余水分,对干体重的评估有一定的意义。     

Mutant fibrinogen A-α-chain associated with hereditary renal amyloidosis and peripheral neuropathy

A middle age Portuguese woman was investigated for renal amyloidosis. She presented with progressive renal failure, proteinuria, hypertension, and sensory symptoms in the feet. Clinical and neurophysiological evaluation disclosed sensory-autonomic neuropathy. Cardiovascular tests and 123-MIBG investigation showed parasympathetic dysfunction and decrease of myocardial innervation, in accordance with small fiber neuropathy, as usually observed in amyloidosis. Immunohistochemical studies revealed AFib amyloidosis and genetic studies the amino acid exchange Glu526Val of the fibrinogen Aα-chain mutation, which was also present in one of her sons. The mutant gene in this patient was associated with the same haplotype as all other reported cases of Glu526Val mutations. This is the first reported AFibamyloidosis in Portugal, and the first case of AFib in which sensory and autonomic nerve fiber dysfunction is described, indicating that small nerve fiber lesion can occur in the fibrinogen Aα chain mutation. This can be important for prognosis, in particular when liver transplantation is considered for treatment.     

Effectiveness of the UroMentor virtual reality simulator in the skill acquisition of flexible cystoscopy

Background Virtual reality (VR) has been recognized as a useful modality in the training of surgical skills.With respect to basic endoscopic skill training of urology,we sought to investigate the effec...     

22～50岁中国人精神心理健康状况与下尿路症状及阴茎勃起功能障碍的相关性(英文)

目的:研究22～50岁的中国男性心理健康与下尿路症状、勃起功能障碍之间的关系。方法:研究对象为907名22～50岁的中国男性。采用Zung抑郁自评量表及焦虑自评量表评估研究对象的抑郁及焦虑状况的严重程度。采用美国国立卫生研究院慢性前列腺炎症状指数(US National Institutes of Health Chronic Prostatitis Symptom In-dex,NIH-CPSI)评估研究对象的慢性前列腺炎相关症状的严重程度,采用国际前列腺症状评分(the InternationalProstate Symptom Score,IPSS)评估下尿路症状的严重程度,采用国际勃起功能指数5(International Index of ErectileFunction 5,IIEF-5)评估阴茎勃起功能情况。结果:共有894例研究对象的数据完整,纳入最后统计分析。与没有抑郁和焦虑情绪的研究对象相比,伴有抑郁和焦虑的研究对象的平均NIH-CPSI评分较高(6.2±6.2 vs.5.0±5.8,P=0.015;8.7±8.1 vs.4.7±5.3,P<0.001),平均IPSS评分也较高(5.9±6.6 vs.4.7±5.8,P=0.029;8.4±8.0 vs.4.4±5.5,P<0.001),平均IIEF-5评分较低(18.3±4.4 vs.20.2±3.5;17.2 vs.4.1 vs.20.1±3.6,P<0.001),总的ED比例较高(69.7%vs.57.8%,P=0.002;81.1%vs.57.0%,P<0.001)。结论:在中国,年龄22～50岁的男性中焦虑、抑郁情绪与下尿路症状、勃起功能密切相关。     

常规腹腔镜器械经脐单孔法阑尾切除术与三孔法的对照观察

对2009年5月至2012年2月诊治的60例阑尾炎患者分别行单孔、三孔腹腔镜阑尾切除术(各30例).与三孔组相比,单孔组手术时间明显延长;住院天数、疼痛评分、应用止痛药和术后并发症,两组差异均无统计学意义(P＞0.05).单孔组脐部切口瘢痕不明显.提示应用常规腹腔镜器械行单孔经脐阑尾切除术,安全、可行,美容效果明显.     

Effect of freeze-drying,cryoprotectants and storage conditions on the stability of secondary structure of insulin-loaded solid lipid nanoparticles

This study aims to monitor the secondary structure behaviour of insulin when it is encapsulated into solid lipid nanoparticles (SLN), under the influence of several critical processing parameters. Insulin was used as a therapeutic protein model. Physicochemical properties of insulin-loaded SLN (Ins-SLN) were assessed, with special focus on the insulin secondary structure after its encapsulation into SLN and after freeze-drying using different cryoprotectants (glucose, fructose and sorbitol). Additionally, a 6-month stability study was performed to evaluate the maintenance of insulin secondary structure over time at different storage conditions (4 °C/60% RH, 25 °C/60% RH, 40 °C/75% RH).     

中国伞兵着陆时足底动力学指标的变化特征

摘要：目的观察伞兵着陆过程中左、右足底动力学指标变化规律。方法利用德国Pedar-X足底压力检测系统检测12名现役八一跳伞大队的跳伞运动员模拟伞兵从1．5米跳台跳下着陆时足底最大应力、最大压力、接触面积、压力时间积分值等动力学指标。将左、右足底按照常规标准分为10区,分别记录各区的动力学指标值,观察各区指标的变化规律,同时比较左、右足底相应各区的动力学指标值。结果左足底最大压力值（kPa）分布规律：9区足跟内侧（7．86±1．68）kPa,10区足跟外侧（7．47±1．88）kPa,8区中足（4．68±0．71）kPa,1区第一足趾（3．96±1．56）kPa,3区第一跖骨区（3．72±1．43）kPa,4区第二跖骨区（2．87±1．05）kPa,5区第三跖骨区（2．72±1．08）kPa,2区第2-4趾（2．64±1．25）kPa,6区第四跖骨区（2．42±0．68）kPa,7区第五跖骨区（2．13±0．87）。左足底最大应力值、最大压力时间积分值与最大压力值分布规律一致。右足最大应力值、最大压力值、最大压力时间积分值分布规律基本与左足一致。结论半蹲式着陆足底受力左右足一致;足底足跟部受力最大;足底内侧受力大于外侧,易导致足内外踝骨折。