慢性阻塞性肺疾病与急性肺炎患者血小板活化功能对比分析

目的:探讨慢性阻塞性肺疾病(COPD)和急性肺炎患者的血小板活化状况进。方法:采用荧光素标记的CD61,CD62p和PAC-1三种单克隆抗体对49例COPD患者和57例急性肺炎患者及20例健康对照组的全血中血小板进行直接免疫荧光染色,然后采用流式细胞仪进行检测。结果:COPD组与急性肺炎组血小板表面受体表达无显著性差异(P>0.05),但两组血小板表面受体表达均明显高于健康对照组(P<0.01)。结论:血小板活化与肺疾病引起的血栓形成有关。     

非计划二次手术质量评价的研究进展

"非计划二次手术"作为一项新的衡量手术水平的事件,受到越来越多的关注。其在医师、科室、医院间具有一定的横向、纵向比较价值,相比其他医疗不良事件,易于跟踪和比较,拥有明确的针对性和指向性,在许多国家已作为外科质量改进的衡量标准。但是,其广泛、全面地应用于医疗质量控制仍存在概念模糊、上报及监测体系不全等困难。随着未来的研究发展、评价体系的完善和相关制度的制定落实,控制"非计划二次手术",将成为医疗质量管理不可忽视的部分。     

新发和复发麻风患者中麻风菌的氨苯砜、利福平耐药基因的检测

目的：检测麻风菌的氨苯砜、利福平耐药基因，以了解复发与耐药的关系。方法：在PCR扩增出麻风菌的氨苯砜耐药基因fol P1、利福平耐药基因rpoB靶片段的基础上，采用直接测序和异源双链分析确定相应基因是否有突变。结果：在7例复发病例中，发现2例为DDS耐药菌株，但未发现有：RFP，耐药菌株。在35例新病人中，有22例和31例分别扩增出fol P1和rpoB基因，但均未发现有DDS、RFP基因突变。结论：结合2例DDS耐药病例的临床病史分析提示，fol P1基因不同突变，可能导致不同程度的DDS耐药。虽然本研究未发现有RFP耐药菌株，但是对复发病例开展DDS、RFP耐药检测却是十分必要的。     

肾素-血管紧张素系统在糖尿病肾病研究探析

临床研究发现,肾素-血管紧张素系统(RAS)与糖尿病肾病的发病具有一定的相关性。本文旨在在此基础上作进一步的研究。文章首先对RAS的基本情况作了分析,然后对RAS与肾病糖尿病的关系进行了探讨,并进而分析了RAS的抑制药剂,以为临床通过控制RAS改善糖尿病肾病提供参照。     

PKM2在克罗恩病组织中的表达及意义

目的检测M2型丙酮酸激酶(PKM2)蛋白在克罗恩病(CD)组织中的表达水平,探究其与患者疾病严重程度及预后的关系。方法前瞻性选取2015年3月至2017年8月在上海市浦东新区浦南医院就诊的126例CD患者作为研究对象,设为CD组;另选取同期在该院接受结直肠镜检查并切除肠息肉组织的52例患者作为对照组。采用蛋白质印迹法检测CD组织和息肉组织中PKM2蛋白表达水平,分析PKM2蛋白表达水平与CD患者疾病严重程度和预后的关系。结果与对照组相比较,CD组PKM2蛋白表达水平较低,差异有统计学意义(P<0.05)。CD组患者PKM2蛋白表达水平与CD简化内镜评分(SES-CD)呈负相关(P<0.05)。预后不良的CD患者PKM2蛋白表达水平低于预后良好者,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,疾病行为、肛周病变和PKM2蛋白表达水平与CD患者的预后关系密切(P<0.05)。结论CD患者PKM2蛋白表达水平越低提示其病情越严重。检测CD组织中PKM2蛋白表达水平有助于评估CD患者疾病严重程度及预后情况。     

视频密度阶差与心肌核素灌注扫描评价心肌微灌注的对比研究

目的 探讨视频密度阶差(VDS)评价心肌微灌注的可行性及应用价值.方法 11只犬使用聚苯乙烯微泡(直径100μm)栓塞微小冠状动脉,栓塞后行冠脉造影并根据造影图像计算其视频密度阶差;并行心肌核素灌注扫描(SPECT),计算其心肌SPECT灌注积分.结果 11只犬,栓塞后的VDS为(15.2±3.8);栓塞后的SPECT积分为(17.6±6.4).VDS与SPECT积分负相关,相关系数为-0.85(P<0.05).结论 VDS,作为一个新的定量指标,与心肌SPECT灌注扫描存在较好的相关性,可以作为临床上评价心肌微灌注的指标.     

In Situ Measurement of Cyclic Plastic Zone and Internal Strain Response of Q&P Steel near Fatigue Crack Tip Region Based on Micro-DIC

The shape and internal dynamic response characteristics of the plastic zone near the fatigue crack tip region, especially the cyclic plastic zone (CPZ), are the main factors affecting the fatigue crack initiation and propagation behaviors of ductile metal materials. The existing methods for characterizing the CPZ have some problems, which include the complexity of the process, the difficulty of achieving in situ measurement, and the inability to characterize the dynamic response in the CPZ during the crack propagation process. Therefore, a novel method is proposed for the in situ measurement of the CPZ near the crack tip region based on image stitching and matching algorithms, a load–strain loop curve characteristic judgement algorithm, and the microscopic digital image correlation (DIC) method. A microscopic camera and a macroscopic camera are used to simultaneously capture the micro crack tip speckle images and the global crack image of the two sides of the Compact Tension (CT) specimen for calculating in situ crack length and crack tip strain fields. The proposed method was performed and verified by a fatigue crack growth (FCG) test and micro-hardness experiments with Quenching and Partitioning 980 (Q&P980) steel, and the results show that the method is feasible because the maximum error is less than 5%. A “butterfly wings” shape of the CPZ and a strain concentration phenomenon in the CPZ of the Q&P980 were observed. Moreover, as the fatigue crack propagates, the area of the CPZ and the degree of the strain concentration increase gradually. This method, which can obtain the in situ and tracking measurements of the crack tip CPZ, will help to increase our understanding of CPZ characteristics, the FCG mechanism, and the behavior of Q&P steel and the plastic metal materials similar to Q&P steel.     

In Situ Measurement of the Strain Field at the Fatigue Crack Tip Based on Sub-Image Stitching and Matching DIC

Studying the in situ measurement and evolution of the strain field at the crack tip during fatigue crack growth (FCG) is of great significance for understanding the fracture characteristics of materials and predicting fatigue life. Herein, a new method is proposed for the in-situ measurement of the strain field at the fatigue crack tip based on microscopic digital image correlation (DIC). The method proposed solves the problem of the existing in situ strain field measurement method being unable to dynamically track the crack tip and take the crack tip image due to the limitation of the field of view of the microscopic camera. A macroscopic camera is used to capture the global crack images on one side of the compact tension (CT) specimen. Meanwhile, a microscopic camera is used to track and capture the crack propagation speckle image on the other side of the CT specimen. The proposed method was verified by experiments with Quenching and Partitioning 980 (Q&P980) steel, and the results showed that the method has high accuracy, with the average measurement error being less than 5% and the maximum error being less than 10%. A butterfly shape of the measured strain field and the strain concentration near the crack tip were observed. The success of this method will help to obtain better insight into and understanding of the fracture behavior of metal materials as well as precise prediction of the fatigue life of metal materials.     

The Association between Smoking Cessation and Depressive Symptoms: Diet Quality Plays a Mediating Role

Objective: This cross-sectional study aimed to explore the association between smoking cessation and depressive symptoms and investigate the mediating role of dietary quality. Methods: We used data from the 2007–2014 National Health and Nutrition Examination Survey. Logistic regression models were applied to evaluate the associations between smoking cessation and depressive symptoms. Stratified analysis was performed according to different HEI levels. We examined the mediating role of HEI in the relationship between depressive symptoms and cessation duration using the Karlson–Holm–Breen (KHB) method. Results: A total of 20,004 participants aged 20 years or older were included in the analyses. There were significant correlations between years for smoking cessation and depressive symptoms (OR: 0.985, 95% CI: 0.971~0.999) after adjusting for correlation covariables. A likelihood ratio test showed that there was an interaction between smoking cessation and diet quality (p = 0.047). In the mediation analysis, we estimated that the increase in HEI scores after quitting smoking could explain the 6.91% decline in depressive symptoms. Conclusion: In this cross-sectional study, smoking cessation showed a protective effect on depressive symptoms and that diet quality can influence and mediate this association.     

NADPH氧化酶4在AGEs诱导内皮细胞活性氧生成中的作用研究

目的 晚期糖基化终末产物(AGEs)能诱发细胞内活性氧(ROS)生成增多而引起内皮细胞损伤,从而促进动脉粥样硬化的发生和发展,本组探讨AGEs刺激下内皮细胞ROS的生成及NADPH氧化酶4(Nox4)的作用.方法 培养人脐静脉内皮细胞(HUVECs),观察AGEs刺激下HUVECs细胞Nox4表达和ROS生成情况,应用RNA干扰技术沉默Nox4后,观察细胞内ROS的变化,分析Nox4的作用.结果 AGEs刺激后HUVECs细胞内ROS增加,而Nox4 siRNA转染后能显著降低内皮细胞ROS水平;Nox4 siRNA转染可以使基础水平的ROS减少45.9%,并对AGEs刺激后的ROS增加有明显的抑制作用.结论 Nox4是内皮细胞ROS生成过程中发挥调控作用的关键靶点,阻断Nox4能有效地抑制AGEs诱导的内皮细胞氧化损伤,进而可能阻遏动脉粥样硬化的发生和发展.