青春期前型外阴纤维瘤临床病理分析

目的:探讨青春期前型外阴纤维瘤(prepubertal-type vulva fibroma,PVF)的临床病理特征。方法:分析2例PVF的临床特点,光镜观察组织病理学形态及免疫组织化学特征并复习相关文献。结果:2例分别为8岁和39岁女性,均以大阴唇肿块就诊。肿块均分布在一侧,4～5 cm大。组织学观察病变位于真皮层边界不清,由稀疏的梭形纤维母细胞样的细胞和大量胶原纤维组成,病变向皮下组织延伸,在邻近的脂肪组织及血管簇、神经周围穿插性生长;梭形细胞形态温和无异型、核分裂象未查见。免疫组织化学标记显示:瘤细胞表达波形蛋白、CD34,不表达SMA、desmin、CD99、S-100蛋白、bcl-2,成人局灶表达ER和PR。结论:PVF是一种好发于青春前期幼女或女童外阴的良性间叶性病变,偶可发生于成年人。其发生可能与激素有关并起源于外阴阴道间质细胞,表现为纤维母细胞分化特征。临床有少量病例如切除不净可局部复发,并见可自发性消退病例。     

低温含血保护液微流量持续灌注对热缺血猪心的保护

目的研究低温含血保护液微流量持续灌注对热缺血猪心的保护作用,探讨心脏移植中供心保护的有效方法。方法24只离体猪心随机分为实验组（n=12,热缺血10min,4℃含血保护液持续灌注8h）和对照组（n=12,热缺血10min,4℃保护液浸泡保存8h）,进行原位心脏移植,分别监测心脏复跳及血流动力学情况：心率（HR）、平均动脉压（MAP）、心输出量（CO）,心肌肌钙蛋白T（cTnT）、肌红蛋白（Mb）水平。结果实验组心脏复跳情况、血流动力学优于对照组;对照组心肌蛋白显著高于实验组（P〈0．05）。结论低温含血保护液微流量持续灌注对热缺血猪心的心功能以及心肌组织有较好的保护作用。     

Microbiological assessment of indoor air of a teaching hospital in Nigeria

Objective

To investigate the quality of indoor air of different wards and units of Olabisi Onabanjo University Teaching Hospital, Sagamu, to ascertain their contribution to infection rate in the hospital.

Methods

The microbial quality of indoor air of nine wards/units of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria was conducted. Sedimentation technique using open Petri-dishes containing different culture media was employed and samplings were done twice daily, one in the morning shortly after cleaning and before influx of people/patients into the wards/units and the other in the evening when a lot of activities would have taken place in these wards. Isolates were identified according to standard methods.

Results

Results showed that there was a statistically significant difference (χ² = 6.016 7) in the bacteria population of the different sampling time whereas it was not so for fungi population (χ² = 0.285 7). Male medical ward (MMW) and male surgical general (MSG) recorded the highest bacterial and fungal growth while the operating theatre (OT) was almost free of microbial burden. The bacteria isolates were Staphylococcus aureus, Klebsiella sp., Bacillus cereus, Bacillus subtilis, Streptococcus pyogenes and Serratia marscences while the fungi isolates included Aspergillus flavus, Penicillium sp., Fusarium sp., Candida albicans and Alternaria sp. Staphylococcus aureus was the predominantly isolated bacterium while Penicillium sp. was the most isolated fungus.

Conclusions

Though most of the microbial isolates were potential and or opportunistic pathogens, there was no correlation between the isolates in this study and the surveillance report of nosocomial infection during the period of study, hence the contribution of the indoor air cannot be established. From the reduction noticed in the morning samples, stringent measures such as proper disinfection and regular cleaning, restriction of patient relatives'' movement in and out of the wards/units need to be enforced so as to improve the quality of indoor air of our hospital wards/units.     

利用微型种植体支抗压低下颌磨牙的临床研究

目的研究安氏Ⅰ类错患者中,采用微型种植体作支抗,压低下颌磨牙的临床效果及其作用特点。方法选择12例成人患者,将24枚微型种植体植于下颌第一磨牙近、远中的颊侧牙槽骨内,Ni-Ti螺旋弹簧拉长后分别连接于下颌第一磨牙带环颊侧,来压低下颌第一磨牙。测量磨牙的压低量、颊舌向的位置变化、近远中倾斜度以及磨牙移动的速度,并通过治疗前后的X线片对比以观察磨牙牙根有无吸收,牙周膜腔的变化情况。通过测量下颌第二磨牙与下颌中切牙的位置变化来衡量支抗强弱。结果下颌第一磨牙平均压低3.5mm,疗程5.2个月,平均移动速度0.67mm/月;磨牙牙冠近颊尖、远颊尖分别颊向移动1.2mm、1.3mm。磨牙牙根没有吸收,牙周膜腔宽度没有改变。下颌第二磨牙与下颌中切牙的位置没有改变。结论所有下颌磨牙均被压低到了恰当的位置,为对颌牙的修复治疗提供了足够的间隙。同时该方法临床操作简单易行,适于推广。     

SA/hIL21双功能融合蛋白的表达、纯化及生物学活性检测

目的 制备链亲和素(SA)标记的人白细胞介素21融合蛋白(SA-hIL-21),检测其生物学活性.方法 构建hIL21-SA-pET21及pET24a-SA-hIL21质粒,利用大肠杆菌BL21(DE3)表达两种双功能融合蛋白,并利用镍金属螯合层析柱(Ni-NTA)纯化,之后透析复性,Western blotting进行鉴定,最后利用MTT法检测hIL21-SA及SA-hIL21融合蛋白与抗CD3单克隆抗体(anti-CD3)共刺激人外周血淋巴细胞的增殖活性,流式细胞仪分析两种融合蛋白对生物素化的MB49肿瘤细胞的锚定修饰效率.结果 hIL21-SA及SA-hIL21重组融合蛋白在大肠杆菌中实现了高效表达,约占菌体蛋白的30%,经复性后hIL21-SA及SA-hlL21具有了双重活性,即不仅可以与抗CD3单抗共刺激淋巴细胞的增殖,而且具有了SA介导的高效结合已生物素化的MB49肿瘤细胞表面的功能(表面修饰效率95.18%,96.91%).结论 本实验成功研制了具有双重活性的hIL21-SA及SA-hlL21融合蛋白,两种融合蛋白的双功能活性无显著性差异,该项研究为SA/hIL21双功能融合蛋白应用于肿瘤疫苗以及肿瘤局部治疗奠定了基础.     

南京医科大学七年制临床医学专业人才培养效果评价

通过对毕业生及其培养或用人单位的问卷调查,本文分析了南京医科大学七年制临床医学专业人才培养的成效,以及江苏省医疗卫生事业发展对高层次医学人才的需求.结果 显示,临床实践能力和科研创新能力是医疗卫生事业发展所需要的高层次医学人才的重要能力;在三级甲等医院工作,具有硕士/博士学位、在专业技术岗位的被调查者更加看重医学生的科研创新能力;而在1年通识教育、4年医学专业教育(含1年临床课程及见习、1年临床通科实习)、2年二级学科轮转模式下培养的七年制临床医学专业毕业生的临床实践能力较强,但是科研创新能力不足,且学业负担偏重.因此,应当加强对七年制临床医学专业学生科研创新能力的培养和临床实践能力的通科训练.

Abstract：

An evaluation of 7-year medical education program in Nanjing Medical University was performed via questionnaire survey to the graduates and the staff of hospitals in which the graduates work,and the demand for advanced quality of medical graduates in the field of medical health care in Jiangsu Province is further analyzed. The results showed that the capacity for clinical practice and the capacity for research and innovation are the most important, which can meet the demands of health service development for high-level medical talents. The staff working in advanced hospitals, possessing master or doctor degree,or working as medical experts put more emphasis on the ability of the graduates to do innovative scientific research. Through the completed procedure of the 7-year program includes college general education for 1 year, medical education for 4 years ( containing senior clinical clerkship for 1 year and internship for 1 year) and alternation for medical and surgery subspecialties for 2 years, the graduates showed higher ability to do clinical practice, but not showed the growth of capacity for research and innovation. The most staff investigated proposed an enhancement in training for the capacity for innovative research and general clinical practice.     

Facteurs associés aux perdus de vue des patients sous traitement antirétroviral dans un centre de traitement ambulatoire du VIH à Conakry,Guinée

Background

Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry.

Determination of sibship in any two persons

BACKGROUND: Parentage testing laboratories may be asked to provide genetic evidence that two persons are or are not related, when no other relatives are available for study. Simple methods using autosomal, codominant, unlinked genetic systems can determine if two people are blood relatives (e.g., siblings). STUDY DESIGN AND METHODS: The odds ratios (full sibship index) of true sibling pairs were determined from two-child paternity cases and compared with regionally and racially matched control pairs of unrelated children. The sharing of two, one, or no alleles was observed in pairs of children at three independent, polymorphic VNTR (variable number of tandem repeat) sequences loci. The sibship index was calculated as (the chance that an observation would occur if two children were siblings) divided by (the chance that it would occur if the two were unrelated). Sibship indices and the frequencies of shared alleles were determined for 20 sibling pairs and 20 control pairs. RESULTS: Sibship index values were less than 1 in all 20 pairs of unrelated children. Sibship index values were greater than 100 in nine pairs of siblings (45%), between 10 and 100 in five pairs (25%), between 1 and 10 in four pairs (20%), and less than 1 in two pairs (10%). Siblings shared two alleles in 17 of 60 observations (28.3%); controls shared two alleles in 0 of 60 observations (0%). CONCLUSION: The sharing of one allele and the sharing of no alleles at a polymorphic locus of high heterozygosity provide limited information for and against sibship, respectively. The sharing of two alleles produces strong evidence favoring sibship. In a given case, the study of more than three polymorphic loci of high heterozygosity may be needed to develop the evidence that two people are siblings. The general logic and methods used for siblings apply to kinship analyses of other two-person pedigrees.     

Long-term intraocular pressure control by trabeculectomy: a ten-year life table

A retrospective study of 179 eyes in 127 patients who underwent trabeculectomy at Sydney Eye Hospital under the supervision of two surgeons between 1977 and 1982 was carried out. Survival analysis by life table method shows cumulative two, five, and 10 year success rates to be 78%, 70%, and 67% respectively, with mean duration of intraocular pressure control (IOP<21 mmHg) being 88 months. Anti-glaucoma medication improved the long-term survival significantly (Hazard Ratio of 0.49 and P = 0.01) so that when the definition for failure is taken as IOP >20 mmHg while using medication, the two, five and 10 year success rates were 89%, 87% and 86% respectively. A rise in average intraocular pressure is seen between two weeks and three months after trabeculectomy. The improvement in long-term success rate with use of topical steroids was suggestive (Hazard Ratio of 0.69) but not conclusive (P = 0.21). No difference was found in survival comparing fornix versus limbal based flap technique.     

Relative Skeletal Maturation and Population Ancestry in Nonobese Children and Adolescents

More rapid skeletal maturation in African‐American (AA) children is recognized and generally attributed to an increased prevalence of obesity. The objective of the present study was to evaluate the effects of population ancestry on relative skeletal maturation in healthy, non‐obese children and adolescents, accounting for body composition and sexual maturation. To do this, we leveraged a multiethnic, mixed‐longitudinal study with annual assessments for up to 7 years (The Bone Mineral Density in Childhood Study and its ancillary cohort) conducted at five US clinical centers. Participants included 1592 children, skeletally immature (45% females, 19% AA) who were aged 5 to 17 years at study entry. The primary outcome measure was relative skeletal maturation as assessed by hand‐wrist radiograph. Additional covariates measured included anthropometrics, body composition by dual‐energy X‐ray absorptiometry (DXA), and Tanner stage of sexual maturation. Using mixed effects longitudinal models, without covariates, advancement in relative skeletal maturation was noted in self‐reported AA girls (～0.33 years, p < 0.001) and boys (～0.43 years, p < 0.001). Boys and girls of all ancestry groups showed independent positive associations of height, lean mass, fat mass, and puberty with relative skeletal maturation. The effect of ancestry was attenuated but persistent after accounting for covariates: for girls, 0.19 years (ancestry by self‐report, p = 0.02) or 0.29 years (ancestry by admixture, p = 0.004); and for boys, 0.20 years (ancestry by self‐report, p = 0.004), or 0.29 years (ancestry by admixture, p = 0.004). In summary, we conclude that advancement in relative skeletal maturation was associated with AA ancestry in healthy, non‐obese children, independent of growth, body composition, and puberty. Further research into the mechanisms underlying this observation may provide insights into the regulation of skeletal maturation. © 2016 American Society for Bone and Mineral Research.