神经根型颈椎病肝肾亏虚证、气血两虚证中医证候指标专家问卷分析

目的：建立神经根型颈椎病肝肾亏虚证、气血两虚证中医证候指标。方法：通过文献循证、回顾病历资料提取相关条目,编制神经根型颈椎病中医证候专家问卷,向全国范围内遴选出的220位专家以信函的方式进行调查,根据专家咨询表的统计分析方法,采用积极系数、均数、满分比、等级和、变异系数5个指标进行分析。结果：回收有效问卷183分,积极系数为83.2%;肝肾亏虚证中,满分比〉0.5、均数〉1.5、变异系数〈0.4的条目有＂颈、肩、肢酸软绵痛＂、＂麻木＂、＂颈项肩臂活动不利＂、＂神疲乏力＂、＂腰膝酸软＂,舌脉部分均数、满分比〉0.5的有＂舌体瘦＂、＂舌质红＂、＂舌质红绛＂、＂少苔＂、＂脉弦细＂、＂脉沉细＂、＂脉弦细数＂,但变异系数均〉0.4;气血两虚证中满分比〉0.5、均数〉1.5、变异系数〈0.4的条目有＂麻木＂、＂活动后痛甚、休息后痛减＂,舌脉部分均数、满分比〉0.5的有＂舌质淡＂、＂苔薄白＂、＂脉细弱＂,但变异系数均〉0.4,条目＂颈、肩、肢软痛＂改为＂颈、肩、肢疼痛乏力＂。结论：以上条目初选为神经根型颈椎病肝肾亏虚证、气血两虚证中医证候指标。     

汽车尾气污染对交通警察健康的影响

目的了解济宁市交警工作场所环境污染状况及环境污染对其健康的影响。方法在济宁市区选取5个有代表性的交通路口交警执勤点,监测其PM10、SO2、NOX、CO、Pb五个污染指标,并选取在五个执勤点上工作的120名交警和作为对照组的98名大专院校学生,按统一表格进行一般健康状况调查,统计分析污染对交警健康状况的影响。结果在交通路口执勤点所检测的5个污染指标有不同程度超标,结果远高于对照点,PM10最高达5.62mg/m3,为对照组平均值的15.8倍,SO2最高达2.63mg/m3,为对照组平均值的41.8倍,NOX最高达1.77mg/m3,为对照组平均值的16.7倍,CO最高达11.8mg/m3,为对照组平均值的6.6倍,Pb最高达1.62μg/m3,为对照组平均值的4.5倍;交警的患病情况显著高于对照组（χ2=5,P〈0.05）。结论交通警察工作场所环境污染较为严重,健康状况受到影响,应采取积极有效的防治措施。     

Results of Anatomic Lateral Ankle Ligament Reconstruction with Tendon Allograft

Chronic ankle instability can be addressed surgically through direct lateral ligament repair, non-anatomic reconstruction, or anatomic reconstruction. The goal of this study was to assess the radiographic, functional, and clinical results of patients undergoing an anatomic lateral ankle ligament reconstruction using an anterior tibial tendon allograft. Eleven patients (12 feet; mean age, 48.9 ± 11.4 years) undergoing lateral ankle ligament reconstruction were followed at a mean of 3.5 ± 1.7 years after surgery (range, 1.2 to 5.0 years). Indications for surgery were previous failed repair (i.e., Broström; one case), hyperlaxity (seven cases), and high-demand patients (four cases). Subjective outcomes including the Foot and Ankle Outcome Score (FAOS), SF-36, and activity level were assessed. Mortise and lateral ankle stress radiographs were performed. The FAOS daily activity and sports activity subscores were 93.4 (range, 77.9 to 100) and 78.6 (range, 30 to 100), respectively. The SF-36v2 physical health and mental health components were 50.4 (range, 30.6 to 65.7) and 45.0 (range, 24.8 to 68.0), respectively. Four patients (five feet) reported no restriction; six patients reported mild restrictions, and one patient reported moderate activity restrictions. Tibiotalar tilt improved significantly from 20.2° to 4.6° after surgery (p < 0.01). The radiographic anterior displacement of the talus from the tibia was 6.5 mm postoperatively. The technique described restores mechanical stability in patients with chronic lateral ankle instability and may be considered in a select group of patients.     

代谢综合征多元医学参考值标准的应用

目的 探讨多指标组合指标法制定的代谢综合征(MS)多元医学参考值标准的应用.方法 以2008年6月至12月在汕头大学医学院第一附属医院行健康体检的居民为研究对象,收集体检相关数据,随机抽取资料完备的1204例,分别采用多元医学参考值标准、2007年<中国成人血脂异常防治指南>(防治指南)以及2005年美国国家胆固醇教育计划成人治疗组第三次报告修订版(ATP III)制定的MS诊断标准计算该人群MS的患病率,分析各定义下诊断MS的差异和一致性.结果 应用多元参考值、防治指南和ATPⅢ三种标准计算人群MS的标化患病率分别为9.9%、9.3%和14.8%(P<0.01);男性患病率(分别为10.5%、11.0%和15.1%)高于女性(分别为8.7%、5.8%和13.1%,P<0.01).多元参考值标准下该人群血压异常率为32.6%,低于防治指南和ATPⅢ标准的检出率(均为45.1%);在诊断为MS的人群中,多元参考值对肥胖的检出率最高(78.7%).多元参考值与防治指南以及ATPⅢ的检出结果一致性较好,Kappa系数分别为0.759和0.715(P<0.01).结论 多元参考值标准分别提出了适合男性和女性MS的诊断标准,对MS各指标检出率有其特点,适用于该地区人群MS的诊断.

Abstract：

Objecttve To investigate the application of the reference value criterion for metabolic syndrome (MS)established by the multivariate combination indicatrixes method.Methods The data of participants was collected In the chronic disease monitoring site built by the First Afflicted Hospital of Shantou University Medical College from June to December in 2008.One thousand two hundred and four people were randomly selected to calculate the preValence rates of MS and its components according to these three criterions proposed by the multivariate combination indicatrixes method,guidelines of dyslipidemia of Chinese adult in 2007,and the Third Report of National Cholesterol Education Program-Adult Treatment Panel III(NCEP-ATP III2005)in 2005,and to compare the differences and agreement rates between these criterions. Results According to multivariate reference value,guidelines and ATP III,the age-adjusted MS prevalence rates were 9.9%,9.3%and 14.8% respectively(P<0.01),and the prevalence rate in male was more than that in female(P<0.01).The prevalence rate of abnormal blood pressure according to multivariate reference value was 32.6%,which was less than the value of guideline and ATP III (45.1%).Among the MS patients,the detection ratio of obesity diagnosticed by multivariate reference value was 78.7%,which was the highest.The diagnostic agreement rate between multivariate and guidelines.multivariate and ATP Ⅲ(2005)was high and the Kappa value was 0.759 and 0.715 respectively(P<0.01).Condusions,The multivariate reference criterion for MS about male and female has been set up.The multivariate reference value criterion for MS is adaptable for enrolled population.     

Targeted polyphosphatase expression alters mitochondrial metabolism and inhibits calcium-dependent cell death

Polyphosphate (polyP) consists of tens to hundreds of phosphates, linked by ATP-like high-energy bonds. Although polyP is present in mammalian mitochondria, its physiological roles there are obscure. Here, we examine the involvement of polyP in mitochondrial energy metabolism and ion transport. We constructed a vector to express a mitochondrially targeted polyphosphatase, along with a GFP fluorescent tag. Specific reduction of mitochondrial polyP, by polyphosphatase expression, significantly modulates mitochondrial bioenergetics, as indicated by the reduction of inner membrane potential and increased NADH levels. Furthermore, reduction of polyP levels increases mitochondrial capacity to accumulate calcium and reduces the likelihood of the calcium-induced mitochondrial permeability transition, a central event in many types of necrotic cell death. This confers protection against cell death, including that induced by beta-amyloid peptide, a pathogenic agent in Alzheimer's disease. These results demonstrate a crucial role played by polyP in mitochondrial function of mammalian cells.     

An analysis of main causes of low efficiency of rendering care for pyo-necrotic complications of syndrome of the diabetic foot

In the city of Chelyabinsk during 1996 through 2003 there was growing incidence of necrotic complications of syndrome of the diabetic foot (SDF) from 26.0 up to 50.5 per 100 000 adults (p < or = 0.001). According to prognosis the incidence of SDF will grow by 2010 more than two times (R2 = 0.9849). Comparison of effectiveness of surgical treatment on Diabetological centers (1st group) and non-specialized institutions (2nd group) has shown that lethality in the first group was 4.2%, in the second group--9.7%. In the first group the frequency of high amputations decreased from 31.3% in 1996 to 12.3% in 2005 (p < 0.05). As a whole, organizational, diagnostic and medical defects of treatment were noted in 89.5 out of 100 patients in both groups, the errors in specialized institutions being made 5.7 times more rarely than in non-specialized ones, that speaks well to specialized Diabetological centers.     

Morphological analysis of genetically damaged thyrocytes in nodular pathology of the thyroid gland

The smears of isolated thyrocytes with micronuclei taken from 25 patients with nodular pathology of the thyroid gland were investigated. In all kinds of benign nodular pathology the number of micronucleated thyrocytes comes to 0.1-0.3%. These values correspond to the spontaneous level of the content of aberrant thyrocytes in the thyroid gland of highly specialized cell populations. In papillary carcinoma of the thyroid gland the average occurrence of micronucleated thyrocytes in the tumor nodule was about 0.4%. In the tissue outside the tumor taken from both the same and the opposite lobes, the content of cells with micronuclei proved to be substantially higher--0.93-1%. So, the marked increase of the concentration of genetically damaged cells in the thyroid parenchyma proved to be characteristic of the carcinoma of the thyroid gland.