AN EPIDEMIOLOGICAL SURVEY OF CHOLELITHIASIS IN SHANGHAI

Objective To obtain a general overview of gallstone disease in Shanghai. Methods 3415citizens aged >20 in the community of Shanghai were randomly selected to undergo a clinical epidemiological study and an ultrasound examination to screen for cholelithiasis. Results Overall prevalence rate of gallstones was 6.5% (8.6% in women and 5.1% in men). Among the 3415 persons investigated, 65 had already undergone cholecystectomy. The percentage of asymptomatic gallstone was 70 .5% . Prevalence of gallstone diseases (gallstones plus cholecystectomy) increased with age significantly. Conclusion Compared to the research in Shanghai ten years ago, especially for the persons older than 50 years, the gallstone disease has become more frequent. The proportion of asymptomatic gallstones and the awareness is increasing.     

人外周血单核细胞和脐血CD34+细胞来源的树突细胞比较

目的比较从人外周血单核细胞及脐血CD34+细胞诱导树突细胞(DC)的方法及其特性.方法用淋巴细胞分离液分离外周血单个核细胞,贴壁法获得单核细胞;经GM-CSF及IL-4诱导获得DC.磁性活化细胞分选系统(MACS)分选脐血CD34+细胞,以GM-CSF、IL-4、TNF-α、SCF、FL、TPO等细胞因子诱导获得DC.用电镜、普通显微镜观察DC形态;流式细胞仪分析DC表型;同种混合淋巴细胞反应(allo-MLR)观察DC刺激T淋巴细胞增殖的能力.结果外周血单核细胞在因子GM-CSF、IL-4、TNF-α,脐血CD34+细胞在GM-CSF、IL-4、TNF-α、SCF、FL、TPO等因子作用下,可生成DC,并表达相应的DC分化抗原CD14、CD80、CD83、CD86、HLA-DR.脐血CD34+细胞具有较强的扩增能力,经2周诱导,体系细胞数可增加173.8士26.7倍,两种来源的DC均能刺激同种异体淋巴细胞的增殖反应.结论外周血单核细胞与脐血CD34+细胞,在体外均可诱导成DC,并具有相应的DC分化抗原和功能.     

心理社会因素对医学生自信水平的影响

目的：寻找影响医学自我评价的有关因素，为提高他们的自信程度提供参考。方法：采用个人评价问卷（PEI）、应付方式问卷、症状自评量有（SCL－90）及一般情况调查表（自制）对450例学生进行调查，结果：性别、身高、体重、班委、恋爱、母亲文化程度，父亲健康状况，家庭经济状况，解决问题，求助等因素与PEI量表总分量呈显著正相关，SCL－90各因子呈显著分和总均分及自责，幻想，退缩，合理化与PEI量表总分负相关。结论：医学生的自我评价受到自身心理状况，应付方式、家庭状况等因素的影响。     

网约护士参与“互联网+护理服务”意愿及影响因素研究

目的 探讨网约护士参与“互联网+护理服务”意愿及影响因素,为提高网约护士参与“互联网+护理服务”的积极性提供参考。方法 2022年1—2月,采用便利抽样法选取广州市开展“互联网+护理服务”医院的279名网约护士为研究对象,采用一般资料调查表、“互联网+护理服务”意愿影响因素量表和组织支持量表进行调查。结果 网约护士参与“互联网+护理服务”意愿得分(12.39±1.61),控制一般资料(职务、获得从业资格时间、居家护理服务经历)的影响后,发现感知风险、感知价值、便利条件、工具支持是网约护士参与“互联网+护理服务”意愿的影响因素(R²=0.641),可解释参与意愿变异的64.1%。结论 网约护士参与“互联网+护理服务”意愿处于中等偏上水平,为患者提供“互联网+护理服务”的意愿受感知风险、感知价值、便利条件和工具支持的影响。     

产科多器官功能障碍综合征临床分析

目的探讨产科多器功能障碍综合征（MODS）的诱因、临床诊断及处理。方法对16例MODS的临床资料进行回顾性分析。结果导致MODS的主要因素为妊娠期高血压疾病及产后出血,器官功能障碍以肾功能衰竭为最多见。结论及时处理MODS的诱发因素,积极治疗妊娠期高血压疾病及产后出血,早期诊断及治疗肾功能衰竭及凝血功能障碍,是减少产科MODS患者死亡的关键。     

眼附属器淋巴组织增生性病变的临床病理和分子遗传学特征及其意义

目的 分析眼附属器淋巴组织增生性病变的临床病理特点,探讨其分子遗传学特征及其意义.方法 收集1995-2007年37例眼附属器淋巴组织增生性病变石蜡组织标本(其中5例为反应性增生性病变,32例为淋巴瘤),依据2001年WHO肿瘤分类标准对32例淋巴瘤标本重新诊断分类.采用IgH、MALT1、bcl-6、c-Mye、bcl-2、CCND1、bcl-10、FOXP1双色分离重排探针、IgH/bcl-2双色融合易位探针和18号染色体着丝粒探针,利用间期荧光原位杂交(FISH)的方法 检测眼附属器淋巴组织增生性病变的分子遗传学特点.结果 32例淋巴瘤均为非霍奇金B细胞淋巴瘤.其中,黏膜相关淋巴组织结外边缘区B细胞淋巴瘤(MALT)淋巴瘤28例(87.5%),滤泡性淋巴瘤2例,弥漫性大B细胞淋巴瘤2例.60.7%(17/28)的眼附属器MALT淋巴瘤携带分子遗传学异常.其中,IgH基因断裂1例,但未找到与其发生相互易位的伙伴基因;基因3拷贝者16例,其中MALT1基因、bcl-6基因和c-Myc基因3拷贝的发生率分别为25%(7/28)、43%(12/28)和7%(2/28).16例基因3拷贝病例中,两种基因3拷贝合并存在者5例,其中bcl-6基因合并MALT1基因3拷贝者4例,bcl-6基因合并c-Myc基因3拷贝者1例.进一步研究显示,MALT1基因3拷贝者均存在18号染色体三体.2例滤泡性淋巴瘤都携带t(14;18)(q32;q21)/IgH-bcl-2.2例弥漫性大B细胞淋巴瘤均存在遗传学异常,1例表现为bcl-6基因3拷贝合并18号染色体三体,另1例表现为bcl-6基因3拷贝合并IgH和c-Myc基因双断裂.5例反应性淋巴组织增牛性标本均未见分子遗传学异常.结论 MALT淋巴瘤是眼附属器最常见的淋巴瘤类型;间期FISH有助于淋巴组织增生性病变的良恶性鉴别及淋巴瘤的分类;MALTI基因3拷贝者由18号染色体三体所致;18号染色体三体和bcl-6基因3拷贝(可能为3号染色体三体所致)是眼附属器MALT淋巴瘤常见的分子遗传学异常.     

基于通用中间件接口服务器的远程医疗信息系统

在远程医疗信息系统共享平台的设计中,提出一种构建通用中间件接口服务器实现多家医院信息系统HIS与PACS的无缝连接方案。着重介绍了DICOM中间件、HL7消息中间件、生态识别和PKI技术在系统集成中的应用。     

雌性Fmr1基因敲除小鼠生殖功能的初步研究

目的初步研究敲除Fm r1基因对动物生殖功能的影响。方法6~8周龄雌性Fm r1基因敲除小鼠24只,分为对照组、春季超排组和冬季超排组,每组8只,进行超排,用放射免疫分析法测定超排前后血清雌二醇(E2)、孕酮(P)、促黄体生成素(LH)和促卵泡生成素(FSH)含量,以及不同季节的超排卵数,并进行统计学处理和分析。结果超排后小鼠血清中P和LH含量明显增加[(24.43±13.33)比(1.60±0.46);(173.86±112.09)比(0.36±0.23),P<0.01]。与冬季(11.44±5.93)比较,春季(37.25±13.91)的超排卵数明显增加(P<0.01)。结论雌性Fm r1基因敲除小鼠的生殖系统功能没有明显异常。与正常小鼠一样,Frm 1基因敲除小鼠机体内P和LH的分泌随动物的生理发育时期而变化。其超排效果随季节而有显著不同。     

广州地区围产儿脏器重量及大小测量的研究

目的　探讨广州地区围产儿脏器重量及大小的发育规律 .方法　选择 6 2 5例胎龄准确的单胎 ,除外明显浸软、IUGR、水肿儿、巨大胎、有胸腹水者 ,新生儿除外先天性心脏病及有明显疾病的脏器 .根据胎龄分为 6组 ,分别测量围产儿体重、身长和各脏器重量、长度 .进行统计分析 .结果　胰腺、肺发育最早 ,肾脏与肺发育最快 ,出生后脑增长最少而胰腺增长最快 ,肠变异最大等规律 .结论　围产儿脏器资料用于围产儿病理研究有一定意义     

Immunity to type IX collagen in rodents: a study of type IX collagen for autoimmune and arthritogenic activities

Type IX collagen (CIX), a cartilage-specific glycoprotein, constitutes ≤ 10% of cartilage collagen. To ascertain whether CIX can induce arthritis as shown for type II and XI collagen (CII and CXI), outbred rats were sensitized with bovine, chick and human CIX; inbred rats, mice, and guinea pigs were sensitized with bovine CIX. Mice and guinea pigs proved resistant to arthritis, as did rats sensitized with CIX/Freund's incomplete adjuvant (FIA). Arthritis was seen in rats when 100 μg of Mycobacterium tuberculosis (Mtb) were added to FIA, but seldom with smaller doses of Mtb, suggesting the arthritis was adjuvant-induced. High levels of antibodies to rat CIX, containing complement-fixing subclasses, were detected in rat sera in addition to DTH and lymphocyte proliferation responses to rat CIX. Given the potential for CIX-induced disease, CIX-sensitized rats were injected intraperitoneally with lipopolysaccharide (LPS) to stimulate proinflammatory cytokine release, and intra-articularly with rat CIX to stimulate arthritis. LPS stimulation was ineffective; however, intra-articularly injected CIX produced transient synovitis. When rats with stable adjuvant arthritis were sensitized with CIX/FIA, significant increases in paw volume were measured compared with controls given CI/FIA. Immunohistochemical studies of actively and passively sensitized rats revealed deposits of CIX antibody, but not C3, at the joint margins where proteoglycan staining was weak. Together, these findings suggest that autoimmunity to CIX, in contrast to CII and CXI, is not directly pathogenic but may contribute to joint injury provided arthritis is initiated by an independent disease process.