激素性股骨头坏死囊性变分布规律及病理特点

背景：股骨头力学承载能力下降是引起股骨头塌陷的主要原因,而囊性变的产生影响了髋关节正常的力学传导途径,但目前很少有文献对股骨头坏死发展过程中二者的关系进行探索。目的：结合热力图模型和激素性股骨头坏死病理结果探讨激素性股骨头坏死囊性变的分布规律及病理特点。方法：以2021年6-12月于广州中医药大学第三附属医院被诊断为激素性股骨头坏死的30例(30髋)患者为研究对象,提取激素性股骨头坏死囊性变轮廓线,将轮廓线匹配至标准股骨头模型上,对轮廓线进行热图呈现;统计股骨头坏死位置与坏死面积,研究二者之间的关系;苏木精-伊红染色观察股骨头标本骨组织形态结构变化。结果与结论：①通过构建激素性股骨头坏死囊性变热力图及结合股骨头病理结果发现,激素性股骨头坏死囊性变好发于股骨头中外侧柱,相较于内侧柱囊性变的面积而言,外侧柱囊性变面积最大,且随着囊性变发生位置的内移,其面积也会随着减小;②并且囊性变周围散在分布微小骨折线,它可能是影响股骨头力学承载能力和头内稳定性的重要因素之一。https://orcid.org/0000-0003-3011-4028(田佳庆)中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

hCG对JEG-3滋养细胞系表达细胞因子的影响

目的：揭示人类绒毛膜促性腺激素（hCG)是否通过改变细胞因子的生成而影响滋养细胞的侵袭性。方法：以永生化的滋养细胞系JEG－3为研究对象,采用逆转录多聚酶链反应（RT－PCR）方法观察了hCG对JEG－3细胞与细胞侵袭力调节有关的多种因素因子表达的影响,结果：JEG－3细胞表达HGF,IGF－II,VEGF和TGF－β3,且VEGF的表达以VEGF121和VEGF165为主,而不表达IGF,TGF－1β,TGF－β2,IL－β1,25U／mL hCG处理50h可显著降低JEG－3细胞中HGF的表达,同时强烈诱导VEGF121和VEGF165的表达,而其它基因的表达未发生明显变化,结论：HGF对滋养细胞的侵入起促进作用,而VEGF则具有抑制效应,说明,高浓度的hCG可能通过两种细胞因子的自分泌机制对滋养细胞的侵入起抑制作用。     

螯合剂去除根管玷污层的作用及其影响因素

背景：根管玷污层可影响根管药物进行消毒,同时可降低充填材料与根管壁的密合性,还可使根尖微渗漏显著增加,造成根管治疗的失败,而能否有效去除玷污层是临床上成功进行根管治疗的前提和关键.目的：从螯合剂基本结构出发对其去除根管玷污层作用进行叙述,深入解析影响螯合剂去除玷污层效果的各种因素.方法：第一作者利用计算机检索 Medline数据库（1999年1月至2011年12月）,以“Chelating agent, smear layer, root canal irrigation, root canal preparation”为检索词进行文献初检,筛选后纳入50篇文章进行综述.结果与结论：影响玷污层去除的因素还有冲洗液的浓度、温度、冲洗量、作用时间、冲洗液的输送方式、与其他冲洗液的协同作用等,其中影响螯合剂去除玷污层的因素主要是冲洗时间和冲洗液的配伍问题,螯合剂对牙本质小管的侵蚀,作用时间越长对其破坏越大.超声的震荡方式也可以增强螯合剂的作用能力,更快的速度到达根尖区,其与次氯酸钠联合应用可提高效能,至于最佳组合仍有待进一步探讨。     

大鼠腹腔脂肪干细胞的分离培养及诱导成骨

背景：脂肪干细胞取材方便、增殖旺盛、具有多向分化潜能,有望取代骨髓间充质干细胞而成为新一代组织工程的种子细胞。然而,脂肪干细胞的分离培养仍存在诸多困难与不足。目的：优化脂肪干细胞的分离培养方法,并鉴定其成骨分化潜能。方法：选取200g成年雌性大鼠1只,无菌环境下切取大鼠肾脏、子宫周围及腹后外侧白色脂肪组织,多次胶原酶消化法分离消化,低糖培养基培养脂肪干细胞,倒置显微镜下观察脂肪干细胞的形态变化及增殖能力。采用成骨诱导培养液对第3代细胞进行成骨诱导,并采用碱性磷酸酶、茜素红染色方法进行鉴定。结果与结论：脂肪干细胞形态以长梭形为主,增殖活跃呈旋涡状生长。经成骨诱导10d后,碱性磷酸酶染色为阳性;成骨诱导28d后,茜素红染色阳性。提示采用多次酶消化法得到的大鼠腹腔源性脂肪干细胞在体外易于分离培养,可以稳定传代。在一定条件诱导下,可以向成骨细胞分化。采用以上方法进行脂肪干细胞的分离培养可以为组织工程提供大量、优质的种子细胞。     

妇科手术后下肢深静脉血栓形成的风险因素研究

目的 探讨妇科手术患者术后形成下肢深静脉血栓的风险因素.方法 选择接受妇科手术的患者500例,手术前对年龄、体重指数、内科合并症、肿瘤性质、恶性肿瘤家族史和血栓栓塞疾病家族史等风险因素进行量化评估.结果 妇科手术后下肢深静脉血栓的发生率为9.20％;年龄（OR=1.066）和肿瘤性质（OR=10.788）是妇科手术后下肢深静脉血栓形成的风险因素.结论 手术前对妇科疾病患者进行下肢深静脉血栓风险量化评估,有助于早期认识疾病的高危因素,降低下肢深静脉血栓的发生率.     

Prevalence of syphilis infection in different tiers of female sex workers in China: implications for surveillance and interventions

Background

Streptococcus pneumoniae is a leading cause of invasive infection in young children causing morbidity and mortality. Active surveillance systems of invasive pneumococcal disease (IPD) are recommended worldwide. The aim of this study was to estimate the current incidence of IPD and to describe the serotype distribution and the antimocrobial susceptibility of S. pneumoniae isolates in children aged less than 5?years residing in North-West Lombardy, Italy.

Methods

A twelve-month prospective active surveillance system recruited all children aged less than 5?years admitted for suspicion of IPD at emergency room of ten hospitals located in the monitored area. Blood samples were taken in all participants for confirmation of IPD based on isolation of S. pneumoniae from blood. Pneumococcal meningitis and sepsis were additionally confirmed by cerebrospinal fluid analysis. Serotyping and antimicrobial susceptibility testing were performed on isolates from blood.

Results

A total of 15 confirmed cases of IPD were detected among 135 recruited children, including pneumonia (n?=?8), bacteremia (n?=?4), sepsis (n?=?2) and meningitis (n?=?1). The annual IPD incidence rate was 50.0/100,000 (95%CI, 30.5-82.5/100,000). Incidence was 58.3/100,000 (28.8-120.1/100,000) among children aged less than 2?years and 44.4/100,000 (22.9-87.5/100,000) among children aged 2?C4?years. Thirteen isolates were typified. The most common serotype was 19A (23.1%) that together with serotypes 1, 7F and 19F accounted for 69.2% of typified isolates. Serotypes 14, 23F, 12B and 15C were also identified. The 7- and 13-valent pneumococcal conjugate vaccines covered respectively 30.8% and 84.6% of typified IPD cases. One isolate (serotype 15C) was penicillin-resistant and caused meningitis.

Conclusions

The inclusion of the 13-valent pneumococcal conjugate vaccine in immunization programs of young children might be considered to reduce incidence and morbidity of invasive pneumococcal disease in this surveilled population.     

22例伪膜性结肠炎临床特征分析

背景:我国不合理使用抗生素的现象严重,抗生素相关性腹泻如伪膜性结肠炎(PMC)的发病率呈上升趋势。目的:综合分析PMC的临床特征以提高其诊治水平。方法:收集2007年6月～2012年2月于湖南省人民医院住院治疗,经结肠镜检查确诊的PMC患者,对其病史资料进行回顾性分析。结果:共22例PMC患者纳入研究,其中70岁以上者18例(81.8%),18例患者存在基础疾病。所有患者均于使用抗生素过程中出现腹泻,并可伴有不同程度的腹痛、发热、血便等其他症状。使用头孢菌素类抗生素者最多见(14例),20例患者联合使用两种或两种以上抗生素。21例接受结肠镜检查者均可见典型伪膜样病灶,内镜分型轻度9例,中度7例,重度5例。经停用原有抗生素以及使用甲硝唑、万古霉素、益生菌制剂等治疗后,21例患者好转出院。结论:PMC多发生于有基础疾病的老年人,病程早期缺乏特异性临床表现。结肠镜检查是诊断PMC的重要手段之一,确诊后应尽早停用原有抗生素,使用足量、足疗程的甲硝唑和万古霉素以及益生菌制剂。     

艾司西酞普兰治疗首发重症抑郁伴失眠患者的临床试验研究

目的观察艾司西酞普兰对首发重症抑郁伴失眠患者睡眠因子的影响。方法中国地区4家中心开放研究,对伴失眠的首发重症抑郁患者进行询问病史、体格检查、实验室检查、匹兹堡睡眠质量指数量表(PSQI)和汉密尔顿抑郁量表(HAMD)等,符合入选标准并且没有排除因素者进入试验。受试者在开始治疗前1天进行失眠严重指数量表(ISI)、蒙哥马利抑郁量表(MADRS)、广泛性焦虑量表(GAD-7)和临床疗效总评量表(CGI)的评分,并开始记录睡眠日记。同时给予艾司西酞普兰早餐后口服治疗,初始剂量为5~10 mg/d。每天清晨与晚上记录睡眠日记,在下一次访视时返还给研究者。分别在开始治疗第7天、第14天和第30天进行随访,再次完成PSQI、ISI、MADRS、GAD-7和CGI的评分。同时包括不良事件的记录。每次随访后根据患者的疗效调整艾司西酞普兰的剂量,最高剂量为20 mg/d。对人口统计学特征、生命体征以及评分量表等应用SSPS 10.0软件进行ANOVA分析。结果入组患者160例,男性67例,平均年龄(42±12)岁;女性93例,平均年龄(41±12)岁。在4个访视点中体重、血压、心率每两个访视点之间均无统计学差异。在4个访视点中PSQI、ISI、MADRS、GAD-7和CGI的评分逐渐减少,并且每2个访视点之间均有统计学差异。开始药物治疗第7天即有明显的疗效,这种疗效从开始药物治疗的第30天仍然继续强化。艾司西酞普兰的剂量由初始剂量(9.7±1.5)mg,逐渐增加到(14.8±4.0)mg,在(14.8±4.0)mg水平发挥了比较理想的疗效。只有2例患者出现轻微头晕、心慌等不适。结论失眠是抑郁症患者最常见的症状,艾司西酞普兰在治疗伴失眠首发的重症抑郁症状的同时可以很好地改善患者的失眠,效果明显。本研究提示艾司西酞普兰治疗伴失眠首发的重症抑郁症患者的最佳有效剂量为15 mg/d。     

Prokaryotic expression, identification and bioinformatics analysis of fbpB-esxA fusing gene from Mycobacterium tuberculosis

ObjectiveTo obtain fbpB–esxA fusing gene of Mycobacterium tuberculosis (MTB), express the encoded fusing protein in Escherichia coli (E. coli), identify protein acquired, and predict the structure and function of the protein utilizing methods of bioinformatics.MethodsfbpB and esxA gene were amplified from genome of MTB H37Rv by PCR. The fbpB–esxA fusing gene ligated by (Gly₄Ser)₃ linker was gained by means of Gene Splicing by Overlapping Extension PCR (SOE-PCR), and fusing gene was cloned into expression vector pET-30a. The recombinant plasmid was sequenced and expressed in E. coli BL21(DE3). The protein was identified by Western blot using anti-HIS antibody. Secondary structure and antigenic epitopes of the protein were predicting using tools of bioinformatics.ResultsThe DNA sequences of fbpB–esxA were identical with that published by GenBank. The Ag85B-ESAT-6 fusion protein about 50 kDa comprised 485 amino acids was efficiently produced from expression system in E. coli BL21(DE3) under the induction of IPTG. Bioinformatics analysis showed the protein contained one transmembrane region and fourteen potential antigenic epitopes.ConclusionsThe Ag85B-ESAT-6 fusion protein is successfully expressed with N-terminal HIS-tag. Gel filtration demonstrated that it exists as insoluble inclusion bodies mainly. The existence of linker doesn't affect immunogenicity of Ag85B and ESAT-6. It will allow for characterization in vitro and establish a foundation of further function research such as vaccine or diagnostic reagent.     

Treatment efficacy of etanercept and MTX combination therapy for ankylosing spondylitis hip joint lesion in Chinese population

To investigate the efficacy of etanercept and MTX (methotrexate) combination therapy in Chinese patients with ankylosing spondylitis hip joint lesion, the possible courses and maintenance protocol, altogether 97 ankylosing spondylitis patients fulfilling the modified New York criteria with hip joint lesion were enrolled in a 12-month trial treated with combined etanercept and MTX. All these patients were required to be poor responders to SSZ (Sulfasalazine) or MTX therapy for 6 consecutive months or the longer. Etanercept was administered subcutaneously twice a week at a fixed dosage of 25?mg for the first six months, followed by 25?mg once a week in patients with good control of both symptoms and radiological progression, or twice a week for another six months in patients with BASDAI> or =?4. Combined MTX was administered intravenously once a week at the dosage of 15?mg. Demographics, clinical and laboratory features, physical function and quality of life using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Harris hip score, and radiological assessment using the BASRI-hip index were recorded. Most patients achieved pain release at the end point of assessment. Significant improvement in Bath AS Disease Activity Index (BASDAI) (P?<?0.05), Bath AS Functional Activity Index (BASFI) (P?<?0.05), and Harris hip score (P?<?0.05) was demonstrated. Radiographic progression was recorded as no exacerbation or alleviated. Larger interval between two etanercept administrations would provide similar advantages to standard method and possibly less adverse events if MTX was combined. Etanercept and MTX combination therapy was beneficial to ankylosing spondylitis patients with hip joint lesion, and staged dosage deduction in the long term proved to be effective as well as adverse event preventing.