乙型肝炎病毒血清标志物全阳性模式一例分析及随访

目的 为了揭示临床实验室乙型肝炎病毒血清标志物少(罕)见模式客观存在的规律,探讨和分析了乙型肝炎病毒血清标志物全阳性模式病例的临床转归情况以及血清标志物的动态变化趋势.方法 以慢性乙型病毒性肝炎患者为对象,用荧光定量PCR和酶联免疫吸附试验同步检测不同时段血清HBVDNA和HBsAg、HBsAb、HBeAg、HBeAb、HBcAb五项血清学标志物,并进行血清肝功能酶学指标的动态跟踪.结果 在长达3个月的时间段内,HBVM持续稳定在全阳性模式不变,用重组人干扰素α2b(安福隆)进行抗病毒治疗的早期应答虽不明显,但治疗至5个月后,随着病毒的阴转,HBeAg和HBeAb也逐步阴转,肝功能酶学指标逐步恢复正常,但HBsAg与HBsAb仍同时保留阳性.结论 HBVM在慢性乙型肝炎患者不同病程中可呈现不同模式的组合,而不能简单的用"大三阳"、"小三阳"或15阳性等模式进行解释,应动态观察乙肝两对半组合模式以及编码的变化,有利于对乙型肝炎的诊治和疗效评估.     

Evaluation of physician experience in achieving non-perfused volume ratio of high-intensity focused ultrasound ablation for uterine fibroids: a multicentre study

ObjectiveTo evaluate the effect of different levels of physician experience on the high-intensity focused ultrasound (HIFU) ablation of uterine fibroids and to provide a reference for the use of non-perfused volume ratio (NPVR) standards during training.MethodsThis prospective multicentre study enrolled patients with uterine fibroids. The effect of the physician’s level of experience on the outcomes under different NPVR standards and the learning curve of six centres without HIFU experience were analysed. The impact of patient demographic and clinical characteristics were also evaluated.ResultsA total of 1352 patients from 20 centres were included in the study. The median NPVRs were 92.00%, 88.10% and 92.86% in the no experience group, inexperienced group and experienced group, respectively. Posterior wall fibroids, lateral wall fibroids and fundus fibroids were inversely correlated with NPVR, while experienced physicians were positively correlated with NPVR. With NPVR ≥ 70% and NPVR ≥ 80% standards, physicians in the no experience group completed the learning curve on the 11th and 16th procedure, respectively. Physicians under a standard of an NPVR ≥ 90% did not complete the learning curve.ConclusionsNPVR ≥ 80% is a standard that is worth using for HIFU treatment of uterine fibroids.     

The altering in sensory sensitivity: a current issue of female breast surgery

Breast surgery is an important treatment for women with malignant breast diseases. In addition to breast appearance, the integrity of breast function is increasing in patients with breast diseases. As the basis of breast physiological function, breast skin sensitivity is important to the quality of life of patients after surgery. Breast skin sensitivity gives the patient a “real” breast feeling. The sensory recovery after breast surgery has also become one of the important goals of breast surgery. In this review, we aim to discuss the research progress on recovery of breast skin sensitivity after different treatment modalities for breast disease.     

Proteomic analysis of the effects of caffeine in a neonatal rat model of hypoxic‐ischemic white matter damage

AimWhite matter damage (WMD) is the main cause of cerebral palsy and cognitive impairment in premature infants. Although caffeine has been shown to possess neuroprotective effects in neonatal rats with hypoxic‐ischemic WMD, the mechanisms underlying these protective effects are unclear. Herein, proteins modulated by caffeine in neonatal rats with hypoxic‐ischemic WMD were evaluated.MethodsWe identified differential proteins and performed functional enrichment analyses between the Sham, hypoxic‐ischemic WMD (HI), and HI+caffeine‐treated WMD (Caffeine) groups. Confirmed the changes and effect of proteins in animal models and determined cognitive impairment via water maze experiments.ResultsIn paraventricular tissue, 47 differential proteins were identified between the Sham, HI, and Caffeine groups. Functional enrichment analyses showed that these proteins were related to myelination and axon formation. In particular, the myelin basic protein (MBP), proteolipid protein, myelin‐associated glycoprotein precursor, and sirtiun 2 (SIRT2) levels were reduced in the hypoxic‐ischemic WMD group, and this effect could be prevented by caffeine. Caffeine alleviated the hypoxic‐ischemic WMD‐induced cognitive impairment and improved MBP, synaptophysin, and postsynaptic density protein 95 protein levels after hypoxic‐ischemic WMD by preventing the HI‐induced downregulation of SIRT2; these effects were subsequently attenuated by the SIRT2 inhibitor AK‐7.ConclusionCaffeine may have clinical applications in the management of prophylactic hypoxic‐ischemic WMD; its effects may be mediated by proteins related to myelin development and synapse formation through SIRT2.     

Characterization and Performance Evaluation of Metakaolin-Based Geopolymer Foams Obtained by Adding Palm Olein as the Foam Stabilizer

Geopolymer foams with different pore structures can be used in construction, water treatment, and heavy metal adsorption. The preparation of high porosity geopolymer foams using vegetable oil as a foam stabilizer is a feasible and cost-effective route. In this study, metakaolin-based geopolymer foams with hierarchical pore structures were fabricated by adding H₂O₂ as the foaming agent with palm olein as the foam stabilizer. The effects of H₂O₂ and palm olein content on the chemical features and pore structure of geopolymer foams were evaluated. Water absorption, thermal conductivity, and mechanical behaviors of geopolymer foams were also investigated. The results indicate that fatty acid salt surfactants were generated in situ in the geopolymer matrix due to the addition of palm olein. Geopolymer foams with H₂O₂ and palm olein addition possess a homogeneously concentrated macropore distribution. Palm olein exhibits a refining effect on intrinsic pores formed by geopolymerization. In addition, using appropriate amounts of palm olein and H₂O₂, geopolymer foams can achieve higher open porosity and better pore connectivity, resulting in the improvement of water absorption and thermal insulation capacity.     

β-谷甾醇对原代大鼠海马神经元细胞活力的毒性

目的:研究β-谷甾醇对正常和痫性放电海马神经元的毒性作用。方法:采用24h内新生Wistar大鼠为细胞源,用Neurobasal培养液培养海马神经元9d后,加入无镁离子处理3h,诱导其痫性放电,加入β-谷甾醇(浓度),作用24h,MTT法检测β-谷甾醇对海马神经元的无毒和对原代大鼠海马神经元癫痫样细胞最佳作用时间的影响。结果:成功分离出大鼠原代海马神经元细胞,β-谷甾醇在20μmol/L浓度下对海马神经元细胞无毒性,最佳作用时间为24h。结论:浓度20μmol/L,最佳作用时间为24h,β-谷甾醇对海马神经元没有毒性,可用于癫痫治疗。     

2013年系统性硬化症分类标准及应用

系统性硬化症是一种临床上常见的自身免疫性疾病,发病机制复杂、临床表现多样,且疾病晚期致残、致死率高.因此,早期诊断、早期治疗非常重要.随着对系统性硬化症认识的不断深入,其分类标准也不断更新和完善,并在临床中得到验证及应用,为疾病的尽早分类及介入治疗提供了依据.     

农村公共卫生管理政府责任缺位的应对措施

目的：探讨农村公共卫生管理政府责任缺位的应对措施。方法针对我地区农村公共卫生管理政府责任缺位,提出建议民营资本进驻的建议,并提供具体方法,分析其实际效果。结果干预后农村医疗总床位数及初级以上执业人员均显著多于干预前（P＜0.05）,干预后患者总住院时间短于干预前（P＜0.05）,均次医疗费用少于干预前（P＜0.05）。结论提高政府对农村医疗资源的支持,能有效减低医疗费用,提高农村基层医务人员工作积极性。     

乳鼠心肌细胞的培养

目的：原代培养乳鼠心肌细胞及进行形态学观察。方法：胰蛋白酶和Ⅱ型胶原分离消化心肌组织，差速贴壁和化学方法纯化心肌细胞。结果：12h心肌细胞基本贴壁，1—3天形成细胞簇，并出现同步搏动。结论：胰蛋白酶和胶原酶混合使用可以分离出数量较多、状态良好的心肌细胞。