后路经皮内窥镜下颈椎椎间盘切除术的解剖学研究及临床意义

目的　探讨后路经皮内窥镜下颈椎椎间盘切除术的安全范围。 方法　选取20具成人颈椎标本，分别测量C3/C4至C6/C7各节段左右两侧V点与硬脊膜外侧距离、V点与椎动脉水平及垂直距离、小关节面宽度，并进行统计学比较。 结果　V点与硬脊膜外侧距离为：左（1.31±0.32）~（2.46±0.60） mm，右（1.29±0.35）~（2.75±0.45） mm，各节段间差别有统计学意义，同一水平左右差别无统计学意义；V点与椎动脉水平距离为：左（2.17±0.42）~（5.10±0.93） mm，右（1.99±0.39）~（5.00±0.71） mm，各节段间差别有统计学意义，同一水平左右差别无统计学意义；V点与椎动脉垂直距离为：左（11.05±1.06）~（13.47±1.12）mm，右（11.33±1.20）~（13.61±1.01）mm，同一水平左右侧差别有统计学意义，节段间比较C3/C4与C4 /C5无明显差异，其余节段间差别均有统计学意义；小关节面宽度为：左（10.79±0.93）~（12.66±0.88） mm，右（10.86±0.68）~（12.54±0.70）mm。 结论　后路经皮内窥镜下颈椎椎间盘切除术的安全范围宜控制在距V点内侧C₃/C₄至C₆/C₇各水平1.20~2.00 mm；磨除范围距V点外侧C₃/C₄至C₆/C₇各水平超过2.00~5.00 mm时可能到达椎动脉体表投影处，因此需注意此时的手术进入深度宜控制在：C₃/C₄~C₆/C₇各节段距V点11.00~14.00 mm。     

睑部的应用人类学研究

对１００套成人干燥胸椎的每块椎骨椎孔的矢，横径，椎弓根的高度，下切迹深度，椎板厚度进行了测量和观察。结果提示：７％的胸椎，椎板内面出现不同程度的骨质增生，引起椎板增厚，是造成胸段椎管狭窄的解剖学基础。     

Different applications of polymerases with and without proofreading activity in single-nucleotide polymorphism analysis

With the completion of the human genome project, single-nucleotide polymorphisms (SNPs) have become the focus of intense study in biomedical research. Polymerase-mediated primer extension has been employed in a variety of SNP assays. However, these SNP assays using polymerase without proofreading function are compromised by their low reliability. Using a newly developed short amplicon harboring restriction enzyme site, EcoR-I, we were able to compare the single-base discrimination abilities of polymerases with and without proofreading function in primer extension in a broad range of annealing temperatures. Thermodynamic analysis demonstrated a striking single-nucleotide discrimination ability of polymerases with proofreading function. Using unmodified 3'-end allele-specific primers, only template-dependent products were generated by polymerase with proofreading activity. This powerful single-base discrimination ability of exo(+) polymerases was further evaluated in primer extension using three types of 3' terminally modified allele-specific primers. As compared with the poor fidelity in primer extension of polymerases lacking 3' exonuclease activity, this study provides convincing evidence that the use of proofreading polymerases in combination with 3'-end modified allele-specific primers can be a powerful new strategy for the development of SNP assays.     

Calcium currents and transmitter output in cultured spinal cord and dorsal root ganglion neurons

The effects of repetitive activation upon voltage-dependent calcium currents (ICa) and transmitter release were studied in dissociated cell cultures of fetal mouse spinal cord and dorsal root ganglion. Sodium and potassium currents were suppressed with tetrodotoxin (TTX) and tetraethylammonium (TEA) ions, 4-aminopyridine (4-AP), and cesium sulfate. Calcium currents were compared under voltage clamp before and after a series of depolarizing clamp pulses in spinal cord (SC) and dorsal root ganglion (DRG) neurons. Repetitive activation resulted in an exponential decline in ICa, with the decrease in ICa being much more marked in DRG compared with SC neurons. Both voltage-dependent inactivation and inactivation related to the intracellular movement of Ca2+ appeared to be involved in the decrement in ICa with repetitive activation. A decrease in transmitter output occurred with repetitive activation in DRG neurons but not in SC neurons (either excitatory or inhibitory). DRG neuron synaptic boutons had fewer mitochondria than did the boutons of either excitatory or inhibitory of SC neurons. The decrement in both ICa and synaptic transmitter output in DRG neurons could last for prolonged periods (at least minutes) following repetitive activation. We hypothesize that this vulnerability of DRG neurons to repetitive activation may be related, at least in part, to a relative incapacity to maintain a low intracellular calcium ion concentration [Ca]i during periods of increased calcium ingress associated with excitation. Such an incapacity to buffer [Ca]i may be one mechanism leading to the inactive synapses seen in some studies in vitro and in vivo of synaptic transmission.     

心肌缺血／再灌注损伤时相性变化的电子示踪研究

本文以结扎家兔冠状动脉左室支为心肌缺血模型,应用镧电子示踪技术,生物体视学定量分析等方法,观察了心肌缺血不同时间再灌注后细胞膜系及线粒体超微结构以及镧示踪所提示的线粒体的功能变化等特点。结果表明,在心肌缺血20分时,细胞膜通透性升高,镧粒子进入细胞,再灌注时更为严重,即出现再灌注损伤。此时镧粒子多集于肌浆管。随缺血时间延长(30—40分),变化愈趋严重,缺血40分后再灌注,镧粒子大量涌入线粒体。而缺血60分,特别是再灌注时,心肌细胞严重破坏,几乎无完整线粒体,其中亦很少有镧颗粒。说明在此情况下的再灌损伤已属不可逆性。膜通透性的变化是由外及里的,即先肌膜而后为细胞内膜。就线粒体来讲则是先外膜而后内膜。实验结果提出可逆性(早期)再灌注损伤期,及不可逆性再灌注损伤期(晚期)的概念。     

Diagnosis and taxonomy of periodical psychosis

The concept and taxonomy of periodic psychosis still remains in controversy for the past 100 years. In China, it was first reported by Ji, and thereafter various rinds of terminology and views were given by different authors. In the presentation, clinical investigation and follow up were carried out in 62 cases. In many of these cases, the so-called "periodic psychosis" or "phasophrenia" was early clinical features of schizophrenia or manic-depression. In those cases with apparent symptoms and signs of diencephalic function, differential diagnosis should be carried out from organic brain syndrome. In a small number of cases, their clinical manifestations, conforming to previous diagnostic criteria, might be an uncommon syndrome. It was concluded by the authors that until now periodic could be considered only as a clinical syndrome rather than a disease entity.     

Dietary Habit Is Associated with Depression and Intelligence: An Observational and Genome-Wide Environmental Interaction Analysis in the UK Biobank Cohort

Dietary habits have considerable impact on brain development and mental health. Despite long-standing interest in the association of dietary habits with mental health, few population-based studies of dietary habits have assessed depression and fluid intelligence. Our aim is to investigate the association of dietary habits with depression and fluid intelligence. In total, 814 independent loci were utilized to calculate the individual polygenic risk score (PRS) for 143 dietary habit-related traits. The individual genotype data were obtained from the UK Biobank cohort. Regression analyses were then conducted to evaluate the association of dietary habits with depression and fluid intelligence, respectively. PLINK 2.0 was utilized to detect the single nucleotide polymorphism (SNP) × dietary habit interaction effect on the risks of depression and fluid intelligence. We detected 22 common dietary habit-related traits shared by depression and fluid intelligence, such as red wine glasses per month, and overall alcohol intake. For interaction analysis, we detected that OLFM1 interacted with champagne/white wine in depression, while SYNPO2 interacted with coffee type in fluid intelligence. Our study results provide novel useful information for understanding how eating habits affect the fluid intelligence and depression.     

公立医院优势学科病种绩效管理研究:以骨科为例

目的从循证视角建立公立医院优势学科病种绩效管理工具。方法以波士顿矩阵理论为指导,以“病种均次毛利率、病种均次住院日”为主要指标,“日均毛利率”为辅助指标,采用Microsoft office EXCEL 365 软件进行分析。结果2019年骨科平均住院日为4.99 d,均次平均毛利率为23.62%,日均毛利率平均值为4.73%。骨科200例以上病种、不同亚专科病区病种、同一亚专科病区内不同病种、不同亚专科病区相同病种,绩效均存在差异。结论 管理者应对不同病种绩效指标进行适当校正,探索精细化病种诊疗与管理模式。