儿童骨骺损伤

总结我院１９８０～１９８９年所收治的儿童骨骺损伤４６８例。随访时间１～８年。介绍了儿童骨骺损伤的Ｘ线分型、诊断要点及治疗方法。认为骨骺损伤的预后主要取决于原发损伤的类型，其次为受伤年龄和受伤部位，受伤年龄愈小或受伤部位为主要发育骨骺，将来所引起的继发畸形则愈大。     

蓝-黄视野计与标准的白-白视野计对早期原发性开角型青光眼视野的对比研究

目的　评价蓝 -黄视野计 (blue- on- yellow perim etry,B/ Y)又称短波长视野计 (short- wavelength auto-mated perim etry,SWAP)与标准的白色视野计 (white- on- white perimetry,W/ W)在早期青光眼视野损害诊断中的意义。方法　利用 Hum phrey- - 75 0型全自动视野计 C- 30 - 2全阈值检测程序对 2 0例 (4 0只眼 )正常人、2 0例 (36只眼 )可疑青光眼、18例 (32只眼 )确诊的早期原发性开角型青光眼 (primary open- angle glaucoma,POAG)分别进行 W/ W与 B/ Y的视野检查。结果　正常人、可疑青光眼、早期青光眼 B/ Y检测的全视网膜光敏感度均值 (MS)低于 W/ W检测的结果 ,两者有显著性意义 (t=11.6 8,P <0 .0 1;t=14 .0 1,P <0 .0 1;t=14 .6 8,P <0 .0 1)。B/ Y检测光敏感度缺损均值 (MD)与 W/ W检测的结果 ,正常人组无显著性意义 (t=1.0 4 ,P <0 .0 1) ,其它两组有显著性意义 (t=4 .88,P <0 .0 1;t=3.378,P <0 .0 1)。W/ W检查正常人组与可疑性青光眼的 MS差别无显著意义 (t=2 .5 4 ,P >0 .0 1) ,B/ Y有显著意义 (t=5 .5 7,P <0 .0 1)。两组的 MD差别均有显著意义 (t=3.16 ,P <0 .0 1,t=6 .2 6 ,P <0 .0 1) ;W/ W与 B/ Y检查正常人组与早期青光眼组的 MS差别有显著意义 (t=6 .4 7,P <0 .0 ;t=10 .19,P     

The role of toll-like receptors (TLRs) in pan-cancer

BackgroundToll-like receptors (TLRs) are important components of the innate and adaptive immune systems, and abnormal TLR expression has been linked to a variety of cancers. However, there was a lack of clarity on the association of TLR stimulation with the carcinogenesis of cancer. The study''s goal was to analyse the clinical importance of TLRs expression at the mRNA level in pan-cancer datasets, as well as the link between TLR expression and carcinogenesis, progression, and clinical prognosis.MethodsThe expression profile of TLRs derived from UCSC pan-cancer data was analysed in multiple dimensions, including clinical analysis, immunological subtype analysis, tumour microenvironment (TME) analysis, tumour stem cell correlation analysis, and drug sensitivity analysis. Additionally, we analyse protein-protein interactions, functional enrichment, and chromatin accessibility, as well as TLR expression in single-cell sequencing data.ResultsOur multi-omics analysis results imply that TLRs may operate as a biological marker for carcinogenesis and progression, a potential target for anti-tumour therapy, and a prognostic biomarker, laying the theoretical groundwork for future translational medicine research.ConclusionTLRs are involved in the formation of malignancies and can be explored in further detail as potential prognostic indicators.

Key Messages

• Toll-like receptors (TLRs) are key factors in the process of the innate and adaptive immune response, and their aberrant expression of TLRs have been widely reported in various cancer. However, the association between TLRs stimulation and tumorigenesis of cancer has not been well clarified.
• In this study, in the pan-cancer data, integrated TLR family gene expression analysis, clinical correlation analysis, immune subtype correlation analysis, tumour microenvironment correlation analysis, tumour stem cell correlation analysis, and drug sensitivity correlation analysis were performed.
• TLRs play an important role in the development of tumours and can be studied in depth as potential prognostic markers.

     

间歇性外斜视眼位控制力评分综述

在间歇性外斜视患者的管理中,眼位控制力至关重要,它是评价手术时机的重要参考指标及监测和判断病情发展严重程度的必要指标之一。因此,眼位控制能力的量化成为间歇性外斜视评估中的重要环节。本文旨在对间歇性外斜视患者眼位控制力评估方法做一综述,帮助临床医生对间歇性外斜视患者制定合理的治疗方案。     

补骨脂对体外黑素细胞黏附和迁移的作用

目的 :研究补骨脂对黑素细胞黏附和迁移的影响。方法 :用补骨脂处理黑素细胞 ,检测其黏附于牛血清纤维结合素和通过微孔滤膜的细胞数量并与生姜和未经药物处理的黑素细胞比较。结果 :补骨脂可显著促进黑素细胞黏附于牛血清纤维结合素和通过微孔滤膜并呈剂量依赖关系 ,但当补骨脂浓度超过 0.2mg·L^-1时这种作用未见增加。补骨脂浓度在 0.01mg·L^-1时 ,黑素细胞黏附并无显著增加 ,但对迁移的影响已可见统计学差异 (P <0.01)。生姜则不具有这样的作用。结论 :在体外 ,补骨脂能明显促进黑素细胞的黏附和迁移 ,这至少可以部分解释应用补骨脂治疗白癜风是有效的。     

白血病患者造血干细胞移植前单次全身照射的预后分析

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.     

The PRB-dependent FOXO1/IGFBP-1 axis is essential for progestin to inhibit endometrial epithelial growth

Progestin inhibits the growth of normal and cancerous endometria via the progesterone receptor (PR), but the distinct functions and signalings of PR subtypes have not been fully understood. The aim of the present study was to dissect the key pathways of progestin to inhibit endometrial epithelial growth. Immortalized endometrial epithelial cells (EM-E6/E7/TERT) with stable PRA or PRB expression were established and used for the experiments. In vitro growth inhibition by progestin was mainly observed in EM-E6/E7/TERT cells with PRB rather than those with PRA. RT-PCR assay confirmed that FOXO1, a key gene for progestin action, was up-regulated by progestin in a PRB-dependent manner. cDNA microarray analysis identified IGFBP-1, which contains FOXO1 binding sites on its promoter, to be induced by medroxyprogesterone acetate (MPA) in EM-E6/E7/TERT cells with PRB but not with PRA. siRNA knockdown of FOXO1 disturbed the induction of IGFBP-1 by MPA, while IGFBP-1 knockdown showed no effect on MPA-induced FOXO1 expression, indicating that FOXO1 is an upstream regulator of IGFBP-1. Luciferase reporter assays showed that MPA activated the IGFBP-1 promoter, which was cancelled by FOXO1 knockdown. Chromatin immunoprecipitation assay confirmed the in vivo binding of FOXO1 to the core promoter of IGFBP-1. IGFBP-1 knockdown significantly attenuated the growth inhibitory effects of MPA. The FOXO1/IGFBP-1 axis is essential for PRB-dependent growth inhibition of endometrial epithelial cells, offering a potential therapeutic clue to enhance the progestin effect.     

综合评价医院工作的指标加权百分位次累加法

本文提出了综合评价医院工作的一种方法——指标加权百分位次累加法。本方法分五个步骤:1.建立评价指标体系;2.制定评价标准值;3.对指标值进行标准化;4.根据指标重要程度赋予相应权重;5.进行综合评价。并通过实际资料对本方法进行了验证。     

The frequency of assessment tools in arthroscopic training: a systematic review

BackgroundMultiple assessment tools are used in arthroscopic training and play an important role in feedback. However, it is not fully recognized as to the standard way to apply these tools. Our study aimed to investigate the use of assessment tools in arthroscopic training and determine whether there is an optimal way to apply various assessment tools in arthroscopic training.MethodsA search was performed using PubMed, Embase and Cochrane Library electronic databases for articles published in English from January 2000 to July 2021. Eligible for inclusion were primary research articles related to using assessment tools for the evaluation of arthroscopic skills and training environments. Studies that focussed only on therapeutic cases, did not report outcome measures of technical skills, or did not mention arthroscopic skills training were excluded.ResultsA total of 28 studies were included for review. Multiple assessment tools were used in arthroscopic training. The most common objective metric was completion time, reported in 21 studies. Technical parameters based on simulator or external equipment, such as instrument path length, hand movement, visual parameters and injury, were also widely used. Subjective assessment tools included checklists and global rating scales (GRS). Among these, the most commonly used GRS was the Arthroscopic Surgical Skill Evaluation Tool (ASSET). Most of the studies combined objective metrics and subjective assessment scales in the evaluation of arthroscopic skill trainingConclusionsOverall, both subjective and objective assessment tools can be used as feedback for basic arthroscopic skill training, but there are still differences in the frequency of application in different contexts. Despite this, combined use of subjective and objective assessment tools can be applied to more situations and skills and can be the optimal way for assessment.Level of EvidenceLevel III, systematic review of level I to III studies.

Key messages

• Both subjective and objective assessment tools can be used as feedback for basic arthroscopic skill training.
• Combined use of subjective and objective assessment tools can be applied to more situations and skills and can be the optimal way for assessment.

     

HACCP原理在中小冷冻饮品生产企业中的应用

通过前期的基线调查,对浦东新区7家未实施HACCP计划的中小冷冻饮品生产企业的状况有了充分的认识,在此基础上,我们与企业共同制订了HACCP计划,确定了关键控制点,并在实际运行中进行纠偏和验证。事实说明各企业的生产过程卫生状况明显改善,提高了产品的安全性。