573例乳腺癌临床资料分析

目的探讨乳腺癌的临床特点以及台疗方法的评价.方法收集1989年～1992年共573例完整的病例资料.按治疗方法分为手术组、手术+放疗、手术+化疗、手术+放疗+化疗、非手术组.对病例的一般临床特点及生存率进行统计学分析.结果年龄35岁～55岁者占408例,发病部位外上象限为333例,病理实性癌占375例.不同治疗方法的生存率分5年和10年如下手术组78%、62%,手术+化疗72%、45%,手术+放疗57%、40%,手术+放疗+化疗60%、45%,非手术组35%.结论乳腺癌高发病率年龄组为中年,病变多位于外上象限,病理多为浸润性非特殊性癌.治疗方法仍以手术治疗为首选,适当地配合放、化疗等.     

Molecular and Cellular Mechanisms of Delayed Fracture Healing in Mmp10 (Stromelysin 2) Knockout Mice

The remodeling of the extracellular matrix is a central function in endochondral ossification and bone homeostasis. During secondary fracture healing, vascular invasion and bone growth requires the removal of the cartilage intermediate and the coordinate action of the collagenase matrix metalloproteinase (MMP)-13, produced by hypertrophic chondrocytes, and the gelatinase MMP-9, produced by cells of hematopoietic lineage. Interfering with these MMP activities results in impaired fracture healing characterized by cartilage accumulation and delayed vascularization. MMP-10, Stromelysin 2, a matrix metalloproteinase with high homology to MMP-3 (Stromelysin 1), presents a wide range of putative substrates identified in vitro, but its targets and functions in vivo and especially during fracture healing and bone homeostasis are not well defined. Here, we investigated the role of MMP-10 through bone regeneration in C57BL/6 mice. During secondary fracture healing, MMP-10 is expressed by hematopoietic cells and its maximum expression peak is associated with cartilage resorption at 14 days post fracture (dpf). In accordance with this expression pattern, when Mmp10 is globally silenced, we observed an impaired fracture-healing phenotype at 14 dpf, characterized by delayed cartilage resorption and TRAP-positive cell accumulation. This phenotype can be rescued by a non-competitive transplant of wild-type bone marrow, indicating that MMP-10 functions are required only in cells of hematopoietic linage. In addition, we found that this phenotype is a consequence of reduced gelatinase activity and the lack of proMMP-9 processing in macrophages. Our data provide evidence of the in vivo function of MMP-10 during endochondral ossification and defines the macrophages as the lead cell population in cartilage removal and vascular invasion. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).     

A randomised trial of bilateral erector spinae plane block vs. no block for thoracolumbar decompressive spinal surgery

Major spinal surgery causes significant postoperative pain. We tested the efficacy and safety of bilateral erector spinae block on quality of recovery and pain after thoracolumbar decompression. We randomly allocated 60 adults to standard care or erector spinae block. Erector spinae block improved the mean (SD) quality of recovery-15 score at 24 postoperative hours, from 119 (20) to 132 (14), an increase (95%CI) of 13 (4–22), p = 0.0044. Median (IQR [range]) comprehensive complication index was 1 (0–3 [0–5]) in the control group vs. 1 (0–1 [0–4]) after block, p = 0.4. Erector spinae block reduced mean (SD) area under the curve pain during the first 24 postoperative hours: at rest, from 78 (49) to 50 (39), p = 0.018; and on sitting, from 125 (51) to 91 (50), p = 0.009. The cumulative mean (SD) oxycodone consumption to 24 h was 27 (18) mg in the control group and 19 (26) mg after block, p = 0.20. In conclusion, erector spinae block improved recovery and reduced pain for 24 h after thoracolumbar decompression surgery.     

Using psychometric ability to improve education in ultrasound-guided regional anaesthesia: a multicentre randomised controlled trial

The learning curve for novices developing regional anaesthesia skills, such as real-time ultrasound-guided needle manipulation, may be affected by innate visuospatial ability, as this influences spatial cognition and motor co-ordination. We conducted a multinational randomised controlled trial to test if novices with low visuospatial ability would perform better at an ultrasound-guided needling task with deliberate practice training than with discovery learning. Visuospatial ability was evaluated using the mental rotations test-A. We recruited 140 medical students and randomly allocated them into low-ability control (discovery learning), low-ability intervention (received deliberate practice), high-ability control, and high-ability intervention groups. Primary outcome was the time taken to complete the needling task, and there was no significant difference between groups: median (IQR [range]) low-ability control 125 s (69–237 [43–600 s]); low-ability intervention 163 s (116–276 [44–600 s]); high-ability control 130 s (80–210 [41–384 s]); and high-ability intervention 177 s (113–285 [43–547 s]), p = 0.06. No difference was found using the global rating scale: mean (95%CI) low-ability control 53% (95%CI 46–60%); low-ability intervention 61% (95%CI 53–68%); high-ability control 63% (95%CI 56–70%); and high-ability intervention 66% (95%CI 60–72%), p = 0.05. For overall procedure pass/fail, the low-ability control group pass rate of 42% (14/33) was significantly less than the other three groups: low-ability intervention 69% (25/36); high-ability control 68% (25/37); and high-ability intervention 85% (29/34) p = 0.003. Further research is required to determine the role of visuospatial ability screening in training for ultrasound-guided needle skills.     

用宿主防御指数辅助诊断中医虚证和不同辩证虚证的探讨

以中医学“虚证”及不同辩证虚证为研究对象，以宿主防御指数为研究总指标，开展了营养学和免疫学的多指标观察，并借助于医学统计学的理论和方法，尝试对中医学“虚证”的诊断。结果显示；虚证患者与正常人相比营养条件差，免疫功能氏下，主要表现为细胞免疫功能低下和免疫调节紊乱，补体主要成分降低，将这些评价指标代入计算机进行逐步判断分析，得出可以判别正常人，气阳虚患者，血阴虚患者的方程式，方程式判别能力Ｆ＝３（Ｐ〈     

健脾益气活血化瘀法对Ⅱ型糖尿病的治疗作用

作者将Ⅱ型糖尿病伴高粘滞血症患者61例随机分为A、B、C、D四组,分别予以降糖灵(A组)、健脾益气方Ⅰ(B组)、活血化瘀方Ⅱ(C组)和方Ⅰ合方Ⅱ(D组)治疗四周,观察其治疗前后血糖、血胰岛素及血液流变学的改变。结果发现,活血化瘀(方Ⅱ)有增强健脾益气(方Ⅰ)的降糖作用。认为其降糖机理除增进周围组织对葡萄糖的利用外,尚具有促进胰岛β细胞分泌胰岛素的作用,推测至少与组织血液循环的改善有关。     

与人精子有共同抗原的临床细菌分离株的筛选

紧ＲＡＨＳ－Ａｂ与４９３株临床细菌分离株进行玻片凝集反应，筛选出４种１１株可与ＲＡＨＳ－Ａｂ发生明显凝集反应的细菌株。选择其中Ｅ．ｃｏｌｉ５０６株作进一步研究。制备Ｅ。ｃｏｌｉ５０６株全菌蛋白进行包被，ＥＬＩＳＡ检测可与ＲＡＨＳ－Ａｂ出现阳性反应。进一步将全菌蛋白与ＲＡＨＳ－Ａｂ进行Ｗｅｓｔａｒｎ印迹反应，发现可出现数处理阳性反应带，其中们于３６ｋＤ和６７ｋＤ的两个条带反应最为明显。制备人精子蛋白     

龙津对体外血栓形成、凝血及纤维蛋白溶解作用的实验研究

在正常和DIC家兔或大鼠中证明,口服龙津后,体外血栓长度缩短,血栓重量减轻,全血凝块和纤维蛋白凝块溶解加速,KPTT延长,ELT缩短,t-PA活性增强(P<0.05)。以上资料提示龙津有抗凝和溶栓的双重作用。     

老年认知功能缺损者二项必选数字记忆测验结果分析

目的：探讨认知功能缺损程度对二项必选数字记忆测验(简称二项测验)成绩的影响。方法：用简易智力状态量表和韦氏成人智力量表简式调查出38例认知功能缺损者(研究组)和19例无认知功能缺损者(对照组)，同时实施二项数字测验。结果：(1)研究组与对照组二项测验容易条目、困难条目、总分的得分差异均无显著性。(2)智商70-89者困难条目分及总分显著高于智商50-69及34-49者；各组间容易条目分的差异均无显著性。(3)二项测验的假阳性率随着认知功能缺损的加重而有增加趋势。结论：二项测验成绩在一定程度上受认知功能缺损的影响，尤其是严重认知功能减退者，应注意假阳性率的问题。     

粒细胞—巨噬细胞集落刺激因子与HBsAg融合蛋白基因的 …

目的 研究粒细胞－巨噬细胞集落刺激因子（ＧＭ－ＣＳＦ）的免疫活性。方法 用聚合酶链反应（ＰＣＲ）技术扩增出粒细胞－巨噬细胞集落刺激因子（ＧＭ－ＣＳＦ）３８４ｂｐ的基因片段及ＨＢｓＡｇ８４６ｂｐ基因片段，扩增产物经柱纯化后，由Ｔ４ＤＮＡ酶连结因子１２３０ｂｐ的片段，将此片段命名为ＬＧＨ，克隆到ｐＵＣ１９质粒中，利用菌落ＰＣＲ法快速筛选阳性克隆及限制酶切鉴定片段的大小。结果 该基因全长１２３０ｂｐ，经