经胫骨隧道前交叉韧带双束八股解剖重建的临床研究

目的观察关节镜下采用自体腘绳肌腱经胫骨隧道前交叉韧带（anterior cruciate ligament, ACL）双束八股解剖重建的临床效果。方法随访上海交通大学附属第六人民医院运动医学科2018年12月—2020年1月收治的103例ACL断裂患者资料，其中男78例，女25例，年龄18~45岁，平均（26.8±5.86）岁；左侧47例，右侧56例，均采用关节镜下自体腘绳肌腱经胫骨隧道打股骨骨隧道，ACL双束八股解剖重建。按照Lysholm评分、国际膝关节评分委员会（IKDC）膝关节评分、Tegner膝关节评分标准和膝关节自我效能量表K-SES评价疗效。结果所有患者术后获随访12～42个月，平均（24±8.18）个月；手术前、末次随访评分比较，Lysholm评分分别为（48.41±4.44）分和（95.34±1.91）分，2组比较差异有统计学意义（P<0.001)；IKDC评分分别为（44.05±4.36）分和（95.66±1.89）分，2组比较差异有统计学意义（P<0.001)；Tegner评分分别为（2.84±0.95）分和（6.15±0.89）分，2组比较差异有统计学意义（P<0.001)；膝关节自我效能量表K-SES量表（3.10±0.83）分和（7.12±1.10）分，2组比较差异有统计学意义（P<0.001)。末次随访103例患者前抽屉试验阴性，轴移试验阴性。98例（95.1%）Lachman试验阴性，5例（4.9%）Lachman试验1°阳性。结论关节镜下采用自体腘绳肌腱经胫骨隧道双束八股解剖重建前交叉韧带是一种恢复膝关节稳定性，恢复伤前活动水平的有效方法。     

某医疗机构核医学工作场所劳务派遣保洁人员的职业健康管理

近几年，"劳务派遣"成了医疗机构终末消毒、保洁、垃圾回收等工作新的用工形式。由于多数用工单位和用人单位不清楚对劳务派遣人员职业健康管理中各自应承担的责任和义务，以至于劳务派遣工在劳动过程中应享有的劳动保护权益未获得切实保障。本文就某医疗机构核医学工作场所劳务派遣保洁人员的职业健康管理监督案例进行讨论。     

医学生人格特质与共情能力的相关性研究

目的  测评医学生的共情能力现状，探讨人格特质对其共情能力的影响,为培养医学生的共情能力提供对策。方法  以上海市3所高校临床医学专业学生为研究对象，采用班级整群抽样的方式进行问卷调研。采用杰斐逊共情量表-医学生版（JSPE-S）和大五人格量表（NEO-FFI）分别评估医学生的共情和人格特质。结果  共发放问卷2 020份，回收有效问卷1 958份，有效率为96.93%。医学生的共情能力总分均值为（103.24±14.35）。共情能力总分与大五人格中的“外向性”“开放性”“宜人性”“严谨性”维度呈显著正相关（r=0.154~0.406, P<0.01），与大五人格中的“神经质”维度呈显著负相关（r=-0.175, P<0.01）。分层回归结果表明：“共情重要性”和“大五人格”量表的5个维度进入回归方程。其中，人格因素占可解释方差变异量的16.2%（P<0.01）。结论  我国医学生的共情能力低于国外医学生，重视人格特质的塑造有助于提高其共情能力。     

HPLC-ABTS-DAD-Q-TOF/MS在线检测大黄抗氧化活性成分

目的：建立大黄特征化学成分和抗氧化活性相关联的二维指纹图谱，研究大黄抗氧化活性物质。方法：利用高效液相多检测器联用的抗氧化活性成分在线检测体系，对大黄中化学成分进行检测，共鉴定出大黄中化学成分15种；其中8种具有抗氧化活性；然后采用清除效率为指标对各活性成分的抗氧化活性进行评价。结果：结果发现化合物葡萄糖紫丁香酸、腺嘌呤、没食子酸、儿茶素或表儿茶素、双花母草素、2-O-桂皮酰-没食子酰葡萄糖等具有较强的清除ABTS^·+的活性，而蒽醌类成分对ABTS^·+的清除作用较弱。结论：采用HPLC-ABTS-DAD-Q-TOF/MS对大黄中的抗氧化活性成分进行快速分析鉴定，初步阐明大黄在抗氧化环节起作用的效应物质。     

Hyodeoxycholic acid protects the neurovascular unit against oxygen-glucose deprivation and reoxygenation-induced injury in vitro

Calculus bovis is commonly used for the treatment of stroke in traditional Chinese medicine. Hyodeoxycholic acid(HDCA) is a bioactive compound extracted from calculus bovis. When combined with cholic acid, baicalin and jas-minoidin, HDCA prevents hypoxia-reoxygenation-induced brain injury by suppressing endoplasmic reticulum stress-mediated apoptotic signaling. However, the effects of HDCA in ischemic stroke injury have not yet been studied. Neurovascular unit(NVU) dysfunction occurs in ischemic stroke. Therefore, in this study, we investigated the effects of HDCA on the NVU under ischemic conditions in vitro. We co-cultured primary brain microvascular endothelial cells, neurons and astrocytes using a transwell chamber co-culture system. The NVU was pre-treated with 10.16 or 2.54 μg/mL HDCA for 24 hours before exposure to oxygen-glucose deprivation for 1 hour. The cell counting kit-8 assay was used to detect cell activity. Flow cytometry and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling were used to assess apoptosis. Enzyme-linked immunosorbent assay was used to measure the expression levels of inflammatory cytokines, including interleukin-1β, interleukin-6 and tumor necrosis factor-α, and neurotrophic factors, including brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor. Oxidative stress-related factors, such as superoxide dismutase, nitric oxide, malondialdehyde and γ-glutamyltransferase, were measured using kits. Pretreatment with HDCA significantly decreased blood-brain barrier permeability and neuronal apoptosis, significantly increased transendothelial electrical resistance and γ-glutamyltransferase activity, attenuated oxidative stress damage and the release of inflammatory cytokines, and increased brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor expression. Our findings suggest that HDCA maintains NVU morphological integrity and function by modulating inflammation, oxidation stress, apoptosis, and the expression of neurotrophic factors. Therefore, HDCA may have therapeutic potential in the clinical management of ischemic stroke. This study was approved by the Ethics Committee of Experimental Animals of Beijing University of Chinese Medicine(approval No. BUCM-3-2016040201-2003) in April 2016.     

神经外科研究生就业率与培养情况分析——以北京市神经外科研究所为例

北京市神经外科研究所是国内培养神经外科人才的高端基地之一。近 10 年来，研究所培养了近 200名研究生，其中包括博士研究生 78 人，硕士研究生 120 人。通过对近 10 年来研究所硕士及博士研究生毕业就业情况梳理，分析三甲医院毕业生就业率、京内就业率、京外就业率及总体就业率情况，探讨提升研究所研究生培养质量的途径，以达到提高研究生核心竞争力的目的，以期对神经外科高层次的医学人才培养提供有益建议，为各级医疗卫生机构提供高层次的神经外科高端人才。     

Mechanisms of repigmentation induced by photobiomodulation therapy in vitiligo

Photobiomodulation (PBM) therapy is based on the exposure of biological tissues to low‐level laser light (coherent light) or light‐emitting diodes (LEDs; noncoherent light), leading to the modulation of cellular functions, such as proliferation and migration, which result in tissue regeneration. PBM therapy has important clinical applications in regenerative medicine. Vitiligo is an acquired depigmentary disorder resulting from disappearance of functional melanocytes in the involved skin. Vitiligo repigmentation depends on available melanocytes derived from (a) melanocyte stem cells located in the bulge area of hair follicles and (b) the epidermis at the lesional borders, which contains a pool of functional melanocytes. Since follicular melanoblasts (MBs) are derived from the melanocyte stem cells residing at the bulge area of hair follicle, the process of vitiligo repigmentation presents a research model for studying the regenerative effect of PBM therapy. Previous reports have shown favourable response for treatment of vitiligo with a low‐energy helium‐neon (He‐Ne) laser. This review focuses on the molecular events that took place during the repigmentation process of vitiligo triggered by He‐Ne laser (632.8 nm, red light). Monochromatic radiation in the visible and infrared A (IRA) range sustains matrix metalloproteinase (MMP), improves mitochondrial function, and increases adenosine triphosphate (ATP) synthesis and O₂ consumption, which lead to cellular regenerative pathways. Cytochrome c oxidase in the mitochondria was reported to be the photoacceptor upon which He‐Ne laser exerts its effects. Mitochondrial retrograde signalling is responsible for the cellular events by red light. This review shows that He‐Ne laser initiated mitochondrial retrograde signalling via a Ca²⁺‐dependent cascade. The impact on cytochrome c oxidase within the mitochondria, an event that results in activation of CREB (cyclic‐AMP response element binding protein)‐related cascade, is responsible for the He‐Ne laser promoting functional development at different stages of MBs and boosting functional melanocytes. He‐Ne laser irradiation induced (a) melanocyte stem cell differentiation; (b) immature outer root sheath MB migration; (c) differentiated outer root sheath MB melanogenesis and migration; and (d) perilesional melanocyte migration and proliferation. These photobiomodulation effects result in perifollocular and marginal repigmentation in vitiligo.     

《针灸大成》关于气海穴临床应用的文献研究

目的:通过检索《针灸大成》中与气海穴治疗作用相关的文献条文,总结气海穴在治疗各系统疾病中运用频次较高的疾病及其配穴规律,为临床针灸对气海穴的使用提供理论支持。方法:以《中华医典》(第五版)中《针灸大成》作为文献检索来源,将气海穴及气海穴的别称“脖胦”“下肓”“丹田”“肓之原”“肓原”“下言”和“气泽”为检索词,用计算机检索工具及人工检索相结合的方法检索符合要求的文献条文,通过建立本研究的数据库,频次分析、条形统计图比较分析等方法,总结出气海穴在治疗各系统疾病中的运用频次及其配穴规律。结果:在《针灸大成》所涉及的条文中,气海穴尤善治疗内科疾病,在治疗内科疾病中排名前3位的是脾胃系病症、气血津液疾病、肾系病症和妇科疾病,气海穴配穴习惯为上下配穴法,同名经配穴法,以及前后配穴法,其中主要为前后配穴法和同名经配穴法。结论:气海穴《针灸大成》中单穴应用占比最高,而在气海穴众多配穴中,运用了本经配穴法、上下配穴法、前后配穴法,配穴归经主要来自任脉和足太阳膀胱经。同名经配穴法,同气相求,可增加疗效;与气海穴配伍较多的足太阳膀胱经以背腧穴为主,此为前后配穴法,亦称腹背阴阳配穴法,腹部为阴,腰背为阳,前后配穴法可起到“从阳引阴”亦可“从阴引阳”的作用,以达到调节阴阳,调和脏法,调畅经络的目的。     

2009-2018年资阳市手足口病流行病学及病原学特征分析

目的 研究2009-2018年资阳市手足口病的流行病学及病原学特征，为有效防控手足口病提供理论依据。方法 从中国疾病控制中心监测信息报告管理系统获取以乡镇为单位的手足口病数据，进行三间分布描述，利用ArcGIS 10.1软件制作专题地图。结果 资阳市2009-2018年累计报告病例19195例，年平均发病率为61.72/10万，虽总体上呈升高的趋势；各乡镇均有手足口病报告；每年有两个发病高峰，分别是5-7月和9-11月，其中5-7月为主高峰，9-11月为次高峰；男女性别比为1.44[DK]∶1，5岁以下儿童共发病18209例，占比为94.9%。2015年之前优势毒株为EV71和CoxA16，2015年之后优势毒株为其他肠道病毒。结论 资阳市手足口病发病呈持续升高态势。手足口病的优势毒株近年来在改变，应增加人肠道病毒的监测种类，落实综合性防控措施，预防和控制手足口病的流行。     

Chalcone hybrids and their antimalarial activity

Malaria, one of the most striking, re-emerging infectious diseases caused by the genus Plasmodium, places a huge burden on global healthcare systems. A major challenge in the control and eradication of malaria is the continuous emergence of increasingly widespread drug-resistant malaria, creating an urgent need to develop novel antimalarial agents. Chalcone derivatives are ubiquitous in nature and have become indispensable units in medicinal chemistry applications due to their diverse biological profiles. Many chalcone derivatives demonstrate potential in vitro and in vivo antimalarial activity, so chalcone could be a useful template for the development of novel antimalarial agents. This review covers the recent development of chalcone hybrids as antimalarial agents. The critical aspects of the design and structure–activity relationship of these compounds are also discussed.