锁骨钩钢板治疗急性Tossy Ⅲ型肩锁关节脱位54例报告

目的：探讨锁骨钩钢板治疗急性TossyⅢ型肩锁关节脱位的疗效。方法：采用welink公司的wolter锁骨钩钢板和AO／ASIF公司的AO锁骨钩钢板，治疗急性TossyⅢ型肩锁关节脱位患者54例，并用Karlsson评价标准进行疗效评价。结果：54例均获随访，随访时间8～15个月，平均12个月。优45例，良8例，差1例，优良率98．1％，无钢板螺钉断裂和切口感染。结论：锁骨钩钢板治疗急性TossyⅢ型肩锁关节脱位的疗效肯定，是较理想的内固定方法之一。     

经皮内窥镜技术治疗老年单节段退行性腰椎椎管狭窄症

腰椎椎管狭窄症（LSS）是骨科常见病之一。随着我国老龄化的加速,老年退行性腰椎椎管狭窄症（DLSS）的发生率逐年增加,腰腿痛和间歇性跛行严重影响患者的生活质量^[1]。DLSS往往由椎间盘突出或合并钙化、小关节骨赘增生及黄韧带肥厚等原因引起,部分患者合并发育性椎管狭窄^[2-3]。临床上根据解剖部位将LSS分为中央管狭窄（椎管中央型狭窄）、关节下管狭窄（神经根管的关节下段,包括侧隐窝）和椎间管狭窄（椎弓根及椎间孔段）^[4-5]。老年DLSS患者一般病史较长,影像学资料提示多节段的椎间盘膨出或突出、黄韧带肥厚、小关节增生、侧隐窝狭窄,有时神经根病变的定位诊断也不明确,是否需要将所有狭窄的间隙部位减压,是否需要广泛的融合固定一直是临床争论的问题^[6]。传统腰椎减压融合术治疗DLSS效果明显,但手术创伤较大,术后感染、切口愈合不良、植骨区不融合、内固定松动断裂、邻椎病等手术并发症使得此类技术的应用受到限制^[7]。近年来,经皮内窥镜技术在治疗DLSS方面优势明显,通过术前病史询问、体格检查及相关影像学资料的反复研究,并根据病情需要可结合椎间盘造影,最终精准定位责任椎间隙及椎管狭窄部位行靶向穿刺,达到定点精准减压。2014年5月-2017年8月,本院采用经皮内窥镜下减压术并射频消融术治疗老年单节段DLSS患者40例,现将诊疗过程报告如下。     

COVID-19 manifestations in people with Parkinson’s disease: a USA cohort

Journal of Neurology - With the explosion of COVID-19 globally, it was unclear if people with Parkinson’s disease (PD) were at increased risk for severe manifestations or negative outcomes....     

Risk factors for infection in Malaysian patients with systemic lupus erythematosus

To determine the incidence, types and risk factors for infection in systemic lupus erythematosus (SLE) patients in Kuala Lumpur, Malaysia, we retrospectively reviewed the medical records of 102 patients with definite SLE attending a specialist clinic. Details of major infections (pneumonia or severe infection requiring intravenous therapy) and minor infections, and their time of onset in relation to immunosuppressive therapy and disease flares were recorded. There were 77 major and 163 minor infections during 564 patient-years of follow-up. In the month following a course of pulse methylprednisolone, the incidence of major infection was 20 times higher and the incidence of minor infection was 10 times higher than at other periods (p<0.0001). In the month after disease flare, the incidence of major infection was 10 times higher and the incidence of minor infection six times higher than at other times (p<0.0001). After allowing for methylprednisolone therapy and disease flares, there was no increase in the rate of infections during treatment with azathioprine, oral or intravenous cyclophosphamide. There was no effect of renal involvement on infection rate.      

热惊厥幼龄大鼠脑内Prolactin蛋白及Zinc transporter 1 mRNA表达

目的 探讨热应激(Heat stress,HS)和热惊厥(Febrile convulsions,FC)对脑内催乳素蛋白(Prolactin,PRL)和锌离子转运体1(Zinc transporter 1,ZnT1)表达的影响,探讨FC的神经免疫学机制.方法 实验在浙江大学附属邵逸夫医院中心实验室进行.采用热水浴诱导FC模型.21 d龄雄性sD大鼠随机分为正常对照组(8只)和热应激组(28只),28只热应激处理大鼠中15只达到5级(设为热性惊厥组,FC),10只未出现惊厥(设为单纯热应激组,HS),3只达到2级惊厥,弃用.应用免疫组织化学技术对HS和FC大鼠PRL免疫反应性在不同脑区的表达进行分析,原位杂交检测ZnT1表达.各组阳性细胞数采用方差分析进行统计.结果 ①对照组大脑皮层偶见零星表达,着色淡且无定位分布特征.HS组PRL-IR阳性细胞在大脑皮层PIR、Ent和Rs区免疫染色较深,PRH、PAR和Fr区染色较浅;另外PRL-IR阳性细胞还分布于丘脑中线一带;而FC组则于大脑皮层、海马、杏仁核、丘脑及下丘脑见大量PRL-IR阳性细胞,呈弥漫性分布,无明显核团分布特征.②HS和FC两组大脑皮层各区PRL-IR阳性细胞数均明显高于对照组(P<0.01).FC组大鼠大脑皮层PIR、Ent、RS区PRL-1R阳性细胞数与HS组大鼠差异无统计学意义(F值分别为688.9、744.3、0.56,P>0.05),PRH和PAR区FC组明显高于HS组(F值分别为2.68、1.48,P<0.01).③FC组海马区域可见明显ZnT1 mRNA表达,而HS组和对照组无明显表达.结论 ①PfuL在HS组和FC组大脑皮层各区明显表达,而FC组在海马和杏仁核等前脑结构内亦有明显表达,表明PRL不仅与热应激的中枢调控有关,也参与海马等前脑结构对惊厥活动的中枢调控机制.②FC组海马ZnT1 mRNA明显表达提示FC组海马区域存在异常增高的锌离子转运.     

抗PD-1单抗生物学活性测定方法的联合验证

针对抗PD-1单抗的报告基因活性测定法开展实验室间的联合验证,以研究该方法多实验室间的可应用和可转移性。本文采用两种协作方案,分别对该方法的检测内、检测间和实验室间精密度以及线性和准确性进行了研究。结果显示:该方法的检测内精密度的95%可置信区间为(1.72～16.89)%,检测间精密度为(2.63～17.67)%,实验室间精密度为(9.00～14.26)%;线性的相关系数均大于0.99,对于不同效价水平准确性的95%可置信区间, 50%为(91.83～104.40)%, 75%为(90.40～101.40)%, 100%为(94.71～105.60)%, 125%为(94.00～102.00)%, 150%为(96.73～104.30)%。联合验证结果证明,该针对抗PD-1单抗的报告基因测活法,其精密度、线性和准确性均良好,可应用于不同实验室抗PD-1单抗的放行检测及稳定性分析。     

Characterization of Lung Injury following Abrin Pulmonary Intoxication in Mice: Comparison to Ricin Poisoning

Abrin is a highly toxic protein obtained from the seeds of the rosary pea plant Abrus precatorius, and it is closely related to ricin in terms of its structure and chemical properties. Both toxins inhibit ribosomal function, halt protein synthesis and lead to cellular death. The major clinical manifestations following pulmonary exposure to these toxins consist of severe lung inflammation and consequent respiratory insufficiency. Despite the high similarity between abrin and ricin in terms of disease progression, the ability to protect mice against these toxins by postexposure antibody-mediated treatment differs significantly, with a markedly higher level of protection achieved against abrin intoxication. In this study, we conducted an in-depth comparison between the kinetics of in vivo abrin and ricin intoxication in a murine model. The data demonstrated differential binding of abrin and ricin to the parenchymal cells of the lungs. Accordingly, toxin-mediated injury to the nonhematopoietic compartment was shown to be markedly lower in the case of abrin intoxication. Thus, profiling of alveolar epithelial cells demonstrated that although toxin-induced damage was restricted to alveolar epithelial type II cells following abrin intoxication, as previously reported for ricin, it was less pronounced. Furthermore, unlike following ricin intoxication, no direct damage was detected in the lung endothelial cell population following abrin exposure. Reduced impairment of intercellular junction molecules following abrin intoxication was detected as well. In contrast, similar damage to the endothelial surface glycocalyx layer was observed for the two toxins. We assume that the reduced damage to the lung stroma, which maintains a higher level of tissue integrity following pulmonary exposure to abrin compared to ricin, contributes to the high efficiency of the anti-abrin antibody treatment at late time points after exposure.     

莪术醇生物构建自体瘤苗治疗晚期胃癌患者近期疗效研究

目的:探讨自体瘤苗治疗胃腺癌对患者免疫功能的影响及临床效应.方法:9例瘤苗组实体瘤术后患者应用自体瘤苗,并与对照组8例进行比较,对其疗效进行判断评价,检测治疗前后其NKC活性及CD3 、CD4 、CD8 水平.结果:实验组使用自体瘤苗治疗后,其NKC细胞的活性及CD3 、CD4 水平明显高于对照组及自身治疗前,其CD8 阱水平低于其他组;近期随诊其生存质量及疗效也明显优于治疗前及对照组.结论:莪术醇生物构建的自体瘤苗能增强胃癌患者的治疗效果,明显提高自身细胞免疫功能,副反应较小,是一种安全、有效、实用的辅助治疗方法.     

新疆男男性行为人群高危行为安全套使用状况及其影响因素分析

  目的  了解新疆男男性行为人群（MSM）队列失访率和随访保持率以及分析失访原因。  方法  于2010年6月 — 2015年3月在新疆乌鲁木齐市、伊宁市、阿克苏市3个地区招募HIV抗体阴性MSM,建立前瞻性队列研究。每3个月进行定位随访,每6个月进行行为学调查和HIV抗体检测。单因素分析采用多组比较的χ²检验,多因素分析采用多元logistic回归。  结果  队列共纳入1 041名调查对象,6个月随访人数900人（86.46 %）,12个月随访884人（84.92 %）;6个月失访141人（13.54 %）,12个月失访157人（15.08 %）.单因素分析结果显示,年龄、文化程度、户籍所在地、月收入、艾滋病相关知识、调查地区、参加队列原因、寻找性伴场所、安全套使用频次、近6个月性伴数量以及感染丙肝状况是MSM失访与随访之间的差异存在统计学意义的变量（P < 0.05）。多因素分析结果显示,文化程度（OR = 0.089,95 % CI = 0.060～0.133,P < 0.001）、调查地区（OR = 1.800,95 % CI = 1.231～2.632,P = 0.002）、参加队列原因（OR = 0.663,95 % CI = 0.465～0.946,P = 0.023）、近6个月性伴数量（OR = 4.070,95 % CI = 2.002～8.278,P < 0.01）是队列失访的影响因素。  结论  新疆MSM队列失访率较高,文化程度、调查地区、参加队列研究的原因以及近6个月性伴数量均与队列失访有关。     

复方丹参滴丸对2型糖尿病合并动脉粥样硬化患者炎症及凝血功能的影响

目的探讨复方丹参滴丸对2型糖尿病合并动脉粥样硬化患者炎症及凝血功能的影响。方法选择2017年1月至2018年12月在上海市宝山区大场医院治疗的86例2型糖尿病合并动脉粥样硬化患者为研究对象,按照随机数表法将患者分为对照组和观察组,每组43例。对照组使用阿司匹林肠溶片治疗,观察组在对照组治疗的基础上使用复方丹参滴丸治疗。治疗3个月,比较两组患者的凝血功能指标、炎症因子及不良反应发生情况。结果治疗后,观察组患者的活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)分别为(26.37±1.91) s、(12.04±0.52) s,明显长于对照组的(23.48±1.51) s、(10.79±0.38) s,纤维蛋白原(Fib)水平为(3.36±0.73) g/L,明显低于对照组的(4.62±0.94) g/L,差异均有统计学意义(P<0.05),但两组患者的凝血酶时间(TT)比较差异无统计学意义(P>0.05);治疗后,观察组患者的血清高敏C反应蛋白(hs-CRP)和肿瘤坏死因子α(TNF-α)水平分别为(2.58±0.49) mg/L、(63.25±9.63) ng/L,明显低...