1997年-2008年太原地区204例出生缺陷回顾性分析

目的了解1997年-2008年间太原市出生缺陷发生情况,为进一步制定干预措施提供依据。方法将1997年-2008年12年中在我院妇产科终止妊娠的出生缺陷患儿按年限分为1997年-2002年（前六年）组和2003年-2008年（后六年）,并对其种类、发生率及城乡分布进行回顾性分析。结果 （1）12年中神经管畸形的发生率为56.11/万,居于首位,占全部出生缺陷的32.35%,虽然后六年的神经管畸形的发生率低于前6年,但无统计学差异（χ2=3.70,P〉0.05）。（2）后6年中28W前B超诊断率（1.12%）比前六年（0.41%）显著提高（χ2=7.49,P〈0.05）。（3）前6年中城市与农村出生缺陷发生率分别为133.94/万、545.45/万,后6年城市与农村出生缺陷发生率分别为129.64/万、436.50/万,（χ2=42.27,P〈0.05;χ2=44.47,P〈0.05）农村的平均发生率为城市的3.7倍,明显高于城市。结论神经管畸形的发生在我省仍较为突出,只有加强对神经管畸形的预防,加强优生优育知识的宣传,改善农村生活环境,提高产前诊断率水平,才有可能有效性地降低出生缺陷的发生。     

临床护理路径对白内障病人手术焦虑和抑郁情绪的影响

白内障是眼科的常见病,也是主要的致盲眼病,其治疗以手术为主。手术对病人可以产生心理刺激,且病人手术前后常因各种原因导致焦虑、恐惧,病人的不良情绪与手术的整个过程及术后效果密切相关。临床路径是一种标准化的临床医护工作管     

S1PR1 expression correlates with inflammatory responses to Newcastle disease virus infection

Newcastle disease virus (NDV) is the causative agent of Newcastle disease, which is characterized by inflammatory pathological changes in the organs of chickens. The inflammatory response to this disease has not been well characterized. Previous reports showed that the sphingosine-1-phosphate-1 receptor (S1PR1), a G protein-coupled receptor, is important to the activation of inflammatory responses. To understand better the viral pathogenesis and host inflammatory response, we analyzed S1PR1 expression during NDV infection. We observed a direct correlation between chicken embryo fibroblast (CEF) cellular inflammatory responses and S1PR1 expression. Virulent NDV-infected CEF cells also had elevated levels of pro-inflammatory cytokines (IL-1β, IL-6 and IL-18). When S1PR1 was inhibited by using the specific antagonist W146, pro-inflammatory cytokine production declined. Overexpression of S1PR1 resulted in increased virus-induced IL-1β production. S1PR1 expression levels did not impact significantly NDV replication. These findings highlight the important role of S1PR1 in inflammatory responses in NDV infection.     

Targeted multimodal imaging modalities

Molecular imaging non-invasively visualizes and characterizes the biologic functions and mechanisms in living organisms at a molecular level. In recent years, advances in imaging instruments, imaging probes, assay methods, and quantification techniques have enabled more refined and reliable images for more accurate diagnoses. Multimodal imaging combines two or more imaging modalities into one system to produce details in clinical diagnostic imaging that are more precise than conventional imaging. Multimodal imaging offers complementary advantages: high spatial resolution, soft tissue contrast, and biological information on the molecular level with high sensitivity. However, combining all modalities into a single imaging probe involves problems yet to be solved due to the requirement of high dose contrast agents for a component of imaging modality with low sensitivity. The introduction of targeting moieties into the probes enhances the specific binding of targeted multimodal imaging modalities and selective accumulation of the imaging agents at a disease site to provide more accurate diagnoses. An extensive list of prior reports on the targeted multimodal imaging probes categorized by each modality is presented and discussed. In addition to accurate diagnosis, targeted multimodal imaging agents carrying therapeutic medications make it possible to visualize the theranostic effect and the progress of disease. This will facilitate the development of an imaging-guided therapy, which will widen the application of the targeted multimodal imaging field to experiments in vivo.     

温针灸联合玻璃酸钠关节腔内注射治疗膝骨性关节炎Meta分析

目的:系统评价温针灸联合玻璃酸钠治疗膝骨性关节炎的疗效。方法:计算机检索自建库截止至2018年7月PubMed,Wed of Science CBM,The Cochrane Library,EMBase,中国期刊全文数据库(CNKI)、万方数据库(Wan Fang Data)、维普中文科技期刊数据库(VIP)中关于温针灸联合玻璃酸钠治疗膝骨性关节炎的随机对照试验(RCTs)。由2位研究员分别进行文献筛选、数据提取和质量评价后,采用Rev Man 5.3软件进行Meta分析。结果:有15篇RCTs纳入本研究,共1247例膝骨性关节炎患者(试验组628例,对照组619例)。试验组:温针灸联合玻璃酸钠;对照组:玻璃酸钠/温针灸/其他治疗。Meta分析结果:试验组治疗膝骨性关节炎总有效率比玻璃酸钠组、温针灸组、其他组分别高15%、20%及24%,且差异有统计学意义(RR=1.15,95%CI:1.10～1.21,P<0.00001;RR=1.20,95%CI:1.05～1.36,P=0.005;RR=1.36,95%CI:1.11～1.66,P=0.003)。试验组治疗膝骨性关节炎改善视觉模拟(VAS)评分优于玻璃酸钠组、温针灸组及其他组,且差异有统计学意义(MD=-1.46,95%CI:-1.84～-1.08,P=0.009;MD=-4.73,95%CI:-6.46～-3.01,P<0.00001;MD=-1.83,95%CI:-2.39～-1.28,P<0.00001);试验组治疗膝骨性关节炎改善WOMAC评分优于温针灸组,且差异有统计学意义(MD=-37.11,95%CI:-49.36～-24.85,P<0.00001)。试验组治疗膝骨性关节炎改善膝关节(LKSS)评分优于玻璃酸钠组及温针灸组,且差异有统计学意义(MD=39.14,95%CI:20.87～57.42,P<0.0001;MD=41.05,95%CI:27.77～54.33,P<0.00001)。结论:温针灸联合玻璃酸钠治疗膝骨性关节炎疗效优于单一用药及其他组,不过本研究纳入文献的质量及数量有限,故仍需更多长时间随访且高质量的RCTs试验进一步验证。     

锥形束CT测量牙龈厚度准确性的初步研究

目的评价锥形束CT(CBCT)法测量牙龈厚度的可信度及准确性。方法选择20例牙龈健康者的120颗上颌前牙,采用CBCT法和牙龈穿刺法测量唇侧中央龈缘下2mm处牙龈厚度,比较两组差异并用Kappa系数评价两种方法的一致性;应用Kappa系数评价不同检查者用CBCT法测量牙龈厚度的一致性,以及组内相关系数ICC评价同一检查者重复测量数据的可信度。结果CBCT法测量牙龈厚度为(1.23±0.27)mm,牙龈穿刺法测量结果为(1.24±0.26)mm,差异无统计学意义(P>0.05),两组之间一致率为83.33%(Kappa=0.547)。不同的检查者CBCT法测量牙龈厚度的一致性检验Kappa系数为0.814,可信度良好(ICC=0.795),同一检查者CBCT法重复测量数据之间一致性检验Kappa系数为0.864,可信度良好(ICC=0.893);CBCT法对厚牙龈生物型具有高的灵敏度(92.05%)和低的特异度(59.38%)。结论CBCT测量牙龈厚度的结果与牙龈穿刺法的结果较一致,具有良好的可信度。     

宫腔内灌注粒细胞集落刺激因子联合低分子肝素在薄型子宫内膜患者冻融胚胎移植周期中的研究

目的:探讨宫腔内灌注粒细胞集落刺激因子(G-CSF)联合低分子肝素(LMWH)对薄型子宫内膜患者冻融胚胎移植(FET)周期中的临床疗效。方法:选取2018年6月-2019年10月于山西医科大学第一医院进行FET助孕治疗的薄型子宫内膜患者175例,根据患者自身意愿分为3组,A组:63例患者仅接受激素替代治疗;B组:52例患者接受激素替代治疗+宫腔内G-CSF灌注;C组:60例患者接受激素替代治疗+宫腔内G-CSF灌注+皮下注射LMWH。对3组患者的子宫内膜厚度、子宫内膜血流阻力指数(RI)、搏动指数(PI)、周期取消率、胚胎种植率、临床妊娠率、早期流产率、异位妊娠率等指标进行比较。结果:在内膜转化日,与A组相比,B、C组子宫内膜厚度、Ⅱ+Ⅲ型血流比例均增加,RI、PI均降低(P<0.05)。治疗结局方面,与A组相比,B、C组胚胎种植率、临床妊娠率增加,周期取消率降低,差异有统计学意义(P<0.05);B、C组间比较差异无统计学意义(P>0.05);C组早期流产率较B组降低,差异有统计学意义(P<0.05)。结论:在FET周期中宫腔内灌注G-CSF可提高薄型子宫内膜患者的子宫内膜厚度,改善子宫内膜的血流情况,提高胚胎种植率及临床妊娠率,注射LMWH可降低早期流产率。     

Muscle cell differentiation and development pathway defects in Emery-Dreifuss muscular dystrophy

Emery-Dreifuss muscular dystrophy (EDMD) is a rare genetic disorder characterised by the early development of muscle contractures, progressive muscle weakness, and heart abnormalities. The latter may result in serious complications, or in severe cases, sudden death. Currently, there are very few effective treatment options available for EDMD and so there is a high clinical need for new therapies. Various genetic mutations have been identified in the development and causation of EDMD, each encoding proteins that are components of the Linker of Nucleoskeleton and Cytoskeleton (LINC) complex, which spans the nuclear envelope and serves to connect the nuclear lamina to the cytoskeleton. Within this review, we examine how mutations in the genes encoding these proteins, including lamins A/C, emerin, nesprins 1/2, FHL1, and SUN1/2 lead to muscle cell differentiation and development pathway defects. Further work to identify conserved molecular pathways downstream of these defective proteins may reveal potential targets for therapy design.