165例男性不育染色体核型及AZF基因缺失分析

目的探讨男性不育患者染色体核型异常及无精症因子（AZF）基因缺失与男性不育的关系。方法对2012年5月-2014年5月来本院就诊的（重庆地区）原发性男性不育患者165例,进行外周血G显带核型分析并采用多重PCR对无精症因子区域的15个标签序列位点进行检测。结果165例生精障碍患者中染色体异常共检出5例,1例为男性性反转（46,XX）,1例为克氏综合征（47,XXY）,1例为47,XY,＋mar,1例为46,XY,Y≥18,1例46,XY,in（9）,其余均为正常核型,总异常率为3.03％（5／165）;AZF基因位点发生微缺失患者共检出25例,总缺失率为15.15S。结论染色体异常和AZF微缺失是男性不育的重要原因,对男性不育诊断时有必要进行检查。     

血管内皮细胞屏障功能的血流动力学调控及其与动脉粥样硬化的关系

动脉粥样硬化是心脑血管疾病的重要病理基础。内衬于血管的内皮细胞是血管壁与血流之间的一道具有选择通透性的屏障,对于维持血管内环境稳态发挥重要作用。血管内皮屏障功能的紊乱是动脉粥样硬化发生发展的重要环节之一。近年的研究表明血流动力学能明显影响血管内皮细胞屏障功能。扰动流和振荡流等异常血流形态能改变血管内皮的通透性,甚至形成动脉内膜破裂。本文通过聚焦内皮细胞内外侧的物质交换、动脉内膜破裂方面的最新研究成果,评述血流动力学变化对血管内皮细胞屏障功能的影响,讨论了值得进一步深入研究的领域,以期为进一步阐明动脉粥样硬化发生发展机制以及有效防治策略的选择提供一个新的思路。     

小儿麻醉医师迈向围术期医师理念的培养

随着现代医学的飞速发展,麻醉学正向围术期医学转变。培养小儿麻醉医师向围术期医师转变的理念,需要在了解儿童病理生理特点的前提下,重点培训小儿麻醉术前访视、术中麻醉相关技能、术后访视、围术期疼痛相关管理及心理创伤的预防与治疗。让患儿安全舒适地度过围术期、减少术后并发症及死亡率、改善远期预后,是每位小儿围术期医师的责任。     

虚拟现实技术应用于外科学研究生手术技能培训效果与评价

目的　探讨将虚拟现实（VR）技术应用于外科学研究生手术技能培训的可行性,并对其培训效果进行评价。方法　以创建肾切除术的VR软件为例,将该VR软件应用于外科学研究生的手术培训,并与传统教学方式进行比较,了解其培训效果。同时发放调查问卷,了解该VR软件的性能特点及技术优势。采用ＳＰＳＳ 23.0进行t检验。结果　采用VR软件培训组的考试成绩[（92.17±0.38）分]明显优于传统教学方式培训组的考试成绩[（87.94±0.43）分],差异有统计学意义（P<0.001）。共回收有效调查问卷35份,82%以上的调查对象认为VR手术教学具有训练画面逼真、立体感强、界面友好、操控简单、交互性良好、便于全维度观看、课程内容精彩丰富、学习效果好、能够激发学习兴趣等优势,100%调查对象认为VR手术教学能够替代传统手术教学方法。结论　将VR技术应用于外科学研究生手术技能的培训具有可行性;将VR技术应用于外科学研究生手术技能培训的效果明显优于传统教学方式,值得进一步推广应用。     

妇乐颗粒联合克林霉素磷酸酯治疗子宫内膜炎的临床研究

目的观察妇乐颗粒联合克林霉素磷酸酯治疗子宫内膜炎的临床疗效。方法选取2018年1月—2018年12月在河南科技大学第一附属医院就诊的子宫内膜炎患者106例,随机分为对照组和治疗组,每组各53例。对照组口服克林霉素磷酸酯片,0.3 g/次,3次/d;治疗组在对照组基础上口服妇乐颗粒,12 g/次,2次/d。两组患者均治疗2周。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状和子宫内膜改善情况以C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)水平。结果治疗后,对照组和治疗组临床有效率分别为69.81%和88.68%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者子宫内膜厚度均明显增加(P0.05),治疗组患者腹痛消失时间比对照组更早(P0.05),子宫内膜厚度也明显比对照组厚(P0.05)。治疗后,两组患者CRP、TNF-α水平均明显降低(P0.05),且治疗组患者CRP、TNF-α水平明显低于对照组(P0.05)。结论妇乐颗粒联合克林霉素磷酸酯治疗子宫内膜炎,临床疗效确切,症状改善明显。     

In vitro characterisation of arterial stiffening: From the macro- to the nano-scale

Accurate measurement of the material properties of arterial tissue is important for better characterisation of diseases and the development of reliable computational models. There are a number of in vitro techniques that are applied to study the biomechanical properties of arterial tissue. This review article presents data obtained using tensile testing, nanoindentation, scanning acoustic microscopy (SAM) and atomic force microscopy (AFM). Each of these techniques provides material property information at a different spatial resolution and in many ways are complementary techniques. The lack of consensus in the literature with regard to the appropriate stress and strain definitions that should be used when reporting tensile testing data is also highlighted. The potential of higher spatial resolution techniques, which provide data at micro-scale (nanoindentation and SAM) and nano-scale (AFM) for application to the characterisation of human aortic tissue are discussed. Finally, studies, which have examined age-related changed in the aorta at these different length scales, are highlighted.     

The clinical significance of pathological studies of congenital intestinal atresia

Objective

The purpose of this study was to explore the mechanisms of postoperative intestinal motility disorders in intestinal atresia patients by investigating the expression profiles of proteins, including calretinin (CR), glial-derived neurotrophic factor (GDNF), bone morphogenetic protein 2 (BMP-2), c-kit, α-smooth muscle actin (α-SMA), and S-100 protein; to decipher the correlation between the area of the pathological segment and the alteration of the above 6 proteins; and thereby to provide a clinical specific reference values to determine the removal length for intestinal tract resection.

Methods

Immunohistochemistry technique was applied to detect the CR, c-kit, GDNF, BMP-2, α-SMA, and S-100 protein in specimens of atretic, proximal, and distal intestine from 25 cases of intestinal atresia and samples of intestinal walls from 10 non-atresia control specimens. The alteration of the enteric nervous system, nerve growth and its regulatory factors, the interstitial cells of Cajal (ICCs), and the enteric muscle system were examined, with particular attention being paid to pathological changes and the lesion area.

Results

The expression of all of the abovementioned 6 proteins in the proximal side of the atresia was significantly lower than in control group. The expression of the abovementioned proteins tended to be higher farther away from the atresia site. The expressions of both GDNF and BMP-2 had returned to normal level at 10 cm proximal to the atresia site, whereas the expressions of CR, c-kit, α-SMA, and S-100 protein only returned to normal at 15 cm proximal to the atresia site. On the distal side, the expression of all 6 markers at 3 cm distal to the atresia site was normal.

Conclusion

Pathological deterioration of the myenteric ganglia, nerve growth factor, and ICCs are the causes of intestinal motility disorders after the surgical repair of intestinal atresia. Our data support resecting an intestinal segment extending from 15 cm proximal to 3 cm distal to the atretic segment. In proximal jejunal atresia, when it is not possible to resect 15 cm, we suggest resecting as much of the hypertrophic proximal intestine as possible. Based on our data, we believe this surgical practice could improve postoperative dysmotility in these patients.     

A novel method of augmenting gene expression and angiogenesis in the normal and ischemic canine myocardium

This study presents a novel method that direct intramyocardial injection of low-dose plasmid DNA and microbubbles combined with insonation could further augment gene expression in normal and ischemic canine myocardium. Plasmids encoding enhanced green fluorescent protein (pEGFP) and hepatocyte growth factor (pHGF) (500???g) were individually mixed with 0.5?ml of microbubble solution (MB) and injected into the normal or acute ischemic canine myocardium. The dogs in the plasmid?+?MB/US group underwent insonation (US). Other dogs were randomly divided into three treatment groups: plasmid and insonation, plasmid and MB injection, and plasmid injection only. The EGFP and HGF mRNA expressions were assessed in the myocardium at the injection site and at sites 0.5 and 1?cm remote from the injection site. Compared to plasmid transfer alone, a mean 13.4-fold enhancement of gene expression was achieved in the EGFP?+?MB/US group at 48?h (p?<?0.01). HGF mRNA expression in ischemic zones was markedly elevated after 28?days, with a mean 9.0-fold enhancement in the HGF?+?MB/US group (p?<?0.01). EGFP protein expression was detected in the normal myocardium at 1?cm remote from the injection site in the EGFP?+?MB/US group. Similarly, HGF protein expression was detected in the ischemic myocardium at 0.5?cm remote from the injection site in the HGF?+?MB/US group. These findings indicate that the radius of gene expression was partly extended in the two plasmid?+?MB/US groups. The capillary density increased from 20.9?±?5.3/mm² in control myocardial infarction dogs without treatment to 126.7?±?38.2/mm² in the HGF?+?MB/US group (p?<?0.01). Taken together, the present data demonstrate that direct intramyocardial injection of an angiogenic gene and microbubbles combined with insonation can augment gene expression and angiogenesis. Consequently, this strategy may be a useful tool for gene therapy of ischemic heart disease.