甘宁黄土高原鼠疫自然疫源地50年防控概述

目的通过对甘宁阿拉善黄鼠鼠疫疫源地50年鼠疫调查及监测材料汇总分析,为该疫源地动物鼠疫监测及预警提供指导。方法收集、整理鼠疫资料,建立甘宁黄土高原黄鼠疫源地1962—2012年鼠疫数据库;黄鼠密度调查采用1日弓形夹法,其他小型啮齿动物调查采用5m夹线法;鼠疫病原学的分离采取剖检鼠类脏器,取肝脾直接压印培养法;鼠体蚤的收集采用梳检法;蚤的细菌学检验采取集组研磨培养法;鼠疫血清学采取间接血凝（IHA）法。结果该疫源地共捕获啮齿动物18种,黄鼠为优势种群;收集蚤类59种（亚种）,方形黄鼠蚤蒙古亚种为优势种群;50年来发生3次动物间鼠疫流行,分离鼠疫菌163株（其中人尸体4株、自然染疫动物135株、寄生蚤24株）,检出阳性血清488份;动物鼠疫流行多发生在5—6月,流行年份黄鼠密度（3．26±1．11）只／hm^2,动物间鼠疫频发区在海原县境内月亮山与南华山草甸草原和山地草原地带。结论海原县境内月亮山与南华山为该疫源地核心区,黄鼠鼠疫终止流行阈值指标为黄鼠密度年均〈0．2只／hm^2,黄鼠密度年均1．11只／hm^2为动物鼠疫流行时的阈值指标,2只／hm^2为动物鼠疫流行的预警指标。     

PICC临床护理路径在培养肿瘤专科护士核心能力中的应用

目的探讨PICC临床护理路径在培养肿瘤专科护士核心能力中的应用。方法制订肿瘤化疗患者的PICC临床护理路径,以加强PICC置管及护理技术培训为重点,根据路径内容对高年资护士进行专科理论知识和健康教育能力的培训,比较培训前后肿瘤专科护士专业核心能力得分和患者满意度的差异。结果培训前肿瘤专科护士专业核心能力得分为（498.21±12.46）分,培训后为（580.76±8.57）分,培训前后比较,P〈0.05,差异具有统计学意义,培训后肿瘤专科护士专业核心能力得分高于培训前;培训前患者满意度为87.9%,培训后为92.8%,培训前后比较,P〈0.05,差异具有统计学意义,培训后患者满意度高于培训前。结论应用PICC临床护理路径对肿瘤专科护士进行培训,有助于提高肿瘤专科护士的核心能力,同时也提高了患者对护理工作的满意度。     

下腰痛生物力学特点的研究进展

目前国内外对于腰椎生物力学改变可导致下腰痛有较为统一的认识。普遍认为通过保持正确的姿势、加强腰背肌和核心肌群的锻炼优化脊柱节段活动的控制和腰椎的稳定性可以预防和治疗下腰痛。本文总结了腰椎骨、椎间盘、小关节、软组织等生物力学特点及其与下腰痛的关系,对下腰痛的发生和复发的预防及治疗具有良好的临床指导作用。     

COMPARISON OF THE IMMEDIATE EFFECT OF DIFFERENT TYPES OF TRUNK EXERCISE ON THE STAR EXCURSION BALANCE TEST IN MALE ADOLESCENT SOCCER PLAYERS

Purpose/Background:

Trunk exercises, such as trunk stabilization exercises (SE) and conventional trunk exercises (CE), are performed to improve static or dynamic balance. Recently, trunk exercises have also been often used as part of warm‐up programs. A few studies have demonstrated the immediate effects of SE and CE on static balance. However, immediate effects on dynamic balance are not yet known. Therefore, the purpose of this study was to compare the immediate effect of SE with that of CE on the Star Excursion Balance Test (SEBT).

Methods:

Eleven adolescent male soccer players (17.9 ± 0.3 years, 168.5 ± 5.4 cm, and 60.1 ± 5.1 kg) participated in this study. A crossover design was used, and each participant completed three kinds of testing sessions: SE, CE, and non‐exercise (NE). Experiments took place for three weeks with three testing sessions, and a 1‐week interval was provided between different conditions. Each testing session consisted of three steps: pretest, intervention, and posttest. To assess dynamic balance, the SEBT score in the anterior, posteromedial, and posterolateral directions was measured before and 5 minutes after each intervention program. The data of reach distance were normalized with the leg length to exclude the influence of the leg length on the analysis.

Results:

The SEBT composite score was significantly improved after the SE (p < 0.05) but did not change after the CE and NE (p > 0.05). Furthermore, in the SE condition, SEBT scores of the posterolateral and posteromedial directions were significantly improved at the posttest, compared with those at the pretest (p < 0.05).

Conclusions:

This study demonstrated the immediate improvements in the posteromedial and posterolateral directions of the SEBT only after the SE. This result suggests that the SE used in this study is effective in immediately improving dynamic balance.

Levels of Evidence:

3b     

The use of the Core Outcome Measures Index (COMI) in patients undergoing total knee replacement

Background

The Core Outcome Measure Index (COMI) is a very short outcome instrument used in spine patients. The aim of this study was to examine the utility of a knee version of the COMI in patients undergoing total knee arthroplasty (TKA) by assessing the reproducibility, construct and discriminant validity, and responsiveness.

Prevention of core cell damage in isolated islets of Langerhans by low temperature preconditioning

AIM: To study the core cell damage in isolated islets of Langerhans and its prevention by low temperature preconditioning (26 ℃). METHODS: Islets were cultured at 37 ℃ for 7-14 d after isolation, and then at 26 ℃ for 2,4 and 7 d before additional culture at 37℃ for another 7 d. Core cell damage in the isolated islets was monitored by video-microscopy and analyzed quantitatively by use of a computer-assisted image analysis system. The analysis included daily measurement of the diameter and the area of the isolated islets and the area of the core cell damage that developed in those islets over time during culture. Histology and TdT-mediated dUTP-biotin nick end labeling (TUNEL) assay were used to characterize the cell damage and to monitor islet function. RESULTS: Microscopic analysis showed that during the 7 to 14 d of culture at 37℃, core cell damage occurred in the larger islets with diameters >200 μm, which included both necrotic and apoptotic cell death. Low temperature (26℃) culture could prevent core cell damage of isolated islets. The 7-d culture procedure at 26℃ could inhibit most of the core cell (excluding diameters>300 μm) damages when the islets were re-warmed at 37℃. CONCLUSION: Our results indicate that core cell damage within isolated islets of Langerhans correlates with the size of islets. Low temperature (26℃) culture can prevent core cell damage in isolated islets, and successfully precondition these islets for incubation at 37 ℃. These novel findings may help to understand the pathophysiology of early loss of islet tissue after transplantation, and may provide a new strategy to improve graft function in the clinical setting of islet transplantation.     

腺病毒介导RNA干扰抑制核心结合因子α1表达阻断软骨细胞的肥大分化

背景:软骨细胞肥大分化是软骨内骨化启动的标志,也是软骨内骨化必不可少的步骤,它是一种级联反应,一旦启动就很难阻断,最终结果是形成骨骼结构。RNA干扰技术是一种转录后水平的基因沉默,相关研究显示采用RNA干扰技术阻断核心结合因子α1表达能够有效地抑制异位骨化形成。目的:利用RNA干扰技术抑制核心结合因子α1表达,从而阻断大鼠软骨细胞肥大分化。方法:构建沉默SD大鼠核心结合因子基因的腺病毒Ad-Cbfa1-si RNA。利用维甲酸及白细胞介素1α促进软骨细胞肥大分化,观察Ad-Cbfa1-si RNA对核心结合因子α1表达的抑制作用。利用核心结合因子α1免疫组化方法比较各组核心结合因子α1的表达从而分析软骨细胞的肥大分化情况。结果与结论:经维甲酸和白细胞介素1α诱导后,阴性对照病毒组软骨细胞出现肥大分化,核心结合因子α1的表达呈阳性反应;Ad-Cbfa1-si RNA组软骨细胞中未见核心结合因子α1明显表达。提示利用RNA干扰技术能够明显抑制核心结合因子α1的表达,从而阻断软骨细胞的肥大分化。     

Histological diagnosis and grading of pancreatic neuroendocrine tumor by endoscopic ultrasound-guided fine needle biopsy using a 25-gauge needle with a core trap: A multicenter prospective trial

ObjectivesPreoperative grading of pancreatic neuroendocrine tumors (PanNET) is challenging. The aim of this study was to prospectively evaluate the use of a 25-gauge needle with a core trap for diagnosis and grading of PanNET.MethodsThis multicenter prospective trial was registered with the University Hospital Medical Information Network (UMIN000021409). Consecutive patients with suspected PanNET between June 2016 and November 2017 were enrolled. All patients underwent endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a 25-gauge needle with a core trap. Samples obtained after the first needle pass were used for central pathological review. EUS-FNB was evaluated in terms of (i) technical success rate, (ii) adequacy for histological evaluation, (iii) complication rate during the procedure, and (iv) concordance between PanNET grading on EUS-FNB and that after analysis of the resected tumor.ResultsFifty-two patients were enrolled. Of the 36/52 patients who underwent surgical resection, 31 were finally diagnosed with PanNET and were eligible for analysis. The technical success rate of EUS-FNB was 100%. The rate of adequacy for histological evaluation was 90.3%. There were no complications related to EUS-FNB. The concordance rate between PanNET grading on EUS-FNB and that after analysis of the resected tumor was 82.6% (95% confidence interval = 61.22–95.05, P = 0.579).ConclusionsEUS-FNB using a 25-gauge needle with a core trap is feasible, providing histological samples are of sufficient quality for diagnosis and grading of PanNET.     

Effect of retinoic acid on the structure of N-glycans on the surface of human hepatocarcinoma cells and its enzymatic mechanism

In order to study the effect of retinoic acid on the structure of N-glycans on the cell surface, the N-glycans of glycoproteins on the surface of 7721 human hepatocarcinoma cells were labelled with [³H] mannose, added to the culture medium. The³H-labelled N-glycans were prepared from cell-surface glycoproteins, desialylated, and subjected to sequential chromatography on concanavalin A andDatura stranonium agglutinin affinity columns to separate the glycans into four fractions of different type and different antennary number. It was found that the percentage of C₂C₂ biantennary complex type N-glycans was increased, but the high-mannose type as well as the triand tetraantennary complex types, especially that with a C_2,6 branched structure, were decreased after the cells had been treated with retinoic acid for 3–5 days. Using aLens culinaris agglutinin affinity column, it was discovered that the core fucose in the biantennary glycan was also decreased. The enzymatic mechanisms of the above changes were revealed in further study to involve the decrease ofN-acetylglucosaminul-transferase V and core -1,6-fucosyltransferase.Abbreviations GlcNAc N-acetylglucosamine - RA retionoic acid - LCA Lens culinaris agglutinin - DSA Datura stramonium agglutinin Supported by a grant from the Natural Science Foundation of China (39040001) and the Chinese Medical Board (93583)