应用高频超声建立未育女性腹直肌间距正常值参考范围及影响因素分析

目的 应用高频超声测量未育女性在四个位置的腹直肌间距并分析相关因素,旨在初步制定正常腹直肌间距(IRD)的参考值范围。 方法 选取2019年6月至2019年9月在我院行健康体检的106名健康未育女性志愿者,体质量指数（BMI）均≤30kg/m2,应用高频超声分别于仰卧位静息状态及卷腹动作测量脐上3cm、脐部、脐下2cm和脐下3cm四个位置的IRD,应用百分位数法计算IRD参考值范围,并分析IRD与年龄、身高、体重、BMI指数之间的关系。 结果 未育女性仰卧位静息状态IRD正常值范围如下：脐上3cm为4~15mm,脐部为5~20mm,脐下2cm为0~7mm,脐下3cm为0~3mm。相关性分析显示IRD与年龄、身高无相关性,与体重和BMI指数呈较弱的正相关。 结论 本研究应用高频超声初步建立了未育女性IRD的参考值范围,为腹直肌分离的诊断提供了依据,IRD与体重和BMI指数呈较弱的正相关。     

Incidence of postoperative pain after use of calcium hydroxide mixed with normal saline or 0.2% chlorhexidine digluconate as intracanal medicament in the treatment of apical periodontitis

Objective

To compare the incidence of postoperative pain after the use of calcium hydroxide powder mixed with normal saline or 0.2% chlorhexidine digluconate as intracanal medicament.

Participants

Fifty-five subjects aged 17–60 years with teeth diagnosed to have apical periodontitis.

Intervention

Two-visit conventional root canal treatment of seventy teeth. The teeth were divided by randomization (balloting) into two groups: control group and experimental group, each with thirty-five teeth treated with calcium hydroxide mixed with normal saline or with 0.2% chlorhexidine digluconate as intracanal medicament respectively. Incidence of postoperative pain was assessed using the universal pain assessment tool and whether or not analgesic was taken.

Main outcome measured

Incidence of post-operative pain.

Result

Postoperative pain occurred only at 1-day and 1-week reviews. In the control group, the overall incidence of pain was the same at both review periods (5.7%), while the experimental group showed a slight decrease in incidence between 1-day (17.2%) and 1-week (11.4%) reviews. Incidence of flare-ups was more in the experimental group (11.4%) than in the control group (5.7%). No significant statistical differences between the two groups were observed (p > 0.05).

Conclusion

The incidence of postoperative pain was lower in the normal saline treatment group, but the difference was not statistically significant.     

正常新生儿血、尿肠型脂肪酸结合蛋白浓度的探讨

目的 探讨正常新生儿血、尿肠型脂肪酸结合蛋白(intestinal fatty acid binding protin,I-FABP)跟性别、胎龄、出生史等的关系,了解血、尿中的相关性.方法 收集云南省第一人民医院2012年12月至2013年4月NICU收治的没有感染、窒息病史的早产儿100例及同期出生的正常足月儿100例为实验对象,出生后24 h内采外周静脉血2 mL及用无菌管收集尿液2 mL,离心,收上清液,-60℃冰箱保存,统一检测.用ELASA方法测定血及尿液中IFABP的浓度.结果 新生儿血、尿中I-FABP在性别、胎龄、出生史进行比较差异无统计学意义(P＞0.05).血、尿中I-FABP有相关性,Spearman相关系数为0.489 (P＜0.05).结论 血、尿中I-FABP浓度与新生儿胎龄、性别、出生史、单胎、多胎等因素无关.血尿中IFABP浓度有相关性,血标本因易导致医源性贫血及依从性差,而尿液I-FABP的检测采集方便、成本低、病人痛苦少等特点,临床上可以用尿液替代血液进行检测.     

组织多普勒超声测定正常人心肌作功指数

目的应用组织多普勒成像(TDI)评价正常人左心室Tei指数。方法对50例正常人分别行超声心动图检查,脉冲血流多普勒方法测算传统Tei值(conventionalTeiindex,c-Tei,);TDI条件下,分别显示二尖瓣环后间隔位点和左室侧壁位点(心尖四腔观)、左室前壁位点和下壁位点(心尖二腔观)、前间隔位点和左室后壁位点(心尖左室长轴观),分别测算各位点的Tei值,取6个位点测值的均值作为左心室整体Tei指标(tissueDopplerTeiindex,t-Tei)测值。结果正常人的左心室整体t-Tei测值为(0.41±0.07),各年龄组间Tei指数测值无明显差别(P>0.05)。不同室壁间心肌的Tei指数测值无差别(P>0.05)。将正常人t-Tei测值与c-Tei值(0.44±0.08)进行比较,无统计学差异(P>0.05)。结论TDISK准确测定正常人心脏整体Tei指数及心肌各节段Tei指数,为评价Tei指数提供了一种新的检测手段。     

胰岛素抵抗对糖耐量正常冠心病患者冠脉病变的影响

目的探讨胰岛素抵抗对糖耐量正常冠心病患者冠脉病变的影响。方法以112例冠心病患者为研究对象,采用自我平衡模型分析法(homeostasismodelassessment,HOMA)指数作为评价胰岛素抵抗的指标,将患者分为胰岛素抵抗组和胰岛素敏感组,应用多元逐步回归分析对相关危险因素进行分析。结果两组患者多支冠脉病变的发生率差异有统计学意义,弥漫性病变的发生率差异有极显著性意义,体重指数、收缩压、空腹血浆胰岛素、总胆固醇、甘油三酯与冠脉病变程度正相关,高密度脂蛋白-胆固醇与之呈负相关。结论冠心病合并胰岛素抵抗患者冠脉多支病变、多处病变及弥漫性病变的发生率高,提示胰岛素抵抗及其所造成的肥胖、高血压、脂质代谢紊乱是冠心病的独立危险因素。     

Impact of ischemia on sample quality of human pancreatic tissues

BackgroundSuccessful clinical evaluation of human tumors relies on proper handling of tissue samples to maximally preserve the cellular and metabolic states in vivo. Pancreatic samples are particularly sensitive to sample mishandling due to the abundance of digestive enzymes. We study how the duration of ischemia, in vivo and ex vivo, both of which are unavoidable lagging periods following surgical dissection, significantly impact the utility of pancreatic samples.MethodsWe systematically characterize a wide range of tissue integrity features, including histological patterns, cellular structures, DNA/RNA quality and activity of major signaling pathways in normal pancreases and pancreatic ductal adenocarcinoma (PDAC) tumor tissues from 41 patients with different ischemia.ResultsWe reveal that tissues experiencing longer periods of ischemia exhibit significant deterioration and could potentially mislead disease diagnosis and preclinical research. Based on these analyses, we propose an optimal procedure that balances better clinical practice and high tissue sample quality.ConclusionsOur work provides a guideline for pancreatic sample handling and could have wide implications in clinical diagnosis and translational research.     

不同糖调节水平非酒精性脂肪性肝病患者肝脏脂肪含量与胰岛β细胞功能及胰岛素抵抗的关系

目的 观察非酒精性脂肪性肝病（NAFLD）患者肝脏脂肪含量（LF）与IR及胰岛β细胞功能的关系. 方法 将286例NAFLD患者分为正常糖调节（NGR）组和IGR组,以校正CT半定量法测定LF,再根据LF分为6个亚组：NGR-1、2、3亚组及IGR-1、2、3亚组.以OGTT、胰岛素释放试验评估IR及胰岛β细胞功能,分析LF与IR及胰岛β细胞功能的关系. 结果 （1）随LF增加,NGR-2亚组△I30/△G30高于NGR-1亚组（P＜0.05）,NGR-3亚组稍低于NGR-2亚组（P＞0.05）;IGR-3亚组△I30/△G30低于IGR-1亚组（P＜0.05）;（2）随LF增加,NGR-2、3亚组HOMA-β均高于NGR-1亚组（P＜0.05）;IGR-3亚组低于IGR-1、IGR-2亚组（P＜0.05）.（3）多元线性回归分析提示,LF是影响HOMA-IR最强的独立危险因素（P＜0.01）. 结论 在NGR人群中,LF增加至5.1％～9.9％时,IR增加,胰岛β细胞早相和整体分泌代偿性增高;当LF达10.0％～20.0％时,胰岛β细胞早相分泌功能可能出现减退.对IGR人群,LF增加至5.1％～9.9％时,胰岛β细胞早相分泌功能已开始降低;当LF达10.0％～20.0％时,胰岛β细胞整体分泌功能恶化.     

Caspase-3和P53在胃癌中的表达及临床意义

目的通过检测Caspase-3和P53在胃癌组织及正常胃黏膜组织中的表达情况,探讨两者与胃癌发生、发展的关系。方法采用免疫组化SP法检测胃癌组织及正常胃黏膜组织中两者的表达情况。结果胃癌组织及正常胃黏膜组织中,Caspase-3的表达阳性率分别为30.0%(15/50)、70.0%(14/20),差异有统计学意义(P0.05);P53在胃癌组织及正常胃黏膜中表达阳性率分别为76.0%(38/50)、25.0%(5/20),差异有统计学意义(P0.05);Caspase-3和P53的阳性表达率与胃癌的浸润深度、分化程度、淋巴结转移密切相关。结论 Caspase-3和P53与胃癌的发生及发展密切相关。     

Evaluation of a chromogenic commercial assay using VWF-73 peptide for ADAMTS13 activity measurement

Introduction

Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy (TMA), related to a severe functional deficiency of ADAMTS13 activity (< 10% of normal). ADAMTS13 activity is thus crucial to confirm the clinical suspicion of TTP, to distinguish it from other TMAs, and to perform the follow-up of TTP patients.

Material and methods

We compared the performance of the commercial chromogenic assay Technozym® ADAMTS13 Activity ELISA (chromogenic VWF73 substrate, Chr-VWF73, Technoclone, Vienna, Austria), to that of our in-house FRETS-VWF73 used as reference method. A large group of 247 subjects (30 healthy volunteers and 217 patients with miscellaneaous TMAs) was studied.

Results

The lower limit of detection of the Chr-VWF73 was 3%, which is well adapted to the clinically relevant threshold for TTP diagnosis (10%). Our results showed a reasonable agreement between FRETS-VWF73 and Chr-VWF73 assays to distinguish samples with an ADAMTS13 activity < 10% from those with an ADAMTS13 activity > 10%. However, Chr-VWF73 assay provided false negative results in ~ 12% of acute TTP patients. Inversely, the Chr-VWF73 assay globally underestimated ADAMTS13 activity in detectable values ranging from 11 to 100% (with a great variability compared to FRETS-VWF73), which may be a concern for the follow-up of TTP patients in remission.

Conclusion

In-house assays developed and performed by expert laboratories remain the reference methods that should be used without limitation to control values provided by commercial assays when needed. Also, the development of an international reference preparation will be crucial to improve standardization.     

The psychological sequelae of thermal injury on children and adolescents: Part 1

The psychological effects of thermal injury and children and their mothers were investigated in a three-part study; Part 1 is concerned with group comparisons regarding the psychological effects of thermal injury on children; Part 2 with aspects of the thermally injured group and Part 3 with psychological effects on their mothers. A total of 44 thermally injured (aged 11–16 years) injured 3–14 years previously, were matched according to age, sex, burn percentage and site of injury. In-depth interviewing and questionnaire responses on measures of psychological disturbance indicated that thermally injured children were differentiated in terms of psychopathology from matched Fracture Controls and Normal Controls. Such differences embraced many aspects of social and recreational functioning, and group differences emphasised depression, anxiety (particularly situational anxiety) and anti-social disorder as being particularly prominent in the thermally injured group. Therapeutic approaches are briefly discussed.