3D打印导板辅助上颈椎椎弓根置钉与徒手置钉的比较

目的 比较个体化3D打印导板辅助上颈椎椎弓根置钉与徒手置钉的精准性。方法 选择2019年6月至2022年6月在蚌埠医学院第二附属医院就诊的上颈椎疾患患者20例,获取每位患者颈椎三维CT数据,根据置钉方式不同分为导板组和对照组,分别制作20例等比例3D打印上颈椎模型,导板组使用3D打印导板辅助上颈椎模型椎弓根螺钉置入,对照组在透视辅助下徒手置钉。根据椎体是否存在骨折,将导板组内20例模型分为钉道损伤组10例（寰椎骨折与枢椎骨折病例）和钉道完整组10例（畸形与关节脱位病例）。比较导板组和对照组螺钉可接受率、单枚螺钉置入时间差异;比较导板组术前理想钉道与术后实际钉道内倾角差异,对比钉道损伤组和钉道完整组置钉结果差异。结果 导板组螺钉可接受率为93.55%,高于对照组的79.03%(P<0.05);导板组单枚螺钉置入时间短于对照组（P<0.05）;导板组术前理想螺钉内倾角与术后实际螺钉内倾角之间差异无统计学意义（P>0.05）;钉道损伤组螺钉突破椎弓根率26.7%高于钉道完整组3.1%(P<0.05)。结论 个体化3D打印导板辅助上颈椎椎弓根置钉在置钉精准度、安全性和置...     

全域扫频OCTA与荧光素眼底血管造影在糖尿病视网膜病变应用中的对比分析

目的 比较全域扫频光学相干断层扫描血管造影（OCTA）与荧光素眼底血管造影（FFA）对糖尿病视网膜病变（DR）的诊断价值。方法 选取2022年2月至2022年4月就诊于安徽医科大学第二附属医院眼科门诊的糖尿病视网膜病变患者35例（70眼）,每位患者均使用超广角彩色眼底照相（UWF CFP）检查。采用全域扫频OCTA和FFA分别检查受试者视网膜,并分析两者对视网膜微血管瘤（MA）、视网膜新生血管（RNV）、视网膜无灌注区（NPAs）、视网膜内微血管异常（IRMA）、糖尿病性黄斑水肿（DME）的检出率差异。结果 全域扫频OCTA中MA、RNV、NPAs、IRMA、DME的检出率与FFA相比,差异无统计学意义（P>0.05）,全域扫频OCTA与FFA对DR的筛查、诊断、分类一致性良好（Kappa值>0.75）。结论 全域扫频OCTA在DR应用中具有广阔的前景,可作为DR无创性筛查、诊断、随访的重要依据。     

Bihemispheric Collateralization of the Cortical and Subcortical Afferents to the Rat's Visual Cortex

A fluorescent dye (usually fast blue or rhodamine tagged latex microspheres) was injected into cortical area 17 (or area 17 and the lateral part of area 18b) of adult and juvenile (15 - 22 day old) Sprague-Dawley albino rats. Another fluorescent dye (usually diamidino yellow) was injected into cortical areas 17, 18a and 18b of the opposite hemisphere. The injections involved only the cortical grey matter. After postinjection survival of 2 - 14 days the distribution of retrogradely labelled mesencephalic and prosencephalic cells was analysed. Both small and large injections labelled retrogradely a substantial number of cells in specific and nonspecific dorsal thalamic nuclei (lateral geniculate, lateral posterior, ventromedial, several intralaminar nuclei and nucleus Reuniens) as well as a small number of cells in the preoptic area of the hypothalamus and the mesencephalic ventral tagmental area (VTA). While labelled thalamic cells contained only the dye injected into the ipsilateral cortex, a small proportion of hypothalamic and VTA cells was labelled with the dye injected into the contralateral cortex. Virtually none of the cells in these areas were double labelled with both dyes. Both small and large injections labelled cells in the ipsilateral telencephalic magnocellular nuclei of the basal forebrain and the caudal claustrum. A substantial minority of labelled cells in these structures was labelled by the dye injected into the contralateral cortex. Furthermore, a small proportion (about 1%) of claustral cells projecting to the ipsilateral cortex were double labelled with both dyes. In several cortical areas ipsilateral to the injected area 17, associational neurons were intermingled with commissural neurons projecting to the contralateral visual cortex. A substantial proportion of associational neurons projecting to ipsilateral area 17 also projected to the contralateral visual cortex (associational-commissural neurons). Thus, in visual area 18a, the associational-commissural neurons were located in all laminae, with the exception of lamina 1 and the bottom of lamina 6, and constituted about 30% of the neurons projecting to ipsilateral area 17. In paralimbic association area 35/13, associational-commissural neurons were located in lamina 5 and constituted about 20% of neurons projecting to ipsilateral area 17. In the limbic area 29d, the associational-commissural neurons were located in laminae 4, 5 and the upper part of lamina 6 and constituted about 10% of the associational-commissural neurons projecting to ipsilateral area 17. In oculomotor area 8, double-labelled neurons were located in lamina 5 and constituted about 10% of the neurons projecting to ipsilateral area 17. Thus, it appears that the axons of mesencephalic and diencephalic neurons projecting to the visual cortex do not send collaterals into both hemispheres. The bihemispheric projection to the rat's visual cortex originates almost exclusively in the retinotopically organized cortical area 18a and in integrative cortical areas 35/13, 29d and 8.     

Urinary excretion of N-acetyl-β-d-glucosaminidase in patients after cyclosporin-treated corneal grafting

Summary Allograft rejection occurs in up to 70% of high-risk keratoplasty patients. For this reason short-term Cyclosporin treatment was administered for three months to prevent graft loss. Of 23 renal healthy patients, 19 enjoyed long-term graft acceptance. We evaluated in these patiens N-acetyl--D-glucosaminidase (NAG) excretion as a marker of renal tubular damage. All patients, except one, showed urinary NAG excretion to be within the normal range. From this we conclude that no renal tubular damage occurs after short-term Cyclosporin treatment.     

我国农村地区实施大病统筹合作医疗或医疗保险方案的技术缺陷

在我国中等发达及上农村地区,大病统筹合作医疗或医疗保险以其可缓解农村居民的就医经济风险而受到欢迎,但是在方案的拟订过程中尚存在一些明显的技术缺陷,比如,“大病”的技术定义、农村居民就医经济风险分析、风险临界线界定、保险经付比测算和保险费率厘定等,这些技术的缺乏,已严重影响农村合作医疗或医疗保险的推广和实施效果。     

Regional cycles of perfusion and non-perfusion in the lung of the term fetal rabbit.

The spatial distribution of pulmonary blood flow and its change over time was investigated in term fetal rabbits, using the plasma tracer fluorescein-isothiocyanate-labeled bovine serum albumin (FITC-BSA). A tracer bolus was injected intravenously and allowed to circulate in vivo for increasing periods of time (2-30 minutes) prior to arrest of the circulation and tissue preparation. Initially, fluorescence was present in the vasculature of 43% of lung parenchymal tissue, disposed as discrete regions or "lobules." Interspersed regions of lung tissue received no tracer inflow. With increasing tracer circulation times (10, 20, and 30 minutes), a greater percentage of lung cross-sectional area contained vessels exhibiting tracer fluorescence (64, 96, and 100%, respectively). In the fetal lung, a high pulmonary vascular resistance (PVR) is maintained. Our studies indicate that, at any given moment, fetal pulmonary blood flow is distributed only to a proportion of discrete lung "lobules," while interspersed "lobules" receive no flow at all. The "lobules" alternate between these "high" and "low" vascular resistance states with a periodicity of approximately 35 minutes, comprising 22 minutes of non-perfusion followed by 13 minutes of perfusion. This circulatory pattern permits both the maintenance of high PVR and uniform lung development. Further, by directing flow to only a portion of the vasculature, greater microvascular flow rates are achieved and hence the risk of blood sludging and stasis is reduced. Recruitment of these "non-perfused" regions at birth could thus produce a significant reduction in PVR.     

pD2-, pA2- and pD2'-values of a series of compounds in a histaminic and a cholinergic system.

(1) Affinity and intrinsic activity values of 75 compounds for a histaminergic and a cholinergic system are presented. The quantitative correlations between the affinity values of 35 compounds and some physicochemical constants (Van der Waals volume, lipophilicity, number of hydrogen atoms on the protonated amine) are discussed. (2) Absence of systematic differences between pD2 and pA2 of partial agonists supports the assumption that these values are equivalent expressions of the same affinity. (3) The "mimetic moiety" in a number of the antihistaminic test compounds hardly contributes to their affinity. The affinity mainly depends on an interaction tendency with additional receptor areas. (4) The correlation between pA2 and pD2' of the whole series of compounds in the histaminergic system is artificial. The method only allows determination of both values if their ratio lies between certain limits. (5) The correlation between pA2 and pD2' for 16 closely related compounds in the guinea pig ileum and for nearly all compounds in the rat intestine has to be explained by an influence of the structural differences on drug transference and/or the less specific binding forces. (6) The metactoid receptors in the two systems are different structures. (7) Possible molecular modifications to maximize the separation of antihistaminic form cholinergic affinity are suggested.     

Importance of uniform heparin coating on biopolymers

Cardiopulmonary surgeries need connectors for extracorporeal circulation. The patient's blood in contact with the tube surfaces modifies its plasmatic proteins, promotes platelet aggregation, and activates the complement system, unleashing thrombus formation. Thus, it becomes necessary for an anticoagulant to keep the circuit free from these events. Heparin is the anticoagulant used even after reports about its disadvantages. Platelet adherence seems to be very dependent on the quality from the surfaces that can promote cellular proliferation, aggregation, and thrombosis. In this study, we compare the quality of the heparin-coated and uncoated surfaces. We used a blood cell culture and scanning electron microscopy (SEM) to visualize the platelet aggregation. It was concluded that there are groove areas that permit platelet adherence, and if they are not coated totally by the heparin, aggregation still occurs although in lower scale than on the uncoated tubes.     

贫困地区儿童环境卫生健康教育效果评价

目的了解河北省贫困地区儿童的环境卫生知识以及对健康教育的态度,探讨健康教育对儿童个人卫生习惯的影响.方法在目标人群中整群随机抽取298人进行基线调查,针对问题进行健康教育,经过5 a的干预后,用同一方法调查194名儿童在环境卫生知识、态度和行为等方面的变化.结果通过环境卫生健康教育,儿童的环境卫生知识、态度和行为发生了很大的变化,对引起腹泻的原因、引起肠道寄生虫病的原因、消化道疾病如何传播等方面知识的知晓率有了显著的提高(P＜0.05);同时,个人卫生习惯有了较大的改变,突出表现在洗手时间和方法、喝开水的人数等方面.结论环境卫生健康教育对提高儿童的卫生知识水平、改变不良卫生行为等方面具有重要的作用.     

儿童铅暴露相关危险因素Logistic逐步回归分析

目的:了解珠江三角洲中心地区儿童铅暴露水平及相关因素。方法:对1 866例1-3岁入托体检儿童进行静脉血铅、锌、钙、铁、铜、锰测定,并做铅暴露危险因素问卷调查。结果:儿童血铅水平均数为116.72 μg／L,≥100 μg／L者占48.77％,年龄、喜饮罐装饮料、母亲职业、居住的楼龄及楼层、居住环境是儿童铅暴露的危险因素,血锌是保护因素。结论:环境铅污染是儿童铅暴露的主要来源,环境污染对儿童已构成严重的威胁,应引起社会的关注。