背根节压迫大鼠脊髓背角广动力神经元电生理学特性研究

目的探讨大鼠腰4、5背根神经节慢性压迫（chronic compression of dorsal root ganglion,CCD）损伤后,脊髓背角广动力（widedynamicrange,WDR）神经元电生理学特性的改变。方法健康SD大鼠随机分为正常组和CCD组（每组12只）,分别检测机械痛敏和热痛敏行为,并利用在体细胞外电生理学方法记录脊髓背角WDR神经元放电。结果CCD术后大鼠出现了机械痛敏和热痛敏行为。与正常组大鼠相比,CCD组大鼠脊髓背角WDR神经元兴奋性增高,表现为有自发放电的神经元比例增加、放电频率增加,对外周感受野轻刷、钳夹等刺激的反应性增强。36．36％（12／33）的CCD组大鼠WDR神经元对Aβ纤维刺激出现后放电现象。结论大鼠腰4、5背根节慢性压迫后引起WDR神经元的兴奋性增加,其可能参与神经病理性疼痛的发生。     

人羧肽酶A1活性中心基因的克隆及原核表达

目的：克隆人羧肽酶A1(carboxyrpeptidase A1，CPA1)活性中心基因，构建重组表达载体并对其进行诱导表达。方法：通过RT-PCR方法扩增出正常胰腺组织中CPA1活性中心基因，克隆入载体pGEM-Teasyr，测序分析．将该目的基因亚克隆于表达载体pGEX-4T-1，测序证实序列正确后转化大肠杆菌DH5α，经IPTG诱导表达重组蛋白。结果：获得了人CPA1活性中心基因，构建了重组表达质粒，表达的蛋白以SDS-PAGE分析，在Mr约46000处出现一条新生蛋白带，经凝胶薄层扫描检测，表达量约占菌体总蛋白的22．1％。结论：成功克隆人CPA1活性中心基因并得到了其原核表达产物，为获得分子量小而具有相似活性的蛋白奠定了基础。     

双钢板垂直和平行放置治疗C型肱骨远端骨折的对比研究

Background Double plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus. However, there is still controversy concerning dual plate positions in terms of providing optimal stability. The purpose of this retrospective study was to compare the clinical outcomes in patients with type C intra-articular distal humeral fractures using perpendicular and parallel plating methods.

Methods Between March 2008 and June 2011, a total of 45 patients with type C distal humerus fractures were treated using two different dual plating methods. Of them, 24 patients were treated by perpendicular plating (group I) and 21 patients were treated by parallel plating (group II). The surgical time, blood loss, and union time were compared between the two groups. The flexion-extension arc, the total range of flexion and extension at the end of follow-up were compared between the two groups. The Mayo Elbow Performance Score (MEPS) was used to determine the elbow functional results.

Results All patients were followed up. The mean duration of follow-up was 16 months (range 12–25 months) in group I and 15.5 months in group II (range 12–25 months). There were no significant differences in the surgical time, blood loss, and the bone union time between the two groups. In group I, the mean elbow flexion-extension arc was 101° and the mean MEPS was 85 points. The rate of excellent and good results was 87.5%. In group II, the mean flexion-extension arc was 100° and the mean MEPS was 86.1 points. The rate of excellent and good results was 90.5%. There were no significant differences in the MEPS, flexion-extension arc, and the total range of flexion and extension between the two groups.

Conclusions Perpendicular and parallel plate configurations with the appropriate surgical techniques can provide anatomical reconstruction and stable fixation of type C intra-articular distal humeral fractures and allow early mobilization of the elbow after an operation. The occurrence of post-operative elbow stiffness can be reduced and good outcomes can be obtained.

     

The Third World Integrative Medicine Congress Abstracts (Excerption)

The 3rd World Integrative Medicine Congress (3rd WIMCO) was held on September 22-24, 2007 in Guangzhou, China. The Congress has showed the academic achievements of integrative medicine in the recent five years covering a wide range of fields, such as basic and experimental research; clinical research; theory, education and management research; new drug research and development; and application of evidence-based medicine.     

1247例儿童发中微量元素的测定与分析

应用Ｘ射线多道能谱分析仪，检测了１２４７例男女儿童发中７种微量元素的含量，并作了统计分析。经对各种元素含量的分布进行检验，均不服从正态分布。报道了它们的正常值范围，与文献资料报道的基本一致。另外，还对男女儿童发中微量元素含量的差异作了显著性检验。     

慢性心力衰竭在社区医院的治疗体会

目的总结慢性心力衰竭在社区健康服务中心治疗的经验。方法对我社区健康服务中心诊疗的慢性心力衰竭患者93例,采用心力衰竭心功能Ⅳ级分级标准进行分级,对Ⅳ级患者采用全科医生每日上门诊疗加定时电话查访;对Ⅰ、Ⅱ、Ⅲ级轻症患者采用全科医生定期上门诊疗加定时电话查访。诊疗过程按慢性心力衰竭诊疗常规进行。结果治疗过程中有2例患者出现心肌梗死而住院治疗,其中1例死亡,1例好转;其余85例患者在接受治疗过程中病情平稳,心功能改善,生活质量提高,降低了因心力衰竭而需要住院治疗的频率,降低了医疗费用。结论慢性心力衰竭病程长,易反复,不易根治,社区健康服务中心在治疗慢性心力衰竭的过程中可发挥重要作用。     

成都地区中老年糖耐量正常人群糖化血红蛋白参考范围

目的：建立成都地区中老年糖耐量正常人群糖化血红蛋白( HbA1c)的参考范围。方法采用分层随机抽样的方法,对成都城市社区1025例中老年人开展横断面流行病学调查,进行OGTT、HbA1c、血压及血脂等检测,予以统一的问卷调查,对其中647例正常糖耐量人群采用正态分布法的95%CI确定HbA1c参考值范围。结果糖耐量正常人群的HbA1c呈近似正态分布,647例中老年正常糖耐量人群HbA1c参考范围5．02%~6．28%,其中男性糖化血红蛋白平均值为5．67%,女性为5．64%,两者差异无统计学意义(F=2．363,P=0．095)。结论成都地区中老年糖耐量正常人群HbA1c参考范围5．02%~6．28%。中老年个体HbA1c超过此范围,需进一步行OGTT明确是否有糖尿病或处于糖尿病前期。     

基层胸痛中心 AMI 患者救治延迟影响因素

〔摘 要〕 目的：探究基层胸痛中心急性心肌梗死（AMI）患者救治延迟影响因素。方法：选取 2018 年 7 月至 2020 年 6 月清远市清城区人民医院胸痛中心收治的 AMI 患者 120 例作为研究对象,采取 Logistic 多因素回归分析法分析救治延迟的影响因素。结果：年龄、发病时机、糖尿病、文化程度、居住地区、就医决策、选择再灌注策略为院前院内治疗延迟时间的独立危险因素。结论：在实际临床工作中,应重点优化对高龄、患有糖尿病、居住在农村的 AMI 患者的救治流程,选择适合的再灌注策略,缩短需经皮冠状动脉介入术的患者转运时间、减少心肌缺血总时间。     

危机管理在消毒供应中心优质服务中的应用

目的 研究危机管理在消毒供应中心优质服务中的应用效果.方法 本院消毒供应中心共有26名工作人员,年龄18～50岁.2011年12月份共回收处理器械1218件（实施危机管理前）,2012 年6月份共回收处理器械1224件（实施危机管理后）,对两个时间段发生的风险事件进行比较分析.结果 采取危机管理措施后,与实施危机管理前相比较,风险事件从39起下降至14起（P＜0.01）,科室满意度从87%提高至97%（P＜0.01）,工作人员职业满意度评分从88.09±1.69提高至97.21±2.46（P＜0.01）.结论 消毒供应中心在提供优质服务中采用危机管理措施,可以明显提高工作效率,降低风险事件的发生,同时还可以提高工作人员的职业满意度,并提高医院其他科室工作人员对中心的满意度,有利于为中心营造出一个安全和谐的工作环境.     

Clades reach highest morphological disparity early in their evolution

There are few putative macroevolutionary trends or rules that withstand scrutiny. Here, we test and verify the purported tendency for animal clades to reach their maximum morphological variety relatively early in their evolutionary histories (early high disparity). We present a meta-analysis of 98 metazoan clades radiating throughout the Phanerozoic. The disparity profiles of groups through time are summarized in terms of their center of gravity (CG), with values above and below 0.50 indicating top- and bottom-heaviness, respectively. Clades that terminate at one of the “big five” mass extinction events tend to have truncated trajectories, with a significantly top-heavy CG distribution overall. The remaining 63 clades show the opposite tendency, with a significantly bottom-heavy mean CG (relatively early high disparity). Resampling tests are used to identify groups with a CG significantly above or below 0.50; clades not terminating at a mass extinction are three times more likely to be significantly bottom-heavy than top-heavy. Overall, there is no clear temporal trend in disparity profile shapes from the Cambrian to the Recent, and early high disparity is the predominant pattern throughout the Phanerozoic. Our results do not allow us to distinguish between ecological and developmental explanations for this phenomenon. To the extent that ecology has a role, however, the paucity of bottom-heavy clades radiating in the immediate wake of mass extinctions suggests that early high disparity more probably results from the evolution of key apomorphies at the base of clades rather than from physical drivers or catastrophic ecospace clearing.