Comparison of capillary blood ketone measurement by electrochemical method and urinary ketone in treatment of diabetic ketosis and ketoacidosis in children

We aimed to compare the recent practical method of capillary β-hydroxy butyrate (βOHB) measurement with the widely used urinary ketone measurement in monitoring metabolic status of the patient during treatment of diabetic ketoacidosis (DKA) and diabetic ketosis (DK). Patients with DKA and DK admitted to the hospital were followed with simultaneous measurements of capillary βOHB by electrochemical method (Medisense Optium, Abbott), and urinary ketone by semi-quantitative method. Blood gases were measured in 2–4 h intervals. Fourteen patients with DKA/DK (7 males and 7 females, age: 9.2 ± 4.2 years) were included with 50 simultaneous measurements of capillary and urinary ketone. No correlation was detected between urinary ketone and blood pH (P = 0.06) and HCO₃ (P = 0.79), whereas a significant negative correlation was found between capillary βOHB and blood pH (r = −0.41, P < 0.05) and HCO₃ (r = −0.35, P < 0.05). Capillary βOHB and urinary ketone levels did not correlate at the beginning and 3.3 ± 1.4 h after treatment, but did correlate in the third samples taken 7.8 ± 2.0 h after treatment (r = 0.8, P < 0.05). Capillary βOHB levels show good correlation with the degree of acidosis (pH and HCO₃). Capillary βOHB measurement is more sensitive than urinary ketone measurement in reflecting the patient’s metabolic status and improvement during treatment.     

昆明小鼠胚胎干细胞向心肌细胞的分化

目的饲养层制作及复苏培养昆明小鼠胚胎干细胞,探索体外诱导胚胎干细胞向心肌细胞分化。方法饲养层制作,复苏及体外培养胚胎干细胞,采用一步法消化贴壁胚胎干细胞,悬浮培养5d,形成拟胚体(EB),待EB贴壁后,加入淫羊藿苷(Icraiin,ICA)诱导液对其诱导并每天观察,免疫荧光检测心肌细胞特异性肌钙蛋白T(cTnT)和心室肌球蛋白轻链(MLC-2v)的表达。结果胚胎干细胞悬浮聚集5d,形成类似球状的拟胚体,将拟胚体贴壁诱导8d,发现拟胚体中出现跳动,诱导后10d拟胚体跳动率达65%,显著高于空白对照组和阴性对照组,一个分化拟胚体中一般出现1-3个跳动点,节律约为50-80times/min,在诱导10d时跳动的合胞体,免疫荧光表明cTnT和MLC-2v表达为阳性。结论胚胎干细胞经悬浮聚集培养5d后经10-7mol/L淫羊藿苷诱导,得到了可以跳动的心肌细胞团。     

Topography of the auditory evoked potential in humans reflects differences between vowels embedded in pseudo-words

To study the processing of vowels embedded in more complex linguistic structures, we compared cortical responses for pseudo-words. Auditory evoked potentials were recorded in 11 right-handed females using a passive oddball paradigm, with /pemu/ and /pomu/ as standard stimuli, differing only with respect to the first syllable. Topographic differences in the N100 were observed between the standards: /pemu/ had larger amplitudes than /pomu/ at more posterior electrode sites whereas a reverse pattern was found at more anterior positions along the midline. This topographic difference can be explained by different generators for the two stimuli. Different vowels and/or the initial formant transition possibly activate different neural populations in the auditory cortex, also when the vowels are embedded in pseudo-words.     

浓硫酸酸蚀聚醚酮酮的时间对其与牙本质剪切粘接强度的影响

目的研究浓硫酸酸蚀聚醚酮酮(polyether?ketone?ketone,PEKK)不同时间对其与牙本质剪切粘接强度的影响,为临床使用PEKK修复体的粘接操作提供科学依据。方法制备PEKK试件44个,随机平均分为A、B、C、D 4组:A组为对照组,仅用水磨砂纸打磨;B组、C组、D组为实验组,分别用98%浓硫酸酸蚀经打磨试件表面5 s、30 s、60 s。另外,每组随机抽取1个试件用慢速切割机制备出剖面,在扫描电镜下观察其剖面的表面形貌。4组试件与牙本质通过树脂粘接后在37℃蒸馏水浸泡24 h,测量剪切粘接强度后统计分析,通过扫描电子显微镜与体视显微镜检查试件断裂界面,统计粘接失败类型。结果B组PEKK试件酸蚀处理后剖面呈海绵状且孔隙大小均匀,C组、D组可见试件剖面有破坏状孔蚀样结构;剪切粘接强度B组(16.84±1.84)MPa、C组(12.33±1.22)MPa和D组(6.44±1.18)MPa均大于A组(3.99±1.06)MPa(P<0.05),其中B组与牙本质的剪切粘接强度最高(16.84±1.84)MPa。结论采用98%浓硫酸酸蚀PEKK表面5 s处理方法可以使PEKK与牙本质获得较好的剪切粘接强度。     

Diagnostic uses of metal detectors: a review

Metal detectors have been used for diagnostic purposes since 1881. They have been utilised to localise a myriad of foreign objects including bullets, intraocular metallic fragments, swallowed coins and other foreign bodies and medical devices. Rapid detection of metallic objects may facilitate diagnosis or treatment. Metal detectors are diagnostically useful because of their low expense, lack of radiation exposure and ease of use. This article reviews the history of metal detection in the practice of medicine and provides an overview of the utility of metal detectors in current diagnostic practice.     

学龄期儿童呼吸道异物特点分析及预防

目的探讨发生在学龄期儿童(6～12岁)呼吸道异物的特点和预防。方法分析1993-2007年收治的178例学龄期儿童气管、支气管异物的病例资料。结果178例中,农村患者147例,城市31例;男性142例,女性36例;110例为化学合成品,54例为植物性异物,10例为矿物性异物,3例为动物性异物,1例种类不明。167例经直接喉镜或硬管支气管镜取出,4例自行咳出,3例开胸取出,3例经气管切开取出,1例行左肺切除术,无死亡病例。结论与婴幼儿和学龄前儿童不同,学龄期儿童以化学合成品类异物最常见;玩具零件和文具零件是学龄期最多见的异物,应重点预防;健康教育的缺乏是导致农村患儿发病率高的原因之一。     

血水混合物浓度及留存时间对模拟木质异物CT表现的影响:体外实验观察

目的 通过体外实验观察不同浓度血水混合物及留存时间对模拟木质异物CT表现的影响。方法 将20根杉木条置入含全血比例为0%、25%、50%、75%与生理盐水（血水）混合物及100%全血试管中,分别对应阴性对照（NC）组、T25组、T50组、T75组及T100组,每组4个样本。将试管置于恒温水浴锅中采集CT图像,每6 h重复一次,共采集300 h;比较相同时间点各组最低密度区CT值、最高密度区CT值和低密度区体积差异,评价时间及血水混合物浓度对木质异物CT参数的影响及其交互作用。结果 随时间延长,各组时间-最低密度区CT值曲线呈速升-缓升型,时间-最高密度区CT值曲线呈速升-平台型;NC组和T25组时间-低密度区体积曲线呈速降型,T50组、T75组及T100组时间-低密度区体积曲线呈缓降型。血水混合物浓度及时间均对木质异物最低密度区CT值、最高密度区CT值及低密度区体积存在影响（P均<0.05）,且二者对最低密度区CT值和低密度区体积存在交互作用（P均<0.05）。结论 血水混合物浓度及留存时间均影响木质异物CT表现。     

诱导多能干细胞建系及体外造血祖细胞定向分化体系的建立

背景：目前,大量文献报道了诱导多能性干细胞系的建立,但大规模体外诱导分化造血祖细胞的研究还缺乏深入的探讨。 目的：建立诱导多能性干细胞体外定向诱导形成造血祖细胞的方法。 方法：采用慢病毒感染的方法将含有Oct4、Sox2、Nanog和Lin28全能性基因的慢病毒颗粒转导人皮肤成纤维细胞,获得了诱导多能性干细胞;在诱导分化体系中添加了 Y-27632,克服干细胞扩增中的凋亡现象;运用OP9细胞产生的条件培养液建立诱导多能性干细胞体外定向分化形成造血祖细胞的分化体系。 结果与结论：①前3代细胞克隆传代时,诱导多能性干细胞发生凋亡的现象很多,很难大规模扩增培养。培养基中添加阻断 ROCK活化的抑制剂,能够明显抑制胚胎干细胞的凋亡。②诱导多能性干细胞在 OP9细胞条件培养液作用下,经过体外诱导分化,形成CD34＋造血祖细胞。     

低场MRI在四肢木、竹类异物诊治中的应用

目的：探讨低场 MRI在四肢木、竹类异物诊治中的应用价值。方法：回顾性分析本院2007年－2013年行MRI检查并经手术探查取出四肢木、竹类异物的15例患者（27块异物）的临床和 MRI 资料,15例均行 SE T1 WI、FSE T2 WI、STIR及GRE T2*WI扫描,分析比较4种序列对异物及周围改变的显示情况。结果：15例患者的27块异物中,SE T1 WI显示13块,FSE T2 WI显示22块,STIR显示27块,GRE T2*WI显示26块。FSE T2 WI、STIR、GRE T2*WI对异物显示率高于SE T1 WI。SE T1 WI对出血的显示率高于FSE T2 WI。SE T1 WI 和GRE T2*WI 对挫伤的显示率均低于FSE T2 WI和STIR。结论：MRI是检出四肢木、竹类异物十分有效的方法,STIR和GRE T2*WI是检出异物最敏感的序列,STIR是显示异物周围改变最敏感的序列,综合运用多种序列可提高异物的检出率,为避免漏诊、误诊应行双侧对比检查。     

Hysteroscopic removal of foreign bodies and its method of monitoring

Objective To evaluate transcervical removal of foreign bodies(TCRF)and to estimate the effectiveness of its monitoring methods.Methods One hundred and thirteen women were identified as having residual intrauterine devices(IUD),residual pregnancy products,unabsorbed strings and broken hooks,which were not removed during routine curettage of IUD removal.All patients were monitored using B ultrasonography while TCRF was performed.Four cases were monitored by laparoscopy simultaneously.One case was monitored by laparoscopic ultrasonography.Results Foreign bodies of one hundred and nine patients were taken out by TCRF.Uterine bleeding, amenorrhoea,discharge,abdominal pain,mlcturition and hematuria disappeared postoperatively.Fetal bones embedded into intramural uterin in four cases were not removed completely.Of these four,one became pregnant 4 months later after TCR and term delivered.One case encountered uterine perforation that was sutured by laparoscopy.Conclusions TCRF is safe and efficient.Sufficient cervical canal distension,selection of equipment and methods to be used is important for successful TCRF.As a non-invasive and effective monitoring method,B ultrasonography is the first choice to monitor for TCRF.For patients with high risk factors for uterine perforation,laparoscopic monitoring should be done simultaneously.Laparoscopic ultrasonography monitoring has both the advantages of B ultrasonography and laparoscopy monitoring,but is invasive and expensive.