三维能量多普勒对前列腺癌分化程度研究

目的 探讨三维能量多普勒在诊断前列腺癌及其分化程度方面的临床价值.方法 回顾性分析经直肠三维能量多普勒检查68个前列腺肿块血流特征,并与病理结果对照分析.结果 前列腺良恶性肿块的血管指数（VI）差异有统计学意义（t=4.654,P=0.000）.以VI＞0.21条/cm^3诊断前列腺癌的灵敏度77.8%、特异度65.2%.高、中、低分化组的前列腺癌肿血管指数分别为0.0975±0.0680、0.1811±0.0977、0.2588±0.0577,组间差异有显著性（P＜0.000）.结论 经直肠三维能量多普勒检查为前列腺癌诊断提供了新的途径和方法,并能协助诊断前列腺癌的分化程度.     

Prunus armeniaca L (apricot) protects rat testes from detrimental effects of low-dose x-rays

Exposure to low x-ray doses damages the spermatozoa, mainly by late-onset (ie, after 3 months) oxidative stress. Antioxidants ameliorate oxidation and prevent tissue damage. Prunus armeniaca L (apricot), rich in carotenoids and vitamins, is a potent natural antioxidant. We hypothesized that an apricot-rich diet might ameliorate the detrimental effects of low-dose x-rays on testis tissue. A 20% apricot diet was composed isoenergetically to the regular rodent diet. The total phenolic content, reducing power, and antioxidant capacity of both diets were determined. Sprague-Dawley rats received apricot-rich diets before and after x-ray exposure. Regular diets were given to controls. Rats were exposed to 0.2 Gy x-rays at the eighth week and were euthanized at the 20th postexposure week. Testicular oxidative status was determined by tissue thiobarbituric acid-reactive substances, reduced glutathione, superoxide dismutase, and catalase activities. For histologic evaluation, qualitative and quantitative microscopic determinations were performed, and Leydig and Sertoli cell counts and Johnsen scores were measured. The control diet group had significant testicular oxidative stress and mild tissue deterioration. Leydig and Sertoli cell counts, tubule diameters, and Johnsen scores were significantly decreased in the exposure groups. Apricot-rich diet significantly ameliorated the oxidative status and prevented the damage in tubular histology. The protective effects were prominent when the diet was maintained throughout the time course and were partially protected when the diet was initiated after exposure. The natural antioxidant activity of apricot ameliorates the delayed detrimental effects of low-dose irradiation on testis tissue. The high total antioxidant capacity of the apricot deserves further investigation.     

The possible combinatory effects of acute consumption of caffeine,creatine, and amino acids on the improvement of anaerobic running performance in humans

Preexercise nutritional investigations have recently become a popular avenue of examining the interaction of multiple ingredients on exercise and training methods. The critical velocity (CV) test is used to quantify the relationship between total running distance and time to exhaustion (TTE), yielding aerobic (CV) and anaerobic parameters (anaerobic running capacity [ARC]). The purpose of this study was to examine the hypothesis that a preexercise supplement containing caffeine, creatine, and amino acids (Game Time; Corr-Jen Laboratories Inc, Aurora, CO) would positively impact CV and ARC in college-aged men and women. In a single-blind crossover design, 10 participants consumed the preexercise supplement (ACT) or placebo (PL) before each testing session. Each participant completed runs to exhaustion on a treadmill at 110%, 90% (day 1), and 105% and 100% (day 2) of the peak velocity (PV) determined from a graded exercise test. The ACT elicited a 10.8% higher ARC (P = .02) compared with the PL, whereas no difference was found in CV (0.6%, P = .38). The TTE was greater for the ACT than the PL at 110% (ACT = 125.7 ± 9.6 seconds, PL = 117.3 ± 12.6 seconds), 105% (ACT = 156.9 ± 11.0 seconds, PL = 143.8 ± 12.9 seconds), and 100% PV (ACT = 185.7 ± 10.7 seconds, PL = 169.7 ± 12.8 seconds) (P = .01-.04); but there was no difference for the TTE at 90% PV (ACT = 353.5 ± 52.7 seconds, PL = 332.7 ± 54.0 seconds) (P = .08). These findings suggest that the acute ingestion of this preexercise supplement may be an effective strategy for improving anaerobic performance, but appears to have no effect on aerobic power.     

军队医院软实力建设探讨

本文论述了构建军队医院核心价值观为支柱,文化吸引力为动力,团队精神为标志的三位一体的军队医院软实力结构模型,坚持以先进的文化理念为引领,人性化的管理为手段,发挥军队医院的专科技术和人才管理优势,以人性化的服务为保障是新时期加强军队医院软实力建设的核心要素。     

基于Pentacam HR的角膜屈光指数计算

目的 评估Pentacam HR测量角膜屈光术后眼角膜参数的可重复性并比较用Pentacam HR角膜参数计算未手术眼和角膜屈光术后眼角膜屈光指数的差异。设计 前瞻性研究。研究对象 接受角膜屈光手术术前及术后检查者,分为两组：A组为接受常规术前检查者207例207眼;B组为接受常规术前检查且术后3个月（LASIK）或6个月（PRK）以上复查者67例133眼。方法 A组受试眼行主觉验光和Pentacam HR检查;B组受试眼手术前后分别行主觉验光和Pentacam HR检查。两组中Pentacam HR检查均获得三次有效结果。主要指标  变异系数（CVw）、组内标准差（Sw）和组内相关系数（ICC）评估Pentacam HR获得的未手术眼（A组）和角膜屈光术后眼（B组）的角膜中央前表面3 mm范围内平均曲率半径（Ra）、角膜中央后表面3 mm范围内平均曲率半径（Rp）和中央角膜厚度（CCT）的可重复性。独立样本t检验分别分析A组和B组中计算获得的角膜屈光指数的差异。结果 A组中Pentacam HR获得的Ra、Rp和CCT分别为（7.780±0.235）mm、（6.341±0.225）mm和（541.67±31.79）μm; B组中Pentacam HR获得的Ra、Rp和CCT分别为（8.625±0.412）mm、（6.379±0.237）mm和（461.89±34.70）μm,均具有很好的可重复性（CVw均<1%,ICC均≥0.99）。基于Pentacam HR获得的参数计算角膜屈光指数,A组为（1.3278 ± 0.0008）;B组为（1.3227±0.0019）（t=34.634,P=0.000）。结论 Pentacam HR获得的未手术眼和角膜屈光术后眼角膜中央前、后表面3 mm范围内曲率半径和中央角膜厚度均具有很好的可重复性。基于Pentacam HR获得的角膜屈光术后眼的角膜屈光指数小于未手术眼的角膜屈光指数。（眼科, 2014, 23： 308-312）     

不同晶状体屈光力计算公式在儿童屈光发育档案中的应用比较

目的比较在缺乏晶状体厚度时,不同晶状体屈光力计算公式的一致性,寻找简化晶状体屈光力流行病学调查的计算公式。方法横断面研究。晶状体屈光力通过3种不同的公式计算得出。计算公式包括需要晶状体厚度值的Bennett公式,以及不需要晶状体厚度值的修正Stenström公式及Bennett-Rabbetts公式。共189名（378眼）7～14岁正视青少年纳入研究,将测量所得的生物学数据代入上述各公式中,以Bennett公式计算所得的晶状体屈光力（PL,Bennett）作为基础值,比较另2种公式计算值（PL,Sten、PL,BR）的准确性。对相关数据进行配对符号检验、Wilcoxon秩和检验及Pearson相关分析。结果分别应用Gullstrand-Emsley与Bennett-Rabbetts模型眼计算,发现PL,Sten[（0.46±0.35）D]较PL,Bennett[（0.29±0.35）D]低,差异有显著统计学意义（Z=-159.5、-120.0,P<0.01）。PL,BR[（0.27±0.35）D]较PL,Bennett[（0.09±0.34）D]低（Z=-112.5、-42.0,P<0.01）。通过修正c常数使PL,BR与PL,Bennett之间差异无统计学意义（Z=5.0,P＞0.05）,两者之间的最大差异仅为1.35 D,同时85.4%的PL,BR与PL,Bennett的误差小于0.50 D。将不同年龄组PL,Bennett与PL,BR（修正c常数后）的差值进行多组Wilcoxon秩和检验（χ²=314.53,P<0.01）,2种公式计算值之间的差异在7～12岁之间逐渐减小,12岁之后差异增大。2种方法所计算得出的晶状体屈光力之间的差值与年龄呈显著负相关（r=-0.36,P<0.01）。结论通过c常数的修正,Bennett-Rabbetts公式与Bennett公式所得晶状体计算值在正视青少年中表现出较好的一致性。     

Detection of endometrial and subendometrial vasculature on the day of embryo transfer and prediction of pregnancy during fresh in vitro fertilization cycles

ObjectivesSuccessful implantation depends on interaction between a blastocyst and a receptive endometrium. Endometrial vasculature is important in the early endometrial response to blastocyst implantation, and vascular changes can affect uterine receptivity. This study aims to investigate whether vascular parameters measured using three-dimensional power Doppler ultrasound (3D PD-US) could predict pregnancy following fresh in vitro fertilization and embryo transfer (IVF–ET) using a gonadotropin releasing hormone (GnRH) agonist long protocol.Materials and methodsThis prospective observational study enrolled 236 nulliparous women who underwent a first IVF–ET using a GnRH long protocol with stimulation by recombinant FSH (rFSH) from May 2009 to April 2012. After excluding two cases of tubal pregnancy, 234 women were in either a pregnant group (n = 113) or a nonpregnant group (n = 121). Color Doppler ultrasound and 3D PD-US examinations were performed on the day of embryo transfer. Main outcomes were pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D) of the uterine artery, vascularization index (VI), flow index (FI), and vascularization flow index (VFI) of the endometrium and subendometrial region. Measurements were analyzed relative to IVF–ET outcome (pregnant vs. nonpregnant).ResultsNo significant differences were observed in patient age, infertility duration, body mass index (BMI), basal FSH levels, number of retrieved oocytes or good quality embryos, or endometrial thickness or volume between the two groups. The pregnant group had higher endometrial VI, FI, and VFI scores than the nonpregnant group (p = 0.001, p = 0.000, p = 0.021, respectively). By contrast, neither subendometrial region VI, FI, and VFI scores (p = 0.770, p = 0.252, p = 0.451), nor uterine artery PI, RI, or S/D scores (p = 0.256, p = 0.527, p = 0.365) differed between groups. Cut-off values of endometrial VI, FI, and VFI scores were 0.95, 12.94, and 0.15 for pregnancy achievement.ConclusionThree dimensional PD-US was a useful and effective method for assessing endometrial blood flow in IVF cycles. Good endometrial blood flow on the day of embryo transfer might be associated with high pregnancy success with a GnRH long protocol, because this is indicative of endometrial receptivity in fresh IVF cycles.     

医用钛缆应用在髌骨粉碎性骨折治疗中

背景：采用医用钛缆材料治疗髌骨骨折操作简便,固定坚强,较好的保护了膝关节的功能。 目的：观察医用钛缆在髌骨粉碎性骨折治疗中的应用疗效。 方法：30例髌骨骨折患者采取自愿选择的方式,选择医用钛缆材料治疗和传统钢丝环扎治疗。比较两组患者内固定时间、出血量、膝关节内固定首次锻炼时间、住院天数、医疗消费、并发症及远期膝关节功能情况,并进行疗效分析。 结果与结论：30例患者均获得1年以上随访。医用钛缆环扎固定组内固定膝关节活动时间早,住院天数短,但医疗费用偏高,远期膝关节功能Bostman评分也较传统钢丝环扎组高(P < 0.05)。结果证实,医用钛缆材料对髌骨粉碎性骨折固定牢靠,具有膝关节锻炼时间早、并发症少的优点,是髌骨粉碎性骨折治疗的较优选择之一。     

不同负荷运动中下肢肌表面肌电图的变化

背景：尝试应用曲线拟合分析方法对表面肌电图进行分析和研究国内外尚处于起步阶段,将其应用于功率自行车运动至疲劳的研究鲜见报道。 目的：探讨功率自行车不同负荷运动中下肢肌中值频率值的变化特征和规律,分析肌肉疲劳拟合曲线的特点及其影响肌肉疲劳的相关因素。 方法：受试者为苏州大学体育学院8名男性青年,利用MONARK功率自行车,对受试者在不同负荷以及不同踏蹬频率下进行测试至疲劳,同时对股直肌、股外侧肌、股内侧肌、胫骨前肌、腓肠肌内侧头和腓肠肌外侧头进行表面肌电信号的采集与记录。分析中值频率指标的变化,并用minitab.15统计软件,按照在F检验的统计学差异有非常显著性意义(P < 0.001)的前提下,选取判定系数R2最大,偏差的平方和最小的原则,对实验结果进行曲线优度拟合。 结果与结论：①功率自行车150 W运动时,肌纤维的募集形式由运动初始快肌纤维募集数量逐渐增多向慢肌纤维募集比例增高转变。②功率自行车300 W运动时,肌纤维的募集形式从运动初期的快肌纤维募集为主逐渐向慢肌纤维募集比例增高转变。③功率自行车150 W运动时,肌肉疲劳的拟合曲线均为三次项曲线,提示影响肌肉疲劳的主要因素有3个。300 W运动时,肌肉疲劳的拟合曲线均为二次项曲线,提示影响肌肉疲劳的主要因素有2个。     

清毒消瘀颗粒的粉体学性质及制粒工艺考察

目的:比较辅料(糊精、可溶性淀粉、甘露醇、微晶纤维素)种类及其不同配比对清毒消瘀颗粒粉体学性质的影响,并优选该制剂的制粒工艺。方法:以颗粒吸湿性、溶化性、成型性、流动性为指标,采用粉体学的研究方法筛选最佳辅料及其配比,在此基础上,采用正交试验考察清毒消瘀方浸膏粉与辅料的配比、乙醇体积分数及用量对清毒消瘀颗粒制粒工艺的影响。结果:选择糊精-甘露醇(1∶1)为混合辅料,清毒消瘀方浸膏粉与混合辅料的配比1∶2,乙醇体积分数85%,乙醇用量13%;清毒消瘀颗粒的成型率、休止角、平衡吸湿率、溶解率分别为94.01%,33.72度,3.562%和97.3%,RSD依次为0.6%,1.6%,1.7%,1.9%。结论:甘露醇的阻湿效果好,与糊精联合使用后制成的清毒消瘀颗粒成型率高、吸湿率低、流动性好、溶解率高,且甘露醇可有效改善颗粒的口感。优选的制粒工艺条件稳定可靠、重复性好,适合工业化生产。