网状分枝扩增法检测EB病毒基因及临床应用研究

目的应用网状分枝扩增法（RAM）检测NHL外周血EB病毒基因，探讨EB病毒感染与NHL的相关性。方法利用人工合成的EBER-1启动子基因，建立网状分枝扩增检测法，以EB病毒阳性细胞株Raji和EB病毒阴性的人白血病细胞株NB4作对照，检测了NHL患者外周血中EB病毒基因。结果RAM能够检出样品中10个分子的靶基因；120例非霍奇金淋巴瘤（NHL）标本中，76例阳性（63．33％），与PCR方法检出结果相一致。结论RAM技术敏感、特异、简便易行；NHL与EB病毒感染具有较高的相关性。     

多渠道教学方式在高职高专护理专业教学中的应用

为适应高职高专教学需求,文章论述了转变教学观念,变传统课堂教学方式为多渠道教学方式的必要性。坚持“以学生为主体”的教学理念,在教师必要的指导和宽松的学习环境中,鼓励学生利用多种渠道自主地、创造性地去学习知识。作为一种特定的教改模式,多渠道教学只有在坚持以学生为中心的教学理念,并具备完整的教学体系的基础上才能得以实现。     

先天性巨结肠患儿清洁灌肠法的研究

清洁灌肠是先天性巨结肠常用的首要辅助治疗方法，是保证手术顺利进行、减少术后并发症的必要的术前准备。分析了先天性巨结肠清洁灌肠的材料及方法。     

外环境中布雷图指数和诱蚊诱卵器指数的差异研究

目的 对外环境布雷图指数法和诱蚊诱卵器法的平行对照研究,比较布雷图指数和诱蚊诱卵器指数的差异,以便明确自然积水对诱蚊诱卵器法监测的影响,为蚊虫及蚊媒传染病防控提供科学依据。方法 2020年5—10月期间每月中旬在上海市静安区各街道（镇）居民区外环境中采用布雷图指数法和诱蚊诱卵器法开展相同区域内的平行对照研究,比较不同监测环境中两监测方法的差异。结果 不同月份中,诱蚊诱卵器指数最高为8月6.86,其次为7月6.74;布雷图指数最高为8月16.24,其次为7月14.56。两监测方法在时间趋势上高度相关（r=0.965,P<0.05）,诱蚊诱卵器指数各月均低于布雷图指数,指数月间分布趋于平缓。诱蚊诱卵器指数老旧公房为5.73,商品房为4.91,差异有统计学意义（Z=12.530,P<0.05）;布雷图指数老旧公房为13.58,商品房为7.14,差异有统计学意义（Z=-4.013,P<0.05）。老旧公房布雷图指数和诱蚊诱卵器指数均高于商品房,老旧公房的布雷图指数为13.58,高于同一地区的诱蚊诱卵器指数5.73,差异有统计学意义（Z=-3.608,P<0.05）。两类型居民区积水构成相近,两类型居民区最多的积水种类依次为盆景、水生植物、闲置容器和储水容器,数量上老旧公房自然积水平均66.43处/居民区,商品房平均49.27处/居民区,随自然积水数量增加,布雷图指数上升。结论 布雷图指数和诱蚊诱卵器指数有较高的一致性,诱蚊诱卵器指数相较于布雷图指数更趋于平缓,不同类型居民区中环境积水数是影响诱蚊诱卵器指数的主要因素,在自然积水较多的环境中,布雷图指数法相较于诱蚊诱卵器指数敏感性更高。     

Negative affective stress reactivity: The dampening effect of snacking

The present study sets out to further elucidate the complex relationship between daily hassles, snacking, and negative affect (NA). The aim of the present study was to examine whether or not moment‐to‐moment energy intake from snacks moderates the association between momentary stress and NA. And, if so, can this moderating effect be replicated by using the amount of macronutrient intake (i.e., carbohydrates, fat, and protein) as moderator on the association between momentary stress and NA? Adults (N = 269), aged 20–50 years, participated in this study. Stress, NA, and snack intake were assessed 10 times a day for 7 consecutive days in daily life with an experience sampling smartphone application. Multilevel regression analyses were performed to assess the hypothesized associations. Our study revealed a dampening effect of snacking on negative affective stress reactivity. However, this dampening effect could not be replicated by the amount of macronutrient intake from snacks. On the contrary, the amount of carbohydrates has an enhancing effect on negative affective stress reactivity. In the end, our study suggests that the critical question is which mechanisms are decisive in the dampening role of snacking on stress reactivity. A multidisciplinary approach may provide a full perspective.     

计算机辅助测量青少年特发性脊柱侧凸脊柱长度的方法及可行性分析

目的 :提出一种新的计算机辅助测量青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)脊柱长度的方法,评价其准确性和可重复性。方法:在前后站立位脊柱全长正位X线片上选取每个椎体的四个顶点,基于Matlab 6.5软件,设定程序确定L4下终板至T1上终板的中线,将中线上点的距离和作为脊柱长度。由1名医师采用计算机辅助测量方法和2名医师采用手工测量方法,随机选取5例AIS患者并对每例患者进行5次重复测量,计算两种方法测量结果的均值和标准差,评价计算机辅助测量脊柱长度方法的准确性和可重复性。选取45例AIS患者,其中女38例,男7例,年龄10～16岁(13.5±1.5岁);Cobb角10°～45°(32.5°±8.7°)。由同一骨科医师在前后站立位脊柱全长正位X线片上分别采用手工测量方法和计算机辅助测量方法获得T1～L4脊柱长度,计算均值和标准差,比较两种测量方法的结果是否存在差异。应用计算机辅助测量方法测量计算出45例AIS患者L4～T1的脊柱长度,对同一医师应用该测量方法间隔4周的两次测量结果做比较,分析同一观察者在不同时间的可重复性;对3名不同医师分别应用该测量方法的测量结果做比较,分析该方法不同观察者间的可重复性。结果:应用计算机辅助测量方法测量5例AIS患者的脊柱长度(±s)分别为325.8±0.46mm、391.3±0.43mm、476.7±0.04mm、441.3±0.79mm和432.8±0.50mm,2名医师应用手工测量方法测量5例AIS患者的脊柱长度分别为325.7±8.3mm、390.9±7.6mm、476.7±6.0mm、441.5±8.2mm、433.1±6.0mm和326.2±5.9mm、391.4±7.5mm、476.1±5.8mm、441.6±8.2mm、432.9±5.8mm,应用计算机辅助测量方法多次测量脊柱长度测得结果的标准差较手工测量结果低得多。采用计算机辅助测量方法与手工测量方法测量45例AIS患者的脊柱长度(±s)分别为404.7±43.2mm和405.1±45.5mm,两组均数比较差异无显著性(P0.05),采用计算机辅助测量方法测量AIS脊柱长度的同一观察者间隔4周的组内相关系数为0.995(P0.05),不同观察者间的组内相关系数为0.942(P0.05)。结论:计算机辅助测量AIS患者脊柱长度的方法较传统的手工测量方法操作简单,并且其准确性和可重复性均较好。     

Human Temporal Bone Removal: The Skull Base Block Method

Objectives To describe a technique for harvesting larger temporal bone specimens from human cadavers for the training of otolaryngology residents and fellows on the various approaches to the lateral and posterolateral skull base. Design Human cadaveric anatomical study. The calvarium was excised 6 cm above the superior aspect of the ear canal. The brain and cerebellum were carefully removed, and the cranial nerves were cut sharply. Two bony cuts were performed, one in the midsagittal plane and the other in the coronal plane at the level of the optic foramen. Setting Medical school anatomy laboratory. Participants Human cadavers. Main Outcome Measures Anatomical contents of specimens and technical effort required. Results Larger temporal bone specimens containing portions of the parietal, occipital, and sphenoidal bones were consistently obtained using this technique of two bone cuts. All specimens were inspected and contained pertinent surface and skull base landmarks. Conclusions The skull base block method allows for larger temporal bone specimens using a two bone cut technique that is efficient and reproducible. These specimens have the necessary anatomical bony landmarks for studying the complexity, utility, and limitations of lateral and posterolateral approaches to the skull base, important for the education of otolaryngology residents and fellows.