在密西西比河钓鱼

<正>我们一家刚到美国时,居住在威斯康辛州的一个小城市。那是一个仅有5万人的城市,城里有几所大学,我猜想,城里人的数字中,大学生肯定占了一大半。城市的西北边有一座桥,桥的那一边是明尼苏达州,桥下流淌着的是著名的密西西比河。     

早期肠内营养与低分子量肝素联合治疗重症急性胰腺炎对病情控制、微循环障碍及并发症的影响

目的 探讨早期肠内营养与低分子量肝素联合治疗重症急性胰腺炎（SAP）的临床疗效，并分析该治疗方案对病情控制、微循环障碍及并发症的影响。方法 选取2020年1月至2021年6月SAP患者98例，按照随机数字表法分为单一组和联合组，每组49例。2组均给予常规基础治疗，单一组采取早期肠内营养支持，联合组采取早期肠内营养支持联合低分子量肝素。比较2组临床疗效、康复进程、治疗前后病情控制情况[急性生理与慢性健康评价系统Ⅱ（APACHEⅡ）、CT严重程度指数（CTSI）评分]，微循环障碍指标[胰腺血流量（BF）、血流容积（BV）、灌注达峰时间（TTP）]，炎性因子[血清C反应蛋白（CRP）、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平及并发症情况。结果 联合组临床治疗总有效率高于单一组（P <0.05）；联合组腹痛缓解、腹胀缓解、肠鸣音恢复、血清淀粉酶恢复时间和住院天数短于单一组（P <0.05）；治疗1周后2组APACHEⅡ、CTSI评分低于治疗前，联合组低于单一组（P <0.05）；治疗1周后2组胰脏BF、BV高于治疗前，联合组高于单一组，TTP短于治疗前...     

微小RNA-144对人结肠癌细胞株增殖、侵袭迁移影响及其与同源盒基因A10结合力

目的 观察微小RNA-144(miR-144)对人结肠癌细胞株增殖、迁移、侵袭的影响及其与同源盒基因A10(homeobox gene A10,HOXA10)的结合力。方法 (1)人结肠癌细胞株HCT116、SW480、CL-11和永生化正常人结肠上皮细胞株FHC中miR-144及HOXA10 mRNA检测：采用实时荧光定量PCR法检测HCT116、SW480、CL-11及FHC中miR-144与HOXA10 mRNA，观察人结肠癌细胞和人结肠上皮细胞miR-144、HOXA10 mRNA表达变化，选择miR-144相对表达量最低HCT116细胞为后续研究对象。(2)miR-144对人结肠癌细胞株增殖、侵袭及迁移的影响观察：取对数生长期HCT116细胞分为3组，1组细胞顺序转染miR-144模拟物（miR-144 mimics）和HOXA10过表达质粒pcDNA3.1-HOXA10,2组细胞转染miR-144 mimics,3组细胞转染空白质粒。转染24 h时测算各组细胞增殖活性、观察各组细胞的侵袭及迁移情况、检测各组细胞miR-144及HOXA10蛋白。(3)HCT116细胞中miR...     

Analysis of clinical features in children with McCune-Albright syndrome北大核心CSCD

Objective To summarize and analyze the clinical features of McCune-Albright syndrome (MAS) in 26 children, to improve the understanding of MAS diagnosis and treatment, and to achieve early clinical diagnosis of MAS. Methods The clinical data of 26 children with MAS treated in Department of Pediatrics, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from August 2011 to June 2021 were retrospectively analyzed.Their clinical characteristics were summarized and studied.t-test, Mann-Whitney U test, χ 2 test or Fisher′s exact probability method was used for comparison between groups. Results (1) Among the 26 MAS patients enrolled, there were 22 females and 4 males.The average onset age of female and male patients was (5.87±2.94) years old and (7.48±3.36) years old, respectively.(2) In female patients, there were 7 cases with the typical triad and 15 cases with the atypical triad.(3) Female patients had the first symptom of vaginal bleeding (8/22) and breast development (14/22). Among the 4 male children, 1 case had " fracture" and 3 cases " lagged behind their peers in height" at the first visit.(4) Compared with the breast development group, the vaginal bleeding group had an earlier onset age[(4.06±1.88) years old vs.(7.82±1.82) years old] (t=5.023, P<0.001), earlier bone maturation[(1.26±0.07) vs.(1.09±0.13)] (t=2.933, P<0.05), a greatly lowered predicted adult height[(-2.16±0.98) SDS vs.(-0.96±1.09) SDS](t=1.352, P<0.05), a lower blood phosphorus level[(1.41±0.14) nmol/L vs.(1.67±0.24) nmol/L] (t=1.941, P<0.05), and a significantly elevated alkaline phosphatase level[339(313, 656) U/L vs.243(205, 452) U/L] (U=1.000, P<0.05). All patients (8 cases) in the vaginal bleeding group had fibrous dysplasia of bone.(5) Ten patients progressed to central precocious puberty (CPP). They showed an older average age of onset[(7.27±2.69)years old vs.(4.69±2.68)years old] (U=44.000, P<0.05), significantly earlier bone maturation at diagnosis[(1.23±0.11) vs.(1.01±0.13)] (t=1.834, P<0.05), and a lower predicted adult height[(152.00±4.62) cm vs.(162.10±6.91) cm] (t=3.805, P<0.05), compared with those who did not progress to CPP.(6) Eleven children developed polyostotic fibrous dysplasia of bone, and most common type (8 cases) was polyostotic fibrous dysplasia of bone, primarily at lower limb bones and skulls.(7) Of the 26 children, 20 cases had scattered Café au lait pigments on the skin.The Café au lait pigmented skin lesions in 35% (7/20) cases crossed the midline. Conclusions With complicated clinical manifestations, MAS is more common and occurs earlier in girls than boys.It is difficult to clinically diagnose MAS in boys due to the insidious onset and atypical symptoms.Female MAS patients with vaginal bleeding as the first symptom usually have an early age of onset, advanced bone age and lower predicted adult height, so they should be monitored and evaluated clinically.Vaginal bleeding is significantly associated with polyostotic fiber dysplasia of bone in MAS patients.Therefore, it is recommended that patients with vaginal bleeding should undergo a routine bone single-photon emission computed tomography scan.This helps understand the situation of occult fiber dysplasia of bone.Patients with later diagnosis and advanced bone age should be aware of the possibility of progression to CPP. © 2022 Chinese Journal of Applied Clinical Pediatrics. All rights reserved.