简介：摘要目的将聚己内酯(PCL)薄膜与1，1′-双十八烷基-3，3，3′，3′-四甲基吲哚碳菁高氯酸盐(DiI)标记的骨髓间充质干细胞(BMSCs)共培养，制备细胞补片。方法取1只清洁级SD大鼠作为实验对象，通过分离培养获得大鼠BMSCs，并进行流式细胞仪鉴定表面标志物。BMSCs培养至3代后，使用DiI染料对BMSCs标记，将DiI标记的BMSCs与PCL制成的薄膜共培养，24 h后在荧光显微镜下观察细胞生长情况，并固定进行电镜扫描，在培养的1、4、7、10 d分别用细胞计数试剂盒(CCK-8)检测细胞增殖。多组间比较采用单因素方差分析，两两比较采用LSD分析。结果BMSCs流式细胞术鉴定：CD90、CD44H强阳性，CD11b/c、CD45阴性。荧光显微镜下，可见DiI标记的BMSCs发红光，呈梭形或多边形。扫描电镜下，PCL薄膜与DiI标记的BMSCs共培养形成的细胞补片，其表面细胞数量多，细胞状态正常。CCK-8测定结果显示第1天吸光度(A)值为0.330±0.025；第4天A值为0.620±0.012，第7天A值为1.033±0.144，第10天A值为1.223±0.133。各时间点A值之间差异有统计学意义(F＝66.441，P<0.05)。结论PCL薄膜可以作为一种DiI标记示踪的支架材料，用于干细胞治疗。

简介：AbstractBackground:The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images.Methods:Taking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR-), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists.Results:The accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87-0.91, 0.89-0.92, 0.87-0.91, and 0.86-0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%).Conclusions:The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.Trial registration:Chictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.

简介：摘要目的探讨秀丽隐杆线虫肌肉表达物3(caenorhabditis elegans muscle excess，Mex3c)参与调控小鼠胚胎神经管发育中的配对盒基因(paired box 3，PAX3)、巢蛋白(Nestin)的表达及其对于神经管发育的影响。方法选取Mex3c+/-和正常野生型小鼠各18只和正常野生型雄鼠6只(用于繁殖)。在母鼠孕10.5 d、12.5 d、14.5 d时，两组各取6只母鼠获取小鼠胚胎并记录总胚胎数、吸收胎数、存活胎数。免疫组织化学染色及蛋白质印迹法检测小鼠胚胎Nestin、PAX3表达，免疫荧光染色检测PAX3，Tunel染色检测细胞凋亡，HE染色观察形态学变化。总胚胎数、吸收胎数、存活胎数为计数资料采用卡方检测；测定的Nestin蛋白、PAX3蛋白、Mex3c蛋白、细胞凋亡数据检测符合正态分布，进行单因素方差分析及S-N-K两两比较。结果免疫组织化学染色检测母鼠下丘脑Mex3c蛋白表达，Mex3c组(16.52±1.60)较对照组(26.05±2.00)低，且差异有统计学意义(P<0.0001)。各组不同时期吸收胎及总胚胎数差异无统计学意义(P>0.05)，表明缺陷Mex3c基因不会导致子代胚胎发育畸形。HE染色结果显示，与对照组相比，Mex3c组神经细胞较小、密度较低。Tunel染色结果显示，Mex3c组孕10.5 d、12.5 d、14.5 d小鼠胚胎神经管内凋亡细胞表达阳性率分别为(12.20±1.30)%、(11.20±0.84)%和(10.00±0.71)%，与对照组的(4.83±1.17)%、(5.17±0.75)%和(7.17±0.75)%比较，差异均有统计学意义(P均<0.01)。免疫组织化学染色结果显示，Nestin蛋白表达在神经纤维，PAX3蛋白表达在细胞核。免疫荧光实验检测PAX3蛋白结果显示，Mex3c组孕12.5 d和孕14.5 d小鼠胚胎PAX3蛋白表达阳性率分别为(9.20±1.30)%和(8.80±1.30)%，与对照组(5.83±0.98)%和(3.67±0.82)%比较，差异均有统计学意义(P<0.01)。蛋白质印迹法结果显示，Mex3c组孕10.5 d、12.5 d、14.5 d时小鼠胚胎Nestin蛋白表达水平分别为0.06±0.02、0.57±0.09和0.69±0.04，与对照组0.79±0.07、0.39±0.14和0.27±0.07比较，Mex3c组表达呈上升趋势而对照组呈下降趋势，组间不同时间点比较，差异均有统计学意义(P均<0.05或0.001)。Mex3c组孕10.5 d、12.5 d、14.5 d时小鼠胚胎PAX3蛋白表达水平分别为0.17±0.02、0.63±0.09和0.72±0.03，与对照组0.03±0.01、0.46±0.08和0.45±0.06比较，Mex3c组表达呈上升趋势而对照组呈下降趋势，组间不同时间点比较，差异均有统计学意义(P均<0.01或0.001)。结论Mex3c参与调控小鼠胚胎神经管发育中PAX3、Nestin蛋白表达并抑制神经管中神经细胞发育及成熟和促使神经管内细胞凋亡。

简介：摘要探讨全3D腹腔镜联合肝脏离断和门静脉结扎的二步肝切除术(ALPPS)治疗合并肝硬化肝细胞癌患者的价值。回顾分析郑州大学附属肿瘤医院行3D腹腔镜ALPPS治疗的3例合并肝硬化肝细胞癌患者资料。2021年4月至6月入院，均为男性，年龄分别为48、66、52岁。分析手术情况、肝体积增长、并发症、随访结果等。3例患者均顺利完成全3D腹腔镜下ALPPS。3例患者一期手术时间分别为285.0、210.0、235.0 min，出血量200.0、100.0、80.0 ml。二期手术前肝体积分别为228、220、209 ml，较前增长49%、67%、58%。两次手术间隔分别为26.0、15.0、17.0 d。二期手术时间为220.0、255.0、240.0 min，出血量200.0、150.0、200.0 ml。1例二期手术后出现大量腹水，给予利尿治疗后好转。均无严重出血、胆漏、感染等严重并发症。门诊复查时随访无复发转移。全3D腹腔镜ALPPS治疗剩余肝体积不足合并肝硬化肝细胞癌安全、有效，使无法手术的合并肝硬化肝细胞癌患者获得根治手术机会。

简介：摘要目的分析抗α-氨基-3-羟基-5-甲基-4-异唑丙酸受体（AMPAR）抗体脑炎的临床特点。方法回顾性总结2020年1月至2021年5月空军军医大学唐都医院诊治的3例抗AMPAR抗体脑炎患者的临床资料，对其临床表现、辅助检查、治疗及预后进行分析。结果3例抗AMPAR抗体脑炎（年龄12~70岁）均急性起病，首发症状包括认知减退、性格改变及少见的头痛、运动障碍，其中例1肺部占位性病变经病理证实为小细胞肺癌，血清及脑脊液抗AMPAR抗体、抗Y染色体性别决定区相关高迁移率组盒蛋白1抗体阳性，激素联合肿瘤化学治疗后症状仍持续存在，无临床复发；例2责任病灶位于双侧额颞叶、半卵圆中心及侧脑室旁，同时合并低颅压综合征典型影像学特征，血清抗AMPAR抗体阳性，激素治疗后症状部分改善；例3颅内病灶位于脑桥及右侧小脑中脚，伴显著小脑萎缩，脊髓磁共振成像提示颈2~胸10水平脊髓病变，血清及脑脊液抗AMPAR抗体阳性，激素联合静脉滴注人免疫球蛋白治疗后症状显著改善。结论抗AMPAR抗体脑炎临床表现异质性高，除边缘系统外，尚可波及脑干、脊髓，出现脑萎缩；存在多重抗神经元抗体尤其是抗神经元细胞内抗原抗体时需密切监测肿瘤；免疫治疗有效，肿瘤叠加多重抗体时预后差。

简介：摘要目的分析微管相关蛋白1轻链3-Ⅱ（LC3-Ⅱ）和激活转录因子3（ATF3）在肝细胞癌中的表达情况，探讨其蛋白表达与HCC患者预后的关系，并分析在HCC组织中，两者的表达是否具有相关性。方法应用免疫组织化学法检测HCC组织及相应癌旁组织蜡块标本中LC3-Ⅱ与ATF3蛋白的表达情况，并分析其与患者临床病理特征和生存期之间的关系。使用免疫蛋白印迹（Western blot）法检测新鲜HCC组织及相应癌旁组织中LC3-Ⅱ与ATF3蛋白的表达，分析两种蛋白表达的相关性。结果LC3-Ⅱ和ATF3蛋白在癌旁组织中的表达明显高于HCC组织，两者的表达水平与HCC组织病理分级和静脉癌栓情况相关（均P<0.05），但与年龄、性别、血清甲胎蛋白、肿瘤直径、HBsAg等的相关性无统计学意义（均P>0.05）。LC3-Ⅱ和ATF3的低表达与HCC患者的不良预后显著相关（均P<0.05）。结论LC3-Ⅱ和ATF3蛋白表达均与HCC的发生发展有关，两者的联合检测有助于HCC的恶性程度的评估，有望成为判断患者预后的重要指标。

简介：目的:检测川陈皮素对MC3T3-E1细胞增殖及成骨分化的作用及机制。方法:采用CCK-8法、碱性磷酸酶(ALP)活性检测及实时定量PCR方法评价川陈皮素对MC3T3-E1细胞增殖、成骨分化及相关基因表达的影响。结果:川陈皮素能促进MC3T3-E1的细胞增殖,刺激细胞ALP活性升高,上调BMP-2、COL-I、OCN、Runx2的基因表达,BMP-2信号阻断剂(Noggin)能抑制成骨分化基因表达。结论:川陈皮素可促进MC3T3-E1成骨分化及成骨基因表达,BMP-2信号通路可能参与了该过程。

简介：摘要：随着社会经济发展越来越快，人们物质生活水平逐渐提高，对于享受生活的方式也越发丰富。尤其是3D电影已经被越来越多的人所接受并喜欢。人们在看3D电影的同时必须佩带3D眼镜，但经调查发现，3D电影的大部分消费群众并不知道3D眼镜对人体的危害，也不知道科学的3D眼镜佩戴及使用方法。科学实验证明，3D眼镜的使用可以引起或诱发很多眼部疾病。尤其对于青少面危害更大。所以提高全民科学使用3D眼镜意识十分重要。

简介：MEG3a是功能未知的母本印记基因MEG3的新型转录产物，研究表明MEG3a在正常垂体组织中高表达．而几乎在全部无功能性垂体腺瘤、大部分功能性垂体腺瘤中不表达。同时，该基因的异位表达能抑制许多癌细胞株的增殖。包括Hela细胞．MCF-7和H4组蛋白等，因而它可能是一种抑癌基因，其生物学功能与细胞增殖有关。本文就MEG3和MEG3a基因与无功能性垂体腺瘤的关系作简要综述。

简介：摘要目的比较IgA肾病患者不同病理分级的血清IgA、C3及IgA/C3水平；探讨血清IgA、C3及IgA/C3水平在IgA肾病病理分级评估中的意义。方法选择我院320例经肾穿刺活检病理检查确诊为原发性IgA肾病患者，用散射比浊法检测患者血清IgA、C3水平及按Lee氏分级标准评估IgA肾病病理分级。结果Lee分级为Ⅰ、Ⅱ级与Lee分级为Ⅲ、Ⅳ、Ⅴ级患者IgA水平分别为(2.75±1.10)vs（2.85±1.26）g/L,(P﹥0.05);血清C3水平分别为（1.18±0.33）vs（1.04±0.29）g/L,(P﹤0.05)；血清IgA/C3率分别为（2.71±1.19）vs（3.24±1.69）g/L,(P﹤0.05)。结论IgA/C3比值在评估IgA肾病病理分级有重要参考意义。

简介：摘要目的探讨病毒性心肌炎患者血清半乳糖凝集素-3（galectin-3，Gal-3）、正五聚体蛋白-3（pentraxin-3，PTX-3）表达水平及其诊断及预后评估价值。方法选取2018年1月—2019年7月本院收治的122例病毒性心肌炎患者为研究对象（心肌炎组），同期选取118例健康体检者作为对照组。采用酶联免疫吸附法检测血清Gal-3、PTX-3及心肌指标脑钠肽（brain natriuretic peptide，BNP）、肌酸激酶同工酶（creatine kinase MB，CK-MB）、心肌肌钙蛋白I（cardiac troponin I，cTnI）水平；采用Pearson法分析病毒性心肌炎患者血清Gal-3、PTX-3与心肌指标的相关性；采用受试者工作特征曲线（receiver operator charateristic curve，ROC曲线）分析血清Gal-3、PTX-3水平对病毒性心肌炎的诊断价值；采用多因素Logistic回归分析影响病毒性心肌炎患者预后的因素。结果心肌炎组血清Gal-3、PTX-3、BNP、CK-MB、cTnI水平高于对照组，差异有统计学意义（P>0.05）。病毒性心肌炎患者血清Gal-3与PTX-3呈正相关（r=0.594、P<0.05），且二者与BNP、CK-MB、cTnI均呈正相关（P<0.05）。血清Gal-3、PTX-3水平诊断病毒性心肌炎的曲线下面积（area under curve，AUC）分别为0.873、0.916，截断值分别为5.431 ng/mL、4.159 ng/mL，特异性分别为74.5%、84.7%，敏感度分别为84.4%、82.0%；二者联合诊断的AUC为0.969，特异性为95.9%，敏感度为88.5%。预后不良组病毒性心肌炎患者血清Gal-3、PTX-3水平高于预后良好组，差异有统计学意义（P<0.05）。Gal-3、PTX-3、cTnI是影响病毒性心肌炎患者预后不良的独立危险因素（P<0.05）。结论病毒性心肌炎患者血清Gal-3、PTX-3表达水平升高，二者对病毒性心肌炎诊断及预后评价均可能有重要价值。

简介：摘要目的探讨地塞米松（Dex）对成骨细胞增殖和凋亡的影响及潜在的作用机制。方法将人成骨细胞hFOB 1.19分为4组：对照组（不加药物），Dex组（300 μM Dex处理48 h），Dex+AA组（300 μM Dex+2 000 μM AA处理48 h）和Dex+NAC组（300 μM Dex+500 μM NAC处理48 h）。抗坏血酸（AA）和N-乙酰-L-半胱氨酸（NAC）均为活性氧（ROS）的清除剂。检测各组细胞的增殖率、凋亡率、ROS和碱性磷酸酶（ALP）水平以及PI3K/AKT/GSK3β信号通路的活性。结果Dex的半抑制浓度（IC50）约在300 μM。与对照组对比，Dex组细胞的细胞增殖率［（100.00±1.76）%比（51.47±5.62）%］和ALP活性［（100.00±0.83）%比（69.71±7.53）%］显著降低（均P＜0.05），细胞凋亡率［（3.71±1.16）%比（18.42±3.19）%］和ROS水平［（1.49±0.37）比（4.40±1.08）］显著增加（均P＜0.05）。与Dex组对比，Dex+AA组和Dex+NAC组细胞的细胞增殖率［（51.47±5.62）%比（89.32±6.74）%、（51.47±5.62）%比（94.58±5.01）%］和ALP活性［（69.71±7.53）%比（85.49±8.17%）、（69.71±7.53）%比（92.55±8.01）%］显著增加（均P＜0.05），细胞凋亡率［（18.42±3.19）%比（9.68±2.23）%、（18.42±3.19）%比（8.97±2.07）%］和ROS水平［（4.40±1.08）比（2.05±0.61）、（4.40±1.08）比（1.96±0.43）］均显著降低（均P＜0.05）。与对照组对比，Dex组细胞的p-PI3K［（0.98±0.17）比（0.26±0.08）］和p-AKT相对表达量［（0.56±0.10）比（0.19±0.06）］、p-PI3K/PI3K［（1.72±0.35）比（0.43±0.10）］和p-AKT/AKT比值［（0.66±0.19）比（0.21±0.08）］均显著降低（均P＜0.05），p-GSK3β相对表达量［（0.12±0.04）比（0.49±0.09）］和p-GSK3β/GSK3β比值［（0.67±0.15）比（1.32±0.24）］均显著增加（均P＜0.05）。与Dex组对比，Dex+AA组和Dex+NAC组细胞的p-PI3K［（0.26±0.08）比（0.76±0.12）、（0.26±0.08）比（0.80±0.12）］和p-AKT相对表达量［（0.19±0.06）比（0.38±0.11）、（0.19±0.06）比（0.42±0.08）］、p-PI3K/PI3K［（0.43±0.10）比（1.21±0.27）、（0.43±0.10）比（1.35±0.21）］和p-AKT/AKT比值［（0.21±0.08）比（0.45±0.04）、（0.21±0.08）比（0.45±0.07）］均显著增加（均P＜0.05），p-GSK3β相对表达量［（0.49±0.09）比（0.26±0.05）、（0.49±0.09）比（0.22±0.07）］和p-GSK3β/GSK3β比值［（1.32±0.24）比（0.83±0.19）、（1.32±0.24）比（0.73±0.16）］均显著降低（均P＜0.05）。结论Dex可通过ROS-PI3K/AKT/GSK3β信号通路诱导成骨细胞凋亡。

简介：AbstractBackground:Pharmacological factors used to induce insulin resistance (IR) in in vitro models may not mimic the full in vivo features of type 2 diabetes mellitus (T2DM). This study aimed to examine the ability of diabetic serum (DS) to induce IR and investigate whether adipose-derived mesenchymal stem cell conditioned medium (ADMSC-CM) reverses DS-induced IR.Methods:DS was obtained from newly diagnosed T2DM patients. IR was induced in differentiated 3T3-L1 cells by employing dexamethasone, tumor necrosis factor alpha (TNF-α), palmitate and DS. Glucose uptake (2-[N-[7-nitrobenz-2-oxa-1,3-diazol-4-yl] amino]-2-deoxyglucose(2-NBDG) uptake assay), intracellular levels of reactive oxygen species (ROS), and superoxide radicals (O2-) (fluorescence microscopy and fluorometry) were analyzed in control and experimental samples. mRNA expression of key genes involved in glucose transport and inflammation were analyzed by using reverse transcription polymerase chain reaction (RT-PCR). Pro-inflammatory cytokines and phospho-insulin receptor substrate (IRS) (Ser-307) protein expression were analyzed by fluorescence activated cell sorter analysis. Statistical significance was determined by using one-way ANOVA followed by Tukey's multiple comparison tests.Results:ADMSC-CM significantly increased the DS-mediated decrease in 2-NBDG uptake (11.01 ± 0.50 vs. 7.20 ± 0.30, P < 0.01) and reduced DS-driven ROS (fluorescence count, 6.35 ± 0.46 vs. 9.80 ± 0.10, P < 0.01) and O2- (fluorescence count, 3.00 ± 0.10 vs. 4.60 ± 0.09, P < 0.01) production. Further, the ADMSC-CM restored DS-induced down regulation GLUT4 (1.52- fold, P < 0.05) as well as the up-regulation of PPARγ (0.35-fold, P < 0.01), and IKKβ (0.37-fold, P < 0.01) mRNA, and phospho-IRS (Ser-307) protein expression compared to the baseline (median fluorescence intensity, 88,192 ± 2720 vs. 65,450 ± 3111, P < 0.01). DS induced IR, similar to the traditionally used pharmacological factors, namely dexamethasone, TNF-α, and palmitate, which can be attributed to the significantly higher pro-inflammatory cytokines levels (TNF-α (2.28 ± 0.03 pg/mL vs. 2.38 ± 0.03 pg/mL, P < 0.01), interleukin 6 (IL)-6 (1.94 ± 0.02 pg/mL vs. 2.17 ± 0.04 pg/mL, P < 0.01), IL-17 (2.16 ± 0.02 pg/mL vs. 2.22 ± 0.002 pg/mL, P < 0.05), and interferon gamma (IFN-γ) (2.07 ± 0.02 pg/mL vs. 2.15 ± 0.04 pg/mL, P < 0.05)) in DS.Conclusions:DS can be explored as a novel inducer of IR in in vitro studies with further standardization, substituting the conventionally used pharmacological factors. Our findings also affirm the validity of ADMSC-CM as a prospective insulin sensitizer for T2DM therapy.

简介：摘要目的探讨CDC25B和14-3-3δ蛋白在膀胱癌中的表达与病理分级、临床分期的关系，为临床上判断膀胱癌的恶性程度和膀胱癌的新的治疗方法提供理论依据。方法采用免疫印迹（WesternBlot）法检测64例膀胱癌、9例癌旁正常膀胱粘膜中CDC25B和14-3-3δ蛋白的表达。1）观察CDC25B和14-3-3δ蛋白在膀胱癌和癌旁正常膀胱粘膜中的表达情况；2）分析CDC25B和14-3-3δ蛋白在膀胱癌中的表达与病理分级和临床分期的关系。结果所测组织中均有CDC25B的表达，膀胱癌中呈高表达；并且在膀胱癌各病理分级、临床分期间的表达亦有差异。CDC25B随着肿瘤的分化程度降低而表达逐渐增加，CDC25B在浸润性膀胱癌中表达高于非浸润性膀胱癌。14-3-3δ蛋白在癌旁正常膀胱粘膜中大量表达，在膀胱癌中均呈低表达，但未见其与肿瘤病理分级有明显相关性。结论CDC25B在膀胱癌组织中表达明显高于癌旁正常膀胱粘膜，且CDC25B的高表达与膀胱癌的分化程度和浸润性密切相关；14-3-3δ蛋白在癌旁膀胱粘膜大量表达，而在膀胱癌组织中均呈低表达，但与肿瘤分化程度无相关性。CDC25B及14-3-3δ蛋白可能成为膀胱癌潜在的诊断标记和治疗靶点。

简介：摘要报道1例基因诊断明确的线粒体3-羟基-3-甲基戊二酰辅酶A合成酶缺乏症(HMGCSD)，并对国内外已报道病例进行文献复习。先证者，女，7个月16 d，因"发热4 d，喘息3 h，呼吸困难、呻吟2 h"急诊入院，主要表现为脑病、肝大、肝损害、低酮性低血糖、高脂血症，于住院第3天死于呼吸循环衰竭。全外显子组测序示HMGCS2复合杂合变异：c.1061＋1G>C与c.476G>T，结合患儿临床特点，可基因诊断HMGCSD。文献检索共收集HMGCSD相关文献13篇，共26例患儿，发病年龄3个月～6岁，发病诱因主要为能量摄入不足，主要表现为低酮性低血糖、肝大、肝损害等，尿4-羟基-6-甲基-2-吡喃酮增高可能有强烈提示意义，3例死亡。26例患儿共报道HMGCS2突变32种，主要突变类型为错义突变。本研究为国内确诊第2例HMGCSD，发现2个HMGCS2新变异，扩展了HMGCS2临床表型及突变谱。

简介：【摘要】目的：探讨3D打印辅助3D胸腔镜下胸部肿瘤手术的护理效果。方法：选取本院于2020年1月至2021年1月间收治的80例胸部肿瘤患者为研究对象，采用随机抽签的方式进行分组，分为实验组和对照组，每组各40例，对照组采用常规护理方式，实验组在常规护理的基础上增加3D打印辅助3D胸腔镜。结果：在并发症发生情况、护理满意度方面，实验组优于对照组（P＜0.05）。结论：3D打印辅助3D胸腔镜下胸部肿瘤手术的护理效果显著，能有效降低并发症的发生情况，提升护理满意度，值得临床推广和使用。

简介：摘要

简介：AbstractPurpose:This meta-analysis compared the clinical outcome of three-dimensional (3D) printing combined with open reduction and internal fixation (ORIF) to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library, PubMed, Embase, VIP database, CNKI, and Wanfang data-base with keywords "acetabular fracture" , "3D printing" , "three-dimensional printing" , "open reduction and internal fixation" , "Acetabulum" , "Acetabula" from January 2000 to March 2020. Two reviewers independently selected articles, extracted data, assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’ s tools and/or Newcastle-Ottawa scale. When the two analysts had different opinions, they would ask the third analyst for opinion. Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF (3D printing group) versus traditional ORIF (conventional group) in the treatment of acetabular fractures were selected. The data of operation time, intraoperative blood loss, intraoperative fluoroscopy times, incidence of complications, excellent and good rate of Matta score for reduction, and excellent and good rate of hip function score were extracted. Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected, including 5 randomized controlled trials and 4 retrospective studies. A total of 467 patients were analyzed, 250 in the conventional group, and 217 in the 3D printing group. The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant (standardized mean difference (SMD) =-1.19, 95% CI:-1.55 to-0.82, p < 0.05). The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group (SMD=-1.08, 95% CI:-1.65 to-0.51, p < 0.05). The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant (SMD=-1.64, 95% CI:-2.35 to-0.93, p < 0.05). The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group (OR = 0.43, 95% CI: 0.24-0.79, p < 0.05). There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups (OR = 0.60, 95% CI: 0.34-1.06, p > 0.05). There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups (OR = 0.84, 95% CI: 0.46-1.56, p > 0.05), but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF, 3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively, but also effectively reduces operation time, intraoperative blood loss, intraoperative fluoroscopy times, and postoperative complications. However, there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.

简介：摘要布鲁氏菌病是由布鲁氏菌属细菌侵人机体引起的人兽共患的变态反应性、职业性、地方性、传染性疾病。当布氏杆菌从皮肤黏膜进入人体后而引起全身网状内皮系统增生，同时伴有菌血症、毒血症和神经、循环、生殖、免疫等多系统损害。随着人们生活水平提高，饮食习惯改变，近几年来布病有明显上升势头。本研究主要阐述了我院3例布鲁氏菌病误诊的临床心得，为布鲁氏菌病的临床诊断提供参考。

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