本文报道一例生后因重症血小板减少诊断为先天性巨细胞病毒感染的病例，抗病毒治疗中断后出现发热、腹泻、便血等结肠炎表现，同时出现噬血表现，除外先天性免疫缺陷、原发性噬血细胞综合征及炎症性肠病，考虑巨细胞病毒感染抗病毒疗程不足和免疫紊乱导致结肠炎及噬血表现。

This paper aims to disclose the hyperglycaemic activity of the polysaccharides extracted from Morchella esculenta (M. esculenta) mycelia. To this end, M. esculenta mycelia were cultured submerged fermentation, and the acidic polysaccharides were extracted and purified by anion exchange chromatography gel permeation chromatography. Then, a group of healthy rats was prepared, together with several groups of diabetes mellitus (DM) rats intervened with different doses of M. esculenta acidic polysaccharides. Next, several Morris water maze (MWM) tests were performed to reveal the regulation effect of these polysaccharides on the mRNA expression of the nerve growth factor (NGF) of the rats. The main results are as follows. The fasting blood glucose (FBG) and serum insulin (INS) of Group D (intervened by 600 μg∙mL-1 of polysaccharide) plunged to 8.12mmol/L and 31.67mU/L, respectively, compared to those of the control group (P<0.01), indicating that the polysaccharides can promote INS secretion. Meanwhile, the relative mRNA expression level of Group D grew by from the level of the control group (p<0.01). Thus, the acidic M. esculenta polysaccharide must have triggered the expression of NGF protein. The research findings lay a solid basis for the development of anti-hyperglycaemia food based on M. esculenta polysaccharides.

近年来, 老年胫骨平台骨折手术入路方式不断变化, 手术治疗效果不断提升, 显著改善了患者的关节功能和生活质量〔1,2〕. 但术后感染和骨髓炎、 关节僵硬、 畸形愈合、 不愈合等均是老年胫骨平台骨折常见并发症〔3〕. 胫骨平台骨折在骨科收治患者中的构成比约为1％, 其中老年患者最为常见. 发生原因主要有高处坠落、 交通事故、 工伤等, 可由间接或者直接暴力导致骨折外侧或内侧平台骨折, 再加上老年人群的骨代谢状况普遍较差, 同时反应灵敏性、 自我防护意识也较差, 因此发生胫骨平台骨折的风险较高〔4〕.在发生胫骨平台骨折后, 患者可出现活动障碍、 膝关节疼痛、 局部肿胀、 肌肉紧张等症状. 不同老年胫骨平台骨折临床治疗方法也存在明显的差异〔5〕. 探讨此类患者的手术入路及术后并发症情况具有重要的临床意义.

目的 对腹腔镜胆囊切除术在胆结石中的治疗效果进行探讨.方法 研究参与对象为40例胆结石患者,均为我院2014年8月至2017年9月收治.采用抽签法分成两组,对照组20例,实施常规开腹手术;实验组20例患者,实施腹腔镜胆囊切除术治疗.观察两组患者手术情况,记录、分析和比较两组患者的手术指标.结果 与对照组相比,实验组的手术时间、肛门排气时间、住院时间均较短,检验显示P<0.05,有统计学意义;与对照组相比,实验组的VAS分值较低,检验显示P<0.05,有统计学意义.与对照组相比,实验组的手术出血量较少,术后并发症率较低,检验显示P<0.05,有统计学意义.与对照组相比,实验组的总有效率较高,检验显示P<0.05,有统计学意义.结论 应用腹腔镜胆囊切除术对胆结石患者实施治疗,创伤性小,安全性高,患者术后恢复较快.

目的 观察不同低载荷振动方式对成骨细胞增殖与分化的影响.方法 应用振动加载器给予培养的成骨细胞MC3T3-E1以强度为0.25 g、频率35 Hz的振动载荷,设置空白组(A组),持续振动10 min(B组)及振动5 min间歇5 min再振动5 min(C组)两种加载模式组,加载结束后分别检测各组MC3T3-E1细胞的增殖能力(CCK-8法)、碱性磷酸酶(ALP)活性及Runx-2蛋白的表达变化.结果 3组之间成骨细胞增殖情况无明显统计学意义(P=0.742),B组与C组ALP活性及Runx-2蛋白的表达明显高于A组,C组的ALP活性及Runx-2蛋白的表达显著高于B组(P<0.05).结论 低载荷机械振动对成骨细胞的增殖并无影响,然而低载荷机械振动可以促进成骨细胞的分化,特别是适当的间歇低载荷机械振动能够更加明显的促进成骨细胞的分化.

多发性硬化症（Multiple Sclerosis,MS）是一种以多病灶性的中枢神经系统的白质炎症、轴索缺失、脱髓鞘、神经胶质增生,由遗传易感性和环境因素共同作用的最常见的中枢神经系统自身免疫性疾病[1]。病变通常累及双侧脑室周围的白质、脑干、小脑、脊髓和视神经,严重者甚至累及大脑皮层[1]。在临床诊疗中,以往多根据临床表现结合以实验室检查来诊断MS,如脑脊液检查,但迄今为止针对MS尚无特异

OBJECTIVE:To investigate the technique and its effect of combined nasolabial flap and free auricular composite flap for full-thickness nasal alar defect.METHODS:From March 2010 to March 2013, 9 patients with full-thickness nasal alar defects were treated with combined nasolabial flaps and free auricular composite flaps. Composite auricular flap was used as inner lining and cartilage framework. The nasolabial flap at the same side was used as outer lining.RESULTS:All the patients were followed up for 6-18 months (average, 12 months). All the 9 composite auricular flaps survived completely. Epidermal necrosis happened at the distal end of 1 nasolabial flap. Alar rim was almost normal and symmetric nose was achieved in 6 cases. The arc and the thickness of the alar rim was not enough in 3 cases, resulting in asymmetric appearance.CONCLUSIONS:The survival area of auricular composite flap can be enlarged with nasolabial flap. The auricular helix edge can be reserved to reconstruct nasal alar rim with smooth and natural arc. Large full-thickness nasal alar defedts can be reconstructed with combined nasolabial flaps and free auricular composite flaps.

In the repair of extensive lower lip and chin defects, the reconstruction of vermilion at the same time is a great challenge to plastic surgeons. We describe a novel method for the reconstruction of lower vermilion with musculomucosal flap from the upper lip in the repair of extensive lower lip and chin defects. Two patients underwent extensive lower lip and chin reconstruction together with vermilion reconstruction. This technique used 3 basic components: musculomucosal flap from the upper lip, buccal mucosal advancement flap, and cutaneous rotational flap from the neck. All the flaps survived without significant complications. Labial function in the motions of expression and speaking was maintained. The patients could basically close their mouths completely, and there were no drooping or small-mouth deformities postoperatively. Functional and cosmetically acceptable lower-lip and chin reconstructions in both patients were achieved.

Background and Purpose: This study aimed to explore the possible association of plasma total homocysteine with carotid plaque stability.Methods: A cross-sectional study was conducted from 2010 to 2011. A stratified random sample of 2,919 Chinese participants aged 40 years or older was enrolled. Plasma total homocysteine levels were measured and carotid plaques were evaluated by ultrasonography. Logistic regression model was used to analyze the association of homocysteine levels to the progression of carotid plaque development, while adjusting for demographics and vascular risk factors.Results: The mean level of plasma homocysteine in the subjects was 14.9 mmol/l. Along with increase in homocysteine level, the risk of advanced carotid plaque elevated (odds ratio = 1.28; 95% confidence interval = 1.09-1.51) after adjusting for age, sex, and other potential confounders. Stratified by sex, higher homocysteine level was strongly associated with advanced carotid plaque in men (OR = 1.41; 95% confidence interval = 1.17-1.70), but not in women.Conclusion: The findings suggest that plasma level of homocysteine may be associated with advanced carotid plaque, which constitutes high risks of stroke, in male Chinese adults.

<正>常因受到外界创伤、感染以及各种皮肤肿瘤手术后而形成组织缺损,特别是老年患者,因身体功能衰退,免疫功能逐步下降,鼻部受到损伤因素作用后更易形成组织缺损。因此,修复各种损伤因素所致的老年患者鼻翼组织全层缺损一直是整形外科医师的重大挑战之一。

<正>颌面部骨折时,由于其解剖特殊,结构不规则,骨质密度不均,各种腔道交杂,并与视、听、嗅及颅脑等重要脏器相邻,还与呼吸道、食道开口为伍,所以其救治有特殊的专业要求〔1〕。既往对于全身状态良好的老年患者,如伴有颌面部开放性损伤,一般将颌面部软组织修复及颌面部骨折复位内固定术同时进行。

In this paper, p-phthaloyl chloride (DB)-grafted SF films was employed to regulate the mineralization of hydroxyapatite in 1.5 x SBF (1.5 times of simulated body fluid) for 24 h at about 36.5 degrees C. It was discussed that the content of DB influence on the structure and morphology of the apatite composites deposited on the SF films. The structure and morphology of the composite materials were investigated by Fourier transform infrared, inductively coupled plasma emission spectrometer, X-ray diffraction and scanning electron microscopy. The results showed that the inorganic phase of component mainly were hydroxyapatite and they were self-assembled on the organic matrix and a three-dimensional framework was formed on the SF films. Ca/P molar ratio in the surface of biocomposites could reached 1.66. And the apatite was similarity to hydroxyapatite in natural bone in both microstructure and composition.

A fault diagnosis algorithm for electronic pedal module is proposed aiming at solving the pedal failsafe issues which is of great importance to the safety of electric vehicles.The fault is diagnosed due to adopting threshold and correlation alliance fault diagnosis methods to the algorithm,and the result is calculated by the fault tolerance method.The diagnosis algorithm is verified by the experiment using the LabVIEW RT tools.The experiment results demonstrate that this algorithm can diagnose the fault accurately and processes stably,calculate the right control signal,and significantly improve the safety of electric vehicles.

Background: Despite large efforts in researching the genesis of Moyamoya disease (MMD), the etiology of this rare disease remains widely unknown. In a previous publication we described two genetic variants in the first exon of transforming growth factor beta 1 (TGFB1) which were associated and showed a tendency toward significance, respectively. In this study we performed a follow-up analysis of TGFB1 by sequencing the complete exon 1 in European and by genotyping previously described positively associated single nucleotide polymorphisms (SNPs) in Japanese patients with MMD.Methods: The complete first exon of TGFB1 was genotyped in 40 MMD patients and 68 healthy controls from central Europe. For verification, genotyping of the previously described SNPs rs1800470 and rs1800471 was performed in 45 Japanese MMD patients and 79 healthy controls. Analysis was performed by capillary sequencing with custom made primers.Results: Sequencing of the first exon of TGFB1 in the European cohort did not reveal any new disease-associated nor other genetic variations. The previously described disease association of rs1800471 and tendency toward significance of rs1800470 could not be replicated in the Japanese cohort.Conclusions: As no new genetic variants were uncovered in this study of the first exon of TGFB1 in European MMD patients and because of the negative association of rs1800470 and rs1800471 in Japanese MMD patients, a role of this exon of TGFB1 in the genesis of MMD is unlikely. Further analyses with even larger cohorts may be necessary to detect causal genetic factors that contribute to the genesis of this disease. (C) 2012 Elsevier Masson SAS. All rights reserved.

<正>Moyamoya病又称脑底异常血管网病,或烟雾病,是以双侧颅内颈内动脉末端及大脑前、中动脉起始部狭窄或闭塞和颅底软脑膜、穿通动脉等小血管代偿增生为主要病理特点的慢性进展性疾病,一旦发生症状,以血管闭塞脑血流下降导致的脑梗

患者女性,54岁,因间断性头部麻木、颈部僵硬感1年,于2009年2月9日入院.病程中无头痛、头晕,无语言及肢体活动障碍,无发热、抽搐,饮食、睡眠、大小便正常.既往"心脏病"病史10年.入院时查体:血压150/80mmHg,除计算力差外余神经系统查体正常.头部CT示两侧大脑半球额、颞、顶叶多发大小不等的囊泡状低密度影,左侧较密集(图1).

Endothelial progenitor cells can be derived from bone marrow,umbilical cord blood,peripheral blood and fetal liver,it is a kind of precursor cell which can differentiate into mature endothelial cells under the action of growth factor,and it is also known as the hemangioblast.EPCs are believed to home to sites of neovascularization,where they contribute to vascular regeneration by forming a structural component of capillaries and by secreting angiogenic factors.Its wide origin,strong proliferative capacity,vasculogenesis and angiogenesis abilities enable it to meet the requirements of seed cells for tissue engineering,in particular,it has become a new force in research of vascularization of tissue-engineered bone;however,there are few researches about EPCs applied in the bone tissue engineering at present,the source,separation and cultivation,identification,induction and differentiation of EPC and its application in bone tissue engineering are reviewed in this article.

Background: To observe the effect of vascular endothelial progenitor cells (EPCs) in periodontal vascular reconstruction is important to study the mechanism of periodontal reconstruction following orthodontics. Objective: To examine if EPCs can be mobilized into the peripheral blood during experimental tooth movement following peripheral blood EPCs from tooth movement ratswere isolated, incubated and assessed in vitro. Design, Time and Setting: A in vitro culture, biologica parameter, randomized, controlled study was performed at the Jilin Provincial Key Laboratory of Stomotology and biomedical Engineering from September 2007 to April 2008. Materials: A total of 24 Wistar rats were equally and randomly assigned into experimental and control groups. Methods: Rat tooth movement models were established in the experimental group. Rats in the control group underwent dragging equipment, but did not undergo force. Peripheral blood was harvested to make cell smear in both groups at day 2 following undergoing force. CD133-positive cell count was detected. Peripheral blood mononuclear cells were isolated by Percoll density gradient centrifugation. At day 12 following incubation, cell smear was obtained to do relative detection in both groups. Main Outcome Measures: Immuocytochemistry and immunofluorescence chemical technique were used to identify surface markers of these cells. Fluorescence chemical technique was employed to measure acetylated low-density lipoprotein and ulex europaeus agglutinin-1 expression. MTT assay was applied to test cell proliferation. Results: Positive rate of CD133 were significantly higher in the experimental group compared to the control group (P < 0.05). Cultured cells could absorb Dil labeled acetylated low-density lipoprotein and FIFC labeled ulex europaeus agglutinin-1, and expressed CD133, VIII factor, CD34. The proliferative activity was greater in the experimental group than in the control group (P < 0.05). Conclusion: Studies have primarily confirmed that experimental tooth movement can induce rat bone marrow EPCs into peripheral blood.

Objective:To investigate the effect of brain-derived neurophin fat(BDNF)on peripheral facial nerve regeneration after end-to-side neurorrhaphy.Methods:30 rabbits were randomly divided into two groups.The distal end of the upper-cheek branch of facial nerve was transected to the down-check branch with epineurial window in an end-to-side fashion.BDNF was injected into the experimental group side postoperatively.The contral group was injected with 0.9% saline(NS).Postoperative evaluation was performed by electrophysiological test and morphological observation after 2,4,8 weeks.Results:The experimental group's nerve conduction velocity,action potential and the histopathology quantity analysis were significant superior than the contral group.Conclusin:BDNF can significant promote regeneration of facial nerve after end-to-side neurorrhaphy.