目的 对比分析阴道镜下宫颈活检、宫颈锥切术中快速病理检查对宫颈上皮内瘤变(CIN)的诊断价值.方法 经阴道镜下宫颈活检确诊为CIN的患者682例,其中低级别上皮内瘤变(LSIL)33例、高级别上皮内瘤变(HSIL)619例、不除外宫颈早期浸润癌30例,均采用宫颈锥切手术治疗.分析患者阴道镜下宫颈活检结果、术中快速病理检查结果,并与术后石蜡病理检查结果进行对比.结果 阴道镜下宫颈活检结果与术后石蜡病理检查结果的总体一致性为79.18％(540/682),漏诊宫颈早期浸润癌17例(2.49％).阴道镜下宫颈活检的病变检出率低于与术后石蜡病理检查(P<0.05).宫颈锥切术中快速病理检查结果与术后石蜡病理检查结果的总体一致性为90.97％(574/631),假阴性率4.75％(30/631),假阳性率4.28％(27/631).术中快速病理检查的病变检出率低于术后石蜡病理检查,但差异无统计学意义,二者一致性较好.宫颈锥切术病变残留率为8.08％(51/631),快速病理检查对切缘残留病变的诊断准确度为97.62％(616/631)、敏感度为80.39％(41/51)、特异度为99.14％(575/580),诊断效能与术后石蜡病理检查差异无统计学意义.结论 阴道镜下宫颈活检有助于早期发现、早期诊断CIN,但存在一定的误诊率和漏诊率.宫颈锥切术中快速病理检查对CIN的诊断准确率较高,尤其对切缘情况的判定具有优势.

Objective To investigate the effects of interleukin-17F (IL-17F) on the proliferation,mineralization and expressions of Runx2 and Osterix in rat osteoblasts.Methods Primarycalvarial osteoblasts were isolated from neonatal Wistarrats ＜ 24 h,cultured with low glucose DMEM medium containing 10％ fetal bovine serum,and the medium was replaced every 3 days.The cells were passaged when the cell fusion area reached about 80％.The fourth generation osteoblasts were divided into 6 groups according to the concentration of IL-17F in the culture medium:0 ng/mL group (control group),1 ng/mL group,10 ng/mL group,20 ng/mL group,50 ng/mL group,and 100 ng/mL group.After 3 days,the proliferation rate of osteoblasts was detected with CCK-8 kit.The mRNA transcription and protein expressions of Runx2 and Osterix were detected with real time fluorescent quantitative PCR and Western blotting,respectively.After 10days,the mineralized nodules were stained with Alizarin red in the control group and 100 ng/mL group.Results The cell proliferation rate was higher in 20 ng/mL,50 ng/mL and 100 ng/mL groups than in the control group (P ＜ 0.05),in a concentration-dependent manner.The levels of mRNA transcription and protein expressions of Runx2 and Osterix in 50 ng/mL group and 100 ng/mL group were higher than those in the control group (P ＜0.05).The positive staining area of mineralized nodules in 100 ng/mL group was larger than that in the control group.Conclusion Interleukin-17F can promote the osteogenesis of rat osteoblasts in vitro.

免疫豁免区是指机体某些特定部位在解剖上与免疫细胞隔绝或在局部微环境中存在抑制免疫应答的机制,从而一般不对外来抗原(包括移植物抗原)产生应答. 中枢神经系统与循环系统间存在血脑屏障,正常情况下免疫细胞不能自由进出中枢神经系统,移植物在此较易存活,因此中枢神经系统被认为是"免疫豁免区".

Objective To observe the levels of serum insulin and osteocalcin,osteoblast specific transcription factor Runx2 and Osterix (OSX)gene in type 1 diabetic rats,and the intervention effect of zoledronic acid.Methods A total of 170 Wistar rats were randomly divided into two groups:40 rats were enrolled into the control group the other animals were injected with streptozotocin (60 mg/kg)to establish type 1 diabetic models.After that,120 rats in this group were randomly divided into the model group (n=40),prevention group (n=40)and treatment group (n=40). Rats in the prevention group and treatment group received a bolus injection of zoledronic acid (0.1 mg/kg)at the onset of diabetes and 2 weeks later,respectively.The serum INS and OC were detected with ELISA.Expressions of Runx2 and OSX mRNA in the right femur were detected with RT-PCR.Results ELISA results showed that the serum INS in the model group,prevention group and treatment group was significantly reduced compared with that in the control group (P<0.05).The serum OC was lower in the model group that in the control group (P<0.05),while higher in the prevention group than in the control group and model group (P<0.05).At week 12,serum OC was higher in the treatment group than in the prevention group (P<0.05).RT-PCR tests showed that the expressions of Runx2 and&nbsp;OSX mRNA were significantly lower in the model group than in the control group (P<0.05),while remarkably higher in the prevention group and treatment group than in the control group and model group (P<0.05 ).The upregulation was higher in the prevention group than in the model group.Conclusion Expressions of Runx2 and OSX mRNA were significantly decreased in the bone of type 1 diabetic rat models. Prophylactic use of zoledronic acid can improve the levels of serum OC,and reverse the decreasing expression of Runx2 and OSX mRNA,thus promoting bone formation.

Objective To investigate the alterations of femoral biomechanics in streptozotocin (STZ) induced type 1 diabetic rats and the influnces of zoledronic acid (ZA).Methods The Type 1 diabetes mellitus models of rats were established by intraperitoneal injection of STZ .All 205 female Wistar rats were randomly assigned into the control group (n=40), the model group (n=55), the ZA prevention group ( n=55 ) and the ZA treatment group ( n=55 ) .ZA 0.1 mg/kg was given to the ZA prevention group immediately after the model establishment and to the ZA treatment group two weeks later .In each group, five rats were harvested randomly for performing the three-point bending test at the 1st, 2nd, 3rd, 4th, 5th, 8th, 12th and 16th weeks after the modeling.The structural mechanical indices (the maximum load and the elastic load) and the material mechanical indices (the elastic modulus and the energy absorption ) were obtained .Results The results showed all the mechanical indices in the control group increased during the 16 weeks.However, in the model group, the elastic modulus and energy absorption indices increased in the early five weeks , but decreased at the 8th week and the 12th week, then increased again to the highest level .The same trend was observed in the model group concerning the maximum load and the elastic load, while the differences were not statistically significant .The intergroup analysis showed that from the 1st week to the 5th week, there was no statistical difference among the groups .In the 8th week and the 12th week, the mechanics indices in the model group , the prevention group and the treatment group were all significantly lower than those in the control group (P<0.05);in the 16th week the indices varied. Conclusions The material mechanics of femur present greater changes than the structural mechanics . Zoledronic Acid could promote the biomechanical property , which was better in the prevention group than the treatment goup .

目的：：探讨持续质量改进对2型糖尿病患者饮食治疗依从性的影响,为其临床应用提供可参考依据。方法：将2012年12月~2013年6月收治的40例2型糖尿病患者作为改进前组,2013年7月~2013年12月收治的40例2型糖尿病患者作为改进后组,改进前组给予常规糖尿病知识教育及饮食管理普及,改进后组给予持续质量改进形成的管理方法；比较两组饮食治疗依从性。结果：改进后组依从性评分明显高于改进前组,且高依从性比例亦明显高于改进前组( P<0.05)；改进后组血糖、糖化血红蛋白及体质量指数均明显低于改进前组(P<0.05)；改进后组满意率明显升高,且满意度评分亦明显高于改进前组(P<0.05)。结论：持续质量改进的管理方法有利于提高2型糖尿病患者饮食治疗依从性,值得推广。

BACKGROUND:Osteoporosis caused by diabetes melitus as common secondary osteoporosis has been paid more and more attention recently. Zoledronic acid serves as a novel drug for osteoporosis, and its effect on osteoblasts in vivo remains unclear. OBJECTIVE:To investigate the changes of the expression of bone morphogenetic protein 2 andNoggin in the femur of type 1 diabetes melitus rats and the effect of zoledronic acid on them. METHODS:Models of type 1 diabetes melitus were established by intraperitoneal injection of streptozotocin in 130 Wistar rats. 3 days later, rats with blood sugar > 16.7 mmol/L for three consecutive times were considered as successful models, 120 in total. These models were randomly divided into model, prevention and treatment groups. Rats in the prevention and treatment groups were intravenously administered zoledronic acid (0.1 mg/kg) on the day of modeling and 2 weeks after model establishment. An additional 40 rats were injected with citrate buffer solution as control group. RESULTS AND CONCLUSION: Compared with the control group, femur bone mineral density, serum alkaline phosphatase levels, and femur bone morphogenetic protein 2 mRNA expression levels were significantly lower in the model group (P < 0.05), butNoggin mRNA expression significantly increased (P < 0.05). Compared with the model group, bone mineral density and bone morphogenetic protein 2 mRNA expression levels were significantly&nbsp;higher in the prevention and treatment groups (P < 0.05), butNoggin mRNA expression significantly lower (P < 0.05), and serum alkaline phosphatase levels gradualy restored. These results indicated that the bone metabolic disturbance occurs in early stage in rats with type 1 diabetes melitus. Zoledronic acid can promote bone formation, increase bone density, and improve bone metabolism.

Objective To investigate the effects of a pulsed electromagnetic field (PEMF) on cell proliferation,differentiation and the genetic expression of osteogenesis specific transcription factor-Osterix (OSX) in the calvaria-derived osteoblasts of SD rats.Methods Primary osteoblasts were separated from the calvarias of Sprague-Dawley rats 24 hours after birth by trypsinazation and collagenase digestion.The osteoblasts at passage 4 were randomly divided into a control group and a PEMF group,Cells in the PEMF group were placed onto PEMF therapeutic apparatus and exposed to 11 mT radiation at 12 Hz for 1 h per day for 3 days.The osteoblasts' proliferation ability was then detected via methylthiazdyl tetrazolium assay.Alkaline phosphatase (ALP) activity in the cell lysate and the supernatant fluid was assayed through disodium phenyl phosphate colorimetric determination to determine the cells'differentiation ability.OSX mRNA expression was determined using real time reverse transcription polymerase chain reaction (RT-PCR).Results The proliferation of osteoblasts in the PEMF group was significantly greater than in the control group.PEMF exposure suppressed ALP activity in both the lysate and the supernatant of the osteoblasts.The OSX mRNA expression in the PEMF group was significantly down-regulated compared with the control group.Conclusion PEMF at 12 Hz and 11 mT can promote the proliferation of osteoblasts,but it inhibits cellular differentiation and down-regulates the mRNA expression of OSX.

研究表明,肥胖儿童高达25%以上伴有2型糖尿病,2型糖尿病儿童85%以上伴有肥胖或者超重,肥胖已成为2型糖尿病发病的主要诱因,严重危害儿童的身心健康。因此,应当关注肥胖儿童,警惕2型糖尿病早发现、早治疗,从饮食、日常习惯等方面加以适应调控,以确保当代儿童的身体健康成长。

To study the function of apoptosis-blocking proteins Bcl-2 and Bcl-xl in the neuroprotective role of ischemic preconditioning (IPC), cerebral ischemia/Reperfusion rat model was established by using 4-vessel occlusion and repassing, the histopathological changes, the percentage of apoptosis and the expression of Bcl-2 and Bcl-xl proteins of the neurons in CA1 region of rat hippocampus with IPC were examined and detected with Nissls staining, Flow cytometry (FCM) and immunohistochemistry technique. The results showed that forebrain ischemia and reperfusion can cause apoptosis of neurons in CA1 region of hippocampus. IPC protects the neurons against the lethal ischemia/reperfusion injury by decreasing the number of apoptotic neurons, and the expressions of Bcl-2 and Bcl-xl are induced by IPC in early period of reperfusin. The results suggest that blocking the process of neuronal apoptosis after ischemic reperfusion may play an important role in the mechanism of neuroprotection induced by IPC.