Epidemiology of work-related hand and wrist injuries in a referral center: A descriptive study

BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the rate declined to less than 5%in 2020 and 2021,at least one in four accidents involved a hand or wrist injury.AIM To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.METHODS An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital,between June,2020 and May,2021.The overall frequency of OHWIs,as well as their distribution by sociodemo-graphic,clinical,and occupational variables,are described.Furthermore,association patterns between sex,anatomical area(fingers,hand,wrist),and type of job were analyzed by correspondence analysis(CA).RESULTS There were 2.101 workers treated for occupational accidents,423(20.3%)were cases of OHWIs,which mainly affected men(93.9%)with a median age of 31 years and who worked mainly in mining(75.9%).OHWIs were more common in the right upper extremity(55.3%)and comprised different types of injuries,such as contusion(42.1%),laceration(27.9%),fracture(18.7%),and crush injury(15.6%).They primarily affected the phalanges(95.2%),especially those of the first finger(25.7%).The CAs showed associations between the injured anatomical area and the worker’s job that differed in men and women(explained variance>90%).CONCLUSION One out of five workers who suffered occupational accidents in Cundinamarca,Columbia had an OHWI,affecting mainly males employed in mining.This occupational profile is likely to lead to prolonged rehabilitation,and permanent functional limitations.Our results might be useful for adjusting preventive measures in cluster risk groups.

Epidemiology of isolated hand injuries in the United Arab Emirates

AIM To provide suggestions for hand injury prevention by study the demography and risk factors of casualties suffering from isolated hand injuries.METHODS All trauma patients with isolated hand injuries who were admitted to Al Ain Hospital for more than 24 h during a period of 3 years were studied. Patient demographics,location, mechanism/time of injury, and length of hospital stay were all analyzed.RESULTS Two hundred and ten patients were studied. Their mean age was 29.7 years. Males constituted 92%. Sixty-five point one percent of all cases were from the Indian subcontinent. The workplace was the most common location of injury(67.1%), followed by the home(17.1%)and road(6.2%). Machinery caused 36.2% of all injuries,followed by heavy object(20.5%) and fall(11%). Cases injured at home were young(P < 0.0001) with an associated higher incidence of females(P < 0.0001).CONCLUSION Male workers in Al Ain city are at greater risk of sustaining hand injuries, predominantly from machinery. Safety education, personal protection, and the enforcement of safety standards are essential to the prevention and avoidance of hand injury.

Relationship between plasma D(-)-lactate and intestinal damage after severe injuries in rats

AIM To explore the kinetic changes in plasma D(-)- lactate and lipopolyssccharide(LPS)levels,and investigate whether D(-)-lactate could be used as a marker of intestinal injury in rats following gut ischemia/ reperfusion,burn,and acute necrotizing pancreatitis (ANP). METHODS Three models were developed in rats:① gut ischemia/ reperfusion obtained by one hour of superior mesenteric artery occlusion followed by reperfusion;② severe burn injury created by 30% of total body surface area(TBSA)full-thickness scald burn;and ③ ANP induced by continuous inverse infusion of sodium taurocholate and trypsin into main pancreatic duct. Plasma levels of D(-)-lactate in systemic circulation and LPS in portal circulation were measured by enzymatic- spectrophotometric method and limulus amebocyte lysate (LAL)test kit,respectively.Tissue samples of intestine were taken for histological analysis. RESULTS One hour gut ischemia followed by reperfusion injuries resulted in a significant elevation in plasma D(-)- lactate and LPS levels,and there was a significant correlation between the plasma D(-)-lactate and LPS(r =0.719,P<0.05).The plasma concentrations of D(-)- lactate and LPS increased significantly at 6h postburn, and there was also a remarkable correlation between them (r = 0.877,P < 0.01).D(-)-lactate and LPS levels elevated significantly at 2h after ANP,with a similar significant correlation between the two levels(r = 0.798, P < 0.01 ).The desquamation of intestine villi and infiltration of inflammatory cells in the lamina propria were observed in all groups. CONCLUSION The changes of plasma D(-)-lactate levels in systemic blood paralleled with LPS levels in the portal vein blood.The measurement of plasma D(-)-lactate level may be a useful marker to assess the intestinal injury and to monitor an increase of intestinal permeability and endotoxemia following severe injuries in early stage.

Long noncoding RNAs HAND2-AS1 ultrasound microbubbles suppress hepatocellular carcinoma progression by regulating the miR-873-5p/tissue inhibitor of matrix metalloproteinase-2 axis

BACKGROUND Increasing data indicated that long noncoding RNAs(lncRNAs)were directly or indirectly involved in the occurrence and development of tumors,including hepatocellular carcinoma(HCC).Recent studies had found that the expression of lncRNA HAND2-AS1 was downregulated in HCC tissues,but its role in HCC progression is unclear.Ultrasound targeted microbubble destruction mediated gene transfection is a new method to overexpress genes.AIM To study the role of ultrasound microbubbles(UTMBs)mediated HAND2-AS1 in the progression of HCC,in order to provide a new reference for the treatment of HCC.METHODS In vitro,we transfected HAND2-AS1 siRNA into HepG2 cells by UTMBs,and detected cell proliferation,apoptosis,invasion and epithelial-mesenchymal transition(EMT)by cell counting kit-8 assay,flow cytometry,Transwell invasion assay and Western blotting,respectively.In addition,we transfected miR-837-5p mimic into UTMBs treated cells and observed the changes of cell behavior.Next,the UTMBs treated HepG2 cells were transfected together with miR-837-5p mimic and tissue inhibitor of matrix metalloproteinase-2(TIMP2)overexpression vector,and we detected cell proliferation,apoptosis,invasion and EMT.In vivo,we established a mouse model of subcutaneous transplantation of HepG2 cells and observed the effect of HAND2-AS1 silencing on tumor formation ability.RESULTS We found that UTMBs carrying HAND2-AS1 restricted cell proliferation,invasion,and EMT,encouraged apoptosis,and HAND2-AS1 silencing eliminated the effect of UTMBs.Additionally,miR-873-5p targets the gene HAND2-AS1,which also targets the 3’UTR of TIMP2.And miR-873-5p mimic counteracted the impact of HAND2-AS1.Further,miR-873-5p mimic solely or in combination with pcDNA-TIMP2 had been transformed into HepG2 cells exposed to UTMBs.We discovered that TIMP2 reversed the effect of miR-873-5p mimic caused by the blocked signalling cascade for matrix metalloproteinase(MMP)2/MMP9.In vivo results showed that HAND2-AS1 silencing significantly inhibited tumor formation in mice.CONCLUSION LncRNA HAND2-AS1 promotes TIMP2 expression by targeting miR-873-5p to inhibit HepG2 cell growth and delay HCC progression.

Epidemiology and Sequelae of Workplace Hand Injuries at a Tertiary Trauma Care Centre

Aims & Objectives: To study the epidemiology of workplace hand injuries, to understand relation between mode of injury and prognosis, to investigate into the possible contributing factors and to study the Socio-economic impact. Design of Study: For the prospective study there were 2 sources of data: 1) Proforma which was filled by the hand surgeon and 2) A questionnaire that was filled up by safety officer. For the retrospective study case, sheets were retrieved from the Medical Records section and a telephonic or personal interview was carried out by a single interviewer. Setting: Department of Plastic and Reconstructive Surgery, Parvathy Hospital, Chennai, India. Patients: A total of 419 industrial injury patients treated from January 2008 to January 2013 were included in the study. Further follow-up regarding return to work and residual disability continues. Main Outcome Measures: Personal details (Age, Gender, Handedness, Work experience, Income). Type of injury, mode of injury, day and time of injury, treatment given, disability and number of working days lost were measured. Results: Those workers who were experienced less than 6 months had more workplace injuries and the commonest contributing factor was co-workers carelessness followed by long working hours and faulty machinery. Maximum injuries occurred on Monday and morning shift. Conclusions: Constant supervision of trainees for 2 years, shorter working hours with regular breaks, regular health checkups for personnel, regular servicing of machines can prevent occurrence of hand injuries. Corrective surgery within 6 hours, systematic and protocol based physiotherapy and rehabilitation can reduce the economic loss and disability arising out of work place injuries.

Abnormal Secondary Growth and Histochemical Localization of Alkaloids in Root System of Aconitum flavum Hand.-Mazz.

[Objective] The purpose of this study was to clarify the structure,growth pattern and histochemical localization of alkaloids in root system of Aconitum flavum Hand.-Mazz.[Method] Paraffin sectioning and histochemistry were employed for performing the analysis in this study.[Result] The root system of Aconitum flavum Hand.-Mazz.consists of taproot,lateral root and adventitious root.The primary structure of root system is normal,but secondary structure shows abnormal.The cambium and the extra cambium of taproot form a ＂U＂-shaped secondary vascular bundle and tertiary bundle in abnormal secondary structure.The sieve tube group is made of little sieve tube group which is differentiated from primary phloem and cambium.Meanwhile,the secondary xylem in tuberous root also appears to be a ＂U＂ shape.Parenchyma cells of secondary phloem occupy most of the tuberous root.The sieve tube group of tuberous root is mainly differentiated from parenchyma cell of secondary phloem.[Conclusion] The difference in abnormal secondary structure of taproot and tuberous root are attributed to their varied cambium compose and activity pattern.Alkaloids are mainly accumulated in parenchyma cell of the inside cortex and between bundle in taproot,while parenchyma of secondary phloem and pith in tuberous root.

Blood-letting punctures at twelve Jing-Well points of the hand can treat cerebral ischemia in a similar manner to mannitol

A rat model of middle cerebral artery permanent occlusion was established using the modified Longa method. Successfully established model animals were treated by blood-letting puncture at twelve Jing-Well points of the hand, and/or by injecting mannitol into the caudal vein twice daily. Brain tissue was collected at 24, 48 and 72 hours after modeling, and blood was collected through the retinal vein before Evans blue was injected, approximately 1 hour prior to harvesting of brain tissue. Results showed that Evans blue leakage into brain tissue and serum nitric oxide synthase activity were significantly increased in model rats. Treatment with blood-letting punctures at twelve Jing-Well points of the hand and/or injection of mannitol into the caudal vein reduced the amount of Evans blue leakage into the brain tissue and serum nitric oxide synthase activity to varying degrees. There was no significant difference between single treatment and combined treatment. Experimental findings indicate that blood-letting punctures at twelve Jing-Well points of the hand can decrease blood-brain barrier permeability and serum nitric oxide synthase activity in rats following middle cerebral artery occlusion, and its effect is similar to that of mannitol injection alone and Jing-Well points plus mannitol injection.

Prevalence and factors of work-related musculoskeletal disorders among hand surgeons

BACKGROUND The nature of tasks required by hand surgeons require both forceful and repetitive maneuvers,thus subjecting these surgeons to the risk of musculoskeletal(MSK)injuries during their years in practice.AIM To assess the prevalence,characteristics and impact of MSK disorders among hand surgeons.METHODS A modified version of the physical discomfort survey was sent to surgeons who were members of the American Society for Surgery of the Hand via e-mail.The collected data were analyzed using descriptive statistics,one-way analysis of variance,and Fisher’s exact test.P values of<0.05 were considered statistically significant.RESULTS Of the 578 respondents,60.4%reported that they had sustained a work-related MSK injury,of which the most common diagnoses were lateral elbow epicondylitis(18.7%),low back pain(17.1%)and carpal tunnel syndrome(15.6%).Among those that reported an injury,73.1%required treatment and 29.2%needed time off work as a direct result of their injury.The number of work-related injuries incurred by a surgeon increased significantly with increasing age(P<0.003),increasing years in practice(P<0.001)and higher case load(P<0.05).CONCLUSION To our knowledge this study is the first of its kind to assess MSK injuries sustained by Hand surgeons with a high incidence.These results should increase awareness on this aspect and fuel future studies directed at preventing these types of work-related injuries,thus minimizing the financial and psychological burden on these surgeons and the healthcare system.

Effects of erigeron breviscapus (Vant.) Hand-Mazz pretreatment on pathology and oxyradical level following spinal cord ischemia-reperfusion injury in rabbits

Objective To investigate the effects of erigeron breviscapus (Vant.) Hand-Mazz (erigeron breviscapus) pretreatment on pathology and oxyradical level in the spinal cord after ischemia-reperfusion (I/R) injury in rabbits. Methods A total of 40 New Zealand white rabbits were randomly divided into three groups: sham-operation group with 10 rabbits treated with only abdominal aorta exposure without occlusion,control group with 15 rabbits that underwent ischemia for 50 minutes and treated with matched saline,and experimental group with 15 rabbits that underwent ischemia for 50 minutes and treated with erigeron breviscapus (9mg/kg) injection before ischemia. Malondialdehyde (MDA) level and superoxide dismutase (SOD) activity in the spinal cord were examined at 6 and 24 hours after I/R,respectively. The morphological changes and the number of the spinal cord anterior horn motor neurons were observed and counted under the light microscope and electron microscope,respectively. Results The level of MDA was markedly decreased and SOD activity was increased in the experimental group compared with those in the control group (P<0.01). Compared with that in the control group,the number of motor neurons in the experimental group significantly increased at 24h after I/R (P<0.01) and the morphous of the motor neurons improved. Conclusion Erigeron breviscapus can reduce oxyradical production and the apoptosis of nerve cells,and protect nerve tissue structure and function after spinal cord I/R.

Long non-coding RNA H19 regulates neurogenesis of induced neural stem cells in a mouse model of closed head injury

Stem cell-based therapies have been proposed as a potential treatment for neural regeneration following closed head injury.We previously reported that induced neural stem cells exert beneficial effects on neural regeneration via cell replacement.However,the neural regeneration efficiency of induced neural stem cells remains limited.In this study,we explored differentially expressed genes and long non-coding RNAs to clarify the mechanism underlying the neurogenesis of induced neural stem cells.We found that H19 was the most downregulated neurogenesis-associated lnc RNA in induced neural stem cells compared with induced pluripotent stem cells.Additionally,we demonstrated that H19 levels in induced neural stem cells were markedly lower than those in induced pluripotent stem cells and were substantially higher than those in induced neural stem cell-derived neurons.We predicted the target genes of H19 and discovered that H19 directly interacts with mi R-325-3p,which directly interacts with Ctbp2 in induced pluripotent stem cells and induced neural stem cells.Silencing H19 or Ctbp2 impaired induced neural stem cell proliferation,and mi R-325-3p suppression restored the effect of H19 inhibition but not the effect of Ctbp2 inhibition.Furthermore,H19 silencing substantially promoted the neural differentiation of induced neural stem cells and did not induce apoptosis of induced neural stem cells.Notably,silencing H19 in induced neural stem cell grafts markedly accelerated the neurological recovery of closed head injury mice.Our results reveal that H19 regulates the neurogenesis of induced neural stem cells.H19 inhibition may promote the neural differentiation of induced neural stem cells,which is closely associated with neurological recovery following closed head injury.

On the Influence Factors of Second-hand House Prices in First-tier Cities——Empirical Analysis Based on Panel Data

With the arrival of the ＂housing stock＂ in first - tier cities, the second - handhousing^market will become the dominant property market. This ardcle aim to the first - tiercities of second - hand housing prices and new home price index for the empirical analysis, thedata related to the cointegration analysis found that the result of the first -tier cities real estatemarket in China, the new home price index is the significant factors influencing the second -hand house price indexi For Beijing, Shanghai second - hand housing and new home price in-dex time series johans test, found that there exists cointegration relationship between two varia-bles,the new city real estate market prices out of a line on the secondary market have clearguide. Therefore, the real estate market regulation aiming at the first -tier cities and the＂housing stock＂ should take the second - hand housing market as the main direction, startingwith the sale price and influencing factors of new houses. At the same time, in different cities,we should adhere to the city＇ s policies, reflect the policy differentiation, promote the reformof the real estate supply side, and promote the return of housing properties.

The miR-9-5p/CXCL11 pathway is a key target of hydrogen sulfide-mediated inhibition of neuroinflammation in hypoxic ischemic brain injury

We previously showed that hydrogen sulfide(H2S)has a neuroprotective effect in the context of hypoxic ischemic brain injury in neonatal mice.However,the precise mechanism underlying the role of H2S in this situation remains unclear.In this study,we used a neonatal mouse model of hypoxic ischemic brain injury and a lipopolysaccharide-stimulated BV2 cell model and found that treatment with L-cysteine,a H2S precursor,attenuated the cerebral infarction and cerebral atrophy induced by hypoxia and ischemia and increased the expression of miR-9-5p and cystathionineβsynthase(a major H2S synthetase in the brain)in the prefrontal cortex.We also found that an miR-9-5p inhibitor blocked the expression of cystathionineβsynthase in the prefrontal cortex in mice with brain injury caused by hypoxia and ischemia.Furthermore,miR-9-5p overexpression increased cystathionine-β-synthase and H2S expression in the injured prefrontal cortex of mice with hypoxic ischemic brain injury.L-cysteine decreased the expression of CXCL11,an miR-9-5p target gene,in the prefrontal cortex of the mouse model and in lipopolysaccharide-stimulated BV-2 cells and increased the levels of proinflammatory cytokines BNIP3,FSTL1,SOCS2 and SOCS5,while treatment with an miR-9-5p inhibitor reversed these changes.These findings suggest that H2S can reduce neuroinflammation in a neonatal mouse model of hypoxic ischemic brain injury through regulating the miR-9-5p/CXCL11 axis and restoringβ-synthase expression,thereby playing a role in reducing neuroinflammation in hypoxic ischemic brain injury.

FMRI and EEG Reactions to Hand Motor Tasks in Patients with Mild Traumatic Brain Injury: Left-Hemispheric Sensitivity to Trauma

Background: Mild traumatic brain injury (mTBI) is one of the most common forms of cerebral pathology in young people and disorders involve dysfunctions in cognitive and motor spheres. We would like to examine the structural and functional alterations of the brain in patients with mTBI while performing hand movements. Methods: Twenty healthy right-handed subjects (age 25.1 ± 3.9) and 10 patients (age 27.9 ± 7.3) with mTBI without hemiparesis participated in the study using functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). FMRI and EEG reactions were analysed during right- and left-hand movements. Results: It was shown that fMRI reactive changes have a larger inter-individual variability of activation during left-hand movements in comparison with right-hand ones in healthy subjects. The TBI patients demonstrated an increase of a diffuse component of fMRI reactive changes compared to healthy people. A greater number of the brain structures was involved, mainly at the subcortical level, mostly in the left hemisphere during right-hand movement. EEG study demonstrated coherence changes for the slow (delta) frequency bands in the left hemisphere, while performing both hand movements. In healthy persons, EEG coherence changes were observed in the fast (alhpa2) frequency band predominantly in contralateral hemispheres, while performing hand movements. Conclusion: So, fMRI and EEG studies revealed the most expressed pathological reactive changes in the left hemisphere and the brain cortical structures during right-hand movements in patients after mTBI. These data allowed us to propose that the younger brain structures were the most sensitive to mTBI.

Preliminary study on the protective effect of electroacupuncture Neiguan acupoint pretreatment on rats with myocardial ischemia-reperfusion injury:role of the miR-214-3p/NCX1 axis

Background:Ischemia-reperfusion can worsen myocardial damage and increase the risk of death.Studies have revealed that ischemic preconditioning provides the best endogenous protection against myocardial ischemia-reperfusion injury(MIRI),and the principle of electroacupuncture(EA)preconditioning is comparable to that of myocardial ischemic preconditioning adaption.Our earlier research demonstrated that EA pretreatment inhibits the expression of calmodulin-dependent protein kinase IIδ(CaMKIIδ),sodium/calcium exchanger 1(NCX1),and cyclophilin D,hence providing protection against MIRI.However,the exact mechanism is still unknown.The expression of NCX1 mRNA is directly regulated by microRNA-214(miR-214).Moreover,it suppresses the levels of CaMKIIδand cyclophilin D.Whether these variables contribute to EA preconditioning to improve MIRI needs to be investigated,though.This study aimed to preliminarily determine whether EA pretreatment ameliorates MIRI by modulating the miR-214-3p/NCX1 axis.Methods:We used a rat MIRI model to investigate the effect of EA pretreatment on MIRI and the expression of miR-214-3p.In addition,adenovirus injection inhibited miR-214-3p expression in the rat MIRI model,and the influence of EA pretreatment towards MIRI was observed in the context of blocked miR-214-3p expression.Both the myocardial histological abnormalities and the alterations in the ST segment of the rat electrocardiogram were analyzed.NCX1 mRNA,cyclophilin D,and CaMKIIδexpression levels were also analyzed.Results:EA pretreatment improved MIRI.In rats with MIRI,EA administration increased miR-214-3p expression while decreasing NCX1 mRNA,cyclophilin D,and CaMKIIδproteins in cardiac tissues.The beneficial effect of EA pretreatment against MIRI was reversed,coupled with elevated levels of NCX1 mRNA,cyclophilin D,and CaMKIIδprotein expression,when an adenovirus injection disrupted the expression of miR-214-3p.Conclusions:Our findings preliminarily show that EA pretreatment inhibits the expression of NCX1 mRNA,cyclophilin D,and CaMKIIδproteins via miR-214-3p,hence exerting MIRI protection.

Exosomes derived from microglia overexpressing miR-124-3p alleviate neuronal endoplasmic reticulum stress damage after repetitive mild traumatic brain injury

We previously reported that miR-124-3p is markedly upregulated in microglia-derived exosomes following repetitive mild traumatic brain injury.However,its impact on neuronal endoplasmic reticulum stress following repetitive mild traumatic brain injury remains unclear.In this study,we first used an HT22 scratch injury model to mimic traumatic brain injury,then co-cultured the HT22 cells with BV2 microglia expressing high levels of miR-124-3p.We found that exosomes containing high levels of miR-124-3p attenuated apoptosis and endoplasmic reticulum stress.Furthermore,luciferase reporter assay analysis confirmed that miR-124-3p bound specifically to the endoplasmic reticulum stress-related protein IRE1α,while an IRE1αfunctional salvage experiment confirmed that miR-124-3p targeted IRE1αand reduced its expression,thereby inhibiting endoplasmic reticulum stress in injured neurons.Finally,we delivered microglia-derived exosomes containing miR-124-3p intranasally to a mouse model of repetitive mild traumatic brain injury and found that endoplasmic reticulum stress and apoptosis levels in hippocampal neurons were significantly reduced.These findings suggest that,after repetitive mild traumatic brain injury,miR-124-3 can be transferred from microglia-derived exosomes to injured neurons,where it exerts a neuroprotective effect by inhibiting endoplasmic reticulum stress.Therefore,microglia-derived exosomes containing miR-124-3p may represent a novel therapeutic strategy for repetitive mild traumatic brain injury.

环孢素引起肾小管上皮细胞培养液中肾损伤分子-1水平升高的机制

目的:探讨环孢素(CsA)引起人肾小管上皮细胞(HKC)培养液中肾损伤分子-1(KIM-1)水平升高的作用机制,阐明KIM-1表达与p38 MAPK通路和EKR1/2 MAPK通路的关系。方法:将处于对数生长期的HKC分为空白组、CsA损伤组、CsA与p38激酶抑制剂合用组、p38激酶抑制剂组、CsA与ERK1/2激酶抑制剂合用组和ERK1/2激酶抑制剂组。MTT法检测各组HKC增殖抑制率,ELISA法测定各组HKC上清液中KIM-1水平,流式细胞术检测各组细胞存活率、细胞凋亡率和细胞坏死率。结果:与空白组比较,CsA损伤组细胞上清液中KIM-1水平显著升高(P<0.05),细胞存活率显著降低(P<0.05),细胞凋亡率和细胞坏死率显著升高(P<0.05);p38激酶抑制剂组和ERK1/2激酶抑制剂组中细胞存活率、细胞凋亡率和细胞坏死率比较差异无统计学意义(P>0.05)。与CsA损伤组比较,CsA与p38激酶抑制剂合用组、CsA与ERK1/2激酶抑制剂合用组细胞上清液中KIM-1水平显著降低(P<0.05),细胞存活率显著升高(P<0.05),细胞凋亡率和细胞坏死率显著降低(P<0.05)。结论:p38 MAPK通路和ERK1/2 MAPK通路参与CsA素引起肾小管上皮细胞培养液中KIM-1水平升高的过程,KIM-1的表达可能成为临床监测CsA肾毒性的生化指标。

CK-MB及cTnI对手足口病患儿心肌损伤的诊断价值研究

目的探讨血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)对手足口病(HFMD)患儿心肌损伤的诊断价值。方法选择2012年7月至2013年6月住院治疗的HFMD患儿80例(HFMD组),同期体检健康儿童50例(对照组)。比较两组血清CK-MB、cTnI水平。结果 HFMD组治疗前CK-MB、cTnI水平分别为(38.10±19.50)U/L、(0.08±0.02)μg/L,均高于对照组(P<0.05)。HFMD患儿治疗前CK-MB、cTnI阳性率分别为56.3%、33.8%,阳性率比较差异有统计学意义(P<0.05)。经治疗后,HFMD患儿CK-MB、cTnI水平均明显下降(P<0.05)。结论联合检测血清CK-MB、cTnI对HFMD合并心肌损伤的早期诊断具有重要临床意义。

血清S-100B、神经烯醇化酶在重型手足口病患儿颅脑损伤中的检测意义

目的:探讨血清S-100B、神经烯醇化酶(NSE)在重型手足口病(HFMD)患儿颅脑损伤中检测的临床价值。方法:用酶联免疫测定法检测S-100B、NSE的水平含量。选取本院2012年6-12月住院部重型HFMD患儿58例(重型HFMD组),其中重型40例,危重型18例(含3例死亡病例);同期住院轻型HFMD患儿39例为轻型HFMD组,另取同期门诊健康体检儿童30例作为正常对照组。分析两者与重型HFMD患儿颅脑损伤严重程度及预后的关系。结果:(1)重型HFMD组患儿血清S-100B、NSE水平明显高于轻型HFMD组及正常对照组,差异均有统计学意义(P<0.01);(2)轻型HFMD组患儿与正常对照组血清S-100B、NSE水平比较差异无统计学意义(P>0.05);(3)危重型与重型HFMD患儿血清S-100B、NSE水平比较差异有统计学意义(P<0.05);(4)重型HFMD患儿治疗前后血清S-100B、NSE水平比较差异有统计学意义(P<0.05)。结论 :血清S-100B、NSE在重型HFMD中可反映颅脑损伤严重程度,可作为重型HFMD患儿颅脑损伤早期诊断及预后评估的重要指标。

碳化硅-碳复合材料用于小关节假体:生物力学研究及三维有限元分析

背景:碳化硅-碳复合材料应用广泛,但其在医学假体材料领域无相关实验研究,效果尚不明确。目的:探究新型碳化硅-碳复合材料的力学性能,采用三维有限元分析法模拟小关节的受力情况,论证其作为人工小关节假体替代材料的可行性。方法:将规定尺寸的碳化硅-碳复合材料与传统碳/碳复合材料放置于电子万能试验机中,测定并计算材料的压缩弹性模量、抗压缩强度、最大抗压缩力、弯曲弹性模量、抗弯强度及最大抗弯力,随后测定并计算材料的摩擦系数、磨损体积和质量磨损率。应用三维有限元分析法,将第三掌骨有限元模型分别定义碳/碳复合材料及碳化硅-碳复合材料单元类型后,给予轴向200 N的作用力,分析其总位移及节点应力情况。结果与结论:碳化硅-碳复合材料的压缩弹性模量、抗压缩强度、最大抗压缩力、弯曲弹性模量、抗弯强度及最大抗弯力高于碳/碳复合材料(P<0.05),摩擦系数、磨损体积和质量磨损率、最大节点应力及最大总位移低于碳/碳复合材料(P<0.05)。结果说明,碳化硅-碳复合材料具有良好的力学性能、抗磨损性能,抗压缩形变及抗应力作用。

血清肺表面活性蛋白A联合血清内皮素-1对儿童手足口病合并肺损伤的早期诊断价值

目的探讨血清肺表面活性蛋白A(SP-A)联合血清内皮素-1 (ET-1)在儿童手足口病合并肺损伤早期诊断中的临床应用价值。方法选择2017年5月至2018年3月我院收治的98例手足口病合并肺损伤患儿作为观察组,另选取同期来我院进行检查的100例正常儿童作为对照组,采用ELISA法测定两组血清SP-A和ET-1水平。结果观察组血清SP-A和ET-1水平均显著高于对照组,差异具有统计学意义(P <0. 05); SP-A用于诊断手足口病合并肺损伤的灵敏度和特异性显著高于ET-1,差异具有统计学意义(P<0.05),取SP-A=72.00mg/L为阈值,其灵敏度和特异性达到最高,分别为85.7%和87.0%;SP-A与ET-1联合检测诊断手足口病合并肺损伤的灵敏度显著高于SP-A检测诊断,差异具有统计学意义(P<0.05)。结论SP-A诊断手足口病合并肺损伤具有较高的灵敏度和特异性,而SP-A与ET-1联合检测灵敏度高于单项检测,二者联合检测提高了手足口病合并肺损伤诊断率,具有良好的早期诊断价值,值得在临床进一步应用。