新生儿凝血指标及部分生化指标检测参考区间调查

目的:调查分析新生儿凝血指标及部分生化指标检测参考区间。方法:以十所三甲医院2012年1月~2014年6月收治的新生儿2683例为研究对象,其中足月儿1700例,早产儿983例,选择同期十所医院职工健康体检1000例为对照组,通过全自动血凝仪、全自动生化分析仪测定所有对象凝血指标及12项生化指标,并建立相关指标参考区间。结果:足月新生儿PT、TT、APTT凝血指标较对照组延长,Fib较对照组降低,差异均有统计学意义(P=0.000);早产儿PT、TT、APTT较足月儿延长(P=0.000),Fib(P=0.001)降低;足月新生儿Glc水平较对照组低(P=0.000),早产儿Glc水平较足月新生儿更低(P=0.000);足月新生儿血钙水平低于对照组,血清TC、Cr、BUN、ALT含量均在对照组之下(P=0.000),早产儿相对更低(P均0.05);足月新生儿LDH、CK酶活性及K+水平均高于对照组(P均0.05),早产儿水平更高(P0.05);足月儿血清Alb、TP及Na+水平低于对照组(P0.05),早产儿更低(P均0.05)。结论:新生儿凝血表达与成人不同,凝血及部分生化指标参考区间的变化与年龄有联系,有必要为新生儿建立与年龄相关的凝血、生化指标参考区间。     

Prescribed moorland burning meets good practice guidelines: A monitoring case study using aerial photography in the Peak District,UK

Upland moors in the UK have been managed for centuries using rotational prescribed-burning, but in recent years there has been contentious debate over its continuing use due to varying effects on moorland ecosystem services. Prescribed-burning should only be carried out using good-practice codes, which include restrictions on the size, location and frequency of burns. Good burning practice is an indicator of management standards and habitat condition in moorland landscapes. However, there has been little attempt to assess management performance with respect to these restrictions. We investigated prescribed-burning on a case-study estate (Howden Moor) in the Peak District National Park from 1988 to 2009 using management maps and aerial photography. The annual area burned (0.9%) was far below recommendations (10%) and patches were in keeping with the target sizes specified (mean ± se: 2370 ± 70 m²). The risk of a large or escaped fire was very low, with less than 1% of fires greater than 15,000 m². However, only 28.9% of the total burnable area was burned, leaving the rest unmanaged and accumulating fuel. Future guidelines might recommend the application of prescribed-burning across the range of Calluna vulgaris growth phases, to reduce fuel load and promote biodiversity at the landscape scale. We show that vegetation mapping and aerial photography are an effective method for monitoring prescribed-burning practice on moorlands. The information derived from such monitoring studies should lead to greater confidence in the standard of prescribed-burning and adherence to good-practice guidelines and requirements imposed by statutory authorities.     

Developmental emergence of fear/threat learning: neurobiology,associations and timing

Pavlovian fear or threat conditioning, where a neutral stimulus takes on aversive properties through pairing with an aversive stimulus, has been an important tool for exploring the neurobiology of learning. In the past decades, this neurobehavioral approach has been expanded to include the developing infant. Indeed, protracted postnatal brain development permits the exploration of how incorporating the amygdala, prefrontal cortex and hippocampus into this learning system impacts the acquisition and expression of aversive conditioning. Here, we review the developmental trajectory of these key brain areas involved in aversive conditioning and relate it to pups' transition to independence through weaning. Overall, the data suggests that adult‐like features of threat learning emerge as the relevant brain areas become incorporated into this learning. Specifically, the developmental emergence of the amygdala permits cue learning and the emergence of the hippocampus permits context learning. We also describe unique features of learning in early life that block threat learning and enhance interaction with the mother or exploration of the environment. Finally, we describe the development of a sense of time within this learning and its involvement in creating associations. Together these data suggest that the development of threat learning is a useful tool for dissecting adult‐like functioning of brain circuits, as well as providing unique insights into ecologically relevant developmental changes.     

湖北地区健康成人网织红细胞相关参数参考区间的建立

目的:建立湖北地区健康成人网织红细胞相关参数的参考区间,以便更准确为临床提供服务。方法:选取我院体检中心751例健康体检者进行空腹静脉采血,采用迈瑞BC-6800血液分析仪进行网织红细胞相关参数检测,建立网织红细胞百分比(RET%)、网织红细胞绝对值(RET#)、低荧光网织红细胞百分比(LFR%)、中荧光网织红细胞百分比(MFR%)、高荧光网织红细胞百分比(HFR%)和幼稚网织红细胞百分比(IFR%)的参考区间。结果:RET%、RET#、LFR%、MFR%、HFR%和IFR%均呈非正态分布,建立的参考区间分别为:RET%:0.54～1.80;RET#:男0.029～0.098、女0.024～0.093;LFR%:男89.9～98.7、女92.4～98.8;MFR%:男1.3～9.6、女1.2～7.3;HFR%:男0～0.5、女0～0.1;IFR%:男1.3～10.3、女1.2～7.4。健康成人男性LFR%、MFR%、IFR%结果存在年龄组间显著性差异,女性未发现年龄组间存在差异性。结论:湖北地区健康成人网织红细胞6项相关参数的参考区间存在地区特异性、性别差异性以及年龄差异性。不同地区实验室应根据当地调查情况,适当的调整网织红细胞相关参数的参考区间,以便更准确的为临床提供判断标准。     

QRS、QT、QTc及LVEF预测心源性猝死的价值分析

摘要 目的：探讨QRS时限值（QRS）、QT间期延长（QT）、QTc间期（QTc）及左室射血分数（LVEF）预测心源性猝死的价值分析。方法：选择2018年1月至2019年12月川北医学院附属医院心血管内科治疗的356例心源性猝死患者进行研究,设为病例组,并选择同期体检的健康人200例作为对照组,分析QRS、QT、QTc及LVEF水平变化情况及其预测价值。结果：病例组QRS、QTc水平显著高于对照组,QT、LVEF水平显著低于对照组,差异显著（P＜0.05）;轻度QRS、QTc显著低于中度、重度患者,QT、LVEF水平显著高于中度、重度患者;中度患者QRS、QTc显著低于重度患者,QT、LVEF水平显著高于重度患者,差异显著（P＜0.05）;ROC结果显示,QRS预测心源性猝死的AUC为0.989,灵敏度△为84.59%,特异度为87.68%,截断值为115.59ms;QT预测心源性猝死的AUC为0.944,灵敏度85.12%,特异度为88.45%,截断值为21.69ms;QTc预测心源性猝死的AUC为0.984,灵敏度为86.05%,特异度为88.61%,截断值为416.39ms,LVEF预测心源性猝死的AUC为0.997,灵敏度87.15%,特异度为89.05%,截断值为45.63%,（P＜0.05）。结论：QRS、QT、QTc及LVEF在心源性猝死患者中检查,可显著提高心源性猝死临床诊断效能。     

不同运动方式对2型糖尿病大鼠骨骼肌Rab5蛋白及糖代谢的影响*

目的: 探讨持续运动和间歇负重运动对2型糖尿病(T2DM)骨骼肌组织细胞形态、骨骼肌Rab5 mRNA及蛋白表达、骨骼肌糖代谢的影响。方法: SD大鼠选取8只为空白对照组(CR),其他采用高脂高糖饲料喂养6周后,腹腔注射STZ(35 mg/kg)构建T2DM模型。选取24只T2DM分3组(n=8),分别为:T2DM模型组(DRM)、持续运动组(DCRE)、间歇负重运动组(DWRE)。持续运动方案:为前1～2 周准备活动15 m/min(10 min)、运动20 m/min(40 min)、整理活动15 m/min(10 min),后3～8周为 18 m/min(10 min)、25 m/min(40 min)、15 m/min(10 min);间歇负重运动方案:采用负荷重量为15%(1～2周)、30%(3～4周)、45%(5～8周),运动均为15 m/min(5 min),共12组,组间休息3 min。8周后,通过HE观察骨骼肌病理形态变化,qRT-PCR检测骨骼肌Rab5、葡萄糖转运酶4(GLUT4)的mRNA表达,免疫荧光组化技术及Western blot检测骨骼肌Rab5的蛋白表达,ELISA检测血浆Rab5和糖化血红蛋白(GHb)浓度。结果: 相比CR,DRM存在骨骼肌病理损伤,骨骼肌Rab5mRNA及蛋白表达、GLUT4 mRNA表达均降低(P＜0.01),血浆Rab5和GHb均显著升高(P＜0.01);与DRM比较, DCRE、DWRE骨骼肌病理损伤均显著减轻,骨骼肌Rab5 mRNA及蛋白表达、GLUT4 mRNA表达均升高(P＜0.05,P＜0.01),血浆Rab5和GHb降低(P＜0.01);DCRE与DWRE组间均无统计学差异(P＞0.05)。结论: 2种运动方式均能改善2型糖尿病大鼠骨骼肌病理损伤,并可通过提高骨骼肌Rab5基因和蛋白表达从而增强 GLUT4转运能力,缓解骨骼肌糖代谢稳态失衡,但2种运动方式对骨骼肌Rab5蛋白和糖代谢的影响无明显差异性。     

On small-sample confidence intervals for parameters in discrete distributions

The traditional definition of a confidence interval requires the coverage probability at any value of the parameter to be at least the nominal confidence level. In constructing such intervals for parameters in discrete distributions, less conservative behavior results from inverting a single two-sided test than inverting two separate one-sided tests of half the nominal level each. We illustrate for a variety of discrete problems, including interval estimation of a binomial parameter, the difference and the ratio of two binomial parameters for independent samples, and the odds ratio.     

受损背根节神经元自发放电节律的整数倍模式及其动力学变化

本文记录了大鼠损伤背根节神经元的自发放电活动。采用背根节慢性压迫动物模型,记录慢性压迫手术后３－１０ｄ背根节的自发放电。在记录的１５６根纤维中,观察到１７根（占１１Ａ％）出现的动作电位峰峰间期以某一基础间期的整数倍模式出现的整数倍时间节律形式,其回归映射图为晶格状点阵结构,并且该时间形式受细胞膜上钠,钾通道的调控。