Hansson针治疗32例股骨颈骨折的临床报告

目的：应用Ｈａｎｓｏｎ针内固定手术治疗股骨颈骨折３２例。方法：股骨颈骨折后以Ｈａｎｓｏｎ针作双针内固定，两根针和两个方向不同的钩构成了三维立体固定，使骨折有持续的对合和生理性加压，１周内可完全负重活动。结果：随访２年以上患者２１例，均骨性愈合，未发现术后股骨头缺血性环死病例。结论：Ｈａｎｓｏｎ针固定牢靠，术后患者可早期下床，令骨折在功能活动中愈合，减少了长期卧床所带来的并发症。     

滑膜切除与低位双头螺纹钉内固定治疗股骨颈骨折

采用滑膜切除与低位双头加压螺纹钉内固定治疗股骨颈囊内型骨折30例。年龄14～67岁，平均47岁。均为GardenⅢ或Ⅳ型骨折．平均随访3年五个月。以患者自觉症状、髋关节活动度及X线照片情况对术后患者恢复情况进行综合评定。随访结果：29例骨折愈合，骨折愈合率96．7％，骨折愈合平均时间为6个月。股骨头缺血性坏死率6．7％。疗效优者17例，良10例，一般1例，差2例，优良率达90．0％．所有病例未发生退钉、断钉者．滑膜切除与低位双头加压螺纹钉内固定治疗股骨颈骨折，手术简单，创伤小，能够促进骨折愈合，减少股骨头缺血坏死率．通过力学测试及临床应用显示，自制加压螺纹钉设计合理，固定可靠，操作简单，对骨质损伤小。     

远端脾腔静脉分流术对肝硬变门静脉高压症大鼠胃粘膜的影响

观察了肝硬变门静脉高压症大鼠在行远端脾腔静脉分流术（ＤＳＣＳ）后胃粘膜的功能改变。结果显示门静脉高压症时胃窦及底部粘膜血流量（ＧＭＢＦ）、糖蛋白（ＧＰ）及ＰＧＥ２、ＰＧＩ２含量等均显著下降，ＤＳＣＳ术后胃底部粘膜的上述指标均逐渐升高，术后５周时明显高于术前；而胃窦部上述指标在术后初期显著下降，尔后逐渐升高至术前水平，以上结果表明：门静脉高压症时胃粘膜防御能力被削弱，导致粘膜病变的发生。ＤＳＣＳ术后选择性改善了胃底部的微循环及功能，对治疗粘膜病变有一定意义。     

断流术对肝硬变门脉高压大鼠胃粘膜影响的研究

通过实验，观察了肝硬变门脉高压大鼠在断流术后胃粘膜结构和功能改变。结果显示门脉高压时窦及底体部胃粘膜血流量（ＧＭＢＦ），糖蛋白（ＧＰ）及ＰＧＥ２，６－酮－ＧＰＦ１α等均明显下降，胃粘膜上皮细胞脱落，粘膜下层水肿，厚度增加，毛细血管腔缩小。断流术后上述指标则进一步降低。胃粘膜上皮呈显著缺血，缺氧表现。以上结果表明，肝硬变门脉高压时胃粘膜防御能力被削弱，导致胃粘膜病变的发生，断流后则进一步损害了胃粘膜     

老年COPD合并胸腰椎骨折PVP术对肺功能的改善研究

目的探讨椎体成形术（PVP）治疗慢性阻塞性肺疾病（COPD）合并胸腰椎骨折患者对肺功能改善情况及分析。方法选择胸腰段脊柱压缩性骨折合并COPD患者48例作为研究对象,手术前后分别测量肺功能并进行分析研究。结果椎体成形术后1周及1个月患者肺功能较术前均显著改善。结论 COPD合并胸腰椎骨折患者经椎体成形术后能有效改善肺通气功能,考虑可能与术后胸廓重建稳定性及疼痛减轻后病人膈肌及肋间肌功能改善有关;而且,我们认为另一个不容忽视的原因是术后病人疼痛减轻,敢于进行咳嗽及排痰,并且呼吸道平滑肌蠕动能力增加,使气道阻力大大降低,从而使肺功能得到一定改善。     

Vascular cell-adhesion molecule-1 plays a central role in the proangiogenic effects of oxidative stress

Oxidative stress exacerbates neovascularization (NV) in many disease processes. In this study we investigated the mechanism of that effect. Mice deficient in superoxide dismutase 1 (Sod1(-/-) mice) have increased oxidative stress and show severe ocular NV that is reduced to baseline by antioxidants. Compared with wild-type mice with ischemic retinopathy, Sod1(-/-) mice with ischemic retinopathy had increased expression of several NF-κB-responsive genes, but expression of vascular cell-adhesion molecule-1 (Vcam1) was particularly high. Intraocular injection of anti-VCAM-1 antibody eliminated the excessive ischemia-induced retinal NV. Elements that contributed to oxidative stress-induced worsening of retinal NV that were abrogated by blockade of VCAM-1 included increases in leukostasis, influx of bone marrow-derived cells, and capillary closure. Compared with ischemia alone, ischemia plus oxidative stress resulted in increased expression of several HIF-1-responsive genes caused in part by VCAM-1-induced worsening of nonperfusion and, hence, ischemia, because anti-VCAM-1 significantly reduced the increased expression of all but one of the genes. These data explain why oxidative stress worsens ischemia-induced retinal NV and may be relevant to other neovascular diseases in which oxidative stress has been implicated. The data also suggest that antagonism of VCAM-1 provides a potential therapy to combat worsening of neovascular diseases by oxidative stress.     

Vascular targeting of ocular neovascularization with a vascular endothelial growth factor121/gelonin chimeric protein

Tumors provide an extremely abnormal microenvironment that stimulates neovascularization from surrounding vessels and causes altered gene expression within vascular cells. Up-regulation of vascular endothelial growth factor (VEGF) receptors has allowed selective destruction of tumor vessels by administration of a chimeric protein consisting of VEGF121 coupled to the toxin gelonin (VEGF/rGel). We sought to determine whether there is sufficient up-regulation of VEGF receptors in endothelial cells participating in ocular neovascularization to permit a similar strategy. After intravenous injection of 45 mg/kg VEGF/rGel, but not uncoupled recombinant gelonin (rGel), there was immunofluorescent staining for rGel within choroidal neovascularization in mice and regression of the neovascularization occurred, demonstrating successful vascular targeting via the systemic circulation. Intraocular injection of 5 ng of VEGF/rGel also caused significant regression of choroidal neovascularization and regression of retinal neovascularization in two models, transgenic mice with expression of VEGF in photoreceptors and mice with ischemic retinopathy, whereas injection of 5 ng of rGel had no effect. These data suggest that the strategy of vascular targeting can be applied to nonmalignant neovascular diseases and could serve as the basis of a new treatment to reduce established ocular neovascularization.     

股静脉留置双腔导管行血液净化治疗临床分析

目的 总结血液净化治疗患者留置股静脉导管的经验,探讨股静脉留置导管在血液净化治疗中的应用及其并发症的防治.方法 1997年3月～2006年2月,我院血液透析室行临时性股静脉留置导管44例.分析此种置管方法的临床并发症及处理方法.结果 误穿股动脉2例(4.5%),皮下血肿1例(2.35),穿刺部位渗血1例(2.3%),导管堵塞6例(13.7%),导管脱落1例(2.3%),置管侧深静脉血栓1例(2.3%).带管时间3天～241天.结论 股静脉留置导管是建立血液净化治疗临时血管通路的一种方便快捷方法,操作简便,并发症少且可以防治,是建立血液净化治疗临时血管通路的理想选择.     

长链非编码RNA Lnc-DQ在肝癌组织中的表达及对其对SMMC7721细胞干性特征的影响

目的 检测长链非编码RNALnc-DQ在肝癌组织中的表达,探讨其对肝癌SMMC7721细胞干性特征的影响。方法 采用实时定量反转录聚合酶链反应（RT-qPCR）检测Lnc-DQ在30例肝癌组织和癌旁组织中的表达;shRNA干扰下调Lnc-DQ在SMMC7721细胞中的表达,克隆形成和成球培养实验观察其对SMMC7721肿瘤干细胞特征的影响;流式细胞仪检测CD133+细胞亚群的比例。结果 Lnc-DQ在肝癌组织中的相对表达显著高于癌旁组织（3.24±0.34 vs 1.81±0.17）,差异具有统计学意义（P<0.05）。shRNA转染可显著下调Lnc-DQ在SMMC7721细胞中的表达（P<0.05）。实验组细胞（sh-Lnc-DQ）克隆形成数为43.62±5.35,较对照组（sh-NC）显著减少（94.31±5.07）,差异具有统计学意义（P<0.05）。成球培养实验显示sh-Lnc-DQ可显著抑制SMMC7721细胞的成球能力（P<0.05）。实验组细胞CD133+细胞比例显著低于对照组织（2.32%±0.25% vs 9.24%±0.69%）,差异具有统计学意义（P<0.05）。结论 Lnc-DQ在肝癌中高表达,下调Lnc-DQ的表达能够抑制肝癌SMMC7721细胞的干性功能。     

腹腔镜手术对老年结直肠癌患者安全性及效果的Meta分析

目的 系统评价腹腔镜手术对老年结直肠癌患者的安全性和效果.方法 以“laparoscopic”“laparoscopic colectomy”“colorectal cancer”“rectal cancer”“octogenarian”“elderly”为检索词,检索Pubmed、Web of Sicence和Embase数据库中2000年1月-2017年5月发表的腹腔镜与开腹手术治疗高龄结直肠癌患者的临床研究,提取数据后采用Stata12.0软件对手术指标、术后并发症及远期疗效进行Meta分析.结果 共纳入18项研究,共计3162例患者,Meta分析结果显示,腹腔镜组手术时间长于开腹组(P＜0.001),但术中出血量、术后切口感染、肠梗阻、心血管意外发病率均低于开腹组(均P ＜0.05);两组在淋巴结清扫数目、吻合口瘘、肺炎发病率和总生存率和无瘤生存率方面差异无统计学意义(P＞0.05).结论 腹腔镜手术对高龄结直肠癌患者可取得与开腹手术相同的远期疗效,且术后恢复快,并发症发病率低,安全可靠.