Pseudo compartment syndrome of the calf in an athlete secondary to cystic adventitial disease of the popliteal artery

We report a patient with calf pain induced by sport and exercise, initially thought to represent compartment syndrome, in whom MRI and duplex ultrasound ultimately revealed cystic adventitial disease of the popliteal artery. Surgical de-roofing of the popliteal artery resulted in complete resolution of symptoms with return to sporting activities.     

肥胖伴黑色棘皮病儿童胰岛分泌功能的临床研究

目的　研究肥胖伴黑棘皮病儿童胰岛素分泌功能的改变 ,探讨其临床意义。方法　对35例肥胖伴黑色棘皮病患儿、38例单纯肥胖患儿及 39例正常儿童进行胰岛 β细胞功能指标的测定。结果　肥胖伴黑色棘皮病组空腹胰岛素、C肽、胰岛素原、真胰岛素、胰岛素原与胰岛素、C肽比值、胰岛素抵抗指数和胰岛 β细胞分泌指数 (中位数及范围 )分别为 18 5 (5 0～ 6 0 5 )pmol/L、3 9(1 3～14 0 ) μg/L、2 8 84 (9 9～ 6 4 2 )pmol/L、32 96 (6 2～ 6 6 0 )pmol/L、1 2 (0 4～ 8 9)、6 9(2 5～ 36 6 )、5 0(0 8～ 14 1)和 30 3 3(5 2 2～ 116 3 8) ,均显著高于单纯肥胖组和正常组 (P <0 0 0 1)。结论　肥胖伴黑色棘皮病已经存在严重的胰岛 β细胞分泌亢进和胰岛素抵抗 ,是儿童患 2型糖尿病的高危 信号     

Factors affecting increasing radiation dose for mammography in North Carolina from 1997 through 2001: an analysis of Food and Drug Administration annual surveys

RATIONALE AND OBJECTIVES: To determine which factors affected the increase in average glandular dose recorded at the annual US Food and Drug Administration Mammography Quality Standards Act inspections of mammography equipment in North Carolina from 1997 to 2001. MATERIALS AND METHODS: Average glandular dose, HVL, kVp, ambient light, luminance, equipment age, processing speed, and system speed for every mammography unit at all facilities in the state were collected by state inspectors. A mixed-effect model was used to assess the average changes of glandular dose over time and to identify the factors associated with these changes. RESULTS: There was a statistically significant increase in the average glandular dose in North Carolina in 1999, 2000, and 2001 when compared with the baseline year of 1997. Factors that were statistically significantly linked to this effect were changes in kVp, processing speed, and system speed. CONCLUSION: Average glandular dose for mammography has recently increased in North Carolina. This change is likely caused by changes in screen-film products and processing techniques.     

单球囊与双球囊后凸成形术对椎体复位作用的研究

目的探讨单球囊与双球囊后凸成形术对椎体压缩骨折复位作用的差异,评价后凸成形术的临床疗效。方法对2000年5月～2004年5月应用球囊扩张后凸成形术(KP)施行椎体复位的58例胸腰椎椎体压缩性骨折(VCFs)患者(90个椎体)的临床资料进行了回顾性分析。58例患者90个椎体分为单球囊组(28个椎体)和双球囊组(62个椎体),两组均经双侧椎弓根穿刺,扩张后灌注骨水泥,分别采用单球囊双侧交替扩张和双球囊双侧同时扩张的方法。分别测量术前术后椎体高度和Cobb角,比较术前术后及两组之间的差异。结果患者术后疼痛均明显减轻或消失。椎体高度平均恢复率726%(229～100%);Cobb角由术前179°(31°～316°)矫正至术后96°(06°～282°),平均矫正87°(03°～272°),术前、术后相比差异有极显著性意义(P<0001)。单球囊组和双球囊组术后椎体高度平均恢复率分别为776%(553%～100%)和643%(229%～100%),术后平均矫正Cobb角分别为99°(03°～272°)和86°(06°～198°),两组相比差异无显著性意义(P>005)。结论后凸成形术可有效缓解椎体压缩骨折患者的疼痛,恢复椎体高度,改善后凸畸形;单球囊与双球囊后凸成形术同样能使压缩骨折的椎体获到较好复位。     

胃癌阻断新技术降低癌细胞血行转移的临床研究

目的　评价胃癌阻断技术降低胃癌门静脉血内癌细胞播散的效果。方法　 2 3例胃癌患者 ,8例术中未采用胃癌阻断技术者为常规手术组 ,15例采用胃癌阻断技术者为阻断组 ,术前、术中抽门静脉血及阻断区域胃网膜静脉弓内静脉血 ,应用RT -PCR技术测定静脉血内CK19mRNA表达情况。结果　切除胃癌病灶之前 ,门静脉血内CK19mRNA的总阳性率为 34 7% ( 8/ 2 3) ,常规组和阻断组的阳性率分别为 37 5 % ( 3/ 8)和 33 3% ( 5 / 15 ) ;术中牵拉胃癌病灶时 ,常规组门静脉血CK19mRNA的阳性率为 87 5 % ( 7/ 8) ,而阻断组的阳性率为 6 7% ( 1/ 15 ) ,两组差异有统计学意义 (P <0 0 5 ) ;阻断组 15例患者癌灶阻断区域网膜血管弓内静脉血CK19mRNA均阳性。结论　术中采用胃癌阻断技术能有效的阻断胃癌细胞播散 ,防止手术操作引致的癌细胞远处转移     

Hangman骨折伴椎间盘损伤的诊断与外科治疗

目的探讨Hangman骨折伴C2-3椎间盘损伤的病理特点及其外科治疗方法。方法21例Hangman骨折伴颈2-3椎间盘损伤患者,均进行颈椎前路C2-3椎间隙融合术,其中18例行颈前路钢板固定。分析其损伤类型、影像学特点和疗效。结果未出现神经症状加重、植骨块移位、吸收和切13感染等并发症,新鲜骨折的枢椎脱位和C2-3成角得到良好恢复,术后6个月C2-3植骨以及枢椎椎弓骨折都获得骨性融合。随访8个月至4年,平均随访2年7个月,绝大部分术前症状消失。结论Hangman骨折并不限定于枢椎椎弓根骨折,合并椎间盘损伤的Hangman骨折是一种特殊的骨折类型,颈椎前路融合手术是符合其病理生理特点的手术方法。     

56例肺及胸膜残腔曲菌病的诊断和手术治疗

目的 总结肺及胸膜残腔曲菌病的诊断和手术治疗经验。方法 对1972年9月至2003年6月我科诊治的56例肺曲菌病及胸膜残腔曲菌病患者的临床资料进行回顾性分析。本组肺曲菌病53例,胸膜残腔曲菌病3例。所有病例均行胸片或肺CT检查并行手术治疗,其中8例在术前经痰培养(5例)或肺组织穿刺活检(2例)或纤维支气管镜活检(1例)获得病原学诊断。53例肺曲菌病中,42例行肺叶切除术,3例行肺段切除术,8例行肺楔形切除术;3例胸膜残腔曲菌病在清除病灶后,2例行胸廓成形术,另1例延长胸腔闭式引流时间,并在残腔内反复注入氟康唑治疗1个月(每次200mg、100ml,1次／2～3d)。结果 全组患者均治愈,无手术死亡。术后随访无复发病例。结论 对肺及胸膜残腔曲菌病应采取积极的手术治疗,手术治疗效果较好。     

Relationship between DNA fragmentation and nuclear status of in vitro-matured porcine oocytes: role of cumulus cells

The present study was conducted to investigate the effects of the attachment of cumulus cells to oocytes and coculture with cumulus cells during maturation culture on the nuclear status and DNA fragmentation of porcine denuded oocytes (DOs). In the first experiment, cumulus cells were removed from cumulus-oocyte complexes (COCs) at 0, 8, 16, 24 or 32 h after the onset of maturation culture and the DOs were then cultured in their original droplets until 42 h of culture was reached. In the second experiment, all COCs were denuded before the onset of culture and the DOs were cocultured with their removed cumulus cells. The DOs were transferred into fresh medium at 0, 8, 16, 24 or 32 h after the onset of coculture with cumulus cells and then cultured until 42 h of culture was reached. After culture, DNA fragmentation and the nuclear status of oocytes were examined using the terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end-labelling (TUNEL) method. When the DOs were returned to the same droplets after removal of the cumulus cells, the removal of the cumulus cells after 16 h of culture significantly decreased the proportion of oocytes remaining at the germinal vesicle (GV) stage. However, coculture treatment of DOs in the presence of their removed cumulus cells had no significant effects on the GV breakdown (GVBD) of oocytes. There were no significant differences in the proportion maturing to MII oocytes among the groups following removal of cumulus cells after the onset of maturation culture; however, DOs cocultured with cumulus cells until the end of maturation culture exhibited an increased maturation rate compared with DOs cocultured for 8 and 16 h. The total proportion of TUNEL-positive oocytes of oocytes remaining at the GV stage was higher than that of oocytes reaching other stages, irrespective of the removal of cumulus cells and coculture treatments. However, coculture for more than 16 h decreased the total proportion of TUNEL-positive oocytes. Our results indicate that the attachment of cumulus cells to oocytes may have a critical role for oocytes undergoing GVBD and that coculture with cumulus cells promotes the ability of oocytes to complete maturation. Moreover, coculture with cumulus cells may assist the oocyte to avoid undergoing DNA fragmentation.     

SARS冠状病毒单克隆抗体制备及在肺尸检标本染色中的应用

目的制备抗SARS冠状病毒的单克隆抗体,用于SARS的实验室诊断。方法灭活SARS冠状病毒(PUMC01)全病毒免疫BALB／C小鼠,取小鼠脾细胞与骨髓瘤细胞(NS-1)融合,用酶联免疫吸附试验(ELISA)、间接免疫荧光法(IFA)及免疫印迹法对所获得的细胞克隆进行筛选和鉴定,并用其中一株(M2)杂交瘤诱生的腹水单克隆抗体对SARS患者尸检肺组织切片进行免疫组织化学染色。结果共筛选出6株杂交瘤细胞,ELISA及IFA法证实其分泌的单克隆抗体与SARS冠状病毒有特异性反应,与其他常见呼吸道病原体均无交叉反应。免疫双扩散方法鉴定1株杂交瘤细胞(M2)为免疫球蛋白IgG3型,其余5株均为IgG1型。免疫印迹试验显示1株杂交瘤细胞(M2)分泌的抗体与相对分子质量68000的蛋白有特异性反应;4株杂交瘤细胞分泌的抗体与相对分子质量27000的蛋白有特异性反应,1株在免疫印迹上未见到结果。SARS患者尸检肺组织病理切片免疫组织化学染色阳性,在肺泡上皮细胞、支气管上皮细胞及巨噬细胞的胞浆均可见阳性颗粒。结论我们制备的6株单克隆抗体是抗SARS冠状病毒的特异性单克隆抗体,用于SARS尸检肺组织免疫组化染色,结果阳性。     

软骨形态发生蛋白1诱导真皮成纤维细胞表达软骨细胞表型的实验研究

目的应用软骨形态发生蛋白(CDMP)生长因子,体外诱导真皮成纤维细胞向成软骨细胞表型分化,探讨其作为组织工程化软骨种子细胞的可行性.方法取包皮环切术后丢弃真皮组织共3例,成纤维细胞体外培养扩增至第二代,以1×104/cm2密度接种,12 h后加入细胞诱导液(10%胎牛血清F-12培养液,CDMP1终浓度为100 ng/ml)单层培养,未加的成纤维细胞培养用CDMP1为对照.诱导7 d后观察细胞形态变化,Image Plus图像分析软件计算细胞长宽比例.激光共聚焦显微镜分别观察诱导前后细胞内Ⅰ、Ⅱ、Ⅲ型胶原表达及分布,Western印迹检测诱导前后细胞Ⅱ型胶原蛋白表达.反转录聚合酶链式反应(RT-PCR)检测诱导后成软骨相关的Sox9、聚集蛋白聚糖与Ⅱ、Ⅸ型胶原mRNA表达;同时检测与成骨相关的X型胶原、碱性磷酸酶(AKP)mRNA表达.培养第二代细胞以2×107个细胞/ml细胞密度进行离心管法培养,诱导14 d后行阿辛蓝与Ⅱ型胶原免疫组化染色.结果诱导后可见单层培养的成纤维细胞形态由长梭形向软骨细胞样多角形转变,Image Plus图像分析软件计算细胞诱导后的长宽比例为(1.40±0.15),较诱导前(7.40±1.30)差异有显著意义(P＜0.05);与正常软骨细胞(1.29±0.24)差异无显著意义.免疫荧光激光共聚焦观察发现诱导后细胞内出现Ⅱ型胶原表达,Ⅰ、Ⅲ型胶原表达呈阳性.RT-PCR检测成软骨相关的Sox9,聚集蛋白聚糖,Ⅱ、Ⅸ型胶原mRNA表达阳性;X型胶原、AKP未检测到mRNA阳性表达.Western印迹检测细胞诱导后Ⅱ型胶原蛋白表达阳性.离心管培养诱导7 d后阿辛蓝染色示糖胺聚糖(GAG)均匀分布于基质中,免疫组化染色示基质中Ⅱ型胶原表达阳性.结论第二代成人真皮成纤维细胞在CDMP1生长因子诱导下可向成软骨细胞表型分化,并能分泌软骨细胞特异性基质,有望成为软骨组织工程新的种子细胞来源.