颈椎过伸致颈髓损伤的手术治疗

目的 探讨颈椎过伸致颈髓损伤的手术指征、方案、时机及疗效.方法 手术治疗44例,38例行颈前路减压、植骨、钛板内固定术,6例行颈后路"单开门"椎管扩大成形、侧块钢板固定、植骨术,22例为早期手术.结果 随访6～36个月,42例脊髓神经功能得到不同程度的改善,ASIA分级较术前平均提高约1.4级,早期手术者提高约1.8级.结论 合理选择手术方案和时机可以改善颈椎过伸致颈髓损伤者脊髓神经功能,早期手术疗效好.     

羧基荧光素乙酰乙酸对大鼠骨髓间质干细胞体外染色的研究

目的 探讨活体染料羧基荧光素乙酰乙酸(CFSE)标记大鼠骨髓间质干细胞(MSCs)的可行性和最适条件.方法清洁型SD大鼠20只,用密度梯度离心结合贴壁法分离、纯化、培养大鼠MSCs,取长满25 cm×25 cm培养瓶瓶底的第3代大鼠MSCs,用2.5,5,10,20,40 μmol/L的CFSE分别作用1,5,10,15,20 min后染色,通过观察染色后细胞荧光强度和细胞贴壁率筛选出CFSE标记大鼠MSCs的最佳标记时间和标记浓度.采用MTT法检测最佳条件CFSE标记的大鼠MSCs的增殖能力.结果浓度10 μmol/L的CFSE在37 ℃下孵育10 min为MSCs染色、观察和研究的最佳条件.此条件下,CFSE标记的MSCs的增殖能力不受影响.结论活体染料CFSE是一种标记率高、细胞毒性小、操作简便的标记大鼠MSCs的新方法,浓度10 μmol/L的CFSE在37 ℃下孵育10 min为CFSE标记大鼠MSCs的最佳条件.     

化疗对骨肉瘤αv和β3整合素表达影响的研究

目的:探讨化疗对骨肉瘤αv、β3整合素表达的影响.方法:免疫组化法检测20例化疗前和31例化疗后骨肉瘤αv、β3整合素的表达情况.结果:αv、β3整合素在骨肉瘤细胞呈强阳性表达,而正常骨细胞均呈阴性表达.P=0.000;化疗后两者表达明显下降,P=0.000.秩和检验表明,化疗后αv整合素与肿瘤Enneking分期(P=0.014)、侵袭(P=0.007)、复发(P=0.021)明显相关;β3整合素表达与肿瘤复发明显相关,P=0.003.多因素分析显示,化疗后αv整合素表达水平是影响骨肉瘤侵袭独立因素,化疗后β3整合素是影响骨肉瘤复发独立因素.结论:αv、β3整合素可能成为骨肉瘤诊断的辅助指标;化疗可能通过下调骨肉瘤细胞αv、β3整合素表达而改变其相应的生物学活性;αv、β3整合素可能分别是影响骨肉瘤侵袭、复发的独立因素;αv、β3整合素可能作为判断骨肉瘤化疗预后的指标及化疗药物作用的靶分子.     

中西医结合治疗术后椎间盘炎10例

中西医结合治疗术后椎间盘炎１０例福建医学院附属第一医院（３５０００４）朱夏林建华林元泽蔡华秀笔者从１９９２年１月至１９９４年８月应用中西医结合治疗术后椎间盘炎１０例，取得较满意的效果。１临床资料根据陆宸照等提出的术后椎间盘炎４大特征为诊断依据。本组１...     

子痫并发视网膜脱离三例报道

妊娠期高血压病是最常见和最危重的产科并发症,其病理生理变化是全身小动脉痉挛,多表现为心血管、肾脏、脑部症状.妊娠期高血压病眼底改变的发生率报道不一,主要变化为视网膜小动脉痉挛和狭窄,导致视网膜脱离极少见,据统计发生率在0.6%～2%[1],与疾病的严重程度有关.本院近年收治3例重度子痫前期和子痫并发视网膜脱离病例,报道如下.     

子痫并发视网膜脱离三例报道

妊娠期高血压病是最常见和最危重的产科并发症，其病理生理变化是全身小动脉痉挛，多表现为心血管、肾脏、脑部症状。妊娠期高血压病眼底改变的发生率报道不一，主要变化为视网膜小动脉痉挛和狭窄，导致视网膜脱离极少见，据统计发生率在o．6％～2％，与疾病的严重程度有关。本院近年收治3例重度子痫前期和子痫并发视网膜脱离病例，报道如下。     

化疗对骨肉瘤整合素αv、PCNA表达的影响

目的探讨化疗对骨肉瘤整合素αV、增殖细胞核抗原(PCNA)表达的影响。方法免疫组化法检测20例化疗前和31例化疗后骨肉瘤整合素αV、PCNA的表达情况。结果骨肉瘤细胞整合素αV、PCNA均呈阳性表达,化疗后整合素αV表达较化疗前下降(P<0.05),PCNA表达没有变化(P>0.05),两者表达互成正相关(P<0.05)。化疗后整合素αV表达与骨肉瘤的Enneking分期、侵袭、复发呈正相关(P<0.05)。结论整合素αV和PCNA可能成为骨肉瘤诊断有益的辅助指标。化疗可能通过下调骨肉瘤细胞整合素αV表达从而影响其生物学活性。化疗后整合素αV表达情况有望成为判断骨肉瘤恶性程度、侵袭、复发的指标,其与PCNA表达成正相关,二者可能在化疗后肿瘤细胞的增殖、修复中存在某种协同作用。     

经皮经肝胆囊穿刺胆道造影与逆行胰胆管造影应用价值比较

目的：比较超声引导经皮经肝胆囊穿刺胆道造影（TGF－PTC）与逆行胰明管造影（ERCP）在胆系疾病诊断中的应用价值。方法：22例患者在B超引导下经皮经肝穿刺胆囊行胆道造影,显示所有的胆系情况,从操作技术、造影情况、并发症发生率等方面,与同期32例经内镜的ERCP患者相比较,总结出项检查技术的临床应用价值。结果：TGB－PTC22例中穿刺成功21例,19例胆道造影成功,无1例发生出血,胆漏,感染,急性胰腺炎等并发症。结果：TGF－PTC22例中穿刺成功30例,造影成功28例,2例并发轻度急性胰腺炎,1例并发轻度胆道感染。结论：与ERCP相似,TGB－PTC是一种简单,可靠,安全,效果好的胆道造影方法。     

MMP-9、CD44v6在骨肉瘤中的表达及其临床意义

目的 探讨骨肉瘤组织中MMP-9、CD44v6的表达及其临床意义。方法 应用免疫组化方法检测70例骨肉瘤、15例骨软骨瘤和15例正常骨组织中CD44v6和MMP-9的表达情况,分析其相关的临床病理因素,并进行回顾性随访。结果 在骨肉瘤组织中,MMP-9、CD44v6阳性表达率明显高于骨软骨瘤和正常骨组织;MMP-9阳性表达与骨肉瘤软组织侵袭及预后有一定关系;CD44v6的表达与MMP-9的表达呈正相关的关系。结论 CD44v6与MMP-9均可作为骨肿瘤恶性表型的辅助指标;MMP-9与骨肉瘤的侵袭、转移相关,可作为预测骨肉瘤转移潜能的指标。     

Tei指数在监测妊娠合并心脏病伴肺动脉高压患者右心室功能中的作用

Objective To investigate clinical value of Tei index used for monitoring right ventricular (RV) function in pregnant women complicating cardiac disease accompanying pulmonary hypertension(PH) and the influence on left ventricular(LV) function due to overload pressure of RV. Methods Fifty-eight pregnant women complicating cardiac disease (including 32 cases with congenital heart disease,14 cases with rheumatic heart disease and 8 cases with arrhythmia)were enrolled in this study, among 26 cases coexisted with pulmonary hypertension. According to the pressure of PH, those patients were divided into three groups:11 cases in mild group[30-49 mm Hg (1 mm Hg=0.133 kPa)],9 cases in moderate group (50-79 mm Hg)and 6 cases in severe group (≥80 mm Hg). In the mean time, 15 healthy pregnant women were matched as control. Tei index were measured for LV and RV respectively. Results (1) The isovolumetric relaxation time [IRT,(93±52) ms] and isovolumetric contraction time [ICT,(66±41) ms] of RV in PH group were significantly higher than normal controls [(39±19) ms in IRT and (38±20) ms in ICT] and the other patients without PH group[(59±12) ms in IRT and (43±19)ms in ICT, P<0.01, P<0.05;P<0.05,P<0.05]; however, ejection time (ET) was(239±46) ms significantly shortened in PH group (P<0.05,P<0.01) when compared with (250±41) ms in patients without PH and (299±38) ms in normal controls. Tei index in PH group were 0.72±0.49, which were significantly higher than 0.38±0.12 in normal controls and 0.43±0.16 in patients without PH (P<0.01,P<0.05). (2) The IRT[(99±27)ms] and ICT[(71±40) ms] of LV in PH group were significantly higher than in normal controls [(88±20) ms,(50±24)ms] (P<0.01,P<0.01). ET of LV in PH group [(202±26)ms] were significantly shortened that (290±21)ms in normal controls and (220±36)ms in patients without PH (P<0.01,P<0.05). Tei index of LV in PH group were significantly higher than 0.43±0.15 in normal controls and 0.58±0.21 in patients without PH (P<0.01,P<0.05). (3) Positive correlation between Tei index of RV and pressure of pumonaroy artery were observed (r=0.84, P<0.01). (4) Tei index of RV in severe PH were significantly higher than mild PH (0.75±0.43 vs. 0.68±0.35, P<0.01) and moderate PH (0.75±0.43 vs. 0.71±0.14, P<0.05). Conclusions (1)The Tei index is a novel efficient Doppler index in assessing RV function of pregnant women complicating cardiac disease accompanying PH. And the fluctuation of Tei index might reflect seriousness of the disease. (2) The overload pressure of RV pressure due to PH has significant influence on LV function.