各种钢板微创内固定治疗四肢骨折

目的 总结各种钢板微创手术治疗四肢骨折的经验。方法 从2002年6月。2004年8月，对62例四肢各型骨折的患者在微创手术下进行了手术内固定。其中男42例，女20例，年龄14-72岁，平均32岁。结果 本组病例切口均顺利愈合，术后3～7天出院；全部获得随访，平均随访时间6个月；骨愈合时间3-10个月。按Johne-Wruhs方法评价功能，优55例，良6例，中1例，差0例，以优良为满意标准，本组病例总体满意率98．4％。结论 各种钢板微创内固定治疗四肢骨折具有手术创伤小、骨折愈合快、功能恢复好的特点。     

Long-term application of diethylstilbestrol upregulates expressions of μ- and m-calpains in pituitary intermediate lobe of female Wistar rats

BACKGROUND: During formation of prolactin neoplasia, how cells and its structure in adenohypophysis affect prolactin cells should be further studied. Intermediate lobe can be regarded as a driving region to release prolactin (PRL) and may promote formation of prolactin neoplasia in pituitary anterior lobe. OBJECTIVE: To observe the effect of diethylstilbestrol (DES) on the expressions of μ and m-calpains in pituitary intermediate lobe of female Wistar rats. DESIGN: Observational contrast animal study. SETTING: Beijing Neurosurgical Institute. MATERIALS: A total of 21 female Wistar rats, 3 weeks old weighing 70–80 g were housed with free access to tap water and standard pellet food. They were kept in a CL-grade condition, at (24±1)℃ and a humidity of (55±5)%, and with a 12 hours day-night cycle. Caprine anti-μ- and m-calpains antibodies were provided by Santa Cruz Biotechnology, CA, USA; rabbit-anti-PRL antibodies by Dako, Denmark; rabbit-anti-ACTH antibody by Boster Company, Wuhan. METHODS: The experiment was carried out in Pathophysiological Department and Animal Laboratory, Beijing Neurosurgical Institute from August 2006 to January 2007. ① Rats were randomly divided into groups with 7 in each group, including vehicle control group, in which rats were injected intraperitoneally with sun-flower seed oil (1 mL/kg, twice a week) for 16 weeks; DES group, where animals were administered with DES (5 mg/kg, twice a week) for 16 weeks; DES + vehicle control group, in which DES was administered for 12 weeks at the same dose with those in DES group, and then was discontinued and replaced by sun-flower seed oil (1 mL/kg, twice a week) for the following 4 weeks. ② At 16 weeks later, pituitary tissue was dealt with HE staining and PRL immunohistochemical examination to observe evoke of tumor; meanwhile, immunohistochemical examination was used to observe expression of PRL of pituitary anterior lobe, expressions of μ- and m-calpains of pituitary intermediate lobe and distribution of adrenocorticotropin. MAIN OUTCOME MEASURES: ① Expression of PRL of pituitary anterior lobe, expressions of μ- and m-calpains of pituitary intermediate lobe and distribution of adrenocorticotropin. ② Morphological observation of pituitary tissue. RESULTS: All 21 rats were involved in the final analysis. ① Results of immunohistochemical examination: Morphological changes of neoplasia in DES group were strongly positive to PRL, and this suggested that formation of prolactin adenoma was observed in pituitary tissue. As compared with vehicle control group, expression of adrenoeorticotropic hormone (ACTH) was increased in both DES group and DES + vehicle control group. In addition, expressions of μ- and m-calpains in pituitary intermediate lobe were higher in DES group than that in vehicle control group. Otherwise, expressions of m-calpains in pituitary intermediate lobe was decreased in DES + vehicle control group, but expression of μ-calpains was still increased. ② Morphological observation of pituitary tissue: Gland tubes were orderly arranged in rats in vehicle control group. Anterior pituitary gland in rats of DES group demonstrated an apparent disappearance of gland tubes and a relatively large-scaled vasculature formation, namely the vascular lake lined by tightly arranged endothelial cells. Local integrated tumor cell arrangements were also detected. In addition, the border between the IL and the anterior lobe was locally blurred. The definite tumor-like changes in pituitary tissues were confirmed in 6 of 7 female Wistar rats in DES group, and one spontaneous occurrence of tumor formation was found in vehicle control group. In DES + vehicle control group, DES withdrawal led to the subtile emergence of gland tube cavity, although tumor-like cells still existed in 4 of 7 rats, suggesting occurrence of the tumor regression due to the withdrawal of DES. CONCLUSION: A long-term application of DES can enhance the expressions of ubiquitours neutral cysteine protease in pituitary intermediate lobe and this suggests that both of them play a key role in release of hormone and formation of prolactin neoplasia through directly promoting PRL expression and release of neighboring pituitary intermediate lobe.     

知识地图在中医药信息领域的应用设想

在“信息爆炸”的现代社会，信息数量的成倍增长为知识的利用与管理带来严峻的挑战。中医药在现代化过程中，数量庞大的古籍、数据、文献等的数字信息化同样面临如何利用、管理的问题。本文将展示一种高效、便捷、可视化的知识管理模式——知识地图，并就其如何在中医药信息领域合理应用与实践，提出了一些前期的思路与设想。     

小切口治疗注射性臀肌挛缩症

目的:评价小切口注射性臀肌挛缩症的效果.方法:采用小切口治疗具有典型症状的臀肌挛缩症22例.所有病例均要求早期开始功能锻炼.结果:平均随访27个月,优良率100%.结论:采用小切口治疗注射性臀肌挛缩症具有创伤小,愈合快,瘢痕小,外形美观等优点.     

Term delivery in a woman with severe congenital neutropenia, treated with growth colony stimulating factor

The patient was diagnosed in childhood as having severe congenital neutropenia and had recurrent admissions with severe infections. In 1987, prior to getting married, she was sterilized. She continued to require i.v. antibiotics when she contracted a severe infection. On one occasion, she was treated with growth colony stimulating factor (G- CSF). Her increased neutrophil count was sustained following this treatment. In June 1993, she wished to start a family and underwent in- vitro fertilization (IVF) treatment. G-CSF was given prior to oocyte retrieval. She conceived on her first cycle and an ultrasound scan revealed a singleton pregnancy. Throughout the course of the pregnancy, her white cell count was monitored closely and remained at <1.0x10(9)/l. The pregnancy progressed uneventfully and at 37 weeks gestation she was admitted for G-CSF injections. At 38 weeks she was delivered of a boy weighing 3350 g, by elective Caesarean section. His white cell count was normal. This is the first case of G-CSF being used before conception and during pregnancy in a patient with congenital neutropenia. It shows that advances in cytokine therapy and close interdisciplinary liaison can lead to a successful outcome and help patients, who would otherwise remain childless, to achieve a family.      

肾移植术后并发卡氏肺孢子虫病活检的病理学研究

报告肾移植术后５例并发卡氏肺孢子虫肺炎。采用纤维支气管镜活检，分别对印片及组织进行银染和ＨＥ染色。病变为上皮细胞脱落，有时增生呈立方状；炎症反应；各种类型渗出物（包括泡沫状渗出物、泡沫细胞团及絮状蛋白渗出物）等３种改变。重点讨论了本病的组织病理学特征，并对不典型病变形成机理加以讨论。     

中国人丙型肝炎病毒囊膜蛋白2HVR1 cDNA的序列分析

目的：了解中国ＨＣＶ流行株高变区１（ＨＶＲ１）的特点。方法：对来自山东（ＳＤ）、上海（ＳＨ）两地患者血清ＲＮＡ进行逆转录－巢式ＰＣＲ，扩增ＨＣＶ囊膜蛋白２基因片段，用ＰＣＲ直接测序法对该片段进行序列测定。结果：（１）扩增片段（命名为Ｐ３８８）对应于日本ＨＣＶ－Ｊ株序列核苷酸１４３９￣１８２６位（氨基酸位３７１￣４９８）；（２）中国人ＨＣＶ ＨＶＲ１位于氨基酸位３８４￣４１０，与发表的ＨＣＶⅡ型ＨＶ     

Studies on hepatitis C virus and prevalence of its infection in China

PrinceandGoldfieldfirstreportedthenon--A,non--Bpost--transfusionhepatitis(NANBH)byexclusivediagnosisin1974.Theepidemiologicda.talaterconfirmedthatthereweretwokindsofNANBH,parenterallytransmittedNANBHandenterallytransmittedNANBH.'In1989,Chooandhiscolleagues['JidentifiedhepatitisCvirus(HCV)genomiccDNAbyimmunoscreeningtheAgtllcDNAlibraryofthevirus,themajorcausativeagentofparenterallytransmittedNANBH.TheanalysisofthegenomeshowedthatHCVisamemberofflavivirusfamilywithasinglepositiv…     

肝硬化患者的脑电活动地形图

对２０例无临床肝性脑病的失代偿期肝硬化患者进行脑电活动地形图（ＢＥＡＭ）检查，并与３３例正常人作对照，以探讨亚临床肝性脑病（ＳＨＥ）的诊断价值。结果表明，２０例肝硬化患者中，ＢＥＡＭ正常５例，轻度异常５例，轻￣中度异常５例，中度异常５例，总异常率为７５％（１５／２０）。ＢＥＡＭ异常的分布特点以弥漫性分布为主要表现，主要为慢频域（δ．θ．δ＋θ／α＋β）活动增强，Ｚ值增高，只有３例波及α频域。提示：     

Bronchial hyperresponsiveness, epithelial damage, and airway eosinophilia after single and repeated allergen exposure in a rat model of anhydride-induced asthma

Bronchial hyperresponsiveness (BHR) and damage of the epithelium, as well as eosinophilia in the airway wall, induced by trimellitic anhydride (TMA) in sensitized brown Norway rats were studied. Rats were challenged once or seven times with aerosol of TMA conjugated to rat serum albumin (TMA-RSA) 3 weeks after intradermal TMA sensitization. Airway responsiveness (-log PC₃₀₀ of acetylcholine i.v.) was measured 24 h after allergen challenge. Epithelial lesion and eosinophil infiltration in the airway walls were quantified under light microscopy, and TMA-specific IgE and IgG in serum were evaluated with ELISA. High levels of TMA-specific IgE and IgG were found in all rats in the sensitized groups compared to nonsensitized groups ( P < 0.001). Repeated allergen challenges of 0.03% TMA-RSA for 7 consecutive days enhanced the level of TMA-specific IgG, compared to single challenge ( P < 0.05). Single allergen challenge of 0.3% TMA-RSA had a nonsignificant tendency to produce BHR in sensitized rats compared to nonsensitized rats ( P =0.06). However, repeated allergen challenges (0.003% and 0.03% TMA-RSA for 7 consecutive days) produced significant BHR in sensitized rats ( P < 0.05). Furthermore, repeated low-dose (0.003%) TMA-RSA challenge produced more BHR than a 10 times higher single dose (0.03%) ( P < 0.05). Slight damage of the airway epithelium was seen in sensitized and repeat-challenged groups. However, bronchial eosinophilia was found in the sensitized and single-challenged groups, but not in nonsensitized nonchallenged, and sensitized repeat-challenged groups ( P < 0.005). We conclude that the brown Norway rat can be sensitized with TMA, and that repeated low-dose allergen challenges produce slight epithelial damage and BHR which is independent of ongoing eosinophilia in the airway wall.