应用颈椎椎间融合器27例的临床分析

目的分析颈椎椎间融合器（CFC）临床应用的疗效。方法对27例植入CFC的脊髓型颈椎病随访3个月～3年，平均1．8年，观察CFC临床应用疗效。结果本组术后均无发生严重的并发症。影像学资料证实脊髓和神经根减压明显，椎间融合器（Cage）融合良好。术后JOA评分均恢复至15分以上，无症状恶化或复发者。结论Cage融合固定术治疗颈椎病有手术创伤小、无供区并发症、术后恢复快及手术成功率高等优点。     

Effect of curcumin on nitric oxide synthase expression in Iipopolysaccharide-activated microglia cells and the anti-oxidative effect of curcumin

BACKGROUND: It has been demonstrated that curcumin can increase the activities of various anti-oxidase in blood and tissue, effectively eliminate various free radicals, reduce the production of peroxisome, and alleviate oxidative stress reaction. Whether it has the same effect on microglia? OBJECTIVE: To observe the effects of curcumin on the expressions of inducible nitric oxide synthase (iNOS), nuclear factor-κB (NF-κB), and superoxide dismutase (SOD) in microglial cell line BV stimulated by lipopolysaccharide (LPS). DESIGN: An observational comparative study. SETTING: Research Room of Biochemistry, Medical College of Nantong University. MATERIALS: Mice microglia cell line BV, iNOS and NF-κB reporter gene plasmids were presented by Dr. Bhat.NR. from the Medical University of South Carolina (USA). Curcumin was produced by the Xi'an Branch of China Chengdu Scholar Bio-Tech. Co.,Ltd.; LPS (E.Coli O26:B6), anti-mice iNOS monoclonal antibody, horseradish peroxidase labeled goat-anti-mice IgG were the products of Sigma Company (USA). METHODS: The experiments were carried out in the Research Room of Biochemistry, Medical College of Nantong University from May 2006 to April 2007. ① Detection of iNOS: The cells were seeded onto 24-well plate at the density of 1×105, After the cells had adhered to the cover glasses, the cells were grouped as negative control group (the primary antibody was replaced by phosphate buffered solution PBS); normal control group (the cells were normally cultured); LPS-treated group (the cells were treated with LPS for 24 hours); curcumin+LPS group (the cells were treated with curcumin for 1 hour and LPS for 24 hours). The expressions of iNOS protein were detected with immunocytochemical staining. ② Determination of iNOS and NF-κB gene activities: According to the introduction of the kit for transfection, iNOS or NF-κB report gene plasmids were transiently transfected with LipofectamineTM2000 liposomes into the cells in the 24-well plate for 24 hours. The cells were divided into normal control group (the cells were normally cultured after transfected with report gene plasmids); blank plasmid group (the cells were normally cultured after transfected with blank plasmids); LPS-treated group (the cells were treated with LPS for 4 hours after transfected with report gene plasmids); curcumin+LPS group (the cells were treated with curcumin for 1 hour and LPS for 24 hours after transfected with report gene plasmids). The content of luciferase in the cell lysis buffer was determined after cell lysis. ③ Determination of SOD activity: The cells were seeded into culture bottle at the density of 1×106, and the divided into four groups, including normal control group (the cells were normally cultured); LPS-treated group (the cells were treated with LPS for 24 hours); curcumin+LPS group (the cells were treated with curcumin for 1 hour and LPS for 24 hours); vitamin C+LPS group (the cells were treated with vitamin C for 1 hour and LPS for 24 hours). The SOD activity was determined with xanthine oxidase and quantitative colorimetric assay. MAIN OUTCOME MEASURES: The expressions of iNOS protein, iNOS and NF-κB, and the activity of SOD were observed. RESULTS: ① Expression of iNOS protein in microglia: The expression of iNOS protein in the LPS-treated group was obviously higher than that in the negative control group (P < 0.01); Those in the curcumin+LPS group were significantly decreased as compared with that in the LPS-treated group (P < 0.01). ② Expressions of iNOS and NF-κB genes: The expressions of iNOS and NF-κB genes in the LPS-treated group were significantly higher than those in the normal control group (P < 0.01); Those in the curcumin+LPS group were significantly lower than those in the LPS-treated group (P < 0.01). ③ SOD activity: The activity of SOD in the LPS-treated group was significantly lower than those in the normal control group (P < 0.01). It in the curcumin+LPS group and vitamin C +LPS group was significantly higher than that in the LPS-treated group (P < 0.01). CONCLUSION: Curcumin could inhibit the expression of iNOS in the activated microglia, and it also has the abilities in eliminating free radicals and antagonizing lipid peroxidation.     

经尿道前列腺汽化电切术后后尿道狭窄的防治(附19例报告)

目的探讨经尿道前列腺汽化电切(TVP)术后后尿道狭窄的防治。方法结合文献,回顾分析19例TVP术后并发后尿道狭窄患者诊治经过。结果19例患者中13例经尿道扩张术治愈,5例行冷刀内切开术 电切术治愈,1例腔内手术失败改开放手术治愈。结论后尿道狭窄为TVP术后常见并发症,多数可用尿道扩张术治愈,对尿道扩张失败者应进行冷刀内切开术 电切术,早期及时处理效果好。     

Effect of schisandrin B and sesamin mixture on CCl(4)-induced hepatic oxidative stress in rats

To study the effects of schisandrin B and sesamin mixture on carbon tetrachloride (CCl(4))-induced hepatic oxidative stress in male Sprague-Dawley rats. The rats were randomly assigned to five groups: control group (olive oil injection), CCl(4) group (CCl(4) injection), silymarin group (CCl(4) injection combined with supplementation of silymarin, 7.5 mg/kg/day), low dose group (CCl(4) injection combined with supplementation of schisandrin B and sesamin mixture at a low dose, 43 mg/kg/day) and high dose group (CCl(4) injection combined with the supplementation of schisandrin B and sesamin mixture at a high dose, 215 mg/kg/day). The hepatic superoxide dismutase and glutathione peroxidase activities of rats in the low dose and high dose groups were increased significantly compared with those in the CCl(4) group. The hepatic reduced glutathione concentration in the silymarin, low dose and high dose groups were increased significantly (48%, 45% and 53%, respectively) when compared with those of the CCl(4) group. In addition, the concentration of glutathione in the erythrocytes of the low dose group was significantly higher than the CCl(4) group by 25%. These results suggest that the schisandrin B-sesamin mixture exerted a hepatoprotective effect by improving the antioxidative capacity in rats under CCl(4)-induced hepatic oxidative stress.     

上尿路梗阻性急性肾功能不全内、外引流的选择

目的探讨内、外引流在上尿路梗阻急性肾功能不全时的选择和效果。方法25例各种原因引起的上尿路梗阻（15例肿瘤性梗阻,10例非肿瘤性梗阻）合并急性肾功能不全,分别或先后对12例行输尿管内置双J管（doub le J,D J）内引流15次,对19例行经皮肾穿刺造瘘（percutaneous nephrectomy,PCN）外引流23次。结果引流成功23例,PCN外引流成功率86.9%（20/23）,双J管内引流成功率60.0%（9/15）,PCN术后继发出血1例。结论对于盆腹腔进展期或广泛转移肿瘤导致的梗阻,PCN解除梗阻优于输尿管支架内引流;非肿瘤性梗阻宜先尝试D J内引流。     

How to Effectively Implement an Indicator System to Improve Performance from a Management Perspective: The Case of Taiwan Healthcare Indicator Series (THIS) System

This study uses the Taiwan Healthcare Indicator Series (THIS) system as an example to examine which determinants would improve performance by sharing indicators from a management perspective. This study population included all 227 hospitals participating in the THIS system in 2006. A structured questionnaire was sent to the director who was responsible for the THIS system via electronic mail. A total of 111 responses were returned by February 10, 2006. Questions included current implementation and impacts of the system. Hierarchical regression models were performed to identify which variables were significantly associated with performance improvement, adjusted for hospital characteristics. Four variables significantly associated with implementing the THIS system to improve performance were ‘senior management support,’ ‘benchmarking,’ ‘making departments improve the underperforming indicators and report the improvement results in performance management meetings,’ and ‘integration with the National Health Insurance payment regulations’. This study contributes substantially to the evidence base about what works to improve performance by information sharing. Although information sharing is the basis of efforts to improve performance, senior management support and how to effectively apply the information are the most important determinants of performance enhancement.     

A free scapular skin flap for penile reconstruction.

INTRODUCTION: There are many possible methods for penis reconstruction, among them, pedicled flaps, myocutaneous flaps, combined osseocutaneous flaps, and free skin flaps. This study evaluated the free scapular skin flap method for penile reconstruction. METHODS: Fifteen men aged 20 to 48 underwent the procedure between March 2000 and February 2006, with follow-up examinations from 6 months to 5 years. RESULTS: Fourteen of the reconstructions were successful, with patients enjoying good cosmetic results as well as functionality. CONCLUSION: The free scapular skin flap technique is a good method for penile reconstruction.     

精液FSH、LH、PRL和T水平与精子质量关系的研究

目的探讨人精液中性激素水平与精子质量的关系。方法参照WHO标准方法,进行精子密度、活动率检测,按不同密度和活动率分为4个组。采用ELISA法分析FSH、LH、PRL和T水平。用脱氧核苷酸末端转移酶(TdT)介导的缺口末端标记(TUNEL)法检测生殖细胞的凋亡。结果68例不育者精子密度和活动率随精液性激素水平减少而下降,呈显著性正相关(P均<0.01),生育组精液中FSH、LH、PRL和T水平分别为(1.73±0.15)mIU/ml、(2.28±0.21)mIU/ml、(6.44±0.30)ng/ml、(1.95±0.11)ng/ml,生殖细胞凋亡率为(4.71±1.23)%,与不育组(1.35±0.18)mIU/ml、(1.86±0.32)mIU/ml、(5.96±0.31)ng/ml、(1.55±0.13)ng/ml和(19.36±2.04)%相比有显著性差异(P<0.01)。不育组FSH、LH、PRL、T水平与生殖细胞的凋亡率呈显著性负相关(r分别为-0.89、-0.94、-0.91、-0.98)。结论精液低性激素水平可使睾丸生殖细胞凋亡率增加,精子密度和活率下降而致男性不育。     

Ad-METH1对培养的内皮细胞分泌活性的影响

目的：研究基因重组血管抑制剂Ad-METH1（metalloprotease and thrombospondin1）对培养的内皮细胞分泌活性的影响,探讨血管生成抑制防治增生性瘢痕的可能机制。方法：制备重组血管抑制剂Ad-METH1,转染培养的人脐静脉内皮细胞,通过放射免疫分析法及酶联免疫分析法研究Ad-METH1对内皮细胞分泌内皮素-1（endothelin-1,ET-1）及碱性成纤维细胞生长因子（basic fibroblast growth factor,bFGF）的影响。结果：基因转染后24h内皮细胞ET-1、bFGF分泌受到明显抑制。结论：Ad-METH1对内皮细胞ET-1、bFGF分泌活性有影响,此是其早期参与抑制增生性瘢痕形成的可能机制之一。     

自身免疫性胰腺炎的CT表现特征(附4例分析)

目的探讨自身免疫性胰腺炎(AIP)的CT表现特征。方法收集4例经临床、实验室检查和类固醇激素治疗有效的AIP患者的CT资料。CT检查包括平扫、双期(动脉期和门静脉期)增强扫描,在CT图像上观察胰腺的形态、大小、质地、强化程度、胰管、胰腺边缘、胰周及腹膜后各间隙等情况并分析AIP的CT表现特征。结果3例AIP表现为胰腺弥漫性肿大,1例为胰头的局限性肿大;病变区域胰腺实质在动脉期强化减弱但出现明显的延时强化;2例在胰腺病变区周围环绕包膜样结构;2例伴胆总管胰头段狭窄,1例ERCP显示胰管不规则狭窄;经类固醇激素治疗后,CT复查显示胰腺情况明显好转。结论AIP的CT表现具有一定的特征性。