天然关节及人工关节的润滑机理探讨

对人类天然关节及人工关节的润滑机理进行了探讨。简要回顾了关节润滑研究的发展历史。对关节润滑中的一些关键问题进行了讨论。另外,对关节润滑机理的研究成果如何在临床实践中应用也进行了讨论。     

α-突触核蛋白对内质网应激及细胞凋亡影响

目的:构建α-突触核蛋白(α-synuclein,SNCA)和SNCA突变基因(SNCAmu)过表达转染293T细胞,观察内质网应激及细胞凋亡.方法:应用PCR技术扩增目的基因并插入慢病毒载体质粒,重组质粒的构建及包装293T细胞,转染24 h后用荧光显微镜观察绿色荧光蛋白(green fluorescent prot...     

双重滤过血浆置换治疗重症抗N-甲基-D-天冬氨酸受体脑炎9例疗效分析

目的 探讨双重滤过血浆置换（DFPP）对重症抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎的治疗效果及临床意义。方法 回顾性分析2014年1月至2018年3月海军军医大学（第二军医大学）长海医院确诊的、经甲泼尼龙冲击治疗无效的9例重症抗NMDAR脑炎患者的病例资料。收集患者在DFPP治疗前后的临床表现及实验室、脑电图、影像学检查资料,并分析DFPP的治疗效果。结果 9例抗NMDAR脑炎患者（男4例、女5例）均入住神经内科重症监护病房治疗,年龄为15～69岁,中位发病年龄为37岁,平均住院时间为（33.2±7.6）d。主要临床症状有精神行为异常（9例）、自主神经功能障碍（9例）、癫发作（7例）、中枢性低通气（5例）、意识障碍（5例）。1例合并卵巢畸胎瘤。9例患者脑脊液抗NMDAR均呈阳性,7例血清抗NMDAR阳性。9例患者均行脑电图检查,7例显示异常,以弥漫性改变、异常慢波为主要表现。头颅磁共振成像检查示：4例患者额叶、顶叶、颞叶、海马等脑区可见异常信号,余5例未见异常。9例患者经甲泼尼龙冲击治疗均无效,行DFPP治疗后5例完全恢复,4例临床症状显著改善、遗留部分症状。结论 对于糖皮质激素治疗无反应的重症抗NMDAR脑炎患者,DFPP作为一种可选择的替代血浆置换的治疗手段可取得较好的临床疗效,且不受异体血浆资源的限制。     

Clinical features of the patients with major depressive disorder co-occurring insomnia and hypersomnia symptoms: a report of NSSD study

BackgroundThe co-occurrence of insomnia and hypersomnia symptoms in patients with major depressive disorder (MDD) is associated with suicidal ideation and functional impairment. The relationship between sleep disturbances and clinical features and outcomes may not be adequately studied. In this study, we measured the functional impairments and clinical features of co-occurring insomnia and hypersomnia symptoms in Chinese patients with MDD.MethodsA post-hoc analysis was performed on data from the National Survey on Symptomatology of Depression (NSSD), which assessed the MDD patients in 32 hospitals by a clinician-rating questionnaire. The clinical features and outcomes were compared among the following four groups: insomnia symptom only, hypersomnia symptom only, both insomnia and hypersomnia symptoms, no sleep disturbance, respectively.ResultsTotally, 234 (7.15%) of 3275 participants with MDD co-occurred insomnia and hypersomnia symptoms. They had more depressive symptoms (27.41 ± 9.123), higher rate of suicide ideation (39.7%), more severe impairment in physical (58.1%), economic (32.9%), work (55.1%), and relationship with families (29.5%). Patients with both sleep disturbances were more likely to excessive worry about sleep, have suicidal ideation, the distress of social disharmony, more somatic symptoms, lack of energy, hyperphagia, loss of mood reactivity, and diurnal change, whereas less likely to have anxious mood.LimitationsSleep disorders were not diagnosed by current standard diagnostic criteria.ConclusionsPatients co-occurring with both sleep disturbances are associated with a higher rate of suicide risk and poorer social function. Our study could provide implications for suicidal risk evaluation and the development of therapeutic strategies for depression.     

腹膜附加带的解剖学观测及其临床意义

目的 了解腹膜腔中腹膜附加带出现情况。方法 对６０例防腐尸体标本的腹膜腔进行观察测量。结果 腹膜附加带的出现率分别为：生殖肠系膜臂为５％；回肠膜为１１．７％；结肠间膜为１５％；横结肠系膜空肠膜为５％；升结肠系膜为８．３％；乙状结肠系膜带为３．３％。结论各种腹膜附加带的出现率在成人与儿童间无显著性差异，它们可使肠管发生扭转或梗阻。     

IFN-γ联合TNF-α活化小鼠腹腔巨噬细胞抗不同毒力株弓形虫的作用

目的： 比较ＩＦＮ－γ联合ＴＮＦ－α体外活化的小鼠腹腔巨噬细胞（ＭΦ） 对强毒株ＲＨ株及弱毒株Ｆｕｋａｙａ株的抗虫作用。方法： 体外以ＩＦＮ－γ与ＴＮＦ－α联合活化昆明系小鼠腹腔ＭΦ,观察其对入侵的ＲＨ株及Ｆｕｋａｙａ株速殖子的抗虫作用, 测定培养上清中ＮＯ的水平。结果： 在以ＩＦＮ－γ１００Ｕ＋ ＴＮＦ－α１００Ｕ 活化的ＭΦ中, 入侵２４ｈ 后的ＲＨ株弓形虫速殖子被完全杀灭, 而Ｆｕｋａｙａ 株速殖子则缓慢增殖, 且前者培养上清中ＮＯ水平显著高于后者。结论：ＩＦＮ－γ活化的ＭΦ对入侵的ＲＨ 株和Ｆｕｋａｙａ株速殖子的抗虫作用存在差异,这可能与ＮＯ的水平有关。     

Histomorphological observation in arterial remodeling following New Zealand rabbit auto-extremity artery transplantation

Objective： To investigate the histomorphological change in auto-extremity artery following transplantation. Methods： 50 New Zealand rabbits were randomly divided into 5 groups（postoperative 1 d, 3 d, 7 d, 14 d, 56 d, n = 10）. Femoral artery was harvested and end-to-side anastomosed with carotid in order to build the auto-extremity arterial graft animal model. On the postoperative 1^st, 35^nd, 7^th, 14th and 56^th days, grafts for morphometric analysis under the Image analysis system were obtained; and electron microscope was scanned to observe endothelial cells. In addition, Immunostaining of sections were performed with the mouse monoclonal antibody of the a -smooth muscle isoform of actin and proliferating cell nuclear antigen antibody. Results： Overall patency rate for all conduits was 86%.The intimal hyperplasia was first observed in the 7^th day group, and continued to increase in the 56^th day group（183.21 ± 111.74） μ m, P 〈 0.01. Additionally, the luminal narrowed（32.43 ± 18.28）% in the 56^th day group. Smooth muscle cells were the mainly hyperplastic components. The most active proliferation of cells was detected in the 14^th day group, where the extracellular matrix gradually deposited in the intima. Conclusion： Moderate intimal hyperplasia occurred in arterial conduits and vascular structure experienced constrictive remodeling after auto-transplantation.     

变应性鼻炎治疗体会

目的探索变应性鼻炎有效、实用的治疗方法。方法选择2005至2007年在本社区卫生服务中心门诊就诊的变应性鼻炎患者389例，其中274例采用西替利嗪口服联合1％呋麻及地塞米松滴鼻治疗，作为药物组；115例采用上述药物结合激光治疗，作为药物激光联合组，并比较两组的治疗效果。结果药物激光联合组的显效率和总有效率比药物组高，差异有统计学意义（P均〈0.01）。结论采用激光结合药物治疗能更有效地缓解控制变应性鼻炎。     

Effect of Qingyitang on activity of intracellular Ca^2＋-Mg^2＋-ATPase in rats with acute pancreatitis

AIM: To study the change of intracellular calcium-magnesium ATPase (Ca(2+)-Mg(2+)-ATPase) activity in pancreas, liver and kidney tissues of rats with acute pancreatitis (AP), and to investigate the effects of Qingyitang (QYT) (Decoction for clearing the pancreas) and tetrandrine (Tet) and vitamin E (VitE) on the activity of Ca(2+)-Mg(2+)-ATPase. METHODS: One hundred and five Sprague-Dawley rats were randomly divided into: normal control group, AP group, treatment group with QYT (1 ml/100 g) or Tet (0.4 ml/100 g) or VitE (100 mg/kg). AP model was prepared by a retrograde injection of sodium taurocholate into the pancreatic duct. Tissues of pancreas, liver and kidney of the animals were taken at 1 h, 5 h, 10 h respectively after AP induction, and the activity of Ca(2+)-Mg(2+)-ATPase was studied using enzyme-histochemistry staining. Meanwhile, the expression of Ca(2+)-Mg(2+)-ATPase of the tissues was studied by RT-PCR. RESULTS: The results showed that the positive rate of Ca(2+)-Mg(2+)-ATPase in AP group (8.3%, 25%, 29.2%) was lower than that in normal control group (100%) in all tissues (P<0.01), the positive rate of Ca(2+)-Mg(2+)-ATPase in treatment group with QYT (58.3%, 83.3%, 83.3%), Tet (50.0%, 70.8%, 75.0%) and VitE (54.2%, 75.0%, 79.2%) was higher than that in AP group (8.3%, 25.0%, 29.2%) in all tissues (P<0.01). RT-PCR results demonstrated that in treatment groups Ca(2+)-Mg(2+)-ATPase gene expression in pancreas tissue was higher than that in AP group at the observing time points, and the expression at 5 h was higher than that at 1 h. The expression of Ca(2+)-Mg(2+)-ATPase in liver tissue was positive, but without significant difference between different groups. CONCLUSION: The activity and expression of intracellular Ca(2+)-Mg(2+)-ATPase decreased in rats with AP, suggesting that Ca(2+)-Mg(2+)-ATPase may contribute to the occurrence and development of cellular calcium overload in AP. QYT, Tet and VitE can increase the activity and expression of Ca(2+)-Mg(2+)-ATPase and may relieve intracellular calcium overload to protect the tissue and cells from injuries.