AO跟骨板在Ⅲ、Ⅳ型跟骨骨折的临床应用

目的 评价AO跟骨板治疗Ⅲ、Ⅳ型跟骨骨折的疗效。方法 21例29足严重跟骨骨折按Sanders分型：Ⅲ型18足；Ⅳ型11足，采用AO跟骨板及髂骨(或人工骨)植骨进行有限坚强内固定。对年老、骨质疏松严重的Ⅲ型和Ⅳ型跟骨骨折后距下关节不能达到解剖复位，整复跟骨外形后，AO跟骨板固定，同时一期行距下关节融合术。结果 按Maryland足部评分系统评价术后功能，本组29足Ⅲ、Ⅳ型跟骨骨折行AO跟骨板固定总体优良率为82．8％。结论 AO跟骨板治疗Ⅲ、Ⅳ型跟骨骨折疗效肯定，术后早期功能练习．减少骨折并发症，是一种治疗Ⅲ、Ⅳ型跟骨骨折的理想方法。     

Morphological and serum hyaluronic acid, laminin and type Ⅳ collagen changes in dimethylnitrosamine-induced hepatic fibrosis of rats

AIM: To study the morphological and serum hyaluronic acid (HA), laminin (LN), and type Ⅳ collagen changes in hepatic fibrosis of rats induced by dimethylnitrosamine (DMN).METHODS: The rat model of liver fibrosis was induced by DMN. Serum HA, type Ⅳ collagen, and LN were measured by ELISA. The liver/weight index and morphological changes were examined under electron microscope on d 7, 14, 21, and 28 by immunohistochemical alpha smooth muscle actin α-SMA staining as well as Sirius-red and HE staining.RESUJLTS: The levels of serum HA, type Ⅳ collagen and LN significantly increased from d 7 to d 28 (P = 0.043).The liver/weight index increased on d 7 and decreased on d 28. In the model group, the rat liver stained with HE and Sirius-red showed evident hemorrhage and necrosis in the central vein of hepatic 10 lobules on d 7. Thin fibrotic septa were formed joining central areas of the liver on d 14. The number of α-SMA positive cells was markedly increased in the model group. Transitional hepatic stellate cells were observed under electron microscope.All rats in the model group showed micronodular fibrosis in the hepatic parenchyma and a network of α-SMA positive cells. Typical myofibroblasts were embedded in the core of a fibrous septum. Compared to the control group, the area-density percentage of collagen fibrosis and pathologic grading were significantly different in the model group (P＜0.05) on different d (7, 14, and 28). The area-density percentage of collagen fibrosis in hepatic tissue had a positive correlation with the levels of serum HA, LN, and type Ⅳ collagen.CONCLUSION: The morphological and serum HA, type Ⅳ collagen, and LN are changed in DMN-induced liver fibrosis in rats.     

桑叶乙酸乙酯萃取物化学成分分析

[目的]提取分离桑叶中的化学成分,并对其进行结构鉴定.[方法]利用800 mL/L乙醇对桑叶进行提取,溶剂梯度萃取,硅胶柱层析分离,利用核磁共振氢谱及碳谱等波谱学方法确定各成分结构.[结果]从乙醇提取物的乙酸乙酯萃取部分得6种化合物,经结构鉴定分别为β-谷甾醇(Ⅰ)、胡萝卜苷(Ⅱ)、山奈酚-3-O--βD-葡萄糖苷(Ⅲ)、槲皮素-3-O-β-D-葡萄糖苷(Ⅳ)、槲皮苷(Ⅴ)及桑黄素-3-O--βD-吡喃葡萄糖苷(Ⅵ),其中化合物Ⅵ为首次从桑叶中分离得到.     

Morphological and serum hyaluronic acid, laminin and type Ⅳ collagen changes in dimethylnitrosamine-induced hepatic fibrosis of rats

AIM: To study the morphological and serum hyaluronic acid (HA), laminin (LN), and type Ⅳ collagen changes in hepatic fibrosis of rats induced by dimethylnitrosamine (DMN). METHODS: The rat model of liver fibrosis was induced by DMN. Serum HA, type Ⅳ collagen, and LN were measured by ELISA. The liver/weight index and morphological changes were examined under electron microscope on d 7, 14, 21, and 28 by immunohistochemical alpha smooth muscle actin α-SMA staining as well as Sirius-red and HE staining. RESULTS: The levels of serum HA, type Ⅳ collagen and LN significantly increased from d 7 to d 28 (P = 0.043). The liver/weight index increased on d 7 and decreased on d 28. In the model group, the rat liver stained with HE and Sirius-red showed evident hemorrhage and necrosis in the central vein of hepatic 10 lobules on d 7. Thin fibrotic septa were formed joining central areas of the liver on d 14. The number of α-SMA positive cells was markedly increased in the model group. Transitional hepatic stellate cells were observed under electron microscope. All rats in the model group showed micronodular fibrosis in the hepatic parenchyma and a network of α-SMA positive cells. Typical myofibroblasts were embedded in the core of a fibrous septum. Compared to the control group, the area-density percentage of collagen fibrosis and pathologic grading were significantly different in the model group (P<0.05) on different d (7, 14, and 28). The area-density percentage of collagen fibrosis in hepatic tissue had a positive correlation with the levels of serum HA, LN, and type Ⅳ collagen. CONCLUSION: The morphological and serum HA, type Ⅳ collagen, and LN are changed in DMN-induced liver fibrosis in rats.     

延边农村地区汉族和朝鲜族居民血脂异常分布特征比较

目的：调查分析延边农村地区汉族和朝鲜族居民血脂异常分布特征。方法：调查于2004-08／09完成，随机抽取延边地区汪清县大兴沟镇汉族和朝鲜族居民455名，均自愿参加调查。排除混血民族。①按统一的调查表（包括研究对象的一般情况、心脑血管疾病的既往史及家族史等）进行家访询问调查。②测量身高、体质量、腰围、臀围、血压等。取清晨空腹静脉血，测量血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇、空腹血糖等指标，均用全自动生化分析仪测定。③分析血脂异常与其影响因素的关系采用Logistic回归分析。结果：调查问卷、体格检查及生化指标检测结果完整者455人。①两民族血脂异常率比较：朝鲜族男女血脂异常率显著高于汉族[84．1％，88．8％；30．7％，42．1％（x^2=48．9，53．4，P〈0．01）]，而且其高胆固醇血症、低高密度脂蛋白胆固醇血症、单纯高收缩压、单纯高舒张压、高血糖等患病率也均高于汉族（P〈0．05-0．01），朝鲜族女性的高三酰甘油血症患病率高于汉族女性（P〈0．01）。②血脂异常者不同血脂类型构成：延边农村地区的血脂异常以低高密度脂蛋白胆固醇为主要类型。③血脂异常相关因素的多因素分析：最终进入方程的因素分别为：民族、性别、收缩压、空腹血糖及腰围（OR=0．108，95％（21：0．061～0．190；OR=1．539，95％CI：0．970～2．441；OR=1．670．95％CI：1．020～2．757；OR=2．565．95％CI：270～5．183；OR=1．890，95％CI：1．196～3．008）。结论：延边农村地区汉族和朝鲜族人群血脂异常患病率存在差异，该地区的血脂异常与居民的民族、性别、收缩压、空腹血糖及腰围有关，并且以低高密度脂蛋白胆固醇血症为主要类型。     

Paeoniflorin ameliorates neuropathic pain-induced depression-like behaviors in mice by inhibiting hippocampal neuroinflammation activated via TLR4/NF-κB pathway

Neuropathic pain (NP) that contributes to the comorbidity between pain and depression is a clinical dilemma. Neuroinflammatory responses are known to have potentially important roles in the initiation of NP and depressive mood. In this study, we aimed to investigate the effects of paeoniflorin (PF) on NP-induced depression-like behaviors by targeting the hippocampal neuroinflammation through the toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway. We used a murine model of NP caused by unilateral sciatic nerve cuffing (Cuff). PF was injected intraperitoneally once a day for a total of 14 days. Pain and depression-like behavior changes were evaluated via behavioral tests. Pathological changes in the hippocampus of mice were observed by H&E staining. The levels of proinflammatory cytokines in the hippocampus were detected using ELISA. Activated microglia were measured by immunohistochemical staining. The TLR4/NF-κB signaling pathway-associated protein expression in the hippocampus was detected by western blotting. We found that the PF could significantly alleviate Cuff-induced hyperalgesia and depressive behaviors, lessen the pathological damage to the hippocampal cell, reduce proinflammatory cytokines levels, and inhibit microglial over-activation. Furthermore, PF downregulated the expression levels of TLR4/NF-κB signaling pathway-related proteins in the hippocampus. These results indicate that PF is an effective drug for improving the comorbidity between NP and depression.     

钾通道在D型钠尿肽抑制胃动力中的作用

目的:探讨钾通道在D型钠尿肽抑制豚鼠胃窦环形肌自发性收缩活动中的作用.方法:采用四道生理记录仪记录豚鼠胃窦环形肌自发性收缩活动;应用放射免疫法测定豚鼠胃窦环形肌组织和灌流液中环-磷酸鸟苷(cGMP)含量;运用全细胞模式的膜片钳技术记录豚鼠胃窦环形肌上钙敏感钾电流和延迟整流型钾电流.结果:DNP抑制豚鼠胃窦环形肌自发性收缩活动并呈现剂量依赖性.1、10、100及1000nmol/L的DNP抑制自发性收缩幅度分别为35%±6%、54%±6%、78%±13%及94%±6%.10 nmol/L鸟苷酸环化酶抑制剂LY83583使收缩幅度抑制减弱(42%±6%vs60%±4%.P<0.05);而用100 nm01/L的cGMP依赖的磷酸脂酶抑制剂zaparinast使DNP对胃窦环行肌自发性收缩的抑制效应增强(72%±7%vs58%±5%,P<0.05).DNP明显增加豚鼠胃窦环形肌组织和灌流液中的cGMP水平.10 nmol/LDNP增加豚鼠胃窦环形肌上钙敏感钾电流,在60mV时增加的幅值为62.31%±3.22%,抑制延迟整流型钾电流,在60 mV时抑制幅度为18%±2.3%.结论:DNP通过增加I<,K(ca)>和cGMP途径实现对豚鼠胃窦环形肌的舒张作用.I<,K(v)>不参与此过程,但在维持豚鼠胃窦环形肌细胞的静息膜电位中起重要作用.     

塞来昔布超前镇痛在经腹前列腺切除术中的应用

目的研究术前口服塞来昔布辅助经腹前列腺切除术后硬膜外自控镇痛（PCEA）的效果。方法40例行经腹前列腺切除术的患者被随机分为两组。术前30min分别口服塞来昔布200mg和维生素C100mg，术后行硬膜外自控镇痛。于术后1、4、8、16、20和24h行VAS评分，并记录PCEA药物用量、按压次数、实进次数和D／D比值，于术后8、16和24h评估下肢运动神经阻滞程度，在术后24h由患者对术后镇痛的总体印象进行评估。结果两组患者的一般情况和术后各时间点的生命体征、VAS评分比较，差异无显著性（P〉0.05）。与C组比较，V组术后4、8、16、20和24h的镇痛药剂量、按压次数、实进次数高（P〈0．05），两组各时间点D／D比值比较，差异无显著性（P〉0.05）。两组患者改良Bromage评分均为0分，差异无显著性（P〉0．05）。两组患者膀胱痉挛发生率和对术后镇痛的总体印象比较，差异无显著性（P〉0．05）。V组有2例（10%）发生恶心、呕吐，而C组无，差异无显著性（P〉0.05）。结论塞来昔布可明显减少经腹前列腺切除术后PCEA的用药量，增加镇痛效果，适于辅助术后硬脊膜外自控镇痛。