MSCT后处理技术在肘关节严重创伤中的应用研究

目的：评价64层螺旋CT（MSCT）后处理技术在肘关节严重创伤中的临床应用价值。方法26例肘关节严重创伤患者行CT检查,运用多平面重建（MPR）、表面遮盖显示（SSD）和容积再现（VR）重建,分析肘关节骨折及脱位情况。结果26例肘关节严重创伤患者轴位影像结合后处理技术共发现53处骨折,7例伴有脱位。其中肱骨外侧髁骨折13处,肱骨内侧髁9处,髁间骨折6处,尺骨鹰嘴骨折12处,尺骨冠状突骨折8处,桡骨小头骨折5处。结论 MSCT运用各种后处理技术结合轴位影像,可以发现各种细小骨折及显示骨折内部情况,能够直观、立体、多方位、多角度显示骨折部位、骨碎片移位、关节面损伤、关节脱位等,有利于临床医生选择合适的治疗方案,提高诊疗水平。     

面神经F波对周围性面神经炎的早期诊断意义

目的探讨面神经F波对于周围性面神经炎的早期诊断意义。方法应用肌电图诱发电位检查仪对53例早期（3d内）周围性面神经炎的患者分别检测健侧和患侧面神经F波。结果其中37例严重病变患者患侧面神经F波消失，健侧面神经F波存在。16例轻至中度病变患者患侧面神经F波存在，但患侧面神经F波的平均潜伏期、潜伏期最小值及潜伏期最大值和健侧相比明显延长，患侧F波出现率和健侧相比明显减少。所有53例患者的统计结果表明F波健侧与患侧的差异有高度统计学意义（P〈0.0001），健侧明显高于患侧。结论面神经F波作为一种能准确评价面神经颅内段功能的简单、敏感的客观方法，为一种早期诊断周围性面神经瘫痪的客观指标，将在面神经疾病的早期诊断中发挥作用。     

全脑DSA在脑血管病变诊断中的价值

目的 收集行介入检查的42例全脑数字减影血管造影(DSA)完整资料,分析其影像检查的选择及在临床方面的应用价值.方法 经CT和/或MRI检查发现或临床高度怀疑脑血管疾病的病例,行全脑DSA检查.结果 行DSA前,CT和/或MRI阳性发现21例,行DSA后阳性发现42例.结论 DSA不但能对动脉瘤、动静脉畸形、烟雾病、脑静脉畸形等定性定位诊断,而且对病变的范围及严重程度亦可清楚地了解,为手术提供较可靠的客观依据,对于脑出血、蛛网膜下腔出血,可进一步查明导致出血的病因,不失为一种行之有效的诊断方法.     

隐球菌脑膜炎无创动态脑水肿监测分析

目的观察隐球菌脑膜炎患者脑水肿变化情况及脑水肿无创监测的灵敏性、稳定性。方法8例隐球菌脑膜炎患者纳入研究组;对照组10例均为排除颅内病变的周围神经病或肌肉疾病患者。采用BORN-BE无创脑水肿监护仪多次、动态监测每位患者双侧大脑半球的水肿指数,并观察脑水肿指数与腰穿测压有无一致性,甘露醇对脑水肿指数的影响。结果对照组患者的脑水肿指数多次监测结果重复性好,左右大脑半球对称。隐球菌脑膜炎组脑水肿指数为9.47±1.24,对照组为5.79±0.84,差异具有显著统计学意义;单次使用甘露醇125ml和250ml相比,脑水肿指数降低幅度无显著性差异,但使用250ml时作用可维持7~8h;对同一患者,脑水肿指数可粗略估计脑脊液压力水平。结论以BORN-BE无创脑水肿动态监护仪可客观监测隐球菌脑膜炎患者的脑水肿情况。     

海口市公立与私立学校中学生主观生存质量及心理健康状况调查

有关中学生的主观生存质量因素的影响如何，心理健康状况如何，如何提高学生的心理健康水平和指导学生正确处理心理矛盾、心理障碍等等这些问题都是值得医务工作者深入探讨的问题。为此文章对海口市公立与私立学校中学生主观生存质量及心理健康学生进行了抽样调查。１对象与方法１．１对象海南省海口市两所公立和两所私立中学的２０００名在校的学生。回收１９１２份调查表，回收率为９５．６％。其中公立学校学生１０００名（５２．３％），高中学生５０９人，初中学生４９１名。私立学校学生９１２名（４７．７％），高中学生４２０名，初…     

RNA干扰技术阻断α-synuclein过表达诱导的细胞凋亡

BACKGROUND： Overexpression of α-synuclein can induce cell apoptosis. RNA interference （RNAi） may block specific gene function and cause gene silencing. OBJECTIVE： To construct a specific and effective RNAi plasmid for the α-synuclein gene and investigate if RNAi can block apoptosis in HEK293 cells, induced by overexpression of wild-type α-synuclein.
DESIGN, TIME AND SETTING： A contrast experiment based on genetically engineered cytobiology was performed at the State Key Lab of Medical Genetics of China, Xiangya Medical College of Central South University, between October 2004 and October 2008.
MATERIALS： HEK293 cells and pBSHH1 plasmid were provided by the State Key Lab of Medical Genetics of China; OligDNA sequence by Sagon Bioengineering Company, Shanghai; Lipofectamine 2000 by Invitrogen, USA; α-synuclein monoclonal antibody, Hoechst 33258, and MTT by Sigma, USA; Horseradish peroxidase-coupled goat anti-rat IgG by KPL, USA; FACSan flow cytometry by BD, USA.
METHODS： Four target sites were used to construct hairpin RNA pBSHH1 vectors - pSYNi-1, pSYNi-2, pSYNi-3 and pSYNi-4 - which were cloned in the pBSHH1 plasmid. HEK293 cells were transfected using Lipofectamine 2000. In addition, a non-transfect group and a negative plasmid transfect group were established. The cultured HEK293 cells were processed as follows： transfection of blank plasmid （blank control group）, transfection of α-synuclein-pEGFP and RNAi negative vector （negative control group）, and transfection of α-synuclein-pEGFP and pSYNi-1 （transfection group）. Cells in all groups were transfected with Lipofectamine 2000 for 48 hours.
MAIN OUTCOME MEASURES： Expression of α-synuclein mRNA and protein were detected by RT-PCR and Western blot. Cell morphology was observed under an inverted fluorescence microscope; cell viability was measured using MTT method; and cell apoptosis was determined with Annexin V-PE flow cytometry.
RESULTS： α-synuclein mRNA and protein expressions were significantly decreased in the pSYNi-1 group when compared with the non-transfect and negative plasmid transfect groups （P 〈 0.05）. The expressions were partially decreased in the pSYNi-2 group, but there was no significant difference in the pSYNi-3 and pSYNi-4 groups. Hoechst staining indicated that cell nuclei were enlarged in the negative control group, coloring was not uniform, and chromatin was accumulated and appeared spot-like. The nucleus coloring was uniform in the transfection group compared to negative control group. Cell viability in the negative control group was significantly lower than blank control group with cell apoptosis being significantly increased （P 〈 0.05）. In comparison with negative control group, cell viability was significantly increased in the transfection group and cell apoptosis was significantly decreased （P 〈 0.05）.
CONCLUSION： pSYNi-1 can inhibit α-synuclein gene expression and block apoptosis of HEK293 cells induced by overexpression of wild-type α-synuclein.     

124例贲门癌术前诊断和外科治疗分析

目的：提高贲门癌术前诊断与外科治疗的认识。方法：对１９８６－１９９６年外科治疗１２４例贲门癌进行回顾怀调查分析。结果：手术切除８２例，姑息手术６例，单纯探查３６例，术后发生吻合瘘３例，腹腔内出血１例，术后７－８个月发生吻合口狭窄４例。除吻合瘘１例发生全身衰竭死亡外，。其余均痊愈出院。结论：内镜检查是诊断贲让癌主要手段。根据各种不同情况采用不同手术进路。使用吻合器可简便手术操作，缩短时间、减少并发症     

小泛素样修饰蛋白对α-突触核蛋白线粒体亚细胞定位及α-突触核蛋白经泛素系统降解的影响

目的 探讨α-突触核蛋白(α-synuclein)的小泛素样修饰蛋白1(small ubiquitin-like modifier1,SUMO-1)化修饰对α-synuclein蛋白亚细胞线粒体定位及α-synuelein蛋白经泛素系统降解的影响.方法 构建野生型、A53T突变型和缺失SUMO-1互作氨基酸的K96R突变型α-synuclein真核表达质粒.将野生型、A53T突变型和K96R突变型α-synuclein真核表达质粒分别转染HEK293细胞;在转染后48 h通过应用线粒体染色剂和激光共聚焦技术,观察野生型、A53T突变型及缺失SUMO-1修饰的α-synuclein蛋白的亚细胞线粒体定位和蛋白聚集情况.在转染后48 h应用anti-ubiquitin抗体进行Western印迹分析,明确野生型、A53T突变型及缺失SUMO-1修饰的α-synuclein蛋白泛素化程度有无差别.结果 将构建所得EGFP-α-synuclein-WT、EGFP-α-synuclein-A53T、EGFP-α-synuclein-K96R真核表达质粒经双酶切鉴定及DNA测序证实;激光共聚焦结果显示野生型、A53T突变型、K96R突变型α-synuclein蛋白均广泛分布于细胞质和细胞核中,以细胞质为主,野生型、A53T型细胞可见绿色荧光物质在胞质积聚,形成强荧光斑块,K96R型胞质内绿色荧光物质聚集少;野生型、A53T突变型、K96R突变型α-synuclein均与线粒体存在共定位,A53T突变型、K96R突变型α-synuclein在SUMO-1修饰或缺失的情况下对α-synuclein蛋白的线粒体亚细胞定位无明显影响.Western印迹结果显示转染缺失SUMO-1互作氨基酸的K96R突变型α-synuclein真核表达质粒组的细胞泛素蛋白的含量与转染空质粒组相比无明显变化,转染野生型、A53T突变型α-synuclein真核表达质粒组HEK293细胞中泛素蛋白的含量减少.结论 α-synuclein基因过度表达及致病突变A53T对α-synuclein蛋白的线粒体亚细胞定位无明显影响;SUMO-1修饰对α-synuclein蛋白的线粒体亚细胞定位也无明显影响;SUMO-1对a-αsynuclein基因过度表达及A53T突变型α-synuclein细胞内泛素化蛋白数量产生影响.     

腰麻联合硬膜外麻醉与硬膜外麻醉用于分娩镇痛的比较

目的比较腰麻联合硬膜外麻醉(CSEA)与硬膜外麻醉(CEA)用于分娩镇痛的效果。方法选择产妇60例,随机均分成腰麻联合硬膜外麻醉CSEA组30例(A组)和单纯硬膜外麻醉CEA组30例(B组)。A组蛛网膜下腔注入0.1%罗哌卡因2mg和芬太尼25ug,然后硬膜外腔置入导管3cm,B组硬膜外穿刺置管成功,经硬膜外导管注入0.1%罗哌卡因和芬太尼2ug/ml总量20ml。两组完成均经硬膜外导管接上微量泵(PCA),以6ml/h的速度0.1%罗哌卡因+芬太尼0.2mg 50ml泵入。记录镇痛效果、麻醉前后血流动力学改变、产程、产后出血量及新生儿Apgar评分、产妇对镇痛效果评估、运动神经阻滞情况以及并发症。结果两组病人年龄、体重、身高、孕期无明显差异(P<0.05),麻醉HR、MAP相同,镇痛效果A组I级多于B组(P<0.05),产妇自我评估达到I级无明显差异(P<0.05),运动神经阻滞无明显差异,两组新生儿Apgar评分[1]无差异,未出现并发症。结论腰麻联合硬膜外麻醉(CSEA)与单纯硬膜外(CEA)麻醉用于分娩镇痛效果满意,但CSEA镇痛效果更好。