电离辐射致股骨头坏死早期病理特点和机制的研究

Objective To observe the earlier pathological character and mechanism of radiation osteonecrosis in femoral head, in order to provide evidences for the earlier diagnosis and prevention of radiation osteonecrosis of femoral head. Methods Single femoral head of rats were irradiated singly with 30 Gy of 137 Cs γ-ray. The rats were executed after 2, 6 and 12 weeks, then the femurs were stained with HE and histopatholngical changes were observed by light microscope. The bone marrow mesenchymal stem cells (BMSCs) were cultured after 2 weeks and its proliferation and the colony formation were observed. The rats were endo-perfused with microfili contrast medium 12 weeks later, and the 3-dimensional structure of capillaries by Micro-CT was re-estabhshed to detect the pathological changes of capillaries after irradiation. Result The irradiated femur showed deranged cbondrocyte, decreased osteocyte, shrinking nucleus, increased empty bone lacuna and reduced bone trabocnla (P < 0.05). Micro-CT showed the discontinued small vessels and absence(6.65 %) capillaries in irradiated femur were obviously less than those of the unirradiated (12.3 %)(P < 0.001). The proliferation of BMSCs was slowed, the number of colony in irradiated group (10 %) was less than that of control (21 %) (P < 0.001). Conclusions The preliminary histopathological changes of osteoradionecrosis on femoral head could be increased the empty bone lacuna, and the bone lacuna above 30 % was the sign of the earlier period of osteoradionecrosis. The osteonecrosis of femoral head induced by radiation is not only correlated to the damages to the bone, but also to the damages to BMSCs and capillaries.     

心肌缺血发作时间的分析与护理对策

近年来心血管疾病随着人们生活节奏的加快 ,工作压力的增长 ,呈现不仅上升而且年轻化的趋势。有相当一部分人发生猝死。急性心肌缺血是发生猝死的主要原因。为了掌握心肌缺血患者发病时间的规律 ,以便更好地做好心肌缺血病患的护理工作。本文通过Holter对 84例冠心病、急性心肌缺血、无症状心肌缺血患者给予 2 4h心电监测 ,发现心肌缺血的发生与时间具有一定关系 ,并据此提出了相应的护理对策。1　资料和方法1.1　一般资料　 2 0 0 2年 3月～ 2 0 0 4年 3月我院住院患者 5 1例 ,门诊患者 3 3例 ,共 84例 ,经临床诊断 ,确诊为冠心病者 49例 …     

小鼠肠腺瘤类器官培养及其辐射敏感性

目的 建立小鼠肠腺瘤类器官的体外培养方法,观察其对电离辐射的反应。方法 采用氧化偶氮甲烷(azoxymethane,AOM)和葡聚糖硫酸钠(detrain sodium sulfate,DSS)诱导小鼠产生肠腺瘤。体外分离腺瘤类隐窝结构,接种于基质胶。通过培养基筛选,确定肠腺瘤类器官的体外培养条件,采用免疫组化染色检测Ki67和β-catenin表达水平。进一步采用X线照射,观察肠腺瘤类器官损伤情况,比较其与大、小肠类器官的辐射敏感性。 结果 经AOM/DSS诱导,小鼠肠腺瘤成瘤率达95%,肿瘤均位于结肠靠近直肠处,肠腺瘤类器官在改良的小肠类器官中生长良好,Ki67阳性腺瘤细胞比例高且β-catenin入核特征明显。经X线照射,各类器官存活比例随辐射剂量增加而降低。9 Gy照射7天后,腺瘤类器官存活率为11.96%±1.42%,高于同剂量大肠类器官的5.46%±1.22% (t=6.0082,P＜0.01),小肠类器官几乎未见存活。腺瘤类器官剂量存活曲线较大、小肠类器官右移,提示其辐射敏感性低于大肠和小肠。 结论 在AOM/DSS诱导产生的小鼠肠腺瘤中成功分离培养出腺瘤类器官,其辐射敏感性低于大、小肠类器官。     

高原地区慢性阻塞性肺疾病患者肺动脉高压发生率及危险因素分析

目的评价高原地区慢性阻塞性肺疾病(COPD)患者肺动脉高压(PH)的发生率及可能的潜在危险因素。方法选取2014年9月至2017年3月在该院呼吸科住院的川西高原地区的COPD患者261例作为研究对象,根据慢性阻塞性肺疾病全球倡议(GOLD指南)分级:GOLDⅠ级92例,GOLDⅡ级116例,GOLDⅢ级39例,GOLDⅣ级14例。患者常规进行彩色多普勒超声心动图检查,肺动脉收缩压(PASP)≥40mm Hg(1mm Hg=0.133kPa)拟诊为PH。结果 PH发生率为29.88%。Ⅰ级PH发生率为19.57%,明显低于Ⅱ级的34.48%和Ⅲ~Ⅳ级的37.74%,差异均有统计学意义(P0.05)。PASP与第1秒用力呼气容积占预计值的百分比(FEV1%)、血氧饱和度、B型钠尿肽、平均血小板体积(MPV)、左心室射血分数、左心房内径存在相关关系(r=-0.297、-0.303、0.255、0.302、-0.336、0.394,P0.05)。Logistic回归分析显示,FEV1%、MPV为PH的危险因素。结论高原地区COPD患者中PH发生率较高,FEV1%较低、MPV较高的患者更易发生PH。     

40例永久性心脏起搏器植入术后并发症原因分析及护理对策

目的探讨永久性心脏起搏器植入术后并发症发生的原因、临床表现、处理方法、护理对策及健康指导。方法对2009年4月～2011年10月植入永久性心脏起搏器40例患者的临床护理资料进行回顾性分析,提出护理措施。结果术后发生并发症7例,发生率为17.5%,其中起搏器囊袋积血2例（28.6%）,起搏器感知障碍1例（14.3%）,起博器综合征1例（14.3%）,电极脱位2例（28.6%）,肺内感染及下肢静脉血栓形成1例（14.3%）。所有并发症经积极处理后,患者均恢复正常。结论重视永久性心脏起搏器植入患者术后观察及护理,熟悉相关理论知识,早期发现及时处理,对预防及减少并发症的发生具有重要意义。     

电离辐射致股骨头坏死早期病理特点和机制的研究

Objective To observe the earlier pathological character and mechanism of radiation osteonecrosis in femoral head, in order to provide evidences for the earlier diagnosis and prevention of radiation osteonecrosis of femoral head. Methods Single femoral head of rats were irradiated singly with 30 Gy of 137 Cs γ-ray. The rats were executed after 2, 6 and 12 weeks, then the femurs were stained with HE and histopatholngical changes were observed by light microscope. The bone marrow mesenchymal stem cells (BMSCs) were cultured after 2 weeks and its proliferation and the colony formation were observed. The rats were endo-perfused with microfili contrast medium 12 weeks later, and the 3-dimensional structure of capillaries by Micro-CT was re-estabhshed to detect the pathological changes of capillaries after irradiation. Result The irradiated femur showed deranged cbondrocyte, decreased osteocyte, shrinking nucleus, increased empty bone lacuna and reduced bone trabocnla (P < 0.05). Micro-CT showed the discontinued small vessels and absence(6.65 %) capillaries in irradiated femur were obviously less than those of the unirradiated (12.3 %)(P < 0.001). The proliferation of BMSCs was slowed, the number of colony in irradiated group (10 %) was less than that of control (21 %) (P < 0.001). Conclusions The preliminary histopathological changes of osteoradionecrosis on femoral head could be increased the empty bone lacuna, and the bone lacuna above 30 % was the sign of the earlier period of osteoradionecrosis. The osteonecrosis of femoral head induced by radiation is not only correlated to the damages to the bone, but also to the damages to BMSCs and capillaries.     

电离辐射致股骨头坏死早期病理特点和机制的研究

Objective To observe the earlier pathological character and mechanism of radiation osteonecrosis in femoral head, in order to provide evidences for the earlier diagnosis and prevention of radiation osteonecrosis of femoral head. Methods Single femoral head of rats were irradiated singly with 30 Gy of 137 Cs γ-ray. The rats were executed after 2, 6 and 12 weeks, then the femurs were stained with HE and histopatholngical changes were observed by light microscope. The bone marrow mesenchymal stem cells (BMSCs) were cultured after 2 weeks and its proliferation and the colony formation were observed. The rats were endo-perfused with microfili contrast medium 12 weeks later, and the 3-dimensional structure of capillaries by Micro-CT was re-estabhshed to detect the pathological changes of capillaries after irradiation. Result The irradiated femur showed deranged cbondrocyte, decreased osteocyte, shrinking nucleus, increased empty bone lacuna and reduced bone trabocnla (P < 0.05). Micro-CT showed the discontinued small vessels and absence(6.65 %) capillaries in irradiated femur were obviously less than those of the unirradiated (12.3 %)(P < 0.001). The proliferation of BMSCs was slowed, the number of colony in irradiated group (10 %) was less than that of control (21 %) (P < 0.001). Conclusions The preliminary histopathological changes of osteoradionecrosis on femoral head could be increased the empty bone lacuna, and the bone lacuna above 30 % was the sign of the earlier period of osteoradionecrosis. The osteonecrosis of femoral head induced by radiation is not only correlated to the damages to the bone, but also to the damages to BMSCs and capillaries.     

骨康灵联合99Tc-MDP治疗糖皮质激素诱发骨质疏松细胞分子机制研究

目的观察骨康灵和99Tc-MDP联合治疗糖皮质激素诱发的骨质疏松优于单独治疗的细胞分子机制。方法用SD大鼠随机分为DEX(地塞米松)、DEX-MDP(地塞米松+99 Tc-MDP 2mg/kg)、DEX-Z(地塞米松+骨康灵2ml/kg)和DEX-MDP-Z(地塞米松+99 Tc-MDP 2mg/kg+骨康灵2ml/kg)组。给药后颈动脉放血,制备含药血清,用MTT和PNPP法检测其对成骨细胞增殖与分化的影响;用TRAP染色和骨片吸收陷窝法观察其对破骨细胞的数目和功能影响;取大鼠股骨骨髓细胞,用Real-time PCR方法检测骨髓细胞RUNX2和PPARγ的表达。结果显示与对照组及单独治疗组相比联合用药组对成骨细胞有微弱的促分化作用,对破骨细胞有较强的抑制其数量和骨吸收的功能;同时联合用药能上调RUNX2与PPARγ的比值。结论中药骨康灵联合99Tc-MDP能有效抑制破骨细胞的数目和功能,同时促进骨髓间充质干细胞向成骨细胞前体分化,这可能是其优于单独治疗的细胞分子机制之一。     

电离辐射致股骨头坏死早期病理特点和机制的研究

Objective To observe the earlier pathological character and mechanism of radiation osteonecrosis in femoral head, in order to provide evidences for the earlier diagnosis and prevention of radiation osteonecrosis of femoral head. Methods Single femoral head of rats were irradiated singly with 30 Gy of 137 Cs γ-ray. The rats were executed after 2, 6 and 12 weeks, then the femurs were stained with HE and histopatholngical changes were observed by light microscope. The bone marrow mesenchymal stem cells (BMSCs) were cultured after 2 weeks and its proliferation and the colony formation were observed. The rats were endo-perfused with microfili contrast medium 12 weeks later, and the 3-dimensional structure of capillaries by Micro-CT was re-estabhshed to detect the pathological changes of capillaries after irradiation. Result The irradiated femur showed deranged cbondrocyte, decreased osteocyte, shrinking nucleus, increased empty bone lacuna and reduced bone trabocnla (P < 0.05). Micro-CT showed the discontinued small vessels and absence(6.65 %) capillaries in irradiated femur were obviously less than those of the unirradiated (12.3 %)(P < 0.001). The proliferation of BMSCs was slowed, the number of colony in irradiated group (10 %) was less than that of control (21 %) (P < 0.001). Conclusions The preliminary histopathological changes of osteoradionecrosis on femoral head could be increased the empty bone lacuna, and the bone lacuna above 30 % was the sign of the earlier period of osteoradionecrosis. The osteonecrosis of femoral head induced by radiation is not only correlated to the damages to the bone, but also to the damages to BMSCs and capillaries.