Therapeutic ultrasound enhances medial collateral ligament repair in rats

The purpose of this study was to evaluate the effects of therapeutic ultrasound (US) on medial collateral ligament healing. A total of 36 3-month-old male Sprague-Dawley rats with transected medial collateral ligaments were studied. Subjects were given 5-min pulsed US therapy (duty cycle; one application in 4 ms; 1:4) daily with different durations (1 day, 5 days and 10 days) and intensities (0, 0.5 and 2.3 W/cm2). After each treatment, the level of transforming growth factor beta-1 (TGF-beta1) of the ligament was measured. TGF-beta1 was not detected in the 1-day group. In the 5-day and 10-day groups, the levels of TGF-beta1 were significantly up-regulated in the high-dose subgroup (p < 0.05). The 10-day group also registered a significantly higher expression of TGF-beta1 than did the 5-day group (p < 0.05). The present findings suggest that pulsed US therapy may enhance ligament repair by up-regulating the extent of TGF-beta1 in a high-dose application. Long-term treatment with this therapy could obtain further improvement.     

Haematological effect of pulsed ultrasound in acute muscular inflammation in rats

Objective

To evaluate the effect of low-intensity pulsed ultrasound (LIPUS) on the haematological dynamics of an acute inflammatory process after an iatrogenic muscular lesion.

Design

Controlled laboratory study.

Setting

Research laboratory.

Participants

Eighteen male Wistar rats (weight 350 to 450 g) were submitted to surgical incision in the biceps femoris muscle (approximately 50%), and subsequently subdivided into control (n = 9) and LIPUS (n = 9) groups.

Intervention

Ultrasound (1.0 MHz) was applied at the lesion site in the pulsed mode (2 ms on, 8 ms off) at 0.4 W/cm² for 3 minutes at 1, 8 and 24 hours post-surgery.

Main outcome measures

In these periods, blood was collected through venepuncture of the retro-orbital plexus and evaluated for different types of leukocytes and erythrocytes.

Results

LIPUS reduced the total leukocyte count at 1, 8 and 24 hours post-surgery (1 hour, control 9017.2 ± 481 × 10³/mm³ vs LIPUS 6189.8 ± 450 × 10³/mm³; 8 hours, control 8078.2 ± 501 × 10³/mm³ vs LIPUS 5371.3 ± 378 × 10³/mm³; 24 hours, control 8192.3 ± 646 × 10³/mm³ vs LIPUS 6059.1 ± 503 × 10³/mm³; P < 0.001). The monocyte count was reduced at 8 and 24 hours post-surgery (8 hours, control 815.5 ± 126 × 10³/mm³ vs LIPUS 375.4 ± 70 × 10³/mm³; 24 hours, control 875.3 ± 124 × 10³/mm³ vs LIPUS 564.7 ± 56 × 10³/mm³; P < 0.001). The number of segmented neutrophils was only reduced at 1 hour post-surgery (control 5033.1 ± 397 × 10³/mm³ vs LIPUS 3594.8 ± 191 × 10³/mm³; P = 0.006), and the lymphocyte count was only reduced at 8 hours post-surgery (control 4759.7 ± 459 × 10³/mm³ vs LIPUS 2584.1 ± 356 × 10³/mm³; P = 0.003). Changes were not observed in the concentrations of young neutrophils, polibocytes and erythrocytes.

Conclusion

LIPUS reduced aspects of the inflammatory process following an acute incisional muscular lesion.     

实时组织弹性成像在PGE2诱导的兔骨骼肌炎症中的应用价值

目的初步探讨实时组织弹性成像在前列腺素E2(PGE2)诱导的兔骨骼肌炎症中的应用价值。方法 20只新西兰大白兔右后肢注射PGE2建立肌肉炎症模型;每周注射1次,共5周,采用自身对照。注射后1、2、5周弹性成像扫查,将弹性图像同病理结果对照。结果 1、2、5周,注射侧同对侧比较差异均具有统计学意义(P0.05);1、2周注射侧比较差异不具有统计学意义(P0.05);1、2周同5周注射侧比较差异具有统计学意义(P0.05)。结论实时组织弹性成像较二维超声能早期发现病变,对肌肉炎症的早期诊断有一定价值。     

Homocysteine effect on protein degradation rates

OBJECTIVES: To show the effect of homocysteine (Hcy) on the degradation rates of proteins. DESIGN AND METHODS: Degradation rates of short-lived proteins in neutrophils were measured in in vivo human model of elevated plasma Hcy and lower vitamin status and in animal model of Hcy added in vitro to rat neutrophils. RESULTS: In the human study, we found significant coefficients of correlation between plasma total homocysteine (tHcy) and the degradation rates of 21 protein fractions. In the animal model, Hcy significantly increased degradation rates of 57 protein fractions. CONCLUSIONS: The increase in protein degradation rates, induced by Hcy, may provide a clue to our understanding of the mechanism of Hcy detrimental effects. Hcy may amplify the specific effect of cellular solutes on protein conformation, thereby monitor protein degradation rates to control enzyme activity. Consequently, the cell may lose its ability to maintain an efficient control of some crucial metabolic pathways, possibly leading to atherogenesis.     

小儿阴囊急症的临床特征和高频超声表现

目的 探讨小儿阴囊急症的临床特征和高频超声表现.方法 分析112例小儿阴囊急症的超声和临床表现,并与最终诊断及治疗方案对照.结果 急性附件扭转65例,超声表现为睾丸上极或附睾头旁回声不均结节,伴或不伴继发反应性炎症.睾丸完全扭转21例,超声示患侧精索螺旋状扭曲成团,睾丸内无明显血流信号;不全扭转4例,患侧精索走行纡曲,睾丸内均可测及少量低阻血流信号.急性睾丸、附睾炎22例,除1例化脓性睾丸炎外,其余病例受累结构血供增多;超声诊断符合率约为98.21%(110/112).三者临床表现虽部分重叠但仍各具特征.15例附件扭转、25睾丸扭转及1例急性睾丸炎接受手术治疗,余均予以保守治疗.结论 客观、准确的急诊超声诊断报告,辅以全面深入的临床资料分析,可为小儿阴囊急症的诊疗提供重要帮助.     

The acute effects of prostaglandin E1 on the pulmonary circulation and oxygen delivery in patients with the adult respiratory distress syndrome

Prostaglandin E₁ was administered intravenously to 10 patients who had the adult respiratory distress syndrome associated with severe infection in order to investigate its hemodynamic effects. Infusion of PGE₁ significantly decreased the mean pulmonary arterial pressure, mean systemic arterial pressure, pulmonary vascular resistance and systemic vascular resistance, and increased the cardiac index, oxygen delivery and oxygen consumption. No significant difference was noted in the intrapulmonary shunt fraction. These results indicate that administration of PGE₁ improves pulmonary hemodynamics and tissue oxygenation in patients with acute respiratory distress syndrome, by reducing right ventricular afterload and increasing the cardiac index.     

膝关节后交叉韧带断裂对内侧副韧带组织学的影响

背景：通过比较Ⅰ型胶原、Ⅲ型胶原相对数量和Ⅰ/Ⅲ型胶原的比值可以一定程度上判断韧带的组织学性能。目的：观察膝关节后交叉韧带断裂兔保持较低生理负荷和活动度时内侧副韧带组织学的变化。方法：24只成年雄性家兔双侧膝关节配对为自身对照,实验侧行后交叉韧带完全切断,对照侧只暴露后交叉韧带而不切断,造模后第8,16,24,40周随机处死6只实验兔。进行苏木精-伊红染色,天狼猩红染色检测Ⅰ型和Ⅲ型胶原的相对数量。结果与结论：①苏木精-伊红染色结果：8,16,24周两组内侧副韧带胶原分布、排列无明显差别;40周时实验组胶原纤维较对照组稀疏。②天狼猩红染色结果：8,16,24周实验组内侧副韧带的Ⅰ型和Ⅲ型胶原纤维总和分别较对照组显著增加（P〈0.05）;40周时实验组较对照组显著减少（P〈0.05）;8周实验组和对照组之间内侧副韧带的Ⅰ/Ⅲ型胶原纤维的比值差异无显著性意义（P〉0.05）;16,24,40周时实验组比值显著分别小于对照组（P〈0.05）。说明兔膝关节后交叉韧带损伤后短期内对内侧副韧带组织学特性无明显影响,随着时间延长,组织学特性显著下降。     

Molecular and Biological Characterization of the Murine Leukotriene B4 Receptor Expressed on Eosinophils

The movement of leukocytes into tissues is regulated by the local production of chemical mediators collectively referred to as chemoattractants. Although chemoattractants constitute a diverse array of molecules, including proteins, peptides, and lipids, they all appear to signal leukocytes through a related family of seven transmembrane–spanning G protein–coupled receptors. The eosinophil is a potent proinflammatory cell that is attracted into tissues during allergic inflammation, parasitic infection, and certain malignancies. Since the molecular mechanisms controlling eosinophil recruitment are incompletely understood, we performed a degenerate polymerase chain reaction on cDNA isolated from murine eosinophils to identify novel chemoattractant receptors. We report the isolation of a cDNA that encodes a 351–amino acid glycoprotein that is 78% identical to a human gene that has been reported to be a purinoceptor (P2Y₇) and a leukotriene B₄ (LTB₄) receptor (BLTR). Chinese hamster ovary (CHO) cells transfected with this cDNA specifically bound [³H]LTB₄ with a dissociation constant of 0.6 ± 0.1 nM. Furthermore, LTB₄ induced a dose-dependent intracellular calcium flux in transfected CHO cells. In contrast, [³⁵S]dATP did not specifically bind to these transfectants. This mRNA was expressed at high levels in interleukin 5–exposed eosinophils, elicited peritoneal macrophages and neutrophils, and to a lesser extent interferon γ stimulated macrophages. Low levels of expression were detected in the lung, lymph node, and spleen of unchallenged mice. Western blot analysis detected the mBLTR protein in murine eosinophils and alveolar macrophages as well as human eosinophils. In addition, elevated levels of mBLTR mRNA were found in the lungs of mice in a murine model of allergic pulmonary inflammation in a time course consistent with the influx of eosinophils. Our findings indicate that this murine receptor is an LTB₄ receptor that is highly expressed on activated leukocytes, including eosinophils, and may play an important role in mediating eosinophil recruitment into inflammatory foci.     

甲状腺结节超声造影研究进展

甲状腺癌在内分泌肿瘤中发病率最高,早期诊断对甲状腺癌的治疗及预后至关重要.超声造影在甲状腺良恶性鉴别诊断方面具有一定价值.本文就甲状腺结节超声造影的现状及其展望作一综述.     

湖南地区成人血清IgG亚类水平调查及影响因素分析

目的调查湖南地区成年人血清IgG亚类的浓度水平,探讨年龄、性别及生活方式等因素的影响。方法用免疫散射比浊法测定170例体检者血清中IgG_1、IgG_2、IgG_3、IgG_4和IgG浓度。结果血清IgG_1、IgG_2、IgG_3、IgG_4和IgG浓度分别为(7.53±0.14)g/L、3.99(3.13,5.02)g/L、0.49(0.30,0.70)g/L、0.53(0.26,0.93)g/L、12.2(10.5,14.1)g/L;血清IgG_1/IgG、IgG_2/IgG、IgG_3/IgG和IgG_4/IgG分别为(61.3±0.69)%、33.38(27.8,38.8)%、3.97(2.5,5.3)%和4.44(2.1,7.3)%。女性血清IgG_3浓度及IgG_3/IgG比值高于男性(P=0.005,0.014);不同性别间IgG_1、IgG_2、IgG_4及IgG_1/IgG、IgG_2/IgG、IgG_4/IgG的差异无统计学意义。31~40岁组血清IgG_3浓度显著高于41~50岁组(P=0.03),而年龄对血清IgG_1、IgG_2和IgG_4浓度的影响无统计学意义。重度吸烟组血清IgG_1的浓度比不吸烟组低,差异有统计学意义(P=0.023)。重度吸烟组IgG_4/IgG高于不吸烟组(P=0.018)。中/重度饮酒组血IgG_1、IgG_3浓度和IgG_3/IgG比值比不饮酒组低(P=0.05,0.004,0.015)。代谢综合征低风险组血清IgG_3和IgG_3/IgG高于高风险组(P=0.034,0.038)。结论性别和年龄对于血清IgG_3浓度的影响有显著意义。重度吸烟可能导致IgG_1的浓度降低和IgG_4/IgG比值的上升。血清IgG_1、IgG_3和IgG_3/IgG的降低与饮酒存在一定的关系。     

高频超声诊断外伤后肢体软组织急性损伤

目的 应用高频超声观察外伤后肢体软组织急性损伤的特征,并评价其诊断价值.方法 对103例外伤后3周内肢体肿胀、疼痛的患者行高频超声检查.结果 103例患者中肌肉撕裂34例,肌腱断裂6例,关节腔积血19例,韧带损伤10例,肌间血肿17例,骨化性肌炎6例,异物11例.97例116处出现皮下组织增厚、肌肉水肿,回声紊乱.结论 高频超声可作为外伤后肢体软组织急性损伤后便捷的、可动态应用的首选影像学检查方法.     

三维超声产前诊断胎儿梅干腹综合征

目的 探讨梅干腹综合征(PBS)的产前超声诊断及其意义,并讨论三维超声在诊断过程中的作用. 方法 回顾性分析6例PBS胎儿的超声表现,并与引产后及尸检结果进行对照分析. 结果 6例胎儿中,5例产前超声诊断为PBS,1例诊断为PBS或后尿道瓣膜.引产后,6例胎儿均证实为PBS,其中4例合并有其他畸形. 结论 产前超声检查是诊断PBS极其有效的首选方法.三维超声成像技术可为诊断PBS提供新的信息.     

超声在筛检大鼠肝泡状棘球蚴病模型中的应用价值

目的 评价超声在筛检大鼠肝泡状棘球蚴病模型中的应用价值.方法 采用经皮肝脏穿刺注射泡状棘球蚴组织混悬液的方法,制备原发性HAE模型,40只Wistar大鼠接种6个月后行B超检查及开腹探查.结果 B超检查示21只大鼠感染泡状棘球蚴,19只未感染,感染率52.50%.开腹探查证实B超检查21只阳性中1只未感染,19只未感染中1只为阳性.B超检查的灵敏度为95.24%,特异性为94.74%,假阳性率为4.27%,假阴性率5.27%.结论 B超检查诊断大鼠肝泡状棘球蚴感染的灵敏度及特异度均较高,可做为一种无创性筛选大鼠肝泡状棘球蚴感染的方法.     

常规超声及超声造影评价不同肾功能移植肾的血流灌注

目的 应用常规超声和超声造影比较不同肾功能的移植肾的灌注状况.方法 根据血清肌酐(SCr)值将60例移植肾患者分为SCr正常组和SCr异常组.二维超声观测移植肾结构及主肾动脉内径;彩色多普勒超声观察主肾动脉、段动脉、叶间动脉及弓形动脉的收缩期峰值流速(PSV)、舒张期末流速(EDV)及阻力指数(RI);超声造影结合时间-强度曲线定量分析段动脉、叶间动脉、皮质及锥体的到达时间(AT)、达峰时间(TTP)、绝对强度(△I)及上升斜率(Increase);分别比较采用每种检查方法所测得的两组患者指标间差异.结果 二维超声和彩色多普勒超声检查(弓形动脉EDV除外)所测得的两组患者指标间差异无统计学差异;超声造影检查SCr正常移植肾的灌注指标大部分优于SCr异常的移植肾,差异有统计学意义.结论 肾功能正常移植肾的超声造影定量指标明显优于肾功能异常的移植肾,超声造影能够检测出肾功能异常移植肾的微循环灌注改变.     

产前超声诊断Larsen综合征

目的 观察胎儿下肢膝关节屈曲方向,提高胎儿下肢关节畸形的产前诊断率. 方法 对妊娠中期和晚期的胎儿行常规超声检查,同时观察胎儿四肢长骨、足部形态和膝关节屈曲方向. 结果 受检胎儿中有3例表现为双下肢膝关节形态异常,1例妊娠30周人工终止妊娠,2例足月剖宫产终止妊娠.3例均为女性,均表现为面部、大关节和手足异常,临床诊断为Larsen综合征. 结论 当产前超声检查时发现胎儿双膝关节向心性屈曲、双下肢运动受限、双下肢长骨短、足部短小或伴形态异常时应高度怀疑Larsen综合征.通过观察胎儿膝关节屈曲方向可提高胎儿下肢关节畸形的产前诊断率.     

Vitamin B(12) deficiency as a cause of delirium in a patient with spinal cord injury

Harrington AL, Dixon TM, Ho CH. Vitamin B₁₂ deficiency as a cause of delirium in a patient with spinal cord injury.A man with spinal cord injury (SCI) and multiple medical comorbidities had new-onset delirium during his 14th month of hospitalization. Diagnostic workup did not elicit an obvious etiology for mental status changes. Delirium persisted despite psychiatry intervention, and he was unable to be weaned from the ventilator because of prolonged agitation. Routine anemia workup revealed a possible untreated vitamin B₁₂ deficiency, although laboratory values were inconclusive. Empiric treatment with cyanocobalamin injections was initiated, and his delirium remarkably resolved after 3 weeks of treatment. We provide a concise review of the etiologies and varied clinical presentations of vitamin B₁₂ deficiency. As illustrated in this case, classic laboratory findings may not appear, and neurologic impairments from SCI can obscure the physical signs of deficiency, making diagnosis difficult. Empiric treatment may be indicated in cases of neuropsychiatric abnormalities not explained by other causes.     

彩超诊断累及肝脏的遗传性出血性毛细血管扩张症

目的 探讨彩色多普勒超声对累及肝脏的遗传性、出血性毛细血管扩张症(HHT)的诊断价值.方法 观察5例临床确诊的 HHT累及肝脏患者的超声表现. 结果 5例患者均表现为肝固有动脉及肝内动脉分支明显增宽伴走行纡曲、扩张,血流速度增快;1例发现肝内动-静脉瘘,1例合并有肝硬化. 结论 彩超为诊断遗传性、出血性毛细血管扩张症(HHT)提供一种新的检查方法,具有重要临床价值.     

不同孕周正常胎儿心脏大小的超声检测与临床意义

目的 探讨产前超声检查胎儿心脏生长指标与孕周的相关性.方法 应用二维超声测量14～39周正常胎儿左心房(LA)、右心房(RA)、左心室(LV)、右心室(RV)、主动脉(AO)和肺动脉(PA)内径及卵圆孔大小(FO)、心脏面积(HA)、胸腔面积(TA)、心脏周长(HC)、胸廓周长(TC),分析孕周与测量值的关系. 结果 线性回归分析表明,胎儿时期心脏各腔室大小、AO、PA及室间隔(IVS)厚度随孕龄增加而增大,与孕周呈显著正相关;肺动脉与主动脉内径比值(PA/AO)、左心房与右心房内径比值(LA/RA)、左心室与右心室内径比值(LV/RV)、心脏周长与相应胸廓周长比值(HC/TC)、心脏面积与相应胸廓面积比值(HA/TA)与不同孕周比较各比值变化不明显. 结论胎儿心脏随孕龄增加而增大,其中心脏面积与孕周最具相关性.     

超声造影评估正常肾脏皮质与锥体的血流灌注差异

目的 利用超声造影评估正常肾脏皮质与锥体的血流灌注差异.方法对30名健康人共60个肾脏行超声造影(CEU),利用ACQ软件的时间-强度曲线(TIC)分析,观察指标为肾皮质和肾锥体的造影剂到达时间(AT)、达峰时间(TTP)及达峰强度(PI),并计算两者的差异.结果肾皮质的AT、TTP及PI 分别为(12.24±3.56)s、(20.67±4.35)s和(25.33±4.17)dB;肾锥体为(14.18±3.34)s、(22.27±3.28)s和(23.03±3.43)dB.两者AT,TTP和PI间差异均有统计学意义(P<0.05).结论正常肾皮质与肾锥体的超声造影TIC定量参数不同,讨论两者的定量指标,可为临床肾相关疾病的诊断和鉴别诊断提供依据.     

Lowering homocysteine and modifying nutritional status with folic acid and vitamin B(12) in Indian patients of vascular disease

Hyperhomocysteinemia is more commonly associated with vascular disease in Indians than in the western populations. It is caused by genetic polymorphisms or dietary deficiencies of the B vitamins. We attempted to identify the association of hyperhomocysteinemia with vitamin B(12) and folate in Indian patients of vascular disease. Homocysteine, vitamin B(12) and folate levels were estimated in 100 controls and 100 patients of vascular disease. Homocysteine estimation was repeated in 73 patients on different vitamin supplements for 6 months. Homocysteine exhibited a significant negative correlation with B(12) only in cerebrovascular disease and peripheral vascular diseasepatients, and with folate in coronary artery disease and cerebrovascular disease patients as well as controls. Single daily dose of folate was as effective as a combination of folate and cobalamin in reducing plasma homocysteine concentrations. Low levels of B(12) contribute to the higher incidence of cerebrovascular disease and peripheral vascular disease, and low folate levels account for higher prevalence of hyperhomocysteinemia in coronary artery disease and cerebrovascular disease. Moreover, irrespective of the cause of hyperhomocysteinemia, folate is known to ameliorate it. Hence, large-scale corrective measures like food fortification or dietary supplementation with folate might benefit the Indian population and reduce the incidence and morbidity of vascular disease.