150例腰椎间盘突出症的非手术治疗

目的通过临床治疗和观察，了解综合疗法在治疗腰椎间盘突出症中的作用和疗效，从而选择一种较好的治疗方法。方法通过对150例腰椎间盘突出症患者的治疗和疗效观察，分析了不同的非手术治疗方法对不同年龄、不同性别和不同类型的腰椎间盘突出症患者的治疗效果。结果150例患者经治疗后疗效分别为优108例，良22例，可15例。差5例，总有效率为96．7％。不同性别之间的治疗时间与治疗效果无明显差异；不同年龄患者、不同治疗时间，其治疗效果无明显差异；不同突出类型患者的治疗时间与效果均不同。结论正确选择治疗的适应证，综合的非手术疗法可以对腰椎间盘突出症取得良好的治疗效果。     

尺骨近端骨折的内固定法选择

目的了解尺骨近端内固定法在不同情况下的选择使用。方法通过近几年来所收治的患者治疗方法及疗效比较观察。结果骨折类型不刚，内固定方法不同，其预后也不同。结论在尺骨骨折时须根据不同骨折类型选择不同的内固定法。     

浸润性乳腺癌分子分型与辅助化疗方案选择

随着基因表达谱与基因芯片技术的开展,乳腺癌在分子水平上表现出的高度异质性也逐渐受到关注。不同分子分型的乳腺癌,其流行病学危险因素、疾病自然进展过程以及对全身或局部治疗的反应性都不尽相同;对于乳腺癌的准确分型能够较为精确地反映肿瘤的生物学行为,对于判断预后、制定更具个体化的治疗策略具有深刻的意义。2011年的St.Gallen共识已针对不同的乳腺癌分子分型给出了原则性的治疗建议,标志着乳腺癌的治疗已逐步进入了在规范化多学科综合治疗模式的基础上,倡导个体化治疗的时代。     

国内不同海拔地区中老年妇女骨质疏松的比较研究

目的本研究通过收集分析不同地区提供的骨密度(BMD)数据,探讨不同海拔与BMD的相关性。方法收集近十年来在国内期刊公开发表的文献资料的29个不同海拔地区骨密度检测结果,将BMD用统一的公式转化为同一年龄组的骨密度T值,再进行统计分析。结果不同海拔地区的骨密度存在差异(r=0.32),海拔与骨密度及日照时间存在正相关关系(P0.05)。结论海拔对中老年妇女骨质疏松有重要的影响。     

不同腭裂类型儿童/i/音鼻音共振峰分析研究

目的：研究单侧腭裂、双侧腭裂、软腭裂儿童的/i/音鼻音共振峰,探讨能够反映不同腭裂类型的客观指标。方法：使用Pr aat语音分析软件在分析正常儿童以及不同腭裂类型儿童不同元音共振峰的基础上,分析/i/音共振峰,确定及分析不同腭裂类型的鼻音共振峰。结果/：i/音鼻音共振峰的频率值以及能量差可以反映不同腭裂类型间的差别。结论/：i/音鼻音共振峰可作为反映腭裂患者共鸣程度以及鼻音的一个新的客观指标。     

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??Invasive breast cancer molecular classification and the choice of adjuvant chemotherapy regimens CHEN Jia-jian, LIU Guang-yu. Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Corresponding author: LIU Guang-yu, E-mail: liugy123@yahoo.com
Abstract With the adoption and development of gene expression technique, the heterogeneity at the molecular level of the breast cancer has attracted attention gradually. The different breast cancer subtypes have different epidemiological risk factors, different natural histories and different responses to systemic and local therapies. To identify the exact subtype of the breast cancer has profound significance on making individualized therapies. The consensus of St. Gallen Breast Cancer Conference 2011 has provided different treatment suggestions according to different subtypes, which indicates that the management of breast cancer has entered the age of advocating individualized treatment on the basis of the standardization multi-disciplinary treatment gradually.     

双氢睾酮对前列腺癌LNCaP细胞线粒体呼吸链酶学变化的影响

目的 观察双氢睾酮对人前列腺癌细胞LNCaP细胞株线粒体呼吸链酶学变化的影响,探讨双氢睾酮引起LNCaP线粒体内酶学变化的作用机制.方法 获得雄激素依赖性细胞(LNCaP)细胞株,进行细胞培养,获得稳定生长及传代的细胞株.不同浓度的雄激素受体激动剂双氢睾酮作用于培养的LNCaP细胞株;不同时间点提取干预措施下的LNCaP线粒体;检测并比较不同时间点、不同浓度药物作用下LNCaP线粒体呼吸链酶学的变化和差异.结果 DHT作用于LNCaP细胞后,线粒体蛋白的含量显著增加(P＜0.05),但SDH、NADH、COX的含量显著下降(P＜0.05),各个指标在不同的时间点上下降的程度有所差异.结论 双氢睾酮可引起LNCaP线粒体内蛋白的表达量升高,促进LNCaP的增殖.     

寰枢椎不稳后路手术固定的研究

目的 比较研究寰枢椎不稳后路固定的方法,为寰枢椎不稳患者制定合理的手术方案。方法 回顾5年来手术治疗的34例寰枢椎不稳病例,并对几种手术方法的适应证、稳定性和疗效进行比较研究,分析其结果。结果 寰枢椎不稳的不同病因采用不同的固定方法临床结果不同。后路钢丝法对齿状突骨折引起的寰枢椎不稳固定效果良好,类风湿关节炎所导致的寰枢椎不稳后路钢丝固定也有好的疗效,但术后需用严格的头颈胸石膏固定。Apofix椎板夹固定与Brooks法固定效果无显著差异。Magerl螺钉是最牢靠的内固定方法。结论 寰枢椎不稳采用后路手术固定应根据不同的病因选择不同的固定融合方法和术后辅助外固定。     

Analysis of stress on the proximal femur in various kinds of loading using the finite element method]

Loading of the limb in bending hip position causes a torque loading component in respect to the femoral axis. In this condition a characteristical increase of the mechanical tension of the femoral surface occurs. The tension was calculated for different kinds of loading and for the first time in different bending hip positions by means of Finite-Element-Method (FEM). The results show, that the torque loading component causes different torsional deformations. Even in physiological gait patterns different sizes of torsion and even changing of the direction of the torsion could be demonstrated.     

Forces required to remove bougies from tracheal tubes*

Following a critical incident on our labour ward, we investigated the forces required to remove different bougies from different tracheal tubes and the effect of lubrication on ease of removal. Two studies were conducted: firstly examining the differences between six different bougies with a standard tracheal tube, and secondly examining the differences between four different tracheal tubes with a standard bougie. The forces varied amongst both the different bougies (p < 0.0001) and the different tracheal tubes (p < 0.0001). Removal was generally easier with lubrication but when corrected for multiple comparisons this did not reach statistical significance.     

Calcium channel blockade in smooth muscle of the human upper urinary tract. II. Effects on norepinephrine-induced activation

The effects of the calcium channel blockers verapamil and nifedipine on norepinephrine-induced activation were studied in different tissues of the human upper urinary tract. In usually inactive ureteral muscle strips, norepinephrine induced predominantly phasic contractions with only minimal effects on resting tension. In contrast, in isolated segments of the renal calyx and pelvis, irrespective of preexisting spontaneous phasic activity, the same agonist effected a long-lasting tonic contraction. These different types of mechanical activity induced by norepinephrine showed different sensitivities to calcium channel blockers, phasic contractions being potently suppressed while the tonic response was little affected by the drugs. This different pattern of response to norepinephrine and the different sensitivity of the responses to calcium channel blockers suggest different and separate coupling mechanisms between the receptors involved and the calcium pools responsible for initiation of contraction. The existence of different calcium pathways activating the contractile proteins in the human upper urinary tract is postulated.     

输液器对酚妥拉明吸附作用的实验研究

目的探讨输液器对酚妥拉明的吸附作用及其影响因素.方法采用紫外分光法测定不同浓度,不同输注速度的酚妥拉明在通过输液器前及输液器后各时段药物浓度.结果不同输注速度及不同浓度酚妥拉明注射液通过输液器即刻其浓度显著下降(P<0.05,P<0.01).同时段不同输注速度相同浓度间差异无显著性意义(均P>0.05);相同输注速度不同浓度间差异有显著性意义(均P<0.05),其中浓度为16 mg/100 ml的吸附量显著高于浓度为8 mg/100 ml和4 mg/100 ml(均P<0.01),后两者之间差异无显著性意义(P>0.05).结论输液器对酚妥拉明有显著吸附作用,浓度越高吸附作用越大,其吸附作用随输注时间延长而降低,30 min后基本恢复至原液水平.     

心肌带结构在常用心脏超声切面的分布

目的 初步观察心肌带(ventricular myocardial band,VMB)结构在常用心脏超声切面的分布情况.方法 成年猪心、牛心和羊心各5个,按照VMB的标准解剖方法将心脏解剖为完整的VMB结构,将VMB各段按标准分界后用油性染料着色,自然凉干后还原为未解剖前状态.将已染色的还原VMB按常用心脏超声切面切开,显示各个平面上VMB各段的分布情况.结果 清楚地显示了VMB各段在不同平面中的分布情况,其中左心室在不同平面中显示由2～3层心肌构成,而右心室则仅由1层心肌构成.结论 在不同的常用心脏超声切面中,心肌带各段的分布情况不尽相同,为今后使用心脏超声进一步深入研究心肌带结构和功能打下了一定基础.     

探讨体重指数对绝经后老年妇女不同部位骨密度的影响

目的分析不同体重指数患者的腰椎和股骨近端、股骨颈、Ward’s三角区的骨密度及T值评分,探讨体重指数对绝经老年妇女不同部位骨密度的影响。方法以我院225例年龄均为60以上的绝经老年妇女为研究对象,计算体重指数将患者分为体瘦组、正常组和肥胖组,检测患者腰椎和股骨近端、股骨颈、Ward’s三角区的骨密度,分析各部位骨密度变化与体重指数的关系。结果体瘦组的患者各部位骨密度明显低于正常和肥胖组的患者,体瘦组与正常组或肥胖组比较,腰椎(L1～L4)、股骨颈、股骨近端、Ward’s三角区的骨密度均有显著的差异(P<0.01);正常组与肥胖组比较,仅L3和L4的骨密度有显著的差异(P<0.05),其余部位的骨密度无显著的差异(P>0.05)。结论体重和体重指数是影响骨密度的一个重要因素,体重和体重指数与绝经老年妇女不同部位的骨密度存在一定的相关性,低体重指数的绝经老年妇女,骨丢失而引起的骨量减少明显,易发生骨质疏松。     

Four-point bending strength of transverse osteotomies stabilized with various Kirschner wire and tension wire band configurations

Four different fixation configurations of K-wires of two different diameters were used to stabilize a transverse osteotomy in chicken humerus bones. Four-point bending was applied to these to assess their apex dorsal bending rigidity. The configurations of K-wires included intramedullary, crossed and two with different tension wire band designs. One of these consisted of two transverse K-wires which did not cross the fracture line, around which the tension wire band was placed. The results showed that there was no statistical significance between the two different tension band wiring techniques and that both were superior to the intramedullary and crossed K-wire fixation techniques.     

Systeme des endoprothetischen Gelenkersatzes des Großzehengrundgelenkes

We compare the different systems for a joint replacement of the first metatarsophalangeal joint. The main aim for the development and redesign of the different arthroplasty systems was to restore the anatomic and physiological function of the foot when the metatarsophalangeal joint is destructed. Former types of implants like spacers often had problems with osteointegration or biological reactions. The up to date modular implant systems allow the surgeon to perform an anatomic and functional arthroplasty or hemiarthroplasty which fit the different patient requirements and have good long term results. The authors compare different implants and their advantages and disadvantages in context of their development over the last years.     

Cross-sectional study of kidney stones by laser-induced breakdown spectroscopy

We performed laser-induced breakdown spectroscopy (LIBS) for the in situ quantitative estimation of elemental constituents distributed in different parts of kidney stones obtained directly from patients by surgery. We did this by focusing the laser light directly on the center, shell, and surface of the stones to find the spatial distribution of the elements inside the stone. The elements detected in the stones were calcium, magnesium, manganese, copper, iron, zinc, strontium, sodium, potassium, carbon, hydrogen, nitrogen, oxygen, phosphorus, sulfur, and chlorine (Cl), etc. We optimized the LIBS signals by varying the laser energy from 10 mJ to 40 mJ to obtain the best signal-to-background and signal-to-noise ratios. We estimated the quantities of different elements in the stones by drawing calibration curves, plotting graphs of the analyte signal versus the absolute concentration of the elements in standard samples. The detection limits of the calibration curves were discussed. The concentrations of the different elements were found to be widely different in different stones found in different age groups of patients. It was observed that stones containing higher amounts of copper also possessed higher amounts of zinc. In general, the concentrations of trace elements present in the kidney stones decreased as we moved from center to shell and surface. Our results also revealed that the concentrations of elements present in the stones increased with the age of the patients. The results obtained from the calibration curves were compared with results from inductively coupled plasma mass spectrometry (ICP-MS). We also used the intensity ratios of different elemental lines to find the spatial distribution of different elements inside the kidney stones.     

四桩型胫骨假体基座的优化设计

目的通过三维有限元分析来研究和评定各种不同设计的四桩型膝关节胫骨假体基座在不同负荷下的生物力学特点,并对其进行优化。方法建立不同长短、粗细、位置四桩胫骨假体基座置换后膝关节的三维有限元模型,对比不同设计在压力负荷和扭转力矩负荷下的不同生物力学反应特点,包括应力、应变、位移和接触变量。通过比较研究对四桩型胫骨平台假体基座的设计进行优化。结果在压力负荷和扭转力矩负荷下,不同设计的生物力学反应特点基本相似,没有明显的区别;而扭转力矩下如果去除胫骨平台骨质表面和金属基座下表面之间的接触影响后（假设二者之间为无摩擦的接触形式）,将固定桩变短、变细和内移使得反映假体固定强度的一些指标有不同程度的下降,不利于假体固定的旋转稳定性。结论在固定金属基座时胫骨平台骨质表面和金属基座下表面之间的固定起着主要的作用;四桩设计的金属基座,适当增加桩的长度和直径以及将固定桩适当外移有利于增加固定的旋转稳定性。     

碘克沙醇对体外血管内皮细胞的影响

目的观察非离子型等渗对比剂碘克沙醇（威视派克）随浓度和时间变化对人血管内皮细胞的活力影响,探讨对比剂毒副作用发生的可能机制。方法人脐静脉血管内皮细胞株置于含不同浓度（4%、10%、20%）非离子型等渗对比剂碘克沙醇培养液中24、48、72 h后,通过噻唑蓝比色法检测细胞增殖活力,用Annexin V/PI双染色法进行细胞凋亡测定,观察不同条件下内皮细胞对对比剂的反应。结果碘克沙醇使血管内皮细胞吸光度下降（P〈0.01）;不同浓度影响不尽相同,而不同作用时间间差异无统计学意义（P〉0.05）。碘克沙醇使血管内皮细胞凋亡率明显增高（P〈0.05）,不同浓度间差异无统计学意义（P〉0.05）。结论体外培养环境下非离子型等渗对比剂碘克沙醇随浓度和时间变化会对内皮细胞产生活力影响,并诱导其凋亡。