骨质疏松症大鼠骨诱导能力改变的研究

目的　探讨骨质疏松性骨折愈合困难的原因 ,为临床治疗骨质疏松性骨折寻找可行性途径和方法。　方法　雌性SD大鼠 4 0只作为供体大鼠 ,随机分为卵巢切除组和对照组 ,每组 2 0只 ,卵巢切除组切除双侧卵巢以复制骨质疏松模型 ,对照组行假手术。 4个月后处死大鼠 ,取肢体长骨按Urist方法分别制备骨基质明胶。雌性SD大鼠 17只 ,双侧股部切开 ,左、右侧肌袋内分别植入卵巢切除大鼠及对照大鼠骨基质明胶。大鼠饲养 14d处死 ,分别取出肌袋植入物组织行组织学检查及骨碱性磷酸酶 (ALP)活性、Ca含量测定。　结果　卵巢切除组的和对照组的植入物组织ALP活性单位分别为 (7 2 2± 2 5 9)IU/ g和 (12 0 1± 6 18)IU/g ,两者差异有显著性 (P <0 0 1)。卵巢切除组的和对照组的植入物组织Ca含量分别为 (5 10± 0 84 ) μg/ g和 (5 73± 0 79) μg/ g ,两者差异有显著性 (P <0 0 5 )。　结论　雌激素缺失所致骨质疏松骨的骨诱导能力较正常骨明显降低 ,骨质疏松性骨折愈合困难与骨骼中骨诱导生长因子的缺乏有关。对于骨质疏松性骨折的治疗要改进骨折固定方法 ,外源补充或促进内源性骨诱导生长因子的表达 ,对于促进骨折愈合具有重要作用。     

心房颤动患者心房肌钙平衡调节蛋白基因的mRNA表达的研究

目的　通过对临床患者的心房肌钙平衡调节蛋白的mRNA表达水平的测定 ,揭示心房颤动 (房颤 )的发生机制。方法　采集风湿性心脏病窦性心律 (窦律 )组患者 (12例 )和房颤组患者 (12例 )的右心耳组织 ,应用逆转录 聚合酶链反应技术以GAPDH为内参照 ,测定心房肌钙平衡调节蛋白mRNA表达水平。结果　与窦律组相比 ,房颤组细胞膜L型钙通道的mRNA表达减低 44 6 2 % (0 2 5±0 16与 0 13± 0 13,P <0 0 5 ) ,肌浆网钙泵mRNA表达水平降低 2 6 2 2 % (0 38± 0 14与 0 2 8± 0 14,P<0 0 5 ) ,而磷酸受纳蛋白、ryanodine受体和细胞膜钠 钙交换的mRNA表达水平差异无显著性。结论房颤患者心房肌细胞膜L型钙通道和肌浆网钙泵mRNA表达水平降低 ,提示细胞内钙超载机制参与了房颤发生和维持。     

获得性漏斗胸膈肌肌凝蛋白重链MyHC-Ⅰ的表达变化和意义

目的通过检测获得性漏斗胸大鼠膈肌肌凝蛋白重链MyHC-Ⅰ的表达变化,探讨肌凝蛋白重链在获得性漏斗胸发生发展中的作用。方法选用4周龄SD大鼠48只,随机分为3组,每组16只。其中肋软骨组和膈肌组分别为从胸骨旁切断下位3对肋软骨并造成膈肌局部物理损伤而获得漏斗胸模型,对照组不做任何干预。于术后第2周和第4周每组各处死大鼠8只,收集膈肌组织,分别进行RT-PCR定量和Western blot检测。结果肋软骨组和膈肌组动物均呈现前胸壁凹陷畸形。与对照组比较,肋软骨组和膈肌组各时间点MyHC-Ⅰ表达均升高(P<0.05);但肋软骨组和膈肌组组间比较,仅术后第2周时MyHC-Ⅰ表达差异有统计学意义(P<0.05)。结论获得性漏斗胸动物膈肌肌凝蛋白重链MyHC-Ⅰ表达增高,说明在动物漏斗胸畸形形成过程中膈肌功能发生了改变。     

风湿性心脏病心房颤动患者左、右心房肌Cx40、Cx43表达的对比研究

通过对伴或不伴心房颤动 (简称房颤 )的风湿性心脏病 (简称风心病 )二尖瓣病变患者左、右心房肌细胞缝隙连接蛋白 (Connexin ,Cx)Cx4 0、Cx4 3表达进行对比研究 ,探讨房颤对Cx表达的影响。选择 31例接受心脏瓣膜置换术的风心病患者为研究对象并分为三组 :实验Ⅰ组 11例 ,为阵发性房颤或房颤持续时间≤ 6个月者 ;实验Ⅱ组12例 ,房颤持续时间 >6个月 ;对照组 8例 ,为窦性心律。分别于手术中切取左、右心房肌标本。用免疫印迹法检测Cx4 0、Cx4 3的表达量。结果 :每例患者自身左、右心房肌比较 ,其Cx4 0及Cx4 3的表达量无显著差异 (P均 >0 .0 5 ) ;而每组中左、右心房肌Cx4 0、Cx4 3表达量均值也无显著性差异 ;其中实验Ⅰ、Ⅱ组与对照组比较 ,Cx4 0表达量明显降低 (左心房 :5 94 9.2± 832 .9,4 16 9.0± 95 5 .9Int×mm2 vs 86 74 .8± 10 0 8.3Int×mm2 ;P <0 .0 5和 <0 .0 1;右心房 :5 992 .1± 80 6 .5 ,4 12 0 .2± 95 4 .9Int×mm2 vs 86 17.4± 10 0 4 .7Int×mm2 ;P <0 .0 5和 <0 .0 1) ;Cx4 3的表达量在三组间无显著差异 (P >0 .0 5 )。结论 :Cx4 0表达下调可能参与了房颤的发生与维持。     

慢性阻塞性肺疾病患者膈肌组织学改变及一氧化氮合酶表达变化的研究

目的 探讨慢性阻塞性肺疾病(COPD)患者膈肌组织学改变的特点和内源性一氧化氮合酶的表达变化.以及COPD患者膈肌功能异常可能的机制.方法 对19例患肺部或食管肿瘤行开胸手术的患者,其中12例轻、中度COPD患者,7例肺功能正常对照者留取膈肌样本.观察膈肌超微结构的改变、并测定膈肌肌球蛋白重链(MHC)表型、肌纤维横截...     

双能X线吸收法测定大鼠骨量的评价及去卵巢骨丢失敏？…

目的　探讨双能X线吸收法 (DXA)测量大鼠骨密度 (BMD)的精密度和准确度及大鼠去卵巢后骨丢失的敏感区域。方法　用扇形束DXA(QDR45 0 0A)重复测量 16只SD大鼠不同骨胳区域BMD的变异系数 (CV)评价精密度 ;测量 40只大鼠骨矿含量 (BMC)与骨灰重比较评价准确度 ;与假手术组比较测定大鼠去卵巢后不同骨胳区域骨丢失率的变化选择骨丢失敏感区域。结果DXA测量BMD的CV为全身 (0 .71± 0 .44 ) % ,腰椎 (0 .82± 0 .5 3) % ,股骨 (0 .5 2± 0 .2 7) % ,胫骨(0 .81± 0 .11) % ,股骨和胫骨的各亚区 (1.46± 0 .2 6 ) % ;BMC与骨灰重呈高度正相关 (r =0 .984～0 .85 5 ) ,BMC显著低于骨灰重 (P <0 .0 0 1) ;生长期大鼠去卵巢 14周与假手术组BMD比较 ,腰椎(- 7.0 3% )、股骨远端 (- 9.0 3% )和近端 (- 7.49% )及胫骨近端 (- 11.7% )BMD显著减少 ,胫骨远端BMD显著增加 (8.82 % )。结论　DXA测量大鼠骨量是精密和有效的方法 ,胫骨近端干骺端和股骨远端干骺端是大鼠去卵巢后骨丢失最敏感区域。     

关节镜下半腱肌加股薄肌肌腱自体移植重建膝关节前交叉韧带(附24例报告)

24例膝关节前交叉韧带 (ACL)患者在关节镜下行半腱肌加股薄肌肌腱自体移植重建术。术后平均随访 12个月。按照 L ysholm膝关节功能评分 :术前 (5 2 .4± 15 .9)分 ,术后 6、12、2 4个月的评分分别为 (85 .0±12 .2 )分、(89.3± 11.7)分、(90 .8± 10 .5 )分 ,与术前比较均有明显统计学差异 (P<0 .0 1)。认为关节镜下半腱肌加股薄肌肌腱自体移植重建 ACL 具有生物力学性质好、取材处并发症少、手术创伤小、固定方法可靠、临床效果优良等特点 ,值得临床推荐使用     

参麦注射液对慢性间歇性缺氧大鼠胸骨舌骨肌收缩性能的影响

目的探讨参麦注射液(SMI)对慢性间歇性缺氧大鼠胸骨舌骨肌收缩性能的影响。方法健康雄性SD大鼠30只,单纯随机抽样分为正常对照组(A组)、慢性间歇性缺氧组(B组)和参麦药物干预组(C组),对B、C组大鼠间歇缺氧(8h/d,5周)以模拟阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者慢性间歇性缺氧的特征。采用电刺激法测定等长收缩胸骨舌骨肌肌条在不同刺激频率下收缩性能的变化。结果(1)B组大鼠胸骨舌骨肌在10～100Hz的电刺激频率下的肌张力分别为(19.5±4.7)、(23.8±4.7)、(33.0±5.1)、(45.1±5.9)、(54.2±7.0)、(66.1±9.1)、(74.2±9.1)、(79.7±9.0)、(82.0±8.4)、(80.7±11.8)g/cm2,与A组比较差异均无统计学意义[A组肌张力分别为(23.2±5.6)、(26.2±5.0)、(35.1±5.4)、(46.0±8.5)、(57.0±9.9)、(69.9±9.7)、(79.2±9.5)、(85.7±7.6)、(87.9±7.9)、(86.6±12.4)g/cm2,P均>0.05];与C组比较差异均有统计学意义[(30.5±2.3)、(40.0±5.4)、(56.2±7.6)、(72.2±6.4)、(82.0±5.5)、(92.4±4.6)、(98.1±4.0)、(99.2±7.4)、(101.8±3.9)、(102.2±4.0)g/cm2,P均<0.05]。(2)在诱导疲劳试验中,B组大鼠胸骨舌骨肌1～5min张力百分比分别为(75.6±8.5)%、(41.6±7.3)%、(29.0±2.7)%、(20.4±2.9)%、(18.5±2.5)%,与A组同时间点比较差异均有统计学意义[(87.9±5.7)%、(72.1±11.5)%、(55.6±9.6)%、(39.7±10.7)%、(33.2±10.2)%,P均<0.05],与C组比较差异均有统计学意义[(87.9±4.4)%、(67.9±14.1)%、(48.4±9.9)%、(38.2±7.0)%、(33.8±9.3)%,P均<0.05]。结论慢性间歇性缺氧能够增加上气道肌的疲劳,SMI具有显著增强上气道肌收缩力和抵抗疲劳的作用。     

孕激素对卵巢切除大鼠子宫肌层发育的影响

目的　探讨孕激素对卵巢切除大鼠子宫肌层发育的影响。方法　将4 0只幼年大鼠随机分为A、B、C、D组,每组各10只。A组为假手术组,只行开关腹手术;B、C、D组均切除双侧卵巢,其中C组及D组分别加用大剂量及小剂量孕激素。连续给药6周后,测量各组大鼠子宫重量,用HE染色法加计算机图像分析技术观察子宫内膜、肌层及垂体、肾上腺的组织形态学变化。结果　B组子宫重量明显减轻至(14 5 .0 0±31.0 8) mg,C组子宫重量由(14 5 .0 0±31.0 8) mg增至(5 4 0 .30±86 .30 ) mg;肌细胞直径由(4.83±0 .2 5 ) μm增至(16 .5 2±0 .4 6 ) μm,与B、D组比较P均<0 .0 5。各组大鼠垂体及肾上腺无明显组织学改变。结论　大剂量孕激素可促进卵巢切除大鼠子宫肌层的发育。     

MT1-MMP、MMP-2和TIMP-2基因在去卵巢大鼠成骨细胞中的表达

目的　通过观察去卵巢 (OVX)骨质疏松模型大鼠成骨细胞膜型基质金属蛋白酶 1(MT1 MMP)基因的表达 ,探讨绝经后骨质疏松的发病机制。　方法　对OVX大鼠与假手术大鼠进行骨密度和骨组织形态计量学测定。股骨远端行原位杂交检测骨组织MT1 MMP、MMP 2和TIMP 2mRNA表达 ,免疫组化检测骨组织MT1 MMP、MMP 2和TIMP 2蛋白质表达。　结果　OVX大鼠第 3、4腰椎骨密度 (0 14 4± 0 0 11) g cm2 、(0 14 3± 0 0 15 ) g cm2 较对照组 (0 15 8± 0 0 18)g cm2 、(0 16 2± 0 0 17) g cm2 明显减少 ,OVX组骨小梁面积 (9 5 8± 3 39) %、厚度 (40 85± 8 0 4 ) μm和数目 (2 30± 0 4 8)个 mm分别较对照组 (2 0 6 3± 4 8) %、(44 73± 6 8) μm、(4 6± 0 7)个 mm明显下降 ,OVX组骨小梁间隔 (5 85 8± 115 1) μm较对照组 (2 5 4 6± 4 8 0 ) μm明显增宽 ;成骨细胞MT1 MMPmRNA与蛋白质表达下调 ,而MMP 2和TIMP 2之间表达无差异。　结论　雌激素不足可使成骨细胞MT1 MMP基因表达减少 ,可能为绝经后骨质疏松的发病机制之一。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

Weighing the QT Intervals with the Slope or the Amplitude of the T Wave

Objective: The reproducibility of QT interval measurements is low, even for the mean QT interval based on the standard ECG. In this study we analyzed whether the reproducibility of the mean weighed QT interval was better than the simple mean QT interval. The weighing was based on the amplitude of the T wave or the slope of the steepest tangent on the terminal part of the T wave. Material and methods: 12‐lead ECGs of 130 postmyocardial infarction patients were obtained. The QT intervals were measured by the tangent‐method on two occasions by the same observer Mismatch QT intervals were defined as QT intervals that were measured at only one occasion. Sixteen ECGs were rejected. The data were split into 34 and 80 ECGs for optimization and validation of the weighing, respectively. The weighed QT dispersion was calculated as the weighed mean of the three longest minus the weighed mean of the three shortest QT intervals. Results: Weighing with the slope increased the reproducibility by 41% (P = 3 10^‐6), but weighing with the amplitude reduced it by 20% (P = 0.02). However, if measurements with errors above 75 ms were rejected, weighing with the slope or the amplitude increased the reproducibility with 26% and 20% (P = 0.02), respectively. Weighing did not change the reproducibility of the weighed QT dispersion. Conclusion: Weighing with the slope improved the reproducibility of the mean weighed QT interval. However, if measurements with errors above 75 ms were rejected, weighing with the amplitude also increased the reproducibility. Weighing did not change the reproducibility of the weighed QT dispersion. Weighing is particularly efficient at reducing the negative impact of mismatch QT intervals on the reproducibility. A.N.E. 2002;7(1):4–9     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

大骨节病病区水,粮实验对动物的骨和软骨中化学元素组成的影响

用质子激发 X 线荧光分析方法(PIXE)测定了大骨节病病区和非病区的水、粮以及用该水粮喂养的大白鼠的肋软骨和硬骨中22种化学元素的含量。结果发现水粮中存在差异的元素反应在用该水粮喂养的大白鼠的骨、软骨中也存在差异,含量都低的元素有 P、Mn、Cu、As、Zn。都高的有铅。其中锌低在水、粮、硬骨和软骨中都完全一致呈非常显著性差异(p<0.01)。提示病区水、粮中化学元素对骨质的影响不是单一元素缺乏或过多所致,而是多种元素的复合因素。     

Assessment of the Soft-Tissue Seal at the Interface between the Base of the Fixed Denture Pontic and the Oral Mucosa

Fixed dentures (bridges) are often selected as a treatment option for a defective prosthesis. In this study, we assess the contact condition between the base of the pontic and oral mucosa, and examine the effect of prosthetic preparation and material biocompatibility. The molars were removed and replaced with experimental implants with a free-end type bridge superstructure after one week. In Experiment 1, we assessed different types of prosthetic pre-treatment: (1) the untreated control group (Con: mucosa recovering from the tooth extraction); (2) the laser irradiation group (Las: mucosa recovering after the damage caused by a CO₂ laser); and (3) the tooth extraction group (Ext: mucosa recovering immediately after the teeth extraction). In Experiment 2, five materials (titanium, zirconia, porcelain, gold-platinum alloy, and self-curing resin) were placed at the base of the bridge pontic. Four weeks after the placement of the bridge, the mucosa adjacent to the pontic base was histologically analyzed. In Experiment 1, the Con and Las groups exhibited no formation of an epithelial sealing structure on the pontic base. In the Ext group, adherent epithelium was observed. In Experiment 2, the sealing properties at the pontic interface were superior for titanium and the zirconia compared with those made of porcelain or gold-platinum alloy. In the resin group, a clear delay in epithelial healing was observed.     

高胆红素血症对肿瘤标志物测定的影响探讨

目的探讨高胆红素血症对Ca19-9、Ca24-2和CEA检测的影响.方法对320例胆管、胆囊良恶性疾病病人,15例胆囊炎病人的胆汁和血清以及10例肝硬化、10例黄疸肝炎病人进行Ca19-9、Ca24-2和CEA检测.结果在良性胆管、胆囊疾病中,Ca19-9的假阳性最高;在胆红素增高的良性疾病中,Ca19-9假阳性率达46.7%;15例胆汁和血清以及10例肝硬化和10例黄疸肝炎病人中,Ca19-9的假阳性率分别为93%、20%、80%和80%.结论高胆红素血症对Ca19-9检测影响最明显,胆囊、胆管良恶性疾病鉴别时,以Ca24-2和CEA检测为佳.     

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency-department to make the diagnosis of heart disease earlier and with greater accuracy.