Temporomandibular joint arthrography following surgical treatment of internal derangements

Arthrograms of the temporomandibular joint were obtained in 20 symptomatic joints that had previous reconstructive arthroplasty with disk repositioning because of internal derangements. Preoperative arthrograms were available for comparison in 18 joints. Symptoms resulting in a postoperative arthrogram included pain, limited ability to open the mouth, and clicking of the joints. Postoperative arthrographic findings included limited anterior translation of the condyle (90%), irregularity in outline of the intraarticular contrast agent (60%), a conical configuration of the posterior recess (25%), decreased size of the joint (28%), anterior displacement of the meniscus (25%), and perforated meniscus (15%). Many of these findings may have resulted from fibrosis and scarring, which may be a response to intraarticular bleeding. The mechanism by which the fibrosis causes the postsurgical arthrographic features is discussed.     

直肠癌全直肠系膜切除术后直肠阴道瘘原因与防治

本文通过分析近5年来我院18例女性直肠癌全直肠系膜切除术后直肠阴道痿的临床资料。发现直肠阴道痿多发生于中低位直肠癌行全直肠系膜切除保肛手术的患者。痿的发生与肿瘤的位置、肿瘤的分期、肿瘤距肛门口的距离．以及手术技巧、手术难度、引流方法有关。而与是否进行预防性造口，以及是否采用腹腔镜手术无关。预防上强调应重视术中直肠前壁的锐性分离、结肠直肠吻合以及术后盆腔的负压引流。治疗上应首先进行保守治疗，即肠内营养，阴道冲洗。早期配合肠外营养、及全身或局部抗炎治疗，大部分直肠阴道痿通过保守治疗可以治愈。保守治疗无效时考虑结肠或回肠末端造口。若长期不愈应考虑吻合口肿瘤复发的可能。     

Impact of clinical history on fracture detection with radiography

The effect of knowledge of localizing symptoms and signs in the detection of fractures was studied. Forty radiographs of the extremities were examined twice by seven radiologists; the sessions were separated by 4 months. In 26 cases, a subtle fracture was present; 14 cases were normal. In half of the cases at each session, the precise location of pain, tenderness, or swelling was provided. The observer was asked to determine if the case was normal or abnormal (provide the exact location of the fracture) and to indicate the degree of confidence in the diagnosis. Responses were converted to a numeric scale for analysis. Analysis of receiver operator characteristic parameters indicates that clues regarding location of trauma facilitate detection of fractures. The improvement is based largely on an increased true-positive rate without an increased false-positive rate, regardless of the decision criteria of the radiologist (overall willingness to "overread" or "underread"). This has direct clinical applicability and reinforces the plea of radiologists for precise clinical information.     

FANCD2、PALB2表达水平与非小细胞肺癌临床特征及预后的关系

目的 探讨范科尼贫血D2蛋白（FANCD2）、乳腺癌易感基因2定位协作蛋白（PALB2）表达水平与非小细胞肺癌（NSCLC）临床特征及预后的关系。方法 选取2017年11月—2019年10月成都市第二人民医院收治的194例NSCLC患者作为研究对象。将手术过程中取得癌组织标本作为NSCLC组,将对应的癌旁组织标本作为癌旁组,每组194例。采用免疫组织化学法检测FANCD2、PALB2在NSCLC患者癌组织及癌旁组织中的表达情况;分析FANCD2、PALB2表达与NSCLC患者临床病理特征的关系;采用Kaplan-Meier法绘制生存曲线,采用Cox比例风险模型分析探讨NSCLC患者预后的影响因素。结果 NSCLC组FANCD2、PALB2阳性率高于癌旁组（P <0.05）。Spearman相关性分析显示,NSCLC患者癌组织中FANCD2蛋白与PALB2蛋白呈正相关（r_s =0.486,P <0.05）。不同年龄、性别、吸烟、组织学分型、肿瘤直径患者FANCD2、PALB2阳性率比较,差异均无统计学意义（P >0.05）。TNM分期为Ⅲ、Ⅳ期,低分化,有淋巴结转移患者高于TNM分期为I、Ⅱ期,中/高分化,无淋巴结转移患者（P <0.05）。多因素逐步Cox回归分析结果显示：TNM分期Ⅲ、Ⅳ期［H^R=4.125,（95% CI：2.187,10.035）］、低分化［H^R=3.146,（95% CI：3.115,9.264）］、淋巴结转移［H^R=4.124,（95% CI：3.005,13.145）］、FANCD2阳性［H^R=5.146,（95% CI：3.784,12.689）］、PALB2阳性［H^R=4.563,（95% CI：2.845,7.398）］是NSCLC患者复发的影响因素（P <0.05）。多因素逐步Cox回归分析结果显示,TNM分期Ⅲ/Ⅳ期［H^R=3.689,（95% CI：2.963,11.254）］、低分化［H^R=2.167,（95% CI：1.998,5.996）］、淋巴结转移［H^R=5.648,（95% CI：3.552,12.953）］、FANCD2阳性［H^R=3.886,（95% CI：2.958,12.775）］、PALB2阳性［H^R=4.633,（95% CI：1.968,11.547）］是NSCLC患者预后的影响因素（P <0.05）。FANCD2阳性患者与阴性患者生存率比较,差异有统计学意义（P <0.05）;PALB2阳性患者与阴性患者的生存率比较,差异有统计学意义（P <0.05）。结论 FANCD2、PALB2在NSCLC患者癌组织中呈高表达,与TNM分期、分化程度、淋巴结转移密切相关,可作为辅助评估患者预后和复发的潜在标志物。     

Th17/Treg细胞免疫平衡的相关调控机制研究进展

免疫系统可识别、抵抗病原微生物及清除体内异常分裂的细胞,平衡的免疫系统对维持正常的机体反应活动至关重要。人体内的多种细胞都可参与维持免疫稳态,其中辅助性T淋巴细胞17（Th17）和调节性T淋巴细胞（Treg）发挥着重要作用,失衡的免疫系统可致多种免疫性疾病的发生。Th17/Treg细胞平衡受细胞因子、代谢、肠道微生态及翻译后修饰等多种机制调控,该文通过总结相关机制为免疫性疾病治疗提供新思路和策略。     

Correction of homeostasis indices in unformed small intestine fistulas

Problems of the correction of indices of protein and water-electrolyte metabolism in unformed fistulas of the small intestine were studied in 44 patients. The authors show that the use of the Alvesin "Novyi" amino acid mixture in parenteral feeding is more promising than the use of preparations of protein hydrolysates. For correction of water metabolism the authors give tea infusion per os.     

Effect of Histamine Receptor Blocking on Human Antibody-dependent Cell-mediated Cytotoxicity

The effect of H1 and H2 receptor-blocking agents on antibody-dependent cell-mediated cytotoxicity (ADCC) was studied. The H1 receptor-blocker clemastinum and the H2 receptor blocker cimetidine dose-dependently inhibited the antibody-dependent cytotoxic activity of normal human peripheral blood mononuclear cells on chicken erythrocytes. The inhibition cannot be explained either by a direct toxic effect on effector cells or by blocking of Fc receptors. The possible involvement of histamine receptor-bearing effector cells in human ADCC is suggested.     

人体腰椎活动节段应力分布的实验研究

本文采用三维光弹性实验方法观察了正常腰椎活动节段的应力分布。用精密浇铸,严格几何相似的光弹性环氧树脂腰椎和硅橡胶椎间盘模型进行三维光弹性实验,并观察腰椎的等应力差图和有效应力值分布。本实验观察到,腰椎椎体上下缘应力分布较均匀对称,其后缘应力大于前缘,后部结构应力较小。作者认为,三维光弹性实验方法具有直观性强,能有效和准确地确定腰椎的应力分布,对腰椎生物力学研究具有重要的实用价值。腰椎后缘应力大于前缘,使椎体后缘承载较大,将会增加腰椎间盘退变和损伤的机会,这可能是引起腰腿痛的重要因素。