三嵌段高分子骨组织工程支架材料的体内生物学性能评价

目的：对三嵌段高分子骨组织工程支架材料-聚（丙交酯-乙交酯）[天冬氨酸-聚乙二醇1的生物相容性进行评价，探讨用于骨组织工程的可行性。 方法：实验于2003-08／12在华中科技大学同济医学院附属协和医院骨科实验室完成。①过敏试验：20只豚鼠随机分为试验组、对照组，每只豚鼠脊柱两侧皮内注射等体积聚（丙交酯-乙交酯）[天冬氨酸-聚乙二醇]浸提液、生理盐水及体积分数为0．05的甲醛溶液，记录激发部位红斑水肿。②急性全身毒性试验：12只小白鼠随机分为试验组和对照组，该两组腹腔分别注射浸提液及生理盐水，4，24，48及72h观察动物的一般状态。③植入试验：聚（丙交酯-乙交酯）[天冬氨酸-聚乙二醇]植入6只新西兰大白兔肌肉内，1，4及8周切取材料周围0．5cm处肌肉组织，苏木精-伊红染色，光镜下观察。 结果：①过敏试验结果：皮内注射浸提液及生理盐水动物皮肤无红斑水肿，注射体积分数为0．05的甲醛溶液出现中度以上红斑水肿。②急性全身毒性试验结果：阴性对照组未见毒性症状，试验组4h后仅1只有轻微的运动减少，24h后恢复正常。③植入试验结果：所有试验动物伤口均一期愈合。 结论：聚（丙交酯-乙交酯）[天冬氨酸-聚乙二醇]具有良好生物相容性，是一种新的骨组织工程支架材料。     

前路一期病变椎体切除并重建治疗胸腰椎结核并后凸畸形

目的:观察前路一期病变椎体切除、人工椎体或钛网融合器植骨替代、椎体钉板或钉棒系统内固定治疗连续两个及以上节段胸腰椎结核并后凸畸形的疗效。方法:34例病变累及连续两个及两个以上椎节的胸腰椎结核患者,术前后凸Cobb角27.8°￣65.4°(38.6°±10.3°),一期行前路病变椎体切除,椎间撬拔撑开复位,人工椎体或钛网融合器植骨替代,辅以椎体钉板或钉棒系统短节段邻近椎节内固定,重建脊柱稳定性,术后均给予短疗程化疗。观察术后局部疼痛缓解、脊髓神经功能恢复、后凸畸形矫正及脊柱稳定性情况。结果:患者术后局部疼痛缓解,术前伴有脊髓神经损伤的12例患者术后神经功能均有不同程度恢复。影像学检查示脊柱内固定物位置良好,椎体序列恢复良好,椎间高度恢复。后凸Cobb角矫正至2.1°￣14.2°(7.5°±8.3°),平均矫正31.2°±8.5°。随访18￣54个月,平均35个月。末次随访时后凸矫正度丢失4.3°±3.8°,均无结核复发。结论:连续两个及两个以上节段的胸腰椎结核采用前路一期行病变椎体切除有利于病灶彻底清除,减少复发;也有利于椎管彻底减压。前路椎体替代、植骨内固定重建脊柱稳定性可更好地纠正和预防脊柱后凸畸形。     

肩峰下空间研究进展

肩峰下空间在撞击综合征、肩关节炎等多种疾病的发病学中起重要作用.传统观点认为撞击综合征的潜在因素是肩峰下空间狭窄对冈上肌腱的刺激,最新研究发现这一解释并不全面.该文介绍了肩峰下空间的研究进展,如骨性距离测量、撞击综合征发病机制等.     

恶性肿瘤患者血清癌胚抗原放射免疫分析

本文采用放射免疫法测定了144例恶性肿瘤患者血清CEA含量,并以同样条件测定了30例正常人作为对照。结果表明恶性肿瘤患者血清CEA含量显著高于健康人,均值为10.3±4.84ng/ml。不同肿瘤患者血清CEA升高的程度不等,其中以肺癌含量最高为14.7±7.83ng/ml。转移性肿瘤CEA含量高于144例肿瘤的平均水平。术后复发者含量不见下降。癌性胸腹水中CEA含量明显升高。因此,血清CEA的测定对恶性肿瘤的辅助诊断,评价疗效和判断预后具有重要的临床意义。     

中西医结合治疗股骨头缺血性坏死

股骨头缺血性坏死是世界骨科难题之一。作者致力于中草药治疗本病的研究三十多年，近来又在手术治疗方面倾注心血，对该病的防治、康复创立了一整套中西医结合新方法，取得了满意效果。自１９８２年以来，共治疗各种股骨头坏死１１０１例，其中单纯中医治疗４３３例，手术配合中药治疗６６８例。按作者制定的百分评分法，总有效率９８％，优良率８４％，无一例需再作人工关节置换术。     

胆囊小隆起性病变的诊断及治疗

报告37例胆囊小隆起性病变，其中良性颈变34例，胆囊癌3例。结果：本组23例有临床症状，多表现为反复发作的右上腹疼痛或不适；病灶部位，大小，多少，有无合并胆石及病变性质与临床症状有关；B-us,OCG,CT的诊断符合率例如辚33／37，9／24和5／10（x^2=18.75,P<0.005)。认为对胆囊小隆起性病变的病灶≥10mm，有增大趋势，呈恶性图像，合并胆石或血清CEA升高的病例应及早手术治疗。     

小儿重肾31例分析

目的　探讨小儿重肾的诊断及治疗。方法　对我院 1989～ 2 0 0 1年收治的 3 1例小儿重肾进行回顾性分析。结果　 3 1例中有 2 3例患儿接受 2 6次手术 ,有 16例行上半重肾及输尿管切除 ,其中有 2例须处理输尿管残端及盲袋所致的梗阻。 2 2例手术后恢复较好 ,仅 1例伴有轻度的尿失禁。结论　对于重肾伴肾积水或发育不良所致的各种临床表现应首先考虑做上半肾及输尿管大部切除术。B超、CT及静脉肾盂造影术 (IVP)对诊断分型有意义。     

Changes in the human vocal tract due to aging and the acoustic correlates of speech production: a pilot study.

This investigation used a derivation of acoustic reflection (AR) technology to make cross-sectional measurements of changes due to aging in the oral and pharyngeal lumina of male and female speakers. The purpose of the study was to establish preliminary normative data for such changes and to obtain acoustic measurements of changes due to aging in the formant frequencies of selected spoken vowels and their long-term average spectra (LTAS) analysis. Thirty-eight young men and women and 38 elderly men and women were involved in the study. The oral and pharyngeal lumina of the participants were measured with AR technology, and their formant frequencies were analyzed using the Kay Elemetrics Computerized Speech Lab. The findings have delineated specific and similar patterns of aging changes in human vocal tract configurations in speakers of both genders. Namely, the oral cavity length and volume of elderly speakers increased significantly compared to their young cohorts. The total vocal tract volume of elderly speakers also showed a significant increment, whereas the total vocal tract length of elderly speakers did not differ significantly from their young cohorts. Elderly speakers of both genders also showed similar patterns of acoustic changes of speech production, that is, consistent lowering of formant frequencies (especially F1) across selected vowel productions. Although new research models are still needed to succinctly account for the speech acoustic changes of the elderly, especially for their specific patterns of human vocal tract dimensional changes, this study has innovatively applied the noninvasive and cost-effective AR technology to monitor age-related human oral and pharyngeal lumina changes that have direct consequences for speech production.     

高效液相色谱法测定去氧氟尿苷含量及其有关物质

目的 用高效液相色谱法（HPLC法）测定去氧氟尿苷的含量及其有关物质。方法 采用Diamonsil C—粒（250mm×4．6mm，5μm），流动相为乙腈-水（1：1），检测波长为269nm，流速为0．8mL／min。结果 去氧氟尿苷质量浓度在10．0～200．4μg／mL范围内与峰面积线性关系良好，r：0．9999（n：5），平均回收率为100．2％，RSD=0．14％。结论 HPLC法简便、准确，专属性好，灵敏度高，可用于去氧氟尿苷含量及有关物质的测定。     

Application of trans-abdominal chorionic villus sampling in prenatal diagnosis of chromosomal diseases in first trimester of gestation

Objective:To evaluate the feasibility and safety of prenatal diagnosis by traneabdominal chorionic villus sam-pling(TA-CVS)via the guidance of B-mode ultrasound in the first trimester of gestation.To explore the technique of long time culture and chromosome preparation of villi in early pregnancy.To evaluate the feasibility of the above techniques in the application of the prenatal cytogenetic diagnosis.Methods:One hundred and thirty-five singleton pregnancies at risk were referred from January 2001 to Decem-ber 2007.Results:The average maternal age was 35.2 years.TA-CVS was performed in the 10～13th weeks of gestation and the average gestational age was 10.89 weeks.All attempts at sampling were successful.The rate of operation-associated fetal loss was 0.74%.The failure rate of prenatal diagnosis because of inadequate amount of specimen was 0.The average culture time was 5-7 days.The success rate of the cell culture was 98.5%.No maternal con-temination and bacterial contamination happened.Fifteen cases of abnormal karyotype and one case of confined pla-cantel mosaiciem were diagnosed.Conclusion:TA-CVS appears to be safe and feasible and might to be offered in the prenatal diagnosis in the first trimester of gestation.The technique of long time culture and chromosome preparation of villi is stable and reliable.It is feasible to apply these techniques in the clinical practice of prenatal cytogenetic diagnose in the early pregnancy.