Rotator cuff lesions of the shoulder: evaluation by direct sagittal CT arthrography

Direct sagittal computed tomographic scanning (DSCT) of the shoulder was performed in 42 symptomatic patients, six healthy volunteers, and two cadaver shoulders. Axial CT scanning and double-contrast arthrography with plain radiographs were performed in 41 patients for comparison. DSCT enabled correct identification of 27 of 29 lesions in 24 patients. Seventeen patients had normal shoulders. Axial CT scanning and DSCT together enabled correct identification of all lesions and were markedly superior to plain-film arthrography. DSCT enabled diagnosis of all cases of complete rotator cuff tear plus three cases of incomplete tear and three of rotator cuff atrophy not identified by the other techniques. Axial CT scanning was better than DSCT for diagnosis of Bankart lesions.     

Kinetics of peripheral blood mononuclear cell mobilization with chemotherapy and/or granulocyte-colony-stimulating factor: implications for yield of hematopoietic progenitor cell collections

BACKGROUND: Peripheral blood progenitor cells (PBPCs) are commonly collected and used to reconstitute hematopoiesis after high-dose chemotherapy. However, strategies for optimal collection and assessment of leukapheresis components are not standardized. STUDY DESIGN and METHODS: Hematopoietic progenitor cell assays were performed on 369 leukapheresis components collected from 95 patients who had received doxorubicin-based chemotherapy and/or granulocyte-colony-stimulating factor (G-CSF). Precollection patient hematologic values, leukapheresis collection values, component hematopoietic progenitor cell assays, and patient outcome measures were summarized. The kinetics of mononuclear cell (MNC) and PBPC mobilization were assessed among four patient groups. RESULTS: Patient group was a significant predictor of the peripheral blood MNC count on the day of collection (p<0.0001), and that value was a significant predictor of granulocyte-macrophage– colony-forming unit (CFU-GM) yield (p<0.0001). This relationship between the peripheral blood MNC count on the day of collection and CFU- GM yield differed according to patient group (p<0.0001). CFU-GM made up a larger fraction of peripheral blood MNCs collected from patients who received chemotherapy plus G-CSF than collected from those who received G-CSF alone. Moreover, the peripheral blood MNC count and the corresponding CFU-GM yield increased significantly on consecutive days of collection in patient groups receiving chemotherapy and G-CSF but were unchanged or decreased in patients receiving G-CSF alone. CONCLUSION: The relationship between peripheral blood MNC count and leukapheresis component CFU-GM yield differed significantly between patients who received chemotherapy and G-CSF and those who received G- CSF alone for the mobilization of PBPCs. Patient peripheral blood MNC count and component CFU-GM yield are useful for both assessing and suggesting revisions to PBPC mobilization and collection strategies.     

普通男大学生关节相对峰力矩与蹲跳高度的关联分析

目的:分析普通男大学生髋、膝、踝、肩、肘各关节相对峰力矩与蹲跳高度的相关性。方法:实验于2004-11/2005-01在河北省体科所完成。①实验对象:随机抽取河北省某大学普通男生30名,年龄(21.8±0.8)岁,身高(170.67±5.48)cm,体质量(65.70±7.99)kg,测试前均从未进行过专门的肌肉力量训练,优势上、下肢均为右侧。②实验方法:从站立开始加摆臂的反向蹲跳,要求受试者上体尽可能保持前后方向稳定,从站立位开始下蹲时上肢向下加速摆臂,并迅速向上蹬伸起跳。从站立开始不加摆臂的反向蹲跳,是排除上肢对蹲跳高度的影响。从半蹲开始加摆臂的无反向蹲跳,要求半蹲的角度控制在105°,静止状态下半蹲预备后,直接进入向上的蹬伸起跳过程,不能出现在起动瞬间身体重心先小幅下移再向上的情况。每种动作做3次,每次间隔10min。③实验评估:通过爱捷图像解析系统得出蹲跳高度,取成绩最好的一次采用Biodex Ⅱ型等速测力及康复系统检测受试者各关节肌力相对峰力矩。利用多因素优势分析法得出在慢速[60(°、快速[240(°)/s])/s]状态下,髋、膝、踝、肩、肘关节相对峰力矩与蹲跳高度的相关性。结果:①从站立开始加摆臂的反向蹲跳高度与各关节相对峰力矩的关系:在慢速状态时与髋关节伸肌相对峰力矩、踝关节背屈肌相对峰力矩、膝关节伸肌相对峰力矩呈明显相关(r=0.808,0.692,0.656),在快速状态时与肘关节屈肌相对峰力矩呈明显相关(r=0.770)。②从站立开始不加摆臂的反向蹲跳高度与各关节相对峰力矩的关系:在慢速状态时与踝关节背屈肌相对峰力矩呈明显相关(=0.747),在快速状态时与膝关节屈肌相对峰力矩呈明显相关(r=0.796)。③从半蹲开始加摆臂的无反向蹲跳高r度与各关节相对峰力矩的关系:从半蹲开始加摆臂的无反向蹲跳高度,在慢速状态时与髋关节伸肌相对峰力矩、踝关节背屈肌相对峰力矩、膝关节伸肌相对峰力矩呈明显相关(r=0.774,0.762,0.712),在快速状态时与肘关节屈肌相对峰力矩呈明显相关(r=0.843)。结论:①加摆臂的反向与无反向蹲跳,髋关节伸肌相对峰力矩、肘关节屈肌相对峰力矩分别是慢速、快速状态下影响其高度的首要因素。②不加摆臂的反向蹲跳,踝关节背屈肌相对峰力矩、髋关节伸肌相对峰力矩分别是慢速、快速状态下影响其高度的首要因素。③提示发展上肢肌肉力量对蹲跳高度的提高大有益处。     

人类白细胞抗原分型技术的进展

学术背景：以往人类白细胞抗原分型主要采用血清学和细胞学方法，随着PCR技术、基因芯片技术及分子生物学技术的发展，已建立从基因水平上进行的人类白细胞抗原分型技术。目的：介绍人类白细胞抗原分型方法，为实际应用提供依据。检索策略：应用计算机检索PubMed1997—07／2007—07期间的相关文章，检索词“HLA technology”，并限定文章语言种类为English。同时检索万方数据库1997—07／2007—07相关文章，检索词为“人类白细胞抗原”，并限定文献语种为中文。共检索到相关文献142篇，选择与人类白细胞抗原分型技术有关的文献55篇。将初步筛选的文章进一步查找全文，排除综述和重复文献，内容相似的选择发表在权威杂志或近3年发表的文献，最后共纳入30篇进行综述。文献评价：文献对不同的人类白细胞抗原分型方法进行汇总分析，符合纳入标准的30篇文献中，6篇为中文文献，24篇为英文文献。资料综合：传统的人类白细胞抗原分型方法主要是血清学和细胞学方法，分型准确性较差。随着PCR技术的广泛应用，人类白细胞抗原基因分型方法得到了迅速的发展。序列特异性引物、序列特异性寡核苷酸探针、直接测序、基因芯片等各具特点的人类白细胞抗原分型技术不断出现，使人类白细胞抗原的分型更加准确、精细、简便、实用，为临床推广应用打下了基础。结论：各种人类白细胞抗原基因分型方法各有优势，不能相互替代，这也是由人类自细胞抗原系统的高度多态性和复杂性所决定的，根据不同的用途可选择相应的方法。     

Demographic characteristics and prevalence of serologic markers among donors who use the confidential unit exclusion process: the Retrovirus Epidemiology Donor Study

BACKGROUND: Most blood centers utilize a confidential unit exclusion (CUE) process, intended to reduce the risk of transfusion-associated infectious diseases by allowing high-risk donors confidentially to exclude their blood from use for transfusion. The effectiveness of this method remains controversial. STUDY DESIGN AND METHODS: Confirmatory or supplemental test results for antibodies to human immunodeficiency virus, human T-lymphotropic virus type I, and hepatitis C virus, as well as hepatitis B surface antigen and syphilis and screening test results for antibodies to hepatitis B core (antigen) and alanine aminotransferase levels were obtained for approximately 1.8 million units donated during 1991 and 1992 at five blood centers within the United States. The prevalences of these infectious disease markers in units that the donors confidentially excluded (CUE+) and units that the donors did not exclude (CUE-) were calculated and examined within demographic subgroups. RESULTS: Units that were CUE+ were 8 to 41 times more likely to be seropositive for antibodies to human immunodeficiency virus and hepatitis C virus, hepatitis B surface antigen, and syphilis and three to four times more likely to react for antibody to hepatitis B core (antigen) or to have elevated alanine aminotransferase levels than units that were CUE- (p < 0.001). The positive predictive value of CUE (the percentage of CUE+ units that were confirmed seropositive for any marker) was 3.5 percent, and the sensitivity of CUE (the percentage of confirmed-seropositive units that were CUE+) was 2.3 percent. CONCLUSION: The current CUE process has low sensitivity and apparently low positive predictive value, and in many cases, it appeared that donors misunderstood it. Yet, CUE was not a “random process,” as CUE+ units were more likely to be seropositive for any infectious disease marker than CUE- units. This suggests that efforts to improve the CUE system may be warranted. As risk factors for transfusion-transmitted infection become more difficult to identify by history-based screening, however, such efforts may have limited effect.     

碱性成纤维细胞生长因子基因转移对成骨细胞生长特性的影响

目的:碱性成纤维细胞生长因子(Basic fibroblast growth factor,bFGF)对骨组织的损伤有修复作用,许多体内外实验均表明外源性植入碱性成纤维细胞生长因子能明显促进骨形成过程。观察碱性成纤维细胞生长因子基因转移对成骨细胞生长特性的影响。方法:实验于2003-01/07在解放军广州军区总医院医学实验科完成。成年雄性新西兰白兔,体质量1.5～2.5kg,采用聚乙烯亚胺(jetPEITM)介导真核分泌表达载体pcDNA3.1-bFGF及非分泌表达载体pEGFP-C3-bFGF转染原代培养的成骨细胞,消化收集转染成骨细胞以及未经转染的成骨细胞,利用血细胞计数器进行细胞计数,绘制细胞生长曲线,同时测定DNA浓度、碱性磷酸酶及骨钙素含量的变化。结果:①未转染的细胞在第8天进入稳定期,而经转染的细胞在第10天才进入稳定期。未转染细胞最终达到的细胞数量为(1.70±0.02)×109L-1,而经转染的细胞数量为(2.10±0.03)×109L-1,差异显著(P<0.05)。②经pcDNA3.1-bFGF转染的成骨细胞的DNA量最高,约为(255±20)mg/L,而经pEGFP-C3-bFGF转染的成骨细胞的总DNA量约为(225±20)mg/L,未经转染的成骨细胞的总DNA量为(100±10)mg/L。③pcDNA3.1-bFGF转染的成骨细胞培养至第9天后,碱性磷酸酶分泌量为(8.0±0.22)IU/mL;而未转染的成骨细胞碱性磷酸酶分泌量为(13.12±0.18)IU/mL。经pEGFP-C3-bFGF转染的成骨细胞所分泌的碱性磷酸酶与未经转染的细胞的分泌量相当,约为(12.56±0.24)IU/mL。④随着培养时间的延长,骨钙素分泌量的变化趋势与碱性磷酸酶相同,但重组质粒转染成骨细胞与未转染细胞最终分泌的骨钙素量差异无显著性(P>0.05)。结论:①经pcDNA3.1-bFGF及pEGFP-C3-bFGF重组质粒转染后,成骨细胞的生长特性有一定的变化,与添加外源碱性成纤维细胞生长因子的影响基本相同。②pcDNA3.1-bFGF转染的细胞分泌的碱性成纤维细胞生长因子能够促进细胞分裂增殖,降低碱性磷酸酶的表达,而pEGFP-C3-bFGF转染的细胞不能分泌表达蛋白,难以发挥其生物学功能。     

健胃愈疡颗粒干预下大鼠胃溃疡黏膜乳癌相关肽和血小板活化因子的表达及与胃黏膜疏水性的相关性研究

目的:观察对胃溃疡复发有较好疗效的健胃愈疡颗粒对溃疡黏膜乳腺癌相关肽和血小板活化因子表达的影响,分析其可能的作用机制。方法:实验于2005-07/2006-07在湘雅医院中心实验室完成。SD大鼠110只,雌雄各半,随机抽签法分为5组,即正常对照组、假手术组、雷尼替丁组、健胃愈疡组,各20只;模型组30只。以Okabe改良法复制大鼠实验性胃溃疡,假手术组仅以生理盐水代替乙酸注入玻管内。造模后24h,雷尼替丁组、健胃愈疡组大鼠分别灌服盐酸雷尼替丁和健胃愈疡颗粒(药物组成为:柴胡、党参、白芍、延胡索、白芨、珍珠层粉、青黛、甘草,湖南湘雅制药有限公司生产)药液10mL/kg,分别相当于2.70,1.62g/kg,1次/d。假手术组、模型组灌服蒸馏水10mL/kg。10d后各组中随机取出10只大鼠剖腹取胃(处死前大鼠禁食24h),90d时将模型组20只大鼠再分为模型复发组和模型非复发组,各10只;除正常对照组、假手术组、模型非复发组大鼠腹腔内注射生理盐水外,其余各组大鼠腹腔内注射白细胞介素1,1μg/kg;在注射48h,大鼠禁食24h后,剖腹取胃。观察其对胃溃疡大鼠胃黏膜氨基己糖及磷脂含量、溃疡指数和胃黏膜血流的影响,并用RT-PCR观察乳癌相关肽乳癌相关肽和血小板活化因子表达的变化。结果:实验动物110只,全部进入结果分析。①模型组10,92d胃黏膜血流均低于正常对照组(P<0.01);健胃愈疡组同期胃黏膜血流均高于模型组(P<0.01)。②健胃愈疡组和雷尼替丁组10d溃疡指数均低于模型组(P<0.01,P<0.05);模型复发组、健胃愈疡组和雷尼替丁组92d溃疡指数均高于模型组(P<0.01);健胃愈疡组10,92d溃疡指数及复发率均低于雷尼替丁组(P<0.05,P<0.01)。③模型组10,92d氨基己糖和磷脂含量均低于正常对照组(P<0.01)。健胃愈疡组10,92d氨基己糖和磷脂含量均高于模型组和雷尼替丁组(P<0.01)。溃疡指数与氨基已糖、磷脂含量呈负相关(r=-0.957,-0.960,P<0.01)。④健胃愈疡组和雷尼替丁组10d乳癌相关肽mRNA表达较正常组和假手术组提高,血小板活化因子mRNA的表达下调(P<0.01),健胃愈疡组两指标表达变化较雷尼替丁组显著(P<0.01);模型复发组、健胃愈疡组和雷尼替丁组92d乳癌相关肽mRNA、血小板活化因子mRNA的表达同组10d比较差异无显著性意义(P>0.05);模型组乳癌相关肽mRNA、血小板活化因子mRNA的表达同组10d比较差异有显著性意义(P<0.01)。结论:健胃愈疡颗粒可提高乳癌相关肽mRNA及下调血小板活化因子mRNA的表达,影响胃黏膜氨基己糖及磷脂含量,可能是其促进溃疡愈合的机制之一。     

织构复合水凝胶体系的假说

生物软组织可视为具有多层次结构的织构复合水凝胶体系(TCHS)、以水凝胶复合元件(HCE)为基本的构件(CP),通过一定的组合、排列方式构筑一系列多层次结构的不同软组织。软组织中任何层次的结构单元既可视为织构复合水凝胶体系又可视为构件。任何层次的TCHS中,构件的结构及其组合排列方式决定着该层次单元的功能。以织构复合水凝胶体系的观点考察了真核细胞、角膜和骨骼肌的多层次结构。双层网络水凝胶、皮芯复合水凝胶纤维人工肌肉模型、时空匹配可降解细胞支架等研究成果初步地证明了提出织构复合水凝胶体系观点的合理性。     

场电子发射器件中实际电子发射点密度达到实用程度的标准

目前薄膜场致电子发射平板显示方面的研究越来越深入,其制备的器件场发射性能也越来越接近实用的程度。但有关其发射点密度达到何值时,即可达到最基本可以应用的程度至今也没有一个可以直接参考的实用标准。因此提出一个这样的客观标准对于场发射显示器今后的应用来讲具有重要的实际意义。作者结合自身10多年从事碳基薄膜场致电子发射研究的经历和相应的光学理论,提出一个场电子发射器件中实际电子发射点密度可达到实用程度的标准。当薄膜场电子发射点密度在场发射器件全部发射区域内都超过106sites/cm2时,肉眼将无法在屏幕上分辨出各个发射点,此时电子发射点已连成肉眼无法分辨出的面,也就是说这时单纯从场发射均匀性上来讲,场发射器件已达到可以应用的程度。