Chevron截骨术对外翻足关节接触特征影响的生物力学研究

目的 探究Chevron截骨术截骨远端外侧位移距离对外翻足关节接触特征的影响,为临床上选择合适的位移距离提供参考依据。方法 测量踝关节中立位状态下正常足、外翻足及外翻足Chevron截骨术截骨远端分别向外侧位移2.0、4.0、6.0 mm后前足、中足和后足各关节接触力、峰值压强和接触面积,并对结果进行分析。结果 与正常足相比,外翻足第1跖楔关节（t=-3.33, P=0.02）、跟骰关节（t=-2.74, P=0.03）和距下关节（后关节面）（t=-2.89, P=0.03）的接触力显著增高;外翻足距舟关节（t=-2.73, P=0.03）与跟骰关节（t=-2.74, P=0.03）的峰值压强显著增高;行Chevron截骨术后,随着截骨远端向外侧位移距离的增加,外翻足第1跖楔关节和跟骰关节的接触力逐渐减小;外翻足距舟关节和跟骰关节的峰值压强逐渐减小。结论 中度外翻足行Chevron截骨术后,当第1跖骨截骨远端向外侧位移6 mm时能有效恢复部分关节间力的分布,且能缓解部分关节局部应力集中现象。     

全髋关节置换术治疗成人发育性髋关节发育不良的难点及处理策略

发育性髋关节发育不良（developmental dysplasia of the hip, DDH）是成人继发性髋关节骨关节炎的最常见病因之一,早期干预不及时或治疗不当常引起髋关节严重畸形,晚期致残率较高。全髋关节置换术（total hip arthroplasty, THA）是治疗晚期成人DDH较有效的方法,但是由于髋臼和股骨近端解剖形态病理性异常使THA手术难度较大。本文就DDH的分型、手术难点及处理策略等结合近年来相关文献报道进行综述,以期为THA治疗成人DDH提供一定的理论依据。     

钻孔减压结合自体松质骨及同种异体骨植骨治疗股骨头坏死的短期疗效观察

目的 对ARCO Ⅱa期至Ⅲa期股骨头坏死（osteonecrosis of the femoral head, ONFH）且接受大通道钻孔减压、病灶清除,并经减压通道行股骨头内自体松质骨、同种异体颗粒骨打压植骨、同种异体腓骨条植骨治疗的患者进行短期临床疗效分析。方法 2018年1月至2020年12月,四川省骨科医院纳入47例（59髋）股骨头坏死患者。其中,男39例,女8例;年龄29 ～ 51岁,平均37.2岁;ARCO Ⅱa期16髋,ARCO Ⅱb期21髋,ARCO Ⅱc期13髋,ARCO Ⅲa期9髋;酒精性ONFH 46髋（酒精组）,激素性ONFH 13髋（激素组）。术后门诊随访,复查X线片（双髋正位及蛙式位片）,观察股骨头形态及骨整合情况,记录患髋Harris评分。结果 本组47例（59髋）随访24 ～ 36个月,平均随访30个月。术后所有患者疼痛明显缓解,部分患者疼痛消失（包括Ⅱa期14髋,Ⅱb期13髋,Ⅱc期4髋）。6例（9髋）患者病情进展股骨头发生塌陷,其中Ⅱb期1髋,Ⅱc期3髋,Ⅲa期5髋。按病因分,酒精性坏死塌陷6髋,塌陷率13%;激素性坏死塌陷3髋,塌陷率23.1%。酒精组和激素组末次随访时Harris评分与术前比较,差异均有统计学意义（P＜0.05）;酒精组术后Harris评分（82.7±5.6）分显著高于激素组（78.3±8.3）分,差异具有统计学意义（P＜0.05）。不同ARCO分期患者术后髋关节功能均得到一定程度改善,其中Ⅱa及Ⅱb期优良率78.4%,Ⅱc、Ⅲa期优良率50%（P＜0.05）。结论 针对ARCO Ⅱa期至Ⅲa期股骨头坏死的患者,采用大直径通道减压、清除死骨,同时植入自体松质骨和同种异体颗粒骨混合物,最后配合同种异体腓骨条加强支撑,短期可有效防止坏死股骨头的塌陷并减轻疼痛、改善患功能。     

Anemia and malnutrition in children at public schools in Osasco,São Paulo,Brazil

The authors studied a sample of students entering the first grade in the Osasco public school system in order to determine both the prevalence of anemia and nutritional status. Osasco is part of the Greater S o Paulo Metropolitan Area. Diagnosis of anemia was made through the hemoglobin concentration of blood from digital puncture. World Health Organization (WHO) levels were used to define anemia. Nutritional Status assessment. was made through weight/age and height/age indices, using Z score distribution and the National Center for Health Statistics (NCHS) reference levels. Prevalence of anemia was 51%. Prevalence levels varied according to the schools' geographic location: 56.9% in peripheral neighborhoods and 41.7% in central areas. Children with illiterate parents had a higher prevalence of this condition. Risk of anemia was higher for children who were over eight years of age when entering the first grade. Acute malnutrition was not found. Prevalence was higher than expected and points to the urgent need to establish an anemia control program for schoolchildren in this population.     

Plasma apolipoprotein B-48, hepatic apolipoprotein B mRNA editing and apolipoprotein B mRNA editing catalytic subunit-1 mRNA levels are altered in zinc-deficient rats.

Apolipoprotein B (apoB) exists as two major isoforms and serves as an obligatory component of lipid-rich plasma lipoprotein particles. Apolipoprotein B mRNA editing is a zinc-dependent, site-specific cytidine deamination that determines whether the apoB-100 or apoB-48 isoform is synthesized. The objective of this work was to examine whether dietary zinc levels affect apoB mRNA editing in vivo. Adult male Sprague-Dawley rats were randomly assigned to zinc-deficient (ZD, <0.5 mg Zn/kg diet), zinc-adequate (ZA, 30 mg Zn/kg diet) or zinc-replenished (ZDA, ZD rats fed the ZA diet for last 2 d) dietary groups for 18 d. The ratio of plasma apolipoprotein B-48 (apoB-48) to total apoB was significantly lower in zinc-deficient compared with zinc-adequate rats. Primer extension analysis indicated a modest but significant reduction in hepatic apoB mRNA editing in ZD rats compared with that of the ZA group. In ZDA rats, hepatic apoB mRNA editing and the percentage of plasma apoB-48 to total apoB were not different from ZA rats. The mRNA abundance of hepatic apobec-1 (apoB mRNA editing catalytic subunit 1) was significantly lower in ZD and ZDA rats than in ZA rats. In summary, the plasma ratio of apoB-48 to total apoB protein as well as hepatic apoB mRNA editing and hepatic apobec-1 mRNA levels were reduced in rats consuming a zinc-deficient diet. These data suggest that one or more components of apoB metabolism may be influenced by dietary zinc status.     

显微手术切除中央沟附近大脑实质内病变

探讨在超声引导下经皮胸腔细针吸取活检对肺外周型肿块、肺的弥漫性病变和纵隔肿块细胞学、病理学诊断的临床应用价值。方法：选择６８例影像学检查提示肺外周型肿块、肺弥漫性病变或纵隔肿块,而痰细胞学和支气管镜检查阴性的病例。应用 ＡＬＯＫＡ－ＳＳＤ ６５０实时灰阶超声仪。采用日本１８Ｇ与 ２１Ｇ细针活检。 ６８例全部做细胞涂片,４０例除做涂片外同时吸取组织块做石蜡切片。计算敏感性,特异性,准确性。结果：经细胞学、组织学两种方法诊断恶性肿瘤４３例,仅细胞学诊断为恶性肿瘤４０例,良性病变２８例,其中３例假阴性。细胞学检查敏感度为９３％,特异性１００％。细胞学总准确率为９５．６％。被检查者无气胸或出血等合并症。结论：该方法简便、迅速、安全且准确。尤其对细支气管肺泡癌的诊断更有帮助。     

保存时间及温度对血清标本补体C_3和CH50测定结果的影响

目的 了解保存时间及温度对补体活性的影响。方法:用单向琼脂扩散法和非离心单管法对不同温度和时间下标本的C_3含量及CH50进行测定。结果与结论:血清补体C_5含量在室温下24h、4C下4dC、-10C和-20C下8d内无显著变化;CH50在室温下12h、4C下24h,-10C和-20C下8d内CH50无明显变化。     

中国林蛙卵油和卵渣中微量元素的测定

目的：为中国林蛙油和卵渣应用提供科学依据。方法：采用等离子光谱和分光光度计法测定中国林蛙卵油和卵渣中的微量元素。结果：卵油和卵渣中均含 Ｚｎ, Ｍ ｎ, Ｃｕ, Ｆｅ 等 ９ 种人体必需微量元素,且 Ｚｎ／ Ｃｕ 比值较小。结论：卵油可能具有抗衰老及防治冠心病和高血压等作用。     

良性增生前列腺组织中鸟氨酸脱羧酶基因表达的研究

为探讨鸟氨酸脱羧酶（ＯＤＣ）基因表达与前列腺良性增生的关系,采用Ｎｏｒｔｈｅｒｎ印迹和ＲＮＡ斑点杂交技术,测定分析了正常人（１０例）和良性前列腺增生症（ＢＰＨ）病人（１５例）前列腺组织中ＯＤＣｍＲＮＡ的丰度。结果显示,良性增生前列腺组织中ＯＤＣｍＲＮＡ丰度较正常前列腺组织显著升高。经密度扫描测定结果显示,Ｎｏｒｔｈｅｒｎ印迹分析中ＢＰＨ前列腺组织中ＯＤＣｍＲＮＡ丰度约为对照组的６～２０倍,斑点杂交为５倍以上。提示ＯＤＣ基因表达增强在良性前列腺增生症形成中起重要作用     

小鼠树突状细胞过继转移抗原作用的实验研究

用绵羊红细胞（SRBC）免疫小鼠,取其脾脏分离树突状细胞（dendriticcellsDCs）将这些带有抗原信息的DCs经尾静脉注射给小鼠．以观察DCs过继转移抗原的作用。结果表明,各试验组小鼠抗体形成细胞（AFC）及血清中SRBC处价明显高于对照组,P＜0．01,再次免疫DC组抗SRBC放价高于初次免疫DC组P＜0．05,提示：DCs具有过继转移抗原的作用。