切开复位内固定治疗肱骨髁间骨折的回顾性分析

目的：总结肱骨髁间骨折切开复位内固定手术经验。方法对68例肱骨髁间骨折患者行开放复位内固定手术治疗。结果68例患者平均随访时间22个月（14～42个月）。3例老年患者术后鹰嘴截骨处延迟愈合,2例青少年患者经鹰嘴截骨入路术后鹰嘴骨骺损伤,7例出现肘关节异位骨化,5例发生创伤性关节炎,1例出现迟发性尺神经炎。根据Mayo肘关节功能评分平均为85．6分,其中优30例,良25例,可7例,差6例,优良率为80．9％。结论肱骨髁间骨折应根据患者年龄及骨骼质量选择合理的手术方式。成人采用经尺骨鹰嘴截骨入路大多可获得满意的临床疗效,老年严重骨质疏松患者慎用经尺骨鹰嘴截骨入路,骨骺发育未成熟的青少年应减少对骨骺的损伤。     

北海市娱乐场所服务小姐性病艾滋病知识与性病感染情况调查

目的了解北海市娱乐场所服务小姐性病艾滋病知识水平及性病艾滋病感染情况,以便为在公共娱乐场所服务小姐中开展预防性病艾滋病的健康干预工作提供依据.方法对北海市区内娱乐场所采用分层整群抽样方法,随机问卷调查娱乐场所内187名服务小姐的人口学社会学特征、性病艾滋病相关知识,并免费对其进行性病艾滋病检测.结果调查对象年龄平均(24.1±4.9)岁,其中以20～24岁者为主(占47.6%);文化程度以初中为主(占56.1%);来自外省者占多数(45.5%).调查对象对性病艾滋病相关知识回答平均正确率为68.2%,其中对艾滋病主要传播途径认知水平比较高,但对于艾滋病性病的非传播途径回答正确率比较低.在调查对象中未检出HIV感染者,性病总感染率为40.6%.结论北海市娱乐场所服务小姐对性病艾滋病相关知识有一定了解,但不全面;娱乐场所服务小姐是性病高危人群,应采取有针对性的有效措施对娱乐场所服务小组开展干预工作.     

正反义人PIN1基因克隆及真核表达载体的构建

目的 克隆正、反义人PIN1基因（hPIN1）及构建hPIN1基因正、反义真核表达载体.方法 应用RT-PCR技术从人骨肉瘤细胞系MG-63细胞总RNA中成功扩增出990bp包含hPIN1基因编码区的cDNA序列,按正、反方向加上BamHⅠ及 HindⅢ双酶切位点后形成正、反义hPIN1基因,然后连入含BamHⅠ及 HindⅢ双酶切位点的pIRES2-EGFP表达质粒上,构建正、反义hPIN1基因的重组真核表达质粒phPIN1.结果 扩增的cDNA经测秩序与基因文库完全一致;BamHⅠ及HindⅢ双酶切后,正、反义表达质粒形成5.3 ＋0.99kb 两条带,与理论计算值完全一致.结论 成功克隆正、反义人PIN1基因及构建hPIN1基因的正、反义真核表达载体.     

抗菌药物的非抗菌作用研究

抗菌药物的非抗菌作用有可能成为一种有益的治疗作用,其在临床应用中或许能起到关键作用。     

胰腺结核1例并文献复习

胰腺结核是一种少见的肺外结核,临床症状与影像学表现无特异性,易与其他胰腺疾病混淆,导致抗结核治疗不及时或接受不必要的手术。对于腹腔淋巴结增大、梗阻性黄疸的年轻患者,尤其不伴有肿瘤标志物升高的孤立性胰腺占位,需考虑胰腺结核的可能。完善相关实验室检查,病理组织活检可帮助鉴别诊断,必要时可行手术探查及引流。本文回顾性分析成都公共卫生临床医疗中心收治的1例胰腺结核患者的临床资料、影像学表现,并进行相关文献复习,旨在提高临床对胰腺结核的诊疗水平,减少漏诊、误诊。     

Effect of electro-acupuncture combined with early rehabilitation on motor function and expressions of CD11b/CD18 and tumor necrosis factor-α in patients with acute cerebral infarction

Objective To observe the effect of electro-acupuncture combined with early rehabilitation on the motor function and expressions of the adhesion molecules CD11b and CD18 in the polymorphonuclear leucocytes (PMN) and monocytes and serum tumor necrosis factor-α (TNF-α) levels in patients with acute cerebral infarction (ACI). Methods A total of 165 ACI patients were randomly divided into control group (group A, n=50), conventional rehabilitation group (group B, n=50) and comprehensive rehabilitation group (group C, n=65). The expressions of CD11b and CD18 in the PMN and monocytes and serum TNF-α levels were determined before and at 1, 2, and 4 weeks after the treatment. Thirty-two healthy subjects were also recruited as the normal control group (group N). The neurological function of the subjects was evaluated by modified Edinburgh-Scandinavia stroke scale (MESSS) and Fugi-Meyer Assessment (FMA), and their activity of daily living (ADL) was assessed using Barthel index (BI). Results The CD11b/CD18 expression in the PMN and MN and serum TNF-α level in groups A, B and C were significantly higher than those in group N before and 1 week after the treatment (P<0.05). CD11b/CD18 expression and serum TNF-α level were significantly lower in groups B and C than in the group A at 1 week after the treatment, and significantly lower in group C than in group B (P<0.05). At 2 weeks of treatment, CD11b/CD18 and TNF-α were significantly lower in groups B and C than in the group A, being the lowest in group C (P<0.05). The scores of mESSS in both groups B and C were lower than that in group A, and the scores were lower in group C than in group B. Group C showed higher FMA scores than group B, both having higher scores than group A. At 4 weeks of treatment, the mESSS scores were significantly lower, hut the FMA and ADL score significantly higher in groups B and C than in the control group (P<0.05), and the differences were more obvious in group C. Groups B and C had greater effective rate than group A (P<0.05), and the rate was the highest in group C (P<0.05). Conclusion Electro-acupuncture combined with early rehabilitation promotes the recovery of motor function in ACI patients probably by regulating the expressions of the adhesion molecules CD11b and CD18 on the PMN and monocytes and the serum levels of TNF-α.     

人工骨填充椎体成形术结合椎弓根螺钉内固定治疗胸腰椎压缩性骨折

椎弓根螺钉内固定是治疗胸腰椎骨折的常用手术方式,但存在一定的内固定失败率。自2003年以来,我们采用椎弓根螺钉内固定系统结合人工骨椎体成形术治疗胸腰椎压缩性骨折45例,取得了良好效果,现总结报告如下。     

联合应用rhBMP-2与bFGF对兔骨髓基质细胞表达VEGF及其成骨潜能的影响

目的：观察兔骨髓基质细胞经rhBMP-2与bFGF刺激后,其VEGF因子表达及成骨潜能的变化。方法：取兔双侧股骨骨髓基质细胞,采用骨髓基质细胞体外培养技术,单独或联合以rhBMP-2、bFGF刺激细胞。细胞培养5d后,进行细胞形态（HE染色）、增殖情况（细胞记数法与MTT法）、碱性磷酸酶（改良钙钴法染色）、成骨结节（图像分析）、VEGF阳性细胞率（免疫组化染色）等项目的检测。结果：①联合应用rhBMP-2、bFGF在细胞记数、ALP活性、矿化面积百分率、VEGF阳性细胞率4个检测项目上优于单独应用rhBMP-2或bFGF,差别有统计学意义。②分开联合应用rhBMP-2、bFGF优于同时应用rhBMP-2或bFGF。结论：合理的联合使用rhBMP-2和bFGE,不仅可促进骨髓基质细胞的快速增殖及向成骨细胞转化,还可促进促血管内皮细胞增生的重要介质VEGF的表达。此项技术可应用于骨组织工程,促进工程化骨在体内的存活。     

髋关节发育不良的全髋关节置换

髋关节发育不良(DDH)的全髋置换不同于一般全髋置换。从作者经治的61例76髋置换的经验和体会,髋关节发育不良的解剖特点决定了全髋置换(THR)的特殊性,稍不慎,就会造成不良后果。医生不仅必须面对发育不良的髋关节,同时还必须制定适于这类畸形的手术方案、假体安置和功能重建后的评估。因此,每一个病例都是一个系统工程。DDH在近年积累的经验表明,实施THR的对象都是DDH成人髋关节炎和疼痛、跛行是这类患者迟早出现、不可逾越的厄运。因此,笔者认为面对渴求获得正常人的功能康复,实施THR重建术,必须充分考虑患者的要求与术者可能提供…     

Q开关钕:钇铝石榴石激光联合重组人酸性成纤维细胞生长因子治疗面部黄褐斑的临床研究

目的:评价Q开关钕:钇铝石榴石激光联合重组人酸性成纤维细胞生长因子(recombinant human acidic fibroblast growth factor,rh-aFGF)治疗面部黄褐斑的有效性与安全性。方法:2012年2月~2014年3月,入选78例面部重度黄褐斑患者,对照组采用波长为1 064nm的掺钕钇铝石榴石(Neodymium-doped Yttrium Aluminium Garnet,Nd:YAG)激光治疗;治疗组在对照组基础上给予rh-aFGF治疗,1次/月,连续治疗3次后观察黄褐斑的临床治疗效果及激光术后并发症的发生。结果:采用rh-aFGF干预后,治疗组与对照组在术后水肿(1.6±0.5 vs 2.2±0.5)、渗出(1.3±0.3 vs 1.8±0.4)、红斑(1.6±0.3vs 2.5±0.7)、疼痛灼烧评分(1.7±0.6 vs 2.7±0.8)、感染发生率(2.6%vs 11.5%)、皮肤弹性增加(25.8±4.7%vs 5.2±2.2%)、皮肤含水增加(55.8±14.6%vs 27.6±6.8%)、色素评分(1.9±0.5 vs 2.7±0.5)、完全愈合时间(4.2±1.6 vs 7.7±2.4)方面,两组比较具有统计学差异(P0.05)。结论:rh-aFGF联合Q开关Nd:YAG激光治疗黄褐斑,可以减少激光术后并发症,增加皮肤弹性及含水量,减少色素沉着的发生。