特殊的儿童嗜铬细胞瘤4例报告

目的探讨小儿特殊嗜铬细胞瘤的临床特点及治疗。方法报告2000-2004年间我院收治的4例小儿嗜铬细胞瘤病例，均为男性，年龄9～12岁。其中双侧肾上腺嗜铬细胞瘤2例，肾上腺外3例，异时再发者2例，有家族史1例。结果经妥善围手术期处理，顺利切除肿瘤，术后血压全部降至正常。结论儿童肾上腺外、双侧肾上腺．多发及再发的嗜铬细胞瘤发生率高于成人，手术切除肿瘤可获得良好的治疗效果。     

冠状动脉血管成形术后再狭窄的研究现状

经皮冠状动脉腔内成形术是目前冠心痛的重要治疗手段，而术后再狭窄的发生严重影响病人的远期疗效与生活质量。本文介绍了再狭窄的发生机制，并从药物、机械、涂层支架、放射及基因方面对再狭窄的防治研究现状进行了综述分析。     

早期盆底肌锻炼防治TUVP术后暂时性尿失禁的临床观察

目的探讨前列腺增生症患者早期行盆底肌锻炼防治经尿道前列腺汽化电切(TUVP)术后暂时性尿失禁和缩短尿失禁持续时间的效果,方法对89例前列腺增生症患者需行TUVP术病例随机分为实验组和对照组。对照组常规在术后拔尿管前1～2d夹闭尿管,定期开放。实验组于明确诊断开始,术后留置尿管期间及拔除尿管后均指导病人进行盆底肌锻炼。比较两组术后尿失禁发生率,尿失禁持续时间。结果实验组术后尿失禁1例,发生率为2.2%,尿失禁持续时间为2d,对照组术后尿失禁11例,发生率25%,尿失禁持续时间7～12d,两组比较,差异有显著性,p<0.01。结论早期行盆底肌锻炼能有效地预防和降低术后尿失禁发生率,缩短尿失禁持续时间。     

Decreased GDNF mRNA expression in dorsal spinal cord of unilateral arthritic rat

It is now well established that nerve growth factor (NGF) plays a key role in inflammation-induced hyperalgesia. It was also reported that brain derived neurotrophic factor (BDNF), another member of neurotrophins, contributed to the pain pathway as a neurotransmitter in the CNS. The present work demonstrated a down-regulation of glial cell line-derived neurotrophic factor (GDNF) mRNA expression in dorsal spinal cord in complete Freund's adjuvant-induced unilateral arthritic rats serving as a chronic pain model. The fast occurring and long lasting down-regulations suggest that GDNF might contribute to pain pathway in a way different from neurotrophins and might play a role in the maintenance of chronic pain status.     

天花粉与混淆品长萼瓜蒌的紫外光谱鉴定

目的：寻求一种鉴定天花粉与其混淆品长萼瓜蒌的有效方法。方法：采用天花粉双边栝楼根以及瓜氨酸作为对照物质，与长萼瓜蒌根同时进行紫外光谱扫描。结果：紫外光谱显示，长萼瓜蒌的水和乙醇溶液在272nm波长处均有最大吸收，而天花粉及瓜氯酸均无此光谱特征，可资鉴别。结论：用紫外光谱法鉴定天花粉与长萼瓜蒌，方法简便可行，结果准确可靠。     

拔罐加TDP治疗慢性咳嗽31例

慢性咳嗽是指患者连续咳嗽3周以上，临床上使用过抗生素及止咳祛痰药疗效不显著者。近几年来笔者采用拔罐加TDP治疗慢性咳嗽，疗效较为满意，现报道如下。     

电致孔对睾酮透皮转运的影响

研究了电致孔技术对睾酮透皮转运的影响,对电压、脉冲持续时间和电极的影响进行了初步探讨.结果表明,电致孔可增大药物的透皮转运速率及其累积透过量,且电力学参数与透皮吸收增量呈正相关,电极也明显影响电致孔透皮速率.     

β1肾上腺素能受体反义寡核苷酸对肾性高血压大鼠血流动力学及心肌肥厚的影响

目的 :观察阳离子脂质体 (DOTAP DOPE)介导的 β1肾上腺素能受体mRNA反义寡核苷酸 (β1 AS ODN)对肾性高血压大鼠血流动力学及心肌肥厚的影响。方法 :建立二肾一夹 (2K1C)肾性高血压大鼠模型 ,随机分为假手术组、模型组、反向寡核苷酸组、反义寡核苷酸组和卡维地洛 (carvedilol)组。ODN与DOTAP DOPE以 1 2摩尔比混合 ,4周末尾静脉注射 0 .5mg·kg-1,卡维地洛 10mg·kg-1·d-1灌胃 4周。定期测血压 ,8周末测血流动力学参数 ,左室重量指数 (LVWI)及血浆内皮素 1(ET 1)浓度 ,并对LVWI与ET 1进行线性相关分析。结果 :与反向寡核苷酸组比 ,β1 AS ODN能降低血压最高达39mmHg并持续 2 7d(30 .4 4± 6 .5 0 ,P <0 .0 1) ,降低左室收缩压 (LVSP) (P <0 .0 5 )、左室舒张末压 (LV EDP) (P <0 .0 1) ,升高左室最大收缩和舒张速率 (±dp dtmax) (P <0 .0 1) ,降低LVWI(P <0 .0 5 )及血浆ET 1(P <0 .0 1) ;与卡维地洛组比 ,各指标均无显著性差异。LVWI与ET 1显著正相关 (r =0 .74 9,P <0 .0 1)。结论 :DOTAP DOPE介导的 β1 AS ODN单剂量静脉注射能持续降压 ,改善血流动力学 ,预防心肌肥厚 ,可能与其降低血浆ET 1有关。     

Clinical Outcomes of Revision Total Knee Arthroplasty after High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Systematic Review and Meta‐Analysis

As more high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are performed, orthopaedic surgeons realize that more HTO and UKA failures will require revision to total knee arthroplasty (TKA) in the future. To systematically evaluate the clinical outcomes of TKA after HTO and TKA after UKA, the Embase, PubMed, Ovid, Web of Science, and Cochrane Library databases were searched for studies investigating revision TKA after HTO and UKA published up to June 2021. RevMan version 5.3 was used to perform the meta‐analysis. The revision TKA after HTO and revision TKA after UKA groups were compared in terms of operative time, range of motion (ROM), knee score, postoperative complications, postoperative infection, revision, and revision implants used. Nine studies were ultimately included in the meta‐analysis. Results revealed that the knee score for the revision TKA after HTO group was better than that of the revision TKA after UKA group (MD 4.50 [95% CI 0.80–8.20]; p = 0.02). The revision TKA after HTO group had a lower revision rate (OR 0.65 [95% CI 0.55–0.78]; p < 0.00001) and fewer revision implants used (OR 0.11 [95% CI 0.05–0.23]; p < 0.00001). There were no statistical differences in operation time (MD ‐2.00 [95% CI −11.22 to 7.21]; p = 0.67), ROM (MD ‐0.04 [95% CI ‐3.69–3.61]; p = 0.98), postoperative complications (OR 1.41 [95% CI 0.77–2.60]; p = 0.27), or postoperative infections (OR 0.89 [95% CI 0.61–1.29]; p = 0.53). To conclude, the revision rate of revision TKA after UKA was greater, and more revision implants were required. It is important for orthopaedic surgeons to preserve bone during primary UKA.