Rupture of the tendon of the long head of the biceps brachii. Surgical versus nonsurgical treatment

Twenty-seven shoulders (in 26 patients) that had surgical repair of a rupture of the long head of the biceps tendon between 1962 and 1981 were evaluated at three to 22 years after injury (mean, 13 years). Thirty similar patients had been treated nonsurgically and were evaluated two to 15 years (mean, 4.6 years) after tendon rupture. Biomechanical testing was performed on ten patients in the surgical group and 13 in the nonsurgical group. Residual arm pain was infrequent in both surgically and nonsurgically treated groups. Residual subjective weakness at the elbow was reported in four of the surgical group and in 20 of the nonsurgical group. Surgically treated patients returned to work later than nonsurgical patients; however, 11 in the nonsurgical group were not able to return to full work capacity, versus only two in the surgical group. On biomechanical testing, the nonsurgical group had lost a mean of 21% of supination strength and 8% of elbow flexion strength but had no weakness in grip, pronation, or elbow extension. The surgical group had lost no strength in any of these testing modes.     

黄连细胞二步法悬浮培养生产黄连生物碱类成分的探索

为提高用植物细胞培养生产镒生代谢产物的单位产量，作者对黄连细胞采用二步法悬浮培养生产黄连生物碱进行了探索。结果显示：黄连细胞采用一步法悬浮培养６周，细胞干，鲜重产率分别为２０．９６ｇ／Ｌ和１７４．９２ｇ／Ｌ，增重约７００％，细胞中总生物碱含量为１４．７９ｍｇ／ｇ．ｃｅｌｌ ｄｗ，培养基中生物碱量为１２．９６ｍｇ／Ｌ，每升培养液共可收获生物碱３２３ｍｇ。采用先在生长培养基中培养３周，在合成碱量为１２     

食管平滑肌瘤的微创手术治疗

目的探讨微创手术在食管平滑肌瘤治疗中的临床应用价值. 方法回顾性分析1996年9月～2002年10月26例食管平滑肌瘤采用微创手术治疗的临床资料. 结果电视胸腔镜食管平滑肌瘤摘除术23例,其中3例(2例胸膜腔紧密粘连,1例肿瘤无法定位)中转开胸(胸腔镜辅助小切口);经颈部食管平滑肌瘤摘除术2例;经食管镜食管平滑肌瘤切除1例.26例手术顺利,术后恢复平稳,无手术死亡及严重并发症,术后病理诊断均为平滑肌瘤.随访2～73个月,平均32.3个月,无复发. 结论电视胸腔镜肌瘤摘除术可作为食管固有肌层平滑肌瘤的首选治疗方法,对于食管粘膜肌层的平滑肌瘤,可考虑经食管镜切除.     

环氧合酶-2及其选择性抑制剂塞来昔布对结肠癌肝转移瘤VEGF、FGF-2影响的实验研究

目的 :研究环氧化酶 2及其选择性抑制剂塞来昔布和血管生成因子VEGF、FGF 2间的关系 ,从而探讨环氧化酶 2对结肠癌肝转移瘤血管形成的影响。方法 :以细胞培养法建立稳定的结肠癌细胞株HT 2 9和HCT 116 ,利用脾切除法建立结肠癌肝转移动物模型 ,免疫组化检测结肠癌肝转移瘤VEGF、FGF 2蛋白表达。结果 :结肠癌肝脏转移率 ,HT 2 9组、HCT 116组、塞来昔布组分别为 83 33%、16 6 7%、33 33%。肝脏转移瘤VEGF、FGF 2的表达 ,HT 2 9组与HCT 116组、塞来昔布组比较均表达增强 ,有显著统计学意义 (P <0 0 1～ 0 0 5 ) ;塞来昔布组与HCT 116组比较无显著性差异 (P >0 0 5 )。结论 :环氧合酶 2与结肠癌肝转移瘤血管生成密切相关 ,其高表达促进了结肠癌肝转移瘤新生血管生成。其机制可能是上调促血管生成因子VEGF、FGF 2的表达     

不同类型高脂血症患者血清sVCAM-1测定的临床意义

目的 :探讨血清可溶性血管细胞黏附分子 (sVCAM 1)浓度在不同类型高脂血症中的临床意义。方法 :应用酶联免疫吸附 (ELISA)法测定 6 6例不同类型高脂血症患者血清sVCAM 1的浓度 ,与正常对照组比较。结果 :高胆固醇组、高胆固醇高甘油三酯组 ,其血清sVCAM 1浓度分别为 (999 81± 16 5 0 3)ng/ml、(10 5 5 4 2± 14 8 6 4 )ng/ml,均高于正常对照组 (P <0 0 1) ,而高甘油三酯组血清sVCAM 1为 (85 1 32 170 5 9)ng/ml,虽高于正常对照组 (P <0 0 5 )。但均低于高胆固醇组和高胆固醇高甘油三酯组 (P <0 0 1) ,高胆固醇组与高胆固醇高甘油三酯组的血清sV CAM 1浓度比较未显示统计学意义 (P >0 0 5 )。结论 :高脂血症患者血清sVCAM 1浓度高于正常对照组 ,不同类型高脂血症患者血清sVCAM 1浓度不同 ,因此 ,血清sVCAM 1可作为评价动脉粥样硬化危险性的血清学指标之一。     

儿童肺吸虫病79例临床分析

目的：通过分析儿童肺吸虫病的临床特征，提高对儿童肺吸虫病的认识，减少误诊。方法：对79例不同类型儿童肺吸虫病进行回顾性分析。结果：治疗后患者自觉症状消失，治愈率较高。结论：儿童不同类型肺吸虫病临床表现虽然复杂，但结合流行病学，经临床及血清学检查，就能及时确诊，79例儿童肺吸虫病药物治疗，疗效满意。     

DNA拓扑异构酶Ⅱα的表达与颅咽管瘤预后的关系

目的检测颅咽管瘤组织中DNA拓扑异构酶Ⅱα(DNATopoⅡα)的表达情况,分析其表达与肿瘤复发的关系,探讨其是否可作为判定颅咽管瘤预后的一个有效指标。方法设计前瞻性队列研究方案,采用免疫组化方法和图像分析技术测定63例颅咽管瘤组织切片中DNA拓扑异构酶Ⅱα的表达水平,评价颅咽管瘤釉质上皮瘤与鳞状乳头瘤病理亚型、复发组与非复发组、原发组与复发组之间肿瘤细胞的增殖能力。结果32例釉质上皮瘤14例复发,31例鳞状乳头瘤6例复发;釉质上皮瘤与鳞状乳头瘤病理亚型之间以及复发组与非复发组肿瘤之间DNA拓扑异构酶Ⅱα的表达水平有显著性差异(P<0.05),而原发组与复发组肿瘤之间DNA拓扑异构酶Ⅱα的表达水平无统计学差异(P>0.05)。结论颅咽管瘤的病理亚型以及DNA拓扑异构酶Ⅱα的表达水平与肿瘤的预后和复发有关,可作为预测肿瘤复发危险性的一个参考指标;DNA拓扑异构酶Ⅱα的表达水平在原发组和复发组肿瘤之间无显著性差异,提示肿瘤在复发过程中瘤细胞的增殖活性无明显变化。     

Botulism in China

During the period 1958-1983, 986 outbreaks of botulism occurred in China, affecting 4,377 individuals and resulting in 548 deaths. The initial cases of botulism were found in Xinjiang province, where the incidence was highest. Outbreaks have occurred in all of the northern provinces and in some of the southern provinces of China. The toxin found most frequently in the northwest region of China was type A; in north China, type B; and in the northeast, type E. The most frequently offending food was home-made strong-smelling preserved bean curd, which was implicated in 74% of the outbreaks. The complex clinical manifestations of botulism can be grouped into those affecting the eyes, the mouth, the pharynx, and the skeletal muscles. Following the institution of effective methods of prevention and treatment, epidemics of botulism in China have been controlled and the mortality rate reduced from 41% (1950s) to 7.6% (1983).     

血清纤维结合蛋白的酶免疫检测法

目的建立血清纤维结合蛋白(Fn)含量的酶免疫分析(EIA)检测方法。方法利用现有Fn检测试剂盒建立Fn的EIA测定法,并对所建立的方法从灵敏度、精密度、特异性、重复性等方面进行方法学评价。结果该法灵敏度为11．69ml／L,线性范围为50～300mg／L,批内变异系数为 3．82％,批间变异系数为5．10％,回收率97．7％。肺结核组及正常对照组血清Fn含量分别为 (188．82±5．51)mg／L和(275．25±18．11)mg／L,两组间差异有显著性意义(P<0．01);肺结核稳定期患者血清Fn显著高于进展期及好转期(P<0．05)。结论该方法线性范围适宜,准确度、精密度较好,符合临床检验工作要求。     

Accidental ingestion of Ecstasy in a toddler.

Toddlers who ingest the drug of abuse 3,4-methylenedioxymethamphetamine (MDMA; 'Ecstasy') are at particularly high risk of serious neurological and cardiovascular side effects. We report of a 20-month-old male toddler who accidentally ingested Ecstasy. He presented with fever and seizures, tachycardia, hypertension, and hyperthermia. Urine amphetamine level was 2111 ng/mL. Treatment included rapid cooling, hydration, and support measures. Vital signs were regularly monitored. His condition became stable on day 2 and urine amphetamine level returned to normal on day 3 of hospitalization. His behavior, activity, and appetite had returned to their usual levels upon follow-up at our outpatient clinic. The incidence of drug abuse with MDMA has increased dramatically over the last decade in developed countries. It can be expected that accidental Ecstasy poisoning in children will increase as well. This case illustrates the need to consider the possibility of accidental Ecstasy ingestion in the differential diagnosis of a child suffering from convulsions with fever.