炎黄保肾胶囊的质量控制研究

目的制定炎黄保肾胶囊的质量控制方法。方法采用HPLC法测定炎黄保肾胶囊中大黄酸、大黄素、大黄酚的含量,并制定含量限度。结果 HPLC法测得炎黄保肾胶囊中大黄酸、大黄素、大黄酚检测浓度分别在8.88~44.40μg·ml-1(r=0.9998)、2.28~11.40μg·ml-1(r=0.9998)、2.08~10.40μg·ml-1(r=0.9999)范围内与峰面积呈良好的线性关系,平均加样回收率为98.04%、99.20%、99.68%。结论该制剂制备工艺稳定,建立的含量测定方法简便、可靠,可用于该制剂的质量控制。     

Reliability of classification systems for intertrochanteric fractures of the proximal femur in experienced orthopaedic surgeons

INTRODUCTION: The aim of this study was to determine the reliability of currently used classification systems for intertrochanteric fractures of the proximal femur, and to determine the reliability of these systems in experienced orthopaedic surgeons. MATERIALS AND METHODS: Forty intertrochanteric fractures of the proximal femur were classified independently by five experienced observers using the AO, Evans, Kyle, and Boyd classification systems on two separate occasions 3 months apart. The interobserver and intraobserver variation was assessed using kappa statistics. RESULTS: The level of agreement for classification into AO groups was almost perfect or substantial, and higher than other classification systems. When the fractures were further classified using the AO classification with subgroups, reliability became worse. CONCLUSIONS: The current study suggests that the AO classification system with groups can be used more reliably to measure intertrochanteric fractures of the proximal femur than Evans, Kyle, and Boyd classification systems. However, the reliability of the AO classification with subgroups is not satisfactory.     

Endovenous laser treatment combined with a surgical strategy for treatment of venous insufficiency in lower extremity: a report of 208 cases

BACKGROUND: We assessed the safety and efficacy of endovenous laser treatment (EVLT) of the saphenous vein combined with a surgical strategy for treatment of deep venous insufficiency in the lower extremity. METHODS: Two hundred thirty venous insufficiencies of the lower limbs in 208 consecutive patients (93 men and 115 women; mean age, 54.15 years) were treated with EVLT combined with surgical strategies. All patients were symptomatic. There were 84 limbs (36.5%) in C(2), 25 (10.9%) in C(3), 109 (47.7%) in C(4), 1 (0.4%) in C(5), and 9 (3.9%) in C(6) (CEAP), and Klippel-Trenaunay syndrome was present in 2 limbs. A total of 119 (51.7%) had perforator vein incompetence. Four therapeutic methods were included in this series according to symptoms, CEAP classification, and venous reflux. Simple EVLT was performed for 15 patients with only great saphenous vein (GSV) incompetence or Klippel-Trenaunay syndrome in 19 lower limbs. EVLT combined with high ligation of the GSV and open ligation of perforators was performed for 5 patients with GSV and perforator incompetence in 5 lower limbs. EVLT was combined with high ligation of the GSV for 76 patients with GSV incompetence in 94 lower limbs. EVLT was combined with external banding of the first femoral venous valve and high ligation of the GSV for 112 patients with primary deep venous insufficiency in 112 lower limbs. All patients were followed up on an outpatient basis for physical examinations and postoperative complaints, and duplex ultrasonography was performed 2 weeks, 6 months, and 1 year after operation. RESULTS: All patients tolerated the procedure well and returned to normal daily activities immediately, achieving a 100% immediate clinical success rate. Spot skin burn injuries occurred in 2 patients (1.0%). Paresthesia in the gaiter area was noted in 15 patients (7.2%). No postprocedural symptomatic deep venous thrombosis or pulmonary embolism occurred. Three patients had local recurrent varicose veins in the calf (1.4%) during a 2- to 27-month follow-up (mean, 6.12 months). Postoperative clinical classes were significantly improved between 2 weeks and 24 months (P = .0001 at 2 weeks and 3 to 18 months; P = .0055 at 24 months compared with before operation), especially in preoperative C(2) to C(3) stage patients, who achieved complete amelioration. CONCLUSIONS: EVLT is a novel minimally invasive treatment with advantages of safety, effectiveness, and simplicity, and it leaves no scars. Its indications can be expanded by combining EVLT with surgical strategies.     

Colorectal carcinoma among Indigenous people: a public hospital-based study in Townsville and Cairns, North Queensland, Australia

INTRODUCTION: There are very little clinical and pathological data on colorectal cancer among Indigenous people in Australia. METHODS: A retrospective study on Indigenous patients treated for colorectal cancer at the Townsville and Cairns Base Hospitals from 1999 to 2004 was carried out in order to better characterise this disease in the Indigenous population. RESULTS: There were 25 patients (12 M, 13 F) with a median age of 57.3 years. The majority (56%) of the tumours were left-sided, being in the sigmoid colon, rectosigmoid junction and rectum. Of the patients, 60% had American Joint Committee on Cancer (AJCC) staging system Stage I and II disease at presentation. There was a relatively high proportion of poorly differentiated adenocarcinomas (40%). Six patients died of the disease. The median follow-up was 20.5 months (range 2-51). CONCLUSIONS: Comparisons were made with available data on colorectal cancer in the general Australian population. The limitations and deficiencies of the study, as well as problems of data collection on Indigenous people were discussed.     

Thoracoscopy‐assisted mini‐open surgery for anterior column reconstruction in thoracic spinal tuberculosis

Objective: To evaluate the clinical effects of thoracoscopy‐assisted mini‐open surgery for anterior column reconstruction in thoracic spinal tuberculosis. Methods: Fifty‐eight patients, 35 men and 23 women, aged 39.2 (range, 19–60) years with thoracic spinal tuberculosis with an average kyphotic angle of 29.2° (range, 18°–42°) underwent thoracoscopy‐assisted mini‐open surgeries, including thorough debridement and anterior spinal reconstruction. According to the Frankel Grading system, preoperative neurological function was judged as Grade B in 3 cases, Grade C in 7, Grade D in 28, and Grade E in 20. All patients were followed up for an average of 4.6 years. Outcomes were evaluated retrospectively. Results: Surgery was accomplished successfully in all cases. The average operation time was 230 min (range, 180–320 min), the average intraoperative blood loss 570 ml (range, 350–1200 ml), and the mean drainage duration 3.6 days (3–5 days). Complications occurred in 19 patients (32.8%). Neurological improvement of one to three grades had occurred in 29 patients by final follow‐up. The average correction rate of the kyphotic angle was 36.4%, and no obvious correction loss was detected during follow‐up. No recurrent tuberculosis was found in the group. Conclusions: Thoracoscopy‐assisted mini‐open surgery provides a simple, safe, effective, and practical technology with minimal invasiveness for the treatment of thoracic spinal tuberculosis.     

Suramin promotes recovery from renal ischemia/reperfusion injury in mice

Suramin is a polysulfonated naphthylurea originally designed as a treatment for trypanosomiasis; but that has also been used to treat rodent models of fulminant hepatic failure and focal brain ischemia. In this study, we determined the effects of suramin on renal ischemia/reperfusion-induced acute kidney injury in mice, in particular its effect when administered after renal injury has been established. Increasing concentrations of suramin were given 24 hours following reperfusion, a time when serum creatinine levels were at their highest level. This treatment improved renal function, as evidenced by decreased blood urea nitrogen and serum creatinine to control values and diminished histopathologic tubular damage. Suramin-treated animals had a significant reduction in apoptotic tubular cells and infiltrating leukocytes. There was also an increase of proliferating tubular cells following reperfusion compared to the number found in untreated animals. Our study shows that suramin promotes the recovery of renal function and has effective therapeutic applications when given after the occurrence of renal injury.     

直肠类癌的临床诊断与治疗分析

为探讨直肠类癌的临床特点、诊断、治疗及预后,回顾分析26例直肠类癌患者的临床资料,并进行随访。结果显示,26例患者中,男性多于女性;平均年龄51岁;肿瘤位于距肛缘8cm以内直肠为21例（80．8％）;主要临床表现为肛周坠胀不适（4例）、大便带血（10例）、排便习惯改变（7例）、不完全性肠梗阻（1例）,无症状者健康体检时发现（4例）;诊断主要依赖于直肠指检、直肠镜检查、电子结肠镜检查及活检结果;26例均行手术治疗且经术后病理证实;术后5年生存率76．9％（20／26）。结果表明,直肠指检对发现直肠类癌有重要作用,影响直肠类癌预后的主要因素为肿瘤大小、肿瘤的浸润及转移情况;早期诊断及早期个体化的手术是治疗本病的关键。     

Effect of rhBMP‐2 on tibial plateau fractures in a canine model

This study was to determine the efficacy of recombinant human bone morphogenetic protien‐2 (rhBMP‐2)/calcium phosphate matrix (CPX) paste to accelerate healing in a canine articular fracture model with associated subchondral defect. rhBMP‐2/CPX (BMP), CPX alone (CPX) or autogenous bone graft (ABG) was administered to a canine articular tibial plateau osteotomy with a subchondral defect in each of 21 female dogs. The unoperated contralateral limbs served as controls. Ground reaction forces, synovial fluid, radiographic changes, mechanical testing, bone density, and histology of bone and synovium were analyzed at 6 weeks after surgery. Radiographic analysis demonstrated that the BMP and CPX groups showed improved bony healing compared to the ABG group at week 6. Histomorphometric analysis demonstrated that the BMP group had significantly increased trabecular bone volume compared to the CPX and ABG groups. Mechanical testing revealed that the BMP group had significantly greater maximum failure loads than the ABG group. Histological analysis demonstrated that the BMP group had significantly less sub‐synovial inflammation than CPX group. This study demonstrated that rhBMP‐2/CPX accelerated healing of articular fractures with subchondral defect compared to ABG in most of the parameters evaluated, and had less subsynovial inflammation than the CPX alone in a canine model. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 466–471, 2009     

Dynamic changes in salivary cortisol and secretory immunoglobulin A response to acute stress

Psychological stress leads to the secretion of cortisol. While this psychoneuroendocrine response helps to maintain physiological as well as psychological homeostasis under stress, exaggerated release of cortisol can suppress aspects of immune function and have negative effects on health. The present study set out to investigate the dynamic changes in salivary secretory immunoglobulin A (sIgA) and cortisol before and after acute stress, and to analyse the relationship between sIgA and cortisol trend. Thirty‐five healthy subjects took part in this study. All subjects underwent an acute stress test (mental arithmetic task). Salivary cortisol and sIgA responses were assessed repeatedly before the stress test, immediately after the stress test and 20 min after the stress test. The levels of salivary cortisol and sIgA both significantly increased after the acute mental arithmetic challenge. However, the increase of sIgA is transient; the sIgA fall was significantly correlated with the cortisol rise during the 20 min after stress (r = 0.569, p < 0.001). These results may help determine the timing of effective intervention in order to reduce the hypersecretion of cortisol and improve mucosal immune function. Copyright © 2008 John Wiley & Sons, Ltd.