腰椎节段形态对峡部、小关节应力及小关节接触力影响的有限元分析

目的:探讨腰椎形态结构变化对峡部裂性滑脱及小关节退变的作用和意义。方法:采用改良的“非种子区域分割方法”及非平行“最佳切割平面”等一系列新型计算机辅助设计(CAD)方法精确建立包括椎间盘高度、腰椎小关节角、椎间盘前凸角改变的L4~L5活动节段有限元模型;在2700N轴向压缩载荷条件下,分别对各有限元模型的峡部、小关节应力、小关节接触力以及椎间盘负载进行测试。结果:压缩载荷下,腰椎活动节段峡部、小关节等效应力及小关节接触力随椎间盘高度的减小而减小,随小关节角的增大而增加,随椎间盘前凸角的增加而减小。结论:椎间盘高度、腰椎小关节角、椎间盘前凸角等形态结构变化对腰椎节段有限元模型的峡部、小关节应力及小关节接触力有明显的影响。提示腰椎峡部应力性骨折及小关节退变的发生与椎间盘高度、腰椎小关节角、椎间盘前凸角等解剖形态因素有关。     

The transient hypercholesterolemia of major weight loss

Serum lipoproteins, body composition, and adipose cholesterol contents of six obese women were studied during and after major weight loss by very-low-calorie diets (VLCDs). Subjects started at 168 +/- 11% of ideal body weight, lost 30.3 +/- 3.7 kg in 5-7 mo, followed by 2+ mo in weight maintenance. Serum cholesterol fell from a prediet (baseline) value of 5.49 +/- 0.32 to 3.62 +/- 0.31 mmol/L (P less than 0.01) after 1-2 mo of VLCDs (nadir), after which it rose to 5.95 +/- 0.36 mmol/L (peak, P less than 0.01 compared with nadir and baseline) as weight loss continued. With weight maintenance, serum cholesterol fell to 4.92 +/- 0.34 mmol/L (P less than 0.05 compared with peak). Adipose cholesterol content did not change in peripheral (arm and leg) biopsy sites but rose significantly in abdominal adipose tissue with weight loss. We conclude that major weight loss was associated with a late rise in serum cholesterol, possibly from mobilization of adipose cholesterol stores, which resolved when weight loss ceased.     

Derivatives of condensed thienopyrimidines: Synthesis and anticonvulsant and tranquilizer activity of hydrochlorides of pyrano[4′,3′:4,5]thieno[3,2-e]imidazo[1,2-a]pyrimidines

New methods for the synthesis of 4-substituted 6,7-dihydro-7,7-dimethyl-5-oxo-9H-pyrano-[4′,3′: 4,5]-thieno[3,2-e]imidazo[1,2-a]pyrimidines and their hydrochlorides are developed. The anticonvulsant and tranquilizer properties of newly synthesized compounds have been studied. __________ Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 41, No. 11, pp. 22–24, November, 2007.     

Complications of endoscopic examinations of the upper segments of the gastrointestinal tract

A ten-year experience with 106610 diagnostic esophagogastroduodenoscopies provided evidence of a 0.03% rate of relevant complications and 2.38% mortality. Out of 39 patients with endoscopy-related complications 5 were operated on: 4 had esophageal perforations, 1 had hemorrhage following biopsy of the ulcer. Out of 7384 therapeutic and operative endoscopies none were associated with lethal outcome. Surgery was avoided either. Complications developed in 45 patients (0.036%): in 44 patients hemorrhages occurred after electroexcision of the polyps.     

灯盏花素注射液对大鼠脑缺血-再灌注脑损害的凋亡抑制作用

目的:研究灯盏花素(Bre)对大鼠脑缺血-再灌注引起脑损伤的保护作用。方法:实验选用40只雄性Wistar大鼠,大鼠被随机分成5组:假手术组、对照组、硫酸镁(Mg-SO4)治疗组、灯盏花素治疗和组。自大鼠颈总动脉插入尼龙线栓栓塞大脑中动脉,造成大脑缺血,拔出线栓实现再灌注。脑缺血10min后给予75mg/kg和50mg/kgBre及30mg/kgMgSO4,分别于脑缺血1h,再灌注2h,5h和23h分别进行神经病学评分,并于脑缺血1h,再灌注23h时测定脑梗死面积,用TUNEL法和免疫组化法分别检测脑组织凋亡细胞和Caspase-3阳性细胞的变化。结果:灯盏花素降低脑缺血-再灌注大鼠神经病学评分,缩小脑梗死面积,降低脑组织凋亡细胞和Caspase-3阳性细胞数量,其作用强于硫酸镁。结论:灯盏花素通过抑制细胞凋亡可显著保护大脑缺血-再灌注引起的脑损伤,其作用优于单用硫酸镁。     

Bone growth patterns in Chinese children and adolescents: a 6-year follow-up study provides evidence for sexual dimorphism and tracking

Summary We prospectively examined bone growth patterns in 894 children aged 6–17 years at the baseline visit, with a 6-year follow-up. Results show bone “tracking” over a six-year interval and sexual dimorphism of bone attained levels and timing of peak bone growth. Our findings underscore childhood and adolescence as critical periods for building bone and developing gender differences. Introduction Bone growth patterns were prospectively examined in 894 Chinese children (496 males), aged 6–17 yrs, from a population-based twin cohort. Whole-body bone area (BA), bone mineral content (BMC), and bone mineral density (BMD) were measured by DEXA at baseline and a 6-yr follow-up. Methods Graphic smoothing plots and generalized estimating equations were used to model bone attained levels, growth, and “tracking”. Results Attained levels of BMC and BA increased curvilinearly with age. Male attained levels were higher than females after age ∼15 yr, but BMD was lower between 13–17 yrs (Tanner stage I to IV). In both genders, peak BMC and BMD growth lagged ∼2 yrs behind peak BA growth, which lagged 2 yrs behind peak height growth. Peak bone growth occurred 1–3 yrs later in males. Over the 6-yr follow-up, all bone measurements “tracked”, but “shifting” across ranks also occurred, and baseline tertile ranking influenced bone growth. Females with early menarche had higher attained levels than females with late menarche at age 12–13 yrs. Conclusion Our findings confirm and expand previous studies on peak bone growth conducted in Caucasian cohorts, particularly sexually dimorphic and maturational effects. The significant “tracking” of bone measurements in this 6-yr follow-up study underscores the importance that osteoporosis prevention should begin in childhood and adolescence. Fengxiu Ouyang and Binyan Wang contributed equally to this article. Source(s) of support: This study is supported in part by grant R01 HD049059, R01 HL0864619 and R01 AR045651 from the National Institute of Health and by the Food Allergy Project.     

Subtotal resection of clavicle for chronic, recurrent, multifocal osteomyelitis in children

Chronic, recurrent, multifocal osteomyelitis (CRMO) is an obscure disease of bone, occurring in children. It appears to be an inflammatory condition with no obvious microbiological cause. Current treatments of antibiotics and anti-inflammatory medication appear to have limited success. This case report looks at two separate cases of CRMO where partial resection of the affected bone—the clavicle—leads to complete resolution of symptoms and regrowth of the excised bone.     

何以解忧惟有监管

没有监督的权力会导致腐败，这是一个显而易见的道理。尽管每一组织、机构、行业乃至个人都必须建立和遵从各自的行业道德和职业操守，但保证每个社会单元都能进退有序，除了建章立制的条令约束，更需要来自第三方的行之有效的监管。事关民生疾苦的医疗卫生无疑首当其冲。