微创内固定系统治疗复杂股骨转子部骨折的初步报告

目的探讨微创内固定系统(LISS)治疗复杂股骨转子部骨折的可行性、手术技术及指征,并总结其近期临床治疗效果。方法自2005年6月～2006年5月,应用LISS治疗复杂股骨转子部骨折12例。骨折采用AO分类法,其中转子间骨折5例：31-A2．2型2例,31-A2．3型2例,31-A3．3型1例；转子下骨折7例：32-A3．1型1例,32-B1．1型3例,32-B2．1型1例,32-B3．1型2例。记录手术时间、术中出血量、术后住院时间,术后观察有无感染、下肢深静脉血栓、心肺疾患、应激性溃疡等并发症。术后1、2、3、6、12个月时常规随访。结果手术时间50～90 min,平均65 min；出血量50～400 mL,平均142 mL,术后住院时间6～15 d,平均9．3 d。无死亡病例。所有患者均未出现切口感染、下肢深静脉血栓、术后心肺疾患、应激性溃疡等并发症。12例均获得3～14个月(平均7．2个月)随访。10例在术后3个月复查骨折时达到临床愈合,1例假体周围骨折术后4个月、1例病理性骨折术后6个月达到临床愈合。所有患者在最后一次随访时均无骨折再移位、髋内翻畸形、内固定切出、内固定失败及股骨头坏死。结论微创反向使用股骨LISS从生物力学和解剖结构上都能满足股骨近端骨折内固定要求,并具有创伤小、操作简便、固定可靠、安全性高、并发症少的特点,尤其适用于老年人合并内科疾病、骨质疏松较重的转子间骨折及复杂的股骨近端骨折。熟练掌握间接复位技术,正确放置A孔导针,避免过早负重是手术成功的关键。     

The onset of ablation of the evoked adductor pollicis muscle twitch in children: a clinical perspective

The time to loss of the adductor pollicis muscle response to ulnar nerve stimulation at 1 Hz (twitch) after succinylcholine, 1.5 mg.kg-1 intravenously (IV), or vecuronium, 0.1 mg.kg-1 (IV), administration was assessed visually in 134 children, age 2-13 yr, during clinically determined, deep halothane, enflurane and isoflurane anaesthesia. The overall time to twitch ablation and duration of succinylcholine's action is in agreement with published times obtained under controlled experimental conditions; the onset time following vecuronium is comparable to those observed during a similar anaesthetic background measured under controlled experimental conditions. Twitch ablation after succinylcholine was achieved in half the time needed following vecuronium regardless of anaesthetic agent. Succinylcholine's and vecuronium's onset time as well as succinylcholine's duration is adequately assessed by the outlined, simple clinical means. The choice of inhalation agent does not affect the time to visible twitch ablation in a clinically relevant manner; nor does it make an appreciable difference, in clinical terms, in succinylcholine's duration of action.     

Increase of prolactin mRNA in the rat hypothalamus after intracerebroventricular injection of VIP or PACAP

Vasoactive intestinal peptide (VIP), the structurally homologous pituitary adenylate cyclase-activating peptide (PACAP) and the pituitary hormone, prolactin (PRL) enhance rapid eye movement sleep (REMS). VIP and PACAP are both inducers of PRL gene expression and release in the pituitary gland. Little is known about PRL regulation in the brain although it is hypothesized that the REMS-promoting activity of i.c.v. administered VIP may be mediated via the activation of cerebral PRL. To test whether VIP or PACAP in fact increase intracerebral mRNA, the peptides (VIP: 30 or 300 pmol; PACAP: 220 pmol) were injected i.c.v. into rats at dark onset. 1 h later, cDNA was synthesized from purified hypothalamic mRNA. Standardized amounts were analysed for PRL using the polymerase chain reaction followed by Southern blotting and hybridization. Compared with β-actin mRNA levels, both VIP and PACAP increased PRL mRNA levels in a dose-dependent fashion though VIP was more effective on a molar basis. The previously reported alternatively spliced PRL mRNA (lacking exon 4) was not detected. The data support the hypothesis that the REMS-promoting activity of central VIP and PACAP might be mediated by cerebral PRL.     

双眼视差视觉诱发电位与立体视觉的关系初探

作者采用双眼视差视觉诱发电位（VEP）记录了18名正常人和9名斜视患者（立体盲），结果正常人视觉刺激VEP P₁₀₀振幅明显高于非视差刺激者；斜视患者视差刺激与非视差刺激VEP P₁₀₀振幅差异无显著性；正常人视差刺激VEP P₁₀₀振幅增加的幅度值[（DSA-NDA）/NDA]明显高于斜视患者。 （中华眼底病杂志，1992，8：10-13）     

麻城市农村某社区O～6岁儿童意外伤害流行状况及影响因素研究

目的 探讨农村地区0-6岁儿童意外伤害流行病学特征及影响因素，为开展伤害预防干预提供依据。方法 以问卷方式调查湖北省麻城市宋埠镇1998年所有发生意外伤害的0—6岁儿童，采用1：1配对病例对照研究的方法探索危险因素。结果 该地区0—6岁儿童意外伤害发生率为3．56％，男女比例为2．67：1。跌伤、烧烫伤和动物咬伤是最常见类型。13．63％的受伤儿童需住院治疗，因伤害致残疾者占1．82％。意外伤害医疗资用支出占家庭年总收入的3．94％。农村儿童意外伤害的影响因素为儿童的照顾者、家庭社会经济状况及儿童性格行为特点等。结论 意外伤害严重影响着农村地区0-6岁儿童的健康，给家庭和社会造成经济损失。预防重点是培训村级医师，开展健康教育，尤其需要提高儿童家长的安全知识水平。     

肺部小孤立病灶的鉴别诊断

本文对我院胸外科自1984年至1991年肺部X线片显示孤立病灶,其直径小于或等于3cm的78例住院患者作回顾性分析,提出其常见病种及鉴别诊断要点,对诊断未肯定的病灶是否立即手术要视病灶的良恶性可能性等因素来决定,特别强调医生的临床经验与分析能力对鉴别诊断的作用.     

Mind-Refreshing Acupuncture Therapy for Facial Spasm, TrigeminalNeuralgia and Stubborn Facial Paralysis

Facial spasm, trigeminal neuralgia and stubborn facial paralysis are commonly seen in clinic. The authors have obtained quite good therapeutic results for the above diseases by using the mind-refreshing acupuncture therapy. These are introduced in the following.     

人免疫球蛋白受体FcγRⅡa的基因克隆及在K562细胞的表达

目的 将外源人免疫球蛋白IgGFe段Ⅱ型受体CD32a分子表达于K562细胞表面，为构建人工抗原递呈细胞提供蓖要前提。方法 自U937细胞RTPCR得到CD3h的cDNA基因，与T载体连接后亚克隆入表达载体pcDNA3．1（＋）。经测序后利用脂质体介导的转染将CD32a分子表达在K562细胞的表面。结果 构建的T载体测序后，Genebank比对证实为CD32a的cDNA分子，免疫荧光和流式细胞仪结果均说明CD32a分子在K562细胞得到表达（96．9％）。结论 获得的人工构建的表达人免疫球蛋白IgGFe受淬的K562细胞。完成人工抗原递呈细胞制备的首要步骤。     

饲料中添加钴、维生素B12对羔羊生长的影响

选用产期接近的3月龄小尾寒羊30只,随机分为二组(试验Ⅰ、试验Ⅱ),每组15只。试验Ⅰ饲喂本场加工的羔羊精饲料,试验Ⅱ饲喂本场加工的羔羊精饲料基础上,每公斤饲料中分别添加钴0.4mg和维生素B120.30mg,试验结果表明:试验Ⅰ与试验Ⅱ日增重相比差异极显著(P<0.01)。     

不同时辰刺激大鼠的交叉上核对血浆中皮质酮含量的影响

应用拉丁方设计，在不同体重组的大鼠，于不同时辰，对交叉上核采取不同强度的刺激，用放射免疫法测定外周血中皮质酮的含量。其结果显示：各体重组间无显著性差异，不同时辰血浆皮质酮的平均含量各组呈现基本相同的节律性变化，无论何时辰刺激交叉上核使之兴奋，均可显著提高血浆皮质酮的含量。完全损毁交叉上核后７２小时血浆皮质酮含量和正常对照组无显著性差异，且其节律性也没有出现明显变化。