复杂胫骨平台骨折2种手术治疗方法的比较分析

目的比较双切口双钢板内固定术与膝前正中切口锁定钢板内固定术治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折的手术效果。方法 76例SchatzkerⅤ、Ⅵ型胫骨平台骨折采用膝前正中切口锁定钢板内固定术治疗38例（A组）,采用双切口双钢板内固定术治疗38例（B组）。比较2组手术时间、术中出血量、住院时间、术后至开始负重时间、骨折愈合时间、胫骨平台内翻角（TPA）、胫骨平台内侧后倾角（PSA）、并发症及末次随访时Rasmussen膝关节功能评分。结果 B组手术时间、术中出血量、住院时间、术后至开始负重时间少于A组,B组术后TPA、PSA小于A组,差异均有统计学意义（P〈0.05）;但2组骨折愈合时间比较差异无统计学意义（P〉0.05）。B组出现钉道感染、关节强直、膝内翻畸形、骨折延迟愈合的患者较A组少,差异有统计学意义（P〈0.05）;2组切口感染、皮肤坏死、内固定松动断裂、膝关节不稳、骨坏死及骨折不愈合并发症比较差异无统计学意义（P〉0.05）。末次随访时Rasmussen膝关节功能评分：A组优5例,良16例,可10例,差7例,优良率55.3%;B组优14例,良15例,可6例,差3例,优良率76.3%;B组Rasmussen膝关节功能评分优于A组,差异有统计学意义（P〈0.05）。结论对于SchatzkerⅤ、Ⅵ型胫骨平台骨折,双切口双钢板内固定术手术时间短,治疗效果较好,并发症较少。     

PI3K-Akt-eNOS信号转导通路在七氟醚后处理减轻大鼠心肌缺血再灌注损伤中的作用

目的 评价磷酯酰肌醇-3-激酶/丝氨酸-苏氨酸激酶/内皮型一氧化氮合酶(PI3K-Akt-eNOS)信号转导通路在七氟醚后处理减轻大鼠心肌缺血再灌注损伤中的作用.方法 健康雄性Wistar大鼠50只,体重250 ～ 280 g,2～3月龄,采用随机数字表法,将大鼠随机分为5组(n=10):假手术组(S组)、缺血再灌注组(I/R组)、七氟醚后处理组(Spo组)、七氟醚后处理+二甲基亚砜组(Spo+D组)和七氟醚后处理+ PI3K特异性抑制剂LY294002组(Spo+L组).I/R组、Spo组、Spo+D组和Spo+L组采用结扎左冠状动脉前降支30 min的方法制备心肌缺血再灌注损伤模型.Spo组、Spo+D组和Spo+L组进行七氟醚后处理:再灌注前1 min使呼气末七氟醚浓度达到2.5％～3.0％,持续吸入5min; Spo+L组于再灌注前5min静脉注射LY294002 0.3 mg/kg,Spo+D组给予等容量二甲基亚砜.再灌注120 min时,每组取10只大鼠,采集动脉血样,检测血清LDH、CK-MB的活性和cTnI浓度.每组处死5只大鼠,取心脏,分离左心室,计算心肌梗死体积;每组处死5只大鼠,取心肌组织,测定Akt、磷酸化Akt(p-Akt)、eNOS和磷酸化eNOS(p- eNOS)的表达,计算p-Akt表达与Akt表达的比值(p-Akt/Akt)和p-eNOS表达与eNOS表达的比值(p-eNOS/eNOS).结果 与S组比较,其余4组血清CK-MB、LDH的活性、cTnI浓度、心肌梗死体积升高,心肌p-Akt/Akt和p-eNOS/eNOS升高(P＜0.05或0.01);与I/R组比较,Spo组和Spo+D组血清CK-MB、LDH的活性、cTnI浓度和心肌梗死体积降低,心肌p-Akt/Akt和p-eNOS/eNOS升高(P＜0.05或0.01),Spo+L组上述指标差异无统计学意义(P＞0.05);Spo组与Spo+D组上述指标比较差异无统计学意义(P＞0.05).结论 PI3K-Akt-eNOS信号转导通路介导了七氟醚后处理减轻大鼠心肌缺血再灌注损伤作用.     

A rare cause of massive rectal bleeding: internal iliac artery aneurysm

Internal iliac artery aneurysm is a rare cause of lower gastro-intestinal tract (GIT) haemorrhage. A fifty-four year old male patient presented with massive rectal bleeding. Sigmoidoscopy was not conclusive and pelvic angiography revealed an aneurysm from a branch off the main trunk of the anterior division of the right internal iliac artery that was located in juxtaposition to the sigmoid colon. The aneurysm was successfully obliterated by transcatheter arterial embolotherapy with acrylic glue. A high index of suspicion of internal iliac artery aneurysm as a possible cause of lower GIT haemorrhage is of paramount importance. Pelvic angiography is essential for the diagnosis, and embolotherapy with acrylic glue was an effective treatment method in this patient.     

The Effect of Hyperbaric Oxygen Treatment on the Renal Functions in Septic Rats: Relation to Oxidative Damage

Purpose To investigate the effects of hyperbaric oxygen (HBO) treatment on renal functions and damage in septic rats.Methods The animals were divided into four groups, each containing ten animals: control, hyperbaric oxygen, sepsis, and sepsis/hyperbaric oxygen. One milliliter of saline containing live Escherichia coli cells (2.1 × 10⁹) was injected intraperitoneally to induce sepsis. The groups treated with HBO were given five sessions of 2 atmospheres absolute of 100% oxygen at intervals of 6 h. Blood, urine, and tissue samples were then collected, and the functional renal parameters, malondialdehyde (MDA) levels, and superoxide dismutase (SOD) and catalase activities were examined.Results The reduced glomerular filtration rate and urine flow returned to normal levels after HBO treatment; however, the increase in fractionated sodium excretion continued. The increased MDA levels in the renal cortex and medulla also decreased to the level of the control group. In the sepsis group, both the SOD and catalase activities decreased in the renal cortex, while a reduction was observed only in the catalase activity in the medulla. The reduced enzyme activities significantly increased in the sepsis/hyperbaric oxygen group.Conclusion HBO treatment has a beneficial effect on renal dysfunction in sepsis. The probable reason for this effect is the reduction in oxidative damage because of the increase in antioxidative capacity.     

伯氏疟原虫T细胞免疫调节蛋白类似基因的原核表达和抗体制备

目的 克隆伯氏疟原虫T细胞免疫调节蛋白（PbTIP）类似基因,原核表达PbTIP重组蛋白,并制备其抗血清。 方法 在GenBank中检索PbTIP类似基因序列,设计特异性引物,从伯氏疟原虫ANKA株扩增获得该基因cDNA片段,克隆入原核表达载体pGEX4T-1并转化大肠埃希菌BL21（DE3）。经异丙基-β-D硫代半乳糖苷（IPTG）诱导表达,十二烷基硫酸钠聚丙烯酰胺凝胶电泳（SDS-PAGE）和蛋白质印迹（Western blotting）鉴定重组蛋白。用重组蛋白GST-PbTIP包涵体免疫BALB/c小鼠,以间接荧光抗体试验(IFAT)和Western blotting鉴定产生的抗体。 结果 获得了纯化的重组蛋白GST-PbTIP及其相应抗体,该抗体可以识别相对分子质量（Mr）约为60 000的伯氏疟原虫感染红细胞内的PbTIP蛋白。 结论 获得PbTIP重组蛋白及其相应抗体。     

Melatonin protects myocardium from ischemia-reperfusion injury in hypertensive rats: role of myeloperoxidase activity

Increased levels of reactive oxygen species, alterations in nitric oxide synthesis, and increased migration of neutrophils to the ischemic tissue play an important role in the pathophysiology of myocardial ischemia-reperfusion (IR) injury. In this study, we have evaluated the effects of melatonin on myeloperoxidase (MPO) activity, tissue glutathione (GSH), lipid peroxidation levels, and blood pressure in L-NAME-induced hypertensive rats with or without IR. NOS inhibitor L-NAME was administrated before inducing cardiac ischemia for 15 days intraperitoneally. For the cardiac ischemia, the left coronary artery was ligated for 30 min, and reperfusion was performed for 120 min after the ischemia. L-NAME treatment in non-ischemic animals increased blood pressure and lipid peroxidation, and decreased glutathione level in myocardial tissue significantly as compared with non-L-NAME-treated animals. Melatonin reversed L-NAME-induced blood pressure elevation and oxidative changes. Cardiac IR increased MDA levels and MPO activity and decreased GSH levels as compared with non-ischemic animals. L-NAME treatment did not change in IR-induced MDA and GSH levels as compared with ischemic control animals. However, MPO activity was significantly higher than control ischemic animals. MDA levels and MPO activity resulting from ischemic injury in melatonin-treated animals were significantly less than L-NAME-treated animals. Taken together-the ischemic and non-ischemic control and melatonin-treated animals-this study shows that neutrophil migration plays an important role on the development of ischemic injury in hypertensive rats.     

Chromosomal translocations induced at specified loci in human stem cells

The precise genetic manipulation of stem and precursor cells offers extraordinary potential for the analysis, prevention, and treatment of human malignancies. Chromosomal translocations are hallmarks of several tumor types where they are thought to have arisen in stem or precursor cells. Although approaches exist to study factors involved in translocation formation in mouse cells, approaches in human cells have been lacking, especially in relevant cell types. The technology of zinc finger nucleases (ZFNs) allows DNA double-strand breaks (DSBs) to be introduced into specified chromosomal loci. We harnessed this technology to induce chromosomal translocations in human cells by generating concurrent DSBs at 2 endogenous loci, the PPP1R12C/p84 gene on chromosome 19 and the IL2Rγ gene on the X chromosome. Translocation breakpoint junctions for t(19;X) were detected with nested quantitative PCR in a high throughput 96-well format using denaturation curves and DNA sequencing in a variety of human cell types, including embryonic stem (hES) cells and hES cell-derived mesenchymal precursor cells. Although readily detected, translocations were less frequent than repair of a single DSB by gene targeting or nonhomologous end-joining, neither of which leads to gross chromosomal rearrangements. While previous studies have relied on laborious genetic modification of cells and extensive growth in culture, the approach described in this report is readily applicable to primary human cells, including mutipotent and pluripotent cells, to uncover both the underlying mechanisms and phenotypic consequences of targeted translocations and other genomic rearrangements.     

血清甘胆酸检测用于慢性HBV携带者肝脏早期损害的研究

目的 :探讨慢性乙肝病毒 (HBV)携带者血清甘胆酸 (CG)水平与肝功能早期损害的关系。方法 :对 384例慢性HBV携带者和 1 2 0例健康人对照 ,用RIA进行血清CG检测 ,同时随机抽取 40例病例做肝组织活检。结果 :慢性HBV携带者血清CG含量为 6 .62±4.2 4mg/L ,明显高于正常健康对照组的 1 .49± 0 .71mg/L(P <0 .0 1 ) ,但HBeAg阳性组与HBeAg阴性组血清CG含量无明显差异 (P >0 .0 5) ,其中HBeAg阳性组CG含量超过正常上限者 66例 (34 .38% ) ,HBeAg阴性组CG含量超过正常上限者 56例 (2 9.1 7% ) ,两者无明显差异 (P >0 .0 5)。病例组血清CG含量与CG异常率随年龄增长有明显增高趋势 (P <0 .0 1 )。 40例病理分析 ,34例 (85 .0 0 % )出现不同程度的炎症性和纤维化改变。且与CG含量呈明显正相关。结论 :慢性HBV携带者多存在早期肝脏损害 ,血清CG检测是一项无创、敏感的肝功能指标 ,它反映肝脏早期受损的程度 ,动态观察肝脏受损情况 ,对于指导临床早期护肝治疗具有重要的实用价值     

过氧化氢对PC12细胞活性的调控及脑活素的抗氧化效能

目的　探讨活性氧对神经细胞活性的调控及脑活素的抗氧化功效。方法　以过氧化氢 (H2 O2 )作为活性氧 ,应用四甲基偶氮唑 (MTT)比色法 ,观察对培养的PC12细胞生长活性的调控和脑活素的抗氧化活性。结果　以 0 .0 3mmol LH2 O2 对PC12细胞具有促进生长的作用 ( P <0 .0 5 ) ,0 .1～ 1.0mmol LH2 O2 可导致PC12细胞不同程度的氧化损伤 ;脑活素浓度在 0～ 10g L对细胞的生长无明显影响 ,当浓度超过 2 0g L后 ,可导致细胞生长受抑制 (P <0 .0 1) ,10～ 2 0g L脑活素可有效保护PC12细胞免受氧化损伤。结论　活性氧对神经细胞的生长具有双重作用 ,脑活素具有保护PC12细胞免受氧化损伤的效能。     

The prevalence of joint hypermobility among high school students

Objective The aim of this study was to determine the prevalence of joint hypermobility among high school students and to define the characteristics of patients with joint hypermobility.Methods The students underwent complete history and physical examination. In order to designate marfanoid habitus, body weight, height, and span/height and upper/lower segment ratios were recorded. The degree of joint hypermobility was scored by the Beighton scoring system. The following features were also examined: arthralgia, myalgia, low back pain, sciatica, spinal deformities, temporomandibular joint pain and crepitus, effusion, swan neck deformity, arachnodactyly, joint dislocation, joint sprain, Raynauds phenomenon, stria, varicose veins, abdominal and inguinal hernia, heart disease history, myopia, dropping eyelids, and antimongoloid slant.Results Eight hundred sixty-one students (433 females and 428 males) with a mean age of 15.4±1.1 years (range 13–19) were examined. Joint hypermobility was observed in 101 (11.7%) of the students. According to the Beighton scoring system, the majority of these (61.4%) were observed to score 4. Our results show that phenotype has no relation with joint mobility. Of the total number of students, there were 31 male (7.2%) and 70 female (16.2%) hypermobile subjects. The difference between sexes was highly significant (P=0.00005). Joint sprain was detected in 14 of hypermobile students (13.9%) and 50 of nonhypermobile students (6.6%). Its presence was the only significant parameter between hypermobile and nonhypermobile students (P=0.0094).Conclusions Joint hypermobility was found in 11.7% of the students in our study, and the results are in harmony with the previous studies on Western populations. Although hypermobility does not seem to be very problematic in young people, as in our focus group, we believe that it is important for physicians to recognize this problem to ensure correct diagnosis and treatment, since it may lead to mimic rheumatic diseases in the future.