住青岛韩国人与中国人脂肪肝人群的流行病学特点

运用流行病学调查方法调查住青岛(住青)韩国人脂肪肝患者1543例(韩国人组)和青岛市民脂肪肝患者1 031例(中国人组)的一般资料、腹部彩超检查及生化指标,应用SPSS 11.0软件进行t检验χ2检验及回归分析.结果住青中国人脂肪肝患病率(35.49%)明显高于住青韩国人(16.68%)(P＜0.01).住青中国人脂肪肝患者空腹血糖、胆固醇高于住青韩国人;住青中国人男性脂肪肝患者超质量、肥胖及高空腹血糖发生率及女性脂肪肝患者超质量、肥胖及高甘油三酯发生率高于住青韩国人(P均＜0.05).脂肪肝与年龄、超质量、高胆固醇、空腹高血糖呈正相关.认为借鉴韩国人的饮食养生文化对于降低中国人脂肪肝患病率具有重要意义.     

膝关节单室置换的近期疗效

Objective To explore the indication and observe short-term clinical outcome of the medial Oxford Ⅲ mobile bearing unicompartmental knee replacement (UKR) through a minimal invasive approach for the patients with osteoarthritis of the knee. Methods A retrospective study of the clinical outcomes from May 2006 to May 2008 was done on 30 knees in 21 patients after receiving the UKR with the mobile bearing Oxford Ⅲ prosthesis. There were 9 males (12 knees), 12 females (18 knees), with the mean age of (61.4±7.3) years (ranged 46-76 years). All patients were evaluated pre and postoperatively using X-ray image, the Knee Society Score (KSS) and the WOMAC osteoarthritis index and examined the ROM and the varus deformity of the knee with osteoarthritis. Results The average follow-up time was 17 months. The mean operation time was (83.0±12.9) min and the mean hospital stay was (9.3±2.0) days. No complications of infection, thrombosis, mobile beating dislocation were found. The loss of flexion of the operated knee was not significant. The average femorotibial angle decreased from 182.0°±4.3° preoperatively to 177.0°±3.5° postoperatively in the anterioposterior view of X-ray. The KSS clinical score and function score were improved from average 44.0±3.7 and 54.0±5.1 to 93.0±3.2 and 92.0±2.4 respectively. The WOMAC Score was average 48.0±4.2 preoperatively, 14.0±2.5 at the last evaluation. Statistically significant differences were found pre and postoperatively from the aforementioned evaluation criterions. Conclusion The short-term clinical outcomes of medial Oxford Ⅲ mobile bearing UKR through a minimally invasive approach are ideal, and it is a good therapy choice for the patients with medial osteoarthritis of the knee. But it is also important to choose the suitable patients with indications.     

闭合性屈指肌腱腱鞘逆行切开治疗扳机指

采用闭合性屈指肌腱第一环形骨车逆行切开技术治疗扳机指７１例（８４指），其中儿童７例（７指），成人６４例（７７指），治愈率达９９％。详细介绍了闭合性屈指肌腱腱鞘逆行切开技术，认为屈指肌腱腱鞘闭合逆行切开术是手术扳机指的简单、安全、有效的方法。     

膝关节单室置换的近期疗效

Objective To explore the indication and observe short-term clinical outcome of the medial Oxford Ⅲ mobile bearing unicompartmental knee replacement (UKR) through a minimal invasive approach for the patients with osteoarthritis of the knee. Methods A retrospective study of the clinical outcomes from May 2006 to May 2008 was done on 30 knees in 21 patients after receiving the UKR with the mobile bearing Oxford Ⅲ prosthesis. There were 9 males (12 knees), 12 females (18 knees), with the mean age of (61.4±7.3) years (ranged 46-76 years). All patients were evaluated pre and postoperatively using X-ray image, the Knee Society Score (KSS) and the WOMAC osteoarthritis index and examined the ROM and the varus deformity of the knee with osteoarthritis. Results The average follow-up time was 17 months. The mean operation time was (83.0±12.9) min and the mean hospital stay was (9.3±2.0) days. No complications of infection, thrombosis, mobile beating dislocation were found. The loss of flexion of the operated knee was not significant. The average femorotibial angle decreased from 182.0°±4.3° preoperatively to 177.0°±3.5° postoperatively in the anterioposterior view of X-ray. The KSS clinical score and function score were improved from average 44.0±3.7 and 54.0±5.1 to 93.0±3.2 and 92.0±2.4 respectively. The WOMAC Score was average 48.0±4.2 preoperatively, 14.0±2.5 at the last evaluation. Statistically significant differences were found pre and postoperatively from the aforementioned evaluation criterions. Conclusion The short-term clinical outcomes of medial Oxford Ⅲ mobile bearing UKR through a minimally invasive approach are ideal, and it is a good therapy choice for the patients with medial osteoarthritis of the knee. But it is also important to choose the suitable patients with indications.     

胎儿房颤合并胸、腹水及心包积液超声表现一例

患者女,30岁,孕1产0,孕39周,无遗传病史.产前常规超声检查显示:宫内单胎,头位,胎儿双顶径9.7 cm,胎儿胸腔、腹腔及鞘膜腔内均探及少量液性无回声区,深度分别为0.4 cm,0.5 cm,0.5 cm.胎儿超声心动图心尖四腔心切面显示:十字交叉存在,右房室腔明显扩大,右心房横径22 mm,右心室横径23 mm,左心房横径13 mm,左心室横径16 mm,房间隔中部可见卵圆瓣回声,室间隔回声无明显中断,肺动脉较主动脉增宽,心包腔内可见深4 mm的液性无回声区,胎儿心律明显不齐.彩色多普勒显示:三尖瓣中至大量反流.     

下腔静脉平滑肌瘤延伸至右心房超声误诊一例

患者女,48岁.4年前因患子宫肌瘤而行肌瘤剜除术,2个月前因子宫平滑肌瘤复发在当地医院行子宫全切术,术前超声检查发现右心房内有占位病变.以右心房黏液瘤入我院.超声检查:心脏各房室腔内径不大,房室间隔连续性好,右心房腔内见低回声团块,大小约3.8 cm×2.9 cm,边界清晰光滑,似覆于右心房下腔静脉开口处,未阻塞三尖瓣口(图1).超声诊断:右心房腔内实性占位,黏液瘤可能性大.     

盆腔脓肿超声检查误诊原因分析

近年来,盆腔脓肿发病率有逐渐增高的趋势.盆腔脓肿因病变累及的部位、范围及程度不同,影像学表现复杂且多变[1],较易误诊和漏诊.本文对89例盆腔脓肿病人B超诊断情况进行回顾性分析,分析超声检查误诊原因.     

人脐血间充质干细胞的生物学特性及其成骨成脂肪分化*

背景：目前有关脐血间充质干细胞的生物学特性及分化能力的研究较少。 目的：观察人脐血间充质干细胞的生物学特性,及其向成骨、成脂肪细胞分化的能力。 方法：从不同胎龄脐血中分离间充质干细胞,对其进行原代和传代培养,并诱导其向成骨及成脂肪细胞分化。 结果与结论：倒置相差显微镜下见分离培养的脐血间充质干细胞贴壁生长,呈成纤维细胞样外观,细胞呈螺旋状排列;透射电镜下可见脐血间充质干细胞胞核比例大,细胞器少,为低分化细胞;原代及传代培养的脐血间充质干细胞生长曲线均呈S型,第3,5代细胞增殖能力最强,低胎龄的脐血间充质干细胞集落形成能力最强。流式细胞仪检测结果显示,脐血间充质干细胞稳定表达间充质干细胞相关抗原CD29,CD44 和CD90,不表达造血细胞标志CD34和CD45。成骨诱导后3 周,碱性磷酸酶染色为强阳性,茜素红染色可见大量钙化基质的形成;成脂诱导3周,油红O染色可检测到胞质中脂滴的形成。提示脐血间充质干细胞具有间充质干细胞的形态特征、生长增殖特点及细胞表面标志物等生物学特性,可向成骨细胞及脂肪细胞分化。     

关节镜下LARS人工韧带与γ射线照射的同种异体肌腱重建前交叉韧带早期临床疗效比较

[目的]比较研究LARS人工韧带和γ射线照射的同种异体肌腱重建前交叉韧带的早期临床疗效。[方法]自2006年1月～2008年1月,前瞻性选择了55例前交叉韧带损伤病例,经医生介绍LARS(ligament advanced reinforcement system,LARS)人工韧带和γ射线照射的同种异体肌腱的使用指征,患者自主选择其中一种韧带作为移植物。其中LARS组25例,保留自身韧带残端不予清创,韧带两端以钛挤压螺钉固定;异体腱组30例,股骨端En-dobutton悬吊固定,胫骨端可吸收挤压螺钉固定。术后均行积极的功能康复训练。两组均于术前及术后3、6、9、12、15、18个月进行Lysholm-Tegner膝关节功能评分及KT-2000测定。[结果]术后52例病人得到完整随访,3例失访(LARS组1例,异体腱组2例)。在术后第3、6、9个月Lysholm-Tegner膝关节功能评分LARS组显著高于异体腱组(P0.01),同期比较两组间差异有逐渐减小的趋势,自术后第12个月起两组比较差异无统计学意义;在术后18个月的随访期内LRAS组KT-2000检测结果优于异体腱组(P0.05),随着时间的延长两组同期KT-2000检测结果差异有增大的趋势。[结论]应用LARS人工韧带重建前交叉韧带的患者较使用γ射线照射的同种异体肌腱重建前交叉韧带的患者术后膝关节前后稳定性好,早期膝关节功能恢复快,但远期效果两者相差不大,还需进一步观察。