老年股骨近端骨折治疗的研究进展

股骨近端骨折包括股骨颈骨折、股骨粗隆间骨折和股骨头骨折,是一种常见的、多发于老年的骨折,同时股骨近端骨折也是骨质疏松症最严重的并发症之一,治疗难度大,预后较差,严重者易致残甚至死亡。随着人类预期寿命的延长和老年社会的到来,绝经后骨质疏松症和老年性骨质疏松症发病率的增加,都会导致股骨近端骨折发生率的增加。如何有效地治疗老年骨质疏松性股骨近端骨折,成为急待解决的重要课题。     

稳定过表达生长分化因子５基因大鼠脂肪干细胞系的建立

目的:探讨慢病毒介导的稳定过表达生长分化因子5(GDF-5)基因大鼠脂肪干细胞(ASCs)的构建条件和方法。方法:取大鼠腹股沟脂肪垫组织,采用Ⅰ型胶原酶消化贴壁法分离培养大鼠ASCs。倒置相差显微镜观察细胞形态,CCK-8法测定细胞生长曲线,流式细胞仪鉴定细胞表型。制备带GDF-5/GFP融合基因的慢病毒载体系统,探索不同感染复数(MOI=1、5、10、20、40、60、80、100)的转染效率,选择最佳MOI,采用流式细胞仪检测转染效率。对转染细胞行流式细胞筛选,测定筛选后转染细胞的阳性率。筛选出的细胞行细胞爬片,DAPI染色,形态学上进一步验证细胞阳性率;并采用CCK-8法检测转染后细胞活力。结果:成功培养大鼠ASCs,流式细胞免疫表型鉴定:间充质干细胞表面抗原(CD90、CD29、CD44、CD105)表达阳性,造血细胞表面抗原(CD45、CD34)和骨髓干细胞表面抗原(CD106)表达阴性。成功构建GDF-5过表达慢病毒载体系统,慢病毒转染大鼠ASCs最佳MOI为40,转染率为65%。采用GFP荧光流式细胞筛选技术筛选后阳性率可提高至96%。CCK-8法显示,转染后细胞活力、生长曲线与未转染细胞无明显差异。结论:胶原酶消化法可成功培养大鼠ASCs,流式细胞筛选技术可显著提高转染细胞阳性率,且对细胞系活力无显著影响。     

高龄股骨转子周围骨折围手术期并发症分析

目的分析高龄股骨转子周围骨折病人的围手术期并发症及其相关因素。方法2005年6月至2008年3月进行手术治疗的年龄大于80岁股骨转子周围骨折病人48例,男16例,女32例,年龄80-97岁（85.02±4.12）岁。股骨转子问骨折44例,股骨转子下骨折4例,所有病例均随访观察至术后1个月。统计病人一般资料,观察术前伴随症及围手术期并发症。统计学分析性别、年龄、术前时间、术前伴随症数量与围手术期发生并发症的关系。结果术前并存伴随症33例（68.75％）,术前伴随症最多者为贫血。发生围手术期并发症17例（35.42％）,围手术期并发症最多者为肺部感染（16.67％）。性别、年龄、术前时间与发生围手术期并发症无明显相关性（P〉0.05）,唯一与围手术期并发症发生存在明显相关性的为术前伴随症（P〈0.05,OR=3.33）。术前伴随症越多,围手术期并发症发生的可能性则越大。结论术前伴随症数量是围手术期并发症的主要影响因素,卧床并发症、术后谵妄、下肢深静脉血栓形成作为患者围手术期常见的并发症应引起充分的重视。     

丘脑卒中为主的汉语失语症临床特征

目的观察以丘脑卒中为主的汉语失语症患者的言语障碍特点。方法在患者发病入院时及发病后3个月,采用中国康复研究中心的汉语标准失语症检查表对19例患者进行评价和影像学资料分析。结果19例丘脑损伤的汉语失语症患者与传统的丘脑性失语的语言障碍表现有部分共性,但由于个体差异,出现了各具特点的语言损伤特征。结论从语言学、心理学、解剖学等方面,分析失语症状学及影像学资料特点,有利于指导语言康复。     

Chronic neuroprotective effects of low concentration lithium on SH-SY5Y cells:possible involvement of stress proteins and gene expression

To investigate the molecular mechanism underlying the neuroprotective effect of lithium on cells, in this study, we exposed SH-SY5Y cells to 0.5 mmol/L lithium carbonate(Li2CO2) for 25–50 weeks and then detected the expression levels of some neurobiology related genes and post-translational modifications of stress proteins in SH-SY5Y cells. cDNA arrays showed that pyruvate kinase 2(PKM2) and calmodulin 3(CaM 3) expression levels were significantly down-regulated, phosphatase protein PP2A expression was lightly down-regulated, and casein kinase II(CK2), threonine/tyrosine phosphatase 7(PYST2), and dopamine beta-hydroxylase(DBH) expression levels were significantly up-regulated. Besides, western blot analysis of stress proteins(HSP27, HSP70, GRP78 and GRP94) showed an over-expression of two proteins: a 105 kDa protein which is a hyper-phosphorylated isoform of GRP94, and a 108 kDa protein which is a phosphorylated tetramer of HSP27. These results suggest that the neuroprotective effects of lithium are likely related to gene expressions and post-translational modifications of proteins cited above.     

遗传性脊髓小脑共济失调41例临床特征及分子遗传学研究

目的:探讨脊髓小脑共济失调(Spinocerebellar Ataxia,SCA)的临床特点和分子遗传学特征.方法:对华西医院2004年7月至2008年4月收治的脊髓小脑共济失调病人进行总结分析.结果:在21例作过SCA1、SCA2、SCA3、SCA6和SCA7 CAG/CAA三核苷酸重复扩增次数检测的患者中,SCA3患者8例(38.1%),SCA6患者4例,(19.0%),SCA2患者1例(4.8%),余下的8例(38.1%)患者SCA1、SCA2、SCA3、SCA6、SCA7基因检测未见异常.结论:SCA3是中国西南地区最多见的SCA亚型,SCA各亚型的临床表现相互重叠,其确诊有赖于基因检查.     

脑钠肽联合C反应蛋白在COPD合并呼吸衰竭预后中诊断价值研究

患者当发生慢性阻塞性肺气肿合并呼吸衰竭往往由于病情发展迅速,患者若不及时抢救往往危及生命[1]。无创正压通气（NIPPV）指经口鼻面罩进行的正压通气,NIPPV常用于急性呼吸衰竭的及时抢救,能够一定程度减少重要脏器损伤,     

Interleukin 28B-related polymorphisms: A pathway for understanding hepatitis C virus infection?

AIM:To analyze the role of rs12979860 and rs8099917polymorphisms in hepatitis C virus(HCV)genotype 1infection of Brazilians.METHODS:A total of 145 adult patients diagnosed with genotype 1 chronic hepatitis C(CHC)who had completed a 48-wk regimen of pegylated-interferonα-2a or-2b plus ribavirin combination therapy were recruited from six large urban healthcare centers and199 healthy blood donors(controls)from a single site between January 2010 and January 2012.Data on the patients’response to treatment was collected.Polymerase chain reaction-restriction fragment length polymorphism genotyping of the interleukin(IL)28B gene fragment encompassing the single nucleotide polymorphisms(SNPs)rs12979860(C/T)and rs8099917(T/G)was carried out for 79 of the CHC patients and 199 of the controls.Bi-directional amplicon sequencing of the two SNPs was carried out for the remaining 66 CHC patients.RESULTS:SNP rs12979860 genotyping was successful in 99.5%of the controls and 97.2%of the CHC patients,whereas the SNP rs8099917 genotyping was successful in 95.5%of the controls and 100%of the CHC patients.The genotype and allele distributions for both rs12979860 and rs8099917 were significantly different between the control and CHC patient groups,with significantly higher genotype frequencies of CC and TT in the controls(P=0.037 and 0.046,respectively)and of TT and GG in the CHC patients(P=0.0009and 0.0001,respectively).Analysis of the CHC patients who achieved sustained virological response(SVR)to treatment(n=55)indicated that the rs12979860 C allele and CC genotype were predictors of SVR(P=0.02).No significant correlation was found between rs8099917 genotypes and treatment response,but carriers of the T allele showed significantly higher rates of SVR(P=0.02).Linkage disequilibrium analysis of the group that achieved SVR showed a significant association between rs12979860 and rs8099917(P=0.07).CONCLUSION:The higher allele frequency of rs12979860 C and rs8099917 T observed in non-HCVinfected individuals may indicate a potential pro