胫骨平台骨折的手术治疗及并发症防治探讨

目的对胫骨平台骨折治疗的临床结果进行分析,并对其相关并发症进行探讨,总结相关经验并提出有效预防措施.方法回顾性分析胫骨平台骨折手术患者74例,骨折类型按Schatzker分型,其中Ⅰ型10例,Ⅱ型15例,Ⅲ型11例,Ⅳ型10例,Ⅴ型12例,Ⅵ型16例.Ⅰ型骨折采用切开复位松质骨拉力螺钉固定,其他类型采用切开复位、钢板螺钉内固定,缺损塌陷处自体或同种异体骨植骨.并对术后并发症进行分析.结果74例获得随访,随访时间1~5 a,平均3.2 a,功能评价采用Hohl膝关节功能分级系统,临床结果优良率达90%,术后各种并发症18例,其中创伤性关节炎10例,关节强直2例,关节不稳4例,感染2例.结论手术内固定是治疗胫骨平台骨折的重要方法,术中解剖复位、牢固内固定、术前正确处理并发症及早期正确适当功能锻炼能有效预防术后并发症,提高手术效果.     

夜间哮喘患者呼吸功能及白三烯昼夜节律的研究

目的:观察夜间哮喘患者通气功能的昼夜节律,并探讨炎症介质白三烯与夜间哮喘的关系。方法:于4、8、16、22时测定哮喘夜间发作组(n=20)、哮喘非夜间发作组(n=22)和健康对照组(n=20)的用力呼气流速峰值(PEF)、1s用力呼气量占预计值百分比(FEV1%)及呼吸驱动指标口腔阻断压(P0.1);同时动态监测尿液中白三烯E4(LTE4)浓度。结果:哮喘夜间发作组PEF、FEV1%于16时达峰值,凌晨4时降到低谷;且其夜间PEF、FEV1%的降低与P0.1的升高呈显著负相关(P<0.01)。哮喘夜间发作组LTE4浓度(pg/mgcreatinine)21:01～次日9:00段(324.22±222.51)显著高于哮喘非夜间发作组(194.95±76.52)及健康对照组(201.11±68.57)(P均<0.05);且哮喘夜间发作组21:01～次日9:00段显著高于9:01～15:00段(P<0.01)。结论:夜间哮喘患者通气功能具有昼夜节律;白三烯多肽的昼夜变化与夜间哮喘的发生密切相关。     

旋毛形线虫体细胞的分离及活性检测

目的探讨旋毛虫体细胞的分离方法和活性检测。方法将从小鼠肌肉分离、纯化的旋毛虫幼虫放入玻璃匀浆器匀浆,胰酶消化。锥虫蓝和中性红染色检测分离细胞的活性。结果分离的细胞中活细胞比率在90%以上。结论锥虫蓝和中性红染色,都能较好地检测细胞的活性。加胰酶消化后,死细胞数略有减少。旋毛虫的体细胞分离,可以不用加胰酶消化。     

血清5''-核苷酸酶在消化道恶性肿瘤的诊断价值

目的探讨血清5’-核苷酸酶（5＇-NT）在消化道恶性肿瘤患者中的诊断价值。方法采用日立公司7170A全自动动生化分析仪测定60例健康人对照、42例肝癌患者、13例结肠癌患者及22例胃癌患者的5＇-NT水平。结果表明肝癌及鲒肠癌等患者5＇-NT显著高于健康人平均水平，P〈0.01及P〈0．05，而胃癌患者5＇-NT显著低于健康人的水平（P〈0．05）。结论测定血清5＇-NT的活性对消化道恶性肿瘤的诊治有重要意义。     

超声循环法提取扁蓄总黄酮

目的在超声条件下寻找提取扁蓄总黄酮的优化条件。方法采用正交设计法,以超声功率、超声时间、提取温度、溶剂体积分数为因素,每个因素3个水平,用紫外分光光度法测定总黄酮作为评价指标。结果最佳提取条件为超声功率800W,超声时间105(35×3)min,提取温度40℃,溶剂体积分数65%。最佳提取条件下总黄酮的质量分数为1.908%。结论采用超声循环提取技术提取扁蓄中总黄酮,提取温度低、时间短,提取效率高,具有广阔前景。     

ELEKTA Precise 医用直线加速器波导隔离器维修

本文介绍了波导隔离器在加速器微波系统中的作用、特点,以及Precise加速器上波导隔离器散热水套渗水的处理方法.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

氯诺昔康复合丙泊酚、芬太尼用于人工流产的临床研究

目的:观察氯诺昔康复合丙泊酚、芬太尼用于无痛人工流产的临床效果.方法:采用双盲法随机将600例早期妊娠妇女分成氯诺昔康组(L组)300例和对照组(P组)300例.麻醉前2h,L组口服氯诺昔康8mg,P组服用安慰剂.麻醉诱导先缓慢静脉注射芬太尼1μg·kg-1,1min后再予丙泊酚1.5mg·kg-1静脉注射.术中根据患者反应每次追加丙泊酚20～30mg.观察记录两组诱导时间、苏醒时间、丙泊酚用药总量、呼吸循环参数改变、术后腹痛发生情况和不良反应.结果:术后腹痛L组少于P组(P＜0.05),术中丙泊酚用药总量L组少于P组(P＜0.05).两组呼吸循环抑制发生率及诱导、苏醒时间差异无显著性(P＞0.05).结论:氯诺昔康用于无痛人工流产可增强麻醉效果,减少丙泊酚用量,减少术后腹痛的发生率,减轻术后腹痛的程度,值得推广应用.     

可生物降解的聚乳酸羟基乙酸牙周缓释凝胶的研究

目的采用聚乳酸羟基乙酸(PLGA)研制替硝唑牙周缓释凝胶。方法根据聚合物的分子量、浓度、载药量和增塑剂等因素来优选最佳配方。结果聚合物溶液中N-甲基-2-吡咯烷酮(NMP)P、EG400、PLGA(75∶25)的最佳比例为65∶5∶30,5%替硝唑与聚合物溶液均匀混合即得凝胶。凝胶必须在室温下避光保存。结论该凝胶缓释时间长达7d,用于牙周炎的治疗有效。     

通过改造工程细胞提高重组蛋白类药物产量的研究进展

哺乳动物细胞是表达蛋白类生物产品的理想宿主细胞。但是,表达水平常较低。通过对工程细胞进行改造,如抑制细胞凋亡、对细胞周期进行调控、提高翻译后加工能力、改变细胞新陈代谢的特性、实现基因组热点整合等,可有效地提高重组蛋白类药物的产量,为生物药品的规模化生产奠定基础