股骨粗隆间骨折术后并发症及原因分析

目的回顾性分析股骨粗隆间骨折的术后并发症并分析其原因。方法 2008年1月~2012年12月,我院手术治疗股骨粗隆间骨折共295例,按Evans分型,Ia型26例,Ib型53例,Ic型97例,Id型52例,II型67例。其中DHS组59例,IMHS组80例,PFN组25例,GAMMA3组28例,INTERTAN组103例。随访3~36个月,对部分发生并发症的病例进行手术干预。结果内固定物切割6例,拉力螺钉退出2例,髋内翻、下肢短缩12例,感染6例,血管损伤2例,股骨头无菌性坏死2例,内植物远端骨折2例,部分经再次手术治疗治愈。结论手术治疗股骨粗隆间骨折,要结合骨折类型、患者全身情况合理选用内固定物,术中复位及操作技术的改进以及术后适度的功能锻炼,能够减少术中及术后并发症的发生。     

Bioactive glass serves as a substrate for maintenance of phenotype of nucleus pulposus cells of the intervertebral disc

The objective of the study was to investigate the capability of bioactive glass 45S5 to serve as a substrate for nucleus pulposus cells in vitro. Nucleus pulposus cells were isolated from adult rabbit discs and seeded onto bioactive glass. At selected time intervals, the cells and glass were evaluated. We found that the cells rapidly attached to the substrate, colonizing it within 12 h. By 21 days, they had formed a lawn of cells over the glass substrate. DNA measurements showed a progressive increase in cell number with time. The phenotype was maintained; the cells expressed aggrecan, and collagen type II and I, but were negative for collagen type X. CD44, a cell-surface glycoprotein that binds hyaluronate, was also expressed by these cells. Electron dispersive X-ray analysis and Fourier transform infrared spectroscopy revealed calcium phosphate-rich layer formation on the substrate surface. The results of this study suggest that nucleus pulposus cell proliferation may be an anchorage dependent event, and that the cells use the calcium phosphate-rich layer to facilitate cell adhesion, and subsequent proliferation. These findings point to the importance of the conditioned bioactive glass as a substrate for nucleus pulposus cells.     

Mechanism of Intestinal Absorption of Ranitidine and Ondansetron: Transport Across Caco-2 Cell Monolayers

We have investigated the transport of ranitidine and ondansetron across the Caco-2 cell monolayers. The apparent permeability coefficients (P _app) were unchanged throughout the concentration range studied, indicating a passive diffusion pathway across intestinal mucosa. No metabolism was observed for ranitidine and ondansetron during the incubation with Caco-2 cell monolayers. P _app values for ranitidine and ondansetron (bioavailability of 50 and 100% in humans, respectively) were 1.03 ± 0.17 × 10^–7 and 1.83 ± 0.055 × 10^–5 cm/sec, respectively. The P _app value for ranitidine was increased by 15- to 20-fold in a calcium-free medium or in the transport medium containing EDTA, whereas no significant change occurred with ondansetron, indicating that paracellular passive diffusion is not rate determining for ondansetron. Uptake of ondansetron by Caco-2 cell monolayers was 20- and 5-fold higher than that of ranitidine when the uptake study was carried out under sink conditions and at steady state. These results suggest that ranitidine and ondansetron are transported across Caco-2 cell monolayers predominantly via paracellular and transcellular pathways, respectively.     

偏侧萎缩-偏侧帕金森综合征——6例报道并文献复习

目的通过分析 6例偏侧萎缩－偏侧帕金森综合征 (HAHP)的临床资料,探讨 HAHP的病因,临床表现,诊断和治疗。方法对 6例 HAHP病人的临床表现进行详细分析并综合文献报告。结果 6例病人全部符合 Bushman等 1988年提出的 HA诊断标准,其中 5例确诊, 1例拟诊。 2例疑诊 HAHP。 6例病人都接受了 B族维生素、地巴唑、胞二磷胆碱、安坦等药物治疗,但几无疗效。结论 HAHP是一种罕见的临床综合征,病因不明。临床上主要表现为偏侧萎缩、偏侧帕金森综合征、发作性肌张力障碍。 HAHP的诊断主要依靠临床表现,神经影像资料可能有助诊断。迄今, HAHP尚无有效治疗。     

脐血液动力学指标在围产儿预后预测中的意义

目的：探讨脐血流阻力指标(S／D、PI、RI)在正常与高危妊娠中的变化及其与围产儿预后的关系。方法：1998年3月至1999年3月住院的正常与高危产妇共计110例,均于产前1周内行多普勒超声检查,并统计相关临床资料。结果：高危妊娠时脐血流阻力指数较正常时明显升高,各组中S／D值超过警戒值(2.20)及危险值(2.66)者围产儿预后不良发生率较S／D值正常者显著升高。结论：彩色多普勒超声测定脐血流阻力指数是一种简便、无创、有效的围产期监测手段,以S／D值2.20为警戒线;S／D值2.66为危险线可能更有助于胎儿缺氧的早期诊断,确保围产儿安全。     

基于肠-肾轴理论浅析膳食纤维对慢性肾病的影响

慢性肾病(chronic kidney disease,CKD)可引起肠道菌群失调及肠道屏障功能受损,而肠道稳态的破坏有 利于肠源性毒素的产生及肠腔细菌、内毒素的易位,加重CKD的尿毒症毒性及全身性炎症。膳食纤维可靶向作用于 “肠-肾轴”,从而降低CKD的尿毒症毒素水平及减轻全身性炎症。膳食纤维有望成为治疗CKD的新策略。     

颅脑肿瘤手术行急性等容血液稀释的临床研究

目的：研究急性等容血液稀释对颅脑肿瘤病人血流动力学、氧转运及凝血纤溶方面的影响,探讨该方法的安全性。方法：选择颅脑肿瘤手术病人12例,麻醉后从右颈内静脉放置Swan～Ganz导管,从桡动脉放血8ml/kg,同时等速从静脉输入等量的海脉素。分别测定血液稀释前后的血流动力学,氧转运及凝血纤溶方面的指标。结果：CO、SV、DO2显著增加(P＜0.05);PT延长(P＜0.05);PLT较血液稀释前减少,其余指标无明显改变。结论：急性等容血液稀释对颅脑肿瘤病人的血流动力学及凝血纤溶功能影响小,而氧供增加,是一安全有效的血液保护方法。     

胆汁泡蛋白ELISA检测法的建立与初步临床应用

目的 建立胆汁泡蛋白快速检测法,筛选有效的胆石症防治手段。方法 获取３３．５ｋｄ胆汁泡蛋白,通过微量抗原免疫法获得高效价抗体,建立ＥＬＩＳＡ标准曲线;并应用ＥＬＩＳＡ法测定正常人、胆石症患者胆汁和血清中泡蛋白含量,同时观察不同溶石防药和利胆冲剂、胆酸钠等对泡蛋白的影响。结果 建立了ＥＬＩＳＡ标准曲线,其曲线方程为Ｙ＝０．０３５Ｘ（ｒ＝０．９９）;正常人胆汁和血清中３３．５ｋｄ泡蛋白含量都明显较胆固     

北京市一些高级办公大楼室内空气质量问题探讨

我们调查了北京一些高档的空调建筑,包括商业和政府机构办公大楼,测试了主要的室内污染和室内气象参数,如温度、湿度、风速等。测试结果指出,在这些建筑中存在着严重的室内空气质量问题。而且,引起不良室内空气质量的原因不是单一的而是多方面的。因此如何提高室内空气质量,为人们提供健康而舒适的室内环境,是空调设计者的迫切任务。     

脑梗塞患者脂蛋白(A)水平与肾脏早期损害

为探讨脑梗塞患者脂蛋白（Ａ）水平与肾脏早期损害的关系,应用ＥＬＩＳＡ法及化学显色终点法分别检测４０例梗塞患者血清ＬＰ（Ａ）水平和尿氨基葡萄糖苷酶活力。结果表明,脑梗塞组血ＬＰ（Ａ）及ＮＡＧ均明显高于正常对照组,且ＬＰ（Ａ）值与尿ＮＡＧ活力呈正相关。