内固定基础上应用骨形态发生蛋白人工骨与自体髂骨植骨治疗骨质疏松性髋骨折的效果比较

目的:比较采用骨形态发生蛋白人工骨植骨加骨折内固定与自体髂骨植入加骨折内固定治疗骨质疏松性转子间骨折的效果。方法:选择2003-10/2005-10桂林医学院附属医院骨科收治的Ⅲ、Ⅳ、V型骨质疏松性转子间骨折患者51例,均知情同意。实验分组:随机将病例分为2组,骨形态发生蛋白人工骨植入组26例,自体髂骨植入组25例。实验干预:采用股骨上段外侧切口,DHS或加防旋钉内固定,骨形态发生蛋白人工骨由处理后的牛松质骨与成品重组人骨形态发生蛋白2按一定比例复合而成,骨折固定后在骨折缺损处、内侧及骨折周围植骨,骨形态发生蛋白人工骨组采用骨形态发生蛋白人工骨植入,自体髂骨组取自体髂骨植入。实验评估:术后定期随访,比较二组患者的基本情况、临床效果和影像学结果(骨折愈合情况和颈干角的变化)。随访时关节功能评定参照采用黄公怡等提出的标准,分为优、良、可、差4级。髋内翻分类标准为颈干角<100°。结果:术后随访1年,51例患者全部进入结果分析。①术后X射线片观察:骨形态发生蛋白人工骨组临床愈合时间短于自体髂骨组[(94.50±22.45),(116.96±15.90)d,P<0.01];骨形态发生蛋白人工骨组术后1年颈干角大于自体髂骨组[(127.19±3.23)°,(120.4±5.22)°,P<0.01]。②髋关节功能及不良事件和副反应:骨形态发生蛋白人工骨组术后以1年髋关节功能优良率优于自体髂骨组(P<0.05);骨形态发生蛋白人工骨组髋内翻、下肢短缩(>2cm)的发生率均低于自体髂骨组[髋内翻(n):4,7;下肢短缩(n):3,5,P均<0.01];钉退出二组差异均无显著性意义(P>0.05)。结论:伴有骨质疏松的转子间骨折患者,采用骨形态发生蛋白人工骨植骨优于自体髂骨植骨,可缩短骨折愈合期,减少髋内翻等并发症的发生率,提高术后髋关节功能优良率,提示骨形态发生蛋白人工骨能替代自体髂骨植骨治疗骨质疏松性转子间骨折。     

The effect of mydriasis from phenylephrine on corneal shape

Purpose: A previous study reported that pharmacologically‐dilated pupils changed the corneal shape. Researchers used mydriatic agents with significant cycloplegic effect. The current study investigates the effect of mydriasis on corneal shape using phenylephrine alone, where phenylephrine has minimal effect on the accommodative system and whether corneal topography can be done after pupil dilation. Methods: Forty‐four young healthy subjects with one eye randomly selected for mydriasis were used in this study. Twenty‐two received one drop of 2.5% phenylephrine (group 1); the other 22 subjects had one drop of 0.4% benoxinate instilled prior to the application of 2.5% phenylephrine (group 2). They were matched for age and refractive error. Anterior chamber depth, pupil size and corneal parameters were compared before and after mydriasis. The corneal parameters included best‐fit sphere (BFS), surface asymmetry index (SAI), surface regularity index (SRI) and the axial and tangential powers in the form of flattest and steepest powers, and in the form of M, J₀, and J₄₅ vector presentation. Results: Group 1 and group 2 subjects had similar pre‐mydriatic baseline ocular parameters. The mean (± SD) pupil dilation was 1.24 ± 0.59 mm for group 1 and 1.80 ± 0.95 mm for group 2. The dilation was significantly larger in group 2 (unpaired t‐tests: t = 2.36, p = 0.02). There were no significant changes in corneal parameters from mydriasis in either group. Conclusions: Previous investigations used mydriatic agents, which affected not only the pupil size but also accommodation. The current study found that mydriasis from phenylephrine, with minimal effect on accommodation, did not result in significant corneal alteration, and corneal topography can be measured after pupil dilation with phenylephrine.     

阿霉素羧甲基葡聚糖微球犬肝动脉栓塞后阿霉素的体内过程

研究了阿霉素羧甲基葡聚糖微球经肝动脉栓塞后的体内动力学过程、靶向特征和微球在体内的肝动脉栓塞效果。对犬进行肝动脉栓塞实验,并与肝动脉阿霉素(ADM)溶液灌注组进行对照。用HPLC荧光检测外周静脉和组织中药物浓度。结果表明:微球组峰浓度为0.558μg/ml,溶液组为1.013μg/ml;微球组的T_1/2(α),T_1/2(β)和MRT分别为溶液组的2.82,3.19和1.28倍。栓塞不同部位组织中ADM浓度,微球组分别是溶液组的8.0和9.1倍。动态血管造影表明:肝内外未见侧枝循环形成,栓塞作用持久,16周后微球仍未见完全降解。     

HPLC测定睾酮乳膏中睾酮的含量

采用ＨＰＬＣ测定睾酮乳膏中睾酮的含量，以甲醇－水（７０：３０）为流动相，波长２４０ｎｍ，在４０－３６０μｇ／ｍｌ范围内线性关系良好ｒ＝０．９９９９，本法操作简便，回收率高。     

抗癌抗生素C1027与单克隆抗体Fab片段偶联物的抗肝癌作用

抗人肝癌单克隆抗体(单抗)3A₅用木瓜蛋白酶消化得到Fab片段。单抗3A₅和Fab片段分别与抗癌抗生素C1027偶联,偶联物经克隆生成法测定对肝癌细胞有很强的杀伤作用,C1027,Fab-C1027和3;3A₅-C1027的IC₅₀分别为6.5×10^-16,8.6×10^-16和4.2×10^-14mol·L^-1;Fab-C1027偶联物对非靶细胞(KB)的IC₅₀值为1.4×10^-13mol·L^-1,与靶细胞(BEL-7402)的IC₅₀值相比,两者相差160倍。说明Fab-C1027的杀伤活性强于3A₅-C1027,并对靶细胞呈选择性杀伤作用。给皮下移植人肝癌的裸鼠iv剂量0.1 mg·kg^-1,结果C1027和Fab-C1027的抑瘤率分别为59和85%,说明Fab片段与C1027偶联物比游离C1027的疗效更高。     

丝瓜叶中丝瓜皂甙O的化学结构研究

丝瓜叶中丝瓜皂甙Ｏ的化学结构研究梁龙，鲁灵恩，蔡元聪（四川省中药研究所重庆６３００６５）丝瓜（ＬｕｆｆａｃｙｌｉｎｄｒｉｃａＲｏｅｍ．）为常食蔬菜，其果实和藤叶中含有多种生理活性的化学物质。我们从丝瓜叶中分离出１３个五环三萜类化合物，前文（１～３）已...     

Casein and soy protein meals differentially affect whole-body and splanchnic protein metabolism in healthy humans

Dietary protein quality is considered to be dependent on the degree and velocity with which protein is digested, absorbed as amino acids, and retained in the gut as newly synthesized protein. Metabolic animal studies suggest that the quality of soy protein is inferior to that of casein protein, but confirmatory studies in humans are lacking. The study objective was to assess the quality of casein and soy protein by comparing their metabolic effects in healthy human subjects. Whole-body protein kinetics, splanchnic leucine extraction, and urea production rates were measured in the postabsorptive state and during 8-h enteral intakes of isonitrogenous [0.42 g protein/(kg body weight . 8 h)] protein-based test meals, which contained either casein (CAPM; n = 12) or soy protein (SOPM; n = 10) in 2 separate groups. Stable isotope techniques were used to study metabolic effects. With enteral food intake, protein metabolism changed from net protein breakdown to net protein synthesis. Net protein synthesis was greater in the CAPM group than in the SOPM group [52 +/- 14 and 17 +/- 14 nmol/(kg fat-free mass (FFM) . min), respectively; P < 0.02]. Urea synthesis rates decreased during consumption of both enteral meals, but the decrease tended to be greater in the subjects that consumed CAPM (P = 0.07). Absolute splanchnic extraction of leucine was higher in the subjects that consumed CAPM [306 +/- 31 nmol/(kg FFM . min)] vs. those that consumed SOPM [235 +/- 29 nmol/(kg FFM . min); P < 0.01]. In conclusion, a significantly larger portion of soy protein is degraded to urea, whereas casein protein likely contributes to splanchnic utilization (probably protein synthesis) to a greater extent. The biological value of soy protein must be considered inferior to that of casein protein in humans.     

Hyperphosphorylation and accumulation of neurofilament proteins in Alzheimer brain and the possible mechanism

Hyperphosphorylation and accumulation of neurofilament proteins in Alzheimer brain and the possible mechanism     

Immunohistochemical expression of matrix metalloproteinases in the granulomatous rosacea compared with the non‐granulomatous rosacea

Background There is a granulomatous variant which is recognized in the rosacea spectrum. However, the pathogenesis of granuloma formation in rosacea has not been clearly demonstrated. Matrix metalloproteinases (MMPs) are required for recruitment of inflammatory cells and for tissue remodelling, making way for the development of well‐organized granuloma. Objective The aim of this study was to investigate the expression of transforming growth factor (TGF)‐β, TGF‐β type II receptor (TβRII), Tumour necrosis factor (TNF)‐α, MMP‐1, 2 and 9 in the granulomatous rosacea (GR) compared with the non‐granulomatous rosacea (NGR) and test the hypothesis that the changes of these profiles in GR would be related with chronic ultraviolet radiation (UVR)‐exposure. Methods Facial skin samples were obtained from 20 patients with GR and NGR (control group). The sections were stained using haematoxylin and eosin, Verhoeff’s elastic stain, and antibodies to TGF‐β, TβRII, TNF‐α, MMP‐1, ‐2 and ‐9. Results The amount of elastotic material was significantly increased in the dermis of GR lesions. Expression of TGF‐β was significantly decreased in the epidermis of GR lesions compared with NGR lesions. In addition, the expression of MMP‐9 was significantly increased in the dermis of GR lesions compared with NGR lesions, especially at the centre of the granuloma on a semi‐quantitative analysis. MMP‐2 expression was also increased in GR lesions, although the difference between the two groups was not statistically significant. Conclusions The results of this study suggest that the increased expression of MMPs in the dermis may participate in granuloma formation of GR in association with UVR.