桡腕关节重建治疗桡骨下端骨巨细胞瘤

目的探讨自体腓骨移植在桡腕关节重建术中的应用价值.方法应用带关节囊腓骨近端移植修复桡骨远端骨巨细胞瘤因瘤段切除后的骨缺损,游离移植4例,带血管蒂移植3例.结果所有被修复骨缺损均良好愈合,腕关节功能与外观令人满意.结论自体腓骨移植是修复桡骨远端缺损的理想供本,操作安全、有效、合并症少.     

再生丝素/NMMO·H2O溶液的流变性能

使用N-甲基吗啉-N-氧化物的水合物(NMMO·H2O)作为再生丝素的溶剂.可以得到w=0.10～0.25的再生丝素/NMMO·H2O溶液.研究了再生丝素/NMMO·H2O溶液流变性能,讨论了剪切速率、温度和溶液中的再生丝素的含量对再生丝素/NMMO·H2O溶液流变性能的影响.     

Ⅰ、Ⅲ型前胶原基因第2外显子核酶对靶RNA的体外切割活性的研究

目的 体外研究锤头型α1Ⅰ型及Ⅲ型前胶原基因第2外显子片段核酶对各自靶RNA分子的切割活性及反应条件。同时观察两反义核酶对瘢痕中成纤维细胞胶原合成的影响。方法 将含α1Ⅰ型及Ⅲ型前胶原基因第2外显子片段的重组质粒(pT-Ⅰ、pT-Ⅲ)，经体外^32P标记转录后形成产物靶RNA。同时将含特异性核酶基因的重组质粒(pT-gⅠ、pT-gⅢ)进行非标记的体外转录，产物(核酶)与各自的^32P-靶RNA按不同的条件混和反应，电泳后放射自显影观察结果。将构建好的核酶以脂质体包裹后导入培养的成纤维细胞内，采用图像分析法观察核酶对成纤维细胞Ⅰ型、Ⅲ型胶原蛋白mRNA合成的影响。结果 两种核酶在37℃、42℃均能有效切割各自的靶RNA，对Mg^2 浓度的要求范围较宽(10～20mmol／L)；反应温度从65℃逐渐降至并维持在37℃的条件下核酶切割活性显提高。Ⅰ、Ⅲ型胶原蛋白mRNA的表达明显降低，胶原蛋白生成降低，胶原生成明显受抑制。结论 针对α1Ⅰ型及Ⅲ型前胶原基因第2外显子片段的核酶能有效地在体外对靶RNA进行切割并能有效地抑制瘢痕中成纤维细胞胶原的合成。     

Carotid intima-media thickness in Parkinson's disease.

There have been a few studies and inconsistent results regarding the coincidence of Parkinson's disease (PD) and atherosclerotic diseases, such as cerebrovascular disease. Carotid intima-media thickness (IMT) is a known marker for subclinical atherosclerosis. The aim of this study was to investigate the carotid IMT between PD patients and controls. We studied 43 patients with PD and 86 matched controls. The carotid IMT in PD patients was significantly smaller than in controls (0.796 +/- 0.179 mm vs. 0.913 +/- 0.237 mm, P < 0.05). In multivariate analysis, the carotid IMT was inversely associated with the duration of levodopa medication and the severity of PD. These results suggest that PD patients have a lower risk of atherosclerosis.     

Stability of poly(D,L-lactide-co-glycolide) and leuprolide acetate in in-situ forming drug delivery systems.

In-situ forming drug delivery systems are prepared by dissolving a drug and a biodegradable polymer (poly(D,L-lactide-co-glycolide), PLGA) in a biocompatible organic solvent (In-situ implant, ISI) or further emulsified into an external phase (oil or aqueous solution), resulting in oil-in-oil or oil-in-water emulsions (In-situ forming microparticles, ISM). The chemical stability of PLGA and the drug is a major concern. In this study, the stability of PLGA and leuprolide acetate in the in-situ forming systems and lyophilized sponges was investigated. The degradation of PLGA increased with increasing storage temperature and water content in the biocompatible solvents. A faster degradation occurred in polar protic solvents (2-pyrrolidone, PEG 400, triethyl citrate) than in polar aprotic solvents (N-methyl-2-pyrrolidone, DMSO, triacetin, ethyl acetate). The presence of leuprolide acetate significantly accelerated PLGA degradation, especially in solution state. PLGA was stable in oily suspensions at 4 degrees C and degraded only slightly faster than solid powder at 25 degrees C. No interaction between the oils and the PLGA was observed as indicated by an unchanged T(g) of approx. 47 degrees C. PLGA underwent a slight degradation at 4 degrees C after 150 days in water and saturated sodium chloride solution. The degradation was slower in saturated sodium chloride solution than in water at 25 degrees C. Residual acetic acid in lyophilized sponges facilitated the PLGA degradation in contrast to dioxane. Leuprolide acetate did not affect the PLGA stability negatively. However, lidocaine significantly enhanced the polymer degradation in the sponges. Finally, leuprolide acetate was chemically stable in the sponges, the oils and the polymer solutions in suspension state, but unstable (aggregation) when dissolved in the polymer solutions and stored at 25 degrees C and 40 degrees C.     

Management of congenital tracheal stenosis

Objectives: Congenital tracheal stenosis is a rare disease. Various methods for treatment exist but there is still much debate as to the appropriate surgical procedure. We present our surgical experiences of patch tracheoplasty and slide tracheoplasty as viable methods for the treatment of congenital tracheal stenosis. Methods: From 1994 to 2002, 13 patients were diagnosed with congenital tracheal stenosis. Eight patients (7 symptomatic and 1 asymptomatic) had their stenosis corrected, three by means of pericardial patch tracheoplasty, four by slide tracheoplasty, and one by resection and anastomosis. Concomitant operations were performed on six patients to treat congenital cardiovascular disease. Five patients showing no significant symptoms did not undergo tracheal surgery and received only cardiac procedures. A retrospective review of the hospital course, complications, and long-term results was conducted. Results: Among the patch tracheoplasty group, every patient suffered from granulation tissue formation. One patient died of respiratory acidosis and one was hospitalized due to recurrent granulation tissue, which required frequent bronchoscopy. The third patient from this group is free of all symptoms. Among the slide tracheoplasty group, one patient died of anastomosis disruption. The three remaining patients are alive and well. The one patient who received resection and anastomosis is alive without symptoms. Conclusions: Surgical repair of long-segment congenital tracheal stenosis exhibited high mortality and morbidity rates. Every patient that underwent pericardial patch tracheoplasty suffered from troublesome granulation tissue. As slide tracheoplasty provided relatively good results in the short and mid-term follow-up periods, it seems to be a preferred method for the treatment of long-segment congenital tracheal stenosis.     

Evaluation of specialized laparoscopic suturing and tying devices.

BACKGROUND: Laparoscopic suturing and tying constitute advanced minimally invasive surgery skills. Developing proficiency in the standard methods with needle drivers is often an arduous process. Recent advances in laparoscopic instrumentations has allowed for easier methods of suturing and tying. This study investigated the hypothesis that the use of a specialized suturing device and a specialized tying device allows inexperienced medical students to suture and tie laparoscopically. METHODS: Preclinical medical students who had not received any training in open or laparoscopic surgery were included in this investigation. Each student was given a 5-minute demonstration of a specialized suturing device and a specialized tying device. The medical students were not allowed to deploy either device before actual use. After the demonstration, each student was given the device to use in a porcine model. Times were recorded and a subjective grade was given for each student. RESULTS: Twenty medical students were involved in this study. All medical students were able to complete the task of suturing and tying. The average time to suture was 104.6 seconds and the average time to tying was 31.2 seconds. The average subjective performance grade was 90 (out of 100). CONCLUSION: Specialized devices are easy to learn and use for laparoscopic suturing and tying with minimal instruction even for inexperienced medical students. Even surgeons who are not well versed in laparoscopic surgery should be able to suture and tie with certain laparoscopic instruments.     

Localization of ulnar neuropathy at the elbow using new stimulator for the inching test.

OBJECTIVE: To evaluate the usefulness of the TenElectrodes, a new stimulator for inching test, in the diagnosis and localization of ulnar neuropathy at the elbow (UNE). METHODS: Sixty-two ulnar nerves in 40 control subjects and 24 ulnar nerves in 23 patients with typical symptoms and signs of UNE were studied. The inching test of ulnar motor nerve using TenElectrodes was done along 8 cm across the elbow in the extended position. RESULTS: In the inching test of the control group, the mean segmental latency difference was 0.19+/-0.08 ms. Maximal latency difference over a 1 cm segment did not exceed 0.40 ms in any of the controls but exceeded 0.5 ms or more in all clinical UNE patients. In all UNE patients, the lesion sites were identified by the inching test using TenElectrodes: the retroepicondylar groove (54.2%), the humeroulnar arcade (29.2%), and dual compression (16.6%). CONCLUSIONS: TenElectrodes is a useful stimulator for the inching test in the diagnosis of UNE. The precise localization of compression was possible in all patients with UNE and the most common site was the retroepicondylar groove.     

端粒酶活性检测在乳腺癌诊断中的意义

[目的 ]探讨细针穿刺乳腺肿瘤组织的端粒酶活性检测在乳腺癌诊断中的意义 .[方法 ]用聚合酶链反应 酶联免疫吸附测定法检测 79例术前乳腺肿瘤细针穿刺活检标本和大体标本的端粒酶活性 ,并与病理诊断进行比较 .[结果 ]乳腺癌 6 5例中穿刺组织端粒酶呈阳性的为 5 7例 ,阳性率为 88% ;大体组织端粒酶呈阳性的为 5 4例 ,阳性率为 83% .淋巴结转移者端粒酶活性高于无淋巴结转移者 .乳腺良性疾病 14例中端粒酶呈阳性的为 2例 ,阳性率为 14 % .[结论 ]术前乳腺肿瘤穿刺组织的端粒酶活性检测有利于乳腺肿瘤的早期诊断及鉴别诊断 .     

开放复位可塑形钛板内固定治疗跟骨骨折33例

目的 评价开放复位可塑形钛板内固定治疗跟骨骨折的疗效。方法 对33例(37足)以后关节突移位为主的跟骨骨折,行跟骨外侧入路、开放性复位可塑形钛板螺钉内固定,必要时行植骨术(18例)。结果 平均随访11.5个月,参照Mary—land food score评分,对患足是否疼痛、步态、距下关节及踝关节活动度、是否支架辅助、术后X线摄片等加以评估,19足疗效为优,17足为良,1足可。其中钛板断裂1例,手术切口皮缘坏死1例,换药后自愈。结论 跟骨外侧入路开放复位可塑形钛板螺钉内固定,必要时植骨术是治疗跟骨骨折的有效方法。