手法治疗原发性膝关节骨关节病37例疗效观察

采用按摩膝关节痛点为主的手法，治疗原发性膝关节骨关节病３７例（４６个膝关节）．根据膝关节局部压痛点多少、髌骨活动程度是否异常、髌股关节磨擦疼痛程度、浮髌程度等体征和膝关节主动屈伸能力、行走能力等功能，对患者的严重程度进行评分和疗效判定。结果优１６膝、良１４膝、可１１膝、差５膝。笔者认为膝关节原发性骨关节病是一种软骨及周围软组织的综合性病损。以点揉痛点为主的手法具有促进病变部位组织血液循环，松解髌骨周围软组织粘连，恢复纤维组织弹性，增加髌骨活动度，减小髌股关节压力，促进膝关节软骨新陈代谢等作用。     

强心冲剂对充血性心力哀竭家兔模型心钠素、血管紧张素Ⅱ的影响

目的观察强心冲剂干预后充血性心力衰竭(CHF)家兔模型心钠素(ANP)、血管紧张素Ⅱ(AngⅡ)的变化,探讨强心冲剂对神经内分泌活性的影响.方法将40只家兔随机分为4组,假手术组、模型组、地高辛组、强心冲剂组,每组10只.采用腹主动脉缩窄术建立家兔CHF模型,予强心冲剂和地高辛灌胃,检测并比较ANP、AngⅡ的活性.结果CHF家兔模型ANP、AngⅡ活性显著升高,神经内分泌激素释放失衡,强心冲剂干预后,可以纠正其失衡状态,明显降低ANP、AngⅡ水平.结论强心冲剂能显著纠正神经内分泌激素释放失衡状态,改善神经内分泌激素的激活,可以防止CHF的进一步恶化.     

Research on Dynamic Compressive Performance and Failure Mechanism Analysis of Concrete after High Temperature and Rapid Cooling

To investigate the dynamic compressive properties of concrete after high temperature and rapid cooling, an experimental study was carried out by considering five temperatures and four strain rates. The coupling effect of high temperature and strain rate on concrete damage morphology and mechanical parameters was comparatively analyzed. The main conclusions are as follows: the compressive damage morphology of concrete is affected by strain rate development trends of significant variability under different temperature conditions. As the strain rate increases, the compressive stress and elastic modulus of concrete are gradually increased. As the temperature increases, the increase in compressive stress is gradually reduced by the strain rate. For the temperatures of 20 °C and 800 °C, the increase in compressive stress by the strain rate is 38.69% and 7.78%, respectively. Meanwhile, SEM and CT scanning technology were applied to examine the mechanism of the effect of high temperature and strain rate on the mechanical properties of concrete from the microscopic perspective, and the corresponding constitutive model was proposed.     

Using a two-step method of surface mechanical attrition treatment and calcium ion implantation to promote the osteogenic activity of mesenchymal stem cells as well as biomineralization on a β-titanium surface

Surface treatment is known as a very efficient measure by which to modulate the surface properties of biomaterials in terms of grain structure, topography, roughness and chemistry to determine the osseointegration of implants. In this work, a two-step method of surface modification was employed to impart high osteogenic activity and biomineralization capacity on a Ti–25Nb–3Mo–2Sn–3Zr alloy (a type of β-titanium named TLM). The preliminary surface mechanical attrition treatment (SMAT) refined the average grain size from 170 ± 19 μm to 74 ± 8 nm in the TLM surface layer and promoted the surface to be much rougher and more hydrophilic. The subsequent Ca-ion implantation did not change the surface roughness and topography obviously, but enhanced the surface wettability of the SMAT-treated TLM alloy. The in vitro evaluations of the adhesion, proliferation, osteogenic genes (RUNX2, ALP, BMP-2, OPN, OCN and COL-I) and protein (ALP, OPN, OCN and COL-I) expressions, as well as extracellular matrix (ECM) mineralization of mesenchymal stem cells (MSCs) revealed that the initial SMAT-treated sample significantly enhanced the adhesion and osteogenic functions of MSCs compared to an untreated TLM sample, and the subsequent introduction of Ca ions onto the SMAT-derived nanograined sample further promotes the MSC adhesion, proliferation, osteo-differentiation and ECM mineralization due to the adsorption of more proteins such as laminin (Ln), fibronectin (Fn) and vitronectin (Vn) on the surface, as well as the increase in extracellular Ca concentrations. In addition, the biomineralization capacity of the samples was also evaluated by soaking them in simulated bodily fluid (SBF) at 37 °C for 28 days, and the results showed that the Ca-ion implanted sample significantly boosted the deposition of Ca and P containing minerals on its surface, which was associated with the generation of more Ti–OH groups on the surface after ion implantation. The combination of the SMAT technique and Ca-ion implantation thus endowed the TLM alloy with outstanding osteogenic and biomineralization properties, providing a potential means for its future use in the orthopedic field.

Combination of the SMAT technique and Ca-ion implantation produced a β-titanium alloy with a bioactive surface layer, which was proved to effectively promote the osteogenic activity of MSCs and Ca–P mineral deposition in vitro.     

Efficacy analysis of Cheng’s GIRAFFE reconstruction after proximal gastrectomy for adenocarcinoma of esophagogastric junction

ObjectiveReconstruction of the digestive tract for adenocarcinoma of esophagogastric junction (AEG) is in dispute. This study evaluated Cheng’s gastric tube interposition esophagogastrostomy with reconstruction of His angle and fundus (Cheng’s GIRAFFE anastomosis) in laparoscopic/open proximal gastrectomy for Siewert type II AEG, which was performed at Zhejiang Cancer Hospital and the First Affiliated Hospital of Zhejiang Chinese Medical University. Here, we discuss the preliminary results of gastric emptying and anti-reflux.MethodsFrom a retrospective database, 74 patients with advanced Siewert type II AEG underwent curative proximal gastrectomy with GIRAFFE anastomosis, and their gastric emptying and anti-reflux outcomes were evaluated by the Reflux Disease Questionnaire (RDQ) score, nuclide gastric emptying, 24-h impedance-pH monitoring and gastroscopy.ResultsSeventy-four patients successfully completed proximal partial gastrectomy with Cheng’s GIRAFFE esophagogastric anastomosis. RDQ score six months after the operation was 2.2±2.5. Results of nuclide gastric emptying examinations showed that the gastric half-emptying time was 67.0±21.5 min, the 1-h residual rate was (52.2±7.7)%, the 2-h residual rate was (36.4±5.1)%, and the 3-h residual rate was (28.8±3.6)%; 24-h impedance-pH monitoring revealed that the mean DeMeester score was 5.8±2.9. Reflux esophagitis was observed by gastroscopy in 7 patients six months after surgery.ConclusionsCheng’s GIRAFFE anastomosis is safe and feasible for Siewert type II AEG.     

灵芪胶囊对H22荷瘤小鼠p53和bcl-2蛋白表达的影响

目的：探讨灵芪胶囊对H22荷瘤小鼠的抑瘤作用及其抑瘤作用机制。方法：采用体内实验法,于无菌条件下抽取传代7d、生长良好的H22荷瘤小鼠腹水,无菌0．9％氯化钠溶液1：3稀释（约含瘤细胞2×10^6／ml）,按0．2ml／7,接种于消毒后的小鼠右前肢腋部皮下,制成肿瘤模型,灌胃给药灵芪胶囊11d后,称取小鼠体重,脱椎处死小鼠,取脾脏及胸腺称重并计算胸腺指数和脾脏指数。用免疫组化法检测各组凋亡相关基因突变型p53和bcl-2基因的表达。结果：灵芪胶囊在明显抑制肿瘤生长的同时不降低体重,在一定剂量对荷瘤动物的免疫器官指数无明显影响;灵芪胶囊三个剂量组突变型p53基因和bcl-2基N的表达均低于模型组。结论：灵芪胶囊对H22荷瘤小鼠有明显抑瘤作用,其机制可能与抑制突变型p53基N和bcl-2基因表达有关。     

妇科恶性肿瘤的时辰化疗进展

目的介绍近年来适用于妇科恶性肿瘤化疗的药物涉及时辰方案设计的研究成果,方法通过搜集并整理近年来国内外时辰化疗的相关临床和临床前试验的相关文献结果与结论应用时辰化疗理论,改进妇科肿瘤患者化疗方案和给药时间,可以有效降低化疗药物的毒副作用,较常规治疗具有优势,但不同人群、不同种族间的时辰依赖性是否存在差异,有待于进一步研究、     

国产头孢三嗪对金葡菌,大肠杆菌及绿脓杆菌超微结构影响的观察

本文采用负染和超薄切片技术在电镜下的观察,研究了国产头孢三嗪在高浓度下和亚最低抑菌浓度下对金葡菌、大肠杆菌和绿脓杆菌超微结构的作用。结果显示,10MIC的头孢三嗪作用3小时即可导致细菌发生不可逆性改变,出现细胞膜皱缩,胞质稀疏,细胞膜连续性丧失,甚至细胞破裂,解体死亡。经Sub-MIC的头孢三嗪作用后,金葡菌呈现菌体增大,横膈增宽;而大肠杆菌和绿脓杆菌则表现为菌体增长和菌丝体形成,胞内出现大小不一的空泡,电子密度下降.本研究证实了头孢三嗪为一杀菌类抗生素;提示本药对细菌的形态学改变,主要由于和PBP_3结合所致。