可移植性Balb/c小鼠急性红白血病动物模型的建立

目的建立稳定的可移植性Balb/c小鼠的急性红白血病动物模型。方法将2×106个的EL9611红白血病细胞通过尾静脉输注每只Balb/c(H-2d)小鼠(n=10),体内传代建立EL9611红白血病动物模型,通过15代的连续传代观察模型的可靠性,以健康BALB/c鼠(n=4)作为正常对照。观察小鼠腹部、肝脾重量,计数实验组和正常对照组的外周血白细胞数,取发病晚期小鼠的外周血涂片行Giemsa染色观察,肝脾组织经10%甲醛固定、石蜡切片、HE染色检查,计算小鼠平均生存时间、发病率和死亡率。结果接种2×106个EL9611白血病细胞后实验组平均生存时间(MST)为(14.5±2.1)d,生存时间与正常对照组相比,P<0.01,经15代的连续传代,未见自发缓解,发病率和死亡率均为100%,无性别选择性,发病晚期小鼠出现肝脾肿大和外周血WBC升高等典型白血病的表现,死亡时肝重(2.40±0.48)g,脾重(0.84±0.20)g,与正常对照组相比,P<0.01,死亡前外周血WBC计数为(3.33±0.27)×107/mL,与正常对照组比,P<0.05,外周血中可见多量异形白血病细胞,病理检查示肝脾正常组织结构破坏,大量白血病细胞浸润。结论采用EL9611红白血病细胞2×106静脉输注体内传代的方式可建立起稳定的可移植性Balb/c小鼠的急性红白血病动物模型。     

内蒙古地区慢性粒细胞白血病患者HLA-DRB1基因多态性的研究

目的为研究内蒙地区汉族人群人类白细胞抗原（human leukocyte antigen,HLA）DRB1基因与CML白血病的相关性。方法采用Luminex流式技术-序列特异性寡核苷酸探针反向杂交（flow cytometry-sequence specific oligonucle-otide probe,FLOW-SSOP）方法对内蒙地区39例慢性粒细胞白血病chronic myeloid leukemia,CML）患者HLA-DRB1等位基因多态性进行分析,以北方地区健康群体资料作为正常对照。结果在HLA-DRB1等位基因中,CML白血病组中DRB1＊1001,＊16XX等位基因频率高于对照组（0.593%,0.603%,P〈0.05）。结论 DRB1＊1001,DRB1＊16XX等位基因与CML相关联,可能是易感基因。     

Recalling the glorious past six decades and foreseeing a promising new century — the 60-year development of Chinese urological surgery

Urological surgery did not take shape as a discipline until the establishment of the new China. From small and weak to large and strong, and with the painstaking efforts of several generations since the inception of reform and opening-up policy, China＇s urological surgery has developed into a significant subject subordinated to clinical medicine.     

头颈部侵袭性纤维瘤9例及文献复习

目的:探讨头颈部侵袭性纤维瘤的临床表现、病理特征、治疗方式及预后.方法:根据2005年世界卫生组织的肿瘤类指导原则,回顾性分析2008 ～ 2012年间收治9例头颈部侵袭性纤维瘤的临床资料并复习相关文献.结果:发病部位以颈部(3例)、下颌下区(2例)最为常见,其次是上颌骨、颧部、眶下区、腮腺各1例,对9例患者都实施手术切除,4例患者因肿瘤已侵犯头颈部重要结构,无法获得阴性切缘,其中1例患者发生恶变,接受放射治疗,另2例术后未接受综合治疗,术后复发,所有病例无远处转移,随访时间为6 ～51个月.结论:头颈部侵袭性纤维瘤诊断主要依靠术后病理,彻底手术切除是治疗并减少复发的主要手段,对于复发或难以完整切除的病例可配合放化疗,且术后长时间密切随访.     

Tolerance to beta 2-agonists in patients with chronic obstructive pulmonary disease

Eleven patients with severe COPD were examined to determine whether tolerance to beta 2-agonists developed after long-term inhalation therapy with these agents. Before the study all patients were on regular treatment with inhaled salbutamol for six months. At the beginning of the study, response of FEV1 to inhaled salbutamol was measured. Dose-response curves were measured after three weeks of treatment with ipratropium bromide and again after a three-week course of inhaled salbutamol. After ipratropium bromide treatment, responses to low doses of salbutamol tended to be larger than after salbutamol treatment, but differences were not significant. Three hours after the last inhalation of salbutamol the FEV1 was lower on days 1 and 42 than on day 21. We conclude that long-term inhalation therapy with beta 2-agonists in patients with COPD decreases the duration of the bronchodilation produced by the same agents but does not affect the peak response.     

Damon-Ⅲ矫治器治疗安氏Ⅱ类1分类错畸形患者硬组织变化的研究

目的探讨Damon-Ⅲ自锁托槽矫治技术治疗安氏Ⅱ类1分类错畸形患者治疗前后的硬组织变化。方法选择采用Damon-Ⅲ自锁托槽矫治技术和MBT矫治技术治疗的安氏Ⅱ类1分类错畸形患者各20例,均采用减数4颗第一前磨牙的治疗方案,未额外使用增强支抗的装置,治疗前后拍摄患者头颅侧位X线片并进行测量。结果2组患者治疗后,上下颌骨矢状向变化不明显,垂直向有增大的趋势,差异有统计学意义;2组患者牙性指标均有变化,但略有不同。结论Damon-Ⅲ自锁托槽矫治技术和MBT矫治技术均可快速高效地治疗安氏Ⅱ类1分类错畸形,后牙支抗消耗较少,但是Damon-Ⅲ自锁托槽矫治技术使患者的前牙转距丧失较多。     

经皮椎体成形术治疗骨质疏松性椎体压缩骨折的早期疗效

目的探讨经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折1周内的临床疗效。方法对64例骨质疏松性椎体压缩骨折患者(83椎)行PVP治疗,记录术前及术后1周内疼痛VAS评分、手术前后Cobb角。结果83椎中10椎骨水泥渗漏至椎体周围及椎间隙,1椎周围静脉内出现骨水泥。VAS评分术后各时点与术前比较差异均有统计学意义(P<0.05),术后各时点比较差异均无统计学意义(P>0.05)。Cobb角手术前后比较差异无统计学意义(P>0.05)。结论PVP治疗骨质疏松性椎体压缩骨折在疼痛与稳定性上效果明确,治疗效果可在术后1 d后显现,1周内疗效稳定;PVP对椎体压缩无改善。     

The safety of spinal pedicle screws in children ages 1 to 12

Background contextPedicle screws have shown to be a safe and effective method of spinal fixation, offering superior multiplanar correction compared with hooks or sublaminar wires in selected situations. Though only food and drug administration (FDA) approved in the adolescent population, they are commonly used in an off-label manner in the preadolescent population.PurposeTo determine if the complication rate of the off-label use of pedicle screws for spinal fixation in the preadolescent 0- to 12-year-old population is comparable with the complication rate in the FDA-approved 13- to 18-year-old population.Study design/settingRetrospective medical record and radiograph review.Patient sampleA total of 726 pediatric patients who underwent a spinal fusion procedure at a single tertiary institution between January 2003 and December 2008 were reviewed.Outcome measuresIncidence of instrumentation failure, infection, neurological complication, and total complications.MethodsThe study population was divided into two groups based on age: the younger group included 0- to 12-year olds and the older group included 13- to 18-year olds at the time of surgery. Groups were further subdivided based on diagnosis: “A,” neuromuscular scoliosis; “B,” idiopathic scoliosis, and “C,” other spinal deformities. Rates of neurovascular complications, infections, and instrumentation complications were compared statistically between the younger and the older groups. Only patients with greater than or equal to 1-year follow-up and greater than or equal to 2-year follow-up were included in the calculations for infection and instrumentation complication rates, respectively.ResultsThere were 206 patients (33% males, 67% females) in the younger group (0 to 12 years) and 520 (41% males, 59% females) in the older group (13 to 18 years). Overall, younger group had a 13.6% complication rate compared with 16.9% in the older group. Younger subjects showed a 13.4% complication rate because of instrumentation-related complications, 0.5% for neurovascular complications, and an infection rate of 9.2%. The older group showed a 15.4% complication rate because of instrumentation-related complications, 1.92% for neurovascular complications, and an infection rate of 11.0%. Complication rates were statistically insignificant between the two groups. Other complications in the younger group included one patient with aspiration pneumonia, two with ileus, and one with pulmonary and other complications in the older group included one patient with aspiration pneumonia, two with ileus, three with superior mesenteric artery syndrome, and three with wound dehiscence.ConclusionsThe complication rates in the young pediatric population associated with the off-label use of pedicle screws for spinal fusions are not statistically different from the complication rates associated with the FDA-approved adolescent population.     

肾上腺节细胞神经瘤的临床病理学分析

目的 探讨肾上腺节细胞神经瘤的临床及病理学特点。方法 收集经手术病理证实的13例肾上腺节细胞神经瘤患者临床资料进行分析。患者男5例，女8例。平均年龄38岁。肿瘤位于左侧7例，右侧5例，双侧1例。体检时B超偶然发现6例，上腹部不适或间歇性腹痛6例，高血压表现1例。血液生化检查未见特殊异常。影像学检查提示肾上腺实性占位。肿瘤最大直径平均6．7cm。结果 行开放手术治疗12例，腹腔镜手术治疗1例。13例手术顺利，无并发症发生。病理表现：肿瘤主要由成熟的神经轴突、神经束和纤维组织构成，其间散在成熟的节细胞、Schwann细胞。其中3例肿瘤部分区域细胞分化不成熟，有异形性。肿瘤伴囊性变2例，伴钙化1例。随访时间4～116个月，平均43个月，未见肿瘤局部复发和远处转移。结论 肾上腺节细胞神经瘤是少见的良性肿瘤，具有独特的病理特点，手术治疗效果良好。