开放手术与关节镜下滑膜切除治疗膝关节绒毛结节性滑膜炎的比较

目的比较开放滑膜切除（OG）与关节镜下滑膜切除（AG）两种方法治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎（PVNS）的复发率、复发时间、Lysholm和IKDC膝关节评分。方法 46例术后病理证实为PVNS患者分别行OG（19例）和AG（27例）治疗。OG组采用膝关节前后联合入路进行滑膜切除,AG组通过高位前外侧、标准前内侧、后内外侧以及髌上外侧的关节镜入路完成滑膜切除。结果 46例均获12个月以上随访：OG组为12～60（31±14.7）个月,AG组为12～72（35±17.8）个月。复发率：OG组为15.8%（3/19）,AG组为18.5%（5/27）（P〉0.05）。复发时间：OG组为2～4年,AG组为0.5～4年。两组的膝关节活动度、Lysholm和IKDC膝关节评分：OG组分别为（134.2±22.1）°、（79.8±8.4）分、（81.9±9.3）分,AG组分别为（139.2±17.9）°、（81.6±9.3）分、（85.2±7.6）分,两组各项比较差异均无统计学意义（P值分别为0.397、0.504、0.193）。除AG组1例复发于术后6个月外,余复发病例均〉2年。结论两种方案的复发率相当,膝关节评分也无明显差异,均可作为弥漫型PVNS的治疗选择。     

耳前小切口颧脂肪垫悬吊术在中面部提升中的应用

目的：探讨通过耳前小切口行颧脂肪垫悬吊术的安全性和促进中面部提升的美容效果。方法：本组就医者12例,面部皮肤弹性良好,均表现为眼角下垂、颊部组织下降、鼻唇沟过深。在内镜辅助下,应用PTFE线,经耳前小切口行颧脂肪垫悬吊术,提升中面部,改善鼻唇沟加深、颊部组织下降等衰老面容。结果：随访观察6～12个月,12例均获得较好的中面部提升效果。除1例发生皮下积血外,无严重并发症,就医者满意。结论：对于面部皮肤组织弹性良好者,耳前小切口颧脂肪垫悬吊术是一种安全、有效、切口隐蔽的中面部年轻化技巧。     

两种固位装置在前牙外伤性脱位治疗中的疗效评价

目的:比较方丝弓正畸法与钢丝-釉质粘接剂法两种固住方法在前牙外伤性松动治疗中的疗效,寻找一种较为美观有效的治疗方法,方法:选取2008年1月-2010年1月就诊于江苏省泰州市人民医院口腔医学专科的因外伤致首牙松动的83例患者,114颗牙,随机分成A,B两组,A组采用方丝弓正畸法进行固定,B组采用钢丝一釉质粘接剂法进行固定,术后分别观察2个月,并比较其疗效.结果:术后2个月,A组成功率明王高于B组,两者的差异有统计学意义(p<0.05).结论:方丝弓正畸法是一种较好的、有效的松动牙或脱位牙的固位方法,值得临床推广.     

人体腰椎有限元建模及内固定的生物力学研究

随着电子计算机的发展,有限元迅速发展成为一种现代计算方法.它是20世纪50年代首先在连续体力学领域--飞机结构静、动态特性分析中应用的一种有效的数值分析方法.1972年,Brekelmans等[1]首次将有限元分析法引入生物力学领域.有限元分析在脊柱结构与功能研究中作用凸显,利用计算机模拟建立腰椎内固定模型,施加边界条件,可明确不同材料和结构的载荷情况.特别是在复杂构件上利用有限元进行应力、应变分析方面效率较高,从而为内固定装置的设计应用提供支持.与其他生物力学研究方法相比,有限元分析法具有实验时间短、费用少、可重复性及力学性能测试全面等突出优点.本文就腰椎内固定有限元模型的研究状况加以概述,并探讨新型内固定装置研制的思路.     

Wallis动态稳定系统治疗腰椎退行性疾病

目的 分析Wallis棘突间动态稳定系统治疗腰椎退行性疾病的早期效果,并探讨其手术适应证.方法 分析26例单独采用Wallis棘突间动态稳定系统或联合固定融合术治疗腰椎退行性疾病患者的临床疗效和初期随访结果,记录术前及术后疼痛视觉模拟量表(visual analogue scale,VAS)评分(10分法)、下腰痛日本...     

USS钉棒系统内固定结合椎体间植骨融合术治疗退行性腰椎不稳症

目的探讨USS钉棒系统内固定结合椎体间植骨融合术治疗退行性腰椎不稳症的疗效。方法对78例退行性腰椎不稳症患者采用USS钉棒系统内固定结合椎体间植骨融合术治疗。采用Oswestry功能障碍指数与JOA下腰痛评分对患者手术前和术后1年随访期进行评分;摄片观察植骨融合情况并统计术后内固定失败（钉棒松动、折断）的发生率。结果 6例术后出现顽固轻微手术区胀痛。所有患者均得到随访,时间13~36个月。术后3个月患者腰背痛明显缓解,术后半年基本可以恢复正常日常生活。随访期内无钉棒松动、折断发生。术后6~8个月骨性融合。术后1年,Oswestry功能障碍指数较低,JOA下腰痛评分较高,与术前比较差异有统计学意义（P〈0.05）。腰椎功能改善总有效率达100%。结论 USS钉棒系统内固定结合椎体间植骨融合术治疗退行性腰椎不稳症临床疗效满意。     

表阿霉素聚氰基丙烯酸正丁酯磁性纳米粒靶向治疗裸鼠移植性肝癌

目的 观察表阿霉素聚氰基丙烯酸正丁酯磁性纳米粒(EPI-PBCA-MNPS)对裸鼠移植性肝癌的作用效果.方法 建立Bel-7402裸鼠人肝癌模型,当肿瘤体积长至20～30mm3时,将其随机分成5组:生理盐水组(NS组)、表阿霉素组(EPI组)、表阿霉素聚氰基丙烯酸正丁酯纳米粒组(EPI-PBCA-NPS组)、表阿霉素聚氰基丙烯酸正丁酯磁性纳米粒组(EPI-PBCA-MNPS组)、表阿霉素聚氰基丙烯酸正丁酯磁性纳米粒组加磁场组(EPI-PBCA-MNPS+MF组),每组10只,除生理盐水组外,其余各组按照0.002mg/g体质量或相当于40 μg/只的表阿霉素静脉注射给药,治疗2周后处死裸鼠,准确测量肿瘤大小并称重,计算瘤体积抑制率及瘤重抑制率,所有肿瘤均编号病理切片,比较治疗前后各组肿瘤细胞坏死的程度.结果 治疗后肿瘤体积抑制率、瘤重抑制率除EPI-PBCA-NPS组与EPI-PBCA-MNPS组差异无统计学意义(P>0.05)外,其余各组间差异有统计学意义(P<0.05),其中EPI-PBCA-MNP+MF组(94.26%、80.82%)显著高于其余组,差异有统计学意义(P<0.01).病理切片显示,EPI-PBCA-MNP+MF组肿瘤细胞坏死程度最重.结论 EPI-PBCA-MNPS具有良好的靶向性,在外加磁场作用下对裸鼠人肝癌模型有显著抑瘤作用.

Abstract：

Objective To observe the effect of epirubicin polybutylcyanoacrylate magnetic nanoparticles (EPI-PBCA-MNPS) on the transplanted hepatoma in nude mice.Methods Human hepatoma cell line Bel-7402 nude mice models were established and divided into 5 groups with each of 10 once gross tumor volume was up to 20-30 mm3:normal saline group (NS),epirubicin group (EPI),epirubicin polybutylcyanoacrylate nanoparticles group (EPI-PBCA-NPS),epirubicin polybutylcyanoacrylate magnetic nanoparticles group (EPI-PBCA-MNPS) and epirubicin polybutylcyanoacrylate magnetic nanoparticles+magnetic field group(EPI-PBCA-MNPS+MF).Except for NS group, the dosage of epirubicin was 0.002 mg/g body weight or 40 μg for intravenous injection.After two-weeks therapy,all nude mice models were executed and the tumor volume and weight were measured so as to calculate the volume inhibition ratio and the weight inhibition ratio.Every tumor specimen was made into pathological section and labelled with serial number for comparing neorobiosis degree in different groups before and after therapy.Results There were statistically difference among the other groups (P<0.05) in the volume inhibition ratio and the weight inhibition ratio after therapy except for EPI-PBCA-NPS and EPI-PBCA-MNPS group (P>0.05).The two ratios in the EPI-PBCA-MNP+MF group (94.26%,80.82%) were significantly more than those in other groups (P<0.01).The pathological sections demonstrated the most severe tumour neorobiosis in the EPI-PBCA-MNP+MF group.Conclusion With the additional magnetic field,EPI-PBCA-MNPS has significant anticancer effect on human hepatoma nude mice models due to its favourable magnetic targeting.     

CD4+CD25+调节性T细胞对小鼠肝脏移植自发性免疫耐受的影响

目的 研究CD4+CD25+调节性T细胞在诱导自发性肝脏免疫耐受中的作用.方法 向受体和供体注射抗CD25抗体(PC61)后进行小鼠原位肝脏移植,观测其生存时间.术后20～30 d切取移植肝脏行HE染色,同时观察CD4+CD25+T细胞对CD4+T细胞和CD8+T细胞功能的影响.结果 去除受体而不是供体小鼠的CD4+CD25+T细胞可以导致肝移植排斥反应.而且,去除CD4+CD25+T细胞使移植物的白细胞浸润明显增多,组织损伤加重.同时,去除CD4+CD25+T细胞导致CD4+T细胞的增殖活性和CD8+T细胞的细胞毒活性明显增强.结论 受体来源的CD4+CD25+调节性T细胞在小鼠肝脏移植免疫耐受诱导中起重要作用.

Abstract：

Objective To examine the contribution of CD4+ CD25+ regulatory T cells to liver transplant tolerance. Methods After injection of anti-CD25 monoclonal antibody (mAb, PC61), mouse orthotopic liver transplantation was performed and survivals were determined. The paraffin-embedded sections of hepatic allografts were cut and stained with hematoxylin and eosin (HE). Furthermore, the effect of CD4+ CD25+ regulatory T cells on proliferative response of CD4+ T cells and cytotoxicity of CD8+ T cells was examined by depleting these regulatory T cells. Results Depletion of these cells in the recipients but not in the donors before liver transplantation caused rejection. Histological analyses of hepatic allografts with PC61 treatment showed extensive leukocyte infiltration and tissue destruction, whereas those in the control group showed minimal changes. Moreover, elimination of CD4+CD25+ T cells resulted in the enhancement of both proliferative response of CD4+ T cells and cytotoxicity of CD8+ T cells against donor-type alloantigen. Conclusions These results suggest that CD4+CD25+ regulatory T cells were important for tolerance induction to hepatic allografts.     

Geometry of thoracolumbar vertebral endplates of the human spine

Novel and better vertebral body replacement constructs are always desired by surgeons. Endplate geometry is crucial for the design of those implants, but current literature on that topic is very scarce. The authors present a morphometric study of thoracolumbar vertebral endplates, the goal of which was to analyze the geometry of endplates from T10 inferior to L3 superior by employing data from CT scans, as well as to verify the reliability of data derived from the CT measurement. Reformatted CT scans of 83 individuals were analyzed and sagittal concave angle, location of concave region, sagittal diameter of endplate, coronal concave angle, as well as transverse diameter of endplate were measured in midsagittal plane and specified coronal plane. The data of CT and cadaveric measurements of ten cadaveric specimens were also compared. Age and gender did not influence sagittal concave angle, location of concave region, and coronal concave angle significantly (P > 0.05). No significant difference has been revealed among each endplate for sagittal concave angle (range 162.5°–163.9°) and location of concave region (range 42.5–44.2%), either. Ranging between 170.9° and 175.7°, coronal concave angle was constantly larger in superior endplate than in inferior one. The sagittal and transverse endplate diameters of females were significantly smaller than those of males (P < 0.05), being about 88% of the latter one. The mean difference between CT and cadaveric measurements was small (Cronbach alpha > 0.8). Those morphologic parameters, especially the concavity of endplates, should be taken into consideration when designing novel vertebral body replacement constructs. CT measurement data could be used to calculate most suitable geometric parameters of those implants.     

α1受体阻滞剂与输尿管下段内镜碎石术后无管化的探讨

目的：总结输尿管镜碎石取石术处理不复杂性输尿管下段结石后不留置支架管与尿管的初步临床经验。方法：回顾性分析从2007年1月-2010年7月对行输尿管镜碎石取石术的42例不复杂性输尿管下段结石患者临床资料：患者被分为两组,A组22例,术后放置双J管;B组20例,术后不放置支架管与尿管,服用α1受体阻滞剂1周。结果：A组手术时间显著长于B组;术后患者血尿的发生率和持续时间、患者肋腹区疼痛、尿频／尿急,两组之间差异有显著统计学意义（P）;术后1个月输尿管无石率,两组均为100％。结论：采用输尿管镜碎石取石术治疗不复杂性输尿管下段结石后可服用αt受体阻滞剂,不必常规留置支架管与尿管,此法创伤轻,痛苦少,恢复快。