儿童肱骨外髁骨折的治疗体会

目的总结儿童肱骨外髁骨折的治疗效果。方法 35例JakobⅠ~Ⅲ度儿童肱骨外髁骨折患儿中,8例(Ⅰ度)采用石膏托外固定治疗,27例(Ⅰ度8例、Ⅱ度11例、Ⅲ度8例)采用切开复位克氏针内固定治疗。结果手术治疗的27例获11个月~5年随访,骨折均骨性愈合;根据Hardacre评分:优17例,良8例,差2例,优良率为25/27。非手术治疗的8例获11个月~2年随访,骨折均骨性愈合;根据Hardacre评分:优6例,良2例,优良率为8/8。结论儿童肱骨外髁骨折手术或非手术治疗均可获得较满意效果。如行非手术治疗,必须严密观察,一旦发现骨折移位应早期手术治疗。     

一次性根治术治疗高位复杂性肛瘘的临床观察

为观察一次性根治术治疗高位复杂性肛瘘的临床疗效,将37例高位复杂性肛瘘患者采用一次性根治术治疗,均一次性治愈,治愈率100％,无并发症和后遗症。结果表明,采用一次性根治术治疗高位复杂性肛瘘疗效确切,值得推广。     

The early and mid-term results of mitral valve repair for mitral regurgitation in children

Purpose

To review the surgical techniques and mid-term results of mitral valve repair in children with moderate or severe mitral regurgitation (MR).

Methods

One hundred and seven children with moderate or severe MR, aged 19.6 ± 8.5 months, were enrolled in this study. The surgical techniques used for mitral valve repair varied according to the mitral valve morphology, and included annuloplasty, annuloplasty ring, cleft closure, reconstruction of the posterior leaflet, etc. The concomitant cardiac anomalies were treated simultaneously. The results of repair were evaluated by transesophageal echocardiography performed during the operation and by serial transthoracic echocardiography performed during the follow-up.

Results

One hundred and six cases had no more than mild regurgitation intraoperatively, whereas only one case had moderate regurgitation. This patient underwent redo repair immediately, and the subsequent regurgitation was trivial. The in-hospital mortality rate was 0.9 % (1/107). The average follow-up was 46.5 ± 8.2 months. One patient died of heart failure 10 months postoperatively. The freedom from moderate or severe regurgitation after mitral valve repair was 92.3 ± 3.3 %.

Conclusion

Pediatric patients with moderate or severe MR require early surgical treatment. The early and mid-term results of mitral valve repair in pediatric patients were satisfactory.     

Expression of NLRP3 inflammasome in the BSA-overloaded rats kidney

Objective To observe NLRP3 inflammasome expression and inflammatory cells infiltration in the BSA-overloaded rats kidney, and to investigate the potential mechanism of renal injury induced by proteinuria. Methods After unilateral right nephrectomy, eighteen healthy male Wistar rats were randomly divided into two groups: protein overload nephropathy model group (n=10), treated with intraperitoneal injections of bovine serum albumin (BSA); control group (n=8), treated with intraperitoneal injections of 0.9% saline for 9 weeks. Body weigh were measured every week and 24 h urine were collected in 0, 2, 5, 7, 9 week. The plasma levels of blood total protein (TP), albumin (Alb), serum creatinine (Scr) and blood urea nitrogen (BUN) were determined by automatic analyzers. Renal pathological changes were evaluated by PAS and Masson stains. Immunohistochemical staining was used to detect the expression of NLRP3, caspase-1, IL-1β, and IL-18, as well as the types of inflammatory cells. The NLRP3, caspase-1, IL-1β, and IL-18 protein and mRNA levels were also analyzed by Western blot and real-time PCR in two groups. Results It was found that there was a significant increase of proteinuria and BUN in model group compare to that in control group (all P＜0.05). However, there were no significant changes in body weight, TP, Alb and Scr between the two groups. Morphological study demonstrated that renal tubular epithelial cell injury, proteinaceous casts in tubular lumen, accompanying with the dominant macrophages and lymphocytes infiltration in interstitium in model group. The immunohistochemistry showed that there were more T (CD3+), B cells (CD20+) and macrophages (CD68+) in renal interstitium in model group than that in control group (P＜0.05). Tubulointerstitial injury score was higher than that of the control group (P＜0.05). Immunohistochemistry, Western blot and real-time PCR all showed that the expression of NLRP3, caspase-1, IL-18 and IL-1 β were significantly increased compared to those in control group (P＜0.05). Furthermore, there were significant correlations between proteinuria and IL-1β/IL-18 expression (P＜0.05). Conclusion NLRP3 inflammasome activation is involved in tubulointerstitial inflammation caused by proteinuria.     

生物可降解聚氨酯的合成及应用

生物可降解聚氨酯材料具有优异的机械性能,良好的血液相容性、组织相容性和生物可降解性,因而在生物医学上得到了广泛的应用.聚氨酯的设计自由度很大,可以通过选择不同嵌段和调节软硬段间的比例,从而合成出具有不同化学结构、机械性能和热性能的聚氨酯以满足不同的应用要求.生物可降解聚氨酯在医学上的应用主要集中在药物缓释载体材料、手术缝合线、人造皮肤、伤口敷料、医用粘合剂、组织工程修复及细胞培养支架等.     

TNFα-Tumstatin45-132分子构建、生物学特征预测和活性验证

目的 构建人重组TNFα-Tumstatin45-132融合蛋白的表达载体，预测接头的合理性和可行性．并对融合蛋白活性进行验证。方法 采用基因融合序列重叠延伸（s0E）策略，构建新型TNFα-Tumstatin45-132表达载体；应用核酸和蛋白质序列软件Antheprot和PepTool对融合基因及接头部位翻译后在二级结构水平上的柔性、抗原性、亲水性等生物特性加以预测；用细胞毒试验和内皮细胞增殖试验测定表达的融合蛋白活性。结果 构建新型重组TNFα-Tumstatin45-132融合基因．经DNA测序证实与设计完全一致；TNFa-Tumstatinml32融合基因的氨基酸序列经软件分析，并与TNFα和Tumstatin45-132单独分析的结果比较，未出现新的抗原性，亲水性没有改变，接头部位具有很低的抗原性，接头部位呈中性；表达的融合蛋白经证实具有杀伤L929细胞和抑制ECV304细胞增殖的作用。结论 通过计算机软件对TNFα-Tumstatin45-132融合蛋白的预测，并与TNFα和Tumstatin45-132分别对比分析，有利于合理设计融合蛋白，最大程度地保留TNFα和Tumstatin45-132各自的生物活性和功能；生物活性分析证实设计具有一定的科学性和合理性。     

冠心病病人A型行为研究进展

从A型行为对冠心病的影响、冠心病病人A型行为的评估、心理干预3方面对冠心病病人A型行为的研究进展进行综述。     

坤泰胶囊联合来曲唑治疗多囊卵巢综合征不孕症的效果

〔摘 要〕 目的：探讨多囊卵巢综合征不孕症患者采用坤泰胶囊联合来曲唑治疗的临床效果。 方法：对重庆市万州区妇 幼保健院 2019 年 1 月至 2020 年 6 月期间收治的 60 例多囊卵巢综合征不孕症患者进行分组,以随机数字表法分成对照组与 观察组,各 30 例,观察组患者采用坤泰胶囊联合来曲唑治疗,对照组患者采用来曲唑治疗,比较两组患者治疗前后性激素 水平、卵巢卵泡质量、子宫内膜厚度、排卵率、妊娠率。 结果：治疗后,观察组患者的睾酮、雌二醇、促卵泡激素、促黄 体生成素水平均低于对照组,差异具有统计学意义（P ＜ 0.05）。观察组患者的直径＞ 18 mm 成熟卵泡数多于对照组,子 宫内膜厚度大于对照组,差异具有统计学意义（P ＜ 0.05）。治疗 50 d 后,观察组患者排卵率、妊娠率均高于对照组患者, 差异具有统计学意义（P ＜ 0.05）。 结论：对多囊卵巢综合征不孕症患者采用坤泰胶囊联合来曲唑治疗的效果显著,可以 有效改善患者性激素水平及其卵巢卵泡质量,增加子宫内膜厚度,提高妊娠率。