骨桥蛋白在肝包虫动物模型外囊壁中的表达

目的:观察动物模型肝包虫囊壁情况,研究骨桥蛋白(Osteopontin,OPN)在小鼠肝细粒棘球蚴外囊壁中的分布特征及表达相关因素,并探讨其意义.方法:肝包虫动物模型的制作、HE染色观察、免疫组化观察53例小鼠肝细粒棘球蚴外囊壁中OPN及巨噬细胞的表达与分布.结果:HE染色外囊的着色明显较周围巨噬细胞带深,不存在渐变的过程;83%肝细粒棘球蚴外囊壁中有不同程度OPN表达,且集中分布于肝包虫纤维囊壁(外囊),与外侧巨噬细胞带比较有显著差异(P＜0.01).结论:在动物模型上证明了外囊与肝实质间存在可分离间隙,OPN主要分布在肝细粒棘球蚴外囊,并在其形成过程中起重要作用.     

影响医院业务收入因素的灰色关联分析

本文对影响医院业务收入的固定资产总值、专业设备资金、每门诊人次收费等八项主要因素运用灰色系统的理论加以分析,主要目的是找出对业务收入影响强弱的因素,分析原因,提出建议,旨在为领导制定计划、安排人员、分配物资等方面提供可靠的信息和依据。     

彭培初治疗前列腺癌经验

本文介绍彭培初教授治疗前列腺癌的经验,提出把握阴阳转归的主线,早期真阴受损,以滋补肾阴为主,晚期阴损及阳,寒凝湿滞,治以温阳散寒的治疗方法,以期提高患者生活质量、延长生命。     

老年上消化道出血60例临床分析

目的 探讨老年上消化道出血的病因及治疗特点.方法 对2008年1月～ 2010年1月我院收治的老年上消化道出血病例进行分析.结果 胃溃疡出血26例(占43%),十二指肠球部溃疡出血8例(占13%),胃癌出血10例(占16%),食管静脉曲张破裂出血11例(占18%),Mallory-Weiss综合征2例(占3%),胆道出...     

晚发型脊柱骨骺发育不良伴进行性骨关节病患者的成骨细胞增殖分化及基因表达谱改变

目的探讨晚发型脊柱骨骺发育不良伴进行性骨关节病(SEDT PA)患者WISP3基因突变所造成的软骨及周围骨组织病变和可能的发病机制。方法从SEDT PA患者及正常同龄个体的股骨头松质骨分离成骨细胞进行体外培养,对培养的成骨细胞进行细胞增殖、骨特异性碱性磷酸酶(BAP)、骨钙素、护骨素测定,利用cDNA表达芯片进行基因表达谱分析,并用免疫组织化学方法对基因芯片进行验证。比较SEDT PA患者及正常对照的成骨细胞在细胞增殖、分化及基因表达谱等方面的改变。同时采用Northern杂交检测成骨细胞的WISP3表达情况。结果与正常人成骨细胞相比,SEDT PA患者成骨细胞的增殖能力较强(0.86±0.04vs0.71±0.10),氚胸腺嘧啶(3H TDR)的掺入量明显较高(1363cpm±350cpmvs867cpm±128cpm)。SEDT PA患者的成骨细胞骨钙素的表达水平明显低于正常同龄人(3.62ng/μg蛋白±0.3ng/μg蛋白vs0.85ng/μg蛋白±0.06ng/μg蛋白),护骨素的表达明显低于正常同龄人(9.43pg/μg蛋白±0.41pg/μg蛋白vs1.98pg/μg蛋白±0.03pg/μg蛋白),而BAP的表达未发生明显改变;WISP3基因的表达极低。cDNA表达芯片分析结果发现,与正常对照比较,SEDT PA患者的成骨细胞有22个基因表达明显上调,16个基因表达明显下调,这些基因包括有成骨细胞的标记分子、细胞外基     

双钢板垂直和平行放置治疗C型肱骨远端骨折的对比研究

Background Double plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus. However, there is still controversy concerning dual plate positions in terms of providing optimal stability. The purpose of this retrospective study was to compare the clinical outcomes in patients with type C intra-articular distal humeral fractures using perpendicular and parallel plating methods.

Methods Between March 2008 and June 2011, a total of 45 patients with type C distal humerus fractures were treated using two different dual plating methods. Of them, 24 patients were treated by perpendicular plating (group I) and 21 patients were treated by parallel plating (group II). The surgical time, blood loss, and union time were compared between the two groups. The flexion-extension arc, the total range of flexion and extension at the end of follow-up were compared between the two groups. The Mayo Elbow Performance Score (MEPS) was used to determine the elbow functional results.

Results All patients were followed up. The mean duration of follow-up was 16 months (range 12–25 months) in group I and 15.5 months in group II (range 12–25 months). There were no significant differences in the surgical time, blood loss, and the bone union time between the two groups. In group I, the mean elbow flexion-extension arc was 101° and the mean MEPS was 85 points. The rate of excellent and good results was 87.5%. In group II, the mean flexion-extension arc was 100° and the mean MEPS was 86.1 points. The rate of excellent and good results was 90.5%. There were no significant differences in the MEPS, flexion-extension arc, and the total range of flexion and extension between the two groups.

Conclusions Perpendicular and parallel plate configurations with the appropriate surgical techniques can provide anatomical reconstruction and stable fixation of type C intra-articular distal humeral fractures and allow early mobilization of the elbow after an operation. The occurrence of post-operative elbow stiffness can be reduced and good outcomes can be obtained.

     

术前放化疗并手术治疗局部晚期食管癌

目的 评价术前放化疗并手术治疗局部晚期食管癌的疗效.方法 2000年1月至2004年12月连续收治符合入组条件的胸段局部晚期食管鳞癌患者42例,应用胸部及腹部CT、食管超声内镜、支气管内镜等检查进行治疗前分期.术前放化疗方案:去甲长春花碱25 mg/m2,于第1、8、22、29天静脉注射,或5氟尿嘧啶(5-Fu)2.4 g/m2于第1～3、22～2,4天持续72 h静脉注射及顺铂(DDP)75 mg/m2,第1、22天静脉注射,同期采用常规分割放疗2.0 Gy/d,每周5 d,总量40 Gy.放化疗结束4～6周后,施行食管癌切除,重建消化道.结果 全组42例,其中41例完成术前放化疗,术前放化疗的临床有效率83.3%;40例进一步接受手术,根治性(R0)切除率97.5%,病理完全缓解率为23.8%.全组1、3、5年生存率分别为66.9%、54.5%、44.9%,中位生存时间为43.4个月;1、3、5年无病生存率分别为61.1%、48.7%、39.5%,中位无病生存时间为32.7个月.术前放化疗引起的骨髓抑制、肺毒性、食管毒性,多数为Ⅰ～Ⅱ度,无术前放化疗的毒副反应导致无法手术或死亡.术后肺部感染、严重心律失常、围术期死亡率分别是22.5%、20.0%、5.0%.结论 术前放化疗并手术可取得较高的临床有效率和完全病理缓解率,明显降低食管癌的分期,有望提高局部中晚期食管癌的生存率.患者对本方案耐受性良好,但放化疗的毒副反应不容忽视.     

甘露散治疗更年期潮热证的实验研究

目的研究甘露散(GanLuSan,简称GLS)对更年期潮热证的影响。方法1.小鼠静注氨茶碱造成潮热模型,灌胃GLS治疗,测定给药后耳廓微循环微动脉血流速度及微动脉与微静脉口径。2.大鼠口服党参与黄芪煎剂造成热证模型,灌胃GLS治疗,测定给药后体温与ATP酶活性。结果GLS可减轻小鼠潮热模型潮热症状,使循环微动脉血流速度降低,微动脉与微静脉口径缩小;对热证模型大鼠,GLS可以降低体温,减少ATP酶活性。结论GLS对试验性更年期潮热证具有治疗作用。     

Differential temporal neural responses of pain-related regions by acupuncture at acupoint ST36: a magnetoencephalography study

Background  Previous neuroimaging studies primarily focused on the spatial distribution of acupuncture needling stimulation. However, a salient feature of acupuncture was its long-lasting effect. This study attempted to detect the spatial-temporal neural responses evoked by acupuncture at an analgesia acupoint ST36 by using magnetoencephalography. To further verify its functional specificity, we also adopted acupuncture at Pericardium 6 and nonacupoint as separated controls.

Methods  Forty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 14 subjects in one group. Both magnetoencephalography data (151-channel whole-head system) and structural functional magnetic resonance imaging data (3D sequence with a voxel size of 1 mm³ for anatomical localization) were collected for each subject. All processing procedures were performed in BrainStorm Toolbox.

Results  Acupuncture at ST36 showed a significantly time-varied brain activities with different onset time. Our results presented that acupuncture at different acupoints (or comparing with nonacupoint) can specifically induce neural responses in different brain areas—acupuncture at ST36 can specifically induce the neural responses of pain-inhibition areas, while acupuncture at PC6 can specifically induce the activities of the insula and amygdala.

Conclusions  In the present study, we attempted to detect the temporal neural responses underlying the functional specificity of acupuncture at ST36, using acupoint belonging to different meridians and non-acupoint with efficacy-irreverent as separate controls. The specific neural substrates involving acupuncture at different acupoints may be related to its functional specificity in clinical settings.