关节镜下人工韧带重建前交叉韧带的临床初步体会

目的探讨关节镜下应用LARS人工韧带重建前交叉韧带的可行性及近期疗效. 方法用法国产LARS人工韧带对16例前交叉韧带(anterior cruciate ligament,ACL)损伤行关节镜下ACL重建术.等距点钻胫骨、股骨骨道,将肌腱拉入骨道,韧带游离部分位于关节腔内,拉紧后2枚螺钉固定韧带,合并损伤同期处理. 结果手术时间51～86 min,平均64 min.术后无滑膜炎、韧带断裂、活动明显受限等并发症.16例均随访1.5～6个月,平均3.8月.按照IKDC评分标准:术前C级6例,D级10例;术后A级6例,B级9例, C级1例(χ2=6.264,P<0.05).Lysholm膝关节功能评分术前36～76分,(63.7±7.3)分;术后86～97分,(94.8±9.6)分(t=10.356,P<0.05). 结论关节镜下LARS人工韧带重建ACL,操作简便,可使膝关节获得即时稳定性,早期康复锻炼,最大限度的防止关节功能受限,近期疗效满意.     

前列腺癌新辅助治疗临床分析（附32例报告）

目的 总结32例前列腺癌患者新辅助治疗（NHT）的作用。方法 32例前列腺癌患者中药物去势17例，手术去势15例，并联合抗雄激素治疗3个月，统计NHT前后前列腺癌体积、肿瘤大小、PSA、FSH、LH和睾酮水平变化。结果 2组NHT后前列腺体积明显变小、肿瘤变小、变软，甚至消失，PSA和睾酮明显下降，药物去势组睾酮水平在耻骨后前列腺癌根治术（RRP）术后2～3个月可恢复正常，而手术去势组RRP术后睾酮呈持续低水平。结论 NHT可明显缩小前列腺体积，降低PSA，有利于手术操作。药物去势对内分泌影响是可逆的，而手术去势内分泌改变不可逆。     

红花注射液治疗老年慢性肾功能衰竭32例临床观察

老年人肾功能随着年龄增长有“自然减退”现象，加上既往存在的高血压、糖尿病、慢性肾炎等疾病，更易出现慢性肾功能衰竭（CRF）。目前老年慢性肾衰的治疗目标是延缓肾功能减退的进程，主要的手段有控制血压、低蛋白饮食、纠正贫血、增加肠道排毒等。笔者采用中医活血化瘀的方法，通过静脉滴注红花注射液改善肾脏的供血，增加肾小球的滤过率，临床取得一定效果，现报道如下，供同道参考。[第一段]     

红景天对高原去势大鼠骨质疏松症的血清IL-6、TNF-α和尿DPD影响

目的:探讨高原高寒地区低氧环境去势大鼠骨质疏松症与血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和尿脱氧吡啶酚(DPD)的关系及红景天预防骨质疏松的作用。方法:选用Wistar雌性大白鼠75只,分别摘除卵巢或假性去卵巢。分为A组(假手术组),B组(切除卵巢组),C组(切除卵巢 尼尔雌醇组),D组(切除卵巢 红景天混合饲料组),E组(切除卵巢 红景天浸液组)。每组15只,术后在海拔3100m青海海北州地区饲养,术后3个月处死,应用放免方法测定血清IL-6、TNF-α和化学发光法测定尿中DPD含量。结果:B组血清IL-6、TNF-α和尿DPD含量显著高于A、C、D、E组。C、D、E组血清IL-6、TNF-α和尿DPD含量与A组比较差异无显著性统计学意义。结论:红景天的抗高原骨质疏松症的作用可能与降低血清IL-6、TNF-α含量和尿中DPD浓度有关。     

Flavonoids modulate monocarboxylate transporter-1-mediated transport of gamma-hydroxybutyrate in vitro and in vivo.

The objective of this study was to determine the effects of flavonoids on the in vitro monocarboxylate transporter 1 (MCT1)-mediated transport and in vivo disposition of the drug of abuse, gamma-hydroxybutyrate (GHB). The uptake of GHB in rat MCT1 gene-transfected MDA-MB231 cells was significantly decreased in the presence of the flavonoids apigenin, biochanin A, chrysin, diosemin, fisetin, genistein, hesperitin, kaempferol, luteolin, morin, narigenin, phloretin, and quercetin, but was not affected by the flavonoid glycosides phloridzin and rutin. The IC(50) values for luteolin, morin, and phloretin were 0.41 +/- 0.14, 6.41 +/- 2.01, and 2.57 +/- 0.48 microM, with the inhibition mechanism for luteolin being competitive. [(3)H]Kaempferol and [(3)H]biochanin A did not exhibit MCT1-mediated uptake, suggesting that these flavonoids are not substrates for MCT1. The combination of luteolin and phloretin inhibited the uptake of GHB in a synergistic manner; however, the combination of luteolin and morin was antagonistic. GHB 1000 mg/kg was administered to rats by i.v. bolus, with or without the concomitant administration of luteolin 10 mg/kg i.v. After luteolin treatment, the renal and total clearances of GHB were significantly increased, probably because of inhibition of the MCT1-mediated renal reabsorption of GHB, and the sleep time significantly decreased (121 +/- 5 min versus 165 +/- 10 min) compared with control rats. Overall, the results of this study indicate that flavonoids from food or herbal products may significantly alter the pharmacokinetics and pharmacodynamics of MCT substrates.     

慢性肾功能不全患者血管活性物质测定在血液净化中的临床研究

目的 评价血管紧张素Ⅱ、氨甲酰血红蛋白、醛固酮及甲状旁腺激素等在血液净化充分性中的意义。方法 120例慢性肾功能衰竭患者，按采用不同的透析膜分为3组：即聚砜膜、醋酸膜、铜仿膜。用放射免疫法测定其血管紧张素Ⅱ（AngⅡ）及醛固酮（ALD）浓度，化学发光法测甲状旁腺激素（PTH）。采用不同的血流量200ml／min及250ml／min比较。结果 对体内中、小分子物质清除率，聚砜膜〉醋酸膜〉铜仿膜。结论 高血流量、高通透性人工合成聚砜膜，对治疗慢性肾功能衰竭，提高肾功能不全患者的身心健康及生活质量、延长患者生命有很重要的临床意义。     

狂犬疫苗免疫后早期血清学抗体结果分析

目的观察接种狂犬病疫苗人群不同时期抗体产生情况，探讨最佳检测时间。方法用ELISA法检测人用狂犬病纯化疫苗接种者血清狂犬病毒抗体。结果对完成全程免疫后第7d、第14d和第30d的血清进行检测，第7d和第14d检出的抗体阳性率无显著性差异。结论现行国产狂犬疫苗的保护性不断提高，早期检测抗体对及时发现免疫失败者、降低发病率有着重要的意义。     

Augmentation of intrarenal angiotensin II levels in uninephrectomized aldosterone/salt-treated hypertensive rats; renoprotective effects of an ultrahigh dose of olmesartan.

Recent studies have suggested that aldosterone plays a role in the pathogenesis of renal injury. In this study, we investigated whether local angiotensin II (Ang II) activity contributes to the progression of renal injury in aldosterone/salt-induced hypertensive rats. Uninephrectomized rats were treated with 1% NaCl in a drinking solution and one of the following combinations for 6 weeks: vehicle (2% ethanol, s.c.; n=9), aldosterone (0.75 mug/h, s.c.; n=8), aldosterone+Ang II type 1 receptor blocker olmesartan (10 mg/kg/day, p.o.; n=8), or aldosterone+olmesartan (100 mg/kg/day, p.o.; n=9). Aldosterone/salt-treated hypertensive rats exhibited severe proteinuria and renal injury characterized by glomerular sclerosis and tubulointerstitial fibrosis. Aldosterone/salt-induced renal injury was associated with augmented expression of angiotensin converting enzyme and Ang II levels in the renal cortex and medullary tissues. Renal cortical and medullary mRNA expression of transforming growth factor-beta (TGF-beta) and connective tissue growth factor (CTGF) as well as the collagen contents were increased in aldosterone/salt-treated hypertensive rats. Treatment with olmesartan (10 or 100 mg/kg/day) had no effect on blood pressure but attenuated proteinuria in a dose-dependent manner. Olmesartan at 10 mg/kg/day tended to decrease renal cortical and medullary Ang II levels, TGF-beta and CTGF expression, and collagen contents; however, these changes were not significant. On the other hand, an ultrahigh dose of olmesartan (100 mg/kg/day) significantly decreased these values and ameliorated renal injury. These data suggest that augmented local Ang II activity contributes, at least partially, to the progression of aldosterone/salt-dependent renal injury.     

先天性胃壁肌层缺损诊治体会

目的 探讨提高新生儿先天性胃壁肌层缺损治愈率的方法。方法 总结分析近年来收治的本症11例患儿(均经过病理检验证实)的临床及相关资料。结果 11例患儿中，8例存活，其中7例为近十年的病例。1例死亡，2例放弃治疗，均为十年以前的病例。在存活者中，经追踪观察及消化道造影检查，残胃有明显代偿性生长，患儿生长发育未受到明显的影响。结论 早期发现、及时手术、控制感染、术后营养、支持治疗，其预后良好。