Serum bone markers in patients with loosening of cemented total hip endoprosthesis]

Serum levels of bone markers N-mid osteocalcin (OCN-Mid) and Cross-Laps in 20 patients (8 men and 12 women) with loosening of at least one element of total hip endoprosthesis confirmed during operation were compared with age and sex matched group with OA. Marker levels were measured by direct chemoluminescency using Modular E-170. Statistical analysis were done with t-Student test (alpha = 0.05). There were no significant differences in OCN-Mid, Cross-Laps levels and OCN-Mid/Cross-Laps ratio between both groups. Implant loosening is a slow process taking place on a relatively small surface in comparison to whole skeleton, so bone markers have no clinical value in diagnostics of total hip loosening.     

早期干预对高危儿在婴儿早期发育的影响

目的：探讨早期干预对高危儿在婴儿早期发育的影响。方法：采用自行设计的一套早期干预方法通过指导家长对实验组实施，分别在3个月、6个月时进行格体生长和行为发育的评估，另设对照组进行比较。结果：实验组和对照组在体重、身长、头围方面均无统计学差异，但实验组的5个能区行为发育商均值都高于对照组，除3个月的语言能区外，其余均有统计学差异。结论：早期干预在婴儿早期就能促进高危儿的行为发育，但对促进高危儿的体格生长无明显效果。     

Plasmid DNA encoding transforming growth factor-beta1 suppresses chronic disease in a streptococcal cell wall-induced arthritis model.

Transforming growth factor beta is a potent immunomodulator with both pro- and antiinflammatory activities. Based on its immunosuppressive actions, exogenous TGF-beta has been shown to inhibit autoimmune and chronic inflammatory diseases. To further explore the potential therapeutic role of TGF-beta, we administered a plasmid DNA encoding human TGF-beta1 intramuscularly to rats with streptococcal cell wall-induced arthritis. A single dose of 300 microg plasmid DNA encoding TGF-beta1, but not vector DNA, administered at the peak of the acute phase profoundly suppressed the subsequent evolution of chronic erosive disease typified by disabling joint swelling and deformity (articular index = 8.17+/-0. 17 vs. 1.25+/-0.76, n = 6, day 26, P < 0.01). Moreover, delivery of the TGF-beta1 DNA even as the chronic phase commenced virtually eliminated subsequent inflammation and arthritis. Both radiologic and histopathologic as well as molecular evidence supported the marked inhibitory effect of TGF-beta1 DNA on synovial pathology, with decreases in the inflammatory cell infiltration, pannus formation, cartilage and bone destruction, and the expression of proinflammatory cytokines that characterize this model. Increases in TGF-beta1 protein were detected in the circulation of TGF-beta1 DNA-treated animals, consistent with the observed therapeutic effects being TGF-beta1 dependent. These observations provide the first evidence that gene transfer of plasmid DNA encoding TGF-beta1 provides a mechanism to deliver this potent cytokine that effectively suppresses ongoing inflammatory pathology in arthritis.     

脑卒中急性期白细胞反应及临床意义

脑卒中急性期大多数患者白细胞增多，表现为中性粒细胞计数与白细胞总数增高，脑出血组白细胞增高姓率高于脑梗塞组，而中性粒细胞增高发生率二组间无差别，外周血白细胞增高与临床神经功能缺损程度评分有密切关系，中性粒细胞计数越高，近期神经功能预后则越差。     

Fit and fill analysis of a newly designed femoral stem in cementless total hip arthroplasty for patients with secondary osteoarthritis

The fit and fill of the femoral canal are critical to the success of cementless femoral stems in total hip arthroplasty. It is difficult for conventional stems to provide a good fit and fill for the femora of patients with secondary osteoarthritis. Based on measurements of 100 femora of these patients, we designed two types of Fukui Medical School (FMS) stems with a proximal lateral flare that differed in the medial radius. We compared the fit and fill of the FMS stems with those of four conventional stems, using computer simulation. The mean proximal fit and total fit of the FMS stems were 46% and 53% respectively, a significant improvement compared with the other stems examined. The mean fill of FMS stems was 82% at the lower end of the lesser trochanter and 84% at the upper end of the isthmus, values that were significantly higher than those of the other stems. Since September 1995, we have implanted FMS stems in 15 hips with secondary osteoarthritis. Radiographic evaluations showed that the canal fill of the FMS stems was significantly greater in the proximal femur compared with other stems previously inserted at our department. A summary of this paper was presented at the 9th Symposium on Computer-Assisted Radiology; June 1995, Berlin, and at the 8th International Symposium on Technology in Arthroplasty; September 1995, Puerto Rico.     

心肌造影超声心动图评估心肌缺血程度的实验研究

本实验制作不同程度心肌缺血的动物模型，以声处理５％人血白蛋白为超声造影剂进行心肌灌注造影，探讨ＭＣＥ时间－强度曲线各指标与心肌缺血程度间的关系。结果表明：心肌显影的峰值强度和曲线下面积均与缺血程度呈显著负相关（相关系数分别为ｒ＝－０．９８，Ｐ值＜０．００５；ｒ＝－０．９４，Ｐ值＜０．０５），且能区分轻度、中度和重度三种程度的心肌缺血；而三项时间指标与心肌缺血程度间未发现显著性差异。本实验的初步结果表明，ＭＣＥ是一项活体评估局部心肌血流灌注的有效方法。