骨髓间充质干细胞移植改善心肌梗死患者心功能

学术背景：目前常用的心肌梗死治疗方法一介入治疗能改善心肌缺血，但坏死心肌不能自主修复。近年来干细胞移植成为治疗缺血性心脏病研究的热点，且间充质干细胞具有取材方便，免疫排斥性低，多向分化性，不涉及伦理道德问题等优点，更是倍受重视。 目的：总结骨髓间充质干细胞移植治疗心肌梗死的研究进展。检索策略：由该论文的研究人员应用计算机检索Pubmed数据库1990-01／2007—12关于骨髓间充质干细胞治疗心肌梗死的文献，检索词“Mesenchymal stem cells，transplantation，myocardial infarction”，并限定文章语言种类为English。同时检索万方数据库2002-03／2007-03相关的文章，检索词为“骨髓间充质干细胞移植，心肌梗死”，并限定文章语言种类为中文。然后对资料进行初审，纳入标准：①与骨髓间充质干细胞治疗心肌梗死密切相关。②同一领域选择近期发表或在权威杂志上发表的文章。排除标准：重复性研究。 文献评价：文献的来源主要是骨髓间充质干细胞移植治疗心肌梗死方面的随机对照试验。所选用的31篇文献中，7篇为综述，其余均为临床或基础实验研究。 资料综合：①骨髓干细胞具有比既往预期更高的可塑性，在心肌梗死后能迁移到心肌损伤部位，在心脏环境中横向分化为心肌细胞和血管内皮细胞，参与坏死心肌组织的再生。②临床研究证实，骨髓干细胞移植可以改善心肌梗死患者的心功能。③关于骨髓间充质干细胞在软骨修复方面的研究虽已取得较大进展，但仍存在许多问题，如测定移植细胞的成活率并找到提高其成活率的方法：心肌梗死面积多大进行细胞移植会更有效：需发明一种能长期标记移植细胞的技术，明确被成功移植的细胞的状态：确定最佳细胞移植的时间、数量，并进一步完善移植方法等。 结论：有关骨髓间充质干细胞改善心肌梗死患者心功能、细胞移植方法等方面的研究取得很大的进展，但仍存在许多需要解决的问题．     

Can the Internet be used as a medium to evaluate knee angle?

Telemedicine promises to revolutionize medical care delivery in rural and remote areas. The ability to accurately evaluate physical impairment via the Internet is important to the possible future provision of Internet-based physiotherapy. This study evaluated the reliability and validity of assessing knee range of motion via the Internet. Two therapists evaluated knee angle on a single subject via two methods of assessment: the Internet and the traditional method (face-to-face). Nine random positions of the knee were chosen with the principal examiner performing 20 face-to-face and two sets of 20 Internet measures in each position (n=540). The secondary therapist performed Internet assessments only. The Internet connection was established at a readily available speed of 17 kbit/s. The Internet-based goniometer was found to be a valid tool for measuring both knee flexion and extension angles. It was shown to possess both high intra and inter-rater reliability. Difference average plots of the scores verified the consistency of measurement between both modes of assessment. The successful evaluation of the physical outcome measure of knee range of motion via the Internet assists the further development of Internet-based physiotherapy applications.     

Absent left common carotid artery in a right aortic arch: Separate origins of left internal and external carotid arteries from brachiocephalic artery

We present a case of cyanotic congenital heart disease with left common carotid artery agenesis in the setting of the right aortic arch highlighting the potential implications in management.