人工关节置换治疗股骨颈骨折内固定失败的疗效观察

目的:观察人工髋关节置换治疗股骨颈骨折内固定失败患者的临床疗效.方法:自2007年6月至2014年1月采用人工髋关节置换治疗29例股骨颈骨折内固定失败的患者,其中男12例,女17例;年龄43~83岁,平均60.3岁;左髋16例,右髋13例.内固定距关节置换时间3~48个月,平均23.3个月.结果:29例患者中,直接生物杯固定20例,植骨修复缺损后生物杯固定7例,植骨修复缺损钛网杯固定后骨水泥臼杯固定2例;股骨柄生物型柄13例,骨水泥柄16例.无术中并发症发生,手术时间(115±38) min,术中出血量(420±175) ml,术后引流量(240±119) ml,术中输血量(200±220) ml,术中补液量(2 200±400) ml,术后输血量(300±200)ml,术后早期脱位1例.术后随访时间5~24个月,平均14.7个月,均愈合良好,未发生假体下沉、松动、脱位等现象.Harris评分由术前的51.1±7.5提高到末次随访88.5±6.4.结论:人工关节置换治疗股骨颈骨折内固定失败患者,可早期下地功能锻炼,减少卧床时间及并发症的发生,有利于早期功能恢复,远期疗效需要进一步观察.     

C反应蛋白和高密度脂蛋白对血凝素样氧化型低密度脂蛋白受体1表达的影响

目的观察C反应蛋白和高密度脂蛋白对单核细胞株THP-1来源的巨噬细胞血凝素样氧化型低密度脂蛋白受体1蛋白和mRNA表达的影响,以及血凝素样氧化型低密度脂蛋白受体1表达的变化与细胞内胆固醇含量变化的关系。方法THP-1单核细胞株经佛波酯诱导分化为巨噬细胞。用不同浓度C反应蛋白或高密度脂蛋白在体外干预巨噬细胞,测定干预前后巨噬细胞血凝素样氧化型低密度脂蛋白受体1蛋白和mRNA表达的变化,并采用高效液相色谱测定巨噬细胞内胆固醇含量的变化。结果与对照组相比,C反应蛋白或高密度脂蛋白均可以诱导THP-1来源的巨噬细胞血凝素样氧化型低密度脂蛋白受体1蛋白和mRNA表达增加(P<0.05),C反应蛋白使巨噬细胞内总胆固醇和胆固醇酯含量显著增加(P<0.01),而高密度脂蛋白使细胞内总胆固醇和胆固醇酯显著降低(P<0.01)。结论C反应蛋白和高密度脂蛋白都能引起THP-1来源的巨噬细胞表面血凝素样氧化型低密度脂蛋白受体1表达上调,提示血凝素样氧化型低密度脂蛋白受体1并不是介导巨噬细胞参与炎症反应病理生理变化的关键性受体。     

Risk factors for genital chlamydial infection.

OBJECTIVE: To discuss the occurrence of genital chlamydia in developed countries and review the literature assessing the potential risk factors for this sexually transmitted disease. DATA SOURCES: A MEDLINE search was performed for all English citations from 1985 to 2000 that contain the keywords "Chlamydia trachomatis", "chlamydial infections", "risk factors" and "sex behaviour". All relevant references cited in articles that were obtained from the search were also included. DATA EXTRACTION: ALL ARTICLES OBTAINED FROM THE ABOVE SOURCES WERE EXAMINED, AND WERE INCLUDED IN THE REVIEW IF THEY MET THE FOLLOWING CRITERIA: primary study examining sociodemographic or behavioural risk factors associated with genital chlamydial infection using multivariate analysis; study subjects 12 years of age and older; and study setting in a developed country. DATA SYNTHESIS AND CONCLUSIONS: Genital chlamydial infection has become the most commonly reported bacterial infection in North America over the past decade. Thirty-eight cross-sectional studies and six cohort studies were included in the present review. Most studies demonstrated that young men and women are at higher risk of being infected with chlamydia than older subjects. Chlamydia seems to be found in a diverse group of people, and unlike gonorrhea, is not concentrated in low income, minority core groups with high rates of partner change. However, a number of studies have shown that communities with well-established control programs are beginning to demonstrate this pattern. There is no clear evidence that chlamydia is associated with type of partners, contraceptive use, or age at first intercourse. Future research should follow this sexually transmitted disease as it evolves through the epidemiological stages to ensure that preventive and treatment services are reaching those people who are most likely to be infected.     

Myosin light chain kinase and myosin phosphorylation effect frequency-dependent potentiation of skeletal muscle contraction

Repetitive stimulation potentiates contractile tension of fast-twitch skeletal muscle. We examined the role of myosin regulatory light chain (RLC) phosphorylation in this physiological response by ablating Ca(2+)/calmodulin-dependent skeletal muscle myosin light chain kinase (MLCK) gene expression. Western blot and quantitative-PCR showed that MLCK is expressed predominantly in fast-twitch skeletal muscle fibers with insignificant amounts in heart and smooth muscle. In contrast, smooth muscle MLCK had a more ubiquitous tissue distribution, with the greatest expression observed in smooth muscle tissue. Ablation of the MYLK2 gene in mice resulted in loss of skeletal muscle MLCK expression, with no change in smooth muscle MLCK expression. In isolated fast-twitch skeletal muscles from these knockout mice, there was no significant increase in RLC phosphorylation in response to repetitive electrical stimulation. Furthermore, isometric twitch-tension potentiation after a brief tetanus (posttetanic twitch potentiation) or low-frequency twitch potentiation (staircase) was attenuated relative to responses in muscles from wild-type mice. Interestingly, the site of phosphorylation of the small amount of monophosphorylated RLC in the knockout mice was the same site phosphorylated by MLCK, indicating a potential alternative signaling pathway affecting contractile potentiation. Loss of skeletal muscle MLCK expression had no effect on cardiac RLC phosphorylation. These results identify myosin light chain phosphorylation by the dedicated skeletal muscle Ca(2+)/calmodulin-dependent MLCK as a primary biochemical mechanism for tension potentiation due to repetitive stimulation in fast-twitch skeletal muscle.     

多囊卵巢综合征患者血清瘦素水平与性激素间的相关性研究

目的探讨多囊卵巢综合征(PCOS)患者血清瘦素(leptin)水平与性激素的相关性。方法选择初诊的PCOS患者34例作为研究对象,选择年龄及体重指数(BMI)相匹配的健康女性作为对照组进行血清瘦素、空腹血糖(FBG)、空腹胰岛素(FIn)、尿促卵泡素(FSH)、黄体生成素(LH)、孕激素(P)/雌激素(E)及睾酮(T)测定,并对它们间的相关性进行分析。结果 PCOS患者血清瘦素、LH、LH/FSH、T、BMI、FBG、胰岛素抵抗指数(HOMA-IR)水平均显著高于对照组,而FSH水平显著降低。血清瘦素水平与BMI、FBG、FIn及HOMA-IR存在相关性,进一步多元回归分析提示,血清瘦素与BMI独立相关。结论 PCOS患者血清瘦素水平变化与肥胖、糖代谢紊乱及性激素代谢异常有一定关系。     

Mechanical characterization of intraluminal tissue with phase-resolved photoacoustic viscoelasticity endoscopy

We developed a phase-sensitive side-scanning photoacoustic viscoelasticity endoscopy (PAVEE) for mechanical characterization of intraluminal tissues. In PAVEE, the PA phase can be extracted from the optical absorption induced ultrasonic waves and provides an index of viscoelasticity that is closely linked to tissue compositions. The transverse resolution of the PAVEE measured by carbon fiber was about 32 μm. The imaging capability of the PAVEE was verified using a vessel-mimicking phantom with different agar density. Moreover, PAVEE was investigated in processed lumen-shaped vascular tissues to evaluate the biomechanical features, which was highly consistent with the histology. The results demonstrated that the PAVEE can obtain viscoelastic properties of intraluminal tissues, which puts a new insight into the intravascular disease and holds great promise for plaque vulnerability detection.OCIS codes: (170.3880) Medical and biological imaging, (170.5120) Photoacoustic imaging, (170.2150) Endoscopic imaging, (120.5050) Phase measurement     

The reliability of evaluation of hip muscle strength in rehabilitation robot walking training

[Purpose] The primary purpose of this study was to evaluate the intraclass correlation coefficient in obtaining the torque of the hip muscle strength during a robot-assisted rehabilitation treatment. [Subjects] Twenty-four patients (15 males, 9 females) with spinal cord injury participated in the study. [Methods] The subjects were asked to walk during robot-assisted rehabilitation, and the torque of the muscle strength which was measured at hip joint flexion angles of −15, −10, −5, 0, 5, 10, 15, 20, 25, and 30 degrees. [Results] The intraclass correlation coefficient of the torque of the hip muscle strength measured by the rehabilitation training robot was excellent. [Conclusion] Our results show that measurement of torque can be used as an objective assessment of treatment with RAT.Key words: Hip muscle strength, Robot-assisted rehabilitation     

持续性根尖周炎中粪肠球菌临床株的分离与鉴定

目的 优化持续性根尖周炎优势菌粪肠球菌临床株的分离、培养、鉴定方法,分离获得粪肠球菌临床菌株.方法 选择30例持续性根尖周炎患者,严格无菌行根尖手术,从切除的根尖及根尖周病变组织中分离培养粪肠球菌临床株,通过形态学观察、生化鉴定及16SrRNA基因扩增测序分析特异性片段扩增方法进行鉴定,获得粪肠球菌菌株.结果 临床样本中培养出乳白色、边缘光滑、隆起的菌落、革兰氏染色阳性的球菌17例,生化检测该菌株耐低温、高温、盐、碱特性及糖代谢特点符合粪肠球菌生化特点,16SrRNA基因扩增测序,经过与NCBI数据库比对,与粪肠球菌致病菌16SrRNA基因序列相似度近99％菌株15例,特异性引物扩增可得到目标条带菌株15例.结论 从30例持续性根尖周炎中分离获得粪肠球菌临床株15株.     

援非抗击埃博拉现场消毒使用含氯消毒剂对工作人员的不良反应

目的了解现场使用含氯消毒剂对工作人员造成的不良反应,为采取有效防护措施提供依据。方法通过问卷调查方式,对援非抗击埃博拉医疗队队员受含氯消毒剂不良影响的情况进行了调查与分析。结果参与调查的援非医疗队28名队员对现场消毒使用的含氯消毒剂均有不同程度的不良反应,以刺激性反应最为明显,流泪、头痛、咳嗽和流鼻涕等症状发生率依次为85.71%、71.43%、67.86%和46.43%;恶心和咽部异物感发生率分别为39.29%和39.29%。结论传染病疫源地现场消毒用含氯消毒剂对直接接触和间接接触的人员均有不同程度的不良反应,使用浓度越高反应越强烈,亟待研究低毒刺激性小的高效消毒剂。