老年正常人与老年骨质疏松症患者下颌角骨密度的比较研究

目的：观察老年正常人与老年骨质疏松症患者下颌骨骨密度的差别。方法：采用双能Ｘ线吸收测量仪（ＤＸＡ，骨密度仪），测量右侧髋部与左侧下颌角的骨矿物密度。结果：老年原发型骨质疏松症患者与老年正常人相比具有较低的下颌角骨密度。结论：骨质疏松症可导致下颌骨骨密度降低；下颌骨骨密度降低也可在一定程度上反映全身骨质疏松的状况；用这种骨密度仪测量下颌角的骨密度具有可行性和实用性，所测结果能反映下颌骨的骨密度变化。     

体外LPS诱导血管内皮细胞通透性改变及其与连接蛋白43的关系

目的研究缝隙连接蛋白(connexin,Cx)43在脂多糖(lipopolysaccharide,LPS)诱导的大鼠血管内皮细胞(vascular endothelial cell,VEC)通透性中的表达变化及其意义。方法以1、2、3、4μg/ml LPS刺激原代培养的大鼠VEC,观察作用15、30 min,1、2、3、4、5、6、7 h后VEC增殖活力和通透性的变化;2μg/ml LPS刺激VEC后,采用RT-PCR和Western blot等方法检测Cx43的表达变化;分析VEC通透性和Cx43表达之间的相关性。结果 1、2μg/ml的LPS对VEC增殖活力无明显影响,3、4μg/ml的LPS明显降低了VEC的增殖(P<0.01);2μg/ml的LPS能够较好地模拟脓毒性休克的血管高通透性(P<0.01);用此浓度的LPS刺激VEC后Cx43的mRNA和蛋白表达均逐渐降低(P<0.01);Cx43的表达与LPS引起的VEC通透性改变呈负相关关系(r=-0.877,P<0.01)。结论 Cx43可能参与了脓毒性休克后VEC通透性的调节;Cx43可能具有抑制脓毒性休克后血管内膜通透性的作用。[关键词]脓毒性休...     

绵阳市城区行政事业人员乙型肝炎病毒感染调查分析

目的了解绵阳城区行政事业人员乙型肝炎病毒的感染情况。方法对来院体检的4743人用ELISA方法检测乙肝两对半:即表面抗原(HBsAg)、表面抗体(HBsAb)、E抗原(HBeAg)、E抗体(HBeAb)、核心抗体(抗HBc)。结果HBsAg阳性率7.59%,30岁以下年龄组乙型肝炎感染率2.96%,31岁～60岁年龄组感染率8.65%,大于60岁年龄组,阳性率7.47%。而感染模式大三阳(HBsAg、HBeAg、抗HBc阳性)占5.6%,小三阳(HBsAg、HBeAb、抗HBc阳性)占78.9%,其他模式占15.5%。结论绵阳城区乙型肝炎感染率低于全国水平,感染模式以小三阳为主。     

The Treatment of Mid-shaft Clavicle Fractures

Objective:

Through reviewing the relevant literature from the past decades, to summarize the assessment and management of fractures of the clavicle, and provide an overview of the clinical results of a range of treatment options.

Data Sources:

The data analyzed in this review are mainly from articles included in PubMed and EMBASE, published from 1960 to 2015.

Study Selection:

Studies involving assessment of fractures of the clavicle were reviewed. Further literatures were gathered regarding the conservative and surgical treatment of these fractures, including the methods of fixation and the surgical approaches used. Both conservative and surgical treatments were then compared and contrasted.

Results:

Through retrieving and reading the abstract, a total of 42 representative articles were selected, which covered all aspects of the conservative treatment and surgical treatment, and compared the advantages and disadvantages of different treatment options.

Conclusions:

Although the majority of recent data suggest that surgery may be more appropriate as it improves functional outcome and reduces the risk of complications, we recommend that the treatment should be individually assessed.     

膝关节半月板Ramp损伤的研究进展

Ramp损伤是膝关节半月板常见损伤,发病率较高,且因为临床表现不典型而不易诊断,目前其最有效的诊断方式是关节镜下探查。Ramp损伤的治疗以手术为主,以重建半月板的稳定性、维持膝关节活动、解除疼痛、恢复关节运动水平、降低关节病风险为目的,手术预后总体良好。本文对Ramp损伤从解剖学、流行病学、生物力学、诊断及治疗方案等方面进行综述,为临床Ramp损伤的诊治提供参考。     

下咽异物致颈深部脓肿的诊治

目的探讨下咽异物迁移致颈深部脓肿的诊治方法。方法对下咽异物迁移至颈部致颈深部脓肿5例病人的临床资料进行分析。结果 5例病人经颈侧切开探查术全部治愈。结论在诊治下咽迁移性异物所致的颈深部脓肿时,应重视影像学的应用,治疗应在全麻下行颈侧切开探查术。     

The Effect of TanshinoneⅡ A upon the TGF-betal/Smads Signaling Pathway in Hypertrophic Myocardium of Hypertensive Rats

To investigate the molecular mechanism by which Tanshinone Ⅱ A （TSN Ⅱ A） prevents left ventricular hypertrophy （LVH）, we examined the expression of AT1R, TGF-β1 and Smads gene in the hypertrophic myocardium of hypertensive rats with abdominal aorta constriction. LVH model was established by creating abdominal aorta constriction. Four weeks later, animals were randomly divided into 4 groups with 8 animals in each. One group was used as model control, the other three groups were treated with TSN ⅡA （20 mg/kg）, TSN ⅡA （10 mg/kg） and valsartan （10 mg/kg）, respectively. Another 8 SD rats were subjected to sham surgery and served as blank control. After 8- week treatment, the caudal artery pressure of the animals was measured. The tissues of left ventricle were taken for the measurement of the left ventricular mass index （LVMI） and pathological sectioning and HE-staining were used for determining the myocardial fiber dimension （MFD）. The mRNA expression of AT1R, protein expression of TGF-betal and activity of Smad-2, 4, 7 were detected by RT-PCR and Western blotting, respectively. Our results showed that （1） the blood pressure of rats treated with TSN Ⅱ A, either at high or low dose, was significantly higher than those in the control and valsartan-treated group （P〈0.01, P〈0.05）; （2） LVMI and MFD in TSN Ⅱ A and valsartan-treated rats were higher than those in the control group （P〈0.05） but significantly lower than those in the model control （P〈0.01）; （3） the high doses of TSN Ⅱ A and valsartan significantly down-regulated the mRNA expression of AT 1R and protein expression of TGF-beta l and Smad-3 in the hypertrophic myocardium （P〈0.01）, and TGF-betal in valsartan-treated animals was more significantly lower than that in rats treated with TSN Ⅱ A; （4） the two doses of TSN Ⅱ A and valsartan significantly up-regulated the protein expression of Smad-7 in the hypertrophic myocardium （P〈0.01）, and Smad-7 in the animals treated with high-dose TSN Ⅱ A was significantly higher than that in rats treated with valsartan. It is concluded that inhibition of myocardial hypertrophy induced by TSN ⅡA independent of blood pressure. The underlying mechanism might be the down-regulated expression of AT1R mRNA and Smad-3, increased production of Smad-7, and blocking effect of TSN Ⅱ A on TGF betal/Smads signal pathway in local myocardium.     

中心医院医疗质量环节管理中影响因素分析

目的探讨中心医院在环节质量管理中的影响因素。方法将某院2004年～2008年出院病案随机抽查2612份,其中丙级病案98份,占3.75%。结论抓住环节质量管理的质控点,把缺陷病案控制在最低限度。     

人参皂甙Rh2诱导黑色素瘤细胞树突生成的机制研究

目的 探讨人参皂甙Rh2诱导黑色素瘤细胞树突生成的机制.方法 在培养的B16黑色素瘤细胞中加入Rh2,记录其诱导细胞树突生成的时间及细胞数.加入甲基-β-环糊精预处理清除胆固醇后,再次观察对Rh2诱导细胞树突生成的影响.用荧光偏振测量仪检测Rh2对反映膜流动性的DPH(1,6-二苯基1,3,5-已三烯)及TMA-DPH(1-[4-(三甲铵)苯基]-6-苯基1,3,5-已三烯)两种荧光探针的影响.结果 在B16黑色素瘤细胞中,Rh2(18.5 μmol/L)在2h内诱导了树突的生成,而用10 mmol/L的甲基-β-环糊精预处理清除胆固醇后即可抑制Rh2的这种作用.加入Rh2后2min内,Rh2即改变了DPH的荧光偏振,但对TMA- DPH却没有影响.结论 Rh2影响了胆固醇调节的膜脂质双层的生理特性,从而可能进一步导致细胞功能的改变.     

浙江中医学术流派的启迪

[目的]研究浙江中医学术流派对当今中医的启迪意义.[方法]以浙江中医学术流派的代表医家为研究对象,分析中医学术流派形成的条件及对中医学术发展的推动作用.[结果]各派医家通过学术创新促进中医学发展,在解决临床难题时推动医学进步;强调理论与临床缺一不可,在理论的指导下,运用自己独特的招数取得理想的疗效;虚怀若谷,善于学习他人经验,不断丰富完善自己;始终把患者的利益放在首位,推行仁心仁术.[结论]浙江中医学术流派纷呈,然其形成却需具备众多条件,值得借鉴.