雄激素对胸腺内雄激素和雌激素受体的影响

胸腺也是性激素发挥免疫调节作用的靶器官 ,雄激素可以通过胸腺上的多种激素受体来发挥作用。已报道胸腺细胞胞浆中存在雄激素受体 (ＡＲ)和雌激素受体 (ＥＲ) 〔1〕,且雄激素对免疫系统有抑制作用〔2〕,但雄激素对胸腺内性激素受体的影响还不清楚。因此 ,本实验旨在了解雄激素对胸腺内ＡＲ、ＥＲ的调节作用。一、材料和方法1.实验动物及分组 :4 0只 4周龄的ＳＤ大鼠分为正常对照组 (10只 ) ,低剂量、中剂量和高剂量组各 10只 ,按隔日腹腔分别注射 0 .1、0 .5、2 .5ｍｇ丙酸睾酮 (丙睾 )注射持续 2周时间 ,末次注射后 4 8ｈ采血并分离血清用…     

膝髋骨性关节炎患者血清中常见血脂含量的比较分析

[目的]探讨膝关节骨性关节炎(osteoarthritis,OA)患者血清中常见血脂的含量变化是否为肥胖引起膝关节OA提供新的理论依据。[方法]选取2011年8月²012年6月行全膝、髋关节置换术的OA患者188例。每位患者入院后第1 d早晨空腹抽静脉血5 ml后立即送至本院检验科检测血清甘油三酯(triglyceride,TG)、总胆固醇(total cholestrol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、载脂蛋白A1(apolipoprotein A1,apo A1)和载脂蛋白B(apolipoprotein B,apo B)的含量。[结果]膝、髋OA患者血清中TG、TC、HDL-C、LDL-C、apo A1及apo B含量无明显差异(P>0.05),行性别分层后仍无差异(P>0.05)。[结论]肥胖多造成膝关节OA可能并非通过影响脂质代谢实现的。     

关节镜下髌腱中1/3重建前交叉韧带手术取腱切口方向选择研究

目的:探讨关节镜下髌腱中1/3重建前交叉韧带手术中,横切口取腱和纵切口取腱的优缺点。方法:以2004年1月至2004年12月间行髌腱中1/3重建前交叉韧带手术病例64例为研究对象,其中横切口取腱32例,纵切口取腱32例,随访时间均超过1年。比较两种方法的手术时间、切口长度、疤痕面积、隐神经髌下支受损和膝关节功能恢复情况。结果:两种方向取腱患者膝关节活动度全部恢复正常,且二者之间无明显差异。横切口取腱手术平均时间较纵切口延长11分钟;横切口长度(5.0cm/m±0.25cm/m)显著短于纵切口(5.8cm/m±0.16cm/m),其疤痕面积(2.32cm2±1.75cm2)显著小于纵切口(7.05cm2±2.75cm2);横切口取腱患者无明显跪地痛表现;横切口取腱患者隐神经髌下支受损率为81.3%(26/32),而纵切口取腱患者为87.5%(28/32),二者无显著性差异。结论:关节镜下髌腱中1/3重建前交叉韧带,横切口取髌腱与纵切口相比,手术难度较大,但术后疤痕小。关节功能不因切口方向选择有任何影响。两种切口方向取腱,隐神经髌下支损伤发生率较高。     

青少年肩关节三角肌挛缩症一例报告

肌肉挛缩症多见于臀肌,胸锁乳突肌,发生于肩关节三角肌的挛缩相对罕见. 本院2008年3月收治青少年肩关节三角肌挛缩症1例.男,16岁,因发现左肩不能内收4年入院.     

低蛋白饮食对环孢素A肾病大鼠肾间质纤维化的作用

Objective To investigate whether low-protein diet has protective effect on the progression of renal interstitial fibrosis in rats with cyclosporine A (CsA)-induced nephropathy. Methods Eighteen male Sprague-Dawley rats were randomly divided into three groups (6 rats in each group). The rats in control group (C group) received common diet; in model group (M group) low-salt diet; in intervention group (Ⅰ group) low-salt and low-protein diet. After diet adaptation period of one week, the rats in C group received subcutaneous injection of olive oil 1 mg/kg daily for 5 weeks, while M group and Ⅰ group subcutaneous injection of CsA (diluted into 25 g/L with olive oil) 1 ml/kg for 5 weeks. All the rats were sacrificed at the end of the 5th week. The food-intake and body weight were measured daily. The creatinine clearance (Ccr) was examined before rats were sacrificed. The semi-quantitative pathological analysis on kidney sections was performed. The mRNA and protein expression of transforming growth factor-β1 (TGF-βI) and type Ⅰ collagen (Col Ⅰ) in kidney tissue was determined with real time PCR and immunohistochemical staining, respectively. Results The food-intake and body weight of rats in M and I groups were significantly lower than those in C group (P<0.05). Compared with C group, the Ccr levels in M and Ⅰ groups were significantly reduced [(0.65±0.15) ml/min, (0.40+0.13) ml/min vs (1.55±0.29) ml/min, P<0.05], the relative fibrosis areas of kidney interstitium in M and I groups were significantly increased (3.60%±0.46%, 3.26%±0.75% vs 0.44%±0.24%, P<0.05), the mRNA and protein expression of TGF-β1 in M and I group was significantly up-regulated (by 2.6 and 3.1 times in mRNA and by 1.5 and 1.6 times in protein, respectively, P<0.05), and the mRNA and protein expression of Col Ⅰ in M and I groups was also significantly up-regulated (by 3.0 and 3.5 times in mRNA and by 2.3 and 2.1 times in protein, respectively, P<0.05). There were no significant differences between M and I groups in every parameters above-mentioned except the rat body weight and Ccr. Both the body weight and Ccr in Ⅰ group were significantly lower than those in M group (P<0.05). Compared with C group, the urine osmotic pressure in M group and in I group were deceased (for M group, P>0.05; for I group, P<0.05). Compared with C group, the serum cholesterol levels in M and I groups were significantly increased (P<0.05), and the serum phosphorus level in I group was significantly decreased (P<0.05). The levels of serum albumin and serum calcium of all three groups had no statistical differences (P>0.05). Conclusion Low-protein diet has no renoprutective effects on the rat model of cyclosporin A nephropathy, on the contrary, may induce body weight loss.     

右膝外伤后关节内枣树皮残留一例报告

外伤后异物残留体内不少见，主要为火器伤，或者沙石、玻璃、金属类等残留。我院收治1例11岁患儿，从树上跌落后枣树皮刺破皮肤进入膝关节。     

髋关节置换术后骨水泥股骨假体断裂原因分析及处理

目的 探讨骨水泥股骨假体断裂的原因和处理方法.方法 自2003年3月至2009年3月,共收治8例国产骨水泥股骨假体断裂患者,男6例,女2例.断裂距初次关节置换手术时间为36～98个月,平均72个月;体重60～88 kg,平均75 kg.均无明确外伤史.分析断裂前、后X线片,观察原假体安放位置、断裂部位、骨水泥固定情况及有无假体周围骨折;对术中假体表面骨水泥覆盖情况及断裂假体取出要点进行同顾性分析.5例行股骨假体翻修手术,采用生物碰股骨假体同定.3例转诊.翻修术后3个月、6个月、1年定期复查,行X线及Harris评估.结果 4例初次置换假体内翻,1例外翻;5例假体偏小.断裂均位于假体中点至中、远1/3交界处,远端崮定牢固.4例断裂前X线片可见近端假体周围细透光线,1例假体周围骨折.近端假体取出容易,远端假体取出困难.4例行股骨开窗,1例行转子延展截骨.翻修病例随访12～80个月,平均48个月.开窗或截骨部化平均愈合时间3.5个月.无假体松动、下沉及感染.末次随访时Harris评分85～97分,平均92分.结论 骨水泥股骨假体断裂可能与骨水泥假体近、远端固定质量不一致有关.对假体断裂者应及早行翻修术,术中股骨开窗安全有效.     

慢性肾脏病患者应用免疫抑制剂发生巨细胞病毒感染的临床分析

目的通过分析慢性肾脏病患者应用免疫抑制剂后发生巨细胞病毒感染的临床特点,探讨慢性肾脏病患者如何防治巨细胞病毒感染。方法回顾性分析我院9例慢性肾脏病患者在应用免疫抑制剂治疗后,发生巨细胞病毒感染的临床表现,以及诊断和治疗方面的特点。结果 9例肾病患者均存在不同程度肾功能不全,均较大剂量应用了糖皮质激素,其中6例合用了吗替麦考酚酯、3例合用了环磷酰胺,巨细胞病毒感染发生在上述治疗的1～3月内,临床表现为肺炎5例,肝功能损害2例,血象三系减少2例。停用免疫抑制剂或减量,除1例外,均给予更昔洛韦抗病毒治疗,其中8例痊愈,1例因合并细菌和真菌感染死亡。结论对应用免疫抑制剂治疗的慢性肾脏病患者,尤其是肾功能不全的患者,应警惕合并巨细胞病毒感染的可能,如能及时诊断和治疗,多数患者预后较好。     

插入式AO/ASIF锁骨钩钢板治疗超重患者陈旧性肩锁关节脱位1例分析

插入式AO/ASIF锁骨钩钢板治疗肩锁关节脱位的方法,由于设计巧妙,符合人体生物力学,操作简单,效果可靠,已经广泛被临床医生应用,国内外都有大量的成功报道[1,2].笔者报告1例AO/ASIF锁骨钩钢板治疗陈旧性肩锁关节脱位,术后出现钢板弯曲压迫肩袖引起疼痛并发症的病例.     

KT2000定量分析单纯膝关节内侧副韧带损伤后关节稳定性变化

目的:评估内侧副韧带损伤后对膝关节前后稳定性的影响并介绍一种新的膝关节内侧副韧带损伤的诊断和疗效评价方法.方法:2003年1月～2008年1月,对收治的42例单纯膝关节内侧副韧带损伤患者,使用KT2000 Knee LdgamentArthrometer分别测量健患侧膝关节.得出其在15磅、20磅、30磅应力时胫骨股骨之间的移动距离,运用配对t-检验进行分析.结果:患侧与健侧在15磅、20磅时胫骨前移存在差异,差异有统计学意义(P<0.05),在30磅时胫骨的前移,15磅、20磅、30磅时胫骨后移均有非常显著差异,差异有统计学意义(P<0.01).结论:膝关节内侧副韧带损伤后膝关节前后稳定性有所降低,且KT2000作为一种新的辅助手段用于膝关节内侧副韧带损伤的诊断和疗效评价,方法简单.结果可靠.