腘绳肌腱重建前交叉韧带移植肌腱的固定

目的:腘绳肌腱重建前交叉韧带曾出现过多种固定器材,分析近年来关于腘绳肌腱重建前交叉韧带的文献资料,了解肌腱固定方式的发展趋势。资料来源:通过计算机检索Medline1995-01/2006-09有关腘绳肌腱重建前交叉韧带移植肌腱固定方式的文献,检索词为“anteriorcruciate ligament,reconstruction,hamstring”,限定文章语言种类为English;另外检索中文期刊全文数据库2000-01/2006-03有关腘绳肌腱重建前交叉韧带移植肌腱固定方式的文献,检索词为“前交叉韧带,重建术,腘绳肌腱”,限定文章语言种类为中文。资料选择:选取有关腘绳肌腱重建前交叉韧带的文章,纳入标准:①随机或自身前后对照的临床研究。②观点明确。③有关于固定方式的评论。排除标准:①综述。②重复性研究。资料提炼:共检索到60篇关于腘绳肌腱重建前交叉韧带的文章,选择其中符合标准的33篇进行综合分析。资料综合:固定方式经历了一个由皮质骨外固定到骨隧道内固定的演变过程,Transfix是目前较为理想的固定方式,肌腱结嵌压固定是最新出现的一种固定方式,其临床效果尚需进一步验证。在固定位置的选择上,多数学者认为应该遵循等距重建。通过对固定方式的比较发现,隧道内固定能减轻术后骨隧道的扩大程度。结论:腘绳肌腱重建前交叉韧带的固定方法越来越趋于隧道内固定,并朝着利于腱骨愈合、减轻骨隧道扩大的方向发展。在固定位置的选择上,学者们尚无统一的意见,其趋势可能是向解剖固定发展。     

缺血性脑损伤诱导内源性神经干细胞的增殖和迁移

目的:观察缺血性脑损伤对内源性神经干细胞增殖、迁移的影响。方法:实验于2004-09/2005-03在新乡医学院人体解剖与组织胚胎重点实验室进行。10～12周体质量300～350g的健康雄性SD大鼠62只,由新乡医学院实验动物中心提供。按随机数字表方法将其分为正常组6只、假手术对照组14只、脑缺血再灌注组42只(分为再灌注1,3,5,7,10,15,20d7个时间点,每时间点6只)。参照Pulsinelli-Brierley法,夹闭大鼠双侧颈总动脉制作短暂性全脑缺血动物模型,全脑缺血10min后再灌注,假手术对照组不夹闭颈总动脉。于脑缺血再灌注不同时间点应用SABC免疫组化法染色显示5-溴-2-脱氧尿嘧啶阳性细胞和巢蛋白阳性细胞,光镜下观察并分析脑缺血损伤后内源性神经干细胞增殖、迁移的变化过程。结果:正常组、假手术对照组大鼠均存活,脑缺血再灌注组大鼠1d、5d、15d、20d各死亡1只,共58只大鼠进入结果分析。①正常组与假手术对照组室管膜下区、海马CA1区、齿状回区域均偶见5-溴-2-脱氧尿嘧啶阳性细胞和巢蛋白阳性细胞。②脑缺血再灌注后1d于海马、齿状回和室管膜下区均有5-溴-2-脱氧尿嘧啶阳性细胞和巢蛋白阳性细胞,随后逐渐增加,7～10d达高峰,术后20d仍有表达;在室管膜下区的5-溴-2-脱氧尿嘧啶阳性细胞和巢蛋白阳性细胞有向皮质、海马迁移的现象。结论:成年大鼠全脑缺血后7～10d内源性神经干细胞增殖达到高峰;增殖的内源性神经干细胞存在由增殖区向靶区迁移的现象。     

原代培养鼠胚脊髓运动神经元活力状态与肌萎灵注射液的干预作用

目的:从细胞水平,观察扶元起萎,养荣生肌的中药制剂肌萎灵注射液对原代培养鼠胚脊髓运动神经元的保护作用。方法:实验于2004-03/2005-03在解放军第三军医大学完成。实验分组:清洁级SD雌性孕鼠,孕期10～14d。应用密度梯度离心法分离鼠胚脊髓运动神经元进行原代培养,运动神经元培养72h后,按培养板及孔分为4.5μg/L肌萎灵组(肌萎灵注射液,含生药0.9g/mL)、9μg/L肌萎灵组、45μg/L肌萎灵组、力如太组(力如太R利鲁唑片,应用时经0.9%NaCl-0.01NHCl溶解)和对照组。实验处理:各组分别加入用新鲜培养基稀释为0.5%(终浓度4.5μg/L)、1%(终浓度9μg/L)、5%(终浓度45μg/L)的肌萎灵注射液,力如太组加入利鲁唑(终浓度10μmo/L),对照组加入等量新鲜培养基。实验评估:①共同培养3d用四甲基偶氮唑盐法观察其对细胞活力的影响,以吸光度表示。②采用NF-200免疫组织化学染色并进行图像分析,测定神经突起主干长度。结果:①培养的运动神经元活力状态比较:4.5,9,45μg/L肌萎灵组培养运动神经元活力显著增强,与对照组相比,差异有显著性意义(0.317±0.054,0.396±0.087,0.329±0.097,0.230±0.130,P<0.05)。力如太组细胞生长与对照组相比无显著差异(0.266±0.141,0.230±0.130,P>0.05)。②脊髓运动神经元突起生长情况结果:4.5μg/L肌萎灵组和9μg/L肌萎灵组可促进其生长,与对照组相比,差异有显著性意义[(315.96±32.32),(373.46±80.24),(159.71±48.95)μm,P<0.05]。结论:肌萎灵注射液可增强运动神经元活力,促进脊髓运动神经元突起的生长。     

上海市0～6岁小儿佝偻病的现状调查

目的:了解上海市小儿佝偻病的现状及影响因素。方法:2005年春季以整群和分层随机抽样法抽取上海市部分城区0～6岁小儿821名,采取问卷调查方法了解小儿的生活环境、饮食习惯、户外活动、营养状况、既往疾病史及母亲的妊娠情况等。佝偻病的诊断以1996年国家卫生部颁布的"婴幼儿佝偻病防治方案"为诊断标准。结果:取得完整有效资料769名,其中男童396名,女童373名;集居儿童456名,散居儿童313名。①小儿佝偻病患病率为17.3%(133/769),其中男童患病率为17.4%、女童为17.2%。②佝偻病与喂养方式(母乳喂养的患病率为13.0%、混合喂养的患病率为17.5%、人工喂养的患病率为25.2%)、鱼肝油添加(按时添加维生素D的患病率为13.5%、偶加或未加维生素D的患病率为32.5%)、居住环境(居住在市区的患病率为23.6%、居住在郊区的患病率为10.6%;集居儿童患病率为13.8%、散居儿童患病率为22.4%)、户外活动时间(经常户外活动的患病率为12.9%、偶尔户外活动的患病率为31.8%)、反复呼吸道感染(小儿有反复呼吸道感染的患病率为26.9%、无反复呼吸道感染的患病率为12.9%)、母孕期缺钙(母孕期有缺钙的患病率为33.2%、无缺钙的患病率为12.0%)等因素有关(P<0.01)。结论:上海市小儿佝偻病患病率有上升趋势。影响因素与城市环境污染、母乳喂养减少、年轻父母科学育儿知识缺乏等有关。     

Mapping a gene defect in absorptive hypercalciuria to chromosome 1q23.3-q24

Absorptive hypercalciuria (AH), a common cause of kidney stones, is due to intestinal hyperabsorption of calcium. The presence of a family history of nephrolithiasis, in about half of the affected individuals studied indicates that an inherited genetic defect is one likely cause of AH. Although it is known that intestinal calcium absorption is regulated by a number of factors, the molecular biological basis for the increased calcium absorption in AH is unknown. This study was designed to determine the chromosomal locus of the gene defect linked to the AH phenotype in three families with a severe form of AH. Three kindreds were evaluated in a systematic autosomal genome-wide linkage analysis study. The AH phenotype, characterized by hyperabsorption of calcium and hypercalciuria, was linked to only one chromosomal locus, 1q23.3-q24. A 2-point logarithm of odds score of 3.3 was obtained with markers D1S318 and D1S196 at a recombination frequency of theta = 0. Nonparametric multipoint linkage analysis yielded a peak nonparametric linkage Z(all)-score of 12.7, P = 6 x 10(-6) Analysis of key recombinants within the families studied localized the gene to a 4.3-megabase region between markers D1S2681 (centromere) and D1S2815. A trait associated with intestinal hyperabsorption of calcium in a severe form of absorptive hypercalciuria has been mapped to chromosome 1q23.3-q24.     

Modern approaches to the treatment of breast cancer

Breast cancer is the most common cause of cancer death in women in this country. Until recently, the traditional treatment has been radical surgery with or without radiation therapy for patients with primary breast cancer, and palliative endocrine therapy followed by chemotherapy for patients with advanced disease. These treatments have met with limited effectiveness in terms of eradicating the disease. Studies in the past decade have given cause for optimism for breast cancer patients. Adjuvant systemic therapy after local treatment appears promising for certain subsets of patients with primary breast cancer. The development of estrogen receptor assays has markedly changed our approach to the disease and improved patient care. Estrogen receptor is an important prognostic factor and is useful in planning appropriate therapy for patients with primary breast cancer as well as those with advanced disease. Further research is urgently needed to improve the dismal survival of certain women with this common malignancy.     

高效液相色谱法测定血清中双氯芬酸浓度及在人体的药代动力学

建立了人血清中双氯芬酸的反相高效液相色谱测定方法。该法操作简便、精密度好、方法回收率为９８．２～１０２．５％，日内、日间ＲＳＤ为１．２９～４。５２％，血药浓度在０．２～１０μｇ／ｍｌ范围内呈线性关系，相关系数０；９９９９，当信噪比为２时，最低检测限为１０ｎｇ／ｍｌ。健康志愿者口服１００ｍｇ双氯芬酸肠溶衣片，药代动力学过程符合一室开放模型，消除半衰期为２．１５ｈ。     

非溶蚀型药物体系的释放动力学新模型──Fick第一扩散定律的修正及其应用

基于以下两点事实:Fick第一扩散定律中的扩散系数并非严格的常数,它随浓度变化;Fick第一扩散定律只适用于浓度梯度恒定的稳定扩散,而许多实验表明浓度梯度也是一个时间函数,本文对Fick第一扩散定律作出两点修正将原定律中浓度梯度和扩散系数分别修正为时间函数和浓度函数,从而导出关于非溶蚀型药物体系的释放动力学模型。该模型较其他常用释放模型有更好的拟合效果,其参数也有较为明确的物理意义。     

Interstitial hyperthermia in combination with brachytherapy

Flexible coaxial cables were modified to serve as microwave antennas operating at a frequency of 915 MHz. These antennas were inserted into nylon afterloading tubes that had been implanted in tumors using conventional interstitial implantation techniques for iridium-192 seed brachytherapy. The tumor volume was heated to 42-45 degrees C within 15 minutes and heating was continued for a total of 1 hour per treatment. Immediately following a conventional brachytherapy dose and removal of the iridium seeds the tumors were heated again in a second treatment. This interstitial technique for delivering local hyperthermia should be compatible with most brachytherapy methods. The technique has proved so far to be practical and without complications. Temperature distributions obtained in tissue phantoms and a patient are described.