应用多元回归分析影响全膝关节置换术后膝关节活动度的相关因素

目的:全膝关节置换手术后患者的满意度很大程度上取决于膝关节疼痛的缓解程度以及关节的最大活动度。对87例接受全膝关节表面置换患者进行客观效果评定并分析影响术后膝关节活动度的相关因素。方法:①对象和材料:选择2005-06/2007-05解放军总医院骨科手术的全膝关节置换患者87例102膝。其中男8例9膝,女79例93膝,年龄46-78岁,平均67.3岁。TACK假体和GeminiII假体51个(Link公司)、LPS后稳定型膝假体17个(Zimmer公司)、后叉保留型及后稳定型膝假体23个(Stryker公司)、后叉保留型假体11个(北京京航公司)。②干预和评估:患者均行全膝关节置换术。采用美国纽约特种外科医院的膝关节评分标准(HSS)对膝关节进行疗效评价;使用多元回归方法对可能影响术后膝关节活动度的因素(包括年龄、体质量指数、屈曲挛缩、内外翻畸形、术前的活动度、出院时的活动度、术前的膝关节HSS评分)进行分析。结果:所有患者均获得1年以上的随访。①膝关节HSS评分:平均为87.5分。优良率90.8%,较术前明显改善(P<0.01)。②多元回归分析:显示出院时患者膝关节的活动度同术后1年的膝关节活动度有关(P<0.01)。③随访结果:所有患者都未发生深部感染、假体松动或骨溶解等远期不良的生物相容性反应。结论:出院时患者膝关节的活动度同术后1年的膝关节活动度有关。术后早期功能训练,有利于最大限度地提高置换术后全膝关节活动度。     

雷公藤叶中二萜化合物的研究

从雷公藤(Tripterygium wilfordii)叶中分离出九个二萜化合物,经物理常数测定、化学反应、以及波谱数据分析,分别鉴定为雷公藤内酯酮(triptonide,1)、雷公藤内酯醇(triptolide,2)、雷公藤内酯二醇(tripdiolide,3);雷醇内酯(triptolidenol,4)、16-羟基雷公藤内酯醇(16-hydroxytriptolide,5)、雷公藤氯内酯醇(tripehlorolide,6)、雷藤内酯三醇(triptriolide,7),以及新化合物雷公藤内酯二醇酮(tripdiotolnide,8)和13,14-环氧9,11,12-三羟雷公藤内酯(13,14-epoxide 9,11,12-trihydroxytriptolide,9)。新化合物的生物活性正在研究。     

Serum-mediated inhibition of the interferon-gamma-induced HLA-DR expression on monocytes in patients with psoriasis

Psoriatic patients have a decreased proportion of monocytes expressing class II major histocompatibility complex antigens (DR+ monocytes) in their peripheral blood. The expression of the DR antigen on monocytes after culture in the presence of either autologous lymphocytes (endogenous interferon-gamma, IFN-gamma) or exogenous IFN-gamma was investigated. In normal AB serum the lymphocytes of the majority of the patients showed a spontaneous IFN-gamma production which was sufficient for DR antigen induction, while the monocytes displayed approximate normal susceptibility to exogenous IFN-gamma as judged by DR antigen expression. However, the sera of psoriatic patients contained one or more factors that interfered with the IFN-gamma-mediated DR antigen expression on cultured monocytes of the same patients. Restoration of IFN-gamma-induced DR antigen expression on monocytes in the presence of the patient's sera was achieved by the addition of superoxide dismutase, 2-mercaptoethanol, or indomethacin. The clinical significance of these observations is discussed.     

Different human papillomavirus 16/18 infection in Chinese non-small cell lung cancer patients living in Wuhan, China

BACKGROUND: Inconsistency in the prevalence of infection by human papillomavirus (HPV) in lung cancer patients was found between different countries with racial and geographic variations. Our previous reports have indicated that a high-risk HPV 16/18 DNA was frequently detected in Chinese lung cancer patients living in Taichung, Taiwan (Cheng et al. Cancer Res. 2001;61:2799-803). Thus, we conducted this study to verify whether there was a similar HPV 16/18 infection prevalence in lung cancer patients from Wuhan, China. METHODS: To reduce the false positive HPV detection, the paraffin sections of 73 lung tumors and 34 non-cancer controls from Wuhan, China were collected for detection of the presence of HPV 16/18 DNA by in situ hybridization (ISH). RESULTS: Our results showed that the rates of HPV 16 and/or 18 infections in patients with lung tumors were significantly higher than in 34 non-cancer control subjects (26.0 versus 2.8% for HPV 16, P = 0.030; 23.3 versus 5.7% for HPV 18, P = 0.031; 27.7 versus 5.9% for HPV 16 or 18, P = 0.003) with a similar infection frequency of HPV 16 and 18 types in lung tumors. This result indicated that HPV 16/18 infection may be associated with lung cancer development in Chinese patients from Wuhan, China. Further statistical analyses revealed that HPV 16 or 18 infection was not correlated with any clinico-pathological parameter studied, including age, gender, smoking status, tumor type, tumor stage and tumor grades. Interestingly, smoking and male patients had a higher prevalence of HPV 16, although not reaching a statistical significance, compared with non-smoking and female patients, respectively (33.3% for smokers versus 20.0% non-smokers; 33.3% for male versus 17.6% for female). As compared with the HPV 16/18 infection in Taiwan, Chinese patients with lung cancer from Wuhan had a different HPV 16/18 infection prevalence. CONCLUSION: Difference in HPV 16/18 infection in lung cancer patients from Wuhan, China and Taichung, Taiwan suggests that HPV 16/18 might play a different role in lung cancer development among Chinese living in different areas.     

伯氨喹在乙醇—水混合溶剂中离解常数的测定及其与维生素C的配合比研究

本文推导出用pH滴定法测定三元弱酸离解解常数的方程,测得25±0.01℃时,伯氨喹在乙醇—水的体积比为1:1的混合溶剂中,离子强度范围5×10~(-3)～5×10~(-2)mol/L时逐级离解常数为Ka_1=(3.84±2.35)×10~(-2)(归属于仲铵基),Ka_2=(1.50±1.17)×10~(-8)(归属于叔铵基),Ka_3=(2.07±0.27)×10~(-10)(归属于伯铵基)。并用pH法及电导法测得伯氨喹与维生素C在上述溶剂中的配合比为1:1。     

角膜内皮炎的内皮细胞测量分析

目的研究角膜内皮炎角膜内皮细胞的变化。方法用角膜内皮镜检查角膜内皮炎患眼的角膜内皮细胞,分析内皮细胞密度和形态的改变。结果角膜内皮镜检查26只患眼,显示内皮细胞密度降低,细胞异形性比率增高。其中10只眼在抗病毒治愈后随访期间无复发,角膜内皮细胞密度未见进一步下降。结论单纯疱疹病毒是角膜内皮炎的主要感染源,可引起角膜内皮细胞的破坏。     

Organic hypoglycemia of pancreatic cause

Insulinomas represent the most common cause of organic hypoglycemia. They are rare tumors: a review of the world literature reported a total number of 2000-3000 cases. The clinical diagnosis is based on the Whipple triad, which consists of: a) symptoms of hypoglycemia, b) blood glucose level: 40-50 mg/dl during the crisis, c) relief of symptoms after oral or intravenous administration of glucose. The most ticklish problem is the settlement of the accurate location of the tumor. Nowadays, there are many diagnostic methods; one of the best appears to be intra-operative ultrasonography. The authors analyse a series of 16 patients, operated between 1985 and 2002 in "I. Juvara" Surgical Clinic and present their opinions concerning tactic and technical aspects of different surgical procedures, with their advantages and limits. The results of the surgical treatment are detailed. There are also mentioned new imagery techniques and laparoscopic procedures, from recent medical issues.