形状记忆合金环抱接骨板治疗锁骨骨折

目的 探讨形状记忆合金环抱接骨板治疗锁骨骨折的手术方法及疗效。方法 采用西脉记忆合金环抱接骨板治疗锁骨骨折54例。结果 54例病人全部获得随访，优良率96.3％。结论 形状记忆合金环抱接骨板治疗锁骨骨折是一种方便有效的方法，具有手术操作简便、内固定确实等优点，但应加强术后管理。     

神经生长因子基因转染联合强化铁营养防治豚鼠爆震性聋的实验研究

Objective To study the protective effects of adenovirus-mediated human beta-nerve growth factor gene (hNGFβ) transfer combined with iron fortified nutrition on blast hearing damage in guinea pigs. Methods Deafness was induced by blast (172dB SPL) in 35 healthy guinea pigs. Seven days after noise exposure, 10 guinea pigs were inoculated with adenovirus-mediated hNGFβ (Ad-hNGFβ) into the perilymphatic space (the gene group), another 10 guinea pigs were given hNGFβ combined with iron fortified nutritional diet (the combination group), still another 10 guinea pigs were inoculated with artificial perilymphatic fluid (APF), and 5 guinea pigs served as control, given neither medicine nor noise exposure. Auditory brainstem response (ABR) threshold shifts were monitored in the guinea pigs before blast exposure and after gene transfer. Changes in cochlear morphology were examined with immunohistochemical and HE staining. Results One week after successful inoculation of hNGFβ, it was noted that Ad-hNGFβ protein was expressed in each turn of the cochlea, and its intensity was almost equal. After gene transfer in the combination group and the gene group, ABR threshold shifts at week 1 and 4 were significantly smaller than those of the APF group. HE staining showed that the number of the spiral ganglion cells in the combination group and the Ad-hNGFβ group was significantly higher than that of the control group after 4 weeks (P<0.01). Conclusions Ad-hNGFβ combined with iron fortified nutritional diet was effective in the prevention and treatment of blast hearing damage of cochlear hair cells.     

小鼠匹鲁卡品致后海马活化素A、抑制素A蛋白及活化素ⅡA受体mRNA的差异表达

目的 :观察癫持续状态 (SE)后小鼠海马活化素A、抑制素A蛋白及活化素ⅡA受体mRNA表达的变化。方法 :采用匹鲁卡品诱导的SE小鼠模型 ,分别应用Westernblot与RT PCR观察SE后活化素A与抑制素A蛋白及活化素ⅡA受体mRNA表达的动态变化。结果 :①活化素A蛋白于SE后 3h开始增高 ,6h显著增高 ,2 4h至高峰 ,48h仍维持在较高水平 ;而未成SE的小鼠活化素A表达无明显变化。②抑制素A蛋白SE后无明显增加 ,同正常小鼠及未成SE的小鼠比较无显著差异。③活化素ⅡA受体mRNA在SE后表达无明显变化。结论 :SE后海马活化素A、抑制素A蛋白及活化素ⅡA受体mRNA表达存在差异性 ;活化素A可能对性脑损伤的保护与修复具有重要作用。     

王霞芳治疗小儿泄泻的经验

小儿泄泻的病因病机因其自身稚阴稚阳的生理特点而较成人为多发,泄泻久甚,易耗伤气液,甚至出现伤阴伤阳的重证、变证。故要重视及时正确地治疗,以防产生危候。王霞芳老师治疗小儿泄泻首先注重审证求因,在精确辨证基础上立法选方而施治,并在病变过程中法随症变,灵活化裁,刻刻护卫脾气胃津,斡旋脾胃气机,重视清浊升降枢机作用。尝用葛根、扁豆衣、荷叶等轻灵升清之品,宣发清阳,泄泻自和。对屡治不愈、迁延日久者,王师认为应辨证细致,选药精到,且又及时而适当地参入止涩药物。固肠止涩法之运用,必须具备苔净,腹软,溲通,无表证和里积等条件,方为合宜。     

寡克隆区带及IgG指数在多发性硬化中的临床意义

目的研究寡克隆区带（OCB）和IgG指数在多发性硬化（MS）中的临床意义。方法收集MS患者54例和其他神经系统疾病（OND）患者271例,包括中枢神经系统感染性疾病62例及非感染性疾病209例的脑脊液和血清标本,分别进行OCB检测（聚丙烯酰胺凝胶电泳）和IgG指数的计算（免疫火箭电泳法）。结果MS组OCB阳性率为35.2%;OND组为8.9%,其中感染组为24.2%,非感染组为4.5%。MS与OND组整体比较OCB阳性率有显著性差异（P〈0.05）,但与感染组相比无显著性差异（P〉0.05）。MS组IgG指数阳性率为83.3%,OND组为78.2%（P〉0.05）。结论OCB对MS有一定的辅助诊断价值,但需除外CNS感染性疾病。IgG指数阳性可作为参考。     

Mental state,physical strength,intelligent cycle and their relationship with epilepsy

Patientsfeelimpatientbecausetheycouldnotpredicttheonsettimeofepilepsy．Ifonsettimeofepilepsycouldbepreciselypredicted，thendrugadministrationanddisabilityofpreventionwillbecomeavailable．In１８７９，Echevarrzafoundonsettimeofepilepsyisdistributedaccordingtosomerules．Inrecentyears，scientistsperformalotstudiesinvolvingcytologyandmolecularbiologyofepilepsy．Clinicaldataindicatedonsetofepilepsyhascloserelationwithbiologicalrhythmsuchasawakeandsleepcycleandmenstrualcycle．Theobjectiveofthisstudy…     

脑电双频指数指导老年病人异丙酚麻醉诱导用量

[目的]通过监测老年病人麻醉诱导时脑电双频指数(BIS)的变化,探讨既能维持足够麻醉深度又能避免严重低血压的异丙酚诱导用量。[方法]40例ASA II～I级的老年病人(65～85岁),随机分成两组。A组静脉注射异丙酚1.6 mg/kg;B组静脉注射异丙酚,其用量是使BIS下降到40～50时的用量。两组均复合维库溴铵0.1 mg/kg和瑞芬太尼1ug/kg诱导后行气管插管分别记录基础值、插管前、插管后1 min、5 min和10 min时的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR),同时记录诱导异丙酚用药量和BIS的变化。[结果]A组异丙酚诱导用药量(99.7±18.05)mg,平均(1.64±0.7)mg/kg,B组(82.9±12.5)mg,平均(1.35±0.5)mg/kg,差异有统计学意义(P﹤0.05)。A组血压(BP)和BIS比B组明显降低。[结论]老年病人异丙酚麻醉诱导的合适用量为(1.35±0.5)mg/kg;既能维持老年人足够的麻醉深度又能避免严重低血压的发生。     

橄榄油对单核吞噬细胞系统的影响

本文采用橄榄油皮下注射、观察其对小鼠腹腔单核吞噬细胞的游出、活化及吞噬功能。结果发现、橄榄油对上述功能均有明显的抑制作。     

Conditional estimation of sensitivity and specificity from a phase 2 biomarker study allowing early termination for futility

Development of a disease screening biomarker involves several phases. In phase 2 its sensitivity and specificity is compared with established thresholds for minimally acceptable performance. Since we anticipate that most candidate markers will not prove to be useful and availability of specimens and funding is limited, early termination of a study is appropriate, if accumulating data indicate that the marker is inadequate. Yet, for markers that complete phase 2, we seek estimates of sensitivity and specificity to proceed with the design of subsequent phase 3 studies. We suggest early stopping criteria and estimation procedures that adjust for bias caused by the early termination option. An important aspect of our approach is to focus on properties of estimates conditional on reaching full study enrollment. We propose the conditional‐UMVUE and contrast it with other estimates, including naïve estimators, the well‐studied unconditional‐UMVUE and the mean and median Whitehead‐adjusted estimators. The conditional‐UMVUE appears to be a very good choice. Copyright © 2008 John Wiley & Sons, Ltd.     

高浓度瘦素自分泌诱导脂肪细胞瘦素抵抗的研究

目的:观察高浓度瘦素对人脂肪细胞分解代谢及脂肪蓄积的直接影响,探讨瘦素自分泌调节在肥胖发生中的作用。方法:取正常成人皮下脂肪组织,常规提取和培养前脂肪细胞,待细胞融合后诱导分化为脂肪细胞后分为二组:低浓度组、高浓度组;分别培养于瘦素终浓度为100ng/ml、1000ng/ml的培养液a中。于培养48h、72h收集培养液检测游离脂肪酸和甘油的浓度,取脂肪细胞行油红O染色并图像分析计算脂肪细胞中脂肪颗粒的积分光密度。结果:与低浓度组相比,瘦素作用48h、72h后,高浓度组培养液中游离脂肪酸浓度均下降[(0.16711±0.011900)mmol/L VS(0.20589±0.008738)mmol/L,(0.17544±0.013920)mmol/L VS(0.23567±0.026220)mmol/L,甘油含量均减少(28.1733±0.91377)μmol/L VS(30.2456±0.30084)μmol/L,(28.9367±0.79530)μmol/L VS(31.8567±0.79024)μmol/L],而脂肪颗粒积分光密度则升高(461136.89±12049.947 VS418570.33±5668.129,441566.56±5921.602 VS 390133.67±7001.304)。结论:高浓度瘦素长时程作用脂肪细胞,可延缓脂肪分解代谢,增加脂肪蓄积。高浓度瘦素经自分泌诱导脂肪细胞产生瘦素抵抗,可能对肥胖发生有重要影响。