颈前路钛网植骨融合术后钛网沉陷的原因探讨

目的：探讨颈前路钛网植骨融合术后钛网发生沉陷的原因及其对临床疗效的影响，并提出相应对策。方法：回顾性分析在我院行颈前路钛网植骨融合术的各类颈椎疾患患者179例，观察患者骨密度、钛网修剪及放置情况、终板处理情况、钢板类型、植骨及椎体撑开情况等。采用日本骨科学会（JOA）评分法评价神经功能的变化。结果：有17例患者发生钛网沉陷，沉陷的原因主要为骨密度下降、钛网修剪放置不当、术中过度撑开、终板刮除过多、使用非限制性钢板、采用同种异体骨植骨、螺钉进钉深度过浅和方向不当、钢板放置位置偏斜等。术后所有患者JOA评分比术前平均增加3．5分（P〈0．01）。162例未发生钛网下沉患者术后3个月和6个月的JOA评分比术前平均增加4．4分和4．7分：发生钛网下沉患者中。6例有临床症状者沉陷时和沉陷3个月时的JOA评分为2．9分和3．8分．7例无临床表现者为3．3分和3．9分．4例有临床症状行翻修手术者翻修术后1周和3个月时JOA评分比翻修前提高3．3分和3．7分。结论：颈前路钛网植骨融合术后可发生钛网下沉，骨质疏松患者应该避免使用钛网。手术时应尽可能增加钛网与终板接触面积，多保留相邻终板，选用限制性钢板，尽量选择自体骨植骨，避免椎间过度撑开等。防止术后钛网沉陷。     

膀胱癌肉瘤与肉瘤样癌诊治再讨论

目的：探讨膀胱癌肉瘤和肉瘤样癌的组织学特性、临床表现、治疗以及预后.方法：回顾性分析1例膀胱癌肉瘤及2例肉瘤样痛患者的临床、病理和随访资料,并复习相关文献进行讨论.结果：3例患者术后病理检查可见上皮源性和间质源性两种恶性成分.1例癌组织CK和EMA阳性,但Vimentin阴性,肉瘤样组织Vi-mentin阳性,诊断为膀胱癌肉瘤,术后给予M-VAC方案化疗,于10个月后死于肿瘤肺部转移.2例癌组织与肉瘤样区有移行,癌组织CK和EMA阳性,但Vimentin阴性,肉瘤样组织CK、EMA及Vimentin阳性,诊断为膀胱肉瘤样癌,术后分别给予GC和M-VAC方案化疗,于8个月和11个月后死于肿瘤肺部转移和心力衰竭.结论：膀胱癌肉瘤和肉瘤样癌具有浸润性生长的生物学特性,恶性程度高,预后不良.其确诊依赖病理学及免疫组织化学检查,手术仍是首选治疗方式.     

Effect of Cu Content on the Precipitation Behaviors,Mechanical and Corrosion Properties of As-Cast Ti-Cu Alloys

Ti-Cu alloys have broad application prospects in the biomedical field due to their excellent properties. The properties of Ti-Cu alloys are strongly dependent on Cu content, microstructures, its Ti₂Cu phase and its preparation process. The aim of this work is to investigate the effect of Cu content on the precipitation behaviors, mechanical and corrosion properties of the as-cast Ti-Cu alloys. The microstructures and phase evolution were characterized by SEM and TEM, and the properties were studied by tensile and electrochemical test. The results show that the volume fraction of Ti₂Cu phase increases with the increase of Cu content. The Ti₂Cu phase presents a variety of microscopic morphologies with different Cu content, such as rod, granular, lath and block shaped. The crystal orientation relationships between the Ti₂Cu and α-Ti matrix in Ti-4Cu and Ti-10Cu alloys are (103)_Ti2Cu//(0[11¯11)_α-Ti, [3¯01]_Ti2Cu//[21¯1¯0]_α-Ti, and (103)_Ti2Cu//(0002)_α-Ti, [3¯31]_Ti2Cu//[12¯10]_α-Ti, respectively. The tensile strength, Vickers hardness and Young’s modulus of the Ti-Cu alloys increase with the increase of Cu content, whereas the elongation decreases. The fracture morphologies of these alloys reveal ductile, ductile-brittle hybrid, and cleavage brittle mode, respectively. The corrosion resistance of the Ti-Cu alloys in SBF solution can be described as: Ti-4Cu alloy > Ti-10Cu alloy > Ti-7Cu alloy. The volume fraction of Ti₂Cu phases and the “protective barrier” provided by the fine lath Ti₂Cu phases strongly affected the electrochemical performances of the alloys.     

Diagnosis and treatment of small cell carcinoma of prostate and a review of literature

<正>Objective To evaluate term efficacy of focal cryoablation for localized single lesion prostate cancer and protection of erectile function. Methods From June 2008 to December 2009,12 patients with localized single lesion prostate cancer were treated with focal cryoabla-     

2型糖尿病患者肾动态显像的研究

目的通过肾动态显像探讨不同阶段2型糖尿病(DM)患者肾脏血流动力学的变化及肾功能受损情况。方法 69例2型DM患者根据尿白蛋白排泄率(UAER)分为DM1组、DM2组、DM3组,进行SPECT肾动态显像观察,并与30例正常对照(Nc)组比较。结果 DM1组肾小球滤过率(GFR)及肾有效血浆流量(ERPF)明显高于Nc组。DM2组GFR、ERPF与Nc组相比无显著性差异,但其肾功能曲线半排时间(t1/2)延长,20 m in残留率(C20)增高。DM3组GFR、ERPF明显下降,肾功能曲线峰时(tp)后延,t1/2明显延缓,C20显著增高。结论核素肾动态显像可早期了解2型DM各时相肾脏血流动力学的变化及肾功能受损程度,为临床DM治疗和随访提供可靠依据。     

Effect of trans-2,3-dimethoxycinnamoyl azide on enhancing antitumor activity of romidepsin on human bladder cancer

PURPOSE: Romidepsin (FK228, depsipeptide, FR901228), a unique cyclic depsipeptide with a histone deacetylase inhibitor (HDACI) activity, is a potential cancer therapeutic agent and currently under clinical trials for several types of cancer. For bladder cancer, romidepsin seems to be a potent antitumor agent from our recent study. In this study, we further delineate a new agent that can enhance both HDACI and antitumor activity of romidepsin. EXPERIMENTAL DESIGN: We screened a chemical library to identify candidate(s) that could enhance romidepsin activity. Chemical synthesis and purification were carried out to produce pure compound to examine its biochemical and antitumor effect on bladder cancer cell lines both in vitro and in vivo. RESULTS: Tranilast, N-(acetoacetyl) anthranilic acid, was first identified as a lead compound from screening, and then, one of the analogues, 2,3-dimethoxycinnamoyl azide (DMCA), seems to be more potent than tranilast. Our data indicate that DMCA can potentiate the HDACI activity of romidepsin and other biological activities, such as cell cycle arrest and apoptosis; these effects were accompanied with the expression of various key cell cycle regulators in different bladder cancer cells. Consistently, DMCA can enhance the in vivo antitumor effect of romidepsin without causing any more weight loss than romidepsin alone. CONCLUSION: DMCA is able to enhance the antitumor effect of romidepsin on bladder cancer from in vitro and in vivo.     

次声刺激对大鼠十二指肠粘膜胃动素水平的影响

目的:研究不同强度及频率的次声刺激对大鼠十二指肠粘膜胃动素水平的影响。方法:取140只雄性SD大鼠随机分为对照组,8Hz、90dB组,8Hz、130dB组及16Hz、130dB组,每组35只。各组大鼠按设计要求分别暴露于不同频率和强度的次声舱中,每天2h;对照组大鼠则,不予次声作用。每组分别于次声作用后第1、7、14、21及28天时随机取出7只,应用放射免疫方法测定肠粘膜中胃动素的含量。结果:与对照组比,次声作用第1天胃动素水平无明显的变化,在作用第7、14、21及28天后则明显降低(P<0.05),于第14天最为明显,与第7天相比具有明显的差异(P<0.05),第21、28天时胃动素水平有所回升,随着频率和强度的增加胃动素水平降低越明显。结论:8Hz、90dB或8Hz、130dB或16Hz、130dB次声刺激均可引起大鼠十二指肠粘膜胃动素含量下降,其影响程度与次声刺激的强度、频率及作用时间有关,而经次声多次刺激后大鼠可产生一定的适应性。     

RP-HPLC测定仁青常觉中士的宁的含量

目的:建立仁青常觉中士的宁的含量测定方法。方法:色谱柱:Diamonsil（TM）钻石C18,（4．6 mm×200m,5μm）;流动相:甲醇-0．01mol／L磷酸二氢钾溶液（25:75）（用10％磷酸溶液调节pH至2．5）;检测波长为254nm;流速:0．8ml／min;柱温:35℃。结果:士的宁色谱峰与其它色谱峰分离良好,进样量在0．03792-0．18960μg范围内,呈良好线性关系（r=0．9999）,平均回收率为97．02％,RSD=1．26％（n=6）。结论:本法简便快捷,结果可靠,为控制仁青常觉的质量提供一个参考方法。     

RP-HPLC测定仁青常觉中士的宁的含量

目的:建立仁青常觉中士的宁的含量测定方法。方法:色谱柱:Diamonsil(TM)钻石C18,(4．6 mm×200m,5μm);流动相:甲醇-0．01mol／L磷酸二氢钾溶液(25:75)(用10％磷酸溶液调节pH至2．5);检测波长为254nm;流速:0．8ml／min;柱温:35℃。结果:士的宁色谱峰与其它色谱峰分离良好,进样量在0．03792-0．18960μg范围内,呈良好线性关系(r=0．9999),平均回收率为97．02％,RSD=1．26％(n=6)。结论:本法简便快捷,结果可靠,为控制仁青常觉的质量提供一个参考方法。     

利用实时分子成像技术探索膀胱癌诊疗的新策略

绝大多数膀胱移行细胞癌（TCC）属表浅型，经尿道切除后复发率高。目前，TCC已位居美国泌尿生殖系统恶性肿瘤发病的第二位，并占到尿路肿瘤病死率的第二位。在过去的20年间，膀胱癌的发病率有所升高。70％-80％的TCC患者表现为低度恶性、非浸润性或局限于黏膜内的浅表型乳头状瘤，经尿道切除后膀胱内灌注化疗或免疫治疗能延长肿瘤非进展期。