腓骨短肌腱重建下胫腓韧带联合

自1999年11月-2003年5月，采用腓骨短肌腱重建治疗下胫腓韧带联合分离39例，效果满意，报告如下。     

两种检测D-二聚体方法比较

目的对D二聚体(D-D)测定的方法进行比较。方法比色法(23例)、免疫比浊法(60例)用STAGO全自动化凝血仪测定。结果两组特异性较一致，阳性率以免疫比浊法较高。结论用自动化凝血仪配套试剂的免疫比浊法检测D-D具有高敏感性、高特异性与重复性好的优点，可作为检测D-D的首选方案。     

050The Angiogenesis Inhibitor Endostatin Impairs Wound Healing at Tumor‐inhibiting Doses

Effective blockade of the pluripotent cytokine TGF‐beta as a means of cutaneous scar reduction is a strategy with great potential. This desired effect may be achieved through the overexpression of mutant TGF beta receptors within the wound milieu. Our goal was to examine the effects of dominant negative mutant TGF‐beta receptor II (dnTGFRII) protein expression in a well‐established rabbit ear model of hypertrophic scarring. Serial injections of a retroviral construct encoding a truncated TGFβRII and the marker green fusion protein (pMSCV‐rIIdn‐GFP) were performed in 7mm punch wounds at day 10 and day 14 (two‐day injection group) or day 8, 10, 12 (three‐day injection group) post wounding. Delivery of a null vector (pMSCV‐GFP) at the same time points served as a negative control. Histomorphometric analysis of wounds harvested at day 28 revealed a statistically significant reduction (33%) in the scar elevation index in 2‐day treated and a more modest reduction in SEI (17.5%) in the 3‐day treated arm compared to null‐treated controls. Confocal microscopy confirmed stable transfection of the construct in both peri‐wound tissue as well as rabbit dermal fibroblasts transfected in vitro. Optimization of this novel application in retroviral gene therapy could lead to effective anti‐scarring strategies.     

髂腰肌血肿致股神经麻痹1例

患者 ,男 ,6 1岁 ,主因风湿性心脏病主动脉瓣置换术后1个月、左下肢麻木无力 3d入院。患者于 1个月前行主动脉瓣人工置换术 ,术后生活及一般情况良好 ,口服华法林 ,每日3 5mg。 3d前无诱因出现左下肢麻木 ,行走无力 ,并逐渐加重至无法站立。查体生命体征正常 ,左侧腹股沟区及臀部分别可见 6cm× 10cm的瘀血斑 ,腹股沟区压痛 ,髋关节屈曲不能伸直 ,Thomas征阳性 ,大腿上段前侧和小腿前内侧感觉减退 ,股四头肌肌力Ⅱ级 ,萎缩不明显 ,膝腱反射减弱。化验凝血酶原时间测定 34s。血常规 :血红蛋白 (Hb) 89g/L ,红细胞压积 (HCT) 0 2 6 ,血小…     

A Meta-Analysis of Multiple Longitudinal Studies From the Collaborative Alcohol-Related Longitudinal Project

The authors used individual and group-level variables within age and sex to predict drinking patterns over time among individuals. Eight longitudinal samples of persons age 21–30 years were analyzed separately. Drinking patterns at final measurement were regressed simultaneously on both individual and group-level variables. The first model tested for marital and drinking status along with group-level mean change in drinking. The second model tested for marital and drinking status along with group-percent married. The third model tested for marital and drinking status along with percent newly married. Using meta-analysis, the authors demonstrated significant and homogeneous effects for the three models tested and for grouplevel mean differences in the first model.     

颈动脉内膜剥脱术后即期脑中风的病因、影响因素及治疗

对２９１例颈动脉内膜剥脱术后患者进行随访研究，１例术后即期死亡；２２例（６．３％）在术后发生脑中风，１７例为中度中风，５例为严重中风，即期中风的病因包括：１４例手术部位颈动脉血栓形成（１４／２２，６４％），４例术中或术后即期脑栓塞，２例阻断颈动脉所致脑缺血，１例脑出血，１例原因不明。此外讨论了术后中风的危险因素和处理方法。     

In vitro generation of tumor-specific cytotoxic lymphocytes. Secondary allogeneic mixed tumor lymphocyte culture of normal murine spleen cells

In vivo or in vitro immunity to murine leukemia virus (MuLV)-induced leukemia cells which do not effectively produce virus, has been difficult to demonstrate. Because immunizations with allogeneic murine leukemia cells have been used to confer syngeneic tumor immunity to virus- producing cells, we attempted to generate lymphocytes, cytotoxic to syngeneic nonproducer leukemia cells, by stimulating normal murine spleen cells with allogeneic nonproducer leukemia cells in mixed tumor lymphocyte culture (MTLC) reactions in vitro. Secondary allogeneic MTLC of normal C57BL/6 or DBA/2 spleen cells effectively produced syngeneic tumor-specific cytotoxic lymphocytes. Target cells lysed in lymphocyte- mediated cytolysis (LMC) assays, included both Friend and Rauscher virus- induced syngeneic murine leukemia cells and chemically-induced hematopoietic tumor cells. Syngeneic tumor cells were lysed regardless of whether they produced infectious MuLV or expressed viral antigens gp-71, p-30, or p-12 at the cell surface. Syngeneic normal cells (thymus, lymph node, or Concanavalin A-stimulated spleen cells) used as targets in LMC assays were uneffected by lymphocytes harvested from secondary allogeneic MTLC. Several other in vitro culture treatments including secondary syngeneic MTLC and repetitive mixed lymphocyte culture stimulations were incapable of generating tumor-specific cytotoxic lymphocytes. Based upon these results, we propose that secondary MTLC stimulation of normal spleen cells with allogeneic nonproducer leukemia cells selects for the proliferation of two subpopulations of antigen-specific cytotoxic lymphocytes. The population capable of effecting syngeneic tumor cell lysis is directed against tumor-associated cell surface antigens which may be distinct from viral structural proteins or glycoproteins. The growth of these tumor-specific cytotoxic lymphocytes may be enhanced by a soluble allogeneic effect factor produced by the proliferation of the second subpopulation of lymphocytes generated in repetitive allogeneic MTLC, namely those lymphocytes with specificities directed against differing histocompatibility antigens.     

诃子醇提物对急性血瘀大鼠微观血液流变学的影响

目的通过血液流变学的实验研究,探讨诃子醇提物对大鼠微观血液流变学指标的影响。方法选取SD雄性大鼠随机分为对照组、血瘀模型组、诃子醇提物组,阳性对照组(复方丹参片)。采用皮下注射肾上腺素加冰水冷浴法造大鼠血瘀模型,通过测定全血粘度、血浆粘度,红细胞压积,红细胞在不同切变率下的变形、取向指数,红细胞膜的渗透脆性等血液流变学指标来观察诃子醇提物对大鼠微观血液流变学的影响。结果正常对照组,诃子醇提物组,阳性对照组各血液流变学指标间的差异不明显。但与血瘀模型组比较,诃子醇提物能明显降低全血粘度、血浆粘度、红细胞压积,增强红细胞变形、取向能力,提高红细胞的抗低渗能力。结论诃子醇提物可以有效改善急性应激性血瘀大鼠的微观血液流变学特性。