人子宫内膜腺上皮核仁管状系统的研究现状

排卵后的子宫内膜发生程序性变化,开始具备接受胚胎的能力,此过程中内膜上皮细胞超微形态出现了显著的变化。核仁管状系统是在透射电镜下观察到的子宫内膜腺上皮细胞核内的特殊结构,其形成与核仁蛋白Nopp140有关,其出现是子宫内膜容受性的重要标志。本文拟从整体上对核仁管状系统的形态、功能及其与子宫内膜容受性和Nopp140的关系进行综述。     

趋化因子受体CXCR4在结肠直肠癌中的表达及意义

目的：研究趋化因子受体CXCR4在结肠直肠癌中的表达及其临床意义。方法：采用RT-PCR法检测8种结肠直肠癌细胞株中CXCR4mRNA表达,应用蛋白印迹法检测细胞株中CXCR4蛋白表达。应用免疫组化染色法、结合组织芯片检测正常结肠直肠黏膜组织54例、结肠直肠癌组织49例中之CXCR4蛋白表达情况,并探讨其与结肠直肠癌临床病理特征的关系。结果：在8种结肠直肠癌细胞株中,CXCR4基因在HT29中表达水平最高。COL0205及SW480次之,HCTll6最低。CXCR4蛋白在结肠直肠癌组织中的表达高于结肠直肠正常黏膜组织,差异具有统计学意义（P=0．000）;在伴发转移的结肠直肠癌组织中,其表达比未发生转移者增强,差异具有统计学意义（P=0．024）。结论：CXCR4表达与结肠直肠癌转移存在密切关系,可能成为结肠直肠癌转移潜在治疗靶点。     

关节镜治疗膝关节骨关节炎技术层面的思考

骨关节炎（osteoarthritis,OA）是指发生于中年以后以关节软骨退行性变为主要表现的慢性关节炎,在65岁以上人群患病率约为80％,随着人口的老龄化病例总数还在增加。膝关节0A因为常常引起关节肿痛和明显的功能障碍对日常生活产生显著影响而成为综合医院骨科的常见病。     

同种异体胫前肌腱与自体腘绳肌腱重建前交叉韧带的病例对照研究

目的：对比异体胫前肌腱与自体胭绳肌腱重建前交叉韧带的临床疗效。方法：2005年9月至2007年5月,重建前交叉韧带100例,其中50例采用经深低温冷冻及v射线照射处理后的畀体胫前肌腱重建,50例采用自体胭绳肌腱重建。固定方式均为股骨端横杆悬挂固定（Rigidfix）和胫骨端中心固定（Intrafix）。术后通过对比两组症状体征、Lysholm评分来对比疗效。结果：两组均顺利完成手术,无感染及韧带再断裂发生。所有患者术后获随访,时间12-33个月（平均25．6个月）。异体组50例术膝轴移试验均阴性,前抽屉试验及Lachman试验为阴性或I度阳性;术后1年以上Lrrsholm总评分平均（89．3±6．3）分。自体组50例术膝体征检查结果与异体组类似,术后1年Lysholm总评分平均（90．5±4．5）分,两组对比差异无统计学意义（P〉0．05）。结论：同种异体胫前肌腱与自体胭绳肌腱重建前交叉韧带疗效相当,医生及患者可根据实际情况选择移植物。     

持续牵引在纠正桡骨远端不稳定骨折中桡骨短缩的作用机制探讨

目的：探讨持续牵引在桡骨远端不稳定骨折治疗中的力学机制。方法：采用复位外固定器治疗30例桡骨远端不稳定骨折,男4例,女26例;年龄18-85岁,平均61岁。按AO分型,其中A3型12例,B2型3例,C1型8例,C2型4例,C3型3例。分别测量患者术前与术后X线上的桡骨茎突与尺骨关节面之间的距离。结果：30例患者获得6-15个月的随访,平均11．2个月。测量X线结果为术前平均（0．55±0．22）cm,术后平均（1．07±0．23）cm,明显高于术前,差异有统计学意义（P〈0．01）。结论：复位外固定器提供的持续牵引其作用机制可以通过筋束骨理论、韧带整复原理及牵拉成骨理论解释。     

DSA透视下逆行双J输尿管支架管置入术

双“J”输尿管支架在输尿管梗阻性疾病的治疗中应用广泛,疗效满意。我院有11例于膀胱镜下未能顺利置入输尿管支架者,在DSA下成功逆行插入,现报道如下。     

Posterior lumbar interbody fusion versus posterolateral fusion in spondylolisthesis: a prospective controlled study in the Han nationality

In this prospective study, our aim was to compare the clinical outcome of posterior lumbar interbody fusion (PLIF) and posterolateral fusion (PLF) in spondylolisthesis. A total of 138 patients with spondylolisthesis were randomly assigned to two groups: those operated on with pedicle screw fixation and posterior lumbar interbody fusion by autografting (PLIF), and those operated on with pedicle screw fixation and posterolateral fusion by autografting (PLF). The patients were followed-up for four years. Clinical evaluation was carried out using the Oswestry disability index (ODI) and pain index (VAS). Radiography was performed preoperatively and postoperatively to assess the fusion. Both surgical procedures were effective, but the PLF group showed more complications related to hardware biomechanics. There was no significant statistical difference in clinical and functional outcome in the two groups. The PLIF group presented a better fusion rate than the PLF group.     

Clinical and radiographic reports following cervical arthroplasty: a 24-month follow-up

We reviewed patients with cervical disc prosthesis replacement for single-level cervical disc disease to evaluate its clinical effect and maintenance of cervical spine motion. Fifteen patients underwent Bryan artificial cervical disc replacement and were followed-up for at least 24 months. No neurological or vascular complications were observed during or after operation. JOA, VAS, and NDI scores showed statistical significant improvement in our follow-up. The procedure achieved an 87% (13/15) satisfactory rate at 24-month evaluations according to Odom's criteria. The range of motion (ROM) of the cervical spine, treated segment, adjacent segment, and functional spinal unit (FSU) decreased at early follow-up, but they recovered to the preoperative level at 12- and 24-month follow-up. Also, preoperative lordosis of the cervical spine and FSU were not only maintained but also even improved during the 24-month follow-up. No obvious degeneration of adjacent discs were found at MRI. There were no cases of prosthesis subsidence or extrusion. The cervical disc prosthesis showed a good clinical outcome; it also restored ROM of the cervical spine and reestablished cervical curvature in our 24-month follow-up. But to be sure of its long term effect, a longer follow-up is needed.     

毛囊干细胞表皮膜片修复裸鼠皮肤缺损的实验研究

目的开发新的组织工程表皮替代物,利用毛囊干细胞-壳聚糖明胶膜片(Chitosan-gelatin membrane,CGM)进行修复裸鼠皮肤缺损的实验研究。方法将体外扩增培养的毛囊干细胞接种于CGM,构建组织工程表皮膜片,裸鼠背部作直径1cm的全层皮肤缺损,将毛囊干细胞-CGM复合物覆盖创面。回植后1周、4周和12周分别进行组织学和免疫组织化学检测。结果毛囊干细胞在CGM上生长良好。毛囊干细胞-CGM修复裸鼠后1周切片示创面有新生上皮覆盖,表皮分化良好,而对照组残留较大未愈创面。修复后4周和12周可见对照组收缩较实验组显著。结论体外构建的毛囊干细胞-CGM可以修复裸鼠皮肤缺损。