成人斯蒂尔病24例临床分析

目的 探讨成人斯蒂尔病(AOSD)的临床特点.方法 回顾性分析24例经临床确诊的AOSD患者的临床表现和实验室检查结果.结果 AOSD的临床主要表现为发热、多形性皮疹、关节痛、咽痛、淋巴结肿大、白细胞总数增高、血沉加快、类风湿因子和抗核抗体阴性及血清铁蛋白明显升高.结论 AOSD临床表现无特异性,容易误诊,诊断时应排除其他发热性疾病;发热、皮疹、关节疼痛和白细胞升高是AOSD的主要临床特点,血清铁蛋白可作为疾病活动性指标.     

γ线照后大鼠胃组织乙酰胆碱含量胆碱酯酶活性及平滑肌对乙酰胆碱反应性的变化

本文以大鼠为实验对象,观察了γ线8Gy照后胃组织内乙酰胆碱含量、胆碱酯酶活性及平滑肌对乙酰胆碱反应性的变化。结果表明,照后1/24～l天胃组织内乙酰胆碱含量明显下降,3天趋向正常,5天基本恢复至照前水平。胃组织的胆碱酯酶活性在照后l/24～5天基本无改变。在同一剂量照后1h,胃窦平滑肌对乙酰胆碱的反应与照前近似,l天后开始减弱,3天后明显下降,与正常相比有非常显著差异。     

体外培养诱导外周血淋巴细胞促进大鼠面神经再生的实验研究

目的:通过在神经缺损处局部回输体外分离培养纯化的淋巴细胞,了解此种方法促进面神经损伤修复的效果。方法:将20只Wistar大鼠的面神经颊支剪断并立即缝合(其余3支反折缝合)制成面神经损伤模型大鼠,将其分成淋巴细胞组和对照组,每组10只,每组再分成2周组和8周组。淋巴细胞组局部回输体外分离培养的外周血淋巴细胞,对照组作对照。于2周和8周测定面神经颊支-触须肌复合动作电位传导速度,辣根过氧化物酶(HRP)神经逆行示踪测定面神经核团的神经元阳性数目。结果:淋巴细胞组面神经颊支-触须肌复合动作电位传导速度8周时为0.64±0.07,与对照组(0.56±0.07)相比,差异有统计学意义(P<0.05)。HRP神经逆行示踪测定面神经核团神经元阳性数目,淋巴细胞组2周及8周与对照组同时间段相比差异均无统计学意义(均P>0.05)。结论:体外分离培养纯化的淋巴细胞在局部应用于神经损伤处对面神经再生修复可起一定的促进作用。     

维纳滤波器在数字化X射线影像中的应用

介绍了一种简单有效的维纳滤波器设计过程,并采用该过程对数字化X射线影像进行滤波,试验表明:维纳滤波器能在去除图像噪声的同时较好地保留图像细节,具有实际应用价值。     

乌体林斯对老年肺结核患者外周血中T淋巴细胞亚群改变的影响

老年肺结核患者细胞免疫功能低下,乌体林斯是一种多功能免疫增强剂,我们在抗痨治疗的基础上加用乌体林斯治疗,取得了较好的疗效,现报告如下。1资料和方法1.1一般资料选取2004年3月～2006年10月我院住院的未经抗痨治疗的老年肺结核患者68例,其中男41例,女27例,年龄61～69岁,随机     

Central Nervous System Lymphomatoid Granulomatosis Presenting with Parkinsonism

Lymphomatoid granulomatosis (LG) is a potentially malignant lymphoproliferative disorder. The lung is the most common involved site, followed by the skin and nervous system. However, LG of the central nervous system presenting with Parkinsonism is very rare. We report a patient with LG who presented with parkinsonian features such as bilateral rigidity, bradykinesia, and agitation. Brain magnetic resonance imaging showed multifocal punctuate enhanced lesions in both supra- and infratentorial areas. Steroid pulse therapy resulted in a dramatical improvement in the symptoms and MRI abnormalities.     

本科护生实习期戴圆筒帽的三方观点调查

目的调查本科护生、带教教师和患者三方对护生实习期戴圆筒帽的看法,为更有利于护生的工作和学习以及营造祥和协调的医疗生活环境提供参考。方法采用问卷调查法及访谈法对112名本科护生及50名科室带教教师和100例患者就其对本科护生实习期戴圆筒帽的看法和建议进行调查。结果96.42%本科护生认为戴圆筒帽弊大于利,88.39%不乐意戴圆筒帽。94.00%带教教师对护生戴燕尾帽无异议。58.00%患者认为实习护生戴圆筒帽使科室护理群体看起来不协调,62.00%认为给他们一种不安全和不可信任感。结论带教实习期戴圆筒帽给护生实习带来负面影响。     

Differential gene expression in cultured osteoblasts and bone marrow stromal cells from patients with Paget's disease of bone.

Paget's disease is a focal condition of bone. To study changes in cells within pagetic lesions, we cultured osteoblasts and stromal cells from 22 patients and compared gene expression in these cells to cells from healthy bone. We identified several differentially regulated genes, and we suggest that these changes could lead to the formation of the lesions. INTRODUCTION: Paget's disease is a focal condition of bone of unknown cause. Although it is regarded as primarily an osteoclast disorder, the tight coupling of the activity of osteoclasts and osteoblasts suggests that the osteoblast could play a key role in its pathogenesis. The aim of the study was to identify possible changes in pagetic osteoblasts and stromal cells that might contribute to the development of pagetic lesions. MATERIALS AND METHODS: Candidate genes were identified based on known bone cell regulators, supplemented with microarray analysis. Gene expression was determined by real-time PCR in primary cultures of osteoblasts and bone marrow stromal cells from pagetic patients and control subjects. Concentrations of secreted proteins were determined by ELISA. RESULTS: Dickkopf1 mRNA and protein levels were increased in both pagetic osteoblast and stromal cell cultures, and interleukin (IL)-1 and IL-6 were overexpressed in pagetic osteoblasts. These changes parallel recent findings in myeloma bone disease, which shares some clinical similarities with Paget's disease. Alkaline phosphatase was overexpressed, and bone sialoprotein and osteocalcin were underexpressed in pagetic osteoblasts, consistent with their circulating levels in pagetic patients. It is hypothesized that overexpression of Dickkopf1, IL-1, and IL-6 would result in stimulation of osteoclast proliferation and inhibition of osteoblast growth, leading to the development of the characteristic lytic bone lesions. By stimulating osteoblast differentiation, Dickkopf1 and IL-6 may also promote mineralization, leading to the conversion of lytic lesions to sclerotic. CONCLUSIONS: These findings suggest that dysregulated gene expression in pagetic osteoblasts could cause the changes in bone cell number and function characteristic of Paget's disease.     

Enhanced chondrogenesis and Wnt signaling in PTH-treated fractures.

Studies have shown that systemic PTH treatment enhanced the rate of bone repair in rodent models. However, the mechanisms through which PTH affects bone repair have not been elucidated. In these studies we show that PTH primarily enhanced the earliest stages of endochondral bone repair by increasing chondrocyte recruitment and rate of differentiation. In coordination with these cellular events, we observed an increased level of canonical Wnt-signaling in PTH-treated bones at multiple time-points across the time-course of fracture repair, supporting the conclusion that PTH responses are at least in part mediated through Wnt signaling. INTRODUCTION: Since FDA approval of PTH [PTH(1-34); Forteo] as a treatment for osteoporosis, there has been interest in its use in other musculoskeletal conditions. Fracture repair is one area in which PTH may have a significant clinical impact. Multiple animal studies have shown that systemic PTH treatment of healing fractures increased both callus volume and return of mechanical competence in models of fracture healing. Whereas the potential for PTH has been established, the mechanism(s) by which PTH produces these effects remain elusive. MATERIALS AND METHODS: Closed femoral fractures were generated in 8-wk-old male C57Bl/6 mice followed by daily systemic injections of either saline (control) or 30 microg/kg PTH(1-34) for 14 days after fracture. Bones were harvested at days 2, 3, 5, 7, 10, 14, 21, and 28 after fracture and analyzed at the tissue level by radiography and histomorphometry and at the molecular and biochemical levels level by RNase protection assay (RPA), real-time PCR, and Western blot analysis. RESULTS: Quantitative muCT analysis showed that PTH treatment induced a larger callus cross-sectional area, length, and total volume compared with controls. Molecular analysis of the expression of extracellular matrix genes associated with chondrogenesis and osteogenesis showed that PTH treated fractures displayed a 3-fold greater increase in chondrogenesis relative to osteogenesis over the course of the repair process. In addition, chondrocyte hypertrophy occurred earlier in the PTH-treated callus tissues. Analysis of the expression of potential mediators of PTH actions showed that PTH treatment significantly induced the expression of Wnts 4, 5a, 5b, and 10b and increased levels of unphosphorylated, nuclear localized beta-catenin protein, a central feature of canonical Wnt signaling. CONCLUSIONS: These results showed that the PTH-mediated enhancement of fracture repair is primarily associated with an amplification of chondrocyte recruitment and maturation in the early fracture callus. Associated with these cellular effects, we observed an increase in canonical Wnt signaling supporting the conclusion that PTH effects on bone repair are mediated at least in part through the activation of Wnt-signaling pathways.     

射频消融术后尿潴留患者的护理

分析86例射频消融术后患者出现尿潴留的不同原因，包括不习惯床上排尿、精神因素、疼痛等。护理对策包括：减少卧床时间，心理护理，变换体位，物理诱导，术后多饮水等，结果81例患者排尿成功，只有5例(5．8％)男性前列腺肥大患者需要导尿。