股骨粗隆间骨折术后并发症及原因分析

目的回顾性分析股骨粗隆间骨折的术后并发症并分析其原因。方法 2008年1月~2012年12月,我院手术治疗股骨粗隆间骨折共295例,按Evans分型,Ia型26例,Ib型53例,Ic型97例,Id型52例,II型67例。其中DHS组59例,IMHS组80例,PFN组25例,GAMMA3组28例,INTERTAN组103例。随访3~36个月,对部分发生并发症的病例进行手术干预。结果内固定物切割6例,拉力螺钉退出2例,髋内翻、下肢短缩12例,感染6例,血管损伤2例,股骨头无菌性坏死2例,内植物远端骨折2例,部分经再次手术治疗治愈。结论手术治疗股骨粗隆间骨折,要结合骨折类型、患者全身情况合理选用内固定物,术中复位及操作技术的改进以及术后适度的功能锻炼,能够减少术中及术后并发症的发生。     

Bioactive glass serves as a substrate for maintenance of phenotype of nucleus pulposus cells of the intervertebral disc

The objective of the study was to investigate the capability of bioactive glass 45S5 to serve as a substrate for nucleus pulposus cells in vitro. Nucleus pulposus cells were isolated from adult rabbit discs and seeded onto bioactive glass. At selected time intervals, the cells and glass were evaluated. We found that the cells rapidly attached to the substrate, colonizing it within 12 h. By 21 days, they had formed a lawn of cells over the glass substrate. DNA measurements showed a progressive increase in cell number with time. The phenotype was maintained; the cells expressed aggrecan, and collagen type II and I, but were negative for collagen type X. CD44, a cell-surface glycoprotein that binds hyaluronate, was also expressed by these cells. Electron dispersive X-ray analysis and Fourier transform infrared spectroscopy revealed calcium phosphate-rich layer formation on the substrate surface. The results of this study suggest that nucleus pulposus cell proliferation may be an anchorage dependent event, and that the cells use the calcium phosphate-rich layer to facilitate cell adhesion, and subsequent proliferation. These findings point to the importance of the conditioned bioactive glass as a substrate for nucleus pulposus cells.     

Mechanism of Intestinal Absorption of Ranitidine and Ondansetron: Transport Across Caco-2 Cell Monolayers

We have investigated the transport of ranitidine and ondansetron across the Caco-2 cell monolayers. The apparent permeability coefficients (P _app) were unchanged throughout the concentration range studied, indicating a passive diffusion pathway across intestinal mucosa. No metabolism was observed for ranitidine and ondansetron during the incubation with Caco-2 cell monolayers. P _app values for ranitidine and ondansetron (bioavailability of 50 and 100% in humans, respectively) were 1.03 ± 0.17 × 10^–7 and 1.83 ± 0.055 × 10^–5 cm/sec, respectively. The P _app value for ranitidine was increased by 15- to 20-fold in a calcium-free medium or in the transport medium containing EDTA, whereas no significant change occurred with ondansetron, indicating that paracellular passive diffusion is not rate determining for ondansetron. Uptake of ondansetron by Caco-2 cell monolayers was 20- and 5-fold higher than that of ranitidine when the uptake study was carried out under sink conditions and at steady state. These results suggest that ranitidine and ondansetron are transported across Caco-2 cell monolayers predominantly via paracellular and transcellular pathways, respectively.     

Heart rate variability and its response to thyroxine replacement therapy in patients with hypothyroidism

目的　测定甲状腺功能减退 (甲减 )患者心率变异 (HRV)及观察甲状腺素替代治疗后的变化。方法　记录 38例甲减患者与 2 1例正常者 2 4小时动态心电图 ,并进行HRV分析。 18例甲减患者治疗 3月后重复HRV测定。结果　甲减时 ,HRV的时阈指标较对照组明显降低 ;频阈指标中 ,高频功率 (HF)较对照组明显增高 ,而低频 (LF)与HF比值较对照组显著减低。甲减患者经甲状腺素替代治疗后 ,HRV时阈指标和频阈指标均明显改善 ,且与FT3和FT4 的恢复程度相一致。结论　甲减时 ,自主神经活动明显改变 ,且以迷走神经兴奋性增加占优势。这种自主神经异常在甲状腺素替代治疗后可部分改善。     

中药离子导入与内服诱发排卵的临床研究

目的：探讨中药内外合用治疗卵巢排卵功能障碍所致不孕症的临床疗效。方法：选择卵巢排卵功能障碍所致手不孕患４５例,治疗组使用中药内外合治方法,对照组仅内服中药,并观察治疗前后的ＢＢＴ、尿液ＬＨ等变化。结果：中药内外合治诱发排卵的总有效率为８６．６％,治疗组疗效明显高于对照组（Ｐ〈０．０１）。     

偏侧萎缩-偏侧帕金森综合征——6例报道并文献复习

目的通过分析 6例偏侧萎缩－偏侧帕金森综合征 (HAHP)的临床资料,探讨 HAHP的病因,临床表现,诊断和治疗。方法对 6例 HAHP病人的临床表现进行详细分析并综合文献报告。结果 6例病人全部符合 Bushman等 1988年提出的 HA诊断标准,其中 5例确诊, 1例拟诊。 2例疑诊 HAHP。 6例病人都接受了 B族维生素、地巴唑、胞二磷胆碱、安坦等药物治疗,但几无疗效。结论 HAHP是一种罕见的临床综合征,病因不明。临床上主要表现为偏侧萎缩、偏侧帕金森综合征、发作性肌张力障碍。 HAHP的诊断主要依靠临床表现,神经影像资料可能有助诊断。迄今, HAHP尚无有效治疗。     

羊红膻根中羊红膻素H等的分离与鉴定

从草药羊红膻Ｐｉｍｐｉｎｅｌｌａ ｔｈｅｌｌｕｎｇｉａｎａ Ｗｏｌｆｆ。根降压有效部位中首次分得５个化合物,经光谱（ＵＶ,ＩＲ,ＭＳ,＾１ＨＮＭＲ,＾１３ＣＮＭＲ,＾１Ｈ－＾１ＨＣＯＳＹ,＾１Ｈ－＾１３ＣＣＯＳＹ,ＤＥＰＴ）解析,鉴定为５－甲氧基－２－甲基苯骈呋喃（Ｉ）,甘油二乙酸酯（Ⅱ）,异香草醛（Ⅲ）,棕榈酸（Ⅳ）,油酸（Ⅴ）,其中化合物Ｉ为具有降压活性的新化合物,命名为羊红膻素Ｈ;化合物Ⅱ～     

颅脑肿瘤手术行急性等容血液稀释的临床研究

目的：研究急性等容血液稀释对颅脑肿瘤病人血流动力学、氧转运及凝血纤溶方面的影响,探讨该方法的安全性。方法：选择颅脑肿瘤手术病人12例,麻醉后从右颈内静脉放置Swan～Ganz导管,从桡动脉放血8ml/kg,同时等速从静脉输入等量的海脉素。分别测定血液稀释前后的血流动力学,氧转运及凝血纤溶方面的指标。结果：CO、SV、DO2显著增加(P＜0.05);PT延长(P＜0.05);PLT较血液稀释前减少,其余指标无明显改变。结论：急性等容血液稀释对颅脑肿瘤病人的血流动力学及凝血纤溶功能影响小,而氧供增加,是一安全有效的血液保护方法。     

脑梗塞患者脂蛋白(A)水平与肾脏早期损害

为探讨脑梗塞患者脂蛋白（Ａ）水平与肾脏早期损害的关系,应用ＥＬＩＳＡ法及化学显色终点法分别检测４０例梗塞患者血清ＬＰ（Ａ）水平和尿氨基葡萄糖苷酶活力。结果表明,脑梗塞组血ＬＰ（Ａ）及ＮＡＧ均明显高于正常对照组,且ＬＰ（Ａ）值与尿ＮＡＧ活力呈正相关。     

430名新疆哈萨克族成人同身寸长度与身高关系的研究

目的：研究新疆哈萨克族成人同身寸长度与身高的关系,为人类学、法医学研究以及针灸取穴提供基础资料。方法：应用 Ｈｒｄｌｉｃｋａ 标准和我国普遍采用的方法测量了４３０ 名（男１９７ 名,女２３３ 名）新疆哈萨克族成人同身寸长和身高。结果：按性别和年龄分组,计算出各组同身寸的均值、身高的均值及身高与同身寸的比值,并提出了由同身寸推算身高的回归方程。结论：通过同身寸长可推算身高,同身寸长和身高有显著性的直结回归关系。