Rapid and Severe Idiopathic Aseptic Necrosis of the Contralateral Femoral Head after Unilateral Total Hip Arthroplasty

BackgroundOsteonecrosis of the femoral head (ONFH) is a multifactorial disease, and agnogenic ONFH, otherwise known as idiopathic ONFH, is rare in clinic. Idiopathic ONFH that exhibits severe necrosis and progresses extremely rapidly is called rapidly destructive hip disease (RDHD). RDHD greatly affects patients but is rarely reported in clinical practice and literature.Case PresentationIn this study, a 64‐year‐old male patient with complete collapse and necrosis of the right femoral head complicated with severe bone destruction at 10 months after left total hip arthroplasty (THA) was reported. The period from the intact structure of the right femoral head to the first discovery of its complete collapse, according to imaging results, was 7 months. The duration from the occurrence of symptoms in the right hip joint to the first discovery of complete collapse and necrosis of the femoral head was only 5 months. At present, the cause has not been determined based on medical history, symptoms, signs, imaging evaluation results, laboratory examination results, and pathological examination results, though it has been identified as severe idiopathic aseptic necrosis of the femoral head with rapid progression, or RDHD. Finally, right THA was performed, and a good outcome was observed in the patient at present.ConclusionsAs a rare hip joint disease, RDHD greatly influences the normal life of patients. RDHD of the contralateral side after unilateral THA is even scarcer. Left THA may be one of the important factors accelerating the necrosis of the right femoral head. Hopefully, with this case report, more attention will be paid to the contralateral hip joint in patients undergoing unilateral THA by clinicians and rehabilitation physicians, and a clinical reference will be provided for the research on RDHD.     

三氧化二砷对小鼠过敏性哮喘的治疗作用及机制

目的 :研究三氧化二砷对小鼠过敏性哮喘的治疗作用及对脾T细胞周期和Bcl 2基因表达的影响。方法 :用卵蛋白建立小鼠过敏性哮喘模型 ,收集肺泡灌洗液 (BALF) ,直接计算白细胞总数和分类 ,双缩脲法检测总蛋白含量 ,应用Medlab生物信号采集系统软件检测小鼠肺功能 ,流式细胞术和免疫荧光法检测脾及BALF中T细胞数、T细胞周期和Bcl 2基因表达的变化。结果 :三氧化二砷可使BALF中总蛋白含量下降 ,白细胞总数减少 ,嗜酸细胞和淋巴细胞减少 ,改善哮喘小鼠肺功能 ;使脾及BALF中T细胞数降低 ;在 1.15mg·kg-1的剂量时可诱导脾T细胞凋亡 ,在 4 .6 0mg·kg-1的剂量时抑制其活化增殖 ;可下调脾T细胞Bcl 2基因表达。结论 :三氧化二砷有平喘作用 ,其作用机制可能与其调节T细胞的激活与凋亡 ,下调Bcl 2基因表达有关。     

外周血血小板参数、抗凝血酶-Ⅲ表达水平在急性肺栓塞患者中的临床意义

目的 调查外周血血小板参数、抗凝血酶-Ⅲ(AT-Ⅲ)表达水平在急性肺栓塞(aute pulmonary embolism,APE)患者中的临床意义.方法 选择2018 年1月-2019 年10 月连续247 例APE 患者作为研究对象.根据人院时的血流动力学和右心室功能障碍情况,确定了高风险APE(n = 120)和低...     

Anisomycin induces glioma cell death via down-regulation of PP2A catalytic subunit in vitro

Aim:

To examine the effects of anisomycin on glioma cells and the related mechanisms in vitro.

Methods:

The U251 and U87 human glioblastoma cell lines were tested. The growth of the cells was analyzed using a CCK-8 cell viability assay. Apoptosis was detected using a flow cytometry assay. The expression of proteins and phosphorylated kinases was detected using Western blotting.

Results:

Treatment of U251 and U87 cells with anisomycin (0.01–8 μmol/L) inhibited the cell growth in time- and concentration-dependent manners (the IC₅₀ values at 48 h were 0.233±0.021 and 0.192±0.018 μmol/L, respectively). Anisomycin (4 μmol/L) caused 21.5%±2.2% and 25.3%±3.1% of apoptosis proportion, respectively, in U251 and U87 cells. In the two cell lines, anisomycin (4 μmol/L) activated p38 MAPK and JNK, and inactivated ERK1/2. However, neither the p38 MAPK inhibitor SB203580 (10 μmol/L) nor the JNK inhibitor SP600125 (10 μmol/L) prevented anisomycin-induced cell death. On the other hand, anisomycin (4 μmol/L) reduced the level of PP2A/C subunit (catalytic subunit) in a time-dependent manner in the two cell lines. Treatment of the two cell lines with the PP2A inhibitor okadaic acid (100 nmol/L) caused marked cell death.

Conclusion:

Anisomycin induces glioma cell death via down-regulation of PP2A catalytic subunit. The regulation of PP2A/C exression by anisomycin provides a clue to further study on its role in glioma therapy.     

罗库溴铵靶控输注用于老年患者腹部手术效果观察

目的:探讨罗库溴铵靶控输注(TCI)用于老年患者腹部手术的效果.方法:60例ASAⅡ级、择期全麻腹部手术老年患者(60～80岁),随机分成A、B、C 3组,每组20例.根据预实验结果,将A、B、C 3组诱导插管时罗库溴铵效应室靶浓度 (Ce) 均设置为3 mg/L,术中维持Ce分别为0.6、0.8、1.0 mg/L.观察各组诱导插管起效时间、气管插管条件、术中肌松条件和术后肌松恢复情况.结果:3组均可顺利完成气管插管;术中A组肌松条件满意率低于B组和C组.与B组比较,C组罗库溴铵用量大、术中肌肉阻滞程度较深、术后恢复时间延长(P<0.05).结论:老年患者腹部手术诱导插管时罗库溴铵TCI Ce设置为3 mg/L、术中Ce维持在0.8 mg/L,可以实现诱导插管顺利、术中肌松满意和术毕迅速恢复的目的.     

醋酸铅对豚鼠耳蜗橄榄束传出神经毒性的研究

目的探讨醋酸铅对豚鼠内侧橄榄耳蜗传出神经的损害。方法 70只成年健康豚鼠随机分为对照组和实验组。对照组(10只)豚鼠腹腔注射生理盐水1ml,共7次。实验组又分为高铅组和低铅组(各30只),分别每天1次腹腔注射0.25%醋酸铅溶液40mg/kg和10mg/kg,连续一周,分别于停药后14、28天(各15只))进行血铅含量和畸变产物耳声发射(DPOAE)检测,检测完成后断头处死,行基底膜铺片染色。结果实验组醋酸铅染毒后,血清中铅含量迅速升高。对照组和低铅组耳蜗传出神经分布均匀,神经纤维连续,DPOAE出现了不同程度的对侧声抑制效应,低铅组14天和28天抑制幅度分别为3.06±1.19dB和2.86±1.33dB;高铅组14天后耳蜗传出神经纤维连续性中断,乙酰胆碱酯酶终末反应物减少,DPOAE对侧声抑制幅度下降为0.74±0.61dB;高铅组28天后传出神经损害最为显著,DPOAE未引出。结论铅可对豚鼠内侧橄榄耳蜗传出神经产生不可逆性的损害。     

铺灸疗法为主治疗强直性脊柱炎的Meta分析

目的：评价铺灸疗法治疗强直性脊柱炎（AnkylOSingSpondylitiS,AS）疗效的优越性、远期疗效及安全性。方法：计算机检索从2000年到2012年在中国知网（CNKI）、万方数据库（WF）中收录的有关铺灸疗法为主治疗AS的随机对照试验（randomizedcontrolledtrial,RCT）文献,对文献进行质量评价,并用ReviewManager5．1软件进行荟萃分析（Meta分析）。结果：总共纳入临床随机对照试验文献17篇,涉及患者共1700名。Meta分析结果显示铺灸疗法治疗强直性脊柱炎的总体有效率优于口服西药疗法和单纯针刺疗法。与口服西药疗法比较,合并后效应指标RR=I．24,95％（ConfidenceInterval,CI）为（1．14,1．35）;与针刺疗法比较,合并后效应指标RR=I．27,95％CI（1．05,1．53）。结论：此次纳入研究丈献质量普遍偏低：全部为单中心RCT研究,无多中心研究。其次,随机分组方法不够准确,多数文献未描述随访、脱落、远期疗效情况,诊断标准、疗效评价指标种类繁多,未能采取国际公认的标准。与口服西药疗法比较,铺灸疗法的总体有效率远高于12服西药疗法,疗效优越且复发率较低,无毒副作用,安全可靠;和针刺疗法比较,虽然药物铺灸疗法总体有效率较高,由于纳入研究数目较少,总病例数亦少,无远期疗效和安全性方面对比,其结果有待于大样本、多中心、方法科学的高质量临床研究加以验证。     

外踝骨折的治疗(附40例分析)

目的探讨外踝骨折的治疗。方法回顾分析40例有移位的外踝骨折的病历资料。25例行切开复位内固定术,其中合并有内侧三角韧带扭伤的外踝骨折21例均行手术治疗,不合并内侧结构损伤的单纯外踝骨折19例有4例行手术治疗,有15例选择手法整复石膏固定。结果手术组与非手术组治疗结果优良率分别为84．0％、86．7％。结论合并内侧三角韧带扭伤的外踝骨折切复内固定手术治疗、不合并内侧结构损伤的单纯外踝骨折非手法治疗,两者均可获得优良疗效。     

中国广东籍汉族人细胞色素P450_2E_1基因5'侧翼区多态性

目的：探讨中国广东籍汉族人细胞色素Ｐ４５０２Ｅ１基因５′侧翼区的多态性分布规律。方法：利用聚合酶链反应和ＲｓａⅠ、ＰｓｔⅠ限制性片段长度多态性（ＰＣＲＲＦＬＰ）技术对８２名正常中国广东籍汉族人的细胞色素Ｐ４５０２Ｅ１基因５′侧翼区的多态性进行了检测。结果：８２名正常中国广东籍汉族人的细胞色素Ｐ４５０２Ｅ１基因５′侧翼区Ｃ１（ＲｓａⅠ＋,ＰｓｔⅠ）、Ｃ２（ＲｓａⅠ,ＰｓｔⅠ＋）等位基因频率分别为０８５４,０１４６;基因型Ｃ１Ｃ１、Ｃ１Ｃ２、Ｃ２Ｃ２的比率分别为０７３２、０２４４、００２４,符合ＨａｒｄｙＷｅｉｎｂｅｒｇ平衡分布。结论：中国广东籍汉族人细胞色素Ｐ４５０２Ｅ１基因５′侧翼区ＲｓａⅠ和ＰｓｔⅠ多态性分布规律与欧美人显著不同。     

固尔苏与珂立苏治疗早产儿呼吸窘迫综合征疗效的比较研究

目的: 评价猪肺表面活性物质(固尔苏)与牛肺表面活性物质(珂立苏)治疗早产儿呼吸窘迫综合征(respiratory distress syndrome,RDS)的疗效和安全性?方法:对南京医科大学附属南京儿童医院新生儿重症监护室2007年1月~2009年7月收治的81例使用肺表面活性物质且进行机械通气的RDS患儿进行分析?81例RDS患儿分入两个组:固尔苏组(54例)和珂立苏组(27例)?分别气管插管给药,比较两组用药前后血气指标?机械通气参数?氧合指数?机械通气时间?用氧时间?住院时间和并发症?结果:用药24 h后两组患儿氧合及机械通气参数较用药前明显改善,差异有显著性意义(P均<0.05)?两组用药后的血气指数?机械通气时间?用氧时间?住院时间及并发症,包括动脉导管未闭(patent ductus arteriosus,PDA)?视网膜病变(retinopathy of prematurity,ROP)?坏死性小肠结肠炎(necrotizing enterocolitis,NEC)?气胸?肺出血和死亡发生率均无统计学差异?两组在治疗后都有持续的平均气道压(mean airway pressure,MAP)和氧合指数(oxygenation index,OI)改善,但起效速度有差别?固尔苏组在用药后的4 h内MAP和OI明显降低(P < 0.01),珂立苏在4~8 h内临床起效速度最快(P < 0.05)?结论:固尔苏与珂立苏在给药后的疗效及安全性相当?固尔苏起效速度较珂立苏快,应根据不同的起效速度及时合理调整呼吸机参数,减少并发症的发生?