Spontaneous regression of periodontoid pannus mass in psoriatic atlantoaxial subluxation. Case report

STUDY DESIGN: A case report of a 41-year-old man with psoriasis who had cervical myelopathy caused by atlantoaxial subluxation and periodontoid pannus mass. OBJECTIVE: To describe the possible mechanism underlying the periodontoid pannus formation and the optimal treatment for such cases. SUMMARY OF BACKGROUND DATA: Atlantoaxial subluxation causing spinal cord compression at the craniocervical junction may develop in patients with rheumatoid or psoriatic arthritis. Periodontoid pannus formation plays an important role in compromising the anteroposterior diameter of the spinal canal and in causing neurologic deficits. Transoral transpharyngeal excision of the pannus is sometimes thought necessary for anterior decompression of the spinal cord. Spontaneous resolution of the periodontoid pannus after posterior atlantoaxial fusion and fixation has been documented in rheumatoid arthritis, but not in psoriatic arthritis. METHODS: The patient underwent posterior atlantoaxial fusion and Halifax fixation. RESULTS: The patient experienced clinical improvement. Regression of the periodontoid pannus mass was observed on magnetic resonance imaging. CONCLUSIONS: Posterior fusion and instrumentation resulted in spontaneous regression of the pannus mass and symptomatic relief. This report provides evidence that atlantoaxial instability may be the sine qua non for the formation of periodontoid pannus, and that amelioration of such instability leads to spontaneous resolution of the pannus mass.     

烫伤后脂多糖受体CD14和肿瘤坏死因子-α基因表达的变化规律

目的 观察烫伤后机体主要脏器脂多糖受体ＣＤ１４（ＣＤ１４）和肿瘤坏死因子－α（ＴＮＦ－α）ｍＲＮＡ的表达的变化规律及二者的相互关系。方法 采用大鼠３５％Ⅲ度烫伤模型,分别于伤前,伤后１２,２４,４８,７２小时活杀动物,留取组织标本或分离腹腔巨噬细胞,检测组织或巨噬细胞ＣＤ１４,ＴＮＦ－αｍＲＮＡ表达。结果 烫伤后肝,肺,肾,肠等组织ＣＤ１４ｍＲＮＡ水平均有不同程度增高,分别于伤后１２小时和４８小时     

精氨酸对烧伤创面愈合的影响

目的 探讨精氨酸对烧伤创面愈合的影响和量效关系。方法 通过大鼠深Ⅱ度烫伤模型,伤后肠道站充不同剂量精氨酸,观察烧伤创面愈合时间,测定烧伤创面愈合面积百分比,创面Ｉ型／Ⅲ型胶原比例,羟脯氨酸（ＯＨＰ）含量和真皮细胞增殖周期,结果 每天补充１００－４００ｍｇ／ｋｇ精氨酸可缩短烧伤创面愈合时间,增加烧伤创面中ＯＨＰ含量,降低烧伤创面Ｉ／Ⅲ型胶原比例,加速真皮细胞ＤＮＡ复制。比较喂不同剂量精氨酸各组,发现     

游离骨膜与复合rhBMP2的异种骨联合移植修复骨缺损的实验研究

目的 探讨复合基因重组人ＢＭＰ２（ｒｈＢＭＰ２）的异种骨与游离骨膜（ＦＰ）联合移植修复节段性骨缺损的效果。方法 将ｒｈＢＭＰ２与去抗原牛松质骨载体（ＢＣＢ）复合,制成ｒｈＢＭＰ２／ＢＣＢ;选用新西兰大耳白兔２８只,制成烧骨干１５ｍｍ缺损动物模型,分别行ＦＰ和ｒｈＢＭＰ２／ＢＣＢ复合移植（ｎ＝６）、ｒｈＢＭ２／ＢＣＢ移植（ｎ＝６）和单纯ＢＣＢ移植（ｎ＝２）;术后４、８、１２、１６周取材,通过Ｘ线、生     

Hepatitis A vaccine in healthy adults: a comparison of immunogenicity and reactogenicity between two- and three-dose regimens

Inactivated hepatitis A virus (HAV) vaccine was administered to 55 healthy seronegative adult volunteers to evaluate the immunogenicity and adverse reactions of two doses of HAV vaccination (25 units) in comparison with a three-dose regimen. The volunteers were randomly assigned to receive one of the two regimens: 26 were vaccinated with two doses at 0 and 24 weeks (Group 1), and 29 were vaccinated with three doses at 0, 2, and 24 weeks (Group 2). The vaccine was well tolerated and there was no serious adverse reaction. In both groups, the seroconversion rate was 100% at week 28. At week 52, all remained positive for anti-HAV regardless of a two- or three-dose regimen. No statistically significant difference in seroconversion rates and geometric mean titers could be demonstrated between the two groups. Thus, the two-dose regimen may be favorable to save cost and time for active immunization against hepatitis A.     

伽玛刀的医学技术评估

伽玛刀是世界上最昂贵的医疗设备之一,我国从１９９２年开始引进。１９９５年卫生部等联合发文暂缓装备。为了规范提供方和患方的行为,以及为卫生行政部门提供决策依据,我们开展了伽玛刀的技术评估。在评估前拟定评估步骤,然后确定评估内容与方法。评估结果,国外１９９４年有５６台伽玛刀,平均每台治疗１９０例,治疗病种是：动静脉畸型病人占３２％,肿瘤病人占６５％,功能性疾病占２％。我国１３台伽玛刀到１９９５年底共治病人７０００例,前６位病种是转移瘤等,虽然比例和顺位与世界有差异,但病例分析结果完全一致。     

食品中分离的李斯特氏菌的致病基因分析

１９９６—１９９７年作者对全国１２个省市的７类食品共３７４６份进行了李斯特氏菌的污染调查,共分离出李斯特氏菌１６５株。用ＰＣＲ技术对分离菌株中李斯特氏菌的２种主要致病因子李氏溶血素Ｏ和内化素的基因进行了检测,其中５７株仅有内化素基因,２７株同时具有内化素基因和李氏溶血素Ｏ基因。两种致病基因均未检出的共有８１株。本研究说明判断单增李氏菌的主要指标是小鼠毒力试验阳性而不是其溶血反应,同时检测溶血素Ｏ和内化素２种基因对单增李氏菌有鉴别意义。     

电化学疗法治疗中晚期食管癌和贲门癌42例

目的探讨应用电化学疗法治疗中晚期食管癌和贲门癌的临床疗效。方法电化学疗法治疗中晚期食管癌和贲门癌４２例,对其治疗前后的疗效进行比较。结果通过对比电化学治疗前后食管Ｘ线钡餐检查及进食改善情况显示,８８％的患者在接受电化学治疗后进食明显改善,８９％的患者食管狭窄扩大在０．５ｃｍ以上。结论电化学疗法治疗食管癌和贲门癌解除食管梗阻见效快,疗效显著,能恢复患者饮食,可为实施其他治疗创造条件,使其远期生存率提高。     

冠心病患者内皮素前列环素白细胞白介素-2的变化及悦宁定的干预作用

通过对４５ 例冠心病（ＣＨＤ）患者外周血循环内皮素（ＥＴ）、前列环素（ＰＧＩ２）代谢产物６－酮类固醇－前列腺素Ｆ１ａ（６－ｋｅｔｏ－ＰＧＦ１ａ）和白细胞（Ｗ ＢＣ）、嗜中性粒细胞（ＰＭＮ）、白细胞介素－２（ＩＬ－２）的测定,以了解ＣＨＤ 患者内皮细胞（ＥＣ）的损伤及功能变化,并悦宁定（ｅｎａｌａｐｒｉｌ）治疗组与对照组比较。结果显示：ＣＨＤ 患者ＥＴ、ＷＢＣ、ＰＭＮ 明显高于正常;６－ｋｅｔｏ－ＰＧＦ１ａ则明显低于正常;ＩＬ－２在急性心肌梗塞（ＡＭＩ）早期明显低于正常,均与病情严重程度相一致。通过ｅｎａｌａｐｒｉｌ治疗后,上述指标明显改善,提示：ｅｎａｌａｐｒｉｌ对ＣＨＤ 患者ＶＥＣ损伤有较好的保护和治疗作用