掌侧锁定接骨板与普通接骨板治疗桡骨远端骨折疗效的比较

目的 比较掌侧锁定接骨板与普通接骨板治疗桡骨远端骨折的长期疗效.方法 对2005年9月-2007年11月间,采用切开复位掌侧锁定接骨板或普通接骨板内固定的45例随访资料完整的患者,进行两种疗法的比较.其中23例行锁定接骨板内固定,22例行普通接骨板内固定.按照AO分型:A型11例,B型11例,C型23例.随访内容包括:腕关节活动度(屈曲、背伸、尺偏、桡偏),前臂旋前、旋后活动范围,影像学资料(尺偏角、掌倾角、桡骨高度),应用DASH上肢功能评定标准和Gartland/Wertey腕关节评分法进行评分.结果 术后随访时间平均为18.8个月(12～36个月).腕关节活动度中,锁定板组背伸及两组的桡偏范围低于Gartland/Werley腕关节评分的基本范围.两组DASH值、腕关节活动度及前臂旋转范围,握力、捏力的恢复差异无统计学意义.Gartland/Werley腕关节评分普通接骨板治疗组优于锁定接骨板治疗组,差异有统计学意义.掌倾角均值两组都低于正常范围,尺偏角与桡骨高度均值在正常范围内,两组间差异无统计学意义.结论 掌侧锁定接骨板与普通接骨板在桡骨远端骨折治疗中具有相同疗效.     

吲哚青绿前囊膜染色在过熟期白内障手术中的应用

目的：探讨过熟期白内障手术中采用吲哚青绿前囊膜染色对连续环形撕囊的作用。方法：随机选取2010年1月至12月于我院进行过熟期白内障手术患者53例（64眼）,术中黏弹剂注入前房后吲哚青绿进行前囊膜染色,撕囊镊连续环形撕囊。随机选取2009年1月至12月行过熟期白内障手术未进行前囊膜染色的患者49例（61眼）作为对照组,比较两组患者撕囊成功率及术后3个月最佳矫正视力。结果：染色组连续环形撕囊成功62眼（96.9%）,对照组成功53眼（86.9%）（χ2=4.23,P〈0.05）,术后3个月最佳矫正视力比较差异无显著性。结论：吲哚青绿前囊膜染色使前囊清晰可辨,可提高过熟期白内障患者术中撕囊成功率。     

恐惧应激对雄性大鼠生殖激素的影响

目的：观察比较不同恐惧应激状态下,大鼠血清卵泡刺激素（FSH）、黄体生成素（LH）和睾酮（T）的变化。方法：建立SD大鼠的急性应激、亚急性应激和慢性应激模型,分别在麻醉后心脏取血,酶联免疫分析法测定并比较各实验组及相应对照组大鼠血清FSH、LH和T的含量。结果：急性应激组大鼠血清FSH、LH和T水平略高于对照组大鼠,但无显著差异（P〉0.05）;亚急性应激组大鼠血清FSH、LH和T水平均低于其对照组,但都无显著差异（P〉0.05）;慢性应激组大鼠血清FSH、LH和T均低于对照组大鼠,其中LH水平的变化有显著差异（P〈0.05）;而T水平有极显著差异（P〈0.001）。结论：急性应激、亚急性应激和慢性应激能影响大鼠血清FSH、LH和T浓度,尤其慢性应激引起的体内激素的变化最大,提示应激对大鼠生理功能的维持以及生殖保护具有干扰作用。     

Ureteric Injury at Burch Colposuspension 4 Case Reports and Literature Review

Summary: The Burch colposuspension operation is an accepted and effective technique for the correction of genuine stress incontinence. It is, however, associated with a number of well-recognized complications. Ureteric injury at the time of colposuspension is a potentially severe, if uncommon, complication of this procedure with legal ramifications for the surgeon as well as health risks for the patient. To date, only 19 cases have been described in the literature. This paper highlights 4 cases of this injury occurring amongst the patients of 1 urogynaecologist (2) and gives an incidence for its occurrence as well as discussing the aetiology and management of this complication.     

体外诱导骨髓间充质干细胞向肾小管上皮样细胞分化

Objective To investigate the differentiation of rat bone marrow mesenchymal stem cells (MSCs) to renal tubular epithelial-like cells under different conditions. Methods MSCs were obtained from rat marrow. MSCs were isolated by gradient density centrifugation and plastic adherence and then purified. Surface markers were identified with flow cytometry after amplification in vitro. The purified MSCs of the third passage were cultured respectively as follows: (1) control group: DMEM medium with fetal bovine serum(FBS). (2) all-trans retinoic acid (ATRA) group: DMEM medium with FBS, ATRA and ischemic reperfusion-injured kidney tissue homogenate. (3)combination group: DMEM medium with FBS, ATRA, ischemic reperfusion-injured kidney tissue homogenate, epidermal growth factor (EGF) and bone morphogenetic protein 7 (BMP-7). After 7 days, the MSCs were collected for alkaline phosphatase (AKP) staining, cytokeratin-18 and E-cadherin immunocytochemical analysis. Results The positive rates of the third passage MSCs in CD44, CD90 and CD29 were 97.8%±0.9%, 96.8%±1.4% and 97.6%±2.4%,respectively, but in CD11b/c and CD34 were only 13.2%±0.6% and 1.2%±0.5%. The MSCs in control group were spindle. The MSCs in ATRA group were round and elliptic. The MSCs in combination group became cobblestone-like cells after 7 days. AKP staining showed that tubular epithelial-like cells from MSCs in control group were negative, some above cells in ATRA group were positive and number of above cells increased in combination group. Compared with negative control group, the ratios of cytokeratin-18 positive cells in ATRA group and combination group were respectively increassed by 29.47%±1.08% and 47.52%±2.13% (all P<0.05), the ratios of E-cadherin positive cells in ATRA group and combination group were respectively increased by 14.88%±2.46% and 36.15%±1.13% (all P<0.05). Conclusion MSCs may differentiate by renal tubular epithelial-like cells under the induction of ischemic reperfusion-injured kidney tissue homogenate and ATRA in vitro, which are further differentiated under the combined induction of EGF and BMP-7.     

氨基胍通过降低周期素激酶抑制剂P27水平减轻高糖培养系膜细胞肥大程度

目的:研究氨基胍(AG)减轻高糖培养系膜细胞(MC)肥大程度与周期素激酶抑制剂P27的关系.方法:Western 印迹方法测定MC裂解液P27水平,[3H]胸腺嘧啶核苷([3H]TdR)及[3H]亮氨酸([3H]Leu)掺入方法测定MC肥大情况.结果:同正常糖(100 mg/dl)培养相比,高糖(450 mg/dl)培养MC中P27水平增高(P<0.01),MC肥大;[3H]Leu掺入增加及[3H]TdR掺入降低(P<0.01);AG(0.25 mmol/L)降低高糖培养MC中P27水平[(2.5±0.6 ) vs (4.0±0.8),P<0.05],使MC肥大程度减轻;[3H]leu掺入降低,[(3 426±532) vs (4 652±309) cpm/孔,P<0.01],[3H]TdR掺入增加[(1 233±69) vs (543±27) cpm/孔,P<0.01].结论:AG可能通过降低高糖培养MC中P27水平减轻MC肥大程度.     

胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

Medium-term Follow-up of the Intravaginal Slingplasty Operation Indicates Minimal Deterioration of Urinary Continence With Time

An assessment of the medium term efficacy of stress incontinence cure in a group of patients who had undergone the intravaginal slingplasty (IVS) operation is presented. Eighty-five unselected patients, aged 27 to 83 years at the time of surgery, 12 with pure stress symptoms, and 73 with mixed incontinence symptoms underwent the IVS procedure between 31 and 57 months previously (mean 3.9 years). The patients were assessed with the same self-administered semiquantitative questionnaire used in the initial assessment. The results were compared with the original cure rate which was 88% at 1.75 years with another 2.5% more than 70% improved (total 90.5%). The cure rate in the 75 patients assessed at 3.9 years was 81%, with another 8% reporting more than 70% improvement (total 89%). Included in the latter were 2 patients who, though originally designated as failures, gradually achieved almost 100% continence within 2 years of surgery. Deterioration of continence following the IVS operation appears more like the Burch colposuspension than needle suspensions. It is possible to explain deterioration of continence with time in terms of age-related connective tissue laxity of the vaginal hammock. Improvement in 2 women with time can be explained by tightening of the hammock via paraurethral scar contraction with time. Whether the IVS operation improves or deteriorates in the longer term may depend on which process predominates.     

掌侧锁定接骨板与普通接骨板治疗桡骨远端骨折疗效的比较

目的 比较掌侧锁定接骨板与普通接骨板治疗桡骨远端骨折的长期疗效.方法 对2005年9月-2007年11月间,采用切开复位掌侧锁定接骨板或普通接骨板内固定的45例随访资料完整的患者,进行两种疗法的比较.其中23例行锁定接骨板内固定,22例行普通接骨板内固定.按照AO分型:A型11例,B型11例,C型23例.随访内容包括:腕关节活动度(屈曲、背伸、尺偏、桡偏),前臂旋前、旋后活动范围,影像学资料(尺偏角、掌倾角、桡骨高度),应用DASH上肢功能评定标准和Gartland/Wertey腕关节评分法进行评分.结果 术后随访时间平均为18.8个月(12～36个月).腕关节活动度中,锁定板组背伸及两组的桡偏范围低于Gartland/Werley腕关节评分的基本范围.两组DASH值、腕关节活动度及前臂旋转范围,握力、捏力的恢复差异无统计学意义.Gartland/Werley腕关节评分普通接骨板治疗组优于锁定接骨板治疗组,差异有统计学意义.掌倾角均值两组都低于正常范围,尺偏角与桡骨高度均值在正常范围内,两组间差异无统计学意义.结论 掌侧锁定接骨板与普通接骨板在桡骨远端骨折治疗中具有相同疗效.     

体外诱导骨髓间充质干细胞向肾小管上皮样细胞分化

Objective To investigate the differentiation of rat bone marrow mesenchymal stem cells (MSCs) to renal tubular epithelial-like cells under different conditions. Methods MSCs were obtained from rat marrow. MSCs were isolated by gradient density centrifugation and plastic adherence and then purified. Surface markers were identified with flow cytometry after amplification in vitro. The purified MSCs of the third passage were cultured respectively as follows: (1) control group: DMEM medium with fetal bovine serum(FBS). (2) all-trans retinoic acid (ATRA) group: DMEM medium with FBS, ATRA and ischemic reperfusion-injured kidney tissue homogenate. (3)combination group: DMEM medium with FBS, ATRA, ischemic reperfusion-injured kidney tissue homogenate, epidermal growth factor (EGF) and bone morphogenetic protein 7 (BMP-7). After 7 days, the MSCs were collected for alkaline phosphatase (AKP) staining, cytokeratin-18 and E-cadherin immunocytochemical analysis. Results The positive rates of the third passage MSCs in CD44, CD90 and CD29 were 97.8%±0.9%, 96.8%±1.4% and 97.6%±2.4%,respectively, but in CD11b/c and CD34 were only 13.2%±0.6% and 1.2%±0.5%. The MSCs in control group were spindle. The MSCs in ATRA group were round and elliptic. The MSCs in combination group became cobblestone-like cells after 7 days. AKP staining showed that tubular epithelial-like cells from MSCs in control group were negative, some above cells in ATRA group were positive and number of above cells increased in combination group. Compared with negative control group, the ratios of cytokeratin-18 positive cells in ATRA group and combination group were respectively increassed by 29.47%±1.08% and 47.52%±2.13% (all P<0.05), the ratios of E-cadherin positive cells in ATRA group and combination group were respectively increased by 14.88%±2.46% and 36.15%±1.13% (all P<0.05). Conclusion MSCs may differentiate by renal tubular epithelial-like cells under the induction of ischemic reperfusion-injured kidney tissue homogenate and ATRA in vitro, which are further differentiated under the combined induction of EGF and BMP-7.