156例四肢多段严重粉碎性骨折的临床特点及手术治疗研究

目的探讨四肢多段严重粉碎性骨折的临床特点和手术治疗方法。方法回顾性分析2003年2月至2013年2月该院骨科收治的156例四肢多段严重粉碎性骨折患者的数据资料,共计428处骨折,分别采用交锁髓内钉、钢板内固定、外固定支架等方法进行外科手术治疗。结果 156例患者出院后随访12∽24个月,428处粉碎性骨折中有346处愈合（80.84%）;50处出现畸形愈合（11.68%）;32处不愈合（7.48%）。交锁髓内钉内固定组与外固定支架组在骨不连发生率显著低于钢板内固定组,差异有统计学意义（χ2=11.86,P〈0.05;χ2=4.42,P〈0.05）;锁髓内钉内固定组在临近关节ROM的优良率显著低于钢板内固定组与外固定支架治疗组,差异有统计学意义（χ2=99.61,P〈0.05;χ2=173.16,P〈0.05）。结论交锁髓内钉固定法是一种临床上比较有效的内固定方法,具有并发症少,临近关节功能术后恢复较好等优势,值得临床推广应用。     

兰州地区几种不同MTHFR基因及其多态性与早产及叶酸代谢水平关系的研究

目的:探讨兰州地区几种不同MTHFR基因及其多态性与早产及叶酸代谢水平的关系。方法:选取298例新生儿及其母亲作为研究对象,根据是否早产分为早产组以及正常组,采用PCR分析3种不同基因多态性与叶酸代谢的关系。结果:MTHFR(A1298C)基因,早产组AC型、AA型以及C、A等位基因频率与正常组比较有差异;MTHFR(G1793A)基因,早产组GG型、AA型以及G、A等位基因频率与正常组比较有差异;MTHFR(C2572A)基因,AA+CA型及C、A等位基因频率与正常组比较有差异(均P0.05)。产妇外周血叶酸和维生素B12水平,AC、CC基因型组较AA基因型组平均水平低(P0.05)。MTHFR(G1793A)基因中,GA型、AA型叶酸、维生素B12均低于GG型(P0.05);AA型叶酸、维生素B12均低于GA型(P0.05),而同型半胱氨酸(Hcy)高于GA、GG型(P0.05)。MTHFR(C2572A)基因AA+CA型者叶酸、维生素B12均低于CC型(P0.05),而Hcy高于CC型(P0.05)。MTHFR(A1298C)基因AC+CC型(OR=1.544,95%CI 1.105~3.694,P=0.041);MTHFR(G1793A)基因GA+AA型(OR=1.938,95%CI 1.326~5.113,P=0.028),MTHFR(G1793A)基因A等位基因频率(OR=1.769,95%CI 1.128~4.031,P=0.039);MTHFR(C2572A)基因AA+CA型(OR=1.650,95%CI 1.017~4.150,P=0.042)为早产的影响因素。结论:MTHFR(A1298C)、MTHFR(G1793A)及MTHFR(C2572A)基因多态性与甘肃地区早产发生率、低叶酸水平有关。     

黄芪注射液对宫颈永生化上皮细胞生长的作用及其细胞周期调控机理

目的:研究黄芪注射液对宫颈永生化上皮细胞生长的调节作用及细胞周期调控机理。方法:选择宫颈永生化上皮细胞(H8细胞)进行实验,用不同浓度的黄芪注射液进行处理,采用MTT法检测细胞活力,流式细胞术检测不同细胞周期的比例以及不同免疫细胞亚群的含量,采用PCR法检测细胞周期相关蛋白的mRNA含量。结果:黄芪注射液处理能够以剂量依赖性的方式降低细胞活力,200μg/mL浓度的抑制效应最显著;200μg/mL黄芪处理组的NK细胞、CD3~+CD4~+CD8~-T细胞含量以及CD3~+CD4~+CD8~-/CD3~+CD4~-CD8~+T细胞比例高于0μg/mL黄芪处理组,CD3~+CD4~-CD8~+T细胞含量低于0μg/mL黄芪处理组;200μg/mL黄芪处理组的G0/G1期、S期细胞比例以及cyclinA、cyclinB、cyclinD1的mRNA含量低于0μg/mL黄芪处理组,G2/M期细胞比例高于0μg/mL黄芪处理组(均P<0.05)。结论:黄芪注射液对宫颈永生化上皮细胞的生长具有抑制效应,其作用途径包括调节免疫细胞含量、停滞细胞周期和下调细胞周期相关蛋白的表达。     

肝硬化患者腹腔镜胆囊切除术45例临床分析

目的探讨肝硬化患者腹腔镜胆囊切除术的手术适应证、手术技巧和可能存在的风险。方法回顾分析我院2004年1月～2008年9月45例肝功能Child A、B级肝硬化患者行LC的临床资料。结果42例患者顺利完成LC,3例因术中止血困难而中转开腹。所有患者术后经过平稳,无胆道损伤、术后再出血及肝功能衰竭等严重并发症发生。结论肝硬化患者行LC难度及风险较大,但只要严格选择患者,准确掌握手术适应证,有熟练的手术技巧,肝硬化患者行LC是安全可行的。     

黄芪注射液干预人宫颈永生化上皮细胞体外实验模型的细胞凋亡变化

BACKGROUND: Immortalized cervical epithelial cells H8 can become cancerous under the induction of carcinogenic agent, and may cause cervical cancer when there is a cofactor interaction. However, there is still a lack of effective intervention for female patients with precancerous lesions, and this treatment is blank in the clinic.  OBJECTIVE: To explore the effects and mechanism of astragalus injection on apoptosis of human immortalized cervical epithelial cells H8. METHODS: This study contained two groups: astragalus drug group and the blank control group. (1) Enzyme linked immunosorbent assay (ELISA) was used to detect DNA fragments of apoptotic H8 after astragalus injection. (2) Enzyme-labeling instrument was used to analyze the changes in caspase-3 and caspase-9 activities a fter astragalus injection. (3) Western blot assay was used to detect the protein expression changes of caspase-3, caspase-9 and PARP in H8 cells after astragalus injection.  RESULTS AND CONCLUSION: (1) ELISA results showed that at 0, 6, 12 and 24 hours after 20 g/L astragalus injection, DNA fragments were gradually increased with time prolonged in a time-dependent effect (P < 0.05). (2) Enzyme-labeling instrument demonstrated that at 0, 6, 12 and 24 hours after 20 g/L astragalus injection, caspase-3 and caspase-9 activities increased in a time-dependent manner (P < 0.05). (3) At 0, 6, 12 and 24 hours after 20 g/L astragalus injection, the expression of cleaved caspase-3 and cleaved caspase-9 were gradually increased in H8 cells (P < 0.05). Cleaved PARP protein expression was gradually decreased (P < 0.05). These findings indicate that astragalus injection could obviously induce H8 apoptosis, which may be associated with the upregulated protein expression of caspase-3 and caspase-9.