听觉剥夺后大鼠听皮层神经元的形态学变化和SHP-2基因的表达

目的研究双侧耳蜗毁损后大鼠听皮层神经元细胞的形态学变化和蛋白酪氨酸磷酸酶2型（src-homology domain containing protein tygosine phosphatase type 2,SHP -2）基因的表达。方法选取SD大鼠48只,随机分为4个实验组（2周组、4周组、6周组、8周组）和4个相应的对照组,每组6只。实验组动物行双侧耳蜗损毁术,通过HE染色和Nissl染色观察听皮层神经元细胞的形态学变化,用RT -PCR技术检测各组听皮层神经元细胞的SHP-2基因的表达,行相对定量分析。结果 HE染色和Nissl染色可见各实验组大鼠听皮层神经元细胞的凋亡形态随时间延长而加重,呈多样化表现;各对照组大鼠听皮层细胞形态正常。实验2、4、6、8周组SHP-2基因的RT -PCR相对表达量分别为1．1±0．28、1．5±0．04、2．5±0．08、11．0±0．06,随时间延长呈上升趋势,各实验组之间差异均有统计学意义（P＜0．05）。结论听觉剥夺可导致听皮层神经元细胞凋亡,凋亡的程度随时间延长逐渐加重;SHP-2基因可促进听皮层神经元细胞的增生,增生的程度也随时间延长而加重;在这两个相互拮抗的因素中,凋亡是最终的结果。     

16例中青年股骨头骨折的临床治疗

[摘要] 目的 探讨和总结中青年股骨头骨折治疗的临床疗效。方法 随访我院自2001年2月~2012年5月手术治疗的16例中青年股骨头骨折病例，男12例，女4例；年龄23~54岁，平均（38.39±8.63）岁。PipkinⅠ型5例；Ⅱ型7例；Ⅲ型1例；Ⅳ型3例。采用Smith-Peterson入路10例，Kocher-Langenbock入路4例，Moore入路2例。骨块摘除3例，拉力螺钉固定13例，3例合并髋臼后壁骨折病例中2例采用重建钢板内固定，1例采用铆钉固定。结果 平均随访时间为（40.1±8.56）月（25.1~50月），所有骨折均愈合，无感染发生，无内固定失败，无接受髋关节置换的病例。按照Merle d’Aubigne和Postel评分，优良率为（9/16）56.3%，中（3/16）18.7%，差（4/16）25%。4例患者发生股骨头内固定术后缺血性坏死，5例患者发生了异位骨化，1例继发创伤性关节炎。结论 运用空心螺钉治疗中青年股骨头骨折可获得满意的早期疗效，但股骨头骨折术后并发症发生率相对较高，需对术后髋部功能进行长期随访     

电针耳穴对D-半乳糖致年龄相关性听力损失豚鼠听觉中枢丙二醛表达的影响

目的探讨丙二醛在豚鼠年龄相关性听力损失发病中的作用和电针对年龄相关性听力损失的防治作用及机制。方法 4月龄豚鼠30只分为三组,每组10只,D-半乳糖模型组:豚鼠颈背部皮下注射D-半乳糖300mg.kg-1.d-1,每日1次,连续注射6周;D-半乳糖+电针组:D-半乳糖的用法用量同模型组,同时电针刺听宫、翳风两个穴位;对照组:给予等量生理盐水颈背部皮下注射,每天1次,连续6周。2年龄豚鼠10只(老年组)自然喂养。实验结束后各组行ABR检测,采用硫代巴比妥酸法(TBA)检测听皮层、下丘和耳蜗核组织中丙二醛的表达。结果①D-半乳糖模型组ABR波Ⅲ潜伏期比对照组延长(P<0.05);D-半乳糖+电针组ABR波Ⅲ潜伏期比D-半乳糖模型组缩短(P<0.05);②D-半乳糖模型组和老年组豚鼠听皮层、下丘和耳蜗核丙二醛含量明显高于对照组(P<0.05);与D-半乳糖模型组相比,D-半乳糖+电针组三个部位的丙二醛含量显著降低(P<0.05),但D-半乳糖模型组与老年组相比无明显差异(P>0.05)。结论豚鼠听觉中枢的老化可能与丙二醛含量升高所导致的脂质过氧化有关;针刺听宫和翳风两个穴位可通过降低丙二醛的表达,在一定程度上抑制D-半乳糖所致的豚鼠听觉中枢的老化过程。     

摘除双侧眼球对大鼠视交叉上核节律性的影响

成年Ｗｉｓｔａｒ雌鼠５７只，随机分为实验组３０只，行双眼摘除术。对照组２７只。术后４周将各组动物体重相近的每３只列为一个配伍组，分别在０９：００～１０：００、１７：００～１８：００、２３：００～２４：００三个时间处死。将含有视交叉上核的脑组织经固定、恒冷箱切片后，用免疫组化ＡＢＣ法染色显示视交叉上核内含ＶＩＰ或ＡＶＰ的神经元，微机图像分析仪上测量光镜下这两种神经元的相对切面面积及平均免疫反应强度。结果：（１）对照组不同时间处死的动物ＶＩＰ能神经元切面面积以２３：００～２４：００最大，０９：００～１０：００次之，１７：００～１８：００最小，呈昼夜节律变化，ＡＶＰ能神经元也以２３：００～２４：００最大，但在０９：００～１０：００和１７：００～１８：００间差异无显著性；（２）摘除双眼后各时间组间ＶＩＰ能神经元和ＡＶＰ能神经元切面面积均不再显示显著性差异。提示实验组动物视交叉上核的这两种神经元功能活动的昼夜节律已发生改变；（３）实验组和对照组动物的ＶＩＰ能神经元和ＡＶＰ能神经元平均免疫反应强度在所测的三个时间中，均未见明显差异。     

心电图在川崎病急性期的应用研究进展

川崎病是一种急性血管炎症性疾病,冠状动脉损伤及心肌炎是其常见的并发症,尤其在急性期可表现出不同程度的心肌损伤,在心电图上可表现出多种异常。心电图作为一种无创的电生理检查手段,对川崎病的早期诊断及治疗预后评估均有重要意义。随着研究的深入,川崎病早期的心电图表现及电生理意义逐渐被认识,现对近年来国内外研究川崎病急性期心电改变及临床意义进行回顾及总结,就心电图在川崎病诊治的应用进展进行综述。     

Effect of socio-economic factors on delayed access to health care among Chinese cervical cancer patients with late rectal complications after radiotherapy

Objectives

To determine the effect of socio-economic status (SES) on delayed access to medical treatment by Chinese cervical cancer patients who suffered from late rectal sequelae (LRS) after external beam radiation therapy (EBRT) and intracavitary brachytherapy.

Methods

Patients diagnosed with LRS were interviewed for their SES, factors including age, residing district, religion, marital status, income, education, insurance and patient delay (the time interval from the onset of symptoms to the first medical consultation) and other factors such as weight, symptom duration and disease stage at diagnosis.

Results

One hundred and twenty nine patients were interviewed. Seventy-one patients (55%) sought medical treatment within three months after the first symptom being recognized and fifty-eight patients (45%) delayed their medical treatment over 3 months. The study shows that age ≥ 55 (OR = 12.1; 95% CI: 3.3-43.9), lower education (OR = 4.6; 95% CI: 2.0-10.4 for women with primary school education or illiterate), low annual household income (OR = 2.3; 95% CI: 1.2-5.1) and widow/divorce (OR = 0.1; 95% CI: 0.01-0.07) were the high risk factors for delayed reporting. Patients with bleeding or bleeding plus other symptoms (61.2%) were more likely to seek treatment within three months, compared to patients with other symptoms only (38.8%) (p = 0.002). Additionally, delayed reporting was found to be significantly associated with the late stage of late rectal sequelae (LRS) (p = 0.000) and the patients with 55 years or older (p = 0.000).

Conclusions

Delayed reporting and late-stage presentation of late rectal sequelae are more prevalent among Chinese cervical cancer patients with 55 years or older, low education, poor marital status, or poor financial status. Effective social support and educational programs should be implemented to encourage these patients to seek medical treatment as soon as possible.