Arthroscopic single-bundle reconstruction of posterior cruciate ligament with quadrupled hamstring tendon

Objective： To evaluate the technique and outcome of arthroscopic sipy, le-bundie reconstruction of posterior crudate ligament （PCL） with quadrupled hamstring tendon. Methods： From April 2001 to October 2004, 49 knees with PCL tears in 49 patients were verified with arthroscope in this department. Of them, 13 were combined with anterior cruciate ligament tears, 14 with disruptions of the posterolateral comer, 6 with ruptures of the posteromedial corner and medial collateral ligament, 9 with lateral meniscus tears, 5 with medial meniscus tears and 2 with popliteal vascular tears. All the damaged PCLs were reconstructed with single-bundie of autogenous quadrupled hamstring tendons under arthroscope. Biodegradable interference screws or blunt titanium interference screws were used for direct anatomic fixation of the reconstructed ligament. Results： After operation, no severe complications occurred at early stage in the 49 patients. All of them were followed up for 10-52 months with an average of 22. 0 months ＋ 10. 7 months. Lysholm score was remarkably improved from 30-60 （ mean： 47.96 ＋ 8. 16） preoperatively to 70-95 （ mean： 89. 08 ＋ 6. 10 ） at the last postoperative follow-up （ P 〈 0.01 ）. Furthermore, there was a significant improvement in International Knee Documentation Committee （IKDC） score from abnormal （ Grade C） in 10 knees and severely abnormal （Grade D ） in 39 preoperatively to normal （ Grade A ） in 20, nearly normal （ Grade B） in 24 and abnormal in 5 at the last follow-up. Of the 49 patients, 40 returned to the same activity level as before and 9 were under the level. Conclusions： Single-bundle reconstruction of PCL with quadrupled hamstring tendons has the advantage of minimal trauma in surgery and satisfactory outcome.     

采用扩散张量纤维束成像技术研究活体Broca语言功能区及其纤维环路的结构

目的 采用扩散张量成像技术揭示健康人Broea区与其他脑功能区间的纤维联系规律。方法 健康成人20名，采用Siemens Trio 3．0T MR仪及工作站行数据采集和后处理及Broea区（B45和44区）纤维追踪，分析由语言功能区发出的神经纤维分布和走行。结果 BroeaB45区纤维束平均值左侧为428束，右侧相应脑区为416束，两侧差异无统计学意义（t=0．216，P〉0．05）；B44区纤维束平均值左侧为432束，右侧相应脑区为344束，两侧差异有统计学意义（t=2．314，P〈0．05）。B45区部分各向异性左侧平均为0．336，右侧同区为0．317（t=-3．656，P〈0．05）；B44区左侧平均为0．342，右侧同脑区为0．342（t=0．093，P〉0．05）。弓状纤维束平均左侧为199束，右侧为205束（t=-0．465，P〉0．05）；平均部分各向异性左侧为0．385，右侧为0．375（t=1．912，P〈0．05）。Broea区发出纤维走行和分布，主要向前上到额叶前部内侧面皮层下，过胼胝体到对侧相应结构，向外下穿外囊向后经颞叶到枕叶，向内下穿苍白球和内囊后肢向下行。结论 Broea区及其相关的纤维结构形成重要的语言纤维环路结构，结构完整是完成语言功能的基础。     

外伤性脾破裂治疗方法的选择

为探讨外伤性脾破裂治疗方法的合理选择。笔者对82例外伤性脾破裂患者的临床资料进行回顾性分析。82例中采用非手术治疗30例，脾切除术24例，其中16例加行脾片大网膜移植术，脾缝合修补术10例，部分脾切除术18例。治愈82例，治愈率100 %。笔者认为，根据脾损伤的具体情况，因地制宜选择治疗方法，既可最大限度地保留脾脏功能，又能安全有效地抢救生命，减少并发症，降低病死率。     

氨乙基异硫脲对大鼠离体心脏冠脉结扎后再灌期心律失常与细胞动作电位的作用

用Langendorff方法与微电极技术研究自由基清除剂氨乙基异硫脲(AET)对离体大鼠心脏冠脉结扎后再灌期心律失常与细胞动作电位的作用。AET(0.001～1mmol/L)使室颤和室速发生率明显下降,使正常窦性心律时间增加。浓度为0.01～1mmol/L的AET可使不可逆室颤发生率下降为零。冠脉阻塞再灌损伤使缺血中心区心肌动作电位波形异常,APA,RP,V_(max)各参数下降。AET(0.1mmol/L)可使异常波形动作电位显著减少。     

泰州市级医院消毒剂使用现状调查

[目的]了解泰州市市级各医院的消毒剂使用现状,为指导临床合理、规范使用消毒剂提供依据和指南。[方法]以泰州市5所市级医院为研究对象,全面调查临床使用消毒剂的种类及其使用中消毒剂的有效成份、年消耗量、消毒方法知晓率、染菌量等背景资料。[结果]5所医院使用的消毒剂种类基本相似,主要是含氯消毒剂等高中水平消毒剂,低水平消毒剂使用量很少,消毒剂年消耗量巨大。医院工作人员消毒知识知晓率低,消毒剂使用不合理,影响消毒效果。使用中消毒剂检测合格率为51.4%;其中消毒剂有效成份合格率71.2%;染菌量指标合格率90.9%。消毒剂染菌量合格率与消毒剂配制浓度、消毒时间、消毒方法知晓率之间呈正相关,相关密切程度：消毒时间〉消毒方法〉消毒剂配制浓度;消毒剂总合格率与消毒剂有效成份合格率之间呈正相关。[结论]医院消毒剂使用不合理,可致医院菌株对常用消毒剂产生抗药性。     

对比因素对儿童分辨物体细节能力的影响

目的观察对比因素对儿童分辨物体细节能力的影响,了解儿童对比视力的状况。方法使用对比视力表,测量53名裸眼视力≥5.0的正常儿童92%,52%,30%对比水平处的对比视力。结果儿童的对比视力随对比度的降低而显著下降,对比度与视力之间存在显著相关;左、右眼的对比视力差异无统计学意义;男性和女性的对比视力差异无统计学意义。结论低对比的学习环境会增加儿童视觉负荷,在防治学生近视过程中应引起重视。     

应用胫前肌瓣修复胫骨骨髓炎合并软组织缺损

自1999年1月-2005年3月,应用胫前肌瓣修复胫骨骨髓炎合并软组织缺损13例,同时辅以中药治疗,获得较满意的效果,现报告如下。1临床资料本组13例,男9例,女4例;年龄18~67岁,平均32岁。致伤原因:车祸伤6例,挤压伤4例,烧伤1例,坠落伤2例。胫骨上1/3段1例,中1/3段2例,下1/3段5例,中下2     

Synergistic mechanisms by which sirolimus and cyclosporin inhibit rat heart and kidney allograft rejection

The studies presented herein examined the mechanism(s) whereby sirolimus (SRL) and cyclosporin (CsA) act synergistically to block allograft rejection. Combination index (CI=1 reflects additive, CI<1 antagonistic, and CI<1 synergistic, effects) analysis documented potent synergism between SRL and CsA to block allograft rejection. Combinations of the two drugs produced synergistic prolongation of heart (CI=0.001–0.2) or kidney (CI=0.03–0.5) allograft survival at SRL/CsA ratios ranging from 1:12.5 to 1:200. Pharmacokinetic analysis of the individual drugs showed that CsA does not affect the blood levels of SRL, and SRL mildly increases the levels of CsA in SRL/CsA-treated rats. Quantitative polymerase chain reaction analysis was used to document that both subtherapeutic (1.0 mg/kg) and therapeutic (2.0 or 4.0 mg/kg) CsA doses inhibited the expression of interferon-gamma (IFN-γ) (P<0.03) and IL-2 (P<0.003) mRNA produced by T helper (Th) 1 cells, as well as IL-10 (P<0.001), but not IL-4 (NS) mRNA produced by Th2 cells. Contrariwise, all tested SRL doses (0.02, 0.04 or 0.08 mg/kg) did not affect cytokine mRNA expression. However, heart allografts from rat recipients treated with synergistic SRL/CsA doses displayed reduced levels of IFN-γ (P<0.01), IL-2 (P<0.001) and IL-10 (P<0.001) mRNA. Thus, because subtherapeutic doses of CsA reduce Th1/Th2 activity, thereby facilitating the inhibition of signal transduction by low does of SRL, the two agents act synergistically to inhibit allograft rejection.     

激光雾化治疗机的研制

介绍一种新型激光治疗装置.它利用超声波产生的雾化气体通道作为光学传导媒介,将激光束汇同雾化药雾通过患者的深呼吸一起传导至患者的呼吸道及肺部,进行治疗.     

胆道支撑管显影材料的制备及体外细胞毒性评价

目的 探讨新型显影胆道支撑管材料制备的可行性，对构建出的材料进行体外细胞毒性评价和筛选。方法 选择具有X线下显影特性的基础材料A、B、C，分别与硅橡胶生胶共混炼，模压后分别得到相应的显影复合材料甲、乙、丙，经一段和二段硫化过程完成加工。采用MTT法作为体外细胞毒性评价的方法，测定参比对照材料和新材料的50％浓度的浸提液对小鼠成纤维细胞的增殖率的影响，确定细胞毒性级别。结果 新材料甲、乙、丙在x线下影像清晰。甲、乙材料的细胞毒性级别为零，丙材料细胞毒性级别为2。结论 构建出在X线下显影的弹性体材料可行。材料甲、乙是制造新型胆道支撑管的初选材料，材料丙无应用的价值。