CR假体与PS假体全膝关节置换治疗膝骨性关节炎合并膝外翻畸形的疗效分析

目的 比较后交叉韧带保留型（CR）假体与后方稳定型（PS）假体行人工全膝关节置换术（TKA）治疗膝骨性关节炎合并膝外翻畸形的临床疗效。方法 回顾性分析南昌大学附属赣州医院关节外科2019年5月至2021年5月收治的60例（60膝）膝骨性关节炎合并膝外翻畸形患者资料,均为单侧置换。30例采用CR假体行TKA治疗（CR组）,30例采用PS假体行TKA治疗（PS组）。比较两组患者的手术时间、术中失血量、术后引流量、术后3 d血红蛋白（Hb）下降量及深静脉血栓发生情况;比较两组患者手术前后膝外翻角;比较两组患者术后1周、1个月、3个月、6个月、1年疼痛视觉模拟评分（VAS）、膝关节活动度（ROM）、美国特种外科医院膝关节评分（HSS）。结果 60例患者均顺利完成TKA手术,所有患者随访13 ～ 28个月,平均（18.51±0.90）个月。CR组术中出血量、术后引流量、术后3 d的Hb下降量较PS组减少（P＜0.05）;两组手术时间相当、术后均无深静脉血栓发生,差异无统计学意义（P＞0.05）;两组手术前后膝外翻角的比较差异无统计学意义（P＞0.05）;CR组术后1周、1个月VAS评分较PS组更低（P＜0.05）,两组术后3个月、6月、1年VAS评分比较差异无统计学意义（P＞0.05）;CR组术后1周、1个月、3个月膝关节ROM和HSS评分优于PS组（P＜0.05）,两组术后6个月、1年膝关节ROM和HSS评分比较差异无统计学意义（P＞0.05）。结论 采用CR或PS假体行TKA手术治疗膝骨性关节炎合并膝外翻畸形均可有效纠正膝关节畸形、减轻膝关节疼痛、改善膝关节活动度及功能,取得满意临床疗效;但相对PS假体,CR假体保留了后交叉韧带,减少了股骨髁部截骨量,从而减少手术出血,更好减轻早期术后疼痛,有助于TKA术后早期功能康复。     

B超对肺癌急症的诊断及疗效评估

目的评价Ｂ超对肺癌急症的快速鉴别诊断价值。方法应用Ｂ超诊断肺癌急症３５例,其中有中央型右上肺癌肿块压迫引起的上腔静脉综合征（ＳＶＣ）５例,探查取胸骨右缘第２、３肋间;中大量心包积液伴亚急性心包填塞症１０例,包括心肌与心包转移癌致急性出血性心包积液２例,探查取心前区及左腋前线第５、６肋间;恶性胸腔大量积液２０例,探查位于两侧背部膈上。介入性治疗,Ｂ超定位穿刺抽液并腔内注入中药榄香烯乳,配合临床化疗药物、输血等综合治疗。结果在４周内急症得到暂时缓解者占８２．８％,稳定占８．５％,无效占８．５％。结论简便、可重复性的超声诊断及时、可靠,并可提供疗效参考依据,证实榄香烯乳对控制急性心肌心包出血有特效,起乳剂微栓止血作用。对部分包裹性胸腔积液无效。Ｂ超对ＳＶＣ诊断有一定局限性。     

A simple test of the vicarious trial-and-error hypothesis of hippocampal function.

Vicarious trial-and-error (VTE) is a term that Muenzinger and Tolman used to describe the rat's conflict-like behavior before responding to choice. Recently, VTE was proposed as a mechanism alternative to the concept of "cognitive map" in accounts of hippocampal function. That is, many phenomena of impaired learning and memory related to hippocampal interventions may be explained by behavioral first principles: reduced conflicting, incipient, pre-choice tendencies to approach and avoid. The nonspatial black-white discrimination learning and VTE behavior of the rat were investigated. Hippocampal-lesioned and sham-lesioned animals were trained for 25 days (20 trials per day) starting at 60 days of age. Each movement of the head from one discriminative stimulus to the other was counted as a VTE instance. Lesioned rats had fewer VTEs than sham controls, and the former learned much more slowly or never learned. After learning, VTE frequency declined. Male and female rats showed no significant differences in VTE behavior or discrimination learning.     

Evidence that BKCa channel activation contributes to K+ channel opener induced relaxation of the porcine coronary artery

The rank order of potency of a series of benzopyran and cyanoguanidine K⁺ channel openers (KCOs) for causing relaxation of the PGF₂-precontracted porcine coronary artery was determined. Glyburide, an inhibitor of K_ATP channels, showed an apparent competitive inhibition of the vasorelaxant activity of the KCOs. The pA₂ values of glyburide when cromakalim and CGP 14877 (P1060) were used as vasorelaxants were 7.66 and 7.83, respectively. Charybdotoxin (40 nM), an inhibitor of BK_Ca channels, also caused a significant inhibition of the cromakalim mediated relaxation of the porcine coronary artery. In order to clarify the site of action of these KCOs, we identified a K⁺ channel current in single porcine coronary arterial cells and measured channel activity in the presence of these compounds. The prominent K⁺ ion current in these cells had characteristics typical of the conventional large Ca²⁺-activated K⁺ channel BK_Ca present in other smooth muscle cells. Using symmetrical K⁺ concentrations, the channel had a conductance of 214 pS and was found to be sensitive to [Ca²⁺]_i and membrane potential. The KCOs were found to reversibly increase the open probability (P_o) of the channel without changing channel conductance. The potency of the KCOs to increase K⁺ channel opening was similar to the potency of these compounds to cause coronary artery relaxation. These results indicate that the porcine coronary artery contains the BK_Ca channel and that this channel, along with other types of K⁺ channels (K_ATP), mediate the vasorelaxant effects of K⁺ channel openers.     

Antibiotic C3368-A,a fungus-derived nucleoside transport inhibitor,potentiates the activity of antitumor drugs

Antibiotic C3368-A (CA) is produced by a fungus strain from a soil sample collected in Antarctica. CA markedly inhibited radiolabeled thymidine and uridine transport in mouse Ehrlich carcinoma cells, its 50% inhibitory concentration (IC₅₀) being 4.6 and 7.7 M, respectively. In clonogenic assay, CA displayed a synergistic effect with methotrexate (MTX), mitomycin C (MMC), 5-fluorouracil (5FU), and Adriamycin (ADR) against human oral epidermoid carcinoma KB cells. CA also markedly enhanced the inhibitory effect of 5FU and ADR on the proliferation of human hepatoma BEL-7402 cells as determined by thep-nitrophenyl-N-acetyl--d-glucosaminide (NAG) enzyme-reaction assay. 5FU or ADR cytotoxicity was not augmented by CA in human fetal lung 2BS cells. In vivo, CA significantly potentiated the inhibitory effect of MMC against colon carcinoma 26 in mice. No significant augmentation of toxicity by the combination was found in treated mice. The results suggest that CA, the newly found nucleoside-tranport inhibitor, may be useful in potentiation of the effect of antitumor drugs.     

选择性支气管动脉灌注治疗中晚期肺癌

报导了３５例选择性 支气管动脉化疗灌注治疗原发性肺癌、３５例共进行支气管动脉灌注６７例次,近期追踪观察有效率为８８．６％,同时对本法的具体实施步骤,药物灌注的理论基础、支气管动脉解剖变异及预防严重并发症的措施,作了具体分析和探讨。     

Human papillomaviruses and papillomatosis lesions of the female lower genital tract

Objective: The objective of this study was to determine whether human papillomavirus (HPV) infections are involved in the development of papillomatosis lesions of the lower female genital tract.Methods: A total of 616 biopsy specimens of genital papillomatous lesions (307 nodular and 309 papular types) from 598 patients were anaylyzed for the presence of HPV DNA sequences by polymerase chain reaction (PCR). These specimens were also examined by histopathological assessment for characteristic HPV-associated cytological changes, by immunohistochemical staining for HPV-associated antigen, and by electron microscopy for the presence of virions.Results: HPV DNA sequences were found in 97.9% (140 of 143 cases) and 1.1% (1 of 91 cases) of the nodular and papular papillomatosis cases tested, respectively. In 18 patients who had both types of papillomatosis lesions, HPV DNA was invariably found only in nodular tissues. HPV-associated antigen, koilocytosis, and virions were found in 53.6% (98 of 183 cases), 70.5% (129 of 183 cases), and 5.9% (5 of 85 cases) of nodular papillomatosis lesions tested, respectively.Conclusions: These data suggest that nodular papillomatosis was closely associated with HPV infection, but that papular papillomatosis of the lower female genital tract may have an etiology other than HPV infection.     

职业人群不健康行为生活方式与高尿酸血症的关系及高血压、血脂异常的效应修饰作用

目的 探索不健康行为生活方式与高尿酸血症的关系,以及高血压、血脂异常的效应修饰作用,为预防高尿酸血症提供理论依据。方法 采用横断面调查研究设计,基于2021年10-12月来自四川省、贵州省28个地级市和重庆市33个区（县）中国铁路成都局集团有限公司的西南职业人群队列基线数据,通过问卷调查、体格测量及实验室生化检测收集研究对象的人口学特征、行为生活方式、慢性非传染性疾病患病情况。不健康行为生活方式得分根据吸烟、饮酒、膳食模式、体力活动和低体重/超重状况进行评分,分值越高不健康行为生活方式越多。采用多因素logistic回归模型分析不健康行为生活方式评分、吸烟状况、饮酒状况等与高尿酸血症的关系,采用分层分析探索高血压等疾病对不健康行为生活方式与高尿酸血症之间关系的修饰效应。结果 共纳入11 748名研究对象,高尿酸血症患病率为34.4%。多因素logistic回归分析显示,现在吸/既往吸烟、现在饮/既往饮酒及BMI异常是高尿酸血症患病的危险因素,不健康行为生活方式对高尿酸血症患病风险呈现累积效应,随着得分的升高,高尿酸血症患病风险升高,OR值由1.64（95%CI：1.34~2.00）上升至2.89（95%CI：2.39~3.50）。分层分析结果显示,在高血压及血脂异常人群中,不健康行为生活方式对高尿酸血症患病风险影响更大。结论 多种不健康行为生活方式的共存会升高高尿酸血症患病风险,这一效应在高血压、血脂异常人群中更明显。及时纠正不健康行为生活方式,并控制高血压和血脂异常,降低患高尿酸血症的风险。     

深圳市一孩先天性残疾家庭的二孩同类病研究

本文对深圳市1990～1997年因独生子女先天残疾通过病残儿鉴定再生育二孩的家庭进行调查,并以同期通过鉴定的后天性残疾家庭为内对照,以农村地区一孩先天残疾未经病残儿鉴定生育二孩的家庭为外对照,了解其二孩先天残疾再发情况,尤其是同类病的再发情况,拟对独生子女病残儿医学鉴定和二胎生育指标的审批工作效果进行评价,为优生工作提供依据。研究结果表明,鉴定组一孩先天残疾家庭二孩先天残疾的患病率为5.81％,与广州市1986～1991年情况类似(5.9％),高于外省(辽宁1990～1992年为1.35％)。鉴定组二胎同类病发生率为2.8％,非鉴定组为4.55％,两组比较虽无统计学差异,但病种上却有不同,鉴定组为再发风险低的血友病、先天性共转性内斜视、脑萎缩,而非鉴定组为再发风险高的先天聋哑、进行性肌萎缩。提示病残儿鉴定工作颇有成效,避免了相当一部分遗传病家庭再次生育残疾儿,但某些环节有待进一步完善;对农村一胎先天残疾家庭生育二胎也必须纳入管理范围。     

富锌鹌鹑蛋对儿童血锌铜钙营养的影响

目的了解富锌鹌鹑蛋对儿童生长发育和血清锌铜钙和其他生化的影响。方法在幼儿园挑选７３名４～４５岁全托健康儿童,随机分为两组,实验组３７例、对照组３６例,两组在同一膳食基础上,用称重法记录食物摄入量,实验组每人每日吃鹌鹑蛋５枚。对照组每人每日服１０％硫酸锌１０ｍｌ。结果两组儿童体格发育比较,实验组身高、体重、上臂肌围和三角肌皮皱厚度较实验前明显增加（Ｐ＜００５）,对照组身高、上臂围和三角肌皮皱厚度较前明显增加（Ｐ＜００５）,两组间体重身高无明显差异（Ｐ＞００５）,上臂肌围和三角肌皱厚度增加有组间差异（Ｐ＜００５）。实验后对照组血红蛋白下降,血清铜、游离原卟啉上升与实验组有显著差异（Ｐ＜００５）,实验组血红蛋白、游离原卟啉、血清铜变化不大。结论富锌鹌鹑蛋有益于儿童生长发育,对铁和血红蛋白影响小,硫酸锌可能干扰铁的吸收,营养状况好的儿童不宜盲目补锌。