松质骨螺钉骨水泥强化的生物力学和组织学研究

目的通过动物实验观察不同骨水泥强化松质骨螺钉的生物力学和组织学变化动态,为骨质疏松骨折患者内固定提供理论基础。方法在10只杂种犬胫骨近端制作松质骨螺钉植入的动物模型,分别采用碳酸化羟基磷灰石水泥(CHC)和聚甲基丙烯酸甲酯(PMMA)强化,分别于术后5d、4、8、12和16周处死动物,观察螺钉拔出的生物力学和组织学变化。结果CHC强化的螺钉拔出力随手术后时间的延长而逐渐升高,16周时达到(512.5 14.5)N,而PMMA强化组螺钉拔出力则随手术后时间的延长而逐渐降低。CHC-骨界面结合紧密,并且随时间延长出现CHC降解和骨长入,而PMMA-骨界面形成一层纤维组织。结论CHC强化能够提高松质骨螺钉植入体内的稳定性,并且随植入时间延长而逐渐升高。     

罗格列酮对实验性慢性环孢素肾病的作用

目的 探讨罗格列酮（RSG）对慢性环孢素肾病（CCN）大鼠模型的肾保护作用。 方法 低盐饮食基础上建立CCN大鼠模型，其中1组模型鼠用RSG同时灌胃。分别在实验开始后第14天和第35天处死动物，检测血浆和肾组织血管紧张素Ⅱ（AngⅡ）、AngⅡ1型受体(AT1R)、转化生长因子β1(TGF-β1)、细胞外调节蛋白激酶（p-ERK）、α-SMA和纤连蛋白（FN）的表达。在体外用不同浓度的CsA和RSG孵育NRK细胞。RT-PCR检测肾皮质TGF-β1，Western印迹分析检测FN、AT1R、p-ERK水平。 结果 RSG可改善环孢素A导致的大鼠肌酐清除率的下降[（0.586±0.094）比(1.072±0.105)ml&#8226;min^-1&#8226;kg^-1，P < 0.01]、血浆和肾组织AngⅡ水平增加（P < 0.01）、肾间质单核细胞浸润（P < 0.01）、肾间质纤维化（1.707±0.019 比 2.335±0.022，P < 0.01）、肾组织α-SMA表达增加（P < 0.01）、肾皮质TGF-β1 mRNA水平增加（P < 0.01）、NRK细胞FN、AT1R和p-ERK蛋白水平增加（P < 0.05）。 结论 RSG可能通过减轻炎细胞浸润、影响AngⅡ作用和下调TGF-β1等途径减轻CsA所致的肾组织损伤。     

(足母)甲瓣切取术后供区创面覆盖的方法选择

目的探讨[足母]甲瓣切取术后供区修复的方法，减少供区并发症的发生。方法对[足母]甲瓣切取术后25例[足母]趾创面，采用三种不同的方法处理，其中采用游离皮瓣移植修复9例，采用足背或足底局部带蒂皮瓣修复12例，采用第二足趾皮甲瓣修复4例。结果移植皮瓣全部成活，术后平均随访10个月，其中2例游离皮瓣在术后6个月进行二期削薄，外观和功能满意。第二趾皮甲瓣修复后的功能在3种方法中效果最好。结论根据[足母]甲瓣供区的缺损情况，采用不同的手术方法进行即时修复，能最大限度减少供区并发症的发生。     

慢性硬膜下血肿术后并发症原因分析及应对措施

目的探讨慢性硬膜下血肿（chronic subdural hematoma，CSDH）术后并发症的原因及应对措施。方法回顾2000年至2004年手术治疗的85例CSDH患者，并结合有关文献进行相关分析。结果术后血肿复发3例，张力性气颅1例，脑挫裂1例，硬膜外血肿3例，脑脊液漏1例，脑内血肿1例。结论认识CSDH术后并发症的原因，早期采取有效措施，可有效预防并发症。     

Estimation of salt intake by urinary sodium excretion in a Portuguese adult population and its relationship to arterial stiffness.

BACKGROUND: Portugal has one of the highest mortality rates from stroke, a high prevalence of hypertension and probably a high salt intake level. AIM: To evaluate Portuguese salt intake levels and their relationship to blood pressure and arterial stiffness in a sample of four different adult populations living in northern Portugal. METHODS: A cross-sectional study evaluating 24-hour urinary excretion of sodium (24 h UNa+), potassium and creatinine, blood pressure (BP), and pulse wave velocity (PWV) as an index of aortic stiffness in adult populations of sustained hypertensives (HT), relatives of patients with previous stroke (Fam), university students (US) and factory workers (FW), in the context of their usual dietary habits. RESULTS: We evaluated a total of 426 subjects, mean age 50 +/- 22 years, 56% female, BMI 27.9+/-5.1, BP 159/92 mmHg, PWV 10.4+/-2.2 m/s, who showed mean 24h UNa+ of 202 +/- 64 mmol/d, corresponding to a daily salt intake of 12.3 g (ranging from 5.2 to 24.8). The four groups were: HT: n = 245, 49 +/- 18 years, 92% of those selected, 69% treated, BP 163/94 mmHg, PWV 11.9 m/s, 24 h UNa+ 212 mmol/d, i.e. 12.4 g/d of salt); Fam: n = 38, 64 +/- 20 years, 57 % of those selected, BP 144/88 mmHg, PWV 10.5 m/s, 24 h UNa+ 194 mmol/d, i.e. 11.1 g/d of salt; US: n = 82, 22 +/- 3 years, 57% of those selected, BP 124/77 mmHg, PWV 8.7 m/s, 24h UNa+ 199 mmol/d, i.e. 11.3 g/d of salt; FW: n = 61, 39 9 years, 47% of those selected, BP 129/79 mmHg, PWV 9.5 m/s, 24 h UNa+ 221 mmol/d, i.e. 12.9 g/d of salt. The ratio of urinary sodium/potassium excretion (1.9 (0.4) was significantly higher in HT than the other three groups. In the 426 subjects, 24h UNa+ correlated significantly (p < 0.01) with systolic BP (r = 0.209) and with PWV (r=0.256) after adjustment for age and BP. Multivariate analysis showed that BP, age and 24h UNa+ correlated independently with PWV taken as a dependent variable. CONCLUSIONS: Four different Portuguese populations showed similarly high mean daily salt intake levels, almost double those recommended by the WHO. Overall, high urinary sodium excretion correlated consistently with high BP levels and appeared to be an independent determining factor of arterial stiffness. These findings suggest that Portugal in general has a high salt intake diet, and urgent measures are required to restrict salt consumption in order to prevent and treat hypertensive disease and to reduce overall cardiovascular risk and events.     

Cardiovascular protection from alcoholic drinks: scientific basis of the French Paradox.

This article discusses the cardiovascular protection afforded by low to moderate consumption of ethanol and the role of ethanol-induced preconditioning. Ethanol, a compound that is found in many popular beverages, has a whole range of cardiovascular protective effects when consumed in low to moderate doses. Although they have yet to be totally clarified, recent data suggest that a combination of several actions at the biochemical and molecular levels play a role in this protection. These include favorable changes in lipid metabolism, antioxidant effects, changes in hemostasis and platelet aggregation, arterial vasodilation mediated by NO release, induction of the expression of cardioprotective proteins, insulin sensitization and lower levels of inflammatory markers. Special emphasis will be given to ethanol-induced preconditioning. Some of the compounds present in red and white wine, such as resveratrol and quercetin, are also partly responsible for some of the cardioprotective effects of alcoholic drinks. These are due to antioxidant effects and changes in platelet aggregation, endothelial function and inflammatory response. The last part of the paper will focus on the clinical applications and possibilities raised by these new findings.     

98例尿道下裂手术的体会

目的通过对尿道下裂手术的改进,进一步完善尿道下裂手术的技巧和护理。方法A组50例尿道下裂Ⅰ期成形术中,采用皮下连续内翻缝合形成新尿道,且固定于阴茎海绵体,由阴茎根部自下而上多层次,多点缝合皮瓣皮下组织至阴茎海绵体上,均无间隙和死腔。B组48例采用常规手术方式作对照。结果A组50例尿道下裂Ⅰ期成形术成功44例,B组48例成功17例,A组与B组相比成功率显著提高(P＜0．05)。结论尿道下裂Ⅰ期成形术成功率关键在于术者对术式掌握的熟练程度和术中及术后对每个细节的认真处理。     

不同微生物诱导家蝇幼虫表达抗菌肽的特性

研究不同微生物诱导家蝇幼虫表达的抗菌肽特性.用3种不同的病源菌通过针刺感染的方法诱导家蝇幼虫表达抗菌肽,通过Sephadex G25分离,用Hult mark改进法和抑菌圈测定法作抑菌试验,用毛细管电泳（CE）分析不同微生物诱导得到的抗菌肽样品差异,检测抗菌肽的热稳定性和酸碱耐受性.发现不同微生物诱导产生的家蝇抗菌肽具有广谱抑菌性,但不同样品对不同病源菌抑菌活性有差异,不同测定抑菌效果的方法对抑菌结果有影响,各种抗菌肽样品CE蛋白谱具有明显不同.抗菌肽样品都具有热稳定性和酸碱耐受性.说明不同微生物诱导产生的家蝇抗菌肽类型以及抗菌肽含量与诱导源有关,抗菌肽为家蝇幼虫体内固有成分,诱导增加了抗菌肽的表达量同时刺激新抗菌肽的产生.用志贺氏菌、金黄色葡萄球菌、鼠伤寒沙门氏菌诱导家蝇幼虫可产生较多含量高活性好的抗菌肽.     

克百威及其代谢产物的小鼠骨髓红细胞微核试验研究

[目的]利用微核试验研究克百威及其4种代谢产物的遗传毒性。[方法]分别以0．1、0．2、0．4mg/kg3个不同剂量水平的克百威及其代谢产物3-羟基呋喃丹、3-酮基呋喃丹、呋喃酚和亚硝基呋喃丹腹腔注射染毒健康小鼠，24h后以同样剂量再次注射染毒，6h后脱颈椎处死动物，制片，观察并计数嗜多染红细胞的微核率，进行统计分析。[结果]克百威、呋喃酚及3-酮基呋喃丹小鼠胸骨骨髓嗜多染红细胞微核实验为阴性结果，高剂量处理组微核率分别为1．3‰、3．25‰和3．62‰，与阴性对照组(1．83‰)差异无显著性；而高剂量组3-羟基呋喃丹(7．00‰)和三个剂量组的亚硝基呋喃丹(微核率分别为3．62‰、5．00‰、7．85‰)均有明显微核效应。[结论]克百威、呋喃酚和3-酮基呋喃丹在受试剂量下微核试验阴性，3-羟基呋哺丹和亚硝基呋喃丹微核试验阳性，提示可能对染色体具有突变效应。