全髋关节置换术治疗强直性脊柱炎致髋关节强直的疗效及康复锻炼的意义

Objective To investigate the clinical effects of total hip arthroplasty (THA) for bony ankylosis in patients with ankylosing spondylitis and the significance of postoperative rehabilitation. Meth-ods From October 1998 to May 2007, 28 patients (46 hips) suffered from ankylosing spondylitis with hip bony ankylosis underwent THA. There were 27 males, 1 female, with the mean age of 38.9 years (range 22 to 58 years). Posterior lateral hip incision was performed in 34 hips, and modified anterior lateral combined with lateral hip incision in 12 hips. Forty hips applied cementless THA and 6 hips applied mixed THA. Har-ris scores, VAS scores and total hip range of motion in all patients were compared pre-and postoperatively to evaluate the clinical effects. Results All patients were followed up from 10 months to 64 months, with the mean time of 38.2 months. No paralysis, decubitus, and lung infection were found. Joint dislocation hap-pened in 1 case 2 weeks after operation, and was cured with close reduction. Heterotopic bone formation with Brooker Ⅰ was found in 6 hips and Brooker Ⅱ in 2 hips. Harris score increased from 28.3±10.3 preop-eratively to 82.7±7.6 postoperatively. VAS score changed from 3.5±1.4 preoperatively to 3.8±1.8 postopera-tively, and no significance was found. The hip movement range increased from 15.6°±9.3° preoperatively to 133.7°±17.6° postoperatively. Bony ankylosis in all patients disappeared and the hip function improved sig-nificantly after operation. Conclusion THA is the optimal method to treat the ankylosing spondylitis with hip bony ankylosis. Early rehabilitation is necessary to improve hip function.     

全髋关节置换术治疗强直性脊柱炎致髋关节强直的疗效及康复锻炼的意义

Objective To investigate the clinical effects of total hip arthroplasty (THA) for bony ankylosis in patients with ankylosing spondylitis and the significance of postoperative rehabilitation. Meth-ods From October 1998 to May 2007, 28 patients (46 hips) suffered from ankylosing spondylitis with hip bony ankylosis underwent THA. There were 27 males, 1 female, with the mean age of 38.9 years (range 22 to 58 years). Posterior lateral hip incision was performed in 34 hips, and modified anterior lateral combined with lateral hip incision in 12 hips. Forty hips applied cementless THA and 6 hips applied mixed THA. Har-ris scores, VAS scores and total hip range of motion in all patients were compared pre-and postoperatively to evaluate the clinical effects. Results All patients were followed up from 10 months to 64 months, with the mean time of 38.2 months. No paralysis, decubitus, and lung infection were found. Joint dislocation hap-pened in 1 case 2 weeks after operation, and was cured with close reduction. Heterotopic bone formation with Brooker Ⅰ was found in 6 hips and Brooker Ⅱ in 2 hips. Harris score increased from 28.3±10.3 preop-eratively to 82.7±7.6 postoperatively. VAS score changed from 3.5±1.4 preoperatively to 3.8±1.8 postopera-tively, and no significance was found. The hip movement range increased from 15.6°±9.3° preoperatively to 133.7°±17.6° postoperatively. Bony ankylosis in all patients disappeared and the hip function improved sig-nificantly after operation. Conclusion THA is the optimal method to treat the ankylosing spondylitis with hip bony ankylosis. Early rehabilitation is necessary to improve hip function.     

腹膜后间隙感染性病变的多排螺旋CT征象分析

目的 结合解剖学基础，探讨腹膜后间隙感染性病变的多排螺旋CT表现。方法 收集30例CT扫描发现腹膜后间隙存在异常、经临床、实验室检查等证实为感染性病变的病例，分析其CT和临床资料。CT检查包括平扫和增强后门静脉期扫描，并对CT数据进行冠、矢状位的多平面图像重组等后处理。结果 胰腺炎和肾脏感染是造成腹膜后间隙感染性改变的主要病因。依解剖区域的不同。炎症在腹膜后不同间隙内(肾旁前间隙、肾周间隙和肾旁后间隙)呈现不同的分布特点和相应的CT征象；炎症的跨间隙蔓延现象也较普遍。结论 多排螺旋CT可以全面、准确地显示腹膜后间隙感染性病变的原发病灶、毗邻组织器官、炎症蔓延范围等解剖细节。     

代谢手术治疗低体质指数的2型糖尿病研究进展

肥胖与糖尿病密切相关,肥胖患者常合并2型糖尿病(T2DM)等慢性代谢性疾病.代谢手术是治疗病态肥胖及肥胖相关代谢性疾病的有效方式,不仅可降低肥胖伴T2DM患者血糖,对于低体质指数(BMI)的T2DM患者也能达到降血糖的效应.低BMI的T2DM患者血糖的改善可能与术后一系列生理化学变化有关,包括胃肠道激素的分泌增加,肠道...     

低分子肝素联合地尔硫[艹卓]治疗不稳定型心绞痛的临床观察

不稳定型心绞痛（UAP）是介于稳定型心绞痛与急性心肌梗死或猝死的一种中间状态，是临床比较严重并且有潜在危险的急性冠脉综合征。我科于2003年至2005年间使用低分子肝素联合地尔硫[艹卓]治疗UAP126例，疗效显著，现报告如下。     

慢性心肌冬眠动物模型的建立

目的建立慢性心肌冬眠动物模型.方法随机选择健康杂种犬22只,使冠状动脉左前降支缩窄50%,继续喂养1个月以上,行第二次手术,暴露犬左心室和左前降支狭窄处,进行①多巴酚丁胺超声心动图负荷试验;②潘生丁负荷试验;③心肌声学造影;④氯化三苯基四氮唑(TTC)染色;⑤病理学检查.结果共10只犬完成了所有实验步骤,存活时间25～55d,平均(45.2±9.59)d.①结扎后与结扎前冠脉内径比为0.44～0.54,平均0.48±0.04;②10只犬均出现并保持了节段性室壁运动异常;③多巴酚丁胺负荷试验中,所有犬均出现室壁运动改善及"双相反应";④潘生丁负荷试验表明冠脉血流储备明显降低;⑤运动异常节段声学造影后的灰阶强度较正常节段明显减低;⑥术后TTC染色及光镜和电镜证实3只犬出现小灶性透壁性心肌坏死,1只犬出现小灶性心内膜下心肌坏死,余6只犬均无心肌坏死发现.结论在动物实验中,建立慢性(＞1 mo)心肌冬眠的动物模型是可行的.     

应用RT-PCR分析食管癌组织中lrig1基因的表达

目的：观察lrigl基因在食管鳞癌中的表达及意义．方法：采用RT．PCR检测36例食管鳞状细胞癌癌组织、相应的癌旁组织和远癌组织中lriglmRNA的表达情况．PCR产物经凝胶电泳，比较3种组织中ragl与GAPDH条带的灰度值之比，半定量分析IriglmRNA的表达水平．结果：36例食管癌组织中有15例（42％）lriglmRNA检测到阳性表达，21例（58％）lriglmRNA表达缺失，其阳性表达率低于相应的癌旁组织（92％）和远癌组织（100．0％，P〈0．05）；癌组织中lriglmRNA表达水平（0．76±0．22）低于相应的癌旁组织（0．89±0．33）和远癌组织（1．13±0．40）；随着肿瘤分化程度的升高，lriglmRNA在癌组织中的阳性表达率也增加（P〈0．05），但lriglmRNA表达缺失与食管癌临床分期（TNM），淋巴结有无转移和病理类型均无统计学差异（P〉0．05）．结论：lriglmRNA在食管癌组织中存在表达缺失和低表达，提示Irigl基因在食管癌的发生发展中可能具有抑癌基因的作用．     

准分子激光角膜屈光术后皮质类固醇性高眼压泪液蛋白变化的初步研究

目的 探讨准分子激光角膜屈光手术前、术后不同时间点和术后激素性高眼压患者泪液总蛋白和各主要蛋白成分的变化.方法 准分子激光角膜屈光术后激素性高眼压患者23例,正常眼压患者术前、术后1周地塞米松组、术后1周氟米龙组、术后1个月、术后3个月各10例,分别取基础泪液5 μl,采用BCA法测泪液总蛋白浓度,SDS-PAGE 法鉴定泪液中各主要蛋白成分的变化,采用SPSS 10.0统计软件进行分析.结果 泪液总蛋白的浓度检测结果显示:术后1周地塞米松组明显高于其他各组(P＜0.05),1个月降至术前水平,术后1周氟米龙组明显低于术后1周地塞米松组;高眼压组变化同正常眼压组,与正常眼压组对应时间点之间无显著差异(P＞0.05).SDS-PAGE结果显示:高眼压组泪液乳铁蛋白、溶菌酶浓度均高于其他各组(P＜0.05),其它蛋白组间无显著差异(P＞0.05).结论 准分子激光角膜屈光术后1周泪液总蛋白含量明显增加,高眼压者泪液总蛋白变化趋势同正常眼压组;准分子激光角膜屈光术后激素性高眼压患者泪液溶菌酶及乳铁蛋白含量增加.     

妊娠合并慢性肾炎

慢性肾小球肾炎 (简称慢性肾炎 )系由多种原发性肾小球疾病所导致的以蛋白尿、血尿、水肿、高血压为临床表现的慢性疾病。由于病因、发病机制、病理类型及病期不尽相同 ,而疾病的表现相异 ,易造成诊断及治疗的复杂化。妊娠合并慢性肾小球肾炎 (简称慢性肾炎 )属于产科高危妊娠中的重要疾病 ,应予高度重视。1　慢性肾炎与妊娠相互影响正常妊娠 ,由于解剖学的变化、内分泌功能的影响以及体位、饮食等因素均可使肾脏功能发生相应变化。妊娠末期肾血流量比非孕时约增加 35% ,而肾小球滤过率增加 50 % ,孕妇和胎儿代谢产物的排泄加重了肾脏的负担…     

深圳市南山区社区中老年居民血脂水平的调查与防治策略

目的：了解深圳市南山区社区中老年居民血脂水平及患病情况，为社区卫生服务预防、保健、康复与诊治工作提供科学依据。方法：对2001—2005年深圳市南山区桃源社区、大勘社区、大学城社区中老年居民的632份完整体检资料进行统计分析，比较不同年龄性别血胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）的水平。结果：不同年龄组高血脂随年龄增长呈增高趋势，同年龄组男女血脂水平也存在差异，≥60岁组有统计学意义。结论：深圳市南山区社区中老年居民高血脂患病率在目前我国城市中居于较高水平，已成为潜在心脑血管疾病的高危地区之一，应高度重视，早期干预，积极控制。