透明质酸、富血小板血浆及两者联合应用对膝骨关节炎的疗效评估

目的 本研究旨在评估透明质酸（hyaluronic aicd , HA）与富血小板血浆（platelet rich plasma , PRP）对膝骨关节炎的疗效,同时探讨两者联合应用的潜在治疗效果。方法 纳入从2016年1月至2017年12月就诊于南京市第一医院的膝骨关节炎患者101例,按治疗方法的不同分为A组（膝关节腔内注射HA）37例、B组（膝关节腔内注射PRP）33例、C组（联合应用）31例。采用膝关节损伤与骨关节炎评分（knee injury and osteoarthritis outcome score , KOOS)在治疗前和治疗后1、3、6个月对疗效进行评估。结果 ①治疗1个月后,三组KOOS评分均较治疗前明显改善（P＜0.05）,其中C组的KOOS疼痛评分显著优于A组及B组（P＜0.05）;②治疗3个月后,3组较治疗前仍维持较好的疗效（P＜0.05）,其中B组与C组KOOS部分评分优于A组（P＜0.05）,B组与C组之间无明显差异（P＞0.05）;③治疗6个月后,B组与C组KOOS评分仍优于治疗前（P＜0.05）,两组无显著差异,而A组KOOS评分较治疗前无明显优势（P＞0.05）。结论 关节腔内注射PRP治疗膝骨关节炎可获得至少6个月的疗效,且在治疗3个月后,疗效优于HA。对于HA+PRP疗法,优势主要表现在短期内更为显著的改善了患者的疼痛症状。     

黏膜功能细胞灭活的去带盲结肠可控膀胱术

目的探讨黏膜功能细胞灭活的去带盲结肠可控膀胱术的临床效果。方法对8例全膀胱切除患者行黏膜功能细胞灭活的去带盲结肠可控膀胱术并进行随访。结果术后随访8～15个月,平均(12±4)个月。向贮尿囊内注入等量生理盐水,术后患者贮尿囊的平均压力小于手术前压力,且差异有统计学意义(P<0.05);术后贮尿囊平均周径大于术前,差别有统计学意义(P<0.05)。随访至12个月时,患者贮尿囊平均容量达到(550±90)mL,无输尿管反流,自控排尿良好,血电解质和肾功能正常,未出现肾盂肾炎及尿路感染。结论黏膜功能细胞灭活的去带盲结肠可控膀胱术具有手术操作简单、贮尿囊容量大、自控排尿良好等优点,是较为理想的尿流改道方法,具有良好应用价值。     

吲哚菁绿荧光导航在肝细胞癌术后腹腔多发转移瘤腹腔镜切除术中的临床应用

目的 探索腹腔镜吲哚菁绿荧光导航在肝细胞癌术后腹腔多发转移瘤切除中的应用价值。方法1 例肝细胞癌患者行肝切除术后7 年出现腹腔多发转移瘤,评估认为其具有根治性切除可能,在腹腔镜引哚菁绿荧光导航下切除腹腔多发转移瘤。结果 术中共计切除13 枚腹腔多发转移病灶,术后病理提示切缘为阴性,患者术后随访1 年余,血AFP水平降到正常水平,影像学检查肿瘤无复发及转移征象。结论 对于存在根治性切除可能的肝细胞癌术后腹腔转移瘤,术中通过应用吲哚菁绿荧光导航切除腹腔多发转移瘤,依然有可能使得部分患者生存获益。     

甲状腺乳头状癌术后刺激状态Tg预测^131I清甲治疗后Tg水平的价值

目的探讨甲状腺乳头状癌患者术后刺激状态甲状腺球蛋白（Tg）水平预测^131I清除术后残留甲状腺组织（简称清甲）治疗后Tg水平的价值。方法甲状腺乳头状癌患者138例,其中男28例,女110例,年龄6～70岁,平均39．4岁。所有患者均已行甲状腺全切或近全切除术,其中102例同时进行了颈部淋巴结清扫术,均经病理学检查确诊,于术后3～4周行^131I清甲治疗。^131I清甲治疗前后定期复查血清FT3、FT4、促甲状腺激素（佟H）、Tg抗体（TgAb）和Tg水平。采用SPSS13．0软件行相关分析和两样本均数差异的t检验。结果甲状腺切除术后和清甲治疗后刺激状态血清Tg水平呈明显正相关（r=0．960,P〈0．01）,清甲治疗后Tg阳性组和阴性组患者术后Tg水平分别为（199．8±327．7）μg／L、（3．5±5．6）μg／L,两组之间差异有统计学意义（t=5．567,P〈0．01）。76％（78例）患者有颈部淋巴结转移,41％（446枚）切除的淋巴结为阳性。颈部淋巴结转移数与术后及清甲治疗后刺激状态Tg水平呈明显正相关（r=0．697,0．633,P均〈0．01）。结论甲状腺乳头状癌术后刺激状态Tg可有效预测^131I清甲治疗后Tg水平,甲状腺全切或近全切除术结合颈部淋巴结清扫术能有效降低清甲治疗后Tg阳性率。     

Prognostic value of postoperative stimulated thyroglobulin levels on 131Ⅰ ablation therapy in papillary thyroid cancer

Objective Stimulated thyroglobulin (Tg) levels postablation was associated with disease recurrence in papillary thyroid cancer (PTC). The aim of this study was to evaluate the prognostic value of postoperative stimulated Tg level on future Tg positivity after 131Ⅰ ablation therapy in PTC. Methods One hundred and thirty-eight patients (28 men, 110 women; age range 6-70 years, mean age 39.4 years) with PTC were included in this study. All patients underwent total or near-total thyroidectomy, and 102 of these patients had lymphadenectomy. All patients had a documented PTC. 131Ⅰ ablation was performed in 3- 4 weeks after thyroidectomy. Sera levels of thyroid hormones (FT3, FT4), thyrotropin (TSH), anti-Tg anti-body (TgAb), and Tg were measured before and after 131Ⅰ ablation. Statistical analysis was performed with SPSS 13.0 software, and correlation anaysis and t-test were used. Results Postoperative stimulated Tg lev-el had a significantly positive association with pestablation stimulated Tg level (r = 0. 960, P < 0.01). Postoperative stimulated Tg level in positive postablation Tg group was significantly higher than that in nega-tive pestablation Tg group [(199.8±327.7) μg/L vs (3.5±5.6) μg/L, t =5. 567, P <0.01]. About 76% (78/102) patients had evidence of metastatic cervical lymph nodes on routine histological testing. And 41% (446/1088) resected lymph nodes were histologically positive for metastatic disease. The number of metastatic lymph nodes resected had a significantly positive relationship with stimulated Tg at pestopera-tion and postablation (r = 0. 697, 0. 633, both P < 0.01). Conclusions Postoperative stimulated Tg level was of better prognostic value on stimulated Tg level after 131Ⅰ ablation therapy. Total or near-total thyroidec-tomy simultaneously conjugated with lymphadenectomy might have a better result in lower postablation stimu-lated Tg pesitivity in patients with PTC.     

人类IL-3受体α亚单位与小鼠AIC2B蛋白的相互作用

目的探索人类IL-3受体(IL-3R)α亚单位与小鼠内源性AIC2B蛋白在诱导细胞增殖信号表达过程中的相互作用。方法通过PCR扩增技术，构建了IL-3Rα亚单位胞浆域缺失突变子34、22和CD，然后将野生型和突变型IL-3Rα亚单位cDNA分别转染到含小鼠IL-3R基因表达的BaF3细胞．并检测了阳性转染子的增殖信号传导和酪氨酸磷酸化。结果表达野生型hIL-3Rα／βc的BαF3阳性对照克隆在生理浓度hIL-3诱导后即可出现细胞增殖和胞浆信号蛋白βc、Jak2及Shc磷酸化；而含野生型IL-3αRa亚单位和AIC2B的BaF3细胞可出现高浓度hIL-3刺激的细胞增殖反应．但无信号传导分子的活化；共表达突变型IL-3Rα与AIC2B的BaF3细胞及未转染的BaF3细胞则对各种浓度的hIL-3刺激均无反应。结论尽管hIL-3Rβc亚单位在hIL-3诱导的信号传导过程中担负关键作用，但小鼠内源性AIC2B也可与hIL-3Rα重建功能性hIL-3R，这种功能的表达需要hIL-3Rα完整受体分子的存在。     

Prognostic value of postoperative stimulated thyroglobulin levels on 131Ⅰ ablation therapy in papillary thyroid cancer

Objective Stimulated thyroglobulin (Tg) levels postablation was associated with disease recurrence in papillary thyroid cancer (PTC). The aim of this study was to evaluate the prognostic value of postoperative stimulated Tg level on future Tg positivity after 131Ⅰ ablation therapy in PTC. Methods One hundred and thirty-eight patients (28 men, 110 women; age range 6-70 years, mean age 39.4 years) with PTC were included in this study. All patients underwent total or near-total thyroidectomy, and 102 of these patients had lymphadenectomy. All patients had a documented PTC. 131Ⅰ ablation was performed in 3- 4 weeks after thyroidectomy. Sera levels of thyroid hormones (FT3, FT4), thyrotropin (TSH), anti-Tg anti-body (TgAb), and Tg were measured before and after 131Ⅰ ablation. Statistical analysis was performed with SPSS 13.0 software, and correlation anaysis and t-test were used. Results Postoperative stimulated Tg lev-el had a significantly positive association with pestablation stimulated Tg level (r = 0. 960, P < 0.01). Postoperative stimulated Tg level in positive postablation Tg group was significantly higher than that in nega-tive pestablation Tg group [(199.8±327.7) μg/L vs (3.5±5.6) μg/L, t =5. 567, P <0.01]. About 76% (78/102) patients had evidence of metastatic cervical lymph nodes on routine histological testing. And 41% (446/1088) resected lymph nodes were histologically positive for metastatic disease. The number of metastatic lymph nodes resected had a significantly positive relationship with stimulated Tg at pestopera-tion and postablation (r = 0. 697, 0. 633, both P < 0.01). Conclusions Postoperative stimulated Tg level was of better prognostic value on stimulated Tg level after 131Ⅰ ablation therapy. Total or near-total thyroidec-tomy simultaneously conjugated with lymphadenectomy might have a better result in lower postablation stimu-lated Tg pesitivity in patients with PTC.     

听力正常青年人骨导听觉稳态诱发反应的测试

目的：测试听力正常青年人气骨导听觉稳态诱发反应阈值，了解对侧掩蔽对骨导听觉稳态诱发反应阈值的影响，为临床应用及诊断提供客观依据： 方法：实验于2005-03／05在武汉大学人民医院临床听力检测中心隔声屏蔽室内进行。选取听力正常的武汉大学在读学生36名（72耳），进行气骨导听觉稳态诱发反应反应阈、主观听阈及纯音听阈测试。受试者随机分为两组：第一组记录0，5，l，2，4kHz听觉稳态诱发反应的气骨导反应阈（骨导测试时不加掩蔽噪声）及行为听阈，第二组记录非测试耳加70dBSPL掩蔽自噪声时的骨导听觉稳态诱发反应反应阈。其中听觉稳态诱发反应听阈值单位采用声压级（SPL），纯占听阈值单位采用听力级（HL），所得的各频率气骨导阈值及掩蔽和无掩蔽时的骨导阈值采用SPSS11．5进行统计分析。 结果：36名受试者均进入结果分析。①第一组受试者听觉稳态诱发反应气骨导反应阈左右耳无显著性差异（P〉0．05）。②第一组受试者听觉稳态诱发反应在频率为0．5，1，2，4kHz时气导反应阈分别为40，34，32．36dBSPL，骨导反应阈分别为53，47，53，51dBSPL。③两组比较，对侧70dBSPL白噪声掩蔽对各频率骨导-听觉稳态诱发反应反应阈值的影响在1-5dB。 结论：影响骨导听觉稳态诱发反应测试因素较多．而由于测试条件的不同导致正常值差异大，因而不同的实验室在临床应用中应依其条件制定相关参考指标；对侧70dBSPL白噪声掩蔽不影响骨导-听觉稳态诱发反应反应阈值，因此正常听力者骨导听觉稳态诱发反应测试时可对侧加掩蔽噪声.     

应用SOS/Umu原位法对新型食用油烟雾致遗传毒性的研究

采用SOS/Umu原位法,对花生油、米糠油、玉米油烟雾的致遗传毒性进行研究。结果表明,三种新型食用油烟雾均具有致遗传毒性。随采样体积的增加,可使TA1535/PSK1002菌株产生β-半乳糖苷酶的量增加,并有明显的剂量——反应关系。     

根治性颈廓清术后并发颈动脉破裂出血的处理（附3例报告）

报告3例头颈部恶性肿瘤累及颈动脉，行根治性颈廓清术，术后一周内发生患侧颈动脉破裂大出血的处理。提示对术前疑有肿瘤及颈动脉，应做好切除颈动脉的准备，术后若发现动脉已明显受累则应同肿瘤一并切除。一旦术后发生颈动脉破裂，应在抗休克的同时结扎切除颈动脉，而不应修补之。