骨折愈合机制的研究进展

骨折愈合是一个复杂的生理过程，在愈合过程中涉及多种细胞和细胞因子的协同作用。最近研究发现Hedgehog（Hh）家族作为一种分泌蛋白和信号分子在脊椎动物发育和骨折愈合过程中起一定的作用。除骨组织本身外，神经组织及其所含NP也参与骨折愈合。骨科医师很有必要了解骨折愈合中发生于细胞和分子水平的现象，探讨骨折不愈合及延迟愈合的机制，以便能采取针对性的措施以促进骨折愈合。     

The effect of PDGFmRNA and IGFmRNA in the platelet concentrated liquid on ulna fracture healing in rabbit

Objective By hybridization in situ and biomechanical approach of platelet-derived growth fator mRNA(PDGFmRNA) and insulin-like growth factor mRNA(IGFmRNA), we discussed the influence of the platelet conentrated liquid on the healing of rabbit ulna fracture.Method We selected 24 New Zealand rabbits,divided them into 4 groups randomly (blank group,serum-control group,group with platelet concentrated liquid and group with bone graft and platelet concentrated liquid), and then made the fracture model on the middle of ulna which was fixed by finger armor plate.Before the operation, we drew out 6 ml blood from femoral artery, performed anti-coagulation with the Sodium Citrate and centrifugated by low and the followed high speed. We purified the white blood plate and injected it into the fracture position. The rabbits were killed at 1st,2nd,5th and 6th week.Qualitative analysis by hybridization in situ of PDGFmRNA and IGFmRNA and biomechanical measurement on the yth week sample were made. Result Bone callus could be seen on the radius spectimen in various degrees when the rabbits were killed at 1st. 2nd, 4th and 6th week, particularly in the last week. The average maximum destructive load on the fracture tip is higher to the control, and there is significant difference (P&;lt;0.01). Conclusion The local application of platelet concentration on the fracture tip can accelerate its healing.     

用BFA－100对人体组成的研究

人体是由脂肪和瘦体组织组成的，一般成人脂肪占体重的２５％，是人体能源库。营养不良时，这些组成成分即发生变化。本文所用ＢＦＡ－１００是由北京军事医学研究所王育才等人研制的人体脂肪分析仪。该分析仪是利用人体中电导和体内含水量、离子浓度有关的原理进行设计。...     

电解质异常与意识障碍

小儿因腹泻、呕吐、发汗等体液丧失易发生脱水症。丧失的体液中的钠浓度往往比血浆钠浓度低,所以急剧的大量腹泻和呕吐能产生高血钠性脱水(高渗性脱水)。尤其是肾性尿崩症,出生后即有尿崩症症状,若不注意补给水分就易产生高血钠症。中枢性高血钠症是由于脑畸形、脑肿瘤、脑炎、外伤等原因导致间脑下垂体(后叶)系的体液渗透压调节机构异常而产生高渗透压血症及高血钠症。见表1 酸中毒治疗中使用大量重碳酸钠和乳酸钠可招致高血钠症。在非酮症性高渗性糖尿病昏迷时,因渗透压性利尿丢失水分,多出现高血钠症。     

米粉ORS治疗婴幼儿轮状病毒性肠炎合并脱水

我院收治60例婴幼儿腹泻,经实验室病原学检测(ELISA聚丙烯酰胺凝胶电泳、电镜)及临床资料均符合轮状病毒性肠炎的诊断。对伴有轻、中度脱水病例应用米粉ORS与WHO推荐的ORS(下称复方ORS),对照观察疗效。资料与方法:以随机抽样的方法,将60例分为米粉ORS治疗组(28例)和原方ORS治     

肝动脉化疗栓塞术后胆汁瘤形成63例临床分析北大核心CSCD

目的探讨经导管肝动脉化疗栓塞术(TACE)或肝动脉栓塞术(TAE)后胆汁瘤形成的临床表现、治疗方法及预后。方法回顾性分析2005年1月—2013年3月行TACE/TAE后形成胆汁瘤的63例患者的临床及影像学资料,分析有无临床症状、胆汁瘤的治疗方式及临床转归。结果 63例患者中,52例胆汁瘤发生于TACE术后4周~3个月,占82.5%,11例胆汁瘤发生于TACE/TAE术后3~6个月,占17.5%。63例胆汁瘤形成患者中48例(76.2%)无临床症状,其胆汁瘤直径(2.64±2.20)cm;有症状胆汁瘤15例,胆汁瘤直径(6.98±6.57)cm,有无症状者胆汁瘤大小比较差异有显著统计学意义(P<0.01)。48例无症状胆汁瘤影像学随访时间37 d至49个月,其中30例(62.5%)大小无变化,13例(27.1%)缩小,3例(6.3%)消失,1例增大,1例胆汁瘤直径3.8 cm、临近肝包膜,发生破裂形成胆汁性腹膜炎,1周后死于感染性休克、肝功能衰竭。有症状胆汁瘤15例临床表现有黄疸2例,发热11例,黄疸并有发热2例。均行穿刺置管引流,11例(71.3%)缩小,4例消失;14例临床症状缓解后拔管,置管时间53 d^11个月,1例合并缺血性胆道狭窄,持续引流18个月仍反复发热。结论胆汁瘤作为TACE/TAE的并发症之一,多发生于术后4周~3个月。无症状者,应定期影像随访,对有症状或临近肝包膜较大的胆汁瘤,应及时穿刺置管引流。     

积雪草总苷对高脂血症小鼠的干预作用

目的 观察积雪草总苷对高脂乳剂诱导的高脂血症小鼠的血脂及肝脏调节作用.方法 以高脂肪乳剂连续灌胃制作小鼠高脂血症模型,给予不同剂量的积雪草总苷予以干预,以复方蛋氨酸胆碱为阳性对照组,1周后检测小鼠血清以及肝组织匀浆TC、TG、HDL-C、ALT、AST含量以及小鼠肝脏组织病理变化,以评价积雪草总苷干预效果.结果 积雪草...     

北京地区护士生活质量调查分析

目的调查北京地区护士生活质量,了解护士生活质量现状,为改善护士生活状况提供依据。方法采用中文版SF-36生活质量问卷调查表(Medical Outcomes Study,Short Form 36,SF-36),于2011年5月至2011年9月对北京地区12家医院,共365名临床一线在职护士进行调查,并与北京地区两家体检机构所收集的无慢性疾病的普通健康人共184例作对照分析,用SPSS 18.0系统软件进行统计处理。结果与健康组相比,护士组在PF(身体功能)方面高于健康组(P<0.05),而在RP(生理职能)、BP(躯体疼痛)、SF(社会功能)、RE(情感职能)、MH(精神健康)五个个方面明显低于健康对照组(P<0.05)。结论护理人员应该充分调动工作积极性,发挥优质护理优势,体现高水平护理的应用价值,提高自身成就感,为提高自身生活质量水平做出最大努力。     

中医康复护理改善肛肠科术后疼痛水肿的疗效分析

目的观察改善肛肠科术后疼痛水肿中医康复护理干预的效果。方法根据就诊顺序单双数分组法选取2016年12月—2018年6月该院就诊的56例改善肛肠科术后疼痛水肿患者进行研究,单数为实验组,双数为对照组,每组人数均为28例。给予对照组患者常规护理干预,在常规护理的基础上给予实验组患者中医康复护理干预。康复护理完成后,对患者采用VAS评分法对患者的术后疼痛感进行评估,并对两组患者术后的创面水肿状况进行比较,分析两种方案的有效性。结果实验完成后,两组患者的疼痛感和创面水肿状况均有所改善,但实验组改善状况更为明显,组间差异有统计学意义(P0.05)。结论在改善肛肠科术后疼痛水肿患者的护理中,采取中医康复护理干预效果更佳,能够对患者的疼痛感有所改善,有助于提高患者的护理满意度,具有较高的临床运用价值。     

促红细胞生成素促进坐骨神经再生的实验研究

Objective To investigate the effect of recombinant human erythropoietin(rh-EPO) on the nerve regeneration of adult rats sciatic nerves. Methods Tirty-six healthy male Wistar rats were involved and left sciatic nerve repaired model was used.The experimental rats were divided randomly into two groups:the EPO group and the control group,18 rats in each group.rh-EPO 3 000 U/kg was injected daily into the abdominal in EPO group,and normal saline was injected into the abdominal every day after operation in control group.On 4 and 8 weeks after operation,these items were determined,the sciatic function index (SFI),biomechanics examination,histological observation,electrophysiological examination,myelinated fibers density and sectional area measurement.Results On weeks 4 after operation,the SFI of EPO group and control group were-65.26 ± 3.42 and-70.83 ± 4.12,respectively,the maximum tensile resistance were (3.86 ± 0.29)N/mm2 and (3.38 ± 0.21 )N/mm2,the delayed ratio of latency of motor nerve were 2.34 ± 0.23 and 2.78 ± 0.29,and the recovery ratio of wave amplitude were 0.23 ± 0.05 and 0.14 ± 0.03 respectively.On eight weeks after operation,the SFI of EPO group and control group were-51.34 ± 2.98 and-57.23 ± 4.86,respcetively,the maximum tensile resistance were (4.67 ± 0.36) N/mm2 and (4.13 ± 0.32) N/mm2,the delayed ratio of latency of motor nerve were 1.32 ± 0.15 and 1.62 ± 0.21,the recovery ratio of wave amplitude were 0.41 ± 0.09 and 0.26 ± 0.07,the nerve fibers cross ratio were 0.57 ± 0.05 and 0.38 ± 0.03,and the recovery ratio of sectional area of myelinated fibers were 0.81 ± 0.06 and 0.58 ± 0.03,respectively.Those items in EPO group were significantly superior to those in the control group (P ＜ 0.05 ＝.Conclusion rh-EPO can promote the injured nerve regeneration and improve the recovery of their function.