Adhesions from flexor tendon surgery: an animal study comparing surgical techniques

Intraoperative and postoperative hemorrhage has long been considered a cause of tendon adhesion and, thus, scarring and poor surgical results. To prevent such problems bipolar coagulators are commonly used during surgery to help achieve hemostasis. Surgical lasers also have been reported to help limit bleeding and scar formation. Very little is known regarding the relationship between hemorrhage and/or direct tendon tissue effects and tendon adhesions with the use of these modalities. We compared 3 different surgical techniques (meticulous sharp scalpel dissection, scalpel dissection plus bipolar coagulation, and CO(2) laser dissection) and used chicken flexor tendons to biomechanically and histologically assess the amount of adhesion formation after each procedure. Our findings show that bipolar coagulation and CO(2) laser application are both associated with significantly increased adhesion formation in tendon surgery compared with sharp dissection alone and that the meticulous, conventional sharp dissection technique is the best method to control adhesion formation. These conclusions have relevance to clinical tendon surgery.     

盐酸小檗碱片剂与胶囊剂体外溶出度考察

目的 对国内6个不同厂家生产的盐酸小柒碱片及胶囊进行了体外溶出度考察。方法 按《中华人民共和国药典》2000年版^[1]溶出度测定法第2法，测定盐酸小檗碱片及胶囊的溶出度，提取参数(T50、Td、m)，并对参数进行相关性研究。结果 除D厂的片剂的溶出度不符合药典规定外，其余4个厂的片剂及F厂的胶囊在45min时的溶出量均大于70％。结论 表明各厂家的产品溶出参数存在显性差异(P＜0．01)。     

环氧化酶-2抑制剂联合顺铂治疗肺癌的实验研究

目的 探讨环氧化酶-2(COX-2)抑制剂尼米舒利(NIM)与化疗药顺铂(DDP)联合应用治疗肺癌的效应及可能机制。方法 应用MTT试验及流式细胞术分别检测NIM与DDP联用对人肺腺癌A549细胞增殖和凋亡的影响，裸鼠移植瘤实验检测NIM与DDP联用对A549细胞成瘤性的影响。结果 在一定浓度范围内NIM、DDP均可抑制A549细胞的生长，其抑制作用呈量一效关系。NIM(25umol／L)与DDP合用可增强对A549细胞生长的抑制作用，DDP浓度≥1mg／L时二者有协同或相加作用。NIM及DDP可有效诱导A549细胞凋亡，联用后凋亡率显著增加。裸鼠移植瘤体内实验显示NIM与DDP均可抑制移植瘤生长，联用后抑瘤率显著增高。结论 NIM与DDP联用对A549细胞、肺癌移植瘤有显著的协同抗肿瘤效应，该作用可能是通讨增强对A549细胞增殖的抑制以及诱导其凋亡来实现的。     

Evaluation of poly(styrene-4-sulfonate) as a preventive agent for conception and sexually transmitted diseases

A commercial preparation of a sodium polystyrene sulfonate (designated as N-PSS; its molecular weight is 500000 daltons) was tested as an inhibitor of sperm function and as a preventive agent for conception and the transmission of sexually transmitted diseases. The polymer is an irreversible inhibitor of hyaluronidase and acrosin; its IC50 values are 5.7 microg/mL and 0.5 microg/mL, for hyaluronidase and acrosin, respectively. N-PSS is also a stimulus of human sperm acrosomal loss. It produces maximal acrosomal loss at 2.5 microg/mL. Contraception in rabbits is nearly complete when rabbit spermatozoa are pretreated with 0.5 mg/mL of N-PSS before artificial insemination; however, N-PSS does not immobilize spermatozoa at concentrations as high as 50 mg/mL. N-PSS has broad spectrum antiviral and antibacterial activities. Infection by human immunodeficiency virus and herpes simplex virus are inhibited by N-PSS; 3-log reductions are produced by 7 microg/mL and 3 microg/mL, respectively. N-PSS is active against Chlamydia trachomatis and Neisseria gonorrhoeae. At 1 mg/mL, N-PSS inhibits chlamydial infectivity by more than 90%. N-PSS produces a 3-log reduction in gonococcal growth at 15 microg/mL. In contrast, N-PSS (5 mg/mL) does not affect the growth of Lactobacillus (normal component of the vaginal flora). N-PSS can be classified as a noncytotoxic contraceptive antimicrobial agent. These properties justify bringing a polystyrene sulfonate into clinical trials for its evaluation as a preventive agent for conception and several sexually transmitted diseases.     

Techniques for primary nerve repair

This article reviews the anatomy of the peripheral nerve, the pathophysiology of nerve injury, and Wallerian degeneration. It reviews the factors for deciding on immediate or delayed primary nerve repair and discusses the concept of longitudinal excursion of peripheral nerves about joints and the techniques for achieving an appropriate tension-free repair. The techniques of primary nerve repair, epineurial repair, and group fascicular repair are reviewed along with techniques for matching fascicles intraoperatively.     

抗肿瘤的PF4及相关肽基因重组腺病毒的构建

利用细菌内同源重组法构建含PF4(血小板第四因子)全长1-70及PF4的小肽17-70基因的重组腺病毒。方法:将连有MCP-1信号肽的PF4全长及其C末端的改构体PF4-17-70两个基因片段克隆至腺病毒穿梭质粒pAdshuttle-CMV中,形成转移质粒pAdshuttle/PF4(1-70)和pAdshuttle/PF4(17-70),将之酶切线性化后与腺病毒骨架质粒pAdEasy-1共转化大肠杆菌BJ5183,抽提并鉴定含目的基因的重组体质粒,而后用磷酸钙共沉淀方法转染HEK293细胞,包装成重组腺病毒AdPF4(1-70)和AdPF4(17-70)。采用PCR方法对重组体腺病毒进行鉴定,扩增并纯化病毒,用TCID50方法测病毒滴度,利用带有CMV-LacZ的对照重组腺病毒(Ad-LacZ)对感染效率进行监测。结果:利用电穿孔法分别将质粒pAdshuttle/PF4(1-70),pAdshuttle/PF4(17-70)与质粒pAdEasy-1共转化大肠杆菌BJ5183获得70%以上的阳性重组体细菌克隆。PCR检测结果表明重组腺病毒已含有目的基因,滴度为1×1010pfu/ml。结论:利用细菌内同源重组法可以简便、快捷地构建含PF4(1-70)、PF4(17-70)cDNA的腺病毒载体,为两者在肿瘤基因治疗中的应用奠定了基础。     

骨巨细胞瘤的生物学行为研究

本文对骨巨细胞瘤（ＧＣＴ）的传统组织学分级与其生物学行为不甚相符的原因进行了研究。采用５１例ＧＣＴ为研究对象，以１３例骨囊肿（良性）和１５例骨肉瘤（恶性）为对照组，采用图像分析仪（ＩＡＴ）对细胞核（ＧＣＴ取基质细胞核），进行了形态计量研究（８项参量），ＤＮＡ含量，ＤＮＡ倍体类型研究，及术后复发病例的ＤＮＡ倍性与其传统分级的比较研究。结果经统计学处理发现ＧＣＴⅠ级和Ⅱ级之间无显著差别，且它们的生物学属性在潜在恶性和低度恶性范畴。研究还揭示ＧＣＴ的ＤＮＡ≥５ｃ细胞数超过７％者系术后复发、转移的高危病例。     

老年性原发骨肉瘤五例报告

目的探讨老年人原发性骨肉瘤的临床特点及诊治方法？方法回顾分析5例老年原发性骨肉瘤患者的临床特点及诊断和治疗方法，5例患者年龄53～61岁。男3例，女2例。病变部位：肱骨近端2例，骨盆及胫骨近端各1例；多发性病灶1例x线检查见：病灶为成骨、溶骨混合性骨破坏，可见骨膜反应．周围见巨大的软组织肿块，基质内可见钙化；CT、MRI、ECT均有不同程度的骨质破坏及核素浓聚信号改变。病理镜下见典型的恶性梭形成骨细胞及肿瘤性骨样基质的组织特征发病首诊时均被误诊或漏诊。确诊后2例接受了新辅助化疗及保肢手术：1例给予化疗及放疗（DT6000cGy）；1例单纯化疗；另1例单纯放疗（DT6000cGy）结果5例患者均获随访．2例分别于确诊后8个月及10个月死于肺转移．3例仍在治疗随访中，2例接受保肢（全膝，半肩）手术者，患肢功能恢复满意。结论老年人原发性骨肉瘤较为少见，临床上容易误诊或漏诊，确诊后给予积极的个体化综合治疗．可以缓解症状，获得相对满意的治疗效果．     

乡镇医院在卫生突发事件中作用的调查

目的评估我省乡镇医院应对卫生突发事件应急能力.方法信访128个县市疾病控制中心负责人和部分乡镇医院负责人,调查内容包括卫生突发事件发生时乡镇医院的定位,应具备的设备、人员配备和经费支持等.结果绝大多数县市疾病控制中心负责人肯定乡镇医院为卫生应急系统的主要组成部分.乡镇医院负责人都认为乡镇医院是应急体系的必须部分,但目前状况不能适应需要,需要投资建设.结论政府应充分重视乡镇医院在卫生突发事件应急体系中的作用和建设.     

乌鲁木齐口岸出入境人员70例HIV感染者的流行病学调查

〔目的〕了解乌鲁木齐口岸出入境人员中HIV流行的现状和传播途径,以便提出防治建议。〔方法〕对2002￣2005年乌鲁木齐口岸出入境人员传染病监测体检中发现的70例HIV感染者进行流行病学调查分析。〔结果〕乌鲁木齐口岸地区HIV流行近年来呈上升趋势,感染者以青壮年为主,男性多于女性,传染途径以性接触为主,同时通过吸毒途径传播的危害不容忽视。〔结论〕必须加强对口岸高危人群和吸毒人群的HIV监测与健康教育以及行为干预措施研究,加强对HIV流行的综合防治能力,防止艾滋病在出入境人员中传播,保护人体健康。