Implant wear induces inflammation, but not osteoclastic bone resorption, in RANK(-/-) mice.

Signaling of RANK (receptor activator of nuclear factor kappa B) through its ligand RANKL appears critical in osteolysis associated with aseptic loosening (AL). The purpose of this study was to investigate the role of RANK in a murine osteolysis model developed in RANK knockout (RANK(-/-)) mice. Ultra high molecular weight polyethylene (UHMWPE) debris was introduced into established air pouches on RANK(-/-) mice, followed by implantation of calvaria bone from syngeneic littermates. Wild type C57BL/6 (RANK(+/+)) mice injected with either UHMWPE or saline alone were included in this study. Pouch tissues were collected 14 days after UHMWPE inoculation for molecular and histology analysis. Results showed that UHMWPE stimulation induced strong pouch tissue inflammation in RANK(-/-) mice, as manifested by inflammatory cellular infiltration, pouch tissue proliferation, and increased gene expression of IL-1beta, TNFalpha, and RANKL. However, the UHMWPE-induced inflammation in RANK(-/-) mice was not associated with the osteoclastic bone resorption observed in RANK(+/+) mice. In RANK(+/+) mice subjected to UHMWPE stimulation, a large number of TRAP(+) cells were found on the implanted bone surface, where active osteoclastic bone resorption was observed. No TRAP(+) cells were found in UHMWPE-containing pouch tissues of RANK(-/-) mice. Consistent with the lack of osteoclastic activity shown by TRAP staining, no significant UHMWPE particle-induced bone resorption was found in RANK(-/-) mice. A well preserved bone collagen content (Van Gieson staining) and normal plateau surface contour [microcomputed tomography (microCT)] of implanted bone was observed in RANK(-/-) mice subjected to UHMWPE stimulation. In conclusion, this study provides the evidence that UHMWPE particles induce strong inflammatory responses, but not associated with osteoclastic bone resorption in RANK(-/-) mice. This indicates that RANK signaling is essential for UHMWPE particle-induced osteoclastic bone resorption, but does not participate in UHMWPE particle-induced inflammatory response.     

医科院校学生心理危机管理浅探

结合医科院校学生心理危机管理的实践，阐述大学生心理危机的内涵、类型、特征及心理危机管理的特性，并从建立预警系统、增设心理委员、危机处理的专业化及危机干预策略等方面探讨在医科院校加强学生心理危机管理的对策。     

顽固性下颌磨牙根尖周炎患者的治疗和护理讨论

目的治疗顽固性下颌磨牙根尖周炎。并尽量减少对牙周膜的机械性损伤。方法采用下牙槽神经阻滞麻醉,并配合局部麻醉。拔牙钳的尖置放于釉牙骨质界以上,采用颊舌向摆动的方式将患牙拔下。在不断滴有生理盐水的条件下,立即用高速车针磨除患牙根尖2￣3mm的牙体组织,根管内3￣5mm深的充填物要用圆钻将其清除,再用牙胶尖和氢氧化钙糊剂充填。将患牙再植入牙槽窝之前,务必用生理盐水将牙槽窝冲洗干净,要求严格控制在15分钟内完成再植,并尽量减少对牙周膜的机械性损伤。再植牙齿一般不需要夹板固定,必要时可采用缝线缝合固定。结果我们选择的5例患者,术后随访1￣2年,1例患者再植失败,4例患者再植成功。结论特异性再植术治疗顽固性下颌磨牙根尖周炎疗效理想,而且较易掌握。     

早产儿呼吸机相关性肺炎抗生素应用策略

随着新生儿高级生命支持技术的发展。新生儿、早产儿抢救效率大为提高，患儿存活率、存活时间等指标也不断提高。在系列生命支持技术中，新生儿、早产儿的呼吸支持占了极其重要的地位。在呼吸机使用频率增加的同时，由于呼吸机使用所导致的呼吸机相关性肺炎（ventilator associated pneumonia，VAP）的发病率也随之提高，成了NICU中十分重要的问题，能否处理得当，直接关系到新生儿抢救的转归。可以肯定的是VAP增加了病人的死亡率、延长机械通气时间、增加住院天数，同时大大提高了治疗费用。     

Correction of frequency and phase variations induced by eddy currents in localized spectroscopy with multiple echo times.

As a consequence of the time-varying magnetic field induced by eddy currents, frequency drifting occurs when the sampling window of localized spectroscopy continuously shifts. The frequency drifting and the concomitant phase variations can severely affect spectroscopy results when data are acquired with multiple echo times (TEs), such as in the measurement of glutamate (Glu) concentration using the TE-averaged method. Specifically, the averaged spectra are further broadened and distorted in the presence of residual eddy currents, and editing of the coupled spins of Glu C4 protons is affected, resulting in errors in the measured relative intensity ratio. Postacquisition correction using unsuppressed water as reference can effectively minimize this detrimental effect, as manifested by the significantly enhanced signal intensity. Also, it is demonstrated that the methyl signals of creatine (Cr) at 3.0 ppm and choline (Cho) at 3.2 ppm can be used as internal references in finding frequency and phase disparities between different TEs.     

Pulmonary Lophomonas blattarum infection in patients with kidney allograft transplantation

The aim of the study was to analyse the clinical manifestation and management of pulmonary Lophomonas blattarum infection in four allograft transplantation recipients retrospectively. Four patients with pulmonary L. blattarum infection were diagnosed by using Fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) examination. Their clinical manifestation and management are summarized. Four cases of pulmonary L. blattarum were found during the period from the second month to the third month after transplantation. Concurring infection by other pathogens was found in three of them. Common initial symptoms included fever (>38 degrees C) without cough and breathlessness. Lower lobe shadowing could be found on chest X-ray. Body temperature decreased to the normal range in three patients and to 37.5 degrees C in the other one, after intravenous injection of metronidazole and tapering immunosuppressant. Radiological examination confirmed improved health condition of the patients afterwards. Two patients received repeated FOB and only dead L. blattarum was found. Pulmonary L. blattarum infection in allograft transplant recipients carry relatively obscure initial symptoms. Possible L. blattarum infection needs to be screened in post-transplantation pulmonary infection patients with similar symptoms, especially in those who respond poorly to anti-infection treatment. Microscopic examination of BAL fluid can help to identify pulmonary L. blattarum infection and metronidazole is an ideal treatment choice.     

抗黄精皂苷多克隆抗体的制备

首先将薯蓣皂苷通过3-羟基位的改造，制成3-琥珀酰薯蓣皂苷，再通过碳二亚胺将其与牛血清白蛋白和卵清蛋白偶联制成免疫原和包被原，免疫新西兰大白兔制备出多克隆抗体，抗体效价为1：12800，为进一步建立黄精皂苷ELISA方法打下基础。     

神经修复导管的材料学及制备方法

目的:综合分析近年来国内外神经修复用导管材料以及制备方法的研究近况。资料来源:应用计算机检索ElsevierScience1996-01/2005-12有关神经修复及神经导管方面的文献,检索词分别为“nerveconduit,nerveguide,nerveregeneration”,限定文献语言种类为English。同时计算机检索清华数字期刊库、万方数据库1996-01/2005-12有关神经修复及神经导管方面的文献,检索词为“神经修复,导管”,限定语言种类为中文。资料选择:对检索到的神经再生、神经修复及神经导管方面的相关信息进行整理,选取针对性强的文章。同一领域的文献则选择近期发表或权威杂志的文章。资料提炼:共收集120篇关于神经修复、神经导管的文献,纳入23篇符合标准的文献。资料综合:用神经导管桥接断离神经是神经修复的重要方法之一,制备神经导管的材料按其降解性能分为生物不可降解材料和生物可降解材料,任何一种材料都有其优缺点,发展复合材料将是制备导管的主要方向。结论:虽然影响神经再生的因素还有许多,如神经生长因子、雪旺细胞等,但是新型的导管及制备方法将会有利于神经修复进一步发展。     

肾损伤的治疗进展

轻度、中度的肾损伤可行保守治疗。严重的肾损伤出血应首选超选择性肾动脉栓塞术,因该技术定位准确,止血迅速,创伤小,恢复快,并发症少,能最大限度地保护肾脏功能,是一种安全可靠治疗肾损伤出血的有效方法。     

塞来昔布对大鼠心脏移植急性排斥反应的抑制作用

目的观察塞来昔布对大鼠心脏移植急性排斥反应的抑制作用。方法以SD大鼠为供者,Wistar大鼠为受者,进行40次腹部异位心脏移植。采用HE染色和原位末端标记(TUN EL)技术检测移植心切片,进行排斥反应的病理分级并计算移植心肌细胞的凋亡指数(AI)。结果移植心的细胞凋亡主要发生于心肌细胞;移植后第3、5d,塞来昔布治疗组心肌细胞凋亡指数分别为:1.03±0.42和3.28±2.42;对照组分别为2.35±1.51和11.35±3.46;两组比较,差异有统计学意义(P<0.001)。结论细胞凋亡是心脏移植急性排斥中组织损伤的重要机制;塞来昔布能明显抑制心肌细胞凋亡。