载脂蛋白A1、B基因多态性对非创伤性股骨头坏死发生的影响

目的:探讨载脂蛋白A1、B基因多态性对非刨伤性股骨头坏死(avascular necrosis of the femoral head,ANFH)发生的影响.方法:应用聚合酶链反应对中国北方汉族143例ANFH患者和92例正常人分别扩增含Apo AI基因启动子-75 bp和第一内舍子 83 bp及Apo B基因Eco RI、XbaI和3-VNTR的DNA片段,限制性内切酶酶切扩增产物,琼脂糖凝胶电泳分离基因多态性.结果:Apo A1基因启动子-75 bp处,ANFH患者中A/A基因型频率明显高于正常组(P＜0.01),而G/A基因型频率明显低于正常组(P＜0.01).Apo AI内舍子 83 bp位点,Apo B基因Eco RI、Xba I位点和3-VNTR区域ANFH患者组和正常组基因型及等位基因频率分布无统计学差异.结论:Apo A1基因启动子区域-75bp位点A/A型可能是非创伤性股骨头坏死易感基因之一,但未能发现Apo A1第一内舍子 83 bp位点及Apo B基因Eco RI、XbaI和3-VNTR位点多态性与非创伤性股骨头坏死发生有明显的关系.     

Polymorphic distribution of Y-chromosome haplotype and mitochondrial DNA in the Bouyei people in China

In the evolution of humans, many kinds of mutations in the human genome have been accumulated, providing credible genetic evidence for the study of human origins and migrations. The "out-of-Africa" hypothesis of modern human evolution and the genetic origin of the Japanese has come about by studying mitochondrial DNA.l,2 Recently, researchers have recognized the power of Y-chromosome markers in resolving migratory patterns of modern humans as more and more Y-chromosome single nucleotide polymorphism markers have been found. The markers on the nonrecombinant part of the Y-chromosome allows for the reconstruction of intact haplotypes which are probably the best genetic tools to study human migrations. We can analyze the paternal history of some people in different areas by Y-chromosome haplotypes.     

还原型谷胱甘肽联合甘草酸二铵对腹部开放伤后海水浸泡犬肝功能损伤的治疗作用

Objective To investigate effect of reduced glutathione and diammonium glycyrrhizinate on the treatment of hepatic damage in experimental dogs following open abdominal injuries coupled with seawater immersion. Methods Twenty-four dogs with open abdominal injuries were randomly divided into 3 groups: the control group (given with simple observation after 1.5 h seawater immersion); the routine treatment group (given routine care and fluid transfusion after 1.5 h seawater immersion) ; the hepatic treatment group (given routine are, fluid transfusion and hepatic treatment as well, after 1.5 h seawater immersion). Each group consisted of 8 dogs. Blood samples were taken at different time points to measure total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), prothromin time (PT), endotoxin, tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), and pathological examination was also made at the same time. Results For the control group, contents of TB, ALT, AST and LDH increased significantly and survival time was less than 24 hours. Contents of TB, ALT, AST and LDH of the routine treatment group also increased significantly, but survival time of all the experimental animals was mere than 24 hours. Reduced glutathione and diammonium glycyrrhizinate could reduce the extent of lesion quite significantly 12～24 hours following open abdominal injuries. Conclusions Reduced glutathione and diammonium glycyrrhizinate seemed to have good effects on the treatment and prevention against hepatic damage induced by trauma coupled with seawater immersion. It could be used as a primary means for the treatment of such kind of hepatic damage.     

Richard钉内固定治疗股骨粗隆间骨折

目的:探讨Richard钉内固定治疗股骨粗隆间骨折的应用。方法:Richard钉内固定治疗股骨粗隆间骨折82例。按Evans分型,Ⅰ型1°13例,Ⅰ型2°38例,Ⅰ型3°22例,Ⅰ型4°9例。其中同时伴股骨颈骨折为4例,伴粗隆下骨折为11例。结果77例得到随访,随访率为93.93.9%,平均随访期13.1(8-22)个月。临床疗效评价按黄公怡评定标准,优良率达97.4％.结论Richard钉主钉的位置正位平行于股骨颈的长轴,在股骨颈中央稍偏内侧,位于股骨距稍上的水平,侧位位于股骨颈的中轴线上,在颈的中央或稍偏后方,长度一般钉尖距股骨头1cm以内。强调准确复位,尤其是小粗隆一侧结构的完整。     

磁共振扩散加权成像对超急性期、急性期脑缺血的应用价值

磁共振扩散加权成像(DWI)可以快速、无创地反映脑缺血区分子水平发生的微观变化,为临床提供信息,本文对其在超急性期、急性期脑缺血的应用价值和限度进行综述。     

第一、二鳃弓综合征颜面不对称的整形外科矫治

目的探讨第一、二鳃弓综合征面部不对称畸形的整形外科矫治方法。方法根据第一、二鳃弓综合征患者临床及X线所示面部双侧不对称情况,采用健侧下颌骨外板去除、颧骨截骨降低;患侧下颌体、颧骨应用健侧下颌骨外板贴附植骨或高密度多孔聚乙烯(Medpor)假体置入等术式,配合颏部水平截骨颏成形术,以缩小面部双侧宽度的差异,矫治颜面不对称畸形。结果共矫治23例,经6个月至3年的术后随访观察,双侧面部宽度差异明显缩小,正面观面部不对称明显改善。结论第一、二鳃弓综合征面部骨骼发育畸形是三维方向的,双侧面骨宽度的差异,是造成正面观面部不对称的重要因素,根据受术者的具体情况,采用以上术式的组合,扩充患侧或同时缩窄健侧骨骼,进行面部骨性支架重建,可以取得良好的矫治效果。     

改良神经刺激仪定位在全麻下乳腺癌术中对神经的保护作用

目的探讨改良神经刺激仪对神经定位的效果，以防止乳腺癌手术对运动神经的损伤，提高手术成功率及术后生活质量。方法选择ASAⅠ～Ⅱ级，乳腺癌预计手术中难以辨认神经血管走行的女性患者20例。应用Stimuplex HNS 12／BRAUN周围神经刺激仪，改良为双极刺激电极在术前、术后均对胸背神经支配的背阔肌、胸长神经支配的前锯肌以及胸前神经支配的胸肌进行肌电检测，以确定手术中神经损伤情况。结果18例患者手术前胸大肌动作电位为（1．59±0．4）mv，手术后为（1．58±0．3）mv，前后比较差异无统计学意义（P〉0．05）。手术前神经传导速度为（40．57±2．33）m／s，手术后为（40．43±2．18）m／s，前后比较差异无统计学意义（P〉0．05）。仅2例出现轻度神经损伤。结论改良神经刺激仪能准确定位神经，避免了神经的直接损伤，基本上达到了肌电图仪的神经探测功能。     

弱精子症患者精子蛋白的初步研究

目的从蛋白质水平探讨弱精子症患者精子蛋白的改变,以期寻找精子活动力低下的原因。方法运用蛋白凝胶电泳技术分离90例特发性弱精子症患者和30例正常供精者精子标本的总蛋白质,结合免疫印迹技术鉴定差异蛋白,并对试验数据进行统计学分析。结果患者组与对照组精子蛋白表达量存在差异,且患者组中精子活力低下不同严重程度者的蛋白含量也存在差异(P<0.05),对于差异显著条带的Western Blotting分析显示差异蛋白为DDX4。结论精子活力与蛋白质差异表达有关,主要差异蛋白DDX4可作为评估精子活力的生物标志物。     

以胆酸为载体的肝靶向疗法

通过肝靶向给药技术将化学治疗药物选择性地投放于肝脏,能够减轻或避免其全身的毒副作用.胆酸是唯一的口服有效的小分子肝靶向载体,以胆酸为载体的肝靶向疗法为肝病及肝脏代谢性疾病提供了新的疗法.如胆酸-一氧化氮供体靶向偶合物能够选择性地将一氧化氮投放于肝脏,产生治疗肝硬化的作用;胆酸-脂肪酸靶向偶合物能够选择性地调节肝脏的脂代谢,具有治疗胆结石、脂肪肝和动脉粥样硬化的作用;胆酸-米非司酮偶合物能够选择性地作用于肝脏,产生特异性的降糖作用,而没有全身副作用.     

手术治疗氟骨症性胸椎管狭窄症

[目的]观察手术治疗氟骨症性胸椎管狭窄症的疗效,总结治疗经验。[方法]对2003年9月-2006年3月之间经手术治疗的15例氟骨症性胸椎管狭窄症患者进行回顾性分析,应用JOA下肢运动功能评分标准进行疗效评估。[结果]15例患者中,2例术后无明显缓解,13例术后神经功能有不同程度恢复,术前术后评分经统计学处理（P〈0.05）,具有显著差异。[结论]短节段整块揭盖减压与蚕食减压相结合为治疗氟骨症性胸椎管狭窄症较好的一种手术方式。