高密度聚乙烯多孔材料在颅骨缺损整复中的应用观察

目的:观察高密度聚乙烯多孔材料Mcdpor在颅骨缺损整复中的临床应用,分析其改善情况.方法:对6例去骨瓣减压术后因颅骨缺损患者行高密度聚乙烯多孔材料修复术治疗.结果:术后切口均Ⅰ期愈合.随访2个月,外形恢复满意,无不良并发症.结论:研究表明高密度聚乙烯多孔材料操作容易,可塑性高,材料在体内可促进自体组织长入,不易感染及外露,具有较好的修复效果,对颅骨缺损修复具有一定的指导意义.     

距骨骨软骨损伤的诊断及关节镜治疗

目的 总结、分析距骨骨软骨损伤的症状、体征、影像学特点、关节镜下治疗方法及手术效果.方法 2000年至2005年共收治34例距骨骨软骨损伤患者,对其临床资料包括症状、体征、X线片、MRI表现、关节镜手术方法等进行回顾性分析,术后随访根据主观和客观评分判断疗效.术前美国足踝外科后足评分平均(71±8)分,术前主观疼痛程度评分(7.5±1.3)分.结果 34例患者MRI均有骨软骨损伤征象,其中21例通过X线片检查发现距骨骨软骨损伤.距骨骨软骨损伤的主要症状为负重疼痛以及运动后加重,MRI诊断准确率较X线片高(χ2=16.07,P＜0.001).31例患者获得随访,平均随访时间为28个月.术后美国足踝外科后足评分(91±9)分,显著高于术前(t=9.147,P＜0.001);术后主观疼痛程度评分(2.4±2.3)分,显著低于术前(t=10.853,P＜0.001);临床疗效优良率为87.1%.结论 MRI检查能够提高诊断的正确率,关节镜微创手术治疗距骨骨软骨损伤效果良好.     

A novel approach to gallbladder cancer in a Jehovah’s Witness

Radiofrequency interstitial thermal ablation (RITA) provides a palliative option for patients suffering from metastatic liver disease. This procedure can be performed using a laparoscopic approach with laparoscopic ultrasound used to position the RITA probe. We describe a case of laparoscopic RITA performed for colorectal liver metastasis that was complicated by tumor lysis syndrome (TLS) following treatment. We consider RITA to be a safe procedure, as supported by the literature, but where intracorporal tumor lysis is the treatment goal we believe that the systemic release of tumor products can overwhelm the excretory capacity; therefore, TLS is an inevitable consequence in some patients.     

左旋肉毒碱对人成骨细胞增殖和凋亡的影响

目的观察左旋肉毒碱(L-carnitine,L-C)对人成骨细胞增殖和凋亡的作用。方法以3H掺入法(3H-TdR)测定左旋肉毒碱对人成骨细胞增殖的影响;以吖啶橙/溴化乙啶染色和细胞凋亡ELISA(酶联免疫吸附法)试剂盒测定左旋肉毒碱对人成骨细胞凋亡的影响;以免疫印记法检测左旋肉毒碱干预前后活化型Caspase-3、-9蛋白质表达水平的改变。结果10~100mmol/L左旋肉毒碱能促进人成骨细胞增殖。吖啶橙/溴乙啶染色法示100mmol/L左旋肉毒碱干预使人成骨细胞凋亡细胞明显减少。ELISA结果示10~100mmol/L左旋肉毒碱干预可显著抑制人成骨细胞凋亡。10~100mmol/L左旋肉毒碱干预可抑制无血清饥饿诱导的人成骨细胞caspase-3、9活化增加。结论左旋肉毒碱促进人成骨细胞增殖,并通过下调Caspase-3、-9的活化抑制人成骨细胞凋亡。     

Changes in circulating human endothelial progenitor cells after brain injury

Endothelial progenitor cells (EPCs) are mobilized from the bone marrow to blood circulation in response to tramatic or inflammatory stimulations. Once released, they actively seek and home to the sites of vascular injury to promote vascular repair. We monitored changes of EPC counts in peripheral blood of 29 patients with traumatic brain injury for up to 21 days. We showed that the levels of circulating EPCs within the first 48 h of injury were lower than control subjects, but increased over time-reaching plateau around 7 days post-injury at a level that was significantly higher than controls. The initial EPC reduction, which was severe in patients with severe injury Glasgow Coma Scale [GCS] < 12), differs from the acute increase in EPC counts found in patients with cardiovascular injury. The subsequent increase in circulating EPCs is primarily through bone marrow mobilization because the cells were stained predominantly for CD133, which labels immature EPCs, but not CD34 (which stains cell of endothelial lineage). The increase appeared earlier in male patients and was greater in those younger than 50 years of age. Changes in circulating EPCs during follow-up periods correlated with platelet, but not leukocyte counts. These results suggest that EPC mobilization following traumatic brain injury may take a different course compared to that associated with body or vascular injuries.     

大鼠急性胰腺炎时ICAM-1在胰、肺组织的表达特征与作用的观察

目的：探讨急性坏死性胰腺炎（ANP）时细胞间粘附分子-1（ICAM-1）在胰腺及肺组织的表达特征和作用。方法。用3.5%的牛磺胆酸钠逆行胰胆管注射制备ANP模型，采用免疫组化技术等方法动态观察ANP时胰腺、肺组织ICAM-1的表达改变和PMN组织聚集的变化。结果：胰腺及肺组织ICAM-1的表达分别在ANP造模后3H、6h明显增强，并于12h达高峰。结论：ICAM-1介导的PMN大量组织聚集可能是ANP早期胰腺及肺组织损伤的重要参与因素。     

益肾排石中药保护高能冲击波致肾损伤的实验研究

目的：探讨益肾排石中药对高能冲击波致肾损伤的保护作用。方法：将家兔30只随机分为两组，中药组和生理盐水对照组各15只，于高能冲击波致兔肾损伤模型，测定不同时间血浆，肾组织浆浆内皮素（ET－1），超氧化物歧化酶（SOD）、丙二醛（MDA）变化及肾组织病理改变。结果：冲击波肾损伤后血浆中ET－1、血清中MDA值及组织均浆中ET－1、MDA值显著升高（P＜0．05），血浆及组织匀浆中SOD显著降低（P＜0．05）；而中药治疗组血浆中ET－1、MDA及组织均浆中ET－1、MDA峰值显著低于对照组（P＜0．05），血浆及组织匀浆中SOD值高于对照组（P＜0．05），且病理检查较对照组损伤轻。结论：益肾排石中药对高能冲击波致肾损伤具有保护作用。     

脐带间充质干细胞旁分泌物质对暴发性肝衰竭大鼠肝功能及肝细胞增殖的影响

Objective To investigate the therapeutic effect of human umbilical cord mesenchymal stem cell-paracrine substance on fulminant hepatic failure (FHF) rat, and to study the effect on liver function and hepatocyte proliferation. Methods Mesenchymal stem cells(MSCs)were separated from human umbilical cord, and surface makers of cells were detected by flow cytometry. Human umbilical cord mesenchymal stem cells-conditioned medium(MSC-CM) was prepared. FHF rat model was induced by intraperitoneal injection of D-galactosamine and they were randomly diveded into three groups: MSC-CM group, NS group, PHGF group. 24 h later, 1 ml MSC-CM, 1 ml 0. 9% NaCl solution and lml PHGF solution was injected into the tail vein of MSC-CM, NS, and PHGF rats, respectively. In each group (n=8 per group), blood samples were collected at 12, 24, 36, and 60 h after treatment from inner canthus for analysis of blood ALT and TBIL levels. We used five rats per group for tissue collection after sacrifice at 36 h after treatment and 10 animals per group for survival analysis. PCNA immunohistochemical staining was used in the sections of liver tissue to detect hepatocyte proliferation. Results 24 h after treatment, the levels of ALT and TBIL in the MSC-CM and PHGF groups were lower than those in the NS group(P＜0. 05), but there was no significant difference between the MSC-CM and PHGF groups. There were more PCNA-positive hepatocytes in the MSC-CM and PHGF groups than in the NS group(P＜0.01), but there was no significant difference between MSC-CM and PHGF group. Survival analysis found that the survival rate of rats in the MSC-CM and PHGF groups was higher than that of rats in the NS group (P=0. 049), but there was no significant difference between the MSC-CM and PHGF group. Conclusions The paracrine substance of human umbilical cord mesenchymal stem cells can stimulate hepatocyte proliferation and improve liver function of FHF rats, potentially creating a new avenue for the treatment of FHF.     

Tracheoesophageal fistula after primary repair of type C esophageal atresia in the neonatal period: recurrent or missed second congenital fistula

Purpose

The aim of the study is to investigate whether a tracheoesophageal fistula (TEF) found after the primary repair of type C esophageal atresia (EA) is a recannulation of the original fistula, a missed proximal fistula, or other rare foregut malformation.

Methods

Between 2000 and 2009, 143 different types of patients with EA were admitted in our hospital. Seven patients (2 from our series, 5 referred to us by other hospitals with the history of primary repair of type C EA) had late presenting TEF. Esophagogram, 3-dimensional computed tomographic (CT) reconstruction, bronchoscopy, and reoperation were performed to confirm the TEF. Their medical records were reviewed and summarized.

Results

Persistent feeding or respiratory problems were the common symptom. The mean age of the first appearance was 17 ± 26 (1-63) months. Preoperative diagnosis was made by esophagograms and bronchoscopy in 6 patients. Reoperations were performed in all patients through thoracotomy. Missed proximal TEF shown as a distinct fistula above the primary anastomosis without much adhesion was confirmed in 5 cases. A recurrent TEF was found in 1 case. A case of communicating bronchopulmonary foregut malformation was confirmed by 3-dimensional CT reconstruction and reoperation.

Conclusion

A missed proximal TEF after repair of EA may be misdiagnosed as a recurrent TEF. Accurate preoperative diagnosis depends on combined evaluations of radiologic contrast study, 3-dimensional CT, and bronchoscopy.     

彩超引导下脓肿穿刺置管引流术治疗哺乳期乳腺炎

探讨彩超引导下脓肿穿刺置管引流术治疗哺乳期乳腺炎的的临床应用效果.2018年5月—2019年7月,手术治疗哺乳期乳腺脓肿形成患者98例,随机分为对照组和研究组,每组49例.研究组行彩超引导下脓肿穿刺置管引流术,对照组行传统脓肿切开引流术,观察两组患者的疼痛、切开瘢痕、复发率情况.结果显示,术后两组患者均未出现复发.研究...