假体隆乳术后形态不佳的矫治

目的探讨假体置入隆乳术后形态不佳的原因和矫治方法。方法根据临床表现将乳房不佳分为5种类型：圆球型、上部膨隆型、下坠型、单侧双乳型及不规则型。通过松解纤维囊、纤维囊折叠缝合、重新分离隆乳腔隙、更换假体、乳房悬吊术等方法，进行矫治再次隆乳术。结果经过至少6个月随访观察，本组106例均获得了满意的手术效果。结论隆乳术后乳房形态不佳主要与假体体积过大、腔隙分离不到位、假体移位、乳房下皱襞过度分离、纤维囊挛缩及引流、包扎位置不当等因素有关，针对不同原因实施相应的手术方法矫治，能够获得满意的手术效果。     

枳椇子总黄酮提取工艺及其解酒作用

分别用水和乙醇作为溶剂加热提取枳椇子中的总黄酮,用比色法测定黄酮的含量,分别以提取时间、加热温度、料液比、提取次数等因素进行正交试验.对两种提取方法进行比较,确定各因素对提取效果的影响并对其解酒作用进行研究.水提取法的最优条件是：100 ℃,料液比1 g：8 mL,加热0.5 h,回流提取3次;醇提取法的最佳条件：80 ℃,料液比1 g：6 mL,加热1.5 h,以体积分数50%的乙醇回流提取3次.实验结果显示,醇提取法比水提取法效果更好,枳椇子提取液具有一定的解酒作用.     

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.     

以失用为主要表现的胼胝体梗死

目的探讨胼胝体梗死的临床表现、病因及鉴别诊断特点。方法对2005年7月收治的1例53岁男性胼胝体梗死患者的临床表现、影像学特点、病因机制及其治疗过程进行回顾分析。结果临床主要表现为发作性黑蒙、言语不利,既往有高血压、糖尿病、脑梗死、吸烟、饮酒史,体格检查以失用为主要表现。头部MRI检查可见左侧脑室旁、胼胝体梗死,右侧基底节、脑桥陈旧性腔隙性梗死;脑血管造影检查显示为多发性血管狭窄,其中以左侧大脑中动脉、右侧颈内动脉及基底动脉最为严重。经颈内动脉内膜剥离术及颈内动脉支架植入术治疗,临床症状缓解。结论失用可以是胼胝体梗死的主要表现,其病因是在脑动脉粥样硬化基础上的血流动力学改变,患者预后良好。     

经鼻给予抗ICAM-1抗体对大鼠脑缺血再灌注损伤的保护作用

目的 探讨经鼻腔给予抗细胞间黏附分子-1(ICAM-1)单克隆抗体(单抗)对大鼠脑缺血再灌注损伤的保护作用.方法 将30只雄性Wistar大鼠随机分为假手术组、脑缺血再灌注组及脑缺血再灌注+经鼻给予高、中、低剂量抗ICAM-1单抗干预组.采用插线法制作局灶脑缺血再灌注模型.各干预组于缺血1 h经鼻给予抗ICAM-1单抗,再灌24 h后取脑行冠状切片.采用TTC、HE及免疫组化染色法测定脑梗死体积及免疫组化阳性区占总面积比.结果 缺血再灌注组脑标本均可见缺血侧的脑膜充血,脑组织肿胀;单纯脑缺血再灌注组及低、中、高抗ICAM-1单抗干预组脑梗死体积(以像素值表示)分别为57 042±12 483、32 871±4 325、25 932±3 103和15 325±3 356,免疫组化阳性区面积占总面积比分别为(6.64±0.476)%、(5.15±0.987)%、(4.36±0.682)%和(3.42±0.537)%,各组间差异均有统计学意义.结论 (1)脑缺血再灌注可使脑组织ICAM-1表达显著增高;(2)经鼻腔给予抗ICAM-1单抗可有效降低脑组织ICAM-1的表达,缩小脑梗死体积;(3)经鼻腔给予抗ICAM-1单抗的剂量同脑梗死体积呈负相关;(4)脑缺血再灌注时ICAM-1免疫组化阳性区面积比与脑梗死体积呈正相关.     

经腹膜后隙途径腹腔镜活体供肾切取32例

目的 探讨经腹膜后隙途径腹腔镜活体供肾切取的技术和效果。方法 32名供者中，男性15名，女性17名。29例取左肾，3例取右肾。供者全身麻醉，取侧卧位，共选3个穿刺点，第1个穿刺点选在12肋缘下2cm与骶棘肌外侧缘1cm交叉点，第2个穿刺点选在第1个穿刺点向前8～10cm，或肋缘下2cm与腋前线交叉点，第3个穿刺点位于髂棘上2cm与腋中线交叉点，分别插入12mm、10mm和5mm的Trocar。以自制水囊扩张器扩张腹膜后隙，游离供肾和输尿管，前6例用直线切割缝合器切断肾动脉和静脉，后26例用带锁的塑料夹夹闭切断肾动脉和静脉，在第1个穿刺点向下的延长切口将肾取出。结果 32只供肾切取顺利，手术耗时60～180min，出血量20～200ml，供肾热缺血时间3～8min，冷缺血时间25～50min。3只肾静脉较短，分别为1cm、1．5cm和2cm，另有1只供肾动脉内膜损伤。移植术后第1d，受者的尿量为2800-10 100ml，无移植肾功能恢复延迟发生。结论 经腹膜后隙途径腹腔镜活体供肾切取是安全、可行的，对供者创伤小，所获供肾的质量较好，但要求有熟练的腹腔镜技术。     

尿激酶冲击治疗频发的短暂性脑缺血发作临床观察

目的观察尿激酶(天普洛欣)对频发的短暂性脑缺血发作(TIA)的疗效。方法124例频发TIA患者随机分为尿激酶冲击治疗的尿激酶组(68例)和常规治疗的对照组(56例)。结果尿激酶组治疗后24小时、3天和15天内TIA发作的控制率分别为67.6%、89.7%和97.1%,均高于对照组的14.3%、76.8%和85.7%(P<0.01)。结论早期应用尿激酶冲击治疗能迅速控制频发TIA发作,明显改善重症患者的预后。     

脊髓损伤大鼠的阴茎海绵体肌电图研究

目的探讨海绵体肌电图诊断脊髓性勃起功能障碍的价值。方法将24只成年雄性SD大鼠(300～400 g)分成:对照组、T9和L6损伤组(每组8只)。损伤脊髓1周后,用肌电图仪采集注射阿朴吗啡前后阴茎肌电数据,采集频率20～3 000 Hz、扫描速度5 ms／d、灵敏度10 μV／d。用t检验方法分析统计数据。结果对照组使用阿朴吗啡10 min均方根振幅为(5．60±0．89)μV, 大于T9损伤组(3．60±1．14)μV(P<0．05);使用阿朴吗啡前、使用后5 min和10 min高／低功率比均为0．05±0．03,小于L6损伤组0．13±0．04、0．15±0．07、0．13±0．07(P<0．05)。T9损伤组使用阿朴吗啡后5 min和10 min平均频率分别为(122．40±47．99)、(151．80±76．42)Hz,较L6损伤组(278．83±118．66)、(265．00±81．35)Hz低(P<0．05)。结论海绵体肌电图对脊髓性勃起功能障碍有诊断价值。     

Perspectives on Health Among Adult Users of Illicit Stimulant Drugs in Rural Ohio

CONTEXT: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. PURPOSE: This research describes illicit stimulant drug users' views on health and health-related concepts that may affect their utilization of health care services. METHODS: A respondent-driven sampling plan was used to recruit 249 not-in-treatment, nonmedical stimulant drug users who were residing in 3 rural counties in west central Ohio. A structured questionnaire administered by trained interviewers was used to collect information on a range of topics, including current drug use, self-reported health status, perceived need for substance abuse treatment, and beliefs about health and health services. FINDINGS: Participants reported using a wide variety of drugs nonmedically, some by injection. Alcohol and marijuana were the most commonly used drugs in the 30 days prior to the interview. Powder cocaine was used by 72.3% of the sample, crack by 68.3%, and methamphetamine by 29.7%. Fair or poor health status was reported by 41.3% of the participants. Only 20.9% of the sample felt they needed drug abuse treatment. Less than one third of the sample reported that they would feel comfortable talking to a physician about their drug use, and 65.1% said they preferred taking care of their problems without getting professional help. CONCLUSIONS: Stimulant drug users in rural Ohio are involved with a range of substances and hold health beliefs that may impede health services utilization.     

△LuxS的表型分析及其在GBS毒力调控机制研究中的应用

目的采用LuxS缺失突变株模型对B型链球菌中数量感应相关分子LuxS的功能及与其相关的自诱导因子-2数量感应通路进行研究，以探索其毒力调控机制。方法采用RT-PCR法、菌落印迹分析、生长曲线测定、cAMP因子测定等方法对该缺失突变菌株的表型特性进行了研究。最后应用哈氏弧菌作为报告菌株，通过生物发光测定法分析了突变株对B型链球菌诱导报告菌株中的生物发光活性的影响。结果发现此缺失突变可导致B型链球菌中scpB基因表达的上调；与野生株相比，突变株的生物发光诱导活性比野生株降低了大约两倍。结论本研究结果证实了LuxS在GBS中AI-2数量感应通路中的重要性，并为GBS中毒力调控机制的进一步研究提供了新的线索。