氟伐他汀对维持性血液透析患者氧化应激及非对称性二甲基精氨酸的影响

目的观察口服氟伐他汀对维持性血液透析（MHD）患者氧化应激状态和非对称二甲基精氨酸（asymmetric dimethylarginine,ADMA）及颈动脉粥样硬化斑块的影响。方法选择透析时间超过6个月的MHD患者64例,分为治疗组36例和对照组28例,治疗组口服氟伐他汀（40mg,1次／d）治疗;对照组不用氟伐他汀。进行为期6个月随访,分别检测治疗前、治疗后6个月末患者的ADMA、血总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、超敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、丙二醛（MDA）。结果治疗后6个月末,2组HDL-C均较治疗前明显升高（P〈0．05）,TC、TG、LDL-C较治疗前明显降低（P〈0．05）,且CRP、IL-6、TNF-α、MDA和ADMA较治疗前明显降低（P〈0．05）。结论氟伐他汀可明显改善MHD患者的血脂水平,同时可改善患者氧化应激状态和降低ADMA的水平。     

定制型肱骨近端假体结合人工补片重建肩关节的疗效分析

目的 探讨肱骨近端骨肿瘤保肢术中使用人工补片重建盂肱关节囊的手术方法及其对稳定肩关节、预防术后肱骨头脱位的效果.方法 2006年2月至2009年1月,回顾性分析接受定制型肱骨近端假体结合聚丙烯非降解性人工补片重建肩关节的患者12例,男7例,女5例;年龄21～55岁,平均38岁.肿瘤类型:骨巨细胞瘤9例,骨肉瘤1例,软骨肉瘤2例.9例骨巨细胞瘤患者中3例为Campanacci Ⅱ期,6例为Campanacci Ⅲ期;1例骨肉瘤患者为Enneking ⅡB期;2例软骨肉瘤患者均为Enneking Ⅱ A期.采用国际骨与软组织肿瘤协会(MSTS)功能评估标准评价术后肩关节功能.结果 患者均获得随访,随访时间24～52个月,平均35个月.手术出血量150～500 ml,平均254 ml;手术时间150～200 min,平均172 min.术后患者肩关节前屈20°～60°,平均41°;外展20°～70°,平均42°.MSTS评分为53%～77%,平均66%.术后无一例患者出现臂丛损伤、切口感染及假体脱位;随访期间无一例患者出现局部复发、远处转移或死亡.结论 使用聚丙烯非降解性人工补片重建盂肱关节囊可显著减少肱骨近端骨肿瘤保肢术后肱骨头假体脱位的发生,便于周围软组织的附着和长入.

Abstract：

Objective To investigate the surgical technique,postoperative function and dislocation incidence of proximal humerus reconstruction with metallic endoprostheses and polypropylene knitted nonabsorbable mesh after proximal humeral tumor resection.Methods Twenty patients with proximal humeral tumor were retrospectively reviewed.They were performed proximal humerus reconstruction with proximal humeral prosthesis and polypropylene knitted non-absorbable mesh from February 2006 to January 2009.There were 5 women and 7 men with a mean age of 38 years(range,21-55 years)at the time of surgery,and giant cell tumor in 9 patients(including Campanacci Ⅱ for 3,Campanacci Ⅲ for 6),osteosarcoma in 1(Enneking ⅡB).and chondrosarcoma in 2 (Enneking ⅡA).The operative time,blood loss,and shoulder movement postoperation were analysed.According to the assessment system by MSTS,the function of limb after surgery was assessed.Results Patients were followed clinically and radiographically for a minimum of 24 months (mean,35 months;range,24-52 months).The mean operative time was 172 min(range,150-200min).The mean blood loss was 254 ml (range,150-500 ml).There were no shoulder dislocations at final follow-up.The mean shoulder flexion was 41°(range,20°-60°)and mean shoulder abduction was 42°(range,20°-70°).The mean postoperative functional assessment score of the limb was 66%(range,53%-77%).None of the Datients had a wound infection,traction neuropraxia or died after the surgical procedure.Conclnsion The data suggests that the use of a polypropylene knitted non-absorbable mesh for proximal humerus reconstruction may reduce dislocations and facilitate soft tissue attachment after tumor resection.     

风湿性二尖瓣狭窄左心房血栓形成的危险因素分析

目的 探讨风湿性二尖瓣狭窄左心房血栓形成的危险因素.方法 2001年1月至2008年12月,2277例风湿性二尖瓣狭窄病人接受手术治疗,男737例,女1540例;年龄19～84岁,平均(50.9±10.2)岁.按左心房有无血栓分为血栓组(554例)和无血栓组(1723例).回顾性分析入选病例的一般资料、心电图、超声心动图及实验室检查资料.对单因素分析中有统计学意义的指标行多因素回归分析.结果 单因素分析发现年龄、二尖瓣瓣口面积、左心房内径、左室舒张末径、C反应蛋白、性别、二尖瓣狭窄程度、二尖瓣反流程度、三尖瓣反流程度、肺动脉高压程度、房颤和心功能分级共12个因素组间差异有统计学意义.多因素回归分析发现年龄、二尖瓣瓣口面积、左心房内径、二尖瓣反流程度、房颤是风湿性二尖瓣狭窄病人左心房血栓形成的主要影响因素.结论 风湿性二尖瓣狭窄病人年龄、二尖瓣瓣口面积、左心房内径、房颤是并发左心房血栓的主要危险因素.二尖瓣反流可以降低左心房血栓形成的风险,是左心房血栓形成的保护性因素.

Abstract：

Objective To analysis of risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis.Methods From January 2001 to December 2008, 2277 patients with rheumatic mitral stenosis underwent operations in our hospital. There were 737 males and 1540 female, the age ranged from 19 to 84 years [average (50.9 ±10.2) years]. Left atrial thrombosis group (554 cases) and no thrombosis group (1723 cases) were divided, retrospectively collected data were analyzed with univariate and multivariate Logistic regression. Results 12 bvariables, including age, mitral valve orifice area, left atrial diameter, left ventricular diastole diameter, CRP, gender , degree of mitral stenosis, or regurgitation, degree of bicuspid regurgitation, degree of pulmonary hypertension, atrial fibrillation and heart function had statistic difference between two groups. With multivariate Logistic regression for these 12 factors, age, mitral valve orifice area, left atrial diameter, degree of mitral regurgitation and atrial fibrillation were found to be the affecting factors for left atrial thrombosis in patients with rheumatic mitral stenosis. Conclusion For patients with rheumatic mitral stenosis, age, mitral valve orifice area, left atrial diameter and atrial fibrillation are the risk factors for left atrial thrombosis. Mitral regurgitation is a protective factor for left atrial thrombosis.     

骨质疏松性椎体压缩骨折PKP与保守治疗的随机对照研究

目的 比较经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)与保守疗法对骨质疏松性椎体压缩骨折患者的有效性和安全性的研究.方法 本研究对象为2007年7月至2010年7月间的164 例患者.骨质疏松性脊柱骨折发生2周以内的急性患者和发生在2～8周内的亚急性患者被随机分为保守治疗组和PKP治疗...     

趋化因子受体7在膀胱癌组织中的表达及其临床意义

目的 探讨趋化因子受体7(CXCR7)蛋白在膀胱癌中的表达情况,并分析其与临床生物学行为及复发的关系.方法 选择148例膀胱移行细胞癌标本,30例正常膀胱组织标本:肿瘤标本中非肌层浸润性癌104例,肌层浸润性癌44例;G147例、G2 73例、G3 28例;单发肿瘤89例,多发肿瘤59例;非肌层浸润性癌中未复发40例,复发64例.采用LSAB免疫组织化学方法,检测膀胱癌和正常组织中CXCR7蛋白的表达,并结合临床资料进行分析. 结果正常组织中CXCR7蛋白的表达水平为10.0%(3/30),肿瘤组织为85.1%(126/148);单发及多发肿瘤CXCR7蛋白高表达率分别为49.4%(44/89)和71.2%(42/59),G1、G2、G3膀胱癌CXCR7蛋白高表达阳性率分别为34.0%(16/47)、65.8%(48/73)、78.6%(22/28),差异均有统计学意义(P＜0.01).非肌层浸润性肿瘤和肌层浸润性肿瘤中CXCR7蛋白高表达阳性率为51.9%和72.7%,组间差异有统计学意义(P＜0.05).非肌层浸润性膀胱癌中,复发组与未复发组中CXCR7蛋白高表达阳性率为64.1%和32.5%,差异有统计学意义(P＜0.01).Kaplan-Merier曲线显示,CXCR7蛋白高表达组患者和CXCR7蛋白低表达组患者术后无复发生存率比较,差异有统计学意义(P＜0.01). 结论CXCR7蛋白高表达与膀胱移行细胞癌的恶性程度及预后相关,提示CXCR7与膀胱癌的发生发展存在相关性.

Abstract：

Objective To explore the expression of CXCR7 in bladder cancer and analyze its clinical significance and relationship with bladder cancer recurrence. Methods The expressions of CXCR7 protein in 148 specimens of bladder cancer and 30 specimens of normal bladder tissues were detected by immunohistochemical staining and its clinical significance was then analyzed. Results The expression of CXCR7 protein was higher in bladder cancers than in the adjacent normal tissues (P＜0.01). CXCR7 protein expression rates were 49. 4% and 71.2% in mutifocal tumors and unifocal tumors, while 34.0%, 65.8% and 78. 6% in G1, G2, and G3 tumors, respectively (P＜0. 01). Expression of CXCR7 protein was higher in muscle invasive bladder cancers than in non-muscle invasive bladder cancers (72. 7% versus 51.9% ,P＜0.05). In patients followed up for 2-95 months, CXCR7 protein expression was significantly higher in patients with recurrence than with non-recurrence (64. 1% versus 32.5%, P＜0.01). Kaplan-Meier analysis and the log-rark test showed that the recurrence-free survival was significantly different between the group of lower CXCR7 expression group and the higher expression group (P＜0.01). Conclusions The expression of CXCR7 protein is high in bladder cancer and the analysis of CXCR7 protein expression is potentially valuable in prognostic evaluation of bladder cancers. CXCR7 may play a role in the development of bladder urothelial cell cancer.     

急性低压缺氧对大鼠血浆内皮素前体原的影响

目的观察急性低压缺氧后内皮素前体原（ｐｐＥＴ）和内皮素－１（ＥＴ－１）的变化规律,探讨ＥＴ－１升高的机理。方法将实验大鼠分成三组,观察急性中度低压缺氧３０ｍｉｎ时及６ｈ后ｐｐＥＴ和ＥＴ－１的含量变化,分析其相关性。结果①急性中度低压缺氧３０ｍｉｎ后ｐｐＥＴ和ＥＴ－１均明显升高（Ｐ＜０．０５或０．０１）,脱离缺氧后６ｈ,ｐｐＥＴ和ＥＴ－１有轻度下降,但仍未恢复到对照组水平（Ｐ＜０．０５）。②缺氧前对照组ｐｐＥＴ与ＥＴ－１呈明显正相关（ｒ＝０．９３,Ｐ＜０．００１）,缺氧３０ｍｉｎ后,ＥＴ－１和ｐｐＥＴ虽明显升高,但二者仍呈明显正相关（ｒ＝０．９０,Ｐ＜０．００１）,脱离缺氧后６ｈ,二者有轻度下降,但二者亦呈明显正相关（ｒ＝０．８０,Ｐ＜０．０１）。结论急性低压缺氧可启动ＥＴ基因系统,ＥＴ－１的升高是ｐｐＥＴ合成和释放增加的结果。急性中度低压缺氧对ＥＴ基因启动的时间较长,至少可维持６ｈ以上。     

模拟飞行缺氧与吸氧对小鼠脏器自由基代谢的影响

目的 观察了两种模拟飞行条件（１５００ｍ轻度低压缺氧和５５００ｍ中度低压吸氧重复暴露下小鼠多脏器自由基代谢变化的特点。方法 昆明种小鼠６０只,随机分为６组（ｎ＝１０）进行缺氧与吸氧实验,实验完毕后,取小鼠尾血做血常规检查。次日,将小鼠断头处死,取脑、心、肺、肝、肾制备匀浆,测定丙二醛（ＭＤＡ）含量和超氧化物歧化酶（ＳＯＤ）活性。结果 １５００ｍ轻度低压缺氧重复暴露８ｗｋ使肺ＭＤＡ含量显著增高,提示     

峰值骨量的种族差异

目的 了解各种族之间峰值骨量(PBMD)参考值的差异.方法 收集国内外20多个国家和地区不同种族人群的PBMD参考值,比较了三大人种的峰值骨量的数据,并进行了统计学分析.结果 一般来说,黑色人种的峰值骨量最高,其次是白色人种,黄色人种的峰值骨量最低.中东地区的峰值骨量接近白色人种.黄色人种到达峰值骨量的年龄早于黑色人种及白色人种.我国各少数民族之间的峰值骨量也不尽相同,女性的峰值骨量的民族差异明显大于男性.结论 不同国家和地区各种族人群之间的PBMD参考值绝大多数存在种族或地域差异,必须针对不同人口和地区建立相应的骨密度正常参考值.     

人结肠癌裸鼠移植瘤热疗和化疗及放疗后凋亡相关基因的变化

目的探讨热疗、化疗、放疗对人结肠癌裸鼠移植瘤凋亡相关基因表达的影响。方法将人类结肠癌细胞株——HT29移植于裸鼠双侧后肢。于实验室模拟热疗条件（43℃，60rain），并参照人类结肠癌临床化疗及放疗方案。实验共分6组，即热疗、化疗、放疗、热化疗、热放疗及热放化疗组。于治疗前后不同时间点处死裸鼠。取肿瘤组织备用。利用免疫组织化学染色检测肿瘤细胞膜、细胞浆及细胞核Bcl－2和Bax基因及P53表达的形态学变化。结果6种治疗方法均能不同程度下调P53和Bcl－2、上调Bax的表达。热放化疗组治疗后48hP53及Bcl－2达到最低水平，Bax达高峰。与另外5组比较差异有统计学意义（P〈0．01）；热疗、热化疗及热放疗3组间对P53表达的下调作用差异无统计学意义，但均较化疗、放疗组下调明显。治疗后48h热放疗组和热放化疗组Bcl－2的表达明显低于其他各组（P〈0．05），热疗组下调Bcl－2作用最小，与另外5组的差异均有统计学意义（P〈0．05和P〈0．01）。热放化疗组上调Bax基因表达的作用发生时间最早（2h）：作用最强，与另外5组的差异均有统计学意义（P〈0．05和P〈0．01）；热疗组发生时间最晚（24h），作用最小，与另外5组的差异均有统计学意义（P〈0．05和P〈0．01）。结论热疗可能通过增强放化疗对凋亡相关基因的表达发挥其增敏作用。热疗联合应用化疗和（或）放疗对人结肠癌裸鼠移植瘤凋亡相关基因表达的改变更为显著。     

红蓝光治疗痤疮临床疗效观察

目的:探讨红蓝光照射治疗痤疮的临床疗效和安全性。方法:将113例轻、中度痤疮患者分为两组,实验组采用本院自制的克林霉素醇溶液联合红蓝光照射治疗,对照组仅外用本院自制的克林霉素醇溶液治疗。采用痤疮综合分级系统(GAGS)评价治疗前、后疗效。结果:实验组和对照组有效率分别为82.8%和43.6%,两组的治疗有效率存在显著性差异(P<0.01)。GAGS综合分值均较治疗前明显下降(P<0.01),但实验组下降更显著。结论:红蓝光治疗面部轻、中度痤疮安全有效。