Stra8基因启动子逆转录病毒包装细胞株的建立

目的:建立小鼠Stra8基因启动子控制绿色荧光蛋白EGFP表达(P(stra8)-EGFP)的逆转录病毒包装细胞株,以方便地将P(stra8)-EGFP转导到目的细胞,为生殖细胞鉴定分选提供基础.方法:PCR扩增小鼠基因组DNA中的Stra8基因启动子片段,构建Stra8基因启动子控制表达的EGFP报告基因逆转录病毒质粒.将质粒脂质体法转染PT67病毒包装细胞,G418抗性筛选后,梯度稀释法将包装细胞单克隆化并扩增成多个细胞株.以包装细胞培养上清液感染NIH3T3细胞的所形成的G418抗性阳性细胞数定义病毒滴度,确定高滴度病毒包装细胞株.通过染毒小鼠骨髓间充质干细胞(mouse bone marrow mesenchymal stem cells,MSCs)验证该细胞株的P(stra8)-EGFP转导效果.结果:所建立的病毒包装细胞株培养上清液滴度达到1.3×10(6) cfu/ml.MSC经包装细胞培养上清液感染后,在(retinoic acid,RA)诱导下能表达EGFP蛋白.结论:成功构建了将P(stra8)-EGFP转导到目的细胞的PT67逆转录病毒包装细胞株.     

黄芪多糖对实验性精索静脉曲张大鼠睾丸HO-1表达的影响及意义

目的 研究黄芪多糖对实验性精索静脉曲张(Varicocele,VC)大鼠睾丸组织中血红素加氧酶-1(HO-l)表达的影响,探讨黄芪有效成分治疗VC的作用及机制.方法 青春期雄性SD大鼠70只,随机分为VC造模组(n=60)和假手术组(n=10,C组).VC造模组大鼠按灌胃药物随机分为黄芪多糖实验组(n=40,A组)和生理盐水对照组(n=20,B组).造模后分别于4周、8周取A、B组和C组大鼠左侧睾丸,用免疫组化方法检测睾丸组织中HO-1的表达.结果 HO-1在A组、B组睾丸组织中的阳性表达率分别为91.6％和94.1％,其表达强度明显高于C组(P＜0.01).A组HO-1表达强度低于B组(P＜0.05).结论 实验性VC大鼠左侧睾丸组织中存在HO-1表达上调.黄芪多糖可下调VC大鼠睾丸组织HO-1表达强度,减少睾丸组织氧化损伤,可能对VC不育有一定治疗作用.     

穿刺引流术治疗脑室出血115例报告

目的探讨微创穿刺引流术治疗脑室出血的疗效。方法 2005年11月-2010年11月对115例CT确诊脑室出血,其中重型脑室出血25例,根据患者脑室出血部位和体积选择性穿刺侧脑室额角,采用双侧或单侧脑室引流,术后尿激酶灌注冲洗,直至脑脊液正常,头颅CT确认血肿消失。结果住院期间治愈或好转88例（76.5%）,植物状态11例,死亡16例。98例随访3-12个月,平均6个月：78例复查头颅CT示脑室大小正常,再出血8例,继发性脑积水5例,死亡7例。结论脑室穿刺引流联合尿激酶灌注冲洗,能尽快清除脑室系统及蛛网膜下腔积血,对降低病死率,提高患者术后生存质量有重要意义。     

SLIPA喉罩和气管插管全麻在腹腔镜胆囊手术中的应用比较

目的 观察SLIPA喉罩与气管插管对患者血流动力学和气道阻力的影响.方法 择期全麻下腹腔镜胆囊手术患者60例,随机均分为SLIPA喉罩组(A组)和气管插管组(B组),记录插入喉罩/气管导管前(T0)、插入喉罩/气管导管后1 min(T1)、3 min(T2)和拔喉罩/气管导管前(T3)、拔喉罩/气管导管后1 min(T4)、3 min(T5)的SBP、DBP、HR和SpO2,同时在8 ml/kg潮气量下监测T1～T3时的平均气道压(Pmean)、气道峰压(Ppeak)和PETCO2,并观察有无反流误吸情况及术后咽喉部并发症.结果 与T0时相比,B组T1、T3、T4时SBP、DBP明显升高,HR明显增快,且相应时点均高于A组(P＜0.05);A组在T1、T2时的Pmean、Ppeak低于B组(P＜0.05);术后咽部不适患者B组(9例)明显多于A组(2例)(P＜0.05).结论 SLIPA喉罩通气用于腹腔镜胆囊手术时,患者应激反应小,术后咽喉部并发症少.     

Bilateral plate fixation for type C distal humerus fractures: experience at a single institution

Type C fractures of the distal humerus are difficult to treat and typically require open anatomical reduction and internal fixation. Here we describe our experience treating patients with type C distal humerus fractures using a trans-olecranon approach with bilateral plate fixation. Fifty-six patients (30 males, 26 females; mean age 49.8 years) were treated over a period of six years. Thirteen fractures were open and 43 closed; all were caused by falls or traffic accidents. All operations were performed successfully with no intraoperative complications. Mean duration of follow-up was 30 months (range 6–70). Mean duration of fracture healing was 2.8 months (range 2–4). Forty-seven out of 56 patients (84%) suffered no postoperative complications. One patient exhibited symptoms of ulnar nerve injury following surgery (nine exhibited symptoms before and after surgery). Two patients had mild cubitus varus deformities, four delayed olecranon osteotomy site healing, and two heterotopic ossifications. In summary, complications were minimal and outcomes satisfactory in patients with type C distal humerus fractures who underwent bilateral plate fixation via a trans-olecranon approach.     

Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures

Objective: To investigate the efficacy of the locking internal fixator (LIF), which includes the locking compression plate (LCP) and the less invasive stable system (LISS), in the proximal and distal tibial fractures. Methods: We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the operation with LIF by the minimally invasive plate osteosynthesis (MIPO) technique. The data consisted of 43 proximal tibial fractures (type AO41C3) and 55 distal tibial fractures (type AO43C3). Results: No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months). Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion: Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.     

干细胞与骨质疏松症研究进展

干细胞是一类具有自我复制能力的多潜能细胞,在一定条件下可分化成多种功能细胞或组织器官,并且不表达组织相容性复合体(MHC),无免疫排斥反应,对许多疾病的治疗具有重要意义。本文对干细胞在骨质疏松症方面的基础研究进行综述,并对干细胞应用于重度骨质疏松症治疗提供理论依据。     

脑卒中后吞咽障碍患者吞咽肌群的康复训练

目的观察吞咽肌群康复训练对脑卒中吞咽障碍的疗效。方法采用随机区组法将80例脑卒中后吞咽障碍患者分为观察组和对照组各40例。对照组采用吞咽治疗仪常规治疗及一般的口腔护理,观察组在此基础上增加吞咽肌群的功能训练。结果观察组临床疗效显著优于对照组(P<0.01)。结论吞咽治疗仪治疗的基础上增加吞咽肌群的康复训练能明显改善脑卒中患者的吞咽障碍。     

人羊膜间充质细胞向成骨细胞诱导分化的实验研究

目的 观察人羊膜间充质细胞(human amnion mesenchymal cells,hAMCs)体外诱导向成骨细胞分化,为骨组织工程提供种子细胞。方法 从剖宫产后废弃的人羊膜组织分离培养hAMCs,经成骨细胞诱导条件培养基诱导后,对细胞形态特征、碱性磷酸酶、骨桥素、骨钙素表达以及I型胶原分泌进行观察和检测。结果 原代培养的hAMCs形态呈长梭形或不规则形,呈均匀分布生长,传代后细胞体积略变大,约5～7d传代1次。经成骨细胞诱导培养15d后,hAMCs碱性磷酸酶、骨钙素、骨桥素的表达呈阳性,并且检测有I型胶原分泌。结论 hAMCs易于体外分离培养及扩增,体外成骨细胞定向诱导的hAMCs具有典型的成骨细胞的形态和功能性特征,是良好的骨组织工程种子细胞。     

闭合性膝关节周围骨折合并腘动脉损伤的手术治疗

[目的]回顾性分析一期单边外固定架固定骨折,二期更换内固定治疗闭合性膝关节周围骨折合并腘动脉损伤的临床疗效.[方法]自2007年3月～2009年6月,共收治闭合性膝关节周围骨折合并腘动脉损伤患者5例,通过临床检查、血管Doppler检查,及早明确诊断,手术探查明确腘动脉损伤后一期采用单边外同定支架跨膝关节固定骨折,及时修复损伤的动脉,预防性小腿骨筋膜室切开减压,术后抗凝、解痉、抗感染治疗,二期更换外固定支架为内固定,术后早期功能锻炼,并随访其疗效.[结果]5例患者均采用该方法,从开始手术至血管再通58～100min,平均70.6 min,术后随访1～2年(平均15.6个月).所有患者受伤肢体均存活,无肌肉软组织坏死,手术切口及减张切口无感染发生,骨折骨性愈合,术后膝关节功能Lysholm评分76～88分,平均83.6分.[结论]一期单边外固定架跨膝关节固定同时吻合胭动脉,二期更换内同定,早期功能锻炼是临床治疗闭合性膝关节周围骨折合并腘动脉损伤的有效方法.