全关节镜下微创复位固定术治疗SandersⅡ、Ⅲ型跟骨关节内骨折的疗效分析

目的 探讨全关节镜下微创复位固定术治疗SandersⅡ、Ⅲ型跟骨关节内骨折的临床疗效。方法 前瞻性随机对照研究。纳入2017年3月—2020年12月徐州仁慈医院足踝外科Sanders Ⅱ、Ⅲ型跟骨骨折患者40例,其中男36例、女4例,年龄18~58（39.6±10.8）岁,左侧22例、右侧18例,Sanders Ⅱ型16例、Ⅲ型24例。40例患者数字表法随机分为关节镜组（采用关节镜下跟骨关节内骨折微创复位、经皮螺钉固定术治疗）、大“L”形切口组（采用传统的大“L”形切口跟骨骨折复位钢板内固定术治疗）,每组20例。观察指标：（1）比较2组患者性别、年龄、体质量指数（BMI）、骨折类型、术前美国足踝外科学协会（AOFAS）踝-后足功能评分等基线资料差异;（2）比较2组患者手术切口长度、手术时间、术中出血量、住院时间、术后切口愈合情况等围术期资料差异;（3）术后观察局部有无麻木感、是否钢板外露、切口皮肤坏死、术后1年是否有创伤性关节炎等手术并发症情况;（4）对比分析2组患者末次随访时AOFAS踝-后足功能评分、Gissnae角和Bohler角。结果 （1）2组患者性别、年龄、BMI、骨折类型、术前AOFAS踝-后足功能评分等基线资料比较,差异均无统计学意义（P值均>0.05）。（2）关节镜组患者的切口长度（0.94±0.08）cm、术中出血量（7.20±1.98）mL、手术时间（41.45±9.96）min、住院时间（8.45±2.01）d,大“L”形切口组患者的切口长度（14.35±1.63）cm、术中出血量（27.35±10.35）mL、手术时间（90.65±12.08）min、住院时间（17.15±6.72）d,关节镜组优于大“L”形切口组,差异均有统计学意义（t=-36.70、-8.54、-14.04、-5.54,P值均<0.001）。（3）术后平均随访12.3个月。术后关节镜组切口均甲级愈合,无创伤性关节炎、足背皮肤麻木。大“L”形切口组20例中,18例患者切口甲级愈合,2例患者切口皮缘坏死、钢板外露,予腓肠神经营养逆行岛状皮瓣修复后伤口愈合;有4例患者术后感足背外侧麻木,经治疗分别于术后8~14个月痊愈。（4）末次随访时AOFAS踝-后足功能评分关节镜组为（92.10±3.16）分、大“L”形切口组为（91.3±2.45）分,术后2组患者跟骨的Gissnae角和Bohler角均在正常范围内,组间比较差异均无统计学意义（P值均>0.05）。结论 与传统的切开复位内固定术相比较,全关节镜下微创手术治疗Sanders Ⅱ、Ⅲ型跟骨关节内骨折,具有手术切口小、手术时间短、内固定牢固、切口愈合好、疗程短、术后瘢痕不明显、功能恢复快等优势。     

双特异性抗体对LAK细胞增殖和细胞毒作用影响的体外研究

将抗ＣＤ３与抗ＨＢｓ的单克隆抗体经化学偶联得到双特异性抗体，观察该双特异性抗体对ＬＡＫ细胞增殖和增强细胞毒性的作用。结果显示双特异性抗体显著提高ＬＡＫ细胞与２．２．１５细胞结合率；促进淋巴细胞增殖。１２５Ｉ－ＵｄＲ释放试验检测发现双特异性抗体增强ＬＡＫ细胞对２．２．１５细胞的细胞毒性且与抗体浓度呈正相关。进一步对抗体的特异性研究表明，加入双特异性抗体后ＬＡＫ细胞对２．２．１５细胞毒性作用显著高于对照组。     

Intact perceptual and conceptual priming in temporal lobe epilepsy: neuroanatomical and methodological implications

Explicit memory appears to be supported by medical temporal lobe structures, whereas separate neocortical regions may mediate perceptual and conceptual implicit memory. Children and adults with temporal lobe epilepsy (TLE) and matched controls were administered experimental verbal memory tests. Performance on implicit tests--word identification and word generation--was contrasted with explicit recognition and recall. Encoding conditions emphasized either conceptual or perceptual aspects of study words and were crossed with presentation modality. The priming performance of participants with TLE did not differ from controls, but participants with TLE did show deficits on recognition and recall measures. Thus, intact left temporal cortex does not appear to be necessary for normal implicit memory performance, even when conceptual processing is emphasized at study or test.     

老年大鼠的海马神经元对微量注射Ach的敏感性

本工作观察了老年大鼠海马神经元对微量注射Ach(10μg/0.5μl)的敏感性。 实验在6只老年大鼠(大于30月龄)和5只年青大鼠(4～5月龄)上进行。结果表明:年青大鼠和老年大鼠的海马神经元对Ach的主要反应模式有所不同,前者多出现神经元放电明显增加的兴奋反应。后者多出现抑制反应,神经元的放电明显减少。此外,老年大鼠的海马神经元对Ach反应的持续时间(包括兴奋和抑制反应)也明显长于年青大鼠。本文对海马神经元敏感性和适应能力的改变可能是影响老年记忆的重要因素进行了讨论。     

The role of fibronectin in tumor implantation at surgical sites

Fibronectins are a family of glycoproteins with modular functional domains. They mediate cell-cell and cell-matrix interactions which are important in embryogenesis, wound healing, metastasis and other processes. We present data on the influence of fibronectin on wound implantation of a murine mammary carcinoma line, TA3Ha. Fibronectin used in these studies was derived from bovine plasma, human serum, human foreskin fibroblasts, and mouse embryo cultures. TA3Ha cells rarely form tumors in the liver of syngeneic mice when injected intravenously but after hepatic wedge resection, 45% (107/240) of the mice develop tumors in the hepatic wound. Wound implantation is markedly reduced when the cells are pre-exposed to 200 µg/ml bovine plasma fibronectin (13%, P = 0.007), human serum fibronectin (0%, P = 0.02), human cellular fibronectin (0%, P = 0.02), or mouse cellular fibronectin (0%, P = 0.04). Lung colonization is also reduced by these fibronectins. These effects are not due to a cytotoxic action of fibronectin, since intraperitoneally injected fibronectin-treated cells form ascites tumor as effectively as do control untreated cells. Local application of a solution containing 0.25 mg/ml mouse cellular fibronectin to the hepatic wound reduces the frequency of tumor implantation from 45% to 5% (1/21, P = 0.001). No tumor implantation inhibition is seen when only suspending medium or albumin in suspending medium is used. The mechanism by which topical application of fibronectin reduces hepatic wound implantation of tumor cells is unclear, but this finding raises an exciting possibility of preventing local recurrence of cancer.     

乙/丙型肝炎病毒双重感染患者前C区终止变异低频率

目的了解乙型肝炎病毒（ＨＢＶ）与丙型肝炎病毒（ＨＣＶ）双重感染患者前Ｃ区基因变异，及其可能的临床意义。方法用聚合酶链反应（ＰＣＲ）与限制片段长度多态性（ＲＦＬＰ）来分析２５例ＨＢＶＤＮＡ和ＨＣＶＲＮＡ均阳性（Ａ组）和３１例ＨＢｓＡｇ和ＨＢＶＤＮＡ阳性但抗－ＨＣＶ和ＨＣＶＲＮＡ均阴性（Ｂ组）的慢性肝病患者前Ｃ区密码２８终止变异（终２８）。结果ＨＢＶ和ＨＣＶ双重感染患者（Ａ组）血清ＨＢＶＤＮＡ第１次ＰＣＲ阳性率（１６％）明显低于单独ＨＢＶ感染组（６５％）（Ｐ＜０．００１）；前Ｃ终２８检出率（２８％）亦明显低于单独ＨＢＶ感染（６８％）（Ｐ＜０．００１）。结论提示双重感染患者ＨＢＶ前Ｃ终止变异低频率可能与ＨＢＶ低水平复制有关     

New X-linked syndrome with apraxia, ataxia, and mental deficiency: clinical, cytogenetic and neuropsychological studies in two Danish families.

In 2 unrelated families 9 males presented with ataxia, apraxia, and neuropsychological abnormalities or mental deficiency, inherited as an X-linked recessive syndrome with partial clinical expression in obligate female carriers. The symptoms were present in early childhood and were non-progressive. Additional findings in 2 males were congenital "club-feet" and generalized seizures. The affected males were 13-62 years old at the time of our examination. Chromosome abnormalities including fragile X fra(X) could not be demonstrated in any case. Results of metabolic screenings were also normal. The clinical picture with X-linked recessive inheritance distinguishes this syndrome from previously described inherited hereditary ataxias.     

新型微波热疗机研制及其临床应用

重点对新型电脑微波热疗机的构成、测温控温方案进行了研究。采用自适应广义预测控制算法对热疗温度进行控制，解决了因更换不同辐射器导致对象特性变化使控制性能降低的问题，从而得到了满意的疗效。文中介绍了该仪器关键的硬件、软件设计，基本的特点和临床应用     

Injuries to the profunda femoris artery and its branches

Six cases of uncommon profunda femoris artery injury are analyzed. One half of the cases were not treated surgically at the time of injury and resulted in chronic arteriovenous fistulas. Even after operative correction, residual symptoms persisted in two of these three cases. The generous use of arteriography is recommended in cases of proximal thigh penetrating injuries to avoid this problem. Either repair or ligation of the injured vessel yielded the same good results. The postoperative hospital stay was short in all instances, ranging from four to eight days, and there were no deaths.