基质金属蛋白酶在脑创伤中的研究进展

脑创伤是目前严重危害人类健康的主要疾病之一，具有较高的致残率和死亡率。而继发性脑损伤是影响脑创伤发展和预后的重要因素之一，适当的治疗可以减轻或避免某些继发性损伤的病理变化，提高患者的疗效，改善预后。近年来，随着对基质金属蛋白基质系（matrix metalloproteinases，MMPs）的不断深入研究，金属蛋白酶系在继发性脑损伤中的作用日益受到人们的重视。本文就基质金属蛋白酶系在脑创伤方面的研究概述如下。[第一段]     

Diagrammatic recording of head and neck tumours1

The increasing demands of clinical audit have resulted in the need for accurate data collection. The use of tumour maps allows standardization of the records of patients with head and neck cancer, which facilitates collation of data in multicentre studies and makes interdepartmental comparisons more meaningful. The aim of this study was to develop an improved standard set of tumour maps for recording the stage of head and neck tumours. A review of the existing tumour diagrams was performed to identify those anatomical areas that are not adequately represented or where ambiguity exists. The areas where improvements could be made were identified as: (1) the anterior commissure of the larynx; (2) axial and sagittal views of the larynx; (3) the pyriform fossa and cervical oesophagus; (4) the oropharynx and vallecula; (5) the nasal cavity and paranasal sinuses; and (6) cervical nodal involvement. A new set of tumour maps is presented in an attempt to correct some of the limitations of the existing diagrams.     

The electrophysiological properties of substantia nigra pars compacta neurones recorded from 6-hydroxydopamine lesioned guinea-pigs in vitro

Summary Intracellular recordings were made from substantia nigra pars compacta neurones in vitro from animals with partial unilateral 6-hydroxydopamine lesions of the nigrostriatal tract. Lesions were assessed and grouped according to the severity of the strital dopamine depletion. No differences were seen between neurones from control and lesioned side nigrae as regards their membrane properties, firing rates, burst activity or percentage of quiescent neurones in any of the lesioned categories. It is concluded that following partial lesioning, the remaining substantia nigra zona compacta neurones in vitro, are functioning normally.     

循证护理在糖尿病皮肤损害临床实践中的应用

目的　应用循证护理 (EBN) ,探索糖尿病皮肤损害有效干预方法 ,减少残疾及死亡率 ,提高病人生活质量。方法　通过临床评估确定护理诊断 ,查阅文献 ,选择最佳护理证据 ,制定护理干预措施。结果　通过治疗及护理干预 ,2 2例糖尿病患者皮肤损害 ,显效 2 1例 ,有效 1例 ,转科 1例 ,出院时患者无并发症。结论　循证护理应用于临床 ,使传统护理经验走向护理科学发展 ;促进护士主动学习 ,提高护士综合素质 ;优质护理服务于个体化 ;解决患者现存的、潜在的护理问题 ,提高患者生存质量。     

后路小切口人工全髋关节置换治疗老年人股骨颈骨折

目的:观察后路小切口人工全髋关节置换术(小切口-THA)治疗老年股骨颈骨折的临床效果。方法:本组24例65岁以上股骨颈骨折患者,女13例,男11例;年龄65～78岁,平均73.4岁。均为外伤后股骨颈头下型骨折,位线差,其中Garden分型为Ⅲ型10例,Ⅳ型14例,全部应用后路小切口技术行全髋关节置换术。结果:术后所有病例随访10～24个月,平均13个月。平均手术时间80min,手术切口平均长8.0cm,平均输血300ml,无局部及全身并发症出现。按UCLA(UniversityofCaliforniaLosAngeles)髋关节功能评分标准,本组UCLA评分由术前平均(11.0±3.8)分升至术后平均(24.3±4.5)分(P<0.01)。本组优17例,良4例,一般3例,优良率为87.5%。结论:后路小切口技术具有创伤小、出血少、恢复快的特点,可获得与常规后路相同的治疗效果,尤其适合老年股骨颈骨折患者。     

Tumor-Like Meniscal Cyst

A 50-year-old woman presented with a 5-year history of mild pain in her right knee, which had increased over the last 2 years. A palpable mass over the anterolateral aspect of the knee was obvious and the last 3 months she was experiencing locking episodes with consequent knee effusion. The differential diagnosis was driven between meniscal cyst, pigmented villonodular synovitis, synovial sarcoma, synovial chondromatosis, and aneurysm. After a diagnostic arthroscopy, the lesion was excised by a limited lateral arthrotomy. The pathologic findings revealed a synovial cyst. Intra-articular synovial cysts are uncommon, nonsymptomatic, and mostly incidental findings on magnetic resonance imaging (MRI) and arthroscopy. This lateral meniscus synovial cyst (2.5 × 2.5 cm) was enlarged within the intracondylar notch and produced disabling knee symptoms. The peculiarity of this lesion was the tumor-like appearance: its large size, the progress of symptoms, and the multilobulated, nonhomogenous signal on the MRI scan. One year postoperatively, the patient is asymptomatic and the MRI obtained at 6 months revealed no remnant of the fully excised cyst.     

计算机导航在骨科手术中的应用

目的将计算机导航技术应用于骨科手术,并对其进行初步分析。方法2004年2～12月,计算机导航系统辅助下共行134枚椎弓根螺钉固定,51枚股骨颈骨折空心钉内固定,58枚交锁髓内钉远端交锁螺钉固定。结果所有病例全部在导航下完成手术,术中明显减少C型臂X线机透视次数,未发生血管和神经损伤并发症。结论计算机导航手术安全有效,更有利于微创手术的开展。     

内固定和人工关节置换治疗老年人股骨颈骨折的临床疗效观察

目的比较人工关节置换术与AO加压空心螺钉术治疗老年人有移位股骨颈骨折的疗效。方法将1995年5月～2004年11月我院收治的78例年龄在65周岁以上的有移位的新鲜股骨颈骨折患者进行回顾性研究，将病例分为A、B两组，A组为人工关节置换组，B组为AO加压空心螺钉治疗组。AO加压空心螺钉治疗组（内固定组）随访12～91个月，平均41．7个月，随访人工关节置换组12～96个月，平均40．3个月。结果按Harris评分标准，A组术后优良率达到82．9％；B组内固定组优良率57．1％。术后远期并发症的发生率A组为19．5％；B组为42．9％。结论人工关节置换术和A0加压空心螺钉均是治疗老年股骨颈骨折的有效方法，但人工关节置换术可提高老年人的生活质量，减低术后并发症的发生率，所以人工关节置换的效果优于AO加压空心螺钉。