膝前框形钢丝内固定治疗髌骨骨折

目的探讨采用钢丝环扎 膝前方框形张力带钢丝内固定法治疗髌骨骨折的经验和临床效果.方法对35例髌骨骨折应用此方法治疗,基中男性24例,女性11例,30例获得3～24个月随访.结果优19例,良10例,可1例,优良率96.7%.术后未出现骨折再移位,无伤口感染.愈合时间6～12周.结论该方法符合生物力学原理,操作简便,适应证广,能早期关节活动,是治疗髌骨骨折的理想方法之一.     

缝隙连接蛋白43在缺血性心律失常中的作用

目的探讨心肌缺血时,心肌缝隙连接蛋白43(connexin43,Cx43)与缺血性心律失常的关系。方法对戊巴比妥钠麻醉大鼠进行30min的冠状动脉缺血。大鼠分为不处理或者接受缺血预适应(ischemic preconditioning,IPC)、静脉注射线粒体ATP磷酸敏感性钾通道(mitoKATP)开放剂二氮嗪(Dia)3组,其余2组为在接受IPC、Dia的基础上加用5羟基奎酸(5-HD)。测量各组的血流动力学指标和心律失常。采用Western blotting检测Cx43的磷酸化程度。结果与对照组相比,IPC、Dia能促进Cx43磷酸化,减少心律失常的发生率,线粒体ATP敏感性钾通道阻断剂5-HD能消除IPC和Dia的上述作用。结论IPC通过开放线粒体ATP敏感性钾通道促进Cx43磷酸化和电耦联,进而抑制心律失常的发生。     

不同分化胃癌细胞系中间隙连接蛋白的表达

目的探讨间隙连接蛋白（Cx）Cx26、Cx32、Cx43、Cx45在转化的人胃细胞系（GES-1）、胃高分化腺癌细胞系（N87）和胃低分化腺癌细胞系（BGC-823）中的表达及其与胃癌发生、发展的关系。方法采用间接免疫荧光方法检测Cx26、Cx32、Cx43、Cx45在不同分化程度胃癌细胞株中的表达，并分析该蛋白表达与胃癌发生、发展的关系。结果在不同分化胃癌细胞株中。Cx26、Cx32、Cx43、Cx45表达呈现1个由高水平到低水平表达直至无表达的梯度分布，既Cx26、cx32、Cx43、Cx45在GES-1中高水平表达，在N87表达减少，在BGC-823中无表达，并且表达部位有差异。结论Cx26、Cx32、Cx43、Cx45的表达与胃癌细胞的分化关系密切，在胃癌的发生、发展中有一定作用。     

试论群众看病难、看病贵的原因及对策

社会各界热切关注的看病难、看病贵,主要原因是卫生资源总体不足,卫生发展落后于经济发展。看病难、看病贵同许多社会现象一样,是有城乡差别的。在城市里是看病贵,小病大治、药价昂贵、名医难求、医托药托泛滥,城里人特别向往大医院、只挂专家门诊, 主要体现的是一个“贵”字,病是能看、能治,但城里人是要求锦上添花。而在农村则因为收入低,经济窘迫,医疗水平差,现实困难重重, 是看病难,小病硬扛,大病小养,因病返贫,因病致贫现象还很普遍,农村是要求雪中送炭。因此,城里人看病难与农村人看病难有天壤之别。不区别城乡差别的现实,那解决问题就是盲人摸象。本文试图从造成群众看病难、看病贵的主要原因中,提出解决的对策。     

套扎和硬化夹心联合与单纯硬化治疗食管静脉曲张出血的对比研究

目的了解套扎与硬化夹心联合法治疗食管静脉曲张出血(EVB)能否获得优于单纯硬化(EIS)的疗效。方法84例肝硬化EVB患者随机接受夹心法或单纯EIS治疗(夹心法组43例,EIS组41例)。EIS组硬化剂采用血管旁、内的联合注射法,夹心法组每条曲张静脉结扎2个皮圈,并于其间曲张静脉内注射1～3mL硬化剂。间隔7～12d重复1次内镜治疗,直至静脉曲张消除。结果夹心法组与EIS组静脉曲张消除率相似(93.0%比92.7%),但夹心法组达到消除的平均治疗次数明显减少(1.8±0.6比3.8±1.1),所需平均时间显著缩短[(17.1±7.1)d比(36.5±15.7)d],再出血率与并发症率明显下降(9.3%比31.7%;8.4%比26.8%)。随访期内两组静脉曲张复发率比较差异无显著性(11.6%比14.6%)。结论内镜下套扎与硬化夹心联合法治疗食管静脉曲张出血的疗效优于单纯硬化治疗的疗效。     

聚髌器与改良张力带治疗髌骨粉碎性骨折疗效比较

为比较两种不同内固定方式在治疗髌骨粉碎性骨折中的临床疗效,将60例病人采用随机分组方法分成两组,分别采用镍钛记忆合金聚髌器(Niti-Patellar Concentrator NT-PC)(A组)和改良张力带钢丝内固定(B组)治疗,并对手术时间、术后骨折复位情况、骨折愈合时间、术后功能锻炼开始时间、膝关节屈曲达到90°的时间、手术后膝关节功能完全恢复时间及术后的并发症等结果进行比较.结果显示A组在手术时间、术后膝关节功能锻炼开始时间、膝关节屈曲达到90°和完全恢复的时间及骨折愈合的时间均早于B组,术后骨折复位比B组好(P＜0.05),手术后无并发症.表明治疗髌骨粉碎性骨折NT-PC比改良张力带钢丝内固定有更广泛的适应症与更理想的效果.     

细胞间隙连接通讯与肿瘤

细胞间隙连接通讯 (GJIC)在多细胞动物细胞的生长、分化和凋亡等生理过程中发挥着重要调节作用。研究表明大多数转化细胞和肿瘤细胞GJIC功能减弱或消失。阻止肿瘤促进剂对细胞GJIC功能的抑制或恢复癌细胞GJIC功能将对肿瘤的预防和治疗具有重要意义。     

The impact of GJA3 SNPs on susceptibility to age-related cataract

AIM: To determine the association of gap junction protein alpha 3 (GJA3) gene tag single-nucleotide polymorphisms (SNPs) with susceptibility to age-related cataract (ARC). METHODS: In total, 486 ARC patients were matched with 500 healthy controls. All the participants underwent complete ophthalmic examinations. Haplotype-tagging SNPs of GJA3 gene were selected from the HapMap Beijing Han Chinese population. Genomic DNA was extracted from the peripheral blood leukocytes of all the subjects. Under three different genetic models: dominant, recessive, and additive, the association between SNPs and ARC was examined. After adjusting for age and sex, the genetic effects of the GJA3 SNPs were evaluated with logistic regression analysis. RESULTS: Four tag GJA3 SNPs (rs6490519, rs9506430, rs9509053, and rs9552089) were included in the present study. None of the SNPs showed a significant relationship with an altered risk of total ARC under the dominant, recessive, or additive models. In the subgroup analysis, rs9506430 had a significant effect on the formation of a posterior subcapsular cataract (P=0.002, OR: 0.227, 95%CI: 0.088-0.590) under the recessive model. CONCLUSION: Our study indicates that GJA3 variants may influence the development of posterior subcapsular cataracts. Further studies need to be designed to confirm this possibility.     

Collagenous gastritis

In the present paper, we report a case of rare collagenous gastritis. The patient was a 25‐year‐old man who had experienced nausea, abdominal distention and epigastralgia since 2005. Esophagogastroduodenoscopy (EGD) carried out at initial examination by the patient's local doctor revealed an extensively discolored depression from the upper gastric body to the lower gastric body, mainly including the greater curvature, accompanied by residual mucosa with multiple islands and nodularity with a cobblestone appearance. Initial biopsies sampled from the nodules and accompanying atrophic mucosa were diagnosed as chronic gastritis. In August, 2011, the patient was referred to Tohoku University Hospital for observation and treatment. EGD at our hospital showed the same findings as those by the patient's local doctor. Pathological findings included a membranous collagen band in the superficial layer area of the gastric mucosa, which led to a diagnosis of collagenous gastritis. Collagenous gastritis is an extremely rare disease, but it is important to recognize its characteristic endoscopic findings to make a diagnosis.     

Is it safe to perform endoscopic band ligation for the duodenum? A pilot study in ex vivo porcine models

Abstract

Aim: In the digestive tract, endoscopic band ligation (EBL) has been routinely used for the treatment of variceal bleeding and superficial malignancies. In recent years, endoscopic treatments for duodenal varices, adenoma, and cancer have also actively incorporated EBL. Although there have been a number of reports on the risks associated with the use of EBL in the esophagus, stomach, and colon, few studies have focused on EBL in the duodenum. We performed EBL procedures to evaluate the risks associated with the use of EBL in the duodenum. Material and methods: Overall, EBLs were performed at nine sites in duodenum sampled from a pig immediately after sacrifice. Submucosal saline injections were placed in three of the nine studied sites. Results: Regardless of saline injection, the full thickness of the duodenal wall was ligated in all attempts. Conclusions: Routine EBL is not recommended in the duodenum because the risk of perforation is unacceptably high.