消化性溃疡的皮质醇分泌异常

采用放射免疫测定法研究了70例非应激性消化性溃疡患者的皮质醇分泌状态;并比较了患者与84例正常人的血清皮质醇浓度及其昼夜分泌节律。发现非应激性消化性溃疡血清皮质醇浓度明显高于健康对照组(P<0.01);然昼夜分泌节律相仿。结果提示,非应激性消化性溃疡有皮质醇分泌的明显异常。     

实验性骨折愈合中骨吸收活动的超微结构观察

将50只家兔造成实验性桡骨骨折,分批取骨痂标本,用光镜和电子显微镜观察表明,在骨折愈合过程中,破骨细胞是骨吸收的主要执行者,巨噬细胞能吞噬死骨,但不能吸收骨质。     

Comparative effects of plateletderived growth factor-BB and insulin-like growth factor-I, individually and in combination, on periodontal regeneration in Macaca fascicularis

Platelet-derived growth factor (PDGF) and insulin-like growth factor I (IGF-I) in combination have previously been shown to enhance periodontal regeneration. The objective of this study was to further characterize the biological effects of this combination of growth factors in non-human primates and compare the effects to those of each growth factor individually. Ligature-induced periodontitis was initiated in 10 cynomolgus monkeys. After periodontal lesions were established, surgery was performed, and either a methylcellulose gel vehicle or vehicle containing 10 μg each of either PDGF-BB, IGF-I or both PDGF-BB and IGF-I was applied to exposed root surfaces. Biopsies were taken 4 and 12 wk after treatment and the extent of periodontal regeneration was assessed by histomorphometry. At both 4 and 12 wk vehicle-treated lesions generally revealed minimal osseous defect fill (ODF) (8.5±2.1% and 14.5±5.7%, respectively) and new attachment (NA) (34.1±5.2% and 26.6±10.5%, respectively). IGF-I treatment did not significantly alter healing compared to vehicle in any parameter at both 4 and 12 wk. PDGFBB-treated sites exhibited significant (p<0.05) regeneration of NA (69.6±12.0%) at 12 wk; trends for PDGF-BB treatment effect were also observed in other parameters at 4 and 12 wk. although these increases were not statistically significant. Treatment with PDGF-BB/IGF-I resulted in 21.6±5.1 % and 42.5±8.3% ODF at 4 and 12 wk, respectively, and 64.1±7.7% and 74.6±7.4% NA at 4 and 12 wk, respectively (all significantly greater than vehicle, p<0.05). The results from this study demonstrated that: 1) IGF-1 alone at the dose tested did not significantly alter periodontal wound healing; 2) PDGF-BB alone significantly stimulated NA, with trends of effect on other parameters; and 3) the PDGF-BB/IGF-I combination resulted in significant increases in NA and ODF above vehicle at both 4 and 12 wk.     

密闭液性环境干燥环境下供皮区创面愈合的比较研究

目的比较研究密闭液性环境和干燥环境下供皮区创面的愈合过程. 方法 1996年7月～1997年3月以13例成人断层供皮区创面为研究对象,其中男9例,女4例,年龄20～50岁,创面面积(100～400) cm2,取皮深度中厚,约0.44 mm.同一个创面分为实验组(密闭液性环境)和对照组(干燥环境),采用自身对照法.应用大体、组织学及电镜观察等方法进行观察. 结果密闭液性环境下创面愈合较快,创面组织中成纤维细胞较早活跃、且持续时间较长,再血管化和再上皮化均较早和较快发生. 结论密闭液性环境下创面愈合较快,与组织修复细胞较为活跃、再血管化和再上皮化较快发生有关.     

Admission rates for peptic ulcer in the Trent Region, UK, 1972–2000: Changing pattern, a changing disease?

BACKGROUND AND AIM: Peptic ulcer disease is believed to be less common and less severe as a result of modern medical treatment. We therefore examined changes in the admission rates for patients with duodenal ulcer and gastric ulcer, both emergency (for haemorrhage, perforation or severe pain) and for elective surgery, before and since the introduction of the new advances in therapy. These admission indices reflect disease prevalence and severity. PATIENTS AND METHODS: We identified admission rates during 1972--2000 within the Trent Regional Health Authority, UK (population 4.7 million), from computerised patient information using diagnostic search codes ICD8-10 and expressed as rates per million resident population. Drug expenditure details were obtained from the Department of Health. RESULTS: Emergency admission rates as a whole changed little, a decline in the young being offset by an increase in the elderly. Haemorrhage was the most common reason (approximately 115 per million for duodenal ulcer and 87 for gastric ulcer) throughout [compared with perforation (80 and 21) and pain (90 and 68)]. In contrast, elective surgery has almost disappeared; this reduction began before the introduction of modern treatment. CONCLUSION: Emergency admission rates for duodenal and gastric ulcer for complications or severe pain have fluctuated over the last three decades but with little overall change. In contrast, elective surgery has declined dramatically, as a result of advances in treatment but also from changes in the natural history.     

十二指肠溃疡患者胃上皮化生与幽门螺杆菌关系的研究

目的 研究十二指肠溃疡患者胃上皮化生和幽门螺杆菌的关系。方法 收集门诊行上消化道胃镜检查确诊的十二指肠溃疡患者70例，另选胃和十二指肠黏膜正常患者55例为对照组。用快速尿素酶法和幽门活组织检查半定量法检测幽门螺杆菌(Hp)，苏木素一伊红染色和Schiff过碘酸染色半定量法检测十二指肠球部胃上皮化生。结果 十二指肠溃疡患者与对照组相比，十二指肠球部胃上皮化生检出率高；十二指肠球部胃上皮化生检出率和评分与胃幽门部Hp的检出率和评分无相关关系。结论 Hp不是十二指肠黏膜胃上皮化生的决定因素，也不是十二指肠黏膜胃上皮化生范围得以扩展的因素。十二指肠溃疡病本身的一些特点是十二指肠黏膜胃上皮化生的主要因素。     

奥美拉唑联合呋喃唑酮及阿莫西林治疗十二指肠溃疡疗效观察

目的 观察奥美拉唑联合呋喃唑酮及阿莫西林治疗十二指肠溃疡的疗效.方法 将十二指肠溃疡患者50例随机分为两组:治疗组26例,予以奥美拉唑每日清晨空腹口服20 mg,治疗4周,呋喃唑酮100 mg,3次/d,阿莫西林1000 mg,2次/d,治疗2周,治疗期间不加其他药物.对照组:奥美拉唑每日清晨空腹口服20 mg,治疗4周.结果 治疗组:治愈率53.85%,好转率42.31%,有效率98.16%;对照组:治愈率41.67%,好转率37.50%,有效率79.17%.治疗组和对照组总有效率经统计学处理有显著差异(P＜0.05).结论 奥美拉唑联合呋喃唑酮及阿莫西林治疗十二指肠溃疡能改善临床症状和促进溃疡愈合.     

Studies on the effects of Pluchea indica less root extract on gastroduodenal ulcer models in rats and guineapigs

The methanolic fraction of P. indica root extract was found to possess significant antiulcer activity in different experimental animal models. In preventive antiulcer tests, significant protective actions in acetylsalicylic acid, serotonin and indomethacin-induced gastric lesions were observed in experimental rats. The extract also afforded significant protection to chemically-induced duodenal lesion in guineapigs. Significant enhancement of healing process in acetic acid-induced chronic gastric lesions were also observed in the extract-treated animals.     

不稳定性骨盆骨折的内固定治疗

目的:探讨不稳定性骨盆骨折手术治疗的临床疗效。方法:自2000年5月至2006年3月手术内固定治疗不稳定性骨盆骨折39例,男25例,女14例;年龄16～61岁,平均38.6岁。根据Tile分型,B1型8例,B2型16例,B3型5例,C1型7例,C2型3例。B型和部分C1型骨折,采用耻骨联合上方弧形切口或经髂腹股沟入路,应用钛合金重建钢板内固定。C1型骨折,主要采用闭合复位,经皮骶髂拉力螺钉内因定。C2型骨折,采用闭合复位,经皮骶髂拉力螺钉内固定,再前方入路内固定。结果:术后随访时间2～68个月,平均18.6个月,骨折愈合时间平均2.4个月。术后并发症:切口感染1例,创伤性湿肺1例,神经牵拉伤1例,均治愈,无死亡病例。按Mears术后影像评定标准:解剖复位31例,复位满意7例,复位不满意1例。按照Majeed的疗效评定标准:优32例,良7例。结论:不稳定性骨盆骨折采用手术内固定,可以有效恢复骨盆的稳定性,远期疗效好,极大地降低其致残率。     

Cellular and Molecular Foundation for Fracture Healing in Children

Abstract Dealing with pediatric fracture patients requires a funded knowledge of complications and remodeling capability of the youth skeleton to find the accurate therapy decision and to avoid unnecessary invasive procedures. Due to the different mechanical environment, fractures in children occur at specific fracture-vulnerable areas. One of those is the growth plate, which on one hand gives rise to the unique ability of correcting angular deformities by specifically increasing the growth rate in definite regions, and on the other hand leads to complications like growth arrest or angular deformity. The pediatric diaphysis presents the exclusive greenstick fracture, only seen in the growing skeleton, which occurs because of the different composition of the pediatric bone. To understand these very specific features of the youth skeleton, the molecular and cellular basis should be taken into consideration. Therefore, this review will present the common characteristics of skeletal development and fracture healing. An insight into the mechanotransduction as part of the remodeling and self-correcting ability of pediatric bone is given to span the bridge between clinical treatment options and scientific background.