骨科下肢侧卧位手术牵引架的研制及临床应用

目的研制并临床验证一种简便、实用、灵活、科学的骨科下肢侧卧位手术牵引架.方法1999年1月～2003年1月采用本手术设备共进行了51例均在侧卧位状态下进行的手术;其中股骨粗隆间骨折23例、股骨粗隆下骨折4例,行DHS22例、Gamma钉5例;股骨中下段骨折24例,行股骨交锁钉3例、梅花钉3例、LCDCP18例.结果采用本手术设备的手术情况是DHS、Gamma钉组的平均手术时间为51±19min、出血量为100士57ml,交锁钉组的手术时间为70±19min、出血量为312±94ml;与常规的仰卧位手术比较P＜0.01,同时方便C-臂X光机透视,尤其是侧位透视.此外,还可运用本手术设备进行股骨中下段骨折的其他各种内固定手术,牵引效能好,方便术区皮肤消毒及术中骨折复位.结论本骨科下肢侧卧位手术牵引架结构简单、零部件少、装卸容易、适应症广、操作方便、利于C-臂X光机透视,术中出血量少、损伤小、手术时间短,具有较好的实用型、先进性、科学性,值得临床推广应用.     

Effect of long-term vigabatrin administration on the immature rat brain

PURPOSE: To determine whether the neuropathologic changes produced by vigabatrin (VGB; gamma-vinyl GABA) administration in the developing rat brain are reversible. METHODS: We injected rats daily with VGB (25-40 mg/kg/day, s.c.) from age 12 days for 2 weeks followed by 2 weeks of a drug-free period. Behavioral testing, magnetic resonance (MR) imaging, biochemical assays, and histologic technique were used to assess the adverse effect of VGB in developing brain and its reversibility. RESULTS: At the end of 2 weeks' VGB administration: (a) there was a hyperactivity and a shortened latency to escape out of cool water; (b) white matter appeared hyperintense in T2 and diffusion-weighted MR images with 4-15% increases in T2; (c) microvacuolation, TUNEL-positive nuclei, and swollen axons were observed in the corpus callosum; (d) myelin staining indicated a reduction in myelination, as did the reduction in activities of myelin and oligodendrocyte-associated enzymes and the decrease in myelin basic protein on Western blots. Two weeks after stopping VGB administration: (a) MR images were normal, and microvacuolation was no longer in the white matter; (b) reduction in myelination reversed partially; (c) the T2 relaxation time remained elevated in the hypothalamus; and (d) the behavioral response remained abnormal. CONCLUSIONS: Long-term VGB administration to young rats causes brain injury, which recovers partially on its cessation. The observed cell death, disrupted myelination, and alterations in behavior indicate a need for further safety assessment in infants and children.     

Regulation of glucocorticoid receptor mRNA and heat shock protein 70 mRNA in the developing sheep brain

Fetal hypothalamo-pituitary-adrenal (HPA) activity increases dramatically at term in sheep, however, little is known about the regulation of glucocorticoid feedback in the developing brain. Heat shock protein 70 (hsp70) is closely associated with glucocorticoid actions within the cell. We hypothesized that there is a decrease in glucocorticoid negative feedback in the brain, near term, resulting from changes in the expression of glucocorticoid receptors (GR) and hsp70. Brains were removed at various stages of development. GR mRNA levels in the paraventricular nucleus (PVN) and cortex, and hsp70 mRNA in the PVN were determined by in situ hybridization. In the hippocampus, GR mRNA levels were measured by Northern analysis. In the PVN, GR mRNA was present by d60. GR mRNA levels reached a peak at d100-110, but then decreased significantly with progression of gestation, and were lowest at term. Hippocampal GR mRNA levels were highest on day 130 of gestation, decreasing to low levels at term. In the cerebral cortex, GR mRNA levels were expressed at high levels in all layers of the cortex by day 110 of gestation with levels decreasing to term. Hsp70 mRNA was present in both parvocellular and magnocellular regions of the PVN, and there was no significant change in late gestation. In conclusion, (1) The high levels of GR mRNA present in the PVN, hippocampus and cerebral cortex during fetal life are likely important in development of these structures at a time when circulating glucocorticoids are low. (2) Changes in GR mRNA levels in the PVN are not associated with alterations in the expression of hsp70. (3) The decrease in GR mRNA in the hippocampus and PVN in late gestation, at a time when fetal plasma cortisol is increasing, likely facilitates maintained hypothalamic drive to the pituitary corticotroph.     

诱导痰分析对预测毛细支气管炎转归的意义

目的观察首次喘息的毛细支气管炎(毛支)患儿诱导痰组分的变化,探讨诱导痰液炎性细胞及细胞因子在预测其转归的价值。方法用4.5%高渗盐水超声雾化法留取70例毛细支气管炎婴儿的诱导痰液,用荧光酶标法、ELISA方法检测诱导痰液中的嗜伊红阳离子蛋白质(ECP)、白介素(IL)-4、干扰素(IFN)-γ水平,台盼蓝染色和瑞氏染色计数嗜酸性粒细胞,随访观察3年。结果毛支发作3年后有24.3%(17/70)患儿发展为哮喘,其初发阶段诱导痰液中的嗜酸性粒细胞(EOS)、ECP、IL-4明显高于未发展为哮喘的单纯毛支患儿(P<0.01),而IFNγ-则明显低于单纯毛支患儿(P<0.01),差异具有显著性。结论对于诱导痰中存在ECP、IL-4、EOS显著增高的毛支患儿有发展为哮喘的可能,在其初发阶段应进行哮喘的早期干预治疗。     

中外高校教师发展中心的比较分析及启示

高校教师发展中心作为高校教学质量保障体系的要素,最初起源于20世纪60年代的美国,其侧重于教师教学能力的发展。20世纪90年代,美国高校教师发展中心建设进入快速发展时期,逐渐成为高等教育教学改革的重要促进机制。中国的高校教师发展中心起步虽较晚,但在教育部的推动下自2012年开始逐步发展,建立了比较成熟的高校教师发展制度。为了进一步完善高校教师发展中心的建设,本文通过文献检索对近20年国内外高校教师发展中心的整体情况进行分析,总结归纳其运行机制,比较国内外高校的教师发展中心的建设情况,并提出高校教师发展中心的建设思路,为未来高校教师发展中心的建设提供理论基础。     

跟骨解剖支持板的研制及临床应用

目的 设计跟骨解剖支持板并研究其治疗跟骨骨折的临床应用价值.方法 通过对跟骨生物力学和骨折机理的探讨,设计了一种用于跟骨骨折内固定治疗的新型跟骨解剖支持板,并应用该钢板治疗跟骨骨折38例(46足).其中39足经过6个月以上随访(6～46个月,平均14.6个月).均行跟骨侧、轴位X线片和印横轴位、冠状位检查,按Sanders分型,其中Ⅱ型骨折10足,Ⅲ型骨折17足,Ⅳ型骨折12足.手术前后对Bohler角、Gissane's角、跟骨水平全长、丘部总高、轴长和体宽等多项指标进行比较,采用Marryland足部评分系统评价术后功能.结果 术后4例切口延迟愈合,2例腓肠皮神经损伤,1例腓骨长短肌腱滑脱,对症处理后均痊愈.术后功能评价显示:优21足,良15足,可3足,优良率达92.3%.结论 跟骨解剖支持板设计合理,结构性能良好,对其进行的多项生物力学测定表明该板可达到跟骨骨折固定的要求.可有效减少并发症,为治疗跟骨骨折提供了一种新的内固定方法.     

Poverty,Development, and Women: Why Should We Care?

Healthy, prosperous nations require healthy women and newborns. Young girls and women in resource-poor nations suffer the greatest ill-health consequences from low status, denial of basic human rights, and poverty. Poverty and poor health result in poor economic development. The Millennium Development Goals call for immediate efforts to reduce poverty, improve health, especially of girls and women, and foster development in the world's poorest nations.     

简论朱熹对古代中医学发展的影响

朱熹为中国古代著名的哲学家,同时又是一位百科全书式的人物。他除了心性义理之学外,对于自然科学尤其对中医与养生学有较深的造诣,其对古代医典,经方,脉诊及用药之道均有独到的见解,朱熹对古代医学发展具有重要的影响,这主要表现在方法论方面,有以下三点：（1）从疑经到创新,提出疑以求信的主张;（2）博文与约礼,强调博约互参,由博反约之法;（3）性与天道,显示出较高的理性思辩水平,这三点对后世医学发展起到一定的促进作用。     

高血压伴焦虑抑郁障碍的研究进展

高血压作为全球高发的疾病,是许多心脑血管疾病的主要危险因素,给社会带来巨大的经济负担。近年来,焦虑障碍和抑郁障碍的发病率逐年上升,高血压共病焦虑抑郁的人数也在不断增加,现有的研究表明两者可能存在相互促进的关系,在发病机制上也有一定共通性,但两者共病的机制尚未完全阐明。本文就原发性高血压伴焦虑抑郁障碍的定义及诊断量表、流行病学、相互影响机制和治疗等展开综述。     

急性冠脉综合征患者冠状动脉计算机断层扫描血管成像斑块定量分析的对比研究

目的 应用冠状动脉计算机断层扫描血管成像(CCTA)斑块定量分析,比较急性冠脉综合征(ACS)和稳定性冠心病(SCAD)患者冠状动脉斑块成分与负荷特征。方法 回顾性纳入2021年1月至3月就诊于中国人民解放军总医院第一医学中心心血管内科的116例冠心病(CAD)患者的临床资料,根据患者临床诊断结果将其分为ACS组(81例)和SCAD组(35例)。2组患者均在14 d内先后接受CCTA和冠状动脉造影检查。采用CCTA斑块定量分析软件测量各类斑块成分体积及负荷、最小管腔直径和重构指数(RI)、偏心指数(EI)等影像学指标并比较分析。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、Wilcoxon检验及χ²检验。结果 ACS组患者较SCAD组患者具有更大的总斑块负荷(TPB)、非钙化成分负荷(NCPB)和脂质成分负荷(LPB),差异均有统计学意义[(60.5±11.2)%和(51.7±14.4)%,(58.9±12.0)%和(50.1±15.2)%,17.9%(11.6%,27.6%)和14.2%(7.5%,20.8%),均P<0.0...