脊柱椎弓根螺钉入路及手术方法的临床应用

目的：探讨椎弓根螺钉最佳入路及手术步骤。方法：对104例胸腰椎骨折脱位患者，分两组采用不同方法、步骤钻入椎弓根螺钉，并对其进行疗效比较。结果：经过技术改进后的方法较传统方法对骨折脱位的复位效果无明显差异，而两者在X线曝光次数、手术时间、出血量及并发症等方面存在显著性差异。结论：技术改进后的椎弓根螺钉进钉方法简单、安全、创伤小、疗效优良。     

中西医结合治疗新生儿高胆红素血症48例

目的 :探讨中西医结合治疗新生儿高胆红素血症的治疗体会。方法 :对 4 8例患儿采用了中药口服、光疗及对症治疗方法。结果 :经治疗后 ,疗程缩短 ,不良反应减少 ,总有效率达 91.7%。结论 :中西医结合治疗新生儿高胆红素血症 ,可减少核黄疸的发生率 ,具有一定的临床意义     

Video-fluoroscopic study of swallowing in children with neurodevelopmental disorders

BACKGROUND: Children with neurodevelopmental disorders can have feeding problems. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Video-fluoroscopic study of swallowing (VFSS) is essential in understanding the pathological mechanisms involved during swallowing. METHODS: The aim of the present study was to assess the role of VFSS in assessment and management of four children with various neurodevelopmental disorders in a multidisciplinary feeding team. We describe the team approach, with the participation of child neurologist, radiologist with the rehabilitation team including the speech therapist, occupational therapist and dietician, in the assessment and plan of management. RESULTS: Video-fluoroscopic study of swallowing had been useful in assessing the type of swallowing problems with treatment goals targeted to the basic underlying pathophysiological mechanism. CONCLUSION: A child neurologist should be involved in the multidisciplinary oromotor rehabilitation program for neurologically impaired children with feeding problems.     

Molecular epidemiology of enterovirus 71 infection in the Western Pacific Region

BACKGROUND: Recently, there have been large outbreaks of hand, foot and mouth disease (HFMD) mainly caused by enterovirus 71 (EV71) associated with severe neurological diseases in the Western Pacific Region (WPR). To monitor the realtime trend of EV71 transmission throughout the WPR, the authors conducted a molecular epidemiological analysis of EV71 infection. METHODS: Viruses were isolated from clinical samples from patients with HFMD or those with neurological complications. The EV71 isolates were identified by microneutralization assay. The VP4 and/or VP1 regions of recent EV71 isolates were sequenced and subjected to phylogenetic analysis using reference EV71 strains. RESULTS: The phylogenetic analysis of EV71 isolates from the WPR revealed two major genogroups, B and C, based on the nucleotide sequence alignment of the VP1 or VP4 region. These two major genogroups were further divided into subgenogroups, B1, B2, B3, and B4 and C1, C2, C3 and C4, respectively. CONCLUSIONS: The molecular epidemiological analyses of recent and previous EV71 isolates in the WPR indicated that two major genogroups of EV71 are co-circulating in Australia, Malaysia, Singapore, Taiwan and Japan. Recent EV71 isolates in Mainland China constitute a new distinct genetic cluster, subgenogroup C4. Two major lineages of EV71 are the major causative agents of the present HFMD epidemics in the WPR and both are considered to be neurovirulent.     

卵巢上皮癌组织中MT1-MMP的表达及意义

目的　探讨膜型基质金属蛋白酶 - 1(membranetype - 1matrixmetalloproteinase,MT1-MMP)在卵巢上皮癌组织中的表达及其与肿瘤生物学行为和预后的关系。方法　用免疫组化SP法检测 5 6例卵巢上皮癌组织、 15例卵巢良性肿瘤组织以及 10例正常卵巢组织中MT1-MMP蛋白的表达。结果　 6 7 9%的卵巢上皮癌组织MT1-MMP表达阳性 ,卵巢良性肿瘤组织很少表达 (4/ 15 ) ,正常卵巢组织中几乎不表达 (1/ 10 ) ,差异有显著性 (P <0 0 1)。MT1-MMP的表达水平与临床分期、组织学分级以及淋巴结转移密切相关。在单因素生存分析中 ,MT1-MMP的表达与患者预后不良有关。但是 ,在多因素分析中 ,MT1-MMP的表达并不是一个相对独立的预后因素。结论　①MT1-MMP在卵巢上皮癌中异常高表达 ;②MT1-MMP表达促进卵巢癌的侵袭和转移 ,可作为判断卵巢癌恶性表型的有用指标 ;③MT1-MMP的阳性表达与患者不良预后有关。     

三种不同病因不孕症患者黄体血肿发生情况比较

目的 :比较 3种不同病因的不孕症患者黄体血肿的发生情况。方法 :回顾性分析了行排卵监测的不孕妇女2 4 0例 ,根据其不孕病因分为 3组 ,子宫内膜异位症组 77例 ,慢性盆腔炎组 (盆腔粘连、结核 ) 4 8例 ,对照组 (女方无明显异常的不孕妇女 ) 115例。比较此 3组患者的黄体血肿发生情况。结果 :子宫内膜异位症组、慢性盆腔炎组、对照组黄体血肿发病率分别为 2 7.2 %、16 .7%、0 .87% ,前两组高于第 3组 ,差异具有非常显著性 (P <0 .0 1)。子宫内膜异位症组黄体血肿发生率高于慢性盆腔炎组 ,但差异无显著性。子宫内膜异位症组与慢性盆腔炎组黄体血肿的直径、黄体血肿形成前卵泡的直径差异无显著性。结论 :子宫内膜异位症和慢性盆腔炎患者黄体血肿的发生率较高 ,诊断为子宫内膜异位症或慢性盆腔炎 (盆腔粘连或结核 )的不孕患者 ,如排卵监测时出现黄体血肿 ,可作为选择腹腔镜检查与手术的参考因素之一。     

The sternocleidomastoid test: an in vivo assay to investigate botulinum toxin antibody formation in humans

In a small number of patients treated with botulinum toxin (BT) antibody (Ab) formation occurs. BT Ab can be detected by the mouse protection assay (MPA) or by the mouse diaphragm assay (MDA). Both methods, however, have major drawbacks. We tested a method for detecting BT Ab which measures the BT-induced reduction in the electromyographic amplitude of the mean maximal voluntary activation (M-EMG) of the sternocleidomastoid muscle. The M-EMG reduction was compared in 17 patients with cervical dystonia and secondary BT therapy failure to the M-EMG reduction previously measured in controls. Values more than 2 SD below the mean of controls were considered abnormal. Six patients showed BT Ab on the MPA and MDA; all of these had abnormal M-EMG reductions. Eleven patients showed no BT Ab on MPA and MDA testing; in ten of these the M-EMG reduction was normal, and in one it was pathological, but MDA testing later changed to positive under continued BT therapy. The sternocleidomastoid test is easy to perform and produces quantitative results. Since its sensitivity and specificity are at least as good as those of the MDA and the MPA, it can replace them.     

胆囊切除术后残余胆囊结石56例诊治及预防

目的:探讨胆囊切除术后残余胆囊结石的诊治和预防方法,减低此并发症的发生率。方法:对56例残余胆囊结石再次手术的病例进行回顾性分析。56例中初次手术行经典胆囊切除术18例,小切口胆囊切除术16例,腹腔镜胆囊切除术22例;急诊手术30例,择期手术26例;初次手术在三级以下医院施行42例,在三级以上医院施行14例。结果:除1例因粘连严重并发门脉高压症,分离时引起大出血被迫终止手术外,55例再次手术成功,切除残留胆囊及结石后,症状均消失,疗效满意。结论:合理掌握胆囊切除术的手术时机、和术式,在术中解剖清楚胆囊管、肝总管、胆总管三管关系,然后距胆总管0.3~0.5cm切断结扎胆囊管,是预防残余胆囊结石的关键。     

妊娠期大鼠摄入氟化物对子代鼠血液和骨氟浓度的影响

目的:观察孕期大鼠摄入不同剂量的氟之后,对子代鼠血液和骨氟浓度及软骨细胞和骨关节结构的影响,以探索通过妊娠期母体给氟预防乳牙龋齿的新途径。方法:给妊娠SD大鼠分别用N aF按1 m g/kg体重、10 m g/kg体重和50 m g/kg体重灌胃至分娩,并用0.9%N aC l灌胃作为对照组。结果:①实验组各组子鼠血清中的氟化物含量均较对照组高(P<0.01);并且与母鼠摄入的氟剂量呈正相关。②在中、高剂量组子鼠上肢骨骨氟的含量明显高于对照组。③在高剂量组子鼠的上肢骨切片中可见软骨细胞和关节结构的破坏。结论:①妊娠期母体摄入的氟化物可进入其子体体内。②当母鼠摄入的氟化物剂量过高时,可引起骨组织的毒性损害。     

髋臼骨折的手术并发症及防治

目的探讨髋臼骨折手术并发症发生原因及防治措施。方法我院对手术治疗的45例髋臼骨折中发生并发症的20例进行分析。结果本组总的并发症发生率为44.4%。其中肺栓塞1例,下肢深静脉血栓行成2例,医源性坐骨神经损伤1例,创伤性关节炎12例,异位骨化7例,股骨头缺血坏死5例。结论选择合适的手术入路,尽早手术,提高手术技巧和复位质量,术后正确有效的干预措施、合理的早期功能锻炼是防治髋臼骨折手术并发症的关键。