镍钛聚髌器（NT－PC）治疗髌骨骨折

目的探讨应用NT-PC治疗髌骨骨折的方法及治疗结果。方法根据NT-PC结构及固定原理对30例髌骨骨折的治疗。结果30例髌骨骨折髌关节面均达到解剖复位,患者能下地行走,扶栏杆或徒手上下一层楼、屈膝平均达到90°的时间是1.5～3.5周。患膝关节伸、屈活动范围达到健侧水平的时间是2～10周。结论根据NT-PC的特点治疗髌骨骨折,尤其是粉碎性骨折,不但在术中容易得到髌关节面的解剖复位,而且术后能有效地将其维持,固定于解剖位直至骨质愈合。术后可早期活动,无需石膏固定,无膝关节功能障碍。     

Pressure Transfer Between Intracranial and Cochlear Fluids in Patients With Meniere's Disease

Objectives: To elucidate the pressure transfer between intracranial and labyrinthine fluids in patients with well‐defined unilateral Meniere's disease. Study Design: Eleven patients previously exposed to hypobaric pressure agreed to be investigated further with the tympanic membrane displacement (TMD) technique. TMD was used to indirectly analyze perilymph pressure changes as the result of changes in body position. Methods: Repeated measurements for both the diseased and the healthy ears were made with the patients supine and then in a sitting position. The TMD parameters for the maximum inward displacement, the Vi, and the mean volume displacement, the Vm, were calculated and compared. Results: The paired comparison showed statistically significant larger Vi values for both ears in the supine position. A similar tendency was observed for the Vm value. This difference of the Vi was significantly larger for the diseased ear compared with the currently healthy ear. The results were compared to the audiometric and electrocochleographic results previously obtained on the same patients when they were subjected to hypobaric pressure. Patients who experienced the largest differences in hearing level thresholds in the lower frequencies also showed the greatest differences in TMD values as the result of postural changes. Conclusions: Despite the limited number, the statistically supported results suggest a relation between the efficiency of the routes of pressure transfer and the observed effect of hypobaric exposure. The results also indicate that for the patients tested, the routes of communication are more effective in the diseased ear than in the healthy ear—a condition that may relate to the pathogeneses of Meniere's disease.     

《黄帝内经》论治思想在血液系统疾病中的应用及设想

《黄帝内经》学术体系丰厚,其论治思想对现代疾病的病因、病机乃至治疗方面都起有重要的指导作用。治求中和、取象比类思想作为《黄帝内经》的医学和哲学思想,在现代血液系统疾病中已经得到了充分的体现及运用。     

Pathological findings of multifocal choroiditis with panuveitis and punctate inner choroidopathy

PURPOSE: To compare the pathological findings between multifocal choroiditis with panuveitis (MCP) and punctate inner choroidopathy (PIC). METHODS: Fourteen eyes of 14 patients clinically diagnosed as having MCP or PIC who underwent surgical excision of choroidal neovascularization (CNV) were studied. Immunohistochemical findings of the excised CNV in MCP (eight eyes) and PIC (six eyes) cases were compared. Antibodies against vascular endothelial growth factor (VEGF), CD68, CD3, and CD20 were used as primary antibodies. RESULTS: Expression of VEGF and CD68 in the CNV was observed in all MCF and PIC cases. In three of eight eyes with MCP, intraocular inflammatory findings were found clinically, while immunohistochemical study demonstrated infiltration of CD20-positive B lymphocytes in the CNV. No B lymphocyte infiltration was found in the six eyes with PIC. No differences in pathological findings were found between the five MCP eyes without intraocular inflammation and the six PIC eyes, with all eyes showing no B lymphocyte infiltration. CONCLUSIONS: In MPC cases showing clinical inflammatory findings, infiltration of B lymphocytes was also observed histopathologically, suggesting that the presence of inflammatory cells in the anterior chamber or vitreous body clinically is an indicator of active inflammatory CNV. However, this study clarifies that MCP eyes without intraocular inflammation and PIC eyes are not different in histopathological findings.     

玻璃体切割联合内界膜(ILM)剥除术与玻璃体切割联合ILM瓣覆盖术治疗不同直径特发性黄斑裂孔的疗效和安全性对比分析

目的 比较玻璃体切割联合内界膜(inner limiting membrane,ILM)剥除术和玻璃体切割联合ILM瓣覆盖术治疗不同直径特发性黄斑裂孔(idiopathic macular hole,IMH)的疗效和安全性.方法 采用玻璃体切割联合ILM剥除或ILM覆盖的方法治疗IMH共127例127眼,根据IMH的最小直径分为小裂孔(63眼,直径≤500 μm)和大裂孔(64眼,直径＞500 μm);依据不同的手术方法进行分组:剥除1组(小裂孔32眼)和剥除2组(大裂孔33眼)采取玻璃体切割联合ILM剥除术;覆盖1组(小裂孔31眼)和覆盖2组(大裂孔31眼)采取玻璃体切割联合ILM瓣覆盖术.对患者术前、术后最佳矫正视力和黄斑裂孔愈合情况进行检查随访.结果 术后12个月时各组最佳矫正视力分别与术前相比,均有不同程度提高;术后剥除1组和覆盖1组(t=0.112 2,P＞0.05),剥除2组和覆盖2组(t=0.750 8,P＞0.05)相比,最佳矫正视力差异均无统计学意义.剥除1组和覆盖1组在术后6个月时闭合率均为100.00％,两组差异无统计学意义(P＞0.05);剥除2组和覆盖2组在术后6个月闭合率分别为84.85％和100.00％,差异有统计学意义(P＜0.05).术前剥除2组和覆盖2组内外节交界面连接带缺损直径差异无统计学意义(P＞0.05);剥除2组和覆盖2组术后1个月时,内外节交界面连接带缺损直径差异无统计学意义(P＞0.05);术后3个月、6个月、12个月时差异均有统计学意义(均为P ＜0.05),覆盖2组的内外节交界面连接带缺损直径比剥除2组小.各时间点剥除1组和覆盖1组内外节交界面连接带缺损直径差异均无统计学意义(均为P＞ 0.05).结论 相对于传统的ILM剥除,ILM瓣覆盖术有助于直径大于500 μm裂孔愈合,对于小裂孔愈合两种术式疗效无明显差异.     

静止中立位状态及加载模拟头部重量后对髓核内压力影响的研究

目的:通过测试颈椎标本在静止中立位及模拟头部重量后的髓核内压力,从而探讨颈椎髓核内压力的变化规律。方法:利用生物力学材料实验机及微型压力传感器测试新鲜人体颈椎标本在静止中立位及加载100N压力时的髓核内压力。结果:静止中立位及加载100N压力时,C3～4和C4～5节段髓核内压力比较无显著性差异(P0.05),C5～6和C6～7节段髓核内压力比较无显著性差异(P0.05);C5～6,C6～7高于C3～4,C4～5髓核内压力(P0.05);加载100N后所有节段髓核内压力均升高具有显著性差异(P0.05)。结论:正常人体下颈段髓核内压力高于上颈段髓核内压力,并且随外在负荷的增加而压力增加。     

Temporal effect of Guanxin No. 2 on cardiac function, blood viscosity and angiogenesis in rats after long-term occlusion of the left anterior descending coronary artery

AIM: Cardiac infarction is one of the main causes of death in both developing and developed countries over past decades. Currently available approaches for treating patients with this disease are not satisfactory. Traditional Chinese medicines have been increasingly paid attention to. The aim of this study was to characterize the dynamic protective effects of Guanxin No. 2 decoction (GX II) on cardiac dysfunction combined with the blood viscosity and myocardial hypertrophy parameters in myocardial infarction (MI) rats. METHODS: Male Sprague-Dawley rats (180-200 g) were randomly divided into three groups: sham-operated, coronary artery ligation (CAL), and CAL plus GX II (GX II, 10.0 g raw materials/kg/d, bid, p.o.). The experiment was carried out at 4 time points as the 3rd, 7th, 14th, and 28th day after ligation. RESULT: It was found that on the one hand, GX II could significantly improve the heart function, and remarkably decrease infarct size and inhibit ventricular remodeling. On the other hand, GX II showed some unique effects such as angiogenesis which was induced in the left ventricular tissue. This result was consistent with the finding of an augmented vascular endothelial growth factor (VEGF) expression in this area. CONCLUSIONS: The studies demonstrated that GX II exerted extensively beneficial cardioprotective effect on CAL rats, it might stimulate angiogenesis of ischemic region to compensate blood supply to the heart via upregulated VEGF expression.     

从内生伏毒谈内疫病机与治法

伏毒学说认为：内生伏毒是导致诸多内科疑难病的重要病因;内疫病机是根据杂气病因学提出的假说,这两个理论均源于中医温病学。针对内生伏毒的辨证原则和治法方药可以用于内疫病机导致疾病,以实现促邪归正治疗宗旨。通过对内疫病机的认识可以加深对伏毒学说的理解,有利于掌握伏毒的辨证原则和治法方药,而伏毒学说则为内疫病机提供了从理论假说走向临床实践的桥梁。     

Nanomaterials for Inner Ear Diseases: Challenges,Limitations and Opportunities

The inner ear is located deep in the temporal bone and has a complex anatomy. It is difficult to observe and obtain pathological tissues directly. Therefore, the diagnosis and treatment of inner ear diseases have always been a major clinical problem. The onset of inner ear disease can be accompanied by symptoms such as hearing loss, dizziness and tinnitus, which seriously affect people’s lives. Nanoparticles have the characteristics of small size, high bioavailability and strong plasticity. With the development of related research on nanoparticles in inner ear diseases, nanoparticles have gradually become a research hotspot in inner ear diseases. This review briefly summarizes the research progress, opportunities and challenges of the application of nanoparticles in inner ear diseases.