T型AO外固定架治疗胫腓骨近关节骨折的临床评价

目的：探讨应用T型AO外固定架治疗距踝关节4cm以内的胫腓骨骨折及Pylon骨折的临床效果及其影响因素。方法：分析我科自1999年1月－2001年2月采用T型外固定架治疗距踝关节4cm以内的胫腓骨骨折及Pylon骨折14例。术后早期功能锻炼，定期复查，有明确骨性愈合后拆除外固定架。结果：14例病人经随诊6个月左右，100％达到骨性愈合，功能恢复完全正常。结论：T型AO外固定架是非常适合于距踝关节4cm以内的胫腓骨折及Pylon骨折的治疗方法。具有操作简单，手术时间短，创伤小，骨折易愈合，固定可靠的优点，功能恢复满意。     

Short-Term Outcomes and Influencing Factors After Ankle Fracture Surgery

The present study investigated the factors influencing the early clinical outcomes after ankle fracture surgery. We included 88 patients, who had undergone implant removal surgery at 1 year after ankle fracture surgery, with ankle computed tomographic (CT) scans obtained before ankle fracture surgery and at implant removal available. We collected demographic information, including age, sex, the presence of diabetes mellitus, level of trauma energy, and fracture classification from the medical records. We also recorded the fracture height using the radiographs and CT images. The medial joint space and articular incongruity were assessed on the follow-up radiographs and CT scans. Bone attenuation was measured by placing a circular region of interest around the ankle joint on the preoperative CT image. The postimplant removal outcomes were assessed using 2 functional questionnaires, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and Foot and Ankle Outcome Score (FAOS). Significant factors related to the AOFAS ankle-hindfoot scale scores and FAOS were identified through univariate analysis using age, sex, radiographic measurements, and CT findings as explanatory variables, followed by multiple regression analysis. On multiple regression analysis, the total FAOS was independently related to the AO classification (p?=?.003) and Lauge-Hansen classification (p?=?.003). The total AOFAS ankle-hindfoot scale score was related to articular incongruity (p?=?.044). The early clinical outcomes after ankle fracture surgery were affected by involvement of the ankle joint fracture rather than the lateral malleolus fracture height. Female sex and the presence of postoperative articular incongruity correlated with inferior early clinical outcomes.     

AO跟骨钢板治疗Sanders III、IV型跟骨骨折18例观察

目的探讨AO跟骨钢板治疗SandersIII、IV型跟骨骨折的疗效。方法自2001年2月至2005年6月,对18例23足SandersIII、IV型跟骨骨折,采用AO跟骨钢板加自体髂骨植骨进行复位内固定治疗。结果本组病例随访6~36个月,平均随访时间18.5个月。按Maryland足部评分标准评价,优8足,良11足,中3足,差2足,优良率78.2%。结论本方法治疗SandersIII、IV型跟骨骨折复位满意,固定牢靠,术中自体髂骨植骨,术后早期关节功能锻炼,疗效肯定,是一种目前治疗SandersIII、IV型跟骨骨折的较好方法。     

Effects of orally administered antioxidants on micronuclei and sister chromatid exchange frequency in workers professionally exposed to antineoplastic agents

The widespread use of antineoplastic drugs in cancer treatment increased concern about possible hazard to workers involved in the preparation and administration of these drugs. In the present study, the effects of commercial antioxidative drug Oligogal Se® on genome protection were analyzed in 15 nurses handling the antineoplastic drugs at the Oncology Department in comparison to twenty healthy volunteers. The nurses took antioxidant mixture Oligogal Se®, consisting of vitamins C, E, A and selenium, one capsule per day, over a period of 6 months. Genome damage was measured in peripheral blood lymphocytes by usage of sister chromatid exchange test and the cytokinesis-block micronuclei test. The frequency of sister chromatid exchange (SCE) and micronuclei (MN) in the exposed group was significantly higher when compared to the control group (SCE, p < 0.05; MN, p < 0.01 respectively). After antioxidant supplementation, the frequency of sister chromatid exchange and micronuclei decreased (p < 0.05) when compared with the values from the beginning of the study, but were still above the values of the control group. The effects of confounding factors such as cigarette smoking and cytostatics exposure time were also evaluated. The data indicated that Oligogal Se® contributed to the decreasing of genome damages in workers handling the cytostatics.     

AO空心钉治疗老年股骨颈骨折临床分析

目的：分析AO空心钉治疗老年新鲜股骨颈骨折的临床疗效。方法：回顾性分析我院2002年2月～2008年2月行AO空心钉治疗的62例老年股骨颈骨折患者的临床资料,从手术时间、出血量、输血量、骨折愈合率、愈合时间、髋关节功能等方面对手术疗效进行评价。结杲：患者平均手术时间为（40．0±16．9）min,平均出血量为（82．0±36．2）mL,无1例输血d术后无坐骨神经损伤和伤口感染。62例随访12～72个月,平均36个月,最终随访时髋关节的Harris评分平均（82．6±5．8）分,优良率达80．6％。结论：AO空心钉内固定治疗老年股骨颈骨折手术时间短,出血少,损伤小,治疗效果好,是老年新鲜股骨颈骨折优先选择的治疗方法之一。     

Cannabis induces different cognitive changes in schizophrenic patients and in healthy controls

It is known that 60 to 80% of schizophrenic patients show deficits in cognition. There may be an increase in these deficits as a result of additional regular use of cannabis. The aim of the study was to evaluate the effect of chronic cannabis consumption on the cognitive functions of schizophrenic patients and healthy control subjects after a minimum abstinence time of 28 days. The study sample consisted of 39 schizophrenics (19 cannabis-abusers and 20 non-abusers) and 39 healthy controls (18 cannabis-abusers, 21 non-abusers). In a 2x2-factorial design (Diagnostic Groups [healthy controls, schizophrenic patients]xCannabis abuse [without, with]) with diagnostic group and cannabis consumption considered between-subject factors) we tested the hypothesis that dually diagnosed patients (i.e. suffering both from schizophrenia and cannabis abuse) perform worse in neuropsychological tests than schizophrenic patients without cannabis abuse. On the whole, schizophrenic patients performed worse than healthy control subjects. Surprisingly, rather than deteriorating neuropsychological performance, regular cannabis abuse prior to the first psychotic episode improved cognition in some tests. This was even more pronounced when regular consumption started before the age of 17. On the other hand, cannabis use deteriorated test performance in healthy controls, especially in cases when regular consumption started before the age of 17. To sum up, regular cannabis abuse has a different effect on cognitive function in schizophrenic patients and healthy controls.     

吡柔比星和顺铂联合应用对人卵巢癌3AO细胞系的作用

目的：观察吡柔比星和顺铂联合应用对人卵巢癌3AO细胞系的抑制效应,并初步探讨其作用机制。方法：用MTT（四甲基偶氮唑盐）法检测化疗药物对人卵巢癌3AO细胞系的抑制率（Fa）;FCM（流氏细胞术）检测肿瘤细胞周期分布和细胞凋亡。结果：吡柔比星和顺铂单独用药可时间和浓度依赖性抑制3AO细胞的生长。IC50（半数抑制浓度）随时间延长而明显减小。联合应用吡柔比星和顺铂后抑制率呈时间和浓度依赖性。两药的IC50也比单独用药时显著降低;吡柔比星和顺铂舍用呈协同作用;两药单用和联合应用对细胞周期均有影响,细胞凋亡率均提高。结论：两药联合呈协同作用,药物的作用均与其诱导凋亡和影响细胞周期有关,但对细胞周期的影响各不相同。