不同治疗方法在中青年股骨颈骨折中的临床应用

目的：探究中青年股骨颈骨折三种治疗方法的临床效果。方法：选取2010年1月-2012年12月本院150例中青年股骨颈骨折患者,按治疗方法不同分为三组,A组38例采用Richards钉内固定,B组50例采用AO多枚加压空心螺纹钉内固定,C组62例采用股方肌骨瓣转位移植加多枚加压空心螺钉内固定,对比三组临床资料差异性。结果：A组平均骨折愈合时间为（188±43）d,B组为（149±32）d,C组为（89±25）d;A组骨折愈合率为73.68%（28/38）,B组为90.00%（45/50）,C组为100%（62/62）;A组功能优良率为47.37%（18/38）,B组为68.00%（34/50）,C组为93.54%（58/62）;C组上述指标与A、B组比较差异均具有统计学意义（P〈0.05）。结论：三种治疗中青年股骨颈骨折的方法中,股方肌骨瓣转位移植加多枚加压空心螺钉内固定的方法骨折愈合时间更短、骨折愈合率更高、功能优良率更高,临床效果更好。     

AO双钢板配合中药熏洗治疗肱骨髁间粉碎性骨折的体会

目的:介绍AO双钢板配合中药熏洗治疗肱骨髁间粉碎性骨折的体会.方法:采用肘后正中纵行切口,行尺骨鹰 嘴截骨入路,切开复位AO双钢板内固定治疗肱骨髁间粉碎性骨折26例,术后配合中药熏洗治疗.结果:26例病人随访1年～2年,术后肘关节功能评定:优10例,良11例,可3例,差2例,优良率为92.3%.结论:我们认为采用AO双钢板内固定治疗肱骨髁间骨折,骨折对位准确,固定牢靠,有助于术后早期功能锻炼;配合中药薰洗,有利于肘关节功能的恢复,是目前治疗肱骨髁间骨折较理想的方法.     

体外扩增CIK细胞对结肠癌SW480细胞株杀伤作用的研究

目的：观察细胞因子诱导的杀伤细胞（CIK细胞）体外增值情况,了解其扩增后杀伤结肠癌SW480细胞株最佳比例及最有效的维持时间.方法：分离健康人外周血单个核细胞在体外诱导制备成CIK细胞,计数不同培养时间的CIK细胞,采用流式细胞仪检测其表型特征.倒置显微镜下观察CIK细胞作用与SW480结肠癌细胞的形态学变化,采用HE染色、AO/EO荧光染色和MTT法检测CIK细胞对SW480结肠癌细胞株的杀伤活性.结果：CIK细胞在体外培养14 d细胞增殖倍数为（100.22±8.68）倍,培养21 d细胞增殖倍数为（300.86±10.13）倍,两者比较差异有统计学意义（P＜0.05）;培养28 d细胞增殖倍数为（305.06±5.13）倍,与培养21 d的细胞增殖倍数比较差异无统计学意义（P＞0.05）.培养21 d的CIK细胞中CD3＋、CD56＋双阳性细胞的百分比为（45.3±5.1）％,与28 d相比较差异无统计学意义（P＞0.05）,第35天细胞增殖（212.50±4.25）倍,呈下降趋势.CIK细胞对结肠癌SW480细胞株有明显的杀伤作用,最高杀伤率为（68.21±1.31）％.结论：CIK细胞具有较强的抗结肠癌细胞活性,体外培养14～21 d具有较强的抗瘤活性,此时应用较为合适.CIK细胞作用于肿瘤细胞应达到一定数量并维持一定时间,可达到较好的抗瘤活性.     

Bcl-2参与的抗凋亡机制在白血病耐药中的作用

目的:肿瘤多药耐药(multi-drug resistance,MDR)是目前肿瘤研究的难点及热点领域.本研究以人慢性粒细胞白血病细胞株K562和阿霉素(ADR)耐药细胞株K562/AO2为研究对象,观察两细胞株在ADR作用下Bcl-2的表达水平,借此探讨其参与的抗凋亡机制在白血病多药耐药中的作用.方法:MTT法测定K562和K562/AO2在ADR作用后的细胞活力(A值);DNA琼脂糖凝胶电泳观察细胞凋亡情况;FCM法测定细胞凋亡率、细胞周期及Bcl-2蛋白的表达.结果:MTT法测得ADR作用的K562细胞存活数下降,1.00μmol/LADR作用48h的K562细胞株A值最低,为0.803±0.032.DNA琼脂糖凝胶电泳及FCM法均显示ADR作用的K562细胞株有凋亡发生.FCM的结果表明,ADR作用的K562细胞株Bcl-2的阳性表达率低,1.00μmol/L ADR作用48 h的Bcl-2阳性表达率是(38.67±0.45)%.结论:耐药的主要机制是通过抑制细胞的凋亡途径完成,bcl-2是凋亡的主要调控基因,是一种耐药基因.     

锁骨钩钢板治疗肩锁关节脱位和锁骨肩峰端骨折

目的：探讨应用AO锁骨钩钢板治疗TossyⅢ型的肩锁关节脱位和NeerⅡ型的锁骨肩峰端骨折的疗效。方法：从2001年2月-2003年9月，应用A0锁骨钩钢板及韧带修复技术，治疗22例肩锁关节脱位或锁骨肩峰端骨折患。损伤时间除2例为陈旧性损伤，其它均为新鲜损伤：损伤原因，车祸19例，牵拉伤3例。其中肩锁关节脱位12例，按Tossy分型，Ⅱ型7例，Ⅲ型5例；锁骨肩峰端骨折10例，按Neer分型，Ⅱ型6例，Ⅲ型4例。取锁骨远端向肩峰端弧形偏后切口，行切开复位AO锁骨钩钢板内固定。术后早期行肩关节CPM功能锻炼。结果：随访3～16个月，平均9个月。术后10周均完全恢复术前日常工作，参照Kadsson肩锁关节修复术后疗效三级评定：A级19例，B级1例，C级0(有2例合并神经损伤未计入)；优良率100％。术后均无感染。复查X线无内固定松动、断裂。无再脱位，骨折端愈合良好结论：AO锁骨钩钢板治疗TossyⅢ肩锁关节脱位和NeerⅡ型锁骨肩峰端骨折，具有创伤小，疗效好，安全性高的特点。     

乌苯美司对JAR,SKOV3和3AO细胞体外生长的抑制作用

目的：观察乌苯美司对人绒毛膜癌和卵巢癌细胞体外生长的抑制作用。方法：应用MTT比色法观察不同浓度的乌苯美司(0．5g／L、1g／L、5g／L、10g／L、15g／L、20g／L)对人绒毛膜癌JAR细胞、卵巢癌3AO细胞和SKOV3细胞的生长抑制作用,溴乙啶和丫啶橙荧光染色荧光显微镜观察凋亡细胞DNA结构改变。结果：乌苯美司能抑制JAR细胞、3AO细胞和SKOV3细胞的生长,且对JAR和SKOV3细胞的抑制作用呈时效(r=0．412,r=0．339．P均=0.000)和量效(r=0.704,r=0．753,P均=0．000)关系、5g／L乌苯美司作用48h后荧光显微镜下见细胞染色质边聚,细胞核碎裂等凋亡改变。结论：乌苯美司通过细胞凋亡途径可抑制绒毛膜癌和卵巢癌细胞的生长。     

2-甲氧基雌二醇逆转K562/AO2细胞耐药及其机制的初步研究

目的研究2-甲氧基雌二醇(2-ME)对K562/AO2细胞耐药性逆转作用及其可能机制。方法利用不同浓度的2-ME作用于K562及K562/AO2细胞,MTT法检测细胞对阿霉素的耐药性,计算耐药倍数及逆转倍数;利用AnnexinV /PI双染色法检测K562/AO2细胞的凋亡效应。结果与K562细胞相比,K562/AO2细胞的耐药倍数为50倍;2-ME可显著降低阿霉素对K562/AO2细胞的IC50,逆转倍数为5.9倍。AnnexinV /PI双染色法检测显示,1、4、16 μmol/L的2-ME处理K562/AO2细胞后细胞凋亡率分别为10.32%、21.56% 和16.45%, 而对照组凋亡率仅为6.68%。结论2-ME能够逆转K562/AO2阿霉素耐药,其机制可能与诱导K562/AO2细胞凋亡有关。     

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.     

Evaluation of the safety and reliability of the newly-proposed AO spine injury classification system

Objective: To evaluate the safety and reliability of the new AO Classification, a recent classification system for Thoraco-Lumbar Spine Trauma (TLST).

Design: Retrospective study.

Methods: We applied the new AO system in patients with TLST treated according to the TLICS. Two researchers classified injuries independently. Eight weeks later, the classification was repeated for intra and inter-observer agreement evaluation. To evaluate safety, we correlated the treatment performed based on the TLICS with the newer AO classification obtained.

Results: Fifty-four patients were included in this study, with a mean follow-up of 363.8 days. Twenty-three neurologically intact patients were initially treated conservatively. Their mean TLICS was 1.78 (1–4 points). Four patients underwent late surgery. Thirty-one patients were treated surgically. Their average TLICS was 7.22 points (4–10 points). Agreements in the four independent evaluations according to AO groups and subgroups were of 64.8% (35/54) and 55.5% (30/54) respectively. Kappa index for groups A, B and C was 0.75, 0.7 and 0.85 respectively. Kappa index for subgroups ranged from 0.16 to 0.85. Regarding safety, thirty (57.6%) patients with total subgroups agreement were analyzed. All patients with fracture in groups B and C underwent surgical treatment and patients in group A received surgery according to neurological status or failure of conservative treatment.

Conclusion: The newer AO spine classification demonstrated good reliability at the level of groups. Subgroups demonstrated worse and varying reliability. Although the safety analysis was limited due to the low level of total concordance among all evaluations, patients from group A can be treated conservatively or surgically, whereas those from groups B and C are treated surgically.     

Inhibition of cathepsin S induces autophagy and apoptosis in human glioblastoma cell lines through ROS-mediated PI3K/AKT/mTOR/p70S6K and JNK signaling pathways

Cathepsin S is a lysosomal cysteine protease that is overexpressed in various cancer models and plays important role in tumorigenesis, however the mechanisms are unclear. In the present study, we found that inhibition of cathepsin S induced autophagy and mitochondrial apoptosis in human glioblastoma cells. Blockade of autophagy by either a chemical inhibitor or RNA interference attenuated cathespin S inhibition-induced apoptosis. Furthermore, autophagy and apoptosis induction was dependent on the suppression of phosphatidylinositide 3-kinases/protein kinase B/mammalian target of rapamycin/p70S6 kinase (PI3K/AKT/mTOR/p70S6K) signaling pathway and activation of c-Jun N-terminal kinase (JNK) signaling pathway. In addition, reactive oxygen species (ROS) served as an upstream of PI3K/AKT/mTOR/p70S6K and JNK signaling pathways. In conclusion, the current study revealed that cathepsin S played an important role in the regulation of autophagy and apoptosis in human glioblastoma cells.