Incorporation of vancomycin-supplemented bone allograftsRadiographical,histopathological and immunohistochemical study in pigs

We compared the incorporation of bone allografts with or without vancomycin in tibial defects of 18 pigs. High-quality radiographs, histological examination, immunological expression of metalloproteinase-13 (MMP-13) and transforming growth factor-beta 2 (TGFß2) indicated that there was no significant difference in bone allograft incorporation between up to 220 times the MIC (minimum inhibitory concentration) in bone allografts with 1 g of vancomycin in each 300 g of allograft or without this supplement.     

No adverse effects of early weight bearing after uncemented total hip arthroplastyA randomized study of 20 patients

Experimental fibular defects in 16 rats were filled with an acid decalcified homogenous bone matrix (bone inductive material). Autogenous bone grafts in corresponding defects in the other legs of the same rats served as controls. After 3 months, 11 of the 16 defects filled with bone inductive material healed with bony union, but only 4 of the 16 defects treated with autogenous bone grafts had healed. The results suggest that bone inductive material can repair bone defects which are too large to be healed by autogenous bone grafts.     

Easier node dissection after chemoradiotherapy for lung cancer with collagen insertion at mediastinoscopy

Objective: Induction chemoradiotherapy followed by anatomical resection is a current therapeutic strategy for non-small-cell lung cancer with mediastinal node involvement. Dense peritracheal fibrosis and sclerosis after chemoradiotherapy cause difficult mediastinal node dissection. We evaluated a novel technique to make the mediastinal node dissection easier after induction therapy. Methods: At the end of mediastinoscopic node biopsy for staging of lung cancer, cotton-type collagen was inserted anterior and lateral to the trachea in patients with pathologically confirmed mediastinal node involve-ment (n=45). The induction therapy consisted of concurrent use of platinum-based chemotherapy and hyperfractionated radiotherapy. After the chemoradiotherapy all patients underwent a pulmonary resection with complete mediastinal node dissection 7–12 weeks after the collagen insertion. Surgical findings of the mediastinum and the time for node dissection were compared with those without collagen insertion at mediastinoscopy after chemoradiotherapy (n=5). Results: All five patients without collagen insertion showed sclerotic and fibrotic change of mediastinal nodes with severe adhesion to the trachea. In 42 of 45 patients with collagen insertion (93.3%) the collagen remained unabsorbed and separated the mediastinal nodes from the trachea. Mediastinal node dissection was easily accomplished by removing mediastinal tissues lateral and anterior to the collagen. The rate of mediastinal node separation was significantly higher with collagen insertion than without (p< 0.0001). The times for node dissection in patients with and without collagen insertion showed no significant difference. Conclusion: Cotton-type collagen insertion at staging mediastinoscopy for lung cancer separates the mediastinal nodes from the trachea and makes the node dissection easier after induction chemoradiotherapy.     

意象思维的本源与临床

中医药学始于农耕文明,直至当今仍具有重要的临床价值,为国民健康提供着有力的保障。作为国学重要分支的中医药学能绵延至今,在于它囊括国学的精髓,符合国人的思维。因此,弘扬原创思维是中医药学发展的前提。结合国学理论对中医原创思维之"意象思维"溯源和梳理,重新认识意象思维启发下司外揣内的思维方法,目的不在比较中医学与他学之间的优劣,重在阐释"以象为素、以素为候、以候为证"中医证候理论的本源。同时以中医学形神共俱、君相互感心身医学模式为切入,阐释意象思维在中医临床中的实践体现。     

军事人员对抗睡眠剥夺策略的研究进展

现代军事斗争和非军事行动呈现出强度大、突发状况多、连续工作时间长的特点,这势必会造成军事人员的睡眠剥夺。然而高强度的作业需要军事人员随时保持良好的工作能力,突发紧急状况需要军事人员保持良好的警觉状态,长时间的工作更需要军事人员保持良好的精神状态和认知能力。军事人员如何有效地对抗睡眠剥夺,保持警醒状态和极高的应激能力成为现代军事医学研究的热点与重点。本文就中枢兴奋药物、预防性睡眠药物、预防性睡眠后快速复醒药物及非药物方式等对抗睡眠剥夺的研究进展作一综述。     

右美托咪定滴鼻用于小儿腹腔镜疝囊高位结扎术的临床观察

目的探讨不同剂量右美托咪定（dexmedetomidine, Dex)滴鼻对腹腔镜疝囊高位结扎术小儿的影响。方法选取90例拟行腹腔镜疝囊高位结扎术患儿,随机分为3组（A组、B组和C组）,每组30例。麻醉诱导前30min,A组经鼻滴入右美托咪定（1μg/kg）,B组经鼻滴入右美托咪定（2μg/kg）,C组为经鼻滴入等量生理盐水。记录患儿滴鼻前即刻（T0）、滴鼻后10min（T1）、滴鼻后20min（T2）、麻醉诱导时（T3）、手术开始时（T4）、拔出喉罩时（T5）的心率（heart rate, HR)、平均动脉压（mean arterial pressure, MAP)和血氧饱和度(saturation pulse oxygen, SpO2),以及麻醉时间、手术时间、诱导期合作表（induction compliance checklist, ICC)评分、儿童苏醒期躁动量表（pediatric anesthesia emergence delirium, PAED）评分、出院后行为问卷（post hospitalization behavior questionnaire, PHBQ）例数和不良反应的发生。结果与A组、C组相比,B组T2、T4、T5时MAP,T2～T5时HR显著下降（P<0.05）。与C组相比,A组和B组ICC评分、PAED评分、PHBQ例数显著下降（P<0.05）。三组患儿一般资料、麻醉时间、手术时间、SpO2及不良反应发生的差异无统计学意义。结论右美托咪定滴鼻用于小儿腹腔镜疝囊高位结扎术,可显著提高麻醉诱导合作度,降低苏醒期躁动和出院后行为改变的发生。术前滴鼻右美托咪定1μg/kg与2μg/kg对MAP和HR影响较小。     

克罗米芬与来曲唑用于多囊卵巢综合征性不孕患者促排卵效果观察

目的 探讨克罗米芬(CC)与来曲唑(LE)用于多囊卵巢综合征(PCOS)性不孕症患者促排卵治疗的效果.方法 以75例PCOS不孕症患者为研究对象,分为CC组和LE组,分别纳入病例37例和38例,观察2组促排卵的临床效果.结果 CC组平均完成4.4个(162/37)周期,LE组平均完成5.2个(198/38)周期,CC组有排卵的周期(54.9%,89/162)明显多于LE组(42.4%,84/198),差异有统计学意义(P<0.05).CC组人绒毛膜促性腺激素(HCG)日子宫内膜厚度、成熟卵泡数和雌二醇(E2)激素水平与LE组比较差异有统计学意义(P<0.05).CC组随访妊娠率35.1%(13/37),LE组39.4%(15/38),差异无统计学意义(P>0.05).结论 克罗米芬用于PCOS患者促排卵,平均促排卵周期少,有排卵的周期比例高,HCG日成熟卵泡数多,但是影响子宫内膜厚度和E2激素水平,治疗后临床妊娠率与来曲唑相当.     

Recombinant gamma interferon induces HLA-DR expression on squamous cell carcinoma,trichilemmoma, adenocarcinoma cell lines,and cultured human keratinocytes

Summary We investigated the effects of recombinant human gamma interferon on the induction of HLA-DR expression by two human squamous cell carcinoma, three trichilemmoma, one eccrine carcinoma, two adenocarcinoma cell lines, and cultured human keratinocytes in vitro. None of eight epithelial cell lines or keratinocytes expressed HLA-DR without gamma interferon treatment. In contrast, pure gamma interferon (500 IU/ml, 72-h treatment) induced HLA-DR expression on 1/2 squamous cell carcinoma, 3/3 trichilemmoma, 2/2 adenocarcinoma cell lines, and 4/4 kerationcyte cell lines, as determined using a fluorescence-activated cell sorter. A maxillary squamous cell carcinoma line and an eccrine carcinoma cell line failed to express HLA-DR with gamma interferon treatment; however, the growth of cells was inhibited by gamma interferon treatment. By indirect immunoperoxidase techniques, tumor cells such as Bowen's disease and squamous cell carcinoma were found to express HLA-DR. Since HLA-DR expression has been shown to be important for various immune responses, these findings suggest that gamma interferon plays important roles in various immune-related skin diseases.     

诱导白木香产生沉香真菌的固体培养条件优化

 目的 对诱导白木香产生沉香的3株活性真菌的固体培养条件进行优化,为该类真菌的推广应用提供参考。方法 采用真菌固体培养方法,对影响真菌生长的营养和培养条件等因子进行优化,实验结果采用单因素方差分析法。结果 得到了培养3株活性真菌的最佳固体培养基配方,获得了真菌固体生长的最适温度、pH值、装料量、基质含水量和光照条件。结论 在实验得到的最佳条件下,能够较快的培养出高质量的固体菌种;为3株活性真菌诱导白木香产生沉香的生产推广提供了菌种培养的优化条件。