外固定架在前臂严重粉碎及多段骨折中的应用

目的：探讨应用单侧多功能外固定支架治疗前臂骨干严重粉碎性及多段骨折的临床疗效。方法：回顾性分析本院1993至2002年间收治的前臂骨干严重粉碎性及多段骨折患共22例。其中开放性骨折5例，均急诊清创复位外固定架固定；闭合性骨折17例，以切开复位单侧多功能外固定架固定结合简单内固定为主要治疗方法。运用Anderson标准进行前臂功能评价。结果：22例患中发生1例骨延迟愈合，1例骨不愈合，均经二次手术植骨后得到愈合。按Anderson标准评价，优7例，良10例，不满意3例，失败2例，优良率78％。结论：单侧多功能外固定支架在前臂尺桡骨骨干严重粉碎性及多段骨折的治疗中有独特的优势，闭合复位外固定架固定或切开复位外固定架固定结合运用简单的内固定可发挥内外固定各自长处，在取得良好固定作用的同时，减少骨折端血运的破坏，达到生物学固定的要求．     

胫骨平台骨折49例手术治疗体会

本院自2000年1月至2005年1月共收治胫骨平台骨折病人75例,其中行手术治疗病人50例,1例病人因胫骨平台骨折和胫骨上段粉碎骨折行双钢板内固定后,膝部以下动静脉血栓大量形成.截肢治疗,故未计在内.……     

局麻止痛膜的制备及质量控制

目的:制备局麻止痛膜并建立其质量控制方法。方法:以聚乙烯醇-124为基质制备局麻止痛膜,并采用高效液相色谱法测定其中主药盐酸达克罗宁的含量。结果:盐酸达克罗宁检测浓度在40.8~408μg/ml范围内与峰面积线性关系良好(r=0.9 998),平均回收率为101.3%(RSD=1.3%,n=6)。结论:局麻止痛膜的制备工艺简单,质量稳定,控制方法可行。     

Detection of circulating antibodies to linear peptide antigens derived from ANXA1 and DDX53 in lung cancer

The EarlyCDT®-Lung test was the first autoantibody-based diagnostic tool for lung cancer, which was developed with a panel of recombinant protein antigens. To confirm whether the antibody test developed with linear peptide antigens has a similar power to that developed with the whole protein molecules, the present work was then undertaken to develop an in-house enzyme-linked immunosorbent assay with linear peptide antigens derived from annexin A1 (ANXA1) and DEAD box protein 53 (DDX53), which have been used to develop the EarlyCDT®-Lung test. A total of 272 patients with non-small cell lung cancer (NSCLC) and 227 control subjects matched in age and smoking history were recruited. Student’s t test showed that the levels of circulating IgG to ANXA1-derived peptide antigens were significantly higher in patients with NSCLC than control subjects (t?=?5.66, P?<?0.0001), in which the increased anti-ANXA1 IgG levels were observed only in patients at stages I, II, or III, but not in those at stage IV. However, the levels of circulating IgG to DDX53-derived peptide antigens were not significantly altered in NSCLC (t?=?1.78, P?=?0.076). Receiver operating characteristic analysis showed that the sensitivity against specificity of >90 % was 23.7 % for ANXA1 IgG assay and 13.8 % for DDX53 IgG assay. This work suggests that the linear peptide antigen derived from ANXA1 may be suitable for the development of diagnostic tool for lung cancer although further screening is needed to identify more such peptide antigens derived from tumor-associated antigens.     

紫外线减毒日本血吸虫尾蚴免疫小鼠的皮肤组织细胞反应

目的 :探讨紫外线减毒血吸虫尾蚴免疫宿主的皮肤组织在抗攻击感染中的作用。方法 :88只小鼠分为 4组 ,1、2组分别以 50± 3条紫外线减毒日本血吸虫尾蚴免疫或日本血吸虫尾蚴感染 ,5wk后以 10 0 0± 10 0条尾蚴进行攻击感染 ;3、4组分别以减毒尾蚴或尾蚴 10 0 0± 10 0条免疫或初次感染。各组均于感染或接种后 6- 12 0 h定时取局部皮肤组织作病理观察。结果 :( 1)免疫攻击组皮肤组织内炎症细胞杀伤童虫现象最明显、炎症反应最强且持续时间最长 ,嗜酸性粒细胞( EOS)浸润百分数最高 ;( 2 )感染攻击组呈现相似炎症反应但程度略轻 ;( 3)免疫对照组减毒童虫在皮肤内滞留时间延长 ,至 12 0 h皮下仍可见较多童虫 ;( 4 )感染对照组皮肤内的童虫数于 72 h后明显减少 ,童虫周围轻微炎症反应。电镜观察可见免疫攻击组童虫内部结构破坏 ,虫体周围 EOS、淋巴细胞增多 ,肥大细胞颗粒溶解。结论 :提示皮肤组织的细胞免疫反应在血吸虫减毒尾蚴免疫的宿主抗攻击感染保护性免疫中起重要作用。     

一氧化氮对感染日本血吸虫小鼠肝脏纤维化程度的影响

目的　研究一氧化氮 (NO)对感染日本血吸虫小鼠早期肝脏纤维化的影响。方法　 NMRI小鼠感染日本血吸虫后第 2 3天起 ,连续用诱导型一氧化氮合酶 (i NOS)的抑制剂氨基胍(Am inoguanidine,AMG)处理小鼠 ,同时设未经抑制的对照组 ,分别在感染后第 38、4 5天观察小鼠肝脏的病理变化。天狼猩红染色 -偏振光显微镜观察并结合图像分析的方法 ,分析肝脏中 、 型胶原的动态变化 ;化学显色法检测肝脏匀浆中能间接反映肝脏纤维化程度的羟脯氨酸的浓度。结果　感染后 38d,肝脏中 、 型胶原的增生程度及 、 型胶原面积比值明显高于对照组 ,但羟脯氨酸的含量与对照组相比差异无显著性 (P>0 .0 5 ) ;感染后 4 5 d,肝脏中 型胶原的增生程度和 、 型胶原面积比值明显高于对照组 ,AMG处理组中羟脯氨酸的含量较对照组高 (P<0 .0 5 )。结论　 NO可抑制日本血吸虫感染小鼠肝脏早期纤维化     

Long-term follow-up and successful treatment of pulmonary alveolar proteinosis without hypercholesterolemia with statin therapy: a case report

Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by the accumulation of excessive surfactant lipids and proteins in alveolar macrophages and alveoli. Oral statin therapy is a novel treatment for PAP with hypercholesterolemia. However, this treatment has never been described in a patient without hypercholesterolemia. Here, we present a case of successful treatment with atorvastatin for a patient with possibly unclassified PAP without hypercholesterolemia who responded poorly to whole lung lavage therapy and inhaled granulocyte-macrophage colony-stimulating factor. After 18 months of atorvastatin treatment, the patient experienced improvements in dyspnea, radiographic abnormalities and pulmonary function. The present case study supports the feasibility of statin therapy for PAP regardless of the level of cholesterol.     

The serological diagnosis of human clonorchiasis by time-resolved fluoroimmunoassay based on GST2-specific IgG4 detection

Due to its delayed fluorescence of a lanthanide chelate, high accuracy and low background the broad linear range, long fluorescent life-time and large Stoke's shift of europium chelates, the time-resolved fluorescence has been developed for higher sensitive immunoassay. In this article, a simple, sensitive and specific method-time-resolved fluoroimmunoassay (TRFIA) was adopted for immunoassay of clonorchiasis, and recombinant glutathione transferases 2 of Clonorchis sinensis (rCsGST2) was used as a diagnostic antigen. To evaluate this novel assay for clinical applications, 409 serum samples were investigated. The diagnostic accuracy of the antigen was evaluated by receiver-operating characteristic (ROC) analysis. The area under the ROC curve (AUC) was 0.965, 95 % confidence interval (CI, 0.946, 0.985). To eliminate the random influence of ambient temperature, test parameters, photometric instruments and so on, the cut-off value was expressed as ratios between the fluorescence of sample and that of a well-defined negative control serum, and the deduced cut-off value was 9.3605. At the optimum cut-off criteria, the technique has a sensitivity of 95.80 %, specificity of 93.60 %. And the cross reactivity revealed that its cross reactivity with Schistosoma japonicum, round worm, hook worm, whip worm, and Toxoplasma gondii was 9.3, 8.3, 7.6, 9.8, and 5.0 %, respectively. Kappa score of agreement between TRFIA and microscopic examination of stools was 0.892, P?<?0.05. These combined results showed that our method is feasible and could be used for the clinical determination of clonorchiasis.     

自身免疫性肺泡蛋白沉积症治疗进展

自身免疫性肺泡蛋白沉积症是一种发病率低、临床表现多样的疾病,全肺灌洗是目前治疗的标准方法,但并不是所有的患者治疗有效.本文将对最近出现的针对其发病机制的治疗方法进行综述.     

后侧入路治疗肱骨中远段骨折合并桡神经损伤的临床分析

目的探讨后侧入路治疗肱骨中远段骨折合并桡神经损伤的临床效果,以期提高临床治疗水平。方法 2009-01—2013-01选取70例肱骨中远段骨折合并桡神经损伤患者为研究对象,随机分成2组,对照组予以前外侧入路,观察组予以后侧入路,比较2组在手术时间、失血量、桡神经损伤率和临床效果方面的差异。结果从总疗效情况看,对照组无效率20%,总有效率80%;观察组无效率5.71%,总有效率94.29%,2组比较差异有统计学意义(P<0.05);从神经恢复上看,对照组轻度损伤20例(57.15%),中度损伤9例(25.71%),重度损伤6例(17.14%)。观察组轻度损伤28例(80%),中度损伤4例(11.43%),重度损伤3例(5.71%),2组比较差异有统计学意义(P<0.05);2组失血量、生活质量评分、骨折延迟愈合情况、桡神经医源性损伤情况、手术时间比较差异有统计学意义(P<0.05)。结论后侧入路治疗肱骨中远段骨折合并桡神经损伤,视野清晰,桡神经解剖暴露满意,对桡神经移位能减少损伤,后侧固定符合张力带原则,有利于肱骨骨折的固定。