中美医学创新能力教育的差异

为了培养创新型医学人才,对比了中美医学教育,发现后者在以下方面有利于创新能力的培养:(1)自由的知识获取途径:①选课自由；②启发式教学；③学习时间机动,；(2)与兴趣物密切接触的机会:①实验室开放；②社会实践多；③协作的能力培养；(3)探索与冒险精神:①探索的文化氛围；②易获基金的支持.     

中等强度旋转恒磁场亚慢性连续照射对大鼠大脑氧化还原和组织病理的影响

目的:探讨中等强度旋转恒磁场亚慢性连续照射对大鼠大脑组织氧化还原指标和组织病理的影响。方法:将22只健康成年雄性Wistar大鼠(购于南方医科大学实验动物中心),体重(220—250)g,随机分成4组:空白对照组(n=5):正常饲养,不给予任何干预;不旋转组(n=5):分别将每只大鼠放置在一个长宽高分别为10cm、10cm、12cm的均匀分布着孔洞的塑料筐里,可以保证在实验时大鼠一直在磁场上方,塑料筐上盖有玻璃板,防止大鼠跳出,然后将大鼠放于磁场上方(0.49T),磁场不旋转,实验期间整只大鼠都暴露于磁场当中;低频旋转组(n=6):将大鼠放于旋转恒磁场上方(0.49T),旋转频率为3000rpm;高频旋转组(n=6):将大鼠放于旋转恒磁场上方(0.49T),旋转频率为6000rpm,每天3h,连续30d。实验结束后取大脑组织进行生化指标丙二醛(MDA)、谷胱甘肽(GSH)、一氧化氮(NO)、髓过氧化物酶(MPO)检测和大脑组织HE染色。结果:各组大鼠大脑组织的MDA、GSH、NO、MPO指标差异无显著性意义(P0.05),组织病理切片未见明显病变。结论:中等强度旋转恒磁场亚慢性连续照射对大鼠大脑组织无明显影响。     

两种HAART方案治疗后艾滋病患者空腹血糖的动态变化

目的观察两种高效抗逆转录病毒治疗(HAART)方案治疗后艾滋病患者空腹血糖的动态变化。方法收集2012年1月—2015年12月在贺州市人民医院行HAART治疗的艾滋病患者400例,按照用药方案不同分为A组(TDF+3TC+EFV)和B组(AZT+3TC+EFV),检测治疗前和治疗后1、3、6、12个月空腹血糖和治疗前及治疗后CD4+T淋巴细胞计数以及治疗期间并发症发生情况。结果 A组和B组治疗前空腹血糖分别为(5.31±0.48)mmol/L和(5.35±0.60)mmol/L,差异无统计学意义(P0.05)。A组和B组治疗后1、3、6、12个月空腹血糖分别为(5.76±0.59)mmol/L和(5.67±0.69)mmol/L、(5.94±0.73)mmol/L和(5.73±0.59)mmol/L、(5.98±0.71)mmol/L和(5.81±0.66)mmol/L、(5.92±0.62)mmol/L月和(5.97±1.06)mmol/L,A组和B组治疗后空腹血糖均明显高于治疗前(P0.05);3个月和6个月的空腹血糖两组间的差异有统计学意义(P0.05),而1个月和12个月的空腹血糖两组间的差异无统计学意义(P0.05)。结论 TDF+3TC+EFV和AZT+3TC+EFV均可使艾滋病患者空腹血糖水平升高,且升高程度相当。     

椎体骨水泥注入联合抗骨质疏松药物治疗急性骨质疏松性椎体压缩性骨折

背景：经皮椎体后凸成形治疗椎体压缩性骨折疗效显著,具有创伤小、出血与并发症少、术后恢复快、大部分老年患者可以耐受等特点,但其只是一种治疗手段,并不能有效预防老年患者术后再次发生椎体压缩性骨折。目的：评估经皮椎体后凸成形联合抗骨质疏松药物治疗急性骨质疏松性椎体压缩性骨折的临床疗效。方法：纳入急性骨质疏松性椎体压缩性骨折患者137例（198个治疗椎体）,其中女111例,男26例,年龄（75.55±6.96）岁,行椎体内注射聚甲基丙烯酸甲酯骨水泥经皮椎体后凸成形治疗,治疗后连续3个月服用抗骨质疏松药物。治疗前、治疗后1周、治疗后3个月检查目测类比评分、骨折椎体高度恢复率、Oswestry功能障碍指数、Cobb角,同时记录并发症发生率及椎体压缩性骨折再发生率。结果与结论：所有患者治疗后1周、治疗后3个月的目测类比评分、骨折椎体高度恢复率、Oswestry功能障碍指数、Cobb角均较治疗前明显改善（P 〈0.001）。术后并发症发生率为0.7%,3个月随访期间未再发生椎体压缩性骨折。表明经皮椎体后凸成形联合抗骨质疏松药物可有效治疗急性骨质疏松性椎体压缩性骨折。     

髓核去细胞基质复合骨髓间充质干细胞体外构建组织工程髓核的研究?

目的：体外培养兔骨髓间充质干细胞(rBMSCs)-髓核去细胞基质支架(NPAMS)复合体(rBMSCs-NPAMS)构建组织工程髓核。方法制备若干 NPAMS,接种 BMSCs 至 NPAMS 体外培养分为 NPAMS 组、实验组和正常对照组(正常髓核)。肉眼及显微镜观察复合体形态变化,并行扫描电镜(SEM)、苏木素-伊红(HE)染色、免疫组织化学、实时定量 PCR(qRT-PCR)、支架的生物力学等检测。结果肉眼下 rBMSCs-NPAMS 形态接近正常髓核;SEM 显示细胞在支架表面大量黏附、并向深部迁移,表面细胞密度比横截面细胞密度大;HE 染色表明随时间延长,rBMSCs-NPAMS 内细胞量递增,分布更广泛;免疫组织化学显示细胞外基质2型胶原(CollagenⅡ)分泌量随时间递增,且实验组 CollagenⅡ表达量大于 NPAMS 组,小于正常对照组;qRT-PCR结果：NPAMS 组未提取到 mRNA,实验组 CollagenⅡ、聚集蛋白聚糖(Aggrecan)mRNA 相对表达量呈时间依赖性递增,但均小于正常对照组(P <0.01),支架与正常髓核在相同位移下的压缩载荷差异无统计学意义(P >0.05)。结论采用髓核体外 NPAMS复合 rBMSCs 可成功构建组织工程髓核。     

经皮椎体成形修复非骨质疏松单节段椎体创伤性压缩骨折

BACKGROUND: It is still controversial about whether percutaneous vertebroplasty can be as an option for treatment of non-osteoporotic single-segmental vertebral traumatic compression fractures.OBJECTIVE: To observe the effect of percutaneous vertebroplasty in repair of non-osteoporotic single-segmental vertebral traumatic compression fractures.METHODS: Totally 20 patients who underwent percutaneous vertebroplasty in repair of non-osteoporotic single-segmental vertebral traumatic compression fractures between March 2010 and January 2013 were collected. The variation of visual analog scale scores and the Oswestry disability index scores of patients was observed before and after the repair.RESULTS AND CONCLUSION:(1) The visual analog scale scores and the Oswestry disability index scores of patients were significantly reduced after repair compared with those before repair, moreover, the visual analog scale scores and the Oswestry disability index scores of patients at the 3, 6, 12 and 18 months after repair were similar. (2) All patients had no adverse effects and complications. (3) These results suggest that percutaneous vertebroplasty in repair of non-osteoporotic single-segmental vertebral traumaticcompression fractures quickly      

经皮椎弓根螺钉内固定修复单节段胸腰椎骨折：活动度改善12个月随访

BACKGROUND: Studies have shown that percutaneous pedicle screw internal fixation in repair of single segment of thoracolumbar fracture can overcome quadrilateral effect, get better biomechanical properties, meanwhile, it also can provide three-point fixation, reduce suspension effect, and reduce the formation of kyphosis. OBJECTIVE: To investigate the clinical efficacy and incidence of complications of the percutaneous pedicle screw internal fixation for treatment of single segment thoracolumbar fractures. METHODS: Totally 36 patients with single segment thoracolumbar fractures treated by percutaneous pedicle screw internal fixation were enrolled. A total of 36 vertebral bodies were treated: T11=5, T12=8, L1=17, L2=6. The visual analog scale scores before treatment and at 3, 6 and 12 months after treatment, the Oswestry disability indexes before treatment, at the first week and at the 12th month after treatment, the Cobb angle before treatment, the first day and at the 12th month after treatment were compared and observed. The incidence of complications was recorded. RESULTS AND CONCLUSION: The visual analog scale scores at 3, 6 and 12 months after treatment was significantly lower than those before treatment (P < 0.001). The Oswestry disability indexes before treatment, at the first week and at the 12th month after treatment were significantly lower those that before treatment (P < 0.001).The Cobb angle before treatment, at the first day and at the 12th month after treatment was significantly smaller than that before treatment (P < 0.001). Only three (8%) patients had complications, including pedicle screw penetrating pedicle into the spinal canal, pedicle screws loosing and the infection in puncture site. These results suggest that percutaneous pedicle screw internal fixation for treatment of single segment thoracolumbar fractures can correct kyphosis, improve the thoracolumbar motion, quickly relieve patient’s back pain, and the incidence of complications is low.       

经皮椎弓根螺钉内固定并伤椎单侧置钉修复单节段胸腰椎骨折

BACKGROUND: Studies have shown that percutaneous pedicle screw internal fixation for treatment of thoracolumbar fracture has got good clinical results, but for the injured vertebra body, whether pedicle screw should be implanted in injured vertebra body and unilateral or bilateral implanting screw is still controversial.