手术治疗胸腰椎结核合并后凸畸形

目的:探讨单切口双入路椎弓根系统内固定、后外侧植骨同期病灶清除、椎间植骨治疗胸腰椎结核合并后凸畸形的疗效。方法:对78例胸腰椎结核合并后凸畸形患者采用单切口双入路行后外侧植骨椎弓根系统内固定,同期病灶清除、椎间植骨治疗,观察患者症状及截瘫改善情况,后凸畸形矫正情况及植骨融合情况。结果:所有患者症状均明显改善,48例合并截瘫的患者中,25例完全恢复正常,7例ASIA分级改善1￣3级;植骨均在术后6个月￣1年融合,治愈率52.08%,好转率14.58%。后凸Cobb角平均矫正28.7°,随访1.4￣6.5年,平均2.6年,后凸角平均丢失2.9°。结论:单切口双入路后外侧椎弓根系统内固定同期病灶清除、椎间植骨可恢复脊柱的即刻稳定性,有利于植骨融合,后凸畸形矫正满意。     

Can marital selection explain the differences in health between married and divorced people? From a longitudinal study of a British birth cohort

In view of the rising divorce rates, the impact of divorce on health has an increasing importance in public health. The differentials in health between the married and the divorced may be explained by ‘marital selection’ and ‘marital protection’. Using longitudinal data from a study of the 1958 British birth cohort, factors that select people into divorce were identified from the areas of socio-economic status, health, and attractiveness, which included physical attractiveness, health-related behaviour and temperament. Evidence for both positive and adverse selection is found. The different sets of selection factors for females and males appear to be in line with gender role expectations. The health differentials between married and divorced men were weak and can be explained away by the selection factors. Having controlled for the selection effects, there were still significant associations between divorce and physical and psychological health in women. Though these unexplained differentials cannot be definitely interpreted as the consequences of marital dissolution, this interpretation remains plausible.     

外周血淋巴细胞染色体、微核和转化率检查制片技术探讨

目的 探索淋巴细胞检查的制片技术,提高检查质量和效率。方法 以某一无放射接触史者外周静脉血为对照组,以同一人外周静脉血通过剂量率为1.002 Gy/min、剂量为2.8 Gy的⁶⁰Coγ射线辐照后为试验组。37℃孵箱培养淋巴细胞48 h后加入秋水仙素,再培养20 h;将培养液分成低渗与非低渗,预固定,再将二者混合、提纯、制片、染色、分析。用相同标本行标准方法实验。结果 改进方法与标准方法比较,试验组的染色体异常率分别为75.8%和74.0%,对照组的染色体异常率均为0。试验组的微核细胞率分别为7.8‰和7.2‰,对照组的微核细胞率分别为1.2‰和1.4‰;试验组的淋巴细胞转化率分别为43.6%和43.2%,对照组的淋巴细胞转化率分别为65.4%和66.2%。结论 改进方法和标准方法对外周血淋巴细胞染色体畸变率、微核细胞率和淋巴细胞转化率检测无统计学差异,而改进方法使制片时程缩短,同时也节约了试剂耗材,提高了制片质量,检测项目在一张玻片上完成,缩短了观察时间,提高了报告效率。     

Spontaneous perforation of the rectosigmoid colon: a report of 2 cases

Spontaneous perforation of rectosigmoid colon is rare but usually results in severe peritonitis, with very high mortality. Two cases of spontaneous rectosigmoid perforations are reported here along with a brief literatures review.     

In vitro and in vivo antifungal activities of the eight steroid saponins from Tribulus terrestris L. with potent activity against fluconazole-resistant fungal pathogens

Antifungal activity of natural products is being studied widely. Saponins are known to be antifungal and antibacterial. We have isolated eight steroid saponins from Tribulus terrestris L. , namely TTS-8, TTS-9, TTS-10, TTS-11, TTS-12, TTS-13, TTS-14 and TTS-15. TTS-12 and TTS-15 were identified as tigogenin-3-O-β-D-xylopyranosyl（1→ 2）-[-β-D-xylopyranosyl（ 1 → 3 ） 3-β- D-glucopyranosyl （ 1 → 4 ）- 1- α-L-rhamnopyranosyl （ 1 → 2 ） 3-β-D-galactopyranoside and tigogenin-3-O-β-D-glucopyranpyranosyl（1→2）-[-β-D-xylopyranosyl（1→ 3）3-β-D-glucopyranosyl（1→4）-β-D-galactopyranoside, respectively. The in vitro antifungal activities of the eight saponins against six fluconazole-resistant yeasts, Candida albicans, Candida glabrata, Candida para psilosis , Candida tropicalis , Candida krusei , and Cryptococcus neo f ormans were studied using microbroth dilution assay. The results showed that TTS-12 and TTS-15 were very effective against several pathogenic candidal species and C. neoformans in vitro. It is noteworthy that TTS-12 and TTS-15 were very active against fluconazole-resistant C. albicans （MIC80 = 4.4, 9.4 mg/ml）, C. neoformans （MIC80 =10.7, 18.7 mg/ml） and inherently resistant C. krusei （MIC80 =8.8, 18.4 mg/ml）. So in vivo activity of TTS-12 in a vaginal infection model with fluconazole-resistant C. albicans was studied in particular. Our studies revealed TTS-12 also showed in vivo activities against fluconazole-resistant yeasts. In conclusion, steroid saponins TTS-12 and TTS-15 from Tribulus terrestris L. have significant in vitro antifungal activity against fluconazole-resistant fungi, especially TTS-12 also showed in vivo activity against fluconazole-resistant C. albicans.     

航天职工2型糖尿病并发骨质疏松的相关危险因素

 目的 探讨航天职工2型糖尿病患者合并骨质疏松的危险因素。方法 选择航天职工中2型糖尿病患者211例,根据骨密度分为骨质疏松组和非骨质疏松组,对比各组患者年龄、糖尿病病程、体重指数、骨钙素、CTX、25-羟维生素D、甲状旁腺素、空腹血糖、糖化血红蛋白、C肽曲线下面积、HOMA-β、HOMA-CR、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇的差异,并进行Logistic回归分析。结果 单因素分析:骨质疏松组和非骨质疏松组比较,糖尿病病程、BMI、25(OH)D、HbA₁c、HOMA-β、HOMA-CR差异有统计学意义(P<0.05)。多因素Logistic回归分析:糖尿病病程(OR=0.007,95%CI:0.000～0.182)、体重指数(OR=8.888,95%CI:1.646～47.998)、糖化血红蛋白(OR=0.497,95%CI:0.332～0.744)、HOMA-β(OR=27.433,95%CI:8.105～92.844)、25-羟维生素D(OR=1.169,95%CI:1.047～1.306)是独立影响因素。结论 长糖尿病病程、低体重、高血糖、胰岛功能差、25-羟维生素D缺乏是航天系统职工2型糖尿病合并骨质疏松的危险因素。     

One-stage anterior debridement,bone grafting and posterior instrumentation vs. single posterior debridement,bone grafting,and instrumentation for the treatment of thoracic and lumbar spinal tuberculosis

Purpose

The aim of this study was to compare single posterior debridement, interbody fusion and instrumentation with one-stage anterior debridement, interbody fusion and posterior instrumentation for treating thoracic and lumbar spinal tuberculosis.

Method

From January 2006 to January 2010, we enrolled 115 spinal tuberculosis patients with obvious surgical indications. Overall, 55 patients had vertebral body destruction, accompanied by a flow injection abscess or a unilateral abscess volume greater than 500 ml. The patients underwent one-staged anterior debridement, bone grafting and posterior instrumentation (group A) or single posterior debridement, bone grafting and instrumentation (group B). Clinical and radiographic results for the two groups were analyzed and compared.

Results

Patients were followed 12–36 months (mean 21.3 months), Fusion occurred at 4–12 months (mean 7.8 months). There were significant differences between groups regarding the post-operative kyphosis angle, angle correction and angle correction rate, especially if pathology is present in thoracolumbar and lumbar regions. Operative complications affected five patients in group A, and one patient in group B. A unilateral psoas abscess was observed in three patients 12 months postoperatively. In one of them, interbody fusion did not occur, and there was fixation loosening and interbody absorption. All of them were cured by an anterior operation.

Conclusion

Anterior debridement and bone grafting with posterior instrumentation may not be the best choice for treating patients with spinal tuberculosis. Single posterior debridement/bone grafting/instrumentation for single-segment of thoracic or lumbar spine tuberculosis produced good clinical results, except in patients who had a psoas abscess.     

Protein-tyrosine kinase p72syk in Fc gamma RI receptor signaling

In this report we show that gamma-interferon (IFN) induces the expression of the nonreceptor protein tyrosine kinase, p72syk, and that cross-linking the Fc gamma RI receptor in IFN-differentiated U937 cells (U937IF cells) results in the activation of syk kinase. We show that syk is tyrosine phosphorylated (12-fold increase) after Fc gamma RI cross-linking. In vitro kinase assays demonstrate that the specific kinase activity of syk increased eightfold after Fc gamma RI cross- linking. The activation of signal transduction through the Fc gamma RI receptor, as measured by the respiratory burst, is associated with the tyrosine phosphorylation and catalytic activation of the syk kinase. We show that syk coprecipitates with the gamma subunit of the Fc gamma RI, Fc gamma RI gamma. The data suggest that p72syk is involved in signal transduction through the Fc gamma RI receptor, involving the Fc gamma RI gamma subunit.