带骨软骨镶嵌移植修复软骨面病损的实验研究

关节软骨缺损的修复是骨科的一个重要课题.目前临床使用的方法主要有自体软骨膜移植,自体骨膜移植,培养的软骨细胞移植,组织工程软骨移植等.近年来,关节镜下的带骨软骨镶嵌移植技术在临床上得到开展和应用.该技术通过特殊的取骨工具,将关节非负重部分的正常软骨连带部分软骨下骨取下后转移到受植区域,修复该区域的软骨病损[1,2].[关键词] 带骨软骨;移植;软骨,关节;创伤和损伤     

A single nucleotide polymorphism rs9468925 of MHC region is associated with clinical features of generalized vitiligo in Chinese Han population

Background Vitiligo has been found to be associated with different HLA antigens in different ethnic groups. In our previous genome‐wide association study (GWAS), we identified independent association signal of rs9468925 (P = 2.21 × 10^?33, OR = 0.74) within HLA‐C‐HLA‐B region. Objectives To explore the association between rs9468925 polymorphism within MHC and the clinical features of generalized vitiligo. Methods The study, using 5566 cases and 6462 controls from previous GWA study investigated the single and combined (GA + GG) genotypic distribution of rs9468925 in subsets of vitiligo patients having different clinical features. We performed a QTL analysis (quantitative trait locus) for age of onset with genotype of rs9468925. Results The GA + GG genotypic distribution of SNP rs9468925 tested with an additive model was found to be significantly different in subgroups of patients of >20 vs. <20 years old (genotypic P = 2.57 × 10^?4, combined P = 3.0 × 10^?3, OR = 0.77, 95% CI: 0.64–0.92), and in patients with different clinical subtypes of vitiligo (genotypic P = 0.03, combined P = 5.0 × 10^?3). However, there was no statistical significance for familial history, halo nevi involvement and autoimmune disease involvement. Conclusions Allele G of rs9468925 on HLA‐C‐HLA‐B may be associated with a higher risk of vitiligo. Our study showed a significant genotypic variation between patients with age of onset ≤20 years and age of onset >20 years. Obvious clinical differences of generalized vitiligo related to genotypic variation found in the Chinese Han population were confirmed in this study.     

颅内动脉瘤术后脑血管痉挛的综合治疗

为了总结颅内动脉瘤术后脑血管痉挛的治疗方法，作者对４６例颅内动脉瘤术后合并脑血管痉挛和延迟性脑缺血的病例，以经颅多普勒（ＴＣＤ）、血清渗透压、颅内压、多项指标动态监测和神经病学追踪双重手段，进行个体化分级监护治疗。用ＴＣＤ监测脑血流速度，将脑血管痉挛为轻、中、重度，并依此标准采用钙离子通道阻断剂和扩容、血液稀释及高血压疗法进行治疗。４４例（９５．６％）术后血管痉挛和延迟性脑缺血完全恢复，有２例（４．３％）并发延迟性脑缺血神经功能障碍。作者还就ＴＣＤ分级、多项监控指标监测的价值和综合治疗相关问题进行讨论。