"动"与"静"在疾病康复中的应用

养生,延年益寿如今己成了人们生活中的热门话题,笔者在临床上经常会遇到病人的询问:患病后是运动好还是静养好呢?回答起来似乎很简单,生命在于运动,当然运动好.     

贵州省地方性氟中毒地区人群GSTP1基因Ile105Val位点多态性分析

Objective To investigate plasma glutathione S-transferase(GSTs) activity and GSTP1 gene Ile105Val polymorphism in Bijie City, Guizhou Province, a coal-burning fluorosis endemic area. Methods One hundred and sixty villagers from Yachi Twon using non-improved cooking stoves were selected as the non-intervened group in Bijie City, Guizhou Province where coal-burning fluorosis was prevailing; 153 villagers as the intervented group were chosen from Changchun Twon, where cooking stoves were improved; 151 villagers were served as the control group from Baiyunshan Twon, Changshun County without endemic fluorosis. The activity of GSTs was tested by colorimetric analysis with spectrophotometer. The genotype of the GSTP1 gene Ile105Val polymorphism, presenting as either homozygous wild-type (AA), or heterozygous mutation type (AG), or homozygous mutation type (GG), was detected through the PCR-RFLP procedure. Results The activity of GSTs in plasma of non-intervened group [(12.44±4.97) kU/L]was significantly lower than that of intervened group (P < 0.05), and that of intervened group[(20.78±6.20)kU/L]was significantly lower than that of control group[(24.30±6.27)kU/L, P< 0.05]. The difference of the enzyme activity of three groups were statistically significant (F = 51.71, P < 0.05), but this enzyme activity did not vary significantly in each sex of each grnup(P > 0.05). Compared intervened group [AA:67.3%(103/153), AG:29.4%(45/153),GG:3.3%(5/153)]and non-intervened group[AA:66.9%(107/160), AG:30%(48/160), GG:3.1%(5/160)]with control group[AA:74.8%(113/151), AG:25.2%(38/151), GG:0 (0/151)], the Ile105Val polymorphism site of GSTP1 gene had significant difference(χ2= 6.04,6.07, both P< 0.05), but not significant between intervened and non-intervened groups(χ2 = 0.02, P>0.05). Conclusions Fluorosis can decrease the activity of GSTs and introduce the GSTP1 gene Ile105Val polymorphism, intervention with the fluorine intake will improve the effect of fluoride on the body.     

贵州省地方性氟中毒地区人群GSTP1基因Ile105Val位点多态性分析

Objective To investigate plasma glutathione S-transferase(GSTs) activity and GSTP1 gene Ile105Val polymorphism in Bijie City, Guizhou Province, a coal-burning fluorosis endemic area. Methods One hundred and sixty villagers from Yachi Twon using non-improved cooking stoves were selected as the non-intervened group in Bijie City, Guizhou Province where coal-burning fluorosis was prevailing; 153 villagers as the intervented group were chosen from Changchun Twon, where cooking stoves were improved; 151 villagers were served as the control group from Baiyunshan Twon, Changshun County without endemic fluorosis. The activity of GSTs was tested by colorimetric analysis with spectrophotometer. The genotype of the GSTP1 gene Ile105Val polymorphism, presenting as either homozygous wild-type (AA), or heterozygous mutation type (AG), or homozygous mutation type (GG), was detected through the PCR-RFLP procedure. Results The activity of GSTs in plasma of non-intervened group [(12.44±4.97) kU/L]was significantly lower than that of intervened group (P < 0.05), and that of intervened group[(20.78±6.20)kU/L]was significantly lower than that of control group[(24.30±6.27)kU/L, P< 0.05]. The difference of the enzyme activity of three groups were statistically significant (F = 51.71, P < 0.05), but this enzyme activity did not vary significantly in each sex of each grnup(P > 0.05). Compared intervened group [AA:67.3%(103/153), AG:29.4%(45/153),GG:3.3%(5/153)]and non-intervened group[AA:66.9%(107/160), AG:30%(48/160), GG:3.1%(5/160)]with control group[AA:74.8%(113/151), AG:25.2%(38/151), GG:0 (0/151)], the Ile105Val polymorphism site of GSTP1 gene had significant difference(χ2= 6.04,6.07, both P< 0.05), but not significant between intervened and non-intervened groups(χ2 = 0.02, P>0.05). Conclusions Fluorosis can decrease the activity of GSTs and introduce the GSTP1 gene Ile105Val polymorphism, intervention with the fluorine intake will improve the effect of fluoride on the body.     

贵州省长顺县燃煤污染型地方性氟中毒健康教育处方试点研究

目的探讨健康教育处方在控制燃煤污染型地方性氟中毒(简称地氟病)中的效果和作用。方法采取卫生行政和疾病控制部门协调、对项目乡村干部和医务人员进行相关知识培训、基线调查、确定针对性的健康教育处方内容,并在乡村卫生院(室)实施,实施后随机抽样追踪调查与评估。结果试点研究期间共计开出有效健康教育处方1882人份,作为宣传单自由阅取约4000人份。项目实施后家庭户主知晓率提高近40%,学生知晓率提高约25%,健康教育处方接受者总体知晓率为63.40%,较基线(8.91%)显著提高。干预后炉灶密闭使用率和烟囱出屋率均显著提高。项目乡村居民已全部不用敞煤火干燥玉米,辣椒煤火干燥率显著减少,密闭保存率显著提高。78%的地氟病防治卫生知识知晓人群已向他人讲解传播,47%的人已采取降氟措施。结论地氟病健康教育处方试点工作在促进病区人群自我保健与防护意识、行为改变和形成方面取得初步成效,为深化贵州省地氟病健康教育与健康促进干预研究,探讨地氟病健康教育与健康促进的可持续性发展模式,以及为在全省推广运用提供了基础数据和科学依据。     

Pavlik吊带治疗6个月内婴儿髋关节发育不良

目的探讨Pavlik吊带治疗6个月内婴儿髋关节发育不良的方法和疗效以及高频超声在诊断治疗中的价值。方法回顾性总结我院2004年1月至2012年1月收治的102例(124髋)6个月内发育性髋关节异常的婴儿,其中男性14例,女性88例,单侧80例,双侧22例,年龄3~24周。据Graf超声波髋关节分型,20髋为Ⅱa(-)型,50髋为Ⅱb型,34髋为Ⅱc型,18髋为Ⅲ型,2髋为Ⅳ型。常规新生儿体检均发现有双侧臀纹不对称,或伴有髋关节屈曲外展受限,经Garf静态超声技术确认。均采用Pavlik吊带治疗,平均间隔2~3周超声监测髋关节发育变化。吊带治疗时间4~20周,随访时间15~30个月,平均24个月。结果 92例(112髋)经Pavlik吊带治疗后,复查超声和X线片指标恢复正常,确认治愈。4例(5髋)治疗过程中超声指标改善明显,58°α角60°,年龄超过8个月后,改用髋外展矫形器固定,4周后X线片指标恢复正常。6例(7髋)年龄超过6个月,指标未恢复正常,且伴有内收肌紧张,予以内收长肌松解后石膏固定。在此6例患儿中,3例(3髋)随访至18个月,髋臼指数大于25°,Sheton氏线不连续,行Salter骨盆截骨术。所有患儿均无股骨头无菌性坏死等并发症。结论 Pavlik吊带对于GrafⅡ型患儿治愈率高,而对于GrafⅢ、Ⅳ型患儿,Pavlik吊带治愈率降低,部分患儿需后续进一步治疗。超声检查可动态观察Pavlik吊带治疗效果。早期超声检查为及时应用Pavlik吊带治疗提供了可能,对减轻患儿晚期畸形和并发症有重要意义。     

孕晚期性生活对宫颈成熟度及妊娠结局的影响

目的 探讨孕晚期性生活对宫颈成熟度及妊娠结局的影响。方法 选择2018年1～10月在安徽省妇幼保健院产科就诊的孕晚期（28周以后）初产妇为研究对象,将适合性生活的160例孕晚期初产妇作为试验组,另选相同条件无性生活的157例初产妇作为对照组,比较两组研究对象的宫颈成熟度及妊娠结局情况。结果 试验组宫颈成熟度评分>6分的初产妇占92.50%,阴道分娩率为88.75%,对照组分别为32.48%和64.33%,两组差异均有统计学意义（P<0.05）。试验组延期妊娠的初产妇占7.50%,药物干预的初产妇占10.00%,剖宫产率为11.25%,急性胎儿窘迫的发生率为3.75%,均低于对照组,两组差异均有统计学意义（P<0.05）。结论 妊娠晚期性生活可促进宫颈成熟,有利于自然分娩,预防过期妊娠,对降低剖宫产率及急性胎儿窘迫发生率可能有一定作用。     

儿童猫抓病诊治分析

目的探讨儿童猫抓病临床表现、实验室检查特点及治疗方法的选择。方法回顾性总结我院1993年1月至2004年8月收治的15例猫抓病患儿，其中男9例，女6例，年龄3～14岁。所有患儿均经手术治疗，病理确诊。结果15例患儿经抗生素和手术治疗后，均治愈并且无复发。结论对儿童猫抓病及早明确诊断和合理治疗，对其痊愈和并发症的预防具有重要的意义。     

儿童膝关节骨肉瘤半膝关节置换15例

为观察半关节假体置换用于儿童膝关节周围骨肉瘤的效果。于1998-10/2006-07对15 例膝关节周围骨肉瘤患儿行瘤段切除并半膝关节假体置换。影像学提示瘤灶位于股骨远端9例，胫骨近端6例，病变范围9~11 cm。术前经病理检查确诊为骨肉瘤。按Enneking分期，均在Ⅱa期。术前均行一两个疗程的化疗。术前根据X射线平片、CT 或MRI 测量设计匹配的假体，假体略长于截骨段1.0~2.0 cm。髌韧带及侧副韧带重建于人工半膝关节假体上。15例患儿均成功完成半膝关节假体置换。随访2~6年，患儿身高增加了4~6 cm，患肢短缩1~3 cm ，均能进行日常生活学习。按Enneking肢体肌肉骨骼肿瘤外科治疗重建膝关节置换后功能评估：优7例，良5例，中2例，差1例。说明将半关节假体应用于儿童膝关节周围骨肉瘤的治疗，具有重建膝关节功能，保留正常端骨骺，最大限度减少膝关节置换后患肢缩短，并为成年后行全关节置换创造了条件。     

甘氨双唑钠下调X射线照射诱导鼻咽癌细胞hMSH2的表达

目的：通过甘氨双唑钠（CMNa）对X 射线照射诱导鼻咽癌CNE-1 细胞错配修复基因hMSH2 表达的影响,探讨CMNa放射增敏的分子机制.方法：应用逆转录酶PCR（RT-PCR）和免疫印迹方法,检测空白组（未照射）、对照组（未加入CMNa进行照射）和实验组（加入1 mmol/l CMNa,每次加入60 min后进行照射）细胞中hMSH2 基因mRNA 及蛋白表达.结果：对照组细胞照射后hMSH2 mRNA 和蛋白表达量逐渐增高,且均高于基础表达量（0.11±0.03,10.27±3.96,P〈0.05）.实验组细胞在照射终止后第1 周hMSH2 mRNA和蛋白表达量最高,以后成逐渐降低,且在照射终止后第2~4 周mRNA（0.19±0.07,0.14±0.05,0.06±0.02）和蛋白表达水平（ 12.81±5.24,11.37±4.63,8.76±4.29） 均显著低于对照组（P〈0.05）.结论：CMNa 可以下调X 射线照射诱导鼻咽癌细胞hMSH2 的表达水平,抑制放射损伤后肿瘤细胞DNA 修复,这可能是肿瘤放疗敏感性增高的原因之一.     

后路短节段固定联合伤椎置钉在胸腰段脊柱骨折中的应用

目的观察后路短节段固定联合伤椎置钉在治疗胸腰段脊柱骨折中的近期临床效果。方法对收治的43例胸腰段脊柱骨折患者采用后路短节段内固定联合伤椎置钉方法进行治疗,对患者术前及术后椎体高度及后凸角度分别进行测定并比较。结果本组患者手术均较成功,无1例出现术后并发症,椎体高度及后凸角度较治疗前显著改善,差异有统计学意义(P<0.05)。结论后路短节段固定联合伤椎置钉治疗胸腰段脊柱骨折手术创伤小,可达到良好的复位效果,有效纠正后凸畸形,值得临床推广使用。