针灸联合关节松动术治疗肩周炎的网状Meta分析＊

目的 运用网状Meta分析方法评价针灸联合关节松动术治疗肩周炎的疗效。方法 运用计算机检索Web of Science、PubMed、Cochrane Library、EMbase、维普（VIP）、中国知网（CNKI）、万方（Wanfang）、中国生物医学文献数据库（CBM），搜寻有关针灸联合关节松动术治疗肩周炎的随机对照试验。所有研究人员均独立纳排文献、提录资料、风险评估，对符合质量标准的RCT研究采用Stata16.0和Review Manager 5.4软件进行分析。结果 共检索出6561篇文献，最终纳入37项研究，涉及10种针灸联合关节松动术方法。总样本量2890例，其中试验组1432例，对照组1458例。网状Meta分析所得结果表明：①在总有效率方面，最好的3种治疗方法为内热针联合组、温针联合组、动筋针联合组；②在降低VAS评分方面，最好的3种治疗方法为内热针联合组、动筋针联合组、针刀联合组。结论 针灸联合关节松动术治疗肩周炎疗效总体优于单独使用，且内热针联合组具有最佳的疗效。     

非程控降温,—80℃冻存自体外周血干细胞的研究

目的：观察非程控降温、－80℃冻存的方法对自体外周血十细胞（APBSC）的保存效果。方法：以6％羟乙基淀粉（HES）、5％二甲基亚砜（DMSO）及4％人血白蛋白（ALB）的混合物为冷冻防护剂，将APBSC直接置于－80℃下保存，冻存前反复苏后测定APBSC的CFU－GM、BFU－E；观察移植后造血功能重建情况。结果：13例患者白细胞在十3～＋7天下降至（0．0～0．1）×10／L，白细胞（0．0～0．2）×109／L持续时间3～6天，于＋9～＋11天恢复至1．0X109／L以上．中性粒细胞绝对值（ANC）于＋9～＋11天达到0．5X109／L。血小板在＋3～＋7天下降至（2．0～21）×109／L，于＋8～＋15天恢复至20×109／L以上。CFU－GM、BFU－E回大率分别为76．5％、78．4％。结论：非程控降温、－80℃冻存是一简便、经济、有效的自体外周血于细胞保存方法。     

干细胞动员对骨创伤大鼠免疫功能的保护作用

目的：观察自体干细胞动员对骨创伤大鼠的免疫功能的保护作用，为战创伤后的免疫抑制及继发性感染、系统性炎症反应等治疗提供依据。方法：挤压折断法复制大鼠双后肢股骨骨折模型，于致伤后0、24、48h连续给模型动物肌肉注射GM—CSF20μg／kg，致伤后72h细胞增殖法检测T、B淋巴细胞活性，ELISA法检测血清IL-1、IL-2、IFN-7、TNF—α浓度，自动系列化分析法检测C3、CA、IgM、IgG浓度，称重法观察脾重与体重的比例变化。结果：股骨骨折模型大鼠致伤后72h，GM—CSF动员骨髓干细胞组大鼠的T、B淋巴细胞活性和血清IFN-γ、IL-2浓度高于对照组（P〈0．01），IL-1、TNF—α浓度低于对照组（P〈0．01），血清C3、CA、IgM、IgG浓度及脾／体重比值高于对照组（P〈0．01）。结论：GM—CSF动员自体干细胞动员对大鼠骨创伤诱导的免疫功能抑制具有保护作用。     

Ca2+ mobilization in physiologically stimulated single T cells gradually increases with peptide concentration (analog signaling)

We have investigated Ca²⁺ mobilization in single T cells stimulated with their physiological ligand, i.e. antigenic peptide bound to major histocompatibility complex (MHC) molecules on antigen-presenting cells (APC). Fibroblasts expressing I-E^d class II molecules were pulsed with a peptide derived from the λ2³¹⁵ immunoglobulin light chain. Onto such antigen-pulsed fibroblasts were sedimented cloned Th1 cells loaded with Fura-2. Changes in cytosolic Ca²⁺ concentration in single T cells were continually monitored by use of an imaging system based on fluorometry. Ca²⁺ mobilization was both peptide-specific and MHC-restricted. Within seconds of the initial APC-T cell contact, a Ca²⁺ spike could be observed. The Ca²⁺ response gradually declined over a 25-min period, during which oscillations were noted. Various parameters characterizing the magnitude of the Ca²⁺ response (latency, increase rate, max and mean Ca²⁺ increase, frequency and period of oscillations) all correlated with the amount of peptide used for pulsing the fibroblasts. Thus, Ca²⁺ mobilization in single T cells appears not to be an all or none phenomenon. Rather, activation is incremental (analog signaling), the degree of Ca²⁺ mobilization probably being related to the number of stimulatory peptide-MHC complexes on the surface of the APC. The extent of calcium mobilization and lymphokine production (interleukin (IL)-2, IL-3, interferon-γ) correlated, at least at the population level.     

论模块化医院船

随着模块化技术的形成和集装箱运输的发展，国外在医院船的建造中模块化技术得到应用，并发挥了快捷经济的效果，船用医疗模块系统装备（医疗集装箱组）加载在集装箱运输船上，即组建模块化医院船，是战时征用民船转换为医院船的理想途径，具有极大的军事，经济效益。     

指伸肌腱修复术后的早期控制下活动

目的 防治指伸肌腱修复术后因制动所致的并发症。方法 对15例Ⅴ～Ⅷ区指伸肌腱损伤修复术后设计活动支具，早期行控制下活动。结果 术后3—6个月随访，按TAM标准评定疗效，优良率100％，无1例发生肌腱断裂。结论 指伸肌腱修复术后早期行控制下活动，是防治术后并发症的有效方法。     

Prospective Randomized Study Comparing the Efficacy of Bioequivalent Doses of glycosylated and nonglycosylated rG-CSF for Mobilizing Peripheral Blood Progenitor Cells

Thirty patients diagnosed with breast cancer were included in a prospective randomized study comparing the in vivo priming effect of bioequivalent doses of glycosylated (lenograstim) and nonglycosylated (filgrastim) rG-CSF administration. Analysis of the efficacy of equivalent biological doses of both rG-CSFs showed no significant differences either in the mobilization of the subpopulations of PBPC considered (CD34⁺, CD34⁺/38⁻, CD34⁺/DR⁻), the content of such CD34⁺ cell subsets in the leukapheresis product, or the cost of the mobilization and collection procedures between both recombinant molecules. These results suggest that priming with bioequivalent doses of the two commercially available forms of glycosylated or nonglycosylated rG-CSF has a similar in vivo effect on PBPC mobilization.     

AO肩锁钢板钩治疗重型肩锁关节脱位

目的评估AO肩锁钢板钩治疗重型肩锁关节脱位的手术疗效.方法回顾性分析两年来27例手术病人的手术治疗和疗效.结果手术方法符合生理结构,手术时间平均30分钟,内固定牢靠.根据Murley和Constant[1]评分,优良率94%.结论 AO肩锁钢板钩治疗重型肩锁关节脱位,手术方法简单,疗效可靠,允许病人术后早期功能锻炼.