中医不同治法对绝经后骨质疏松症大鼠骨骼、骨骼肌SDF-1含量影响的比较研究

目的探究用中医滋补肾阴、温补肾阳、健脾、补肾健脾治法治疗绝经后骨质疏松症是否会引起骨骼、骨骼肌中SDF-1水平的变化,从而扩展中医防治骨质疏松症的现代医学机制。方法除正常组外,将去卵巢致骨质疏松症的大鼠随机分为模型组、补肾阴组、补肾阳组、健脾组、补肾健脾组和福善美组。采用酶联免疫吸附法检测各组大鼠血清ALP、TRACP及骨骼、骨骼肌中SDF-1的水平。结果模型组大鼠血清ALP和TRACP水平均比正常组显著升高(P<0.01);各治疗组均比模型组显著降低(P<0.01),以福善美组降低最为明显,其次为补肾健脾组。②模型组大鼠的骨骼和骨骼肌SDF-1水平均比正常组显著升高(P<0.01);与模型组相比,补肾阳组、福善美组大鼠骨组织SDF-1水平显著降低(P<0.01),健脾组、补肾阴组也降低(P<0.05),福善美组、健脾组大鼠的骨骼肌SDF-1水平显著降低(P<0.01)。结论骨质疏松症的发生与骨骼、骨骼肌中SDF-1水平的升高有关。②补肾阴、补肾阳、健脾和补肾健脾法可以减少绝经后骨质疏松症大鼠骨骼、骨骼肌中SDF-1的水平,从而对骨质疏松症起到一定的防治作用。     

骨髓间充质干细胞向成骨细胞分化中CXCR4蛋白表达的研究

目的 探究中医补肾阴、补肾阳、健脾、补肾健脾不同治法对骨髓间充质干细胞向成骨细胞分化过程中CXCR4蛋白表达的影响,从而为中药防治骨质疏松症提供依据。方法 体外分离培养大鼠BMSCs,将SPF雌性SD大鼠用随机数字表法随机分成6组,依次分别为：正常组、诱导液组、补肾阴组、补肾阳组、健脾组、补肾健脾组。对大鼠进行7 d灌胃,制备含药血清,各组成骨诱导18 d后,进行茜素红染色检测矿化情况,采用酶联免疫吸附法(ELISA)检测上述每组细胞上清液CXCR4、BMP2蛋白表达水平。结果 诱导18 d后,与正常组相比,补肾阳组与补肾健脾组BMP-2含量均显著升高(P<0.01),诱导组、补肾阴组BMP-2含量有所升高,但差异不具有统计学意义(P>0.05);与诱导组相比,补肾健脾组BMP-2含量均显著升高(P<0.01),补肾阴组与补肾阳组BMP-2含量有所升高,但差异无统计学意义(P>0.05),各含药组BMP-2蛋白浓度比较依次为：补肾健脾组>补肾阳组>补肾阴组>健脾组;与正常组相比,各组CXCR4含量均显著升高(P<0.01),且补肾健脾组上...     

中医不同治法调控ERK2、JNK促进肌源性干细胞向成骨分化的研究

目的 通过观察中医不同治法促进大鼠肌源性干细胞(muscle-derived stem cells, MDSCs)成骨分化及细胞外调节蛋白激酶2(extracellular regulated protein kinase 2,ERK2)、c-Jun氨基末端激酶(c-Jun N-terminal kinase, JNK)蛋白表达情况，探究基于“脾肾相关”理论下，中医防治骨质疏松症(osteoporosis, OP)的作用机制。方法 在随机数字表法下，将大鼠分为正常组、诱导组、补肾组、健脾组及补肾健脾组，制备含药血清，选取第4代大鼠MDSCs进行实验，CCK8法检测细胞增殖，p-NPP法检测细胞碱性磷酸酶(alkaline phosphatase, ALP)活性，ELISA法检测细胞ERK2、JNK蛋白表达。结果 (1)各组均可促进MDSCs增殖。(2)与正常组相比，各组ALP活性显著升高(P<0.01),其中补肾健脾组最高。(3)诱导组、补肾组、补肾健脾组ERK2蛋白表达显著高于正常组(P<0.01),健脾组高于正常组，差异无统计学意义；各组JNK蛋白表达显著低于正常组(P...     

基质细胞衍生因子1α诱导脂肪来源干细胞迁移促进糖尿病缺血下肢肌肉修复的实验研究

背景与目的：基质细胞衍生因子1α (SDF-1α)是一种定向诱导细胞迁移的趋化因子，研究显示，间充质干细胞（MSCs）在受损组织中可以沿着SDF-1梯度迁移到损伤部位并参与组织修复，然而目前尚缺乏SDF-1α诱导脂肪来源干细胞（ASCs）对糖尿病缺血下肢进行组织修复的体内研究。因此，本研究探讨SDF-1α促进大鼠脂肪来源干细胞（r ASCs）向糖尿病大鼠缺血下肢肌肉组织迁移及对组织修复的影响。方法：取SD大鼠脂肪组织分离培养rASCs，行细胞形态观察，鉴定成脂、成软骨及成神经分化能力，并使用带绿色荧光蛋白（GFP）的腺病毒转染和标记r ASCs。将大鼠用STZ法构建糖尿病模型，并结扎大鼠的右下肢股动脉造成下肢缺血后，随机分为两组，通过尾静脉向两组大鼠体内注射r ASCs，其中一组在患肢中段部位肌肉处注射SDF-1α蛋白（SDF-1α+rASCs组），另一组则用同样方式注射等量磷酸盐缓冲溶液（rASCs组）。治疗后的第1、2周行大鼠双下肢血流量检测，计算及比较各组大鼠的缺血下肢-健侧下肢血流比值。在第4周时处死大鼠，取缺血部位的肌肉组织行HE染色，观察不同治疗方法组中肌肉组织的排列情况。...     

中医不同治法对骨质疏松症大鼠骨密度及骨骼肌Ca2+-Mg2+-ATP酶影响的比较研究

目的观察中医不同治法对糖皮质激素诱导骨质疏松症大鼠骨密度、骨骼肌Ca2+-Mg2+-ATP酶变化的影响,探讨中医防治骨质疏松症的作用机制。方法将120只雌雄各半的大鼠随机分为正常对照组、模型对照组(模空组)、补肾中药组、健脾中药组、活血化瘀中药组和骨疏康中药组6个组。用地塞米松肌注造模。实验结束后,腹主动脉取血处死大鼠,用酶联免疫法测定大鼠骨骼肌Ca2+-Mg2+-ATP酶,用双能X线骨密度仪测大鼠离体股骨上1/3骨密度。结果①与正常组比较,模空组大鼠离体股骨上1/3骨密度显著降低(P<0.01);与模空组比较,各治疗组大鼠股骨上1/3骨密度均有不同程度的升高,其中以补肾中药组升高程度最为显著(P<0.01),其余各治疗组骨密度较模空组升高程度比较无统计学意义。②与正常组比较,其他各组大鼠骨骼肌的Ca2+-Mg2+-ATP酶显著降低(P<0.01);与模空组比较,各治疗组大鼠骨骼肌的Ca2+-Mg2+-ATP酶均明显升高(P<0.01);补肾组大鼠骨骼肌的Ca2+-Mg2+-ATP酶升高最为明显,明显高于骨疏康组、活血组、健脾组,差异具有非常显著性(P<0.01);活血组大鼠骨骼肌的Ca2+-Mg2+-ATP酶升高程度最低,与补肾组、健脾组、骨疏康组比较具有统计学差异(P<0.01);健脾组和骨疏康组升高程度也比较明显,但二者比较无统计学意义。结论补肾、健脾方法对骨质疏松症大鼠的骨密度和Ca2+-Mg2+-ATP酶具有一定调节作用。     

丹参抑制转化生长因子-β1诱导的肌源性干细胞向肌成纤维母细胞分化

目的 观察丹参对失神经骨骼肌肌源性干细胞(MDSCs)向肌成纤维母细胞分化的抑制作用.方法 采用差速贴壁法分离出大鼠失神经骨骼肌MDSCs,加入转化生长因子-β1(TGF-β1)和丹参进行干预,将细胞分为3组:A:对照组;B:10 μg/L TGF-β1组;C:10 μg/L TGF-β1+ 150 mg/L丹参组.荧光实时定量聚合酶链反应(qRT-PCR)和Western blot检测各组细胞在干预后5个时间点α-平滑肌肌动蛋白(α-SMA)和波形蛋白(Vimentin) mRNA和蛋白表达.结果 与A组比较,B组和C组细胞α-SMA、Vimentin的mRNA在干预后第2、3、5、7天均明显升高(P＜0.05),其蛋白表达在干预后第3、4、6、8天亦显著升高(P＜0.05);与B组比较,C组细胞α-SMA、Vimentin的mRNA和蛋白在对应时间点均明显降低(P＜0.05).结论 丹参能抑制TGF-β1诱导的失神经骨骼肌MDSCs向肌成纤维母细胞的分化.     

干细胞抗原-1在大鼠阴茎海绵体组织中的表达

肌源性干细胞(MDSCs)是近年来发现的中胚层起源的多能干细胞.我们通过测定干细胞抗原-1(Sca-1)在不同月龄组SD大鼠阴茎海绵体平滑肌组织中的表达,观察阴茎海绵体中是否存在肌源性干细胞.     

干细胞抗原-1在大鼠阴茎海绵体组织中的表达

肌源性干细胞(MDSCs)是近年来发现的中胚层起源的多能干细胞.我们通过测定干细胞抗原-1(Sca-1)在不同月龄组SD大鼠阴茎海绵体平滑肌组织中的表达,观察阴茎海绵体中是否存在肌源性干细胞.     

干细胞抗原-1在大鼠阴茎海绵体组织中的表达

肌源性干细胞(MDSCs)是近年来发现的中胚层起源的多能干细胞.我们通过测定干细胞抗原-1(Sca-1)在不同月龄组SD大鼠阴茎海绵体平滑肌组织中的表达,观察阴茎海绵体中是否存在肌源性干细胞.     

干细胞抗原-1在大鼠阴茎海绵体组织中的表达

肌源性干细胞(MDSCs)是近年来发现的中胚层起源的多能干细胞.我们通过测定干细胞抗原-1(Sca-1)在不同月龄组SD大鼠阴茎海绵体平滑肌组织中的表达,观察阴茎海绵体中是否存在肌源性干细胞.     

上下颌第二恒磨牙拔除后第三磨牙自行迁移情况的比较观察

目的：对上下颌第二恒磨牙拔除后第三磨牙自行迁移的情况进行观察、比较。方法：将27例病例分为上颌组和下颌组,上颌组15例拔除上颌第二恒磨牙,下颌组12例拔除第二恒磨牙。两组在治疗前和治疗1年后分别拍摄术前及术中x线侧位头影测量片,测量第三磨牙在水平方向、垂直方向移动距离,同时记录所有病例第三磨牙临床萌出情况,并对两实验结果进行统计学分析、比较。结果：上颌组上颌第三磨牙在水平方向和垂直方向分别移动7．83mm、7．73mm,下颌组下颌第三磨牙在水平方向和垂直方向分别移动6．12mm、4．97mm,上下颌间无统计学意义,除下颌组一名患者之外,其余患者第三磨牙均已萌出,两组间无显著统计学差异。结论：无论上颌、下颌,拔除第二恒磨牙都是一种良好的拔牙模式。     

三维外固定架结合有限内固定治疗肱骨干粉碎性骨折

[目的]探讨三维外固定架结合有限内固定治疗肱骨干粉碎性骨折的临床疗效。[方法]2000年1月-2006年5月，收治肱骨干粉碎性骨折28例，骨折根据AO／ASIF分类，其中：B1型5例，B2型3例，B3型9例，C1型6例，C2型4例，C3型1例，采用三维外固定架结合螺钉和／或钢丝有限内固定治疗，术后3d行合理的康复治疗。从手术情况、并发症、骨折愈合及功能评价等方面对疗效进行分析。[结果]28例患者术后获平均13（10—15）个月随访，27例患者获骨性愈合，愈合率96．4％，骨折愈合时间12—33周，平均19．5周。除1例骨折未愈合外，余肩、肘关节功能均正常，优良率92．8％。[结论]三维外固定架结合有限内固定是治疗肱骨干粉碎性骨折的较好方法，符合骨折治疗的微创生物学原则，操作简单，固定可靠，功能恢复满意。     

Resection of the inferior head of the pancreas: Report of a case

We developed a new technique for partial resection of the head of the pancreas with an end-to-side pancreaticoduodenostomy, while preserving the duodenum, the common bile duct, and the upper part of the head of the pancreas around the duct of Santorini. A resection of the inferior head of the pancreas was performed in a patient with an intraductal mucin-producing tumor of the pancreas. This procedure is considered to be appropriate for treating both benign disease and noninvasive malignant disease involving either the uncinate process or the duct of Wirsung, because it removes both the uncinate process and the pancreatic tissue around the duct of Wirsung. We thus believe that a resection of the inferior head of the pancreas with an end-to-side pancreaticoduodenostomy can help play a significant role in the management of patients with benign diseases and localized malignant tumors of the pancreas.     

颈部放射性溃疡的治疗

目的:探讨颈部放射性溃疡的手术方法。方法:彻底或姑息性切除颈部放射性溃疡组织后,根据颈部组织损伤程度的不同,分别用同侧胸三角皮瓣或胸大肌肌皮瓣进行颈部缺损的修复,供区使用全厚皮片修复。结果:11例胸三角皮瓣、3例胸大肌肌皮瓣全部成活,愈合良好,术后患者生活质量明显改善。结论:胸三角皮瓣与胸大肌肌皮瓣血运可靠,是修复颈部放射性溃疡的有效、简单和安全的方法。     

Identification of risk factors for 30-day postoperative complications in patients undergoing primary ventral hernia repair: a prospective cohort study of 2,374 patients

Background

Primary ventral hernia is a common condition. Surgical repair is associated with complications, but no clear predictive risk factors have been identified. The European Hernia Society classification offers a structured framework to describe hernias and to analyze postoperative complications. Given this structured nature, the European Hernia Society classification might prove useful for preoperative patient or treatment classification. The objective of this study was to investigate the European Hernia Society classification as a predictor for complications within 30 days after primary ventral hernia surgery.

Selection of Candidates for Lung Transplantation: The First Italian Consensus Statement

Lung transplantation is a well-established treatment for selected patients with advanced chronic respiratory insufficiency. Recognizing those patients with end-stage lung disease who might benefit from lung transplantation is a crucial task. Considering the presence of inadequate evidence-based practice, international and national scientific societies provided consensus opinions regarding the appropriate timing of listing. The Study Group for Thoracic Organs Transplantation (branch of the Italian Society for Organs Transplantation) promoted and realized a Delphi conference among the Italian lung transplantation centers to provide guidance to clinical practice based on international recommendations. The experts from the nine Italian centers completed two rounds of standardized questionnaires (answer rate, 100%): 42 statements received a consensus ≥80%. The selected statements presented in this article are intended to assist Italian clinicians in selecting patients for lung transplantation.     

Sex-based differences in transfusion need after severe injury: Findings of the PROPPR study

BackgroundWomen are underrepresented in trauma research, and aggregated results of clinical trials may mask effects that differ by sex. It is unclear whether women respond differently to severe hemorrhage compared with men. We sought to evaluate sex-based differences in outcomes after severe trauma with hemorrhage.MethodsWe performed a secondary analysis of the Pragmatic Randomized Optimal Platelet and Plasma Ratios trial. Trauma patients predicted to require massive transfusion were randomized to a 1:1:1 vs 1:1:2 plasma to platelet to red blood cell transfusion ratio. Analysis was performed according to sex, controlling for clinical characteristics and transfusion arm.ResultsA total of 134 women and 546 men were analyzed. In multivariable analysis, there was no difference in mortality at 24 hours (hazard ratio for women 0.64, 95% confidence interval 0.34–1.23, P = .18) or in time to hemostasis (hazard ratio 1.10, 95% confidence interval 0.84–1.42, P = .49) by sex. We observed no difference between sexes in volume of blood products transfused during active hemorrhage. However, after anatomic hemostasis, women received lower volumes of all products, with a 38% reduction in fresh frozen plasma (mean ratio 0.62 (95% confidence interval 0.43–0.89, P = .01), 49% reduction in platelets (mean ratio 0.51, 95% confidence interval 0.33–0.79, P < .01) and 49% reduction in volume of red blood cells (mean ratio 0.51, 95% confidence interval 0.33–0.79, P < .01).ConclusionMortality and time to hemostasis of trauma patients with hemorrhage did not differ by sex. Although there was no difference in transfusion requirement during active hemorrhage, once hemostasis was achieved, women received fewer units of all blood products than men. Further research is required to determine whether women exhibit differences in coagulation during and after severe traumatic hemorrhage.