Pemberton手术为主多种辅助手段治疗大龄儿童先天性髋脱位

目的　应用Pemberton手术为主多种辅助手段治疗大龄儿童先天性髋脱位 ,从而降低术后髋关节脱位、僵硬和股骨头坏死发生率。方法　自 1989年 8月 - 1999年 8月 ,用Pemberton手术为主多种辅助手段治疗大龄儿童 (7～ 14岁 )先天性髋脱位 4 6例 (5 8髋 ) ,随访 2～ 9年 ,平均 5年 3个月。辅助手段包括 :①髂腰肌及内收肌切断 ,股骨髁上骨牵引 ;②股骨粗隆下旋转加短缩截骨 ;③单髋人字石膏制动 ;④髋关节早活动 ,晚负重 ;⑤术后被动活动髋关节加主动功能锻炼。结果　髋关节完全复位率10 0 % ,髋关节屈曲小于 90°者 4髋 ,占 6 9% ,按Salter提出的股骨头坏死诊断标准 4 6例 (5 8髋 )中 ,股骨头坏死 6髋 ,占 10 3% ,明显降低了大龄儿童先天性髋脱位术后髋关节僵硬、股骨头坏死率。结论　Pemberton手术为主多种辅助手段治疗大龄儿童先天性髋脱位疗效确切 ,优良率高。     

Activation of the Notch signaling pathway disturbs the CD4+/CD8+, Th17/Treg balance in rats with experimental autoimmune uveitis

Objective and design

The present study aimed to investigate the relationship between the disturbed balance of CD4⁺/CD8⁺, Th17/Treg and the activation of the Notch signaling pathway in experimental autoimmune uveitis (EAU).

Methods

An EAU rat model was induced in Lewis rats, and pathology analysis was performed by hematoxylin and eosin (H&E) staining. CD4⁺, CD8⁺, Th17, and Treg levels in spleen, lymph nodes and eye tissues were determined by flow cytometry. Meanwhile, the expression of Notch1, DLL4, IL-10, and IL-17 was determined by quantitative polymerase chain reaction (Q-PCR) and enzyme-linked immunosorbent assay (ELISA). In addition, the inhibitory effect of N-(N-(3,5-difluorophenacetyl-l-alanyl))-S-phenylglycine t-butyl ester (DAPT) on Th17 differentiation by Notch signaling in vitro was further investigated using T lymphocytes from EAU rats on day 12 post-immunization by flow cytometry.

Results

The pathological results showed that inflammatory cell infiltration occurred in ocular tissues in EAU rats. The CD4⁺/CD8⁺ and Th17/Treg ratios in EAU rats were apparently higher than those in normal control individuals. Q-PCR and ELISA analyses indicated the expression of Notch1, DLL4, IL-10, and IL-17 in EAU rats gradually increased on day 6 after immunization, peaked on day 12, and then gradually decreased. The dynamic trends in Notch1 and DLL4 expression in EAU rats were identical to those of CD4⁺/CD8⁺ and Th17/Treg levels. DAPT can significantly inhibit the activation of Notch signaling, decrease Th17 cell differentiation, and attenuate the level of the Th17 cell lineage, contributing to the balance of the Th17/Treg ratio.

Conclusion

The activation of the Notch signaling pathway can regulate Th17 and Treg cell differentiation, disrupt the CD4⁺/CD8⁺ and Th17/Treg balance, and aggravate the severity of EAU; inactivation of the Notch signaling pathway contributes to the CD4⁺/CD8⁺ and Th17/Treg balance in EAU rats. Our findings highlighted that the dynamic change in the CD4⁺/CD8⁺ and Th17/Treg ratio was consistent with the expression trend of Notch signaling in EAU rats, suggesting that Notch signaling may be a potentially important therapeutic target in clinical practice.

     

重庆三甲医院医务人员健康教育专业知识掌握及运用情况调查

目的:了解在渝三级甲等医院医务人对健康教育专业知识的掌握及其在具体工作中的实际应用情况,探索影响健康教育开展的因素。方法:采用先整群后随机的多级抽样方法,用自编问卷对337名医务人员进行调查分析。结果:337名医务人员对健康教育专业知识平均知晓率为76.1%;医务人员中62.6%的人认为健康教育有很大作用,89.6%的人愿意接受专门培训,45.4%的人表示在医护工作中经常进行病患健康教育,49.6%的人经常干预病人不良行为。结论:不同学历、职业、职称的医务人员对大部分健康教育专业知识的知晓率无显著差异;他们对健康教育态度较积极,但实际运用不够,仍有必要经常对医务人员进行健康教育专业知识培训。     

萎胃散治疗大鼠慢性萎缩性胃炎实验研究

目的:研究萎胃散治疗慢性萎缩性胃炎(CAG)的疗效及其机制。方法:将SD大鼠分为5组,即正常对照组、模型组与萎胃散高、低剂量组及维酶素组。正常对照组大鼠仅予生理盐水灌胃;用主动免疫法及阿司匹林、乙醇、去氧胆酸钠灌胃同时造大鼠CAG模型;造模后治疗组大鼠以萎胃散高、低剂量治疗60d,以胃黏膜固有腺体萎缩程度为观察指标,判断萎胃散疗效。结果:与模型组比较,萎胃散高、低剂量及维酶素组大鼠的CAG病变状况显著好转(P<0.05),病理检查可见腺体恢复正常。结论:萎胃散可使胃黏膜固有腺体增多,对CAG有良好的治疗作用。     

灾后医疗卫生机构重建时医用设备配置的思考

灾后医疗卫生机构的重建,关系到灾区人民群众的生命安危和健康水平,关系到社会安定和灾区重建的决心与应对灾害的能力,在当前应从急需入手分步实施,突出重点设备从简配置,采购时一定要把好质量关。     

Increased mRNA expression levels of ERCC1, OGG1 and RAI in colorectal adenomas and carcinomas

Background  

The majority of colorectal cancer (CRC) cases develop through the adenoma-carcinoma pathway. If an increase in DNA repair expression is detected in both early adenomas and carcinomas it may indicate that low repair capacity in the normal mucosa is a risk factor for adenoma formation.     

Biodegradability of the molluscicidal saponins of Phytolacca dodecandra

The biodegradability of water-extracted saponins of berries from the Endod plant, Phytolacca dodecandra L'Herit, was evaluated under OECD standardized conditions. Persistence of the saponins was evaluated by determination of saponin concentrations in water over a 30-day period, using a quantitative HPLC method and a semiquantitative hemolytic assay, which is considered a potential field method. The two methods were compared. Bioassays were simultaneously conducted using Biomphalaria glabrata fresh water snails to assess the molluscicidal potency over time. All experiments were carried out in water, which was chemically balanced to sustain snails, and to one set river water was added to the medium to mimic natural conditions. (1) Saponin concentrations in water treated with an aqueous extract of P. dodecandra cultivar E44 were stable for 2 days then rapidly decreased during the third and fourth day. Lethal concentrations to snails were LC50 = 9.6 mg/l (95% CI: 6.3 to 19.4) in one set and LC50 = 6.8 mg/l (95% CI: 5.4 to 12.2) in the other. Adding river water to one set of the experiments had no effect on the mean saponin concentration over time (F = 0.02, P = >0.05). (2) Comparison of the hemolytic assay with the HPLC method showed no significant difference in mean saponin concentrations (t = 0.32, P > 0.05, 95% CI: -2.67 to 3.64), and a correlation of r2 = 0.88 between the two methods. (3) The saponin fraction of an aqueous extract of P. dodecandra was readily biodegraded (t1/2 = 15.8 h), and the complete consumption within a 10-day window indicates ready degradability in aquatic environments under aerobic conditions. (4) These results show that the use of Endod berries for snail control in schistosomiasis-infested water bodies is environmentally acceptable.