Background: Human amniotic mesenchymal stem cells (hAMSCs) are being widely applied in various fields. Therefore, hAMSCs represent a promising candidate to facilitate cartilage regeneration. Nonetheless, no studies have investigated the application of hAMSC sheets to repair cartilage defects in vivo. Purpose: To evaluate hAMSC sheets encapsulating cartilage particles to promote repair of rabbit osteochondral defects. Study Design: Controlled laboratory study. Methods: hAMSC sheets were constructed with passage 3 hAMSCs. The phenotypic and structural characteristics of hAMSC sheets were evaluated by flow cytometry and scanning electron microscopy, respectively. The potential for chondrogenic differentiation of hAMSC sheets was assessed by cartilage-specific marker staining, immunohistochemistry, and mRNA and protein expression (SOX9, COLII, and ACAN). Osteochondral defects (diameter, 3.5 mm; depth, 3 mm) were created in the left patellar grooves of 20 New Zealand White rabbits (female or male). The defects were treated with hAMSC sheet/cartilage particles (n = 5), cartilage particles (n = 5), hAMSC sheets (n = 5), or fibrin glue (n = 5). Macroscopic and histological evaluations of the regenerated tissue were conducted after 3 months. The survival time and differentiation of transplanted hAMSCs in the defect area were evaluated by immunofluorescence. Results: hAMSC sheets had a multilayered structure, with cells stacked layer by layer. Importantly, hAMSC sheets highly expressed phenotypic markers of mesenchymal stem cells. Cartilage-specific marker staining and immunohistochemistry were positive, and mRNA and protein expression was higher in the chondrogenically induced hAMSC sheet group than in the hAMSC sheet group ( P < .05). hAMSC sheet/cartilage particles formed a large amount of hyaline-like cartilage in the defect area. In addition, macroscopic and histological scores were significantly higher than those in the other groups. Integration with surrounding normal cartilage and subchondral bone regeneration in the hAMSC sheet/cartilage particles group were better when compared with the other groups. A large number of human nuclear-specific antigen-positive cells were observed in the defect area of hAMSC sheet/cartilage particles and hAMSC sheet groups. Moreover, some positive cells expressed SOX9. Conclusion: hAMSC sheets encapsulating cartilage particles facilitate osteochondral defect repair. Clinical Relevance: Delivery of cells in the form of a cell sheet in conjunction with cartilage particles provides a novel approach for cell-based cartilage regeneration.

目的 分析不同部位神经移位修复臂丛神经根性撕脱伤患者的疗效及影响手术效果的相关因素.方法 选取2010年1月-2014年12月哈尔滨医科大学附属第四医院骨外科行膈神经移位术、肋间神经移位术及健侧C7神经移位术的臂丛神经根性撕脱伤患者47例作为研究对象,根据神经部位分为膈神经移位组16例、肋间神经移位组15例及健侧C7神经移位组16例.屈肘、屈指肌力恢复釆用BMRC分级系列进行评估,肘关节活动度采用中华医学会手外科学会上肢部分功能试用标准评定.结果 3组不同部位神经移位术后的肌力与肘关节功能恢复有效率比较差异无统计学意义(P>0.05).影响膈神经移位术肌力恢复有效率的相关因素有患者年龄、神经移植长度、损伤至手术时间和功能锻炼时间(χ2/t=-5.310、7.111、-5.536、3.400,P均<0.01);影响肋间神经移位术肌力恢复有效率的相关因素有年龄、神经移植长度和功能锻炼时间(χ2/t=-3.883、8.182、3.067,P均<0.01),健侧C7神经移位术肌力恢复有效率的相关因素有年龄、损伤至手术时间及功能锻炼时间(χ2/t=-2.423、-3.381、3.985,P<0.05或P<0.01).影响膈神经移位术肘关节功能恢复有效率的相关因素有患者年龄、神经移植长度、损伤至手术时间和功能锻炼时间(χ2/t=-2.340、4.752、-2.221、2.907,P<0.05或P<0.01);肋间神经移位术肘关节功能恢复有效率的相关因素有损伤部位、神经移植长度和功能锻炼时间(χ2/t=5.000、5.000、2.582,P<0.05);健侧C7神经移位术肘关节功能恢复有效率的相关因素有年龄、神经移植长度、损伤至手术时间有关(χ2/t=-2.571、4.752、-4.875,P<0.05).结论 3种不同神经移植术后肌力与肘关节的功能恢复有效率存在差异,但无统计学意义;不同术式肌力与肘关节的功能恢复受不同因素影响.

Metabolic abnormality is one of the hallmarks of cancer cells, and limiting material supply is a potential breakthrough approach for cancer treatment. Increasing researchers have been involved in the study of glioma cell metabolism reprogramming since the significance of IDH1 was confirmed in glioma. However, the molecular mechanisms underlying metabolic reprogramming induced by methionine deprivation regulates glioma cell proliferation remain unclear. Here we demonstrated that methionine deprivation inhibited glioma cell proliferation via downregulating interleukin 1 receptor antagonist (IL1RN) both in vitro and in vivo, methionine deprivation or knocking down IL1RN induced glioma cell cycle arrest. Moreover, we confirmed that IL1RN is a tumor associated gene and its expression is negatively correlated with the survival time of glioma patients. Altogether these results demonstrate a strong rationale insight that targeting amino acid metabolism such as methionine deprivation/IL1RN related gene therapy may offer novel direction for glioma treatment.

脚上的鞋子每天都会对膝关节产生影响,而膝关节是最容易出现炎症的部位,如果鞋子穿得不合适,可能会伤害膝关节,甚至导致膝关节炎. 三种鞋子伤害膝关节 高跟鞋 常穿高跟鞋会对膝关节造成一定的损伤.研究显示,无论是穿10厘米以上的细高跟鞋,还是5～10厘米的粗跟鞋、坡跟鞋,走路时都会对膝关节施加额外的压力,为患上膝关节炎埋下了隐患.

Objective To investigate the therapeutic effects of two types of flaps repairing severe contractures of the first web space by retrospective study.Methods From January 2004 to June 2012,we operated 35 patients who were severe contractures of the first web space.There were 18 cases reconstructed with snuffbox flap (group A),17 cases were reconstructed with the posterior interosseous artery(PIA) flap (group B).After operation,curative effects were evaluated by measuring hand's function and the first web space.All data were analyzed by statistics.Results All the patients were followed-up for a mean of 12 months (ranged from 6 to 18 months).In group A,there were two cases partial superficial necrosis.In group B,there were three patients partial superficial necrosis,one patient distal partial necrosis,and one patient with secondary injury of deep branch of radial nerve.the width of first web space was augmented an average of (32.11 ±3.07)mm in group A and (31.71 ±2.57)mm in group B,first web space was augmented an average of 58.78° ± 4.73° in group A and 58.82° ± 3.76° in group B,and evaluation of thumb function according to AMA system were improved 17.06％ ± 5.35％ in group A and 15.96％ ± 4.06％ in group B.There were no significant difference between group A and group B (P ＞ 0.05).Conclusions Snuffbox flap is a prior selection than the PIA flap in reconstruction of first web space.

患者男,54岁.因"左手红肿、疼痛渐进性加重1周"入院.该患者既往无明确的外伤史,无发热寒战病史,无低热、盗汗史.局部检查:左手掌尺侧轻度红肿、压痛明显(图1),可触及约4 cm×3 cm大小的肿物,不规则,活动度差,表面红肿,轻度隆起,局部皮温高,未触及波动感,手指屈伸活动时疼痛明显,手指血运及感觉无明显异常.入院后给予完善相关辅助检查,实验室检查:白细胞6.95×10-9/L,中性粒细胞72.81％.X线片及CT示:第四、五掌骨无明显骨膜反应及骨质变化.B超显示:未见明显脓肿.左手MRI显示:第四、五掌骨间软组织T2WI见斑状等信号,T1WI呈略高信号(图2).入院后抗感染治疗1周,未见明显好转,而行手术探查.

生命在于运动。然而，一些骨质疏松患者却对运动敬而远之，害怕一不小心就会骨折。但实际上，预防和减轻骨质疏松的方法，恰恰就是锻炼。

年轻时保养不当,上了年纪,胳膊、腿难免会不好使.有些症状可能会慢慢消失,有些则是危险信号,需要多注意,勤锻炼. 膝关节响,蹲马步 经常不运动可能使膝、肩等处关节囊产生的滑液不够,上了年纪,走路时能听到膝关节嘎嘎作响.应通过运动增加关节的灵活度,蹲马步就是个不错的方法:脚尖朝前,大腿与地面平行,挺胸、收腹、平视.每天坚持做一次,开始可以每次做5分钟,慢慢延长时间.

目的探讨优质护理服务在贫困山区脑卒中后抑郁患者中的应用及效果。方法组织护理人员进行优质护理服务及人文关怀知识培训,对108例贫困山区脑卒中后抑郁患者实施优质护理服务。结果实施优质护理服务后脑卒中后抑郁患者的抑郁指数得分是(0.52±0.06)分,对护理工作满意度得分是(71.10±2.00)分,对疾病知识认知水平得分是(75.31±17.24)分,与开展实施优质护理服务前相比较数据有显著改善。结论在边远农村开展实施优质护理服务,不仅能降低该区患者的抑郁指数,而且还能提高患者对疾病知识认知水平和护理工作满意度。

目的探讨厄贝沙坦对高血压患者脉搏波传导速度(PWV)和踝臂指数(ABI)的影响。方法将200例伴有危险因素的高血压患者随机分为2组,治疗组100例给予厄贝沙坦治疗,对照组100例给予安慰剂治疗,治疗6个月后,观察2组治疗前后血压、PWV、ABI的变化。结果治疗组血压、PWV较治疗前明显降低,ABI增加,与对照组比较均有显著性差异。结论厄贝沙坦可降低高血压患者的血压和PWV,增加ABI。

目的 探讨逍遥丸联合黛力新在治疗"冠心病"型焦虑症中的安全性及有效性.方法 将经冠状动脉造影或冠状动脉CTA示冠状动脉正常并诊断为焦虑症的患者随机分为对照组(A组)、逍遥丸组(B组)、黛力新组(C组)和逍遥丸联合黛力新组(D组).观察各组患者出院时情绪症状缓解率、躯体症状缓解率、患者情绪症状缓解时间及躯体症状缓解时间.结果 D组患者情绪症状、躯体症状的缓解率明显高于A、B、C组(P均<0.05);B、C组情绪症状、躯体症状的缓解率高于A组(P均<0.05);C组情绪症状、躯体症状缓解率与B组比较无显著性差异(P均>0.05);B、D组7 d时躯体症状的缓解率高于A、C组(P均<0.05);C、D组15～21d时情绪症状缓解率高于A、B组(P均<0.05).结论 逍遥丸联合黛力新在"冠心病"型焦虑症患者的治疗中安全、有效,可以快速有效缓解患者的焦虑症状.

目的观察康复训练配合理疗、针刺治疗脑卒中后吞咽障碍的疗效。方法将36例临床确诊为脑卒中吞咽障碍的患者随机分为观察组和对照组。观察组20例采用康复训练、理疗与针刺综合治疗,对照组16例只采用针刺与理疗。结果经过4周治疗,观察组吞咽能力较对照组有显著提高(P<0.05)。结论中西医综合康复疗法是治疗脑卒中后吞咽障碍的良好途径。

Cerebral ischemic stroke is a prevalent disease in senior individuals. The anticoagulation and thrombolysis to recover blood supply as well as the diminution of neural excitotoxicity to protect brain cells have not shown to fully improve stroke patients. The comprehensive mechanisms and medication specificity remain to be addressed. The silence of specific mRNAs by RNA interference provides revenues for such goals. We examined whether the silence of protease-activated receptor-1 (PAR-1) by siRNA protects brain tissues from ischemic injury. In three groups of Wistar rats, their lateral ventricles received the injections of lentiviral vectors carrying siRNA for PAR1, small RNA in mismatching PAR1 or saline. A week after the injections, these rats were treated by one side of middle cerebral artery occlusion (MCAO). The scores of neurological deficits, the volume of ischemic infarction and the expressions of PAR-1, HSP-70 and MAP-2 were measured in 24h of MCAO. Our results show that the silence of PAR-1 significantly reduces neurological deficits and infarction volume, as well as elevates HSP-70 and MAP-2 expressions. Thus, the knock-down of PAR1 minimizes the ischemic impairments of cerebral cortex via HSP70 and MAP-2 pathways.

目的探讨影像检查在乳腺癌诊断中的应用及价值。方法对70例经临床手术病理证实的乳腺癌患者影像学检查资料(包括彩色多普勒超声、数字乳腺钼靶片)进行回顾性分析,总结每项检查对乳腺癌的诊断方法及影像综合诊断过程中应注意的问题。结果乳腺癌的彩色多普勒超声、数字钼靶片诊断正确率分别为90%,82%,二者结合的诊断正确率为100%。结论影像综合检查对乳腺癌的早期发现、确诊及制订治疗方案具有重要价值。

目的比较经左胸、上腹正中切口行贲门癌根治手术的优缺点,探讨手术的最佳径路。方法回顾性分析2003年1月—2007年12月邯郸市中西医结合医院外科经左胸(121例)和经上腹部切口(162例)行贲门癌根治术患者的临床资料。比较2组的淋巴结清扫数、手术时间、出血量、术后并发症发生率、术后平均恢复时间。结果经左胸组和上腹组淋巴结清扫数、手术时间、出血量、术后并发症发生率、术后平均恢复时间比较有显著性差异(P均<0.05)。结论贲门癌根治术经左胸入路只对贲门旁淋巴结清扫有优势,而经上腹入路手术时间短、出血量少、并发症发生率低、术后平均恢复时间短,更对腹腔淋巴结清扫有优势。

BACKGROUND: There are non-excellent outcomes with limited arthroscopic clean-up in patients with adult Kaschin-Beck disease. OBJECTIVE: To compare the curative effect of different materials in total hip arthroplasty for patients with secondary hip osteoarthritis due to adult Kaschin-Beck disease. METHODS: A total of 20 hips with total hip replacements were performed in 13 patients with secondary hip osteoarthritis due to adult Kaschin-Beck disease from March 2006 to May 2010. There were 5 cases receiving bone cement prosthesis and 15 cases receiving non-bone cement prosthesis. RESULTS AND CONCLUSION: The mean follow-up was 8-48 months. Compared with preoperation, the mean Harris hip scores on the 14th day after the operation and at the last follow-up were all improved significantly (P < 0.05). There was no significant difference between bone cement prosthesis and non-bone cement prosthesis (P > 0.05). There was no loosening, migration,heterotopic ossification radiographically, and no revision during the follow-up. Total hip arthroplasty can alleviate the joint ache and improve joint movable function. Different-material total hip arthroplasty is an effective treatment for patients with secondary hip osteoarthritis due to adult Kaschin-Beck disease.

<正>骨质疏松症是一个世界性的健康问题,其治疗药物被分为抗吸收类及抗合成代谢类。抗吸收类药物通过抑制破骨细胞活性减少骨吸收,目前包括二磷酸盐类,选择性雌激素受体拮抗剂,降钙素和雌激素类,各种新的抗吸收类药正在研究。抗代谢药主要是刺激骨的形成,目前在美国唯一被批准的抗

上了岁数以后,很多老年朋友都有腰膝酸痛的症状.这里推荐一个十分简单的做法,每天只需3分钟,坚持一段时间,症状就会有明显改善.如果您有膝盖酸痛的症状,可以这样做:在家中相对宽敞的空间,穿上宽松的衣物,脱掉鞋子,仰卧在地板上,两手自然地放在身体左右两侧.

<正>变应性鼻炎(AR)是多种免疫活性细胞和细胞因子参与的鼻黏膜慢性炎症反应性疾病,其发病机制尚未阐明[1]。该病也是诱发哮喘的危险因素,在临床上,AR伴有哮喘者对患者的生理和心理均造成巨大影响[2]。AR发病率近年呈上升趋势,严重者并发鼻息肉。2006年5月—2010年7月本院五官科门诊应用中西药联合治疗季节性AR(SAR)200例,获得

目的总结人工全髋关节置换术(total hip arthroplasty,THA)治疗系统性红斑狼疮继发股骨头缺血性坏死(avascular necrosis of the femoral head,ANFH)患者的手术注意事项及围手术期处理。方法2007年3月-2009年4月,对5例系统性红斑狼疮继发ANFH患者症状严重侧行THA治疗。男1例,女4例;年龄46～58岁。系统性红斑狼疮病程4～24年,手术时均处于红斑狼疮静止期。双侧ANFH根据Ficat分期均为Ⅳ期,病程2～12年。术前Harris评分为(30.8±5.4)分。结果5例均顺利完成手术,围手术期输血量为1200～2200mL。术后出现切口皮肤变态反应性炎症、血肿形成、浅部感染、切口窦道形成各1例,均经对症处理后愈合;1例切口Ⅰ期愈合。3例术后出现反复发热,经对症处理后症状消退。术后患者均获随访,随访时间6～30个月,平均14.4个月。髋关节术前症状均显著缓解。术后Harris评分为(86.5±3.8)分,与术前比较差异有统计学意义(P<0.001)。结论系统性红斑狼疮继发ANFH患者行THA术后并发症发生率较高,应注意准确掌握手术适应证,加强围手术期护理,以获得较好疗效。