Objective To discuss the feasibility and safety of different laparoscopic lumbar surgeries by animal experiment.Methods Three domestic pigs were selected.Their L2 to S1 intervertebral disks were exposed by the laparoscope through the approaches of peritonaeum and posterior peritonaeum.Comparison was made in the advantages and disadvantages of those two approaches at different segments.And the safety and efficacy of those two operations were evaluated.Results Retroperitoneal pneumoperitoneum was successfully established in the three porcine models.The L1-L6 vertebrae were successfully exposed through the retroperitoneal approach,and relative intervertebral disks were excised.Complications such as hemorrhage and injuries of nearby organs did not occur.The average volume of bleeding induced by the operation was about 150 ml.The operative time did not become shorter along with the technical proficiency,which explained the sharp slope of the learning curve and the operating difficulty of the laparoscopic operation.When the lumbosacral area was exposed,the peritoneal approach had significant advantage which would not excessively drag the big vessels.However,the retroperitoneal way had the advantages in the approach to L2-L5 vertebrae.Conclusion This animal experiment identifies that the exposure of the laparoscopic anterior lumbar spine and the excision of the intervertebral disk are feasible.Swine can be used as the ideal animal for the training operation.

Objective To provide a better preoperative design and precise intraoperative navigation in the spinal deformity surgery by digital technique. Methods From Decenber 2006 through August 2011.58 patients with spinal defornity requiring instrumcntation were recruited for the present study.They were 21 men and 37 women.aged from 3 to 68 years (average,21 years) After a three dimensional CT senning of the deformmed spine was performed,the data were transferred via a.dicom network to a computer workstattion Mimics software was used to generate three dimensional reconstruction models of the spine.Visual prcoperational plans simulating the actual surgery were designed.And visual drill templates which potentially enabled a fit in a lock-and-key fashion similar to a physical casting of the vertebral surfaee were also dcsigned.Acrylate drill guides were manufactured using rapid prototyping.The biomodels and drill guides were sterilized and used intraoperatively to asist surgical navigation and placement of instnumentation.Results The three dimensional preopcrational plans were found to he of great assishnce in the execution of the surgery.The navigational templates provided accurate screw placcrment without instrumental complications.The designs of the first 2 templates were suboptimal as the contact surfaee was too large and eomplex.Operating time was reduced as a result of less reliance on intraoperative radiographs Conclusion The digital technique is a novel method which can produce better preoperative design and precise intraoperative navigation for pedicle screw placcment in the spinal deformity surgery.

自2009年10月～2009年11月对急性软组织扭挫伤的180例病人进行用药观察,按照随机数字表分为:治疗组与对照组.治疗组使用奇正消痛贴膏,对照组使用双氯芬酸二乙氨乳剂,观察消痛贴膏组与双氯芬酸二乙胺乳剂组的疗效,现将结果总结如下:

异基因干细胞移植(SCT)受者感染巨细胞病毒(CMV)和CMV肺炎的发生率较高,是患者死亡的主要原因。抗病毒治疗能有效地控制早期CMV疾病的发生,但是毒性和副作用较大,大量应用还会发生细菌和真菌感染及晚期CMV疾病。而过继性免疫疗法通过给患者输注CMV特异T细胞来控制CMV感染,是一种全新的治疗方案,没有毒性和副作用。该文综述了控制SCT受者感染CMV的新方法。

目的:应用同种异体骨移植治疗骨缺损,并评价疗效。方法:新鲜同种异体骨在-80℃保存3 w,经过超声清洗脱脂等一系列破坏细胞并降解抗原性的处理,再经辐射灭菌、复温后,将同种异体骨植入缺损区。植入长度大于缺损区长度,外固定架加压固定,术后抗感染。结果:术后3个月植骨与骨交界处有骨小梁通过,6个月骨折线模糊,1~1.5年植骨骨化。结论:同种异体骨移植治疗骨缺损,植入1~1.5年后,异体骨骨化,疗效显著,是治疗骨缺损的良好方法。

病例男,1968年生,已婚,2003年10月15日13∶40因车祸伤急送当地县医院,血型鉴定为O型,输O型全血400 ml.10月20日转入我院,诊断为:中度闭合性颅脑外伤;额骨断裂性凹陷性骨折;腰4椎体压缩骨折;右股骨中上段闭合性横断骨折.

Objective To develop a convenient method efficiently expands the frequency of specific CTLS.Methods We used different concentrations of CMV-speeific epitope peptides pp65 to stimulate PBMCs for expansion of CMV-specific CTLs.CMV-specifie CTLs were doubly labeled by tetramers-PE and CD_8-FITC for FACS analysis.Results The method expands CMV-speeific CTLs efficiently.CMV-specific CTLs were expanded from 1% to 20% of PBMCs quickly(namely 40% of CD_8~+ T cells).The method provided a large number of cells with tetramer staining of CD_8~+ T cells for FACS analysis from a single blood sampling.Conclusions Peptides stimulation methods are convenient,easy to operate and expanded CMV- specific CTLs efficiently.The increased frequencies of CMV-specific CTLs allowed the data of different individuals to be easily compared and sequentially evaluated.The methods lay the base for adoptive immunotherapy to prevent CMV disease.

BACKGROUND: There are differences in physical and biological activity between the antibody from mammals and egg yolk antibody (IgY) from chicken. IgY is acid- and heat-resistant, and can prevent and cure the infectious diseases in animals and human being, which is also benefit to develop routine diagnostic immunoassays. Conventional ELISA assay for IgY takes much more time than dot-immunobinding assay.OBJECTIVE: To detect the IgY stability byusing dot-immunobinding assay.DESIGN: Open trail.SETTING: Department of Transfusion, Kunming General Hospital of Chinese PLA.MATERTALS: The experiment was completed in the Kunming General Hospital of Chengdu Military Area Command of Chinese PLA from January to June 2006. Two White Leghorn hens (30 weeks old) were selected. HLA-A*0201 α chain served as the antigen. The total protein concentration of the purified antigen was 0.04 g/L with the molecular mass of 32 000(self-prepared); nitrocellulose filter (NC, import and divided); nonfat dry milk (Anyi Corp. No. 20051220); DAB (Boshide Corp.);caprylic acid (made by Shanghai Xinghuo Chemical Factory); ammonium sulfate (Shantou Guanghua Chemical product).METHODS: ①HLA-A*0201 α chain with the total protein concentration of 0.04 g/L was purified with egg yolk antibody,and identified by SDS-PAGE. ②1 μL antigen was spotted into the center of NC membrane and dried in the incubator at 37 ℃. Then the NC membrane was blocked in 1 mL PBST and put in the incubator at 37℃ with shaking in 90 r per minute for 15 minutes. Then the liquid was exchanged with 1 mL PBST and added the primary antibody at a final concentration of 10 mg/L. After 30 minutes shaking in the incubator at 37 ℃, the NC membrane was washed in PBST for three times. The second antibody, mouse anti-chicken IgY conjugated to horseradish peroxidase (HRP) was added and after 30 minutes incubation, the NC membrane was washed three times in PBST. Binding was revealed by incubation with a DAB reagent. A positive reaction was represented by adeep brown spot,Irdlcating that IgY had better activity; if the spot became lighter IgY lost part activity, and when the spot disappeared, the IgY lost a the activty.According to intensity (gray degree)of the dot compared tothe standard, the remained percent of activity of the IgY was calculated. ③IgY was adjusted to three different protein concentrations with PBS: 1, 0.1, 0.01 g/L and stayed at room temperature for four months. 10 μg lgY was taken out from each concentration sample every month to detect the activity by dot-immunobinding assay. ④IgY was put into seven EP tubes with 100 μL per tube and numbered 1-7. Number 1 to 3 was adjusted pH to 5, 3 and 2, respectively with 1 mol/L HCI; Number 4 to 6 was to 9, 11 and 12, respectively with 1 mol/L NaOH. The pH of number 7 was neutral without adding acid or base. The samples were stayed in incubator at 37 ℃ for 3 hours. 10 μg IgY from each tube was taken every hour to detect the stability at different pH by dot-immunobinding assay. ⑤IgY was added to six EP tubes (10 μL per tube) and numbered 1-6. Number 1-6 was put into waterbath at 30, 40, 50, 60, 70 and 80 ℃ for 15 minutes. After cooled in refrigerator at 4 ℃, 10 mg samples from each tube and standard sample (untreated sample) taken to check the thermal stability by dot-immunobinding assay.MAIN OUTCOME MEASURES: ①SDS-PAGE of IgY. ②IgY stability at room temperature. ③IgY stability at different pH. ④ Detection of IgY thermal stability.RESULTS: ①Purified IgY after SDS-PAGE had two major binds, the molecular mass of the heavy chain was 66.000,and the light chain was 25 000. ②1, 0.1, 0.01 g/L IgY still had partial activity after staying at room temperature for four months. ③When pH ranged from 5 to 9, IgY still had partial activity after staying in 37 ℃ for 3 hours. If pH was lower than 5 or higher than 9, it lost the whole activity in above condition. ④Purified IgY was added to six EP tubes, the number 1-4 still had partial activity, but number 5 and 6 showed some white precipitate, which was caused by protein denaturation at higher temperature.CONCLUSION: IgY stability is higher than others. The dot-immunobinding assay described a rapid and simple method for the demonstration and characterization of functional activity of egg yolk antibody. With only small volume antigen and antibody, and specific dot, the dot-immunobinding assay method could process many samples at the same time.

目的:探讨骨科手术患者术中自体血回输的临床效果,以期能减少异体血的用量。方法:将骨科择期手术患者,术中随机分为自体血回输组,及异体血输血组,比较两组术后24h伤口引流量、血常规等情况。结果:两组患者手术顺利,自体血回输组术中均未用异体血,但少数患者术后发生低凝状态,输入异体血。结论:术中自体血回输能减少异体血输入量,但须适当补充新鲜血浆和凝血因子。

目的探讨利用自体血回收机在骨科手术患者术中回输自体血的临床疗效,以期能减少异体血的用量。方法骨科择期手术患者,术中使用自体血回收机回收洗涤红细胞适时回输,平均回收自体血800~1000ml。术中均未用异体血。结果患者手术顺利,但术后少数患者发生低凝状态,输入异体血。结论术中自体血回输能减少异体血输入量,但须适当补充新鲜血浆和凝血因子。

治疗性单采可有效去除体内多余的血液成分(如红细胞、白细胞、血小板等)或有害物质(如置换血浆去除其中的药物、外来毒素、自身抗体、免疫复合物及炎性介质等),以达到缓解症状、控制病情的目的.本文介绍用CS-3000Plus血细胞分离机去除血小板1例.

Objective To study the histomorphological change of CQD artificial tendon applied in repairing rabbit's tendon.Methods The posterior limbs on one side of the rabbit were selected,the tendons were freed and the intermediate bands were removed,and then CQD artificial tendons were applied to replace the defective parts and sutured on the normal tendons,the biological membrane wrapped up the artificial tendons and the skin was sutured.The other side posterior limbs were the control;the operation method was same except that the artificial tendons were not wrapped up by the biological membrane.Observation was made 2 weeks,1m,2m,3m,4m after operation.Results The activities were not limited,and no local infection occurred,the cut healed 10 days later;the histological and electron microscopic observation showed that the healing was ahead of that of the control.Conclusions CQD artificial tendon can replace the tendons in animal,which will provide the new material for artificial tendons in clinical application.

输血传播疾病一直为人们所重视,提高血液质量,杜绝经血液传播疾病的重要措施一是无偿献血,二是对血液进行初复检.为了解驻滇部队人群中血源性传染疾病的感染和分布特点,以及无偿献血者的健康状况,更好地开展军队无偿献血工作,确保血液质量;本中心对驻滇部队2008～2010年度11588名无偿献血者献血前五项血清病原学及酶学指标进行调查分析,现报告如下:

由于云南省的特殊地理位置,本中心采血人群处于吸毒和艾滋病病毒(HIV)感染的重灾区,尤其是一些边疆少数民族地区,军队献血者同样面临着艾滋病病毒的严重威胁和变成高危人群.因此,我们对所有无偿献血者艾滋病抗体(HIV-Ab)复检检测均采用进口试剂,并进行了严格的质量控制,现介绍如下.

1 军队血站质控体系现状 军队血站不仅要担负血液的采集、检验、成分分离、储存、供应任务和成分单采,还要担负为临床配血、发血、血液治疗和野战输血等卫勤保障任务.由于编制体制原因,多数军队医院血站没有单独设立质控科(室),也没有专职的质控员来监管质控工作,血液质量控制通常局限于血液检验方面;众所周知,严格的血液质量控制应做到对血液采集、加工、供应、临床输血、输血反应及血液治疗等实施全程质控.

本文对驻滇部队11588名无偿献血者五项血清检测指标进行检测和分析,结果表明,驻滇部队无偿献血者的血液质量明显高于国内普通无偿献血者,本中心高质量的血液为安全有效输血提供了良好的保证.

冷沉淀是用新鲜冰冻血浆(FFP)制备的成分血,主要用于治疗先天性缺乏Ⅷ因子(FⅧ)的血友病A;也可用于因大失血、肝功能障碍等凝血因子减少而导致的出血性疾病的辅助治疗.笔者就其近年来在外科手术方面的应用情况作一综述.

自体输血是减少血液浪费和保障输血安全的重要手段.本文总结了本院43例妇产科手术患者应用急性血液稀释法自体输血(AHD)的一些经验和体会.

输血是临床上最重要的辅助治疗手段之一,而自体输血(AT)是避免因血型不合引起溶血性输血反应、异体输血产生同种免疫反应和避免输血相关疾病传播的有效方式,尤其对一些稀有血型患者输血具有重要意义.笔者对36例骨科择期手术患者实施AT,取得良好的临床效果.

近年来,由于实验诊断技术的提高,与输血传播感染的危险性大大降低了,但献血员窗口期献血的风险仍然存在.为了将输血传播感染的风险降到最低,国内外的研究者进行了许多窗口期的研究,现综述最近几年的研究进展.