目的比较动力髋螺钉(DHS)固定、近端锁定板(PLP)固定、近端解剖板(PAP)固定及人工关节置换(AJR)等4种手术方式治疗股骨转子间骨折的安全性和疗效。方法对318例在本院手术治疗的股骨转子间骨折患者的临床资料进行回顾性分析,按照手术方式分为DHS组、PLP组、PAP组及AJR组,比较各组的平均手术时间、术中出血量、术中输血量、手术相关并发症发生情况、愈合时间及Harris髋关节功能评分。结果 PLP组手术时间最短,与其他3组比较差异有统计学意义(P0.05);DHS组术中出血量及术中输血量最多,与其他3组比较差异有统计学意义(P0.01);PLP组骨折愈合时间最短,与其他3组比较差异有统计学意义(P0.01);PLP组Harris髋关节功能评分最高,但各组间比较差异无统计学意义(P0.05);DHS组、PLP组、PAP组、AJR组手术相关并发症发生率分别为7.14%、3.09%、8.33%、9.80%,各组间比较,差异无统计学意义(均P0.05)。结论 DHS、PLP、PAP、AJR等4种手术方式各具不同的优缺点,但PLP在手术安全性和疗效方面较其他3种手术方式更具有一定优势。

Objective To compare the operation safety and effect of four different surgical procedures including dynam-ic hip screw (DHS) fixation,proximal lock plate (PLP) fixation,proximal anatomical plate (PAP) fixation and artificial joint replacement (AJR) in the treatment of intertrochanteric fracture. Methods Clinical data from 318 patients with in-tertrochanteric fracture accepted surgical treatment in our hospital were retrospectively analyzed.According to different surgical procedures,they were divided into four groups: DHS group,PLP group,PAP group,and AJR group.The average operation time,intraoperative amount of bleeding,intraoperative blood transfusion,complications related to surgery,healing time,and Harris hip joint function scoring were compared among these four groups. Results The operation time in PLP group was shortest with statistical differences in comparison with the other three groups separately (P 0.05).The incidences of complica-tions related to surgery in DHS group,PLP gr

应用第3代携带 CMV 启动子-EGFP 报告基因表达元件的重组慢病毒，脂质体法转染293T 细胞，调整转染条件进行了平行比较从而获得最优条件组合，得到的包装病毒感染鸡、鸭胚成纤维细胞并计算表达效率。结果表明4种质粒（pLP1、pLP2、p-VSVG、pll3．7）以6．5∶2．5∶3．5∶7．5比例组成混合液转染效率最高，而此条件下提高脂质体-DNA 转染复合物浓度达到1∶2时包装病毒滴度达到峰值。用包装病毒感染鸡胚和鸭胚成纤维细胞的效率分别为12％和8％。试验结果证实重组慢病毒可以成功转染家禽细胞，对于进一步探索慢病毒对家禽干细胞的转染和转基因家禽的获得提供了试验依据。

The third generation lentiviral system constructed with CMV promoter-EGFP reporter gene expression element were packaged in 293T cells by various combinations of plasmids and liposome to get the optimum level, and by the final transfection efficiency of the recombinant lentivirus was detected by infection efficiency of chicken and duck embryonic fibroblast cells.Results showed that optimal combination of the four plasmids (pLP1,pLP2, p-VSVG,pll3.7)were at a ratio of 6.5∶2.5∶3.5∶7.5 mixture and the liposome-DNA concentrations was 1∶2.Packaging lentivirus can transfect CEF and DEF cells and get 12% and 8% efficiency respectively.The results showed that the recombinant lentiviral vector can transfect poultry cells.It provides the experimental basis for fur-ther exploration of poultry stem cells and transgenic poultry.

目的 分析并确定佩梅样病(Pelizaeus-Merzbacher-like disease,PMLD)3个家系的临床及分子遗传学特点,为PMLD患者家庭提供准确的遗传咨询及产前检查打基础.方法 2010年5月至2013年3月北京大学第一医院儿科收集3个家系4例(P1-4) PMLD男性患儿及其家系成员临床资料,其中P1与P2为表型相似的同胞兄弟,进行临床特点分析:包括病史、体征、辅助检查特点;应用聚合酶链反应和DNA直接测序方法进行缝隙连接蛋白gamma-2基因(GJC2)与蛋白脂蛋白1基因(PLP1)突变检测,采用多重连接依赖的探针扩增技术(MLPA)检测PLP1重复突变,明确基因突变类型,进行分子遗传学特点分析.结果 1.临床特点:4例患儿均具有共济失调以及头颅磁共振成像(MRI)脑白质髓鞘化不良特点,P1-3主要于婴儿期发病,以眼球震颤为首发症状,均表现为精神运动发育落后、肌张力低下.P4于8岁7个月以手抖、听力下降发病,根据临床特征及头颅MRI表现P1-4均符合临床诊断PMLD.2.遗传学特点点:4例PMLD患儿共发现GJC2 5种核苷酸改变:c.579delC(p.Gly193fsX17)、c.1296_1297insG(p.Gly433fsX59)、c.735C＞A(p.Cvs245X)、c.689delG(p.Gly230AlafsX241)与c.1199C＞ A(p.Ala400Glu),均为国际上未报道的新突变. P1-3均为复合杂合突变致病,分别遗传自表型正常的父母;P4发现GJC2 c.1199C ＞A(p.Ala400Glu)纯合突变,表型正常P4之父为本位点的杂合改变,母亲在本位点为野生型.结论 本研究3个家系4例PMLD患儿临床表现均符合PMLD的特点,PMLD临床诊断成立.GJC2分析发现了5种突变均为国际上尚未报道的新突变,扩展了GJC2的突变谱.明确了PMLD 3个家系临床与分子遗传学特征,为准确的遗传咨询和进一步的产前诊断打下了基础.

Objective To analyze the clinical and molecular genetic features in 3 pedigrees with PelizaeusMerzbacher-like disease (PMLD),thus providing a better genetic counseling and correct prenatal diagnosis for those families with PMLD.Methods Clinical data of 4 male pediatric patients (P1-4) and their family members in 3 pedigrees with PMLD were collected from May,2010 to Mar.2013 in Department of Pediatrics,Peking University First Hospital,including medical history,physical signs,and auxiliary examinations.For 4 pediatric patients,P1 and P2 were siblings with similar clinical manifestations.Polymerase chain reaction and sequence analysis of DNA were performed to determine the gene mutation of gap junction protein gamma-2 (GJC2) and proteolipid protein 1(PLP1),and multiplex ligation-dependent probe amplification was utilized to detect PLP1 duplication.With these detection methods,the gene mutations were confirmed,and then genetic features were analyzed.Results 1.Clinical features:Four patient

目的 研究探讨针刺复合神经阻滞治疗上肢截肢术后幻肢痛(phantom limb pain,PLP)的疗效. 方法 80例上肢PLP患者采用随机数字表法分为4组(每组20例):基本治疗组(A组)、针刺+基本治疗组(B组)、神经阻滞+基本治疗组(C组)、神经阻滞+针刺+基本治疗组(D组).治疗前后分别采用视觉模拟评分法(visual analogue scales,VAS)、简明健康状况调查表(the MOS item short from health survy,SF-36)和综合疗效评估,并分别进行治疗前后和组间比较. 结果 4组患者治疗前后VAS评分及SF-36评分差异均有统计学意义(P＜0.05),治疗后VAS评分降低,SF-36评分明显升高;与A组(52±6)比较,B组(42±8)、C组(42±8)、D组(32±6)治疗后VAS评分明显降低,差异有统计学意义(P＜0.05);与A组[(精神评分(58±9),身体评分(36±5)]比较,B组[(精神评分(67±9),身体评分(43±4)]、C组[(精神评分(66±6),身体评分(43±5)]、D组[(精神评分(77±10),身体评分(50±6)]治疗后SF-36评分明显升高,差异有统计学意义(P＜0.05);与B组、C组比较,D组治疗后VAS评分明显降低,SF-36评分明显升高,差异有统计学意义(P＜0.05);4组患者综合疗效比较:治疗5周后,与A组(70％)比较,B组(85％)、C组(85％)、D组(100％)的综合疗效差异有统

Objective To investigate the effect of combination therapy of nerve block and acupuncture to phantom limb pain of upper extremity after amputation.Methods Eighty patients with phantom limb pain of upper limb were randomly divided into four groups (n=20):20 patients received basic treatment (A group),which included Medications and Psychotherapy,20 patients recieved acupuncture and basic treatment (B group),20 patients recieved nerve block and basic treatment (C group),20 patients recieved nerve block,acupuncture and basic treatment (D group).Scores of VAS,SR-36 and comprehensive comparison of efficacy were used to assess before and after treatment among the four groups.Results visual analogue scales (VAS) scores and SF-36 scores of four groups of patients were significant differences after treatment compared with before treatment (P＜0.05).VAS scores decreased after treatment,while SF-36 scores were significantly increased.When compared with A group (52±6),VAS scores of B gro

为了解决数控机床最小维修的可靠性评估问题,提出了基于幂律过程的可靠性评估方法,建立了基于幂律过程的故障数据模型。对故障数据进行趋势检验和更新过程检验,验证了幂律过程应用的前提条件成立。提出CBT与CLT的分步检验方法对评估涉及的多台机床的同质性进行了验证。用极大似然估计法和Fisher信息矩阵法给出了模型参数的点估计与区间估计,并给出了机床可靠性指标的点估计和基于Delta法的区间估计。应用Cramér-von Mises法对模型进行拟合优度检验。实例分析表明:幂律过程能够反映出数控机床的瞬时与累积可靠性特性,提出的CBTCLT分步检验方法能够有效地对多台机床同质性做出判断,得到的结果更符合实际。

An approach of assessing reliability for multiple NC machine tools with minimal repair based on power law process (PLP)was proposed,and a PLP function for failure times was built. Trend test and renewal test were performed on the failure data to assure the application of power law process was valid. CBT (common beta test)and CLT (common lambda test)two-step-test was de-veloped to check the homogeneity of multiple machines in assessing. Point and confidence interval estimators were given by maximum likelihood method and Fish information matrix. Point estimates of reliability indexes were also derived with their confidence bounds of-fered through Delta method. The Cramér-von Mises method was finally adopted to do the goodness-fit-test. Real example analysis dem-onstrates that PLP can give both instantaneous and cumulative reliability properties for NC machine tools,CBT&CLT test is capable to verify the homogeneity of multiple machines adequately,hence the results are more practical.