氯胺酮脑保护作用的可能机制

众多研究显示，氯胺酮对脑缺血缺氧性损伤具有保护作用。主要通过调节神经细胞凋亡；与NMDA受体结合，抑制兴奋性氨基酸毒性及钙离子内流；抑制炎性因子生成和蛋白激酶表达等几个方面发挥脑保护作用。     

朱砂对大鼠的肝肾毒性研究

目的:研究朱砂的肝、肾毒性特点,提出朱砂安全用药剂量和用药时间建议,为朱砂的临床安全用药提供科学依据.方法:小鼠单次灌胃给药,测定最大耐受量.采用SD大鼠随机分为对照组和朱砂0.025,0.05,0.1,0.4,0.8 g·kg-1·d~(-1)(相当于《中国药典》剂量高限的1/2,1,2,8,16倍)剂量组.各剂量组均每日灌胃给药1次,连续3个月,于给药后1,2,3个月和停药1个月,测定尿液定性、血常规以及血清生化指标,并观察肝、肾、心、脑等主要脏器的组织形态学变化,确定无明显不良作用水平(NOAEL).结果:朱砂在HgS为98%、可溶性汞为21.5μg·g~(-1)情况下,给小鼠单次灌胃给药最大耐受量达到24g·kg~(-1)(等于摄入可溶性汞516μg·kg~(-1)),相当于人日用量约3 000倍,未见明显毒性反应.朱砂超过一定剂量用药达到1个月以上,肾脏和肝脏均可见与朱砂毒性有关的病理改变,其中,肾脏对朱砂更为敏感.大鼠灌胃朱砂1个月和3个月的无明显毒性剂量分别为0.1,0.05 g·kg~(-1)·d~(-1)(累积摄入可溶性汞64.5,96μg·kg~(-1)).按照安全系数为60计算出人服用朱砂的日允许摄入量(acceptable daily intake,ADI)约为0.000 9～0.001 7 g·kg~(-1)·d~(-1),相当于60 kg人日用剂量为0.05～0.1 g.结论:反复使用朱砂时,建议在可溶性汞含量≤21 μg·g~(-1)的条件下,朱砂的用药剂量不宜超过0.05～0.1 g,用药时间不宜超过2周.     

Enhancement of Viability of Fat Grafts in Nude Mice by Endothelial Progenitor Cells

BACKGROUND: A recent discovery showed that endothelial progenitor cells (EPCs) could augment collateral vessel growth to ischemic tissues. OBJECTIVE: The objective was to demonstrate the effects of EPCs on the vasculogenesis and survival of free transplanted fat tissues in nude mice. METHODS: EPCs from human donors were cultured in vitro for 7 days. Human fat tissues were injected subcutaneously into the scalps of 20 6-week-old nude male mice. EPCs stained with CM-DiI were mixed with the transplanted fat tissues and injected into the mice. EBM-2 medium was used as control group. The animals were euthanized 15 weeks after the procedure. Graft volume were measured, and histologic evaluation was performed. The central part of fat tissues was histologically evaluated 15 weeks after the fat injection. RESULTS: The survival volume of the experimental group was significantly greater than that of the control group (p< .05). Less cyst formation and fibrosis was obtained in the experimental group. Histologic evaluation of the central part of fat tissues 15 weeks after the fat injection showed that capillary densities increased markedly in the experimental group mice. CONCLUSION: The results indicate that EPCs have the ability to enhance the survival and the quality of the transplanted fat tissues.     

Emergency endovascular repair of iliac artery rupture caused by post-stenting angioplasty with an endograft

I liac artery rupture is a rare complication of post-stenting angioplasty and can lead to massive life-threatening haemorrhage. Conventional surgery can not repair the damaged vessel easily and may cause substantial blood loss and high operative morbidity and mortality. We report our experience with a self-expanding covered endoprosthesis for endovascular repair of the rupture of an iliac artery caused by stenting angioplasty.     

输尿管镜气压弹道碎石治疗输尿管结石（附32例报告）

目的 总结输尿管镜气压弹道碎石治疗输尿管结石的临床效果。方法 回顾分析32例应用输尿管镜气压弹道碎石治疗输尿管结石患者资料。男10例，女22例；平均年龄29岁。结石位于输尿管下段24例，中段6例。上段2例。其中行原位体外冲击波碎石（ESWL）治疗后结石未能排出者8例。结果 碎石成功率90．6％（29／32）。2例因输尿管异常置镜失败，转开放性手术；1例输尿管穿孔后留置双J管，择期行ESWL治疗成功。B超显示肾积水较术前减轻或消失，KUB、IVP未发现输尿管狭窄。结论 输尿管镜气压弹道碎石治疗输尿管结石创伤小、成功率高、并发症少。     

下颌第一磨牙三维有限元模型的建立

目的：建立下颌第一磨牙三维有限元模型。方法：通过螺旋CT扫描的方法，利用Mimics、Geomagic Studio 7等图像处理软件，HyperMesh网格自动划分软件，通过特定的MSC．MARC有限元软件建立下颌第一磨牙三维有限元模型。结果：准确的建立了牙本质、牙釉质、髓腔、牙槽骨、牙周膜等组织形态的三维有限元模型。结论：本实验建模方法可行性强，方便快捷，具有良好的生物力学与几何力学相似性。为临床口腔医师提供了一种简捷而精确的有限元建模方法。     

噻吗洛尔与普萘洛尔治疗高血压病与心绞痛的疗效比较

劳累性心绞痛38例采用噻吗洛尔2.5-5mg, tid,共4wk;另12例采用普萘洛尔10-20mg, tid,共4wk。结果:前者显效率为79％,显著高于后者42％(P<0.05)。高血压病(Ⅰ,Ⅱ期)37例采用噻吗洛尔治疗,方法同上;另13例采用普萘洛尔20-40mg, tid,疗程亦4wk。结果:2组均有显著降压疗效(P<0.01),噻吗洛尔治疗后1h即获显效,普萘洛尔须24h才获显效。噻吗洛尔7％(5/75)、普萘洛尔4％(1/25)治疗后发生窦性心动过缓,前者被迫停药,后者未停药。     

颅内动脉瘤血管内栓塞治疗及并发症分析

目的 探讨血管内栓塞治疗破裂后颅内动脉瘤及并发症发生机制及防治对策.方法 对76例破裂后颅内动脉瘤采用早期血管内栓塞治疗,回顾性分析发生的并发症原因及防治方法.结果 76例动脉瘤患者发生并发症8例,占10.5%.其中动脉痉挛3例,弹簧圈提前解脱1例,弹簧圈脱落1例,术中动脉瘤破裂1例,术后1周动脉瘤再次破裂死亡1例,大脑中动脉血栓形成1例.结论 正确理解并发症发生机制和熟练掌握操作技术是控制颅内动脉瘤血管内栓塞治疗并发症的关键.恰当的处理可避免严重后果.     

拉米夫定治疗慢性乙肝的疗效及乙肝病毒YMDD变异的研究

目的评价拉米夫定治疗慢性乙肝病人的1年疗效、乙肝病毒YMDD变异率、变异与治疗前HBV-DNA、ALT水平的联系。方法治疗组按入选标准随机选择32例慢性乙型肝炎患者给予拉米夫定100 mg/d并随访1年,并于治疗开始后3、6、9、12个月检测肝功能、HBV-M、HBV-DNA、YMDD变异。对照组随机选择36例从未接受抗病毒治疗的HBV-DNA阳性、ALT异常的慢性乙型肝炎患者,检测YMDD变异株。结果①拉米夫定治疗一年,HBV-DNA转阴率71.88%(23/32),HBeAg/HBeAb血清转换率18.52%(5/27),ALT复常率62.5%(20/32);治疗前及治疗12个月后ALT水平分别为132.59±66.07、49.78±27.94,治疗前后差别有统计学意义(P<0.001)。②治疗组在治疗前未发现YMDD变异,治疗6个月发现2例YMDD变异,变异率6.25%,治疗12个月发现5例YMDD变异,变异率15.63%;对照组36例从未接受抗病毒治疗的慢性乙型肝炎病人中检测出2例YVDD变异株与野生株共存。③治疗前ALT<3×ULN组及≥3×ULN组YMDD变异率分别为11.76%、20.00%,两组差别无统计学意义(P=0.645);治疗前HBV-DNA<106copies/mL组及≥106copies/mL组YMDD变异率分别为5.88%、26.67%,两组差别无统计学意义(P=0.161)。结论拉米夫定能迅速抑制乙肝病毒复制、改善肝功能;治疗前HBV-DNA水平及ALT水平不足以预见YMDD变异的发生;乙肝病毒YMDD变异株存在于未使用拉米夫定的慢性乙肝患者中,建议在抗病毒治疗前对YMDD变异进行常规检测。