积雪草总苷对环磷酰胺致小鼠免疫功能低下的影响

目的 探讨积雪草总苷（TCA）对环磷酰胺（CTX）致小鼠免疫功能低下的影响。方法采用一次性腹腔注射CTX 100mg／kg制造小鼠免疫损伤模型，同时应用TCA24、12、6mg／kg 3个剂量灌胃10d进行预防性治疗，观察其对小鼠胸腺指数、脾脏指数、巨噬细胞吞噬百分率、血清溶血素水平等指标的影响。结果 TCA高剂量（24mg／kg）、中（12mg／kg）剂量对小鼠胸腺指数、吞噬百分率和血清溶血素水平有明显的增强作用，同时TCA高剂量对小鼠脾脏指数也有一定的保护作用。结论TCA对CTX致小鼠免疫功能低下有一定的预防作用。     

肾移植术后早期国产环孢素药动学的临床研究

目的:探讨肾移植受者术后早期服用国产环孢素的药动学变化特点。明确环孢素各时点血药浓度与时间曲线下面积(AUC)的相关关系。方法48例肾移植受者始服环孢素6mg/kg·d~(-1)1周后,按不同品种分环孢素组24例,赛斯平组14例及田可组10例,分别于服药即刻,服药后1、2、3、4、5、6、8、10、12h抽血查环孢素浓度(以C_0、C_1、C_2……C_(12)表示),比较不同品种药动学的变化特点。然后用逐步回归分析法计算环孢素的总体C_0、C_2、峰浓度C_(max),达峰时间(T_(max)),AUC以及各种指标的变异系数,并计算各浓度值与AUC的相关关系。结果三种国产环孢素在使用相同剂量时,C_0、C_2、C_(max)T_(max)及AUC差异均不显著,具有同质性。合并分析后,总体值C_0为(214.2±113.0)μg/L,总体C_(max)=C_2为(1048.0±378.7)μg/L,达峰时间(2.0±0.9)h,平均2h,AUC为(5106.4±1471.8)μg/(h·L)。抽血检测的10个时点浓度中,C_1、C_2、C_3、C_4、C_6、C_7与AUC的相关性有显著意义,其中C_2偏相关系数0.96最大,而变异系数(34.9％)相对较小。C_0不仅变异系数(52.8％)较大,且与AUC的相关性亦不显著。结论 国产环孢素总体峰浓度为C_2,与AUC具有较好的相关性,对AUC的变化影响大。可以将C_2作为临床一个常规的环孢素浓度监测指标。     

撬拨复位空心钉内固定治疗跟骨舌状骨折

目的探讨撬拨复位空心钉内固定治疗跟骨舌状骨折的临床意义。方法对31例39侧跟骨舌状骨折，行闭合撬拨复位空心钉内固定术。结果全部病例得到随访，平均随访22个月，根据Maryland评分系统进行术后功能评价。优18足，良16足，可3足，差2足，优良率87．2％。结论跟骨舌状骨折行撬拨复位空心钉内固定可以较好复位，固定可靠，早期开始功能锻炼，疗效满意。     

A Latex Finger Strip and Nylon Zip-Tie Combo as a Tunable Digital Tourniquet

BACKGROUND: Surgery on digit and nail requires a clear bloodless field that is often achieved by a tourniquet. OBJECTIVE: The objective is to present a simple, effective, and safe tourniquet for digital surgery. MATERIALS AND METHODS: A latex glove and a nylon zip-tie were used. A long strip is cut from the little finger tube of a latex glove. This is used for wrapping around the digit for exsanguination. The pressure is then maintained with a household nylon zip-tie. The finger strip is then cut to expose the operative field ready for surgery. The tourniquet pressure can be adjusted by tightening or loosening of the nylon zip-tie. RESULTS: Exsanguination and a bloodless field can be effectively achieved. The long tail of the nylon zip-tie reminds the operator to remove it at end of the surgery. CONCLUSION: A latex strip and nylon zip-tie combo serves as a simple, effective, and safe tourniquet for digital surgery.     

儿童髓母细胞瘤中C—Jun和C—Fos表达与预后的关系

目的探讨C-Jun和C—Fos在儿童髓母细胞瘤中的表达及临床意义。方法回顾性分析84例经手术病理证实并获随访的儿童髓母细胞瘤临床病理资料，男46例，女38例，年龄6～12岁，按术后生存期3、5、10年，分为A、B、C三组，每组病例数各为42例、27例和15例。采用免疫组化S-P法检测患儿肿瘤组织中C-Jun和C-Fos的表达。使用spe踟m相关分析和COX回归模型作统计学处理。结果84例儿童髓母细胞瘤中，C-Jun和C—Fos阳性表达各71例（84．52％）和65例（77．38％），A、B、C三组中Cqun和C—Fos阳性表达率各为100％和97．6％,40．74％和77．78％、13．33％和20％，三者两两比较，差异均有统计学意义（P〈O．01）；Spearman相关分析显示，C-Jun和C—Fos的表达与患者的生存时间呈显著负相关，且二者表达具有协同性。COX回归模型分析显示，C-Jun和C—Fos是患儿预后的不良因素。结论儿童髓母细胞瘤中存在C-Jun和C-Fos的阳性表达，并与患儿预后呈负相关。     

颈动脉支架植入术的术中护理干预

目的:探讨颈动脉支架植入术的术中护理干预的疗效及护理。方法:54例患者分为对照组和干预组。对照组(n=21),干预组(n=33),对照组给于常规护理,干预组在常规护理基础上给与认知、心理、行为干预。观察两组的疗效并进行比较。结果:干预组的静脉输液通畅,高压灌注线管理良好,恐惧,意识体征变化,尿潴留均较对照组有明显改善(P<0.01)。结论:在颈动脉支架植入术的术中实行护理干预有重要意义,值得推广应用。     

胸腰段骨折术后内固定断裂及松动的原因分析

目的探讨脊柱胸腰段骨折内固定术后,内固定物断裂及松动的原因与对策。方法1999年4月至2006年9月期间,采用内固定手术治疗287例胸腰段骨折患者,其中T10 12例,T11 24例,T12 40例,L1 125例,L2 48例,L3 26例,L4 12例。结果17例患者发内固定物断裂,其中12例椎弓根螺钉断裂,2例螺钉松动,2例固定棒断裂,1例连接杆断裂。结论针对患者的具体情况选用合适的内固定器材,术中充分植骨,尽早取出内固定材料以及术后常规进行外固定能有效的防止椎弓根内固定物的断裂。一旦发生内固定物的断裂应该根据具体情况进行处理,可获得较好的预后。     

Characterization of Latent Transforming Growth Factor-β From Human Seminal Plasma

PROBLEM : Human seminal plasma is known to exhibit immunosuppressive activity. Transforming growth factor β (TGF-β) has been identified as an immunosuppressive factor in human seminal plasma. Biologically active TGF-β represents a family of 25-kDa homodimeric proteins linked with disulfide bonds. TGF-β associates with high molecular weight proteins noncovalently to form a type of latency that is biologically inactive. Quantitative distribution of active form of TGF-β versus inactive latent form of TGF-β, and mechanism of the TGF-β activation in human seminal plasma remain to be elucidated. PURPOSE : To characterize seminal plasma latent form of TGF-β, including its concentration, and the mechanism underlying the activation of TGF-β. METHOD : Gel filtrations on ACA-34 and Biogel P-60 were used to fractionate seminal plasma. TGF-β was measured by enzyme immunoassay using antibodies specific for TGF-β₁ and TGF-β₂, respectively. Radioreceptor assay with recombinant human [¹²⁵I]-TGF-β₁ was applied to qualitatively identify TGF-β₁. Kinetic experiments with various pH, temperature and time, along with protease inhibitors, were performed to delineate the activation mechanism of latent TGF-β. RESULTS : Human seminal plasma contained both TGF-β₁ and TGF-β₂, predominantly in latent form. The total concentration of TGF-β₁ averaged 238 ng/ml versus an average of 18 ng/ml for TGF-β₂. The in vitro activation or release of TGF-β₁, from latent TGF-β₁ was achieved only at acidic pH of <4.0, and was time and temperature dependent. At pH 3.7 and 37°C, a significant activation of latent TGF-β₁ was achieved after an incubation of only 15 min, reached the maximum at 120 min, and the activated TGF-β₁ remained relatively stable for at least 24 h. The activation was not inhibitable by a series of protease inhibitors examined, alone or in combination (e.g., phenylmethylsulfonyl fluoride, E-64, pepstatin, leupeptin, ethylenediamine tetraacetic acid). Competitive radioreceptor assay established the functional identity of TGF-β₁ in human seminal plasma with recombinant human TGF-β₁. CONCLUSION : Human seminal plasma TGF-β is biologically activated from high molecular weight latent TGF-β by acid pH. The acidic environment of female lower genital tract could represent an in vivo physiological condition for activation of seminal plasma TGF-β that may immunologically protect the integrity of sperm.     

Reciprocity between tissue calmodulin and cAMP levels: modulation by excess zinc

Signal transduction of many intracellular events is initiated by a minute influx of calcium ions into the cells, resulting in the formation of calcium-calmodulin complex and cAMP. Because zinc appears to have an inhibitory effect on a number of tissue reactions, it is postulated that this occurs through modulation of intracellular calcium influx. To test the hypothesis that the inhibitory effects of zinc are mediated through the calcium calmodulin-cAMP pathway, zinc was administered by various routes to five groups of nude mice (control, intragastric, intraperitoneal. intradermal and oral groups), and calmodulin and cAMP concentrations were measured in the cytosol of epidermal cells. Calmodulin levels decreased significantly in the groups given intraperitoneal zinc (P>0.025) and intradermal zinc (P>0.001) injections. Significant elevations of cAMP levels were noted with intradermal zinc (P>0.025). Overall, the relationship between calmodulin and cAMP appeared to be inversely logarithmic, with the lowest calmodulin levels associated with the highest cAMP concentrations. In addition, there was a significant trend towards a smaller calmodulin/cAMP ratio in all zinc-treated groups, except the mice fed dietary zinc. These results appear to correlate with tissue zinc levels obtained with these various forms of zinc administration. Our results therefore indicate that there is a reciprocity between epidermal calmodulin and cAMP levels, which may be modulated by external factors such as zinc.     

肝移植术后早期黄疸的原因分析

目的 探讨肝移植术后早期黄疸的原因。方法 回顾性分析87例肝移植患者术后早期黄疸发生的原因及临床特征。结果 87例患者中，术后46例（52．87％）发生黄疸，共发生21种并发症，有17种（80．95％）并发症伴发黄疸，导致黄疸发生的常见原因依次为缺血．再灌注损伤（n=25，28．73％）、胆道并发症（n=23，26．44％）、急性排斥反应（n=19，21．84％）、药物性肝损害（n=4，4．60％）、移植肝病毒感染（n=4，4．60％）、腹腔内或全身严重感染等（n=3，3．45％），有2例（2．30％）原因不明；46例中，部分病例同时存在多个原因。不同原因所致的黄疸，在发生时间、胆红素水平的变化等方面均呈现相应的特征。结论 黄疸是肝移植术后早期较常见的临床表现，导致黄疽的原因复杂，甄别其主要原因，对指导治疗至关重要。