房间隔入路的解剖学研究及临床应用

对３３具尸体的房间隔的大小、构成及周围重要组织结构进行观察和测量。提出房间隔切开时的正确方向、安全长度及可能发生的危险。结合４６６例临床应用，讨论了避免切口合并症发生及发生后的正确处理方法。     

足组织缺损的显微修复

１９８４年～１９９４年共收治各种足部组织创伤缺损２３６例，均采用显微外科技术进行组织移植修复，其中单纯皮瓣移植修复１８７例，复合皮瓣移植修复４９例。吻合血管游离移植修复９７例，带血管蒂移位修复１３９例。４例前足缺损者用带肩胛骨的复合皮瓣移植修复，６例足跟严重缺损者用带血管的腓骨复合皮瓣移植修复。经１～１０年随访，皮瓣、复合皮瓣、移植或再植的骨骨各全部成活，愈合良好，足功能基本得到恢复，可行走、负重，１８６例恢复了原工作。认为，恢复足部结构完整与重建足跟、足底的感觉是获得良好功能的关键     

成人原发性肾病综合征血容量与肾素,醛固酮,心钠素的关系

探讨成人原发性肾病综合征(NS)血容量与肾素、醛固酮及心钠素的关系。方法 应用~(113)mInCl标记转铁蛋白稀释法测定血容量,放免法测定血浆激素水平。对水肿期NS28例、正常26例及其中NS缓解期随访18例进行检测。结果 (1)水肿期NS血容量与正常组无差别,血浆肾素活性(PRA)、血管紧张素Ⅱ(ATⅡ)、醛固酮(Ald)、心钠素(ANP)水平均较正常组高,白蛋白、各激素水平与血容量无显著相关;(2)缓解期与水肿期比较,总的血容量无差异,Ald、ANP显著降低,PRA、ATⅡ则无明显差异;(3)Ald与24小时尿排钠(UNaV)显著负相关。结论 Ald和ANP是NS钠排泄的主要调节因子。     

腰椎峡部裂的CT诊断

目的：回顾性分析腰椎峡部裂的ＣＴ表现并讨论其诊断与鉴别诊断，材料与方法，２３例患先行腰椎侧位扫描定位图像，采用与椎间盘平行的角度，自病变脊椎的上一椎体下缘边续发描至于下椎体上缘，层厚４或５ｍｍ必要时在峡部行２ｍｍ，层厚扫描，结果；２３例中，累及双侧２１例，单侧２例，发生在Ｌ５１６例，Ｌ４７例，ＣＴ表现为同一脊椎关节突间的低密度裂隙，出瑞椎弓根下缘平面，走行不规则，裂隙可宽可窄，表面不光滑。     

Effect of exercise on plasma atrial natriuretic factor and cardiac function in men and women

In order to provide an integrated view of the physiology of atrial natriuretic factor (ANF) during exercise, we studied changes of its plasma concentrations in 13 normal subjects (seven males, six females) during three graded exercise levels and two periods of recovery (5 and 30 min), concomitantly with an assessment of cardiac function and ventricular volumes by multigated radionuclide angiography. Mean ANF levels (+/- SEM) increased in all patients at the second (P less than 0.002) and third (P less than 0.002) exercise levels, and after 5-min recovery (P less than 0.01): in males from 16 +/- 7 to 30 +/- 11 pg ml-1 at the third level, in females from 27 +/- 12 to 61 +/- 33 pg ml-1. Normal values were observed after 30-min recovery. Even if mean ANF levels were all higher in females, this difference did not reach statistical significance (P = 0.06). Significant decreases of ventricular volumes, as well as increases of ejection fraction and rate pressure product, were noted during exercise and were similar in both sexes. The kinetics of plasma ANF concentrations, compared with the increase of rate pressure product, was characterized by a latency and a remanence in recovery. This remanence, also present in the changes of ventricular volumes, supports the hypothesis that other factor(s) like catecholamines might still exert their influence after the exercise stops.     

Cytoprotective actions of 2,4-dimethoxybenzylidene anabaseine in differentiated PC12 cells and septal cholinergic neurons

The potential cytoprotective actions of a novel nicotinic agent 2,4-dimethoxybenzilidene anabaseine (DMXB) were investigated in differentiated PC12 cells and transected rat septal cholinergic neurons in vivo. In NGF-differentiated PC12 cells, removal of both NGF and serum led to cell loss, a reduced % of cells expressing neurites, the release of lactate dehydrogenase, and a decrease in total cellular protein. Cell loss was apparent within 24 h, and remained constant between 4–8 days post-NGF removal. NGF alone (100 ng/ml), DMXB (10 μM), but not nicotine (10 μM), prevented these cell and neurite losses. DMXB-induced cytoprotection was blocked by 1 μM mecamylamine. DMXB (1 mg/kg, ip) injected twice but not once per day protected cholinesterase-staining septal neurons from retrograde degeneration following unilateral fimbrial transections. The twice per day DMXB injection-protocol also decreased cell roundness among cholinesterase-staining cells in the lesioned septal hemisphere compared to saline-injected animals. These studies suggest that DMXB may exert cytoprotective activity in NGF-sensitive neuronal populations. © 1994 Wiley-Liss, Inc.     

先天性输精管缺如患者生育问题的研究

自1988年至1991年共收治25例先天性输精管缺如患者,在20例行手术诊治术中15例用自体睾丸精索鞘膜制成人工精池囊,5例又在囊内放置用微涤纶制成的异质管。术中抽吸10例附睾内精子进行快速活化,其中5例活化成功,行人工授精,结果2例怀孕,1例已生育一女孩。认为该症是有生育可能的,但需要解决3个问题:(1)采用显微外科技术把附睾内部活着的精子取出一定数量;(2)选配好快速活化剂使精子快速活化成功;(3)用患者的精浆培养自己的精子。建议对梗阻性无精子症在用手术疏通精路的同时可以采用快速活化精子技术行人工授精,以提高生育的效果。     

胚胎颅骨骨膜移植修复髋关节软骨大面积缺损

１９９０年５月～１９９４年４月，对４２例（４７个髋）关节软骨全厚缺损患者采用冷冻保存胚胎颅骨骨膜移植进行修复，其中１４例股骨头骨质Ⅳ期坏死者，同时施行带旋髂深血管蒂髂骨植骨。对３４例（３８个髋）进行了２年～６年（平均４０个月）随访。结果表明，按照吴之康髋关节人工置换术后疗效评定标准，优良２５例，很好５例，好３例，尚可１例。认为，与自体移植物修复关节软骨大面积缺损相比，这种方法无附加损伤，具有移植材料、形态与股骨头相似等特点，是治疗髋关节软骨大面积缺损的一种有效方法。     

抗感染重组合异种骨对犬污染性桡骨缺损的一期植骨修复作用

目的探讨抗感染重组合异种骨(anti-infective reconstituted bone xenograft,ARBX)对犬污染性桡骨缺损的一期植骨修复的效果. 方法在重组合异种骨(reconstituted bone xenograft,RBX)基础上,结合抗生素局部缓释技术,制备具有较强抗感染能力和较高成骨作用的ARBX.取成年杂种犬8只,于双侧桡骨中上段制成15 mm节段性骨缺损,在缺损处注入5×106 CFU/ml金黄色葡萄球菌1 ml,静置15分钟后,于双侧缺损区分别植入ARBX、RBX,并用钢板固定.术后6个月对存活的6只犬进行取材,通过解剖学、X线片、组织学及细菌学检查,比较ARBX和RBX一期植骨修复犬污染性桡骨缺损的效果. 结果术后6个月,ARBX侧有5只完全修复,1只中央部3 mm缺损未修复,均无骨髓炎表现,标本细菌培养均为阴性.RBX侧有1只部分修复,5只未能修复,残留8～13 mm缺损,均有明显骨髓炎表现,标本细菌培养均为阳性. 结论 ARBX具有较高成骨活性和较强的抗菌能力,能够一期植骨修复细菌污染性骨缺损.