先天性麻痹性斜视眼肌的形态学改变及临床意义

目的研究先天性麻痹性斜视眼肌的形态学改变。方法将先天性麻痹性斜视12例18眼按年龄不同分为三组，将术中切下的眼外肌制成光镜和电镜标本进行比较。结果三组先天性麻痹性斜视的眼外肌均有病理性改变。年龄越大、病程越长，其病理改变越明显。结论先天性麻痹性斜视应早期手术治疗，以免眼外肌病理改变加重，影响双眼视功能恢复。     

Characterization of ureteral dysfunction in an experimental model of congenital bladder outlet obstruction

PURPOSE: Ureteral dysfunction is a significant sequela of congenital bladder outlet obstruction. However, the structural and functional alterations associated with ureteral dysfunction are not well defined. A model of fetal bladder obstruction in sheep was used to characterize the changes in ureteral smooth muscle, extracellular matrix (ECM) and functional properties in response to bladder outlet obstruction. MATERIALS AND METHODS: Partial bladder outlet obstruction was created in fetal sheep at gestational age 95 days via placement of a metal ring around the proximal urethra as well as ligation of the urachus. Ureters were harvested at 109 and 135 days (full term = 140 days) to determine the relative composition of smooth muscle, ECM and urothelium by morphometric analysis and to measure DNA and protein concentrations. Ureteral tissue from 135 day gestation obstructed and control sheep was harvested and immediately placed in Krebs solution. Smooth muscle strips (2-3 mm. x 7-8 mm.) were suspended in organ baths. The frequency and amplitude of spontaneous ureteral contractions was as well as the response to electric field stimulation (EFS) were determined. RESULTS: Bladder outlet obstruction caused a significant increase in ureteral weight, smooth muscle mass and total ECM at both 109 and 135 days gestation. Total ureteral DNA was greater in obstructed compared with sham ureters at 135 days gestation. Obstructed ureters demonstrated greater amplitude and frequency of spontaneous contractions as well as more pronounced response to EFS when compared to sham ureters. CONCLUSIONS: The fetal ureter responds to bladder obstruction with smooth muscle hyperplasia and hypertrophy which is associated with increased spontaneous activity and augmented response to EFS. ECM content is markedly increased indicating a shift in the balance of connective tissue synthesis and degradation. Congenital post-obstructive ureteral dysfunction therefore appears to be the result of dysregulated smooth muscle cell growth and altered ECM homeostasis producing abnormal ureteral contractility.     

硝苯地平对大鼠肺动脉平滑肌细胞增殖的影响

目的研究钙拮抗剂硝苯地平对肺动脉平滑肌细胞增殖的影响 ;探讨钙离子拮抗剂对肺血管构型重建的抑制作用。方法分离培养大鼠肺动脉平滑肌细胞 ;用MTT法检测细胞增殖 ;用流式细胞仪分析细胞周期。结果硝苯地平能剂量依赖地抑制血清诱导的肺动脉平滑肌细胞增殖 ,对照组的增殖指数和S期细胞分数为 36 0 2 %和 15 88% ;硝苯地平 1× 10 -8mol·L-1、1× 10 -7mol·L-1、1× 10 -6mol·L-1组的PI和SPF分别为 31 16 %、2 6 94 %、2 4 95 %和 13 10 %、11 4 7%、9 6 0 %。结论肺动脉平滑肌细胞增殖中有钙离子信号的参与 ;硝苯地平能够抑制血清诱导的肺动脉平滑肌细胞增殖 ;硝苯地平对肺血管构型重建可能有一定的抑制作用     

Inhibition of pressure induced bladder smooth muscle cell hyperplasia using CRM197

PURPOSE: In vivo the effects of sustained hydrostatic pressure on the bladder wall and its components are evident under physiological and pathological conditions. We previously reported that exposure of bladder smooth muscle cells to 20 and 40 cm. H2O hydrostatic pressure for as little as 1 hour resulted in the up-regulation of heparin binding epidermal growth factor messenger RNA in a time dependent fashion as well as in activation of the heparin binding epidermal growth factor growth factor gene. In our current study we investigated the use of CRM197 as an agent for blocking undesirable cellular level events, such as smooth muscle cell hyperplasia, eliminating the irreversible alterations in bladder and kidney function that result from chronic and/or severe bladder outlet obstruction. MATERIALS AND METHODS: Control and experimental neonatal ovine smooth muscle cells were exposed to 0.3 pressure and 8.5 cm. H2O, respectively, for 7 days. We evaluated the mitogenic activity of the supernatant medium from bladder smooth muscle cells exposed to 8.5 cm. H2O for 5 days (conditioned medium) before and after the addition of 0.1 mg./ml. CRM197. Bladder smooth muscle cell apoptosis was also assessed after CRM197 exposure. Statistical analysis was performed using the Student t test with p <0.05 considered significant. RESULTS: Exposing bladder smooth muscle cells to sustained 8.5 cm. H2O hydrostatic pressure for 7 days resulted in increased cell proliferation. Conditioned medium contained mitogenic activity, which was ablated after CRM197 was added. No direct toxic effect of CRM197 on bladder smooth muscle cell growth was appreciated (no apoptosis). CONCLUSIONS: We demonstrated a proliferative response of neonatal bladder smooth muscle cells after exposure to sustained hydrostatic pressure. This response was partially due to the release of heparin binding epidermal growth factor and was blocked by adding CRM197. These data support the potential use of CRM197 in drug targeted therapy for diseases involving bladder outlet obstruction.     

SB_(224289)对5-HT诱导的肺动脉平滑肌细胞增殖的影响

目的研究 5 HT1B受体拮抗剂SB2 2 42 89对 5 HT诱导的肺动脉平滑肌细胞增殖的影响 ,探讨肺血管构型重建的 5 HT1B受体机制。方法分离培养大鼠肺动脉平滑肌细胞 ,用MTT法和3 H TdR掺入法检测细胞增殖和DNA合成。结果SB2 2 42 89能剂量依赖地抑制 5 HT诱导的肺动脉平滑肌细胞增殖。SB2 2 42 89能剂量依赖地抑制 5 HT诱导的肺动脉平滑肌细胞的DNA合成 ,SB2 2 42 89能阻断 5 HT对肺动脉平滑肌细胞的促有丝分裂作用。结论SB2 2 42 89能抑制 5 HT引起的肺动脉平滑肌细胞的增殖。5 HT1B受体在 5 HT诱导的肺动脉平滑肌细胞增殖中有重要作用。     

超声影像检查臀肌筋膜挛缩症的临床意义

目的　探讨臀肌筋膜挛缩症的超声诊断价值。方法　用超声影像对 2 0 0 0年 1月至 2 0 0 3年 4月重庆医科大学儿童医院收治的 5 0例 (97侧 )臀肌筋膜挛缩症患儿的臀部肌肉进行检查 ,总结其声像图特征 ,测量挛缩带的宽度与厚度 ,并与手术发现进行对比。结果　超声检查轻型臀肌筋膜挛缩症病例大部分臀肌纤维显示清楚 ,肌纤维中可见异常强回声条结构 ,筋膜增厚 ,回声增强 ,挛缩带宽度小于 3cm ,厚度小于 1cm。重型病例臀肌肌纤维结构紊乱甚至消失 ,表现为肌层内强回声团块或斑块样结构 ,挛缩带宽度大于 3cm ,厚度大于 1cm。轻型与重型挛缩带厚度及宽度超声测值与手术测值比较差异显著 (P均 <0 0 1)。结论　超声检查在术前诊断中的作用是肯定的 ,挛缩带超声测值较手术测值偏小。     

Surgical resection of locally recurrent cervical cancer: a single institutional 70 patient series

Pelvic recurrence of cervical cancer is a life-threatening situation and only local control can provide hope for remission. The aim of this study was to evaluate the role of surgery in the treatment of cervical cancer recurrence. This retrospective study analyzed a series of 70 patients who underwent resection of cervix locoregional recurrence. Thirteen patients had palliative salvage surgery for pelvic complications. Twenty-nine resections were considered as curative. Fifty recurrences required pelvic exenterations. The hospital mortality rate was 9% and the morbidity rate was 44%. Overall 5-year actuarial survival rate was 23%. Survival was significantly higher: (a) after curative resection and (b) after centropelvic recurrence resection. Local control was obtained in 48% of the cases and 13 patients are alive with a median follow-up of 75 months. In conclusion, the results of this small and heterogen series seem to justify an attempt to resection for centropelvic recurrences whenever possible. Palliative surgery should be reserved to salvage therapy and highly selected patients.     

盆腔舒胶囊抗炎镇痛作用及对子宫收缩影响

目的： 通过盆腔舒胶囊对慢性炎症的抗炎及镇痛作用研究，探讨其治疗慢性盆腔炎的作用机制。方法：抗炎作用采用二甲苯小鼠耳廓肿胀模型、大鼠子宫炎症模型、小鼠滤纸片肉芽肿增生模型；镇痛作用采用小鼠热板法及小鼠扭体反应法；对家兔子宫的影响采用对正常家兔体外子宫平滑肌收缩的影响和对缩宫素所致家兔体外子宫平滑肌收缩的影响两种方法。结果：盆腔舒胶囊抗炎作用优于妇科千金片，接近氢化可的松；镇痛作用强于妇科千金片，接近阿司匹林；对正常家兔和对缩宫素所致家兔体外子宫平滑肌的抑制作用优于妇科千金片，接近阿托品。结论：盆腔舒胶囊具有良好的抗炎，镇痛及抑制子宫平滑肌收缩的作用。     

腹膜外盆腔淋巴结清扫及保留卵巢功能的宫颈癌根治

目的探讨年轻早期宫颈癌患者行宫颈癌根治术中．腹膜外盆腔淋巴结清扫加卵巢移位术的安全性及可行性。方法研究资料选择45例年龄为26～40岁宫颈癌Ⅰb-Ⅱa期的患者。其中，研究组（22例）宫颈癌根治术行腹膜外盆腔淋巴结清扫＋卵巢移位术，对照组（23例）行传统的官颈癌根治术。比较两组术中及术后情况，并随访1～4年。结果研究组与对照组比较．手术时间、出血量、术后排气时间、并发症．差异有硅著意义（P〈0．01）。研究组术后2年卵巢功能正常。两组复发率及生存率差异无显著意义（P〉0．05）。结论腹膜外盆腔淋巴结清扫＋卵巢移位的宫颈癌根治术术中出血少、恢复快、并发症少，可保留卵巢功能．不影响患者的生存率和肿瘤复发率。     

家兔颈动脉内膜损伤后血管平滑肌细胞表型转化及p38的表达变化

目的观察动脉内膜损伤后血管平滑肌细胞(VSMC)表型转化及其与p38表达的关系。方法分别用HE染色、免疫组化和免疫印迹(W estern b lot)方法检测家兔假损伤组(S组)和损伤组损伤后不同时间点血管形态学改变及血管壁中增殖细胞核抗原(PCNA)、平滑肌α肌动蛋白(SMα-actin)和p38蛋白表达的变化。结果⑴内膜损伤后1 d血管中膜管腔侧、3 d管腔内表面可见增殖的VSMC,5~7 d新生内膜(NI)形成并逐渐增厚,14~35 d NI进行性增厚。各组中膜均有增殖的VSMC向腔面集聚。⑵S组动脉中膜VSMC及内皮细胞PCNA为阴性。中膜于损伤后1~14 d,NI于5~14 d PCNA阳性细胞率逐渐增加,14 d达高峰,28 d后开始逐渐减少,且NI阳性率略高于中膜。⑶S组动脉中膜SMα-actin表达为阳性,内皮细胞为阴性。SMα-actin阳性面积于损伤后1 d开始减少,3 d最为明显,5 d后开始逐渐增加,NI阳性表达略低于中膜。⑷S组动脉中膜p38较少或无表达,损伤后1~35 d呈持续高表达,以3~14 d最为明显,NI阳性表达略高于中膜。损伤后p38表达变化与PCNA表达变化呈正相关,且早于SMα-actin表达减少。结论内膜损伤后VSMC增殖能力与其表型转化密切相关,p38参与了损伤后VSMC表型转化的信号转导。