同种异体肾移植手术2种麻醉方法的效果比较

目的　比较同种异体肾移植手术椎管内阻滞和静吸复合全麻的优缺点。方法　回顾性分析 2 0 0 3年 1— 8月我院器官移植中心所做的同种异体肾移植手术的麻醉 ,对符合条件的 38例患者进行比较。结果　 2组间比较ASA分级 ,术中输液量 ,移植肾血流开放前收缩压、舒张压、心率、麻醉并发症 (仅包括硬膜外血肿或心功能衰竭 )和移植肾存活率无显著性差异 ,体质量和ICU停留时间有显著性差异 ,静吸复合全麻组比椎管内阻滞组体质量更重 ,ICU停留时间更长。结论　椎管内阻滞有时不能满足手术要求 ,能满足手术要求的椎管内阻滞 ,手术结束后循环功能较稳定 ,烦躁不安少见 ,手术后恢复较快 ;静吸复合全麻能更好地满足手术要求 ,尤其是体质量较大的患者 ,但在拔出气管导管前后可能引起血流动力学剧烈波动 ,甚至心功能衰竭 ,手术后恢复较慢     

长江中下游地区菱属植物的DNA分子鉴别

目的 对野生菱和栽培菱种rDNA ITS片段进行分析，探讨该片段在两大群体中的系统学及鉴别研究意义。方法 对菱的rDNA ITS区进行了PCR扩增、测序，运用clustal、Mega 2．0等软件对ITs区进行序列分析鉴别。结果 获得rDNAI TS1、ITS2和5．8S rDNA完整序列，10个居群菱的ITS1与ITS2序列的长度分别为234～236 bp和220～221 bp，5．8S区均为164bp，不同居群的碱基差异为0．22％～2．94％。变异位点数为16个，信息位点数6个。用NJ法根据ITS序列数据构建系统发生树。结论 尽管菱属各居群间rDNA ITS的差异百分率较小，其亲缘关系较近，但根据ITS序列的特征可以很好地鉴别野生菱、栽培菱，菱属植物有可能都起源于同一种野生类居群。     

Pseudoinfarction Pattern in an Infant

A 4-week-old female infant presented with congestive heart failure, moderate mitral regurgitation, and an electrocardiographic pattern of anterolateral myocardial infarction. Angiography revealed normal coronary arteries and moderate mitral regurgitation. A single-catheter electrophysiology study confirmed the presence of an accessory atrioventricular conduction pathway.     

葛根素注射剂与发热相关性的病例对照研究

目的：探讨不明原因短期发热（SFUO）的危险因素，论证最早上市的葛根素注射剂——普乐林与发热的相关性。方法：采取1：2匹配病例对照，选择温州医学院附属第一医院1995～1997年住院的心脑血管病病例为调查对象．将符合SFUO标准的45例纳入病例组，对照组为相匹配的90例病例。选取普乐林、其他活血化瘀中药、抗生素、生物制品、其他西药注射剂、阿司匹林服用、过敏史、微侵袭手术、重大精神刺激等9项候选危险因素，进行调查分析．筛选出危险因素。结果：单因素条件logistic回归分析将“使用普乐林”筛选为发热的危险因素，比值比（OR）为13．772．P〈0．001；多因素条件logistic回归分析显示，最终有统计学意义的只有普乐林注射液，OR值10．947。结论：最早上市的葛根素注射剂——普乐林的使用是SFUO的独立危险因素，两者存在相关性.     

椎弓根钉内固定系统治疗胸腰椎骨折

目的探讨椎弓根内固定系统治疗胸腰椎骨折的手术和临床疗效。方法回顾性分析椎弓根内固定系统治疗胸腰椎不稳性骨折或脱位42例患者手术前后的临床表现、X线和CT扫描的测量结果。结果本组随防2个月~3年,椎体高度完全恢复34例,恢复程度>90%,6例,>80%,2例,术后神经功能恢复按Frankel标准,术前不全瘫患者均有不同程度恢复。结论椎弓根内固定系统是治疗胸腰椎骨折的一种好的方法。     

Simultaneous detection of tyrosine hydroxylase-immunoreactivity and vasopressin mRNA in neurons of the human paraventricular and supraoptic nucleus

The extracellular signal-regulated protein kinase-1 and -2 (ERK1 and ERK2), also referred to as the p44/42 mitogen-activated protein kinase (p44/42 MAP kinase), plays an essential role in neuronal signal transduction, but its function involved in nociceptive response has not been deeply studied yet. Here we report immunohistochemical evidence that p44/42 MAPK might be critical in nociceptive response. We found that after formalin was injected into the perioral skin of the upper lip of mice, the number of activated p44/42 MAPK-like immunoreactive neurons was significantly increased in the laminae I and II of the caudal subnucleus of the trigeminal spinal nucleus (Sp5C). The positive neurons and fibers were mostly concentrated in the middle portion of Sp5C dorsoventrally, where the afferent fibers innervating the skin of the upper lip are terminated. The reactive products were localized in perikarya, dendrites, nuclei, and diffusely in the neuropil. The present result suggests that p44/42 MAPK may be important in the transmission and modulation of noxious information in Sp5C.     

Long-term effects on feeding and body weight after stimulation of forebrain or hindbrain CRH receptors with urocortin

Research on the contribution of CRH receptor stimulation to energy homeostasis has focused on forebrain substrates. In this study, we explored the effects of caudal brainstem administration of the CRH receptor agonist, urocortin, on food intake and body weight, and on plasma glucose and corticosterone (CORT) in non-deprived rats. Urocortin (0, 0.3, 1, 3 microg) delivered, respectively, to the fourth and lateral ventricles yielded substantial suppression of food intake measured 2, 4 and 24 h later. A significant but more modest anorexia was observed between 24 and 48 h after injection. Intake responses did not differ between the injection sites, but body weight loss measured 24 h after lateral-i.c.v. injection was substantially greater than that after fourth-i.c.v. injection. Fourth-i.c.v. urocortin administration (3 microg) produced substantial elevations in plasma glucose and CORT that were not distinguishable in magnitude and duration from responses to lateral-i.c.v. delivery. Unilateral microinjection of urocortin into the dorsal vagal complex significantly reduced 24-h food intake at a dose (0.1 microg) that was subthreshold for the response to ventricular administration, suggesting that fourth-i.c.v. effects are mediated in part by stimulation of CRH receptors in this region of the caudal brainstem. The results indicate that similar effects can be obtained from stimulation of anatomically disparate populations of CRH receptors, and that interactions between forebrain and hindbrain structures should be considered in the evaluation of CRH contributions to food intake and body weight control.     

_62;翟会侠000900

s, managements and outcomes of 20 complications are shown in table. Finally, by the means of aggressive endovascular and medical therapies, disable stroke and death within 30 days was 3.2% (5/155) and 1.3% (2/155), respectively. Conclusions Higher risk of procedure-related neurological complicati     

椎弓根内固定联合椎间融合器植骨治疗腰椎滑脱症

目的探讨联合应用椎弓根内固定和椎间融合器植骨融合治疗腰椎滑脱症的方法和临床疗效。方法用后路减压、复位椎弓根内固定联合应用单枚斜向椎间融合器融合或单侧经椎间孔腰椎体间融合器融合治疗有症状的腰椎滑脱症。本组随访21例,时间6～24个月,平均14个月。结果滑脱椎体复位理想,8例Ⅰ度滑脱完全复位,13例Ⅱ度中有7例完全复位,6例仍有Ⅰ度滑脱。融合节段全部获得骨性融合。疗效评价:优14例,良5例,可2例;优良率94%。结论联合应用椎弓根内固定和椎间融合器植骨融合在治疗腰椎滑脱症起到协同作用,为神经减压后的脊柱提供理想的复位和固定的力量,利于植骨融合,临床疗效满意,是治疗腰椎滑脱症的一种理想方法。     

脊柱椎弓根螺钉入路及手术方法的临床应用

目的：探讨椎弓根螺钉最佳入路及手术步骤。方法：对104例胸腰椎骨折脱位患者，分两组采用不同方法、步骤钻入椎弓根螺钉，并对其进行疗效比较。结果：经过技术改进后的方法较传统方法对骨折脱位的复位效果无明显差异，而两者在X线曝光次数、手术时间、出血量及并发症等方面存在显著性差异。结论：技术改进后的椎弓根螺钉进钉方法简单、安全、创伤小、疗效优良。