经皮激光椎间盘减压术治疗椎间盘源性腰痛

目的探讨经皮激光椎间盘减压术（percutaneous laser disc decompression，PLDD）治疗椎间盘源性腰痛的疗效。方法2002年6月～2004年12月我院对36例椎间盘源性腰痛，采用英国DIOMED公司半导体激光仪，激光功率15W，每个激光脉冲持续1s，间隔1s，照射能量800～1200J。VAS评分评价治疗效果。结果手术时间15～60min，平均30min。32例出现“疼痛复制效应”。36例随访6～36个月，平均11个月，32例有效（术后VAS评分改善≥3分18例，≥分14例），4例无效，有效率88．9％（32／36）。结论PLDD治疗椎间盘源性腰痛安全、有效、微创。     

New stand magnifiers do not meet rated levels of performance

A new range of stand magnifiers has been released by the COIL company in the United Kingdom. Examination of these magnifiers reveals that they fail to deliver the rated magnifications labelled prominently on the appliances, as a result of the manufacturer's conformance with the requirements of the German DIN standard and the use of back vertex power (F'_v) rather than equivalent dioptric power (F_m) of the magnifier. In this study we provide information on the optometric parameters of these new stand magnifiers that will assist the more accurate specification of improvements in vision expected from their use.     

Catabolic effects and the influence on hormonal variables under treatment with gynodian-depot® or dehydroepiandrosterone (DHEA) oenanthate

53 patients from a mainly climacteric population were treated monthly with 200 mg dehydro-epiandrosterone (DHEA) oenanthate or with 1 ampoule Gynodian-Depot®. Pronounced adiposity was present in 15 of these cases. Hormonal variables were determined before the treatment and during the depot effect of the preparations in order to study the principle which supports the oestrogenic influence and any weight-reducing influence under administration of DHEA. The elimination of lowpolar oestrogens increased considerably in 4 out of 13 post-menopausal cases treated with DHEA. This effect is probably indirect and presupposes intact ovaries. The incorporation of exogenous DHEA into the excretion of 17-ketosteroids and of 17-ketogenic steroids, such as those of androsterone + aethiocholanolone, depends on the size of the initial pool inasmuch as it is higher in small initial pools than in saturated pools - the size of the pool being age-dependent.

An average weight loss of >1 kg/mth was observed under DHEA treatment in 7 out 15 adipose cases. In comparison to the other 8 adipose cases, these 7 were younger and therefore also displayed higher values for 17-ketosteroids and their individual fractions. These circumstances appeared to explain why the administration of DHEA resulted in higher levels of free plasma DHEA which, in contrast to the cases without loss of weight, also resulted in an increase of renal DHEA-sulphate clearance. It was concluded from the findings that this is the explanation for the catabolic effect of exogenous DHEA.

Post-menopausally increased FSH and LH fractions were markedly suppressed in about half of the determinations after Gynodian-Depot administration, the findings indicating that DHEA is probably involved in suppression of the LH fraction.     

小剂量低LET辐射对人淋巴细胞SCE的影响

本文用磷酸盐Giemsa法观察了小剂量X射线照射对人离体外周血淋巴细胞SCE的影响。其结果照射组各剂量点均不明显地高于对照组,证实了SCE对电离辐射不敏感,说明染色体结构畸变和SCE的发生是彼此独立的两个不同事件。     

荷包环扎式结直肠吻合保肛术治疗低位直肠癌*

目的 :评价荷包环扎式结直肠吻合保肛术治疗低位直肠癌的价值。方法 :对低位直肠癌采用荷包环扎结直肠吻合保肛术治疗 2 3例 (A组 ) ,采用Miles手术治疗 2 6例 (B组 )。结果 :A组术后 1、3年生存率分别为 10 0 % (2 3/ 2 3) ,95 7% (2 2 / 2 3) ,术后无局部复发病例 ;排便功能优 16例 (6 9 6 % ) ,良 7例 (30 4 % )。B组术后 1、3年生存率分别为 10 0 % (2 6 / 2 6 ) ,96 2 % (2 5 /2 6 ) ,术后局部复发率 3 8% (1/ 2 6 )。两组术后 1、3年生存率 ,局部复发率经统计检验 ,均无显著差异 (P值均 >0 0 5 )。术后并发症 :A组无吻合口瘘及吻合口狭窄发生 ,盆腔感染 1例。B组 :切口感染 1例 ,人工肛门狭窄 1例。结论 :采用螺纹支架管荷包环扎结直肠吻合保肛术治疗低位直肠癌既能达到根治目的 ,又有保留肛门的良好排便功能 ,且并发症少 ,操作简便易行 ,不用特殊器械 ,值得推广应用     

A comparative study of angiogenic and cytokine responses after laparoscopic cholecystectomy performed with standard- and low-pressure pneumoperitoneum

Background  Surgical procedures enhance production of pro- and anti-inflammatory cytokines and angiogenic factors that play a pivotal role in the immunological response to surgical trauma and take part in the pathogenesis of tumor growth and adhesions formation. The purpose of the study was to access the influence of low-pressure CO₂ pneumoperitoneum on the inflammatory and angiogenic responses during the postoperative period after laparoscopy. Methods  The study group consisted of 40 patients, operated on due to cholelithiasis using standard-pressure (n = 20) and low-pressure (n = 20) CO₂ pneumoperitoneum. Serum concentration of interleukin (IL)-6, IL-8, IL-10, vascular endothelial growth factor (VEGF)-A, and endostatin were measured before and at 6, 24, and 48 h after surgery with commercially available enzyme-linked immunosorbent assay (ELISA). Results  Concentrations of IL-6 increased significantly after the operations in both groups. No differences were observed between the groups in regards to IL-6, IL-8, and IL-10 levels. Concentrations of VEGF-A measured at 6 and 48 h were significantly lower in patients who underwent laparoscopies performed with low-pressure pneumoperitoneum. No significant variations were observed in endostatin serum concentration. Concentrations of the studied parameters were not influenced by duration of surgery or by age, gender, or body mass index (BMI) of the patients. Conclusions  The results obtained in our study do not show any significant differences between studied operative procedures with regards to systemic inflammatory response. Changes in the concentrations of VEGF-A and endostatin observed in the studied population may suggest this technique is more favorable with regards to angiogenesis process intensity, along with all its consequences and implications.     

Myelination of the corpus callosum in the cat: time course, topography, and functional implications

The parameters of myelin development were ascertained in two specific regions of the corpus callosum in a series of cats aged 12 postnatal days through adult. The posteriormost portion of the splenium and the anterior-most portion of the genu were examined in cross section by using the electron microscope. Measurements were made to determine the age at which myelin first appeared, the number and distribution of myelinated fibers, the number and distribution of myelin lamellae, and cross-sectional area of ensheathed axons during development. The results indicate that myelination begins and ends earlier in the anterior region of the callosum. Measurements of myelin lamellae indicate similarities between anterior and posterior regions of the callosum, although development occurs earlier in the genu than in the splenium. No evidence was found for a sequence in the size of axons acquiring myelin sheaths, except that extremely small fibers are the last to begin myelinating. Myelination of the splenium of the corpus callosum begins at the very end of the behavioral and physiological critical period for the corpus callosum's role in visual functional development (Elberger: Behav. Brain Res. 11:223-231, '84; Elberger and Smith: Exp. Brain Res. 57:213-223, '85). Since myelination of a pathway is used as an index of functional reliability, this indicates that the basis for the callosal role in developing visual functions is probably not based on its physiological input to visual cortex.     

Muscular activation patterns of healthy persons and low back pain patients performing a functional capacity evaluation test

The results of most reported studies show differences between the muscular activity of low back pain patients and healthy subjects, but the focus has usually been on trunk muscles only, and they have not involved work-related tests or exercises. The reintegration of chronic low back pain patients to job market is a common problem. Therefore assessment systems like the functional capacity evaluation (FCE) according to Isernhagen [S.J. Isernhagen, Work Injury: Management and Prevention, Aspen Publishers Inc., Gaithersburg, MD, 1988] are often used tools to determine the physical abilities and deficits of long-time incapacitated persons. The aim of the present study was to compare the healthy persons and chronic low back pain patients in performing a FCE-test and to analyse their muscular activation and motion patterns. The results indicate differences in the activation patterns of the groups in the test task “floor to waist lift” common in many occupations.     

低剂量辐射增强小鼠肿瘤基因-放射治疗效应的免疫学机制研究

目的 探讨低剂量辐射全身照射对小鼠Lewis肺癌移植肿瘤基因-放疗方案中的免疫增强作用机制。方法 小鼠右后肢皮下接种Lewis肺癌细胞建立荷瘤模型,基因-放疗组中小鼠肿瘤局部注射由多聚乙烯亚胺包裹的pEgr-IL18-B7.1重组质粒,分别接受由2 Gy 局部照射和0.075 Gy 全身照射组合的不同治疗方案,通过³H-TdR标记方法检测小鼠CTL和NK细胞毒活性,ELISA方法检测TNF-α和IFN-γ分泌活性,观察各治疗组对荷瘤小鼠抗肿瘤免疫的作用。结果 在pEgr-IL18-B7.1基因治疗方案中,单次大剂量辐射局部照射后加多次低剂量全身照射与常规多次大剂量辐射局部照射相比,小鼠CTL和NK细胞毒活性显著增强,TNF-α和IFN-γ分泌活性有不同程度的增高。 结论 低剂量辐射可以通过促进CTL和NK细胞毒效应,上调TNF-α和IFN-γ细胞因子表达,从而增强机体抗肿瘤免疫功能,提高肿瘤基因-放疗的抑瘤效果。