异丙酚复合芬太尼维持麻醉对脑代谢的影响

观察异丙酚复合芬太尼维持麻醉对脑代谢的影响。方法： 择期手术病人８ 例, 芬太尼、硫贲妥钠、维库溴铵诱导插管, 静脉联接Ｇｒａｓｅｂｙ 微泵异丙酚８ ｍｇ／ （ｋｇ·ｈ） , 芬太尼１ μｇ／ （ｋｇ·ｈ）维持麻醉。连续监测ＭＡＰ、心电图、脉搏氧饱和度和呼气末二氧化碳分压, 同步采集动脉血和颈内静脉血作血气分析, 计算动－ 静脉氧含量差（Ｄａ － ｖＯ２） 和脑氧摄取率（ＥＲＯ２） 。结果： 异丙酚麻醉维持平稳, Ｄａ － ｖＯ２ 和ＥＲＯ２ 在给药３０ ｍｉｎ 、６０ ｍｉｎ 较气管插管后５ ｍｉｎ 无明显改变, 有平均动脉压下降和心动过缓。结论： 异丙酚复合芬太尼维持麻醉可保持脑氧供需平衡稳定。     

Performance of EAST in diagnosing inhalant allergens in children with allergic rhinitis

The performance of enzyme linked immunosorbent assays (EAST) for identifying six indoor allergens was evaluated using skin prick test (SPT) as reference tests in 154 children with allergic rhinitis. Sensitivity of EAST ranged from 9% (cat) to 54% (HDM) with specificity of 74%(cockroach) to 100% (cat) with an agreement ranged from 58 to 86%. Cut off values ?> ?0.35 kU/L showed best sensitivity and specificity. Our findings agree with extant literature which suggests that the ability of EAST to determine the precipitating allergen is moderate. Assays for definitively identifying the inhalant allergen are currently not available.     

Is mitochondrial DNA copy number a good prognostic marker in resectable pancreatic cancer?

Background

The aim of this prospective study was to investigate mitochondrial DNA (mtDNA) copy number in a group of resectable pancreatic cancer (PC) tumor tissues and adjacent normal pancreatic tissues, and to explore the correlation between the mtDNA content in tissues and the clinicopathological parameters and the overall survival.

3cm以下肺结节螺旋CT下经皮活检的技术评价

目的：评价多排螺旋CT引导下经皮肺切割针活检直径≤3cm肺结节的价值。方法：CT引导下经皮肺穿刺活检肺部病灶直径≤3cm结节101例，病灶用意大利或美国20G活检针至少穿刺取材。结果：肺结节穿刺准确率达100％，病理证实恶性病灶73例、良性病灶28例，其中结节太小取材少不能定性1例。诊断准确率为99．01％，并发症中气胸发生率13．86％、咯血17．82％，无严重并发症，穿刺针通过肺大泡而没有引起气胸1例。结论：CT引导经皮穿刺直径≤3cm肺部结节活检的准确性高而并发症较低，可作为肺内3cm以下孤立性结节灶在临床治疗前病理诊断的首选方法。     

小肾癌诊断与治疗(附12例报告)

目的　提高对小肾癌的诊断和治疗水平 ,探讨不同手术方法的优缺点。方法　通过对 1992年 2月～ 2 0 0 1年 2月收治的 12例小肾癌的临床表现、诊断、治疗及预后进行分析并结合有关文献进行讨论。结果　 12例中全部手术治疗 ,9例行根治性肾切除术 ,3例行保留肾单位肾肿瘤切除术 ,术后均经病理证实。 10例获得随访 ,8例无癌存活 ,最长已超过 7年。结论　小肾癌多为B超偶然发现 ,术前B超、CT肾动脉造影综合分析明确诊断 ;手术方式依据具体情况采取根治性切除术或保留肾单位手术 ;预后主要取决于肿瘤的分期和分级。     

Notch1 signaling,hippocampal neurogenesis and behavioral responses to chronic unpredicted mild stress in adult ischemic rats

Accumulating evidence indicates that the Notch signaling pathway fulfills important roles in ischemia-stimulated neurogenesis, which may be regarded as an etiological factor in post-stroke depression. Here we explored Notch₁ signaling, hippocampal neurogenesis and behavioral responses to chronic unpredicted mild stress (CUMS) in adult ischemic rats. Animals were treated with permanent middle cerebral artery occlusion followed by an 18 day CUMS procedure. Proliferating cells in the hippocampus and their cell fate were investigated on days 19 and 28 after ischemic surgery. Additionally, expression of the Notch₁ intracellular domain (NICD) and its downstream targets Hes1 and Hes5 was examined. A sucrose preference test and forced swim test were used to assess behavioral responses. CUMS produced depressive-like behaviors and decreased the number of proliferating cells on day 19 (both p < 0.001), accompanied by a decreased expression of both Hes1 and Hes5 in the hippocampus of ischemic animals (p < 0.001). On day 28, CUMS resulted in a decreased number of neurogenically-differentiating cells in the subgranular zone (p < 0.001) while permitting differentiation into astrocytes in the hilus (p < 0.05). Hes1 and Hes5 protein expression levels were increased. The expression of the NICD was significantly decreased at both time-points. CUMS led to expression changes in the Notch₁ signaling cascade in ischemic rats, most of which concerned hippocampal neurogenesis. This suggests that variation in Notch₁ activity and subsequent expression of its downstream targets, including Hes1 and Hes5, may, at least in part, contribute to modulation of ischemia-related hippocampal neurogenesis by CUMS.     

听觉脑干诱发电位对颅脑损伤患者监测和预后的应用

作者对急性颅脑损伤病人70例应用脑干听觉诱发电位(BAEP)就伤情评价和预后判断做了初步研究。对 BAEP 的异常按照 Greenberg 等的方法分Ⅳ级。结果表明,BAEP 级别与 GCS 记分呈负相关(r=-0.69),BAEP 级别越高,GCS 记分可能越低,临床状态则越差。本组原发和继发脑干损伤病人在 BAEP 疫常程度上无显著性差异。但在原发脑干损伤的诊断上可提高其可靠性。不同病期测定 BAEP 提示Ⅱ、Ⅲ级者最易发生变化,改善者占71.43%和35.71%,变化率为7.14和21.43,说明对这类病人应密切观察,反复监测。BAEP 级别越高,病人预后可能越差。     

彩色多普勒超声在早发性小乳腺癌诊断中的临床价值

目的探讨彩色多普勒超声对早发性小乳腺癌的诊断价值。方法对56例≤35岁经手术病理确诊为小乳腺癌(肿瘤最大直径≤2cm)的超声声像图进行回顾性分析。结果早发性小乳腺癌原发病灶以浸润性导管癌为主,占83.93%(47/56),部位以外上象限为多,占32.14%(18/56)。由于癌肿所含组织成分不同而声像图也不尽相同。结论加强对彩色多普勒超声声像图的认识对对提供超声诊断早发性小乳腺癌早期诊断有重要意义。     

Connective tissue, mechanical, and morphometric changes in the lungs of weanling rats fed a low protein diet

We studied the effect of low-protein diet (8% casein) on lung growth in rats from 3 to 7 weeks of age. Their diet was isocaloric with that of control animals fed a diet of 20% casein. The calorie intake of experimental animals was increased during the first 3 weeks of the experiment, but they increased less (about 10%) in body weight, had less protein and less water when the whole body was examined, and had lower serum proteins and decreased urinary hydroxyproline. The experimental animals remained in positive nitrogen balance by maintaining low urinary nitrogen excretion. The lungs of the experimental animals were abnormal, with decreased absolute amounts of hydroxyproline and desmosine and of these relative to unit lung weight. The lungs contained more air per gram of lung tissue, and the volume of air in the lung was increased at all transpulmonary pressures above zero. When corrected for increased total lung capacity, there was a loss of recoil at mid-lung volumes. Saline-filled volume-pressure curves, corrected for lung volume, showed similar loss of recoil. Alveolar multiplication was quantitatively normal, but the experimental animals had larger alveoli. We conclude that the protein deprivation in isocalorically fed animals has a specific effect on lung scleroprotein content, which may be due to diminished synthesis, and this results in both structural and functional abnormalities in the lung. Our results indicate the importance of dietary protein in lung development and possibly as one of the causes of emphysema. Further studies are needed to know whether this would be a problem in infants of Kwashiokor.