周围神经小间隙动脉套桥接与外膜缝合比较研究

将大鼠的腓总神经切断后，进行如下４组实验：Ａ．原位３ｍｍ间隙动脉套桥接，Ｂ．原位断端外膜缝合，Ｃ．远侧断端旋转１８０°３ｍｍ间隙动脉套桥接，Ｄ．远侧端旋转１８０°外膜缝合。术后１２周的电生理学，组织学评价显示，Ｂ组神经再生效果最佳，Ａ、Ｃ两组接近Ｂ组，而Ｄ组较差。     

小间隙修复周围神经的研究进展

小间隙桥接修复周围神经损伤的效果要优于断端相对旋转的传统神经外膜缝合,用小间隙桥接的缝合方法给神经一个密闭的自我选择空间,以有利于神经在此间隙内形成有效再生。自体神经外膜袖套桥接修复周围神经损伤是小间隙修复周围神经中的一种方法,自体神经外膜作为桥接物有其特有的优越性,比其他的小间隙缝合方法更容易在临床上推广。     

切断大鼠脑血管的副交感神经未增加梗塞体积

本研究用Ｓ－Ｄ大鼠，在其一侧筛孔（ＥＦ）处切断支配脑血管的副交感神经舒血管神经，看是否能增加该侧大脑中动脉栓塞后脑梗塞的体积。脑梗塞体积的测量在栓塞后２４ｈ由６层切面之和求得。４组动物中除Ｄ组（假手术组）未见到梗塞外，其余３组的（Ａ组为神经切断加大脑中动脉栓塞；Ｂ组为暴露出神经但未切断大脑中动脉栓塞，Ｃ组为单纯大脑中动脉栓塞）梗塞体积（平均数±标准差）分别为（１５３±４２）ｍｍ３、（１４７±４２）ｍｍ３和（１４８±４５）ｍｍ３，方差分析结果，无差别（Ｐ＞０．０５）。同时也没有看到各组间梗塞部位的差别。本研究未能证实副交感神经纤维在脑缺血这一病理生理过程中的作用。     

甲壳胺膜管修复周围神经缺损的实验研究

观察甲壳胺膜管桥接大鼠坐骨神经缺损，对神经再生的作用。方法ＳＤ大鼠１０２只，随机分为Ａ、Ｂ、Ｃ３组，按缺损长度与神经干直径之比制作实验动物模型（Ａ组：缺损３倍，Ｂ组：缺损５倍，Ｃ组：缺损８倍）。设自身对照，双后肢随机作为实验侧和对照侧。实验侧用甲壳胺膜管桥接缺损，对照侧用肌表面旷置法。术后４，８，１２周作大体观察、组织学观察和远端轴突再生率的比较。结果４周后各组双后肢均形成溃疡；８周后Ａ组溃疡愈合；１２周后Ｂ组实验侧溃疡愈合，Ａ、Ｂ组均无明显肌萎缩，能展趾活动，有肌肉收缩现象。Ｃ组及Ｂ组对照侧溃疡及肌萎缩加重。桥接体周围无瘢痕粘连，与周围组织分界清楚。各时相每组内实验侧远端轴突再生率优于对照侧（Ｐ＜０００１）。１２周后，３组间实验侧远端轴突再生率两两比较：Ａ组优于Ｂ、Ｃ组，Ｂ组优于Ｃ组（Ｐ＜０００１）。Ａ、Ｂ组髓鞘成熟良好，Ｃ组仍有髓鞘溃变现象；３组实验侧均无胶原纤维增生。结论甲壳胺膜管桥接周围神经缺损，可防止瘢痕侵入，有利于轴突再生。     

神经端侧吻合研究进展

神经端侧吻合法就是将受损神经的远断端缝合到正常神经的侧面或将神经片段桥接于正常神经和损伤神经远端侧面的方法。其神经再生的机制尚不清楚。影响端侧吻合神经再生的因素有 :端侧吻合的角度、神经营养因子、神经预变性处理与否、神经束膜吻合法和外膜缝合法、神经端端和端侧吻合法、外膜开窗与否、吻合处与效应器的距离及神经桥接与否。     

神经端侧吻合研究进展

神经端侧吻合法就是将受损神经的远断端缝合到正常神的侧面或将神经片段桥接于正常神经和损伤神经远端侧面的方法。其神经再生的机制尚不清楚。影响端侧吻合神经再生的因素有：端侧吻合的角度、神经营养因子、神经预变性处理与否、神经膜吻合法和外膜缝合法、神经端端和端侧吻合法、外膜开窗与否、吻合处与效应器的距离及神经桥接与否。     

家兔周围神经侧侧缝合的神经再生

目的：研究周围神经侧侧缝合后神经再生及其临床应用价值。方法：将实验兔随机分为3组。左侧前肢尺神经、正中神经为实验神经，切断尺神经并切除约2cm。A组尺神经断端以远1cm处将正中神经、尺神经相邻面的神经外膜、束膜切开，相对缝合外膜、束膜；B组先同法切开两神经外膜，不再切开神经束膜，仅将相邻神经束间结缔组织导向缝合再缝合外膜；C组将尺神经远断端与正中神经相邻面行端侧外膜缝合。术后1周行形态学、电生理、组织学检测。结果：各检测结果均显示术后12周各组神经缝合后神经均再生，且再生质量无显差异。结论：周围神经侧侧缝合后神经能够再生，再生质量与神经端侧缝合相似。     

颈椎滑脱时曲度值的X线改变

目的：旨在分析颈椎滑脱时曲度值的改变,并寻找较好的表述方法。材料与方法：选择１１４例正常及６９例Ｃ３滑脱的颈椎侧位片,采用Ｂｏｒｄｅｎ法和文献＾１测量法测量,分别得出正常组及Ｃ３滑脱组的Ｄ１、Ｄ２值,并计算Ｄ１－Ｄ２的差值。结果：正常组Ｄ１值１０．３３±４．２０ｍｍ、Ｄ２值３．８０±２．０３ｍｍ;Ｄ值６．２５±３．１７ｍｍ,Ｃ３滑脱组Ｄ１值１３．０１±３．６９ｍｍ、Ｄ２值２．６５±２．００ｍｍ;Ｄ     

TCD与CT对急性脑梗塞早期侧支循环的改变对比研究

近几年来陆续有报道应用经颅多普勒研究缺血性脑血管病的脑循环状况，本文通过ＴＣＤ观察ＭＣＡ区脑梗塞４８小时内颅内血流速度，对照ＣＴ以探讨脑梗塞早期侧支循环的改变。１　对象与方法１－１　仪器与检查方法：德国产ＢＬＴ－２０００Ａ型ＴＣＤ（经颅多普勒）检查仪，发射频率２ＭＨｚ探深度２５～１２０ｍｍ，间距１ｍｍ。患者取平卧位，保持安静状态，于颞窗侧两侧大脑中动脉（ＭＣＡ）、大脑前动脉（ＡＣＡ）、大脑后动脉（ＰＣＡ）、颈内动脉（ＩＣＡ）、椎动脉（ＶＡ）、基底动脉（ＢＡ）和小脑下后动脉干同节段的血流速度。１－…     

150例大鼠原位肝移植手术方法比较

探索大鼠原位肝移植最佳手术方法与模型。采用雄性ＳＤ大鼠３００只，分三袖套法，改良三袖套法和二袖套法，即缝合肝上下腔静脉法行原位肝移植１５０次。各组无肝期：ＴＣ组（１５．５±５．５）ｍｉｎ，ＭＴＣ组（１３．５±３．５）ｍｉｎ，ＡＳＶＣ组（２１±４．０）ｍｉｎ。手术时间：ＴＣ组（９０±２５）ｍｉｎ，ＭＴＣ组（８０±１８）ｍｉｎ；ＡＳＶＣ组为（９５±２０）ｍｉｎ。术后血管并发症发生率；ＴＣ组为４２％，Ｍ     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.