不同分期老年慢性肾病患者矿物质骨代谢水平变化的观察及临床意义

目的:检测不同分期老年慢性肾病(CKD)患者的矿物质骨代谢水平,并分析其与肾脏损害严重程度的相关性。方法:纳入本院2015年09月~2017年09月收治的老年慢性肾病患者213例,根据CKD分期标准将其分为5组,分别为CKD1期(n=42)、CKD2期(n=45)、CKD3期(n=39)、CKD4期(n=41)、CKD5期(n=46)。采血检测5组矿物质骨代谢指标水平,包括血钙(Ca2+)、血磷(P3-)、血钙×血磷(Ca2+×P3-)、骨钙素(OC)、骨型碱性磷酸酶(BSALP)、全段甲状旁腺激素(i PTH),并记录血清IL-6水平。结果:CKD3期、CKD4期、CKD5期的血Ca水平低于CKD1期、CKD2期,CKD3期、CKD4期、CKD5期的血P3-、Ca2+×P3-、OC、BSALP、i PTH水平高于CKD1期、CKD2期,且CKD2期的血BSALP高于CKD1期,组间比较差异显著(P 0. 05); CKD5期的血Ca2+水平低于CKD3期、CKD4期,而血P3-、Ca2+×P3-、OC、i PTH水平高于CKD3期、CKD4期,差异有统计学意义(P 0. 05)。CKD1期的血清IL-6水平明显低于其他各组,CKD5期的血清IL-6水平高于其他各组,差异有统计学意义(P 0. 05)。结论:不同CKD分期患者的矿物质骨代谢水平存在差异,且患者血Ca2+×P3-与血清IL-6水平、肾小球病变积分密切相关,临床可将其作为评估CKD病情的重要指标。     

自体血液回收技术对红细胞膜ATP酶的影响

目的　探讨血液回收技术对红细胞膜Na+ K+ ATP酶和Ca2 + Mg2 + ATP酶活性的影响。方法　将 2 4例患者麻醉前静脉血、术野回收原血及回收红细胞血液标本采用沈茂星法测定红细胞膜Na+ K+ ATP酶和Ca2 + Mg2 + ATP酶活性 ,并予统计分析。结果　经血液回收技术处理后的红细胞膜Na+ K+ ATP酶和Ca2 + Mg2 + ATP酶活性与术野回收原血值比较均有显著降低 (P<0 0 5 )。结论　自体血液回收技术能使红细胞膜Na+ K+ ATP酶和Ca2 + Mg2 + ATP酶活性明显降低。     

慢性肾脏病钙、磷及甲状旁腺激素水平变化的对比分析

目的 观察各期慢性肾脏病(CKD)患者的钙、磷及甲状旁腺激素(PTH)水平并分析其临床特征,为早期防治提供依据.方法 选择2006年1月至2010年12月在新疆自治区人民医院肾病科住院的CKD患者294例,检测血清磷(P)、钙(Ca)、肌酐(Cr)、血清白蛋白(ALB)、CaP及血清甲状旁腺激素(PTH)的浓度.并进行回顾性分析.结果 CKD1 ～2期患者血清钙、磷与对照组比较无显著性差异.CKD2期患者血清肌酐与对照组比较有显著性差异(P＜0.05).CKD3～5期患者血清钙浓度低于对照组(P＜0.05),与CKD1 ～2期比较有差异,CKD5期患者血清钙浓度明显低于CKD3 ～4期有显著性差异.CKD3 ～5期患者血磷高于对照组及CKD1 ～2期,有显著性差异(P＜0.01),血磷增高明显与血钙和PTH有显著性差异(P＜0.05).CKD2 ～5期患者血肌酐高于对照组及CKD1期患者有显著性差异(P＜0.01),与各组间比较亦无明显差异.结论 对于CKD3期患者我们应该积极给予降低血磷的综合治疗,以防治继发性甲状旁腺功能亢进发生.     

不同钙浓度透析液对血液透析患者透析前后电解质变化的影响及其相关关系

目的:研究两种不同钙浓度透析液对维持性血液透析患者透析过程中电解质的影响及其相关关系。方法:筛选中山大学附属第五医院和浙江省立同德医院血液净化中心维持性血液透析患者共160人,分别使用两种不同钙浓度(1.75 mmol/L和1.25 mmol/L)的透析液进行透析,即普通钙组和低钙组,检测透析前后血清电解质,并进行部分电解质间的相关分析。结果:(1)两组透析后血清总钙(t Ca)显著升高,血K+、Mg2+、Cl-、P、HCO3-均显著降低(P0.01)。和普通钙组相比,低钙组透后t Ca显著下降,K+、Cl-、HCO3-显著增加(P 0. 01)。透析后血P和Mg2+在两组间无统计学意义(P0.05)。血Na+在普通钙组透后显著降低(P0.01),在低钙组透析前后差异无统计学意义(P=0.71)。(2)血清t Ca与Na+、K+、Cl-均呈显著负相关,而与Mg2+、P无显著相关性,Cl-与HCO3-呈显著正性相关。结论:不同钙浓度透析液影响透后血钙、钠、钾、氯的变化,但不影响血磷和镁水平。1.75 mmol/L钙浓度透析液会增加钙负荷,故临床维持性血透患者应个体化选择不同钙浓度透析液。     

慢性肾脏病患者成纤维细胞生长因子23与肾功能及钙磷代谢的关系

目的 探讨慢性肾脏病（CKD）患者随着肾功能的变化,其成纤维细胞生长因子23（FGF23）与钙磷代谢的关系。 方法 研究对象为2008年8月至2009年4月在上海交通大学附属第一人民医院肾内科住院的初诊CKD患者72例,按照肾小球滤过率（GFR）水平分为5组,另设健康对照组20例。抽取受试者静脉血并分离血清,以酶联免疫法检测FGF23、25（OH）VitD3、1,25（OH）2VitD3;全自动生化分析仪测量钙（Ca）、磷（P）、血肌酐（Scr）、尿素氮（BUN）、白蛋白（Alb）水平;免疫放射法测定全段甲状旁腺激素（iPTH）。 结果 CKD患者血清FGF23水平随GFR降低逐渐升高,在CKD4期和5期时,血FGF23、P、iPTH上升明显,1,25（OH）2VitD3显著下降,与CKD1期差异有统计学意义（均P < 0.05）。CKD2~3期与CKD1期的FGF23、P、Ca、iPTH、活性维生素D水平差异均无统计学意义。血Ca、25（OH）VitD3随着肾功能下降有降低趋势,但各期间差异均无统计学意义。Pearson相关分析显示,CKD1~5期logFGF23与P、logiPTH呈正相关（r = 0.653,P < 0.01;r = 0.800,P < 0.01）,与GFR、1,25（OH）2VitD3呈负相关（r = -0.753,P < 0.01;r = -0.265,P < 0.05),与Ca、25（OH）VitD3无相关。CKD1~3期logFGF23与logiPTH呈正相关(r = 0.374,P < 0.05),而与Ca、P、25（OH）VitD3、1,25（OH）2VitD3、GFR均无相关。CKD4~5期log FGF23与P、logiPTH呈正相关（r = 0.381,P < 0.05;r = 0.515,P < 0.01）,与GFR呈负相关（r = -0.654,P < 0.01）,与Ca、25（OH）VitD3、1,25（OH）2VitD3无相关。 结论 随着肾功能减退,血清FGF23、P、iPTH水平逐渐升高,活性维生素D水平逐渐下降,尤以CKD4~5期明显。在肾脏病早期阶段（CKD1~3期）血iPTH水平与FGF23有关。当GFR<30 ml/min时,肾功能状态、血磷、血iPTH均可影响血FGF23水平。     

慢性肾脏病患者血清人附睾分泌蛋白4的变化及与肾脏纤维化的关系

目的探讨慢性肾脏病(chronic kidney disease,CKD)患者血清人附睾分泌蛋白4(epididymis gene product 4,HE4)的变化以及和肾脏纤维化的关系。方法选取住院女性CKD患者190例,采用ELISA(双抗体夹心法)检测血清HEA,用MDRD公式计算肾小球滤过率。按照美国肾脏病基金会K/DOQI指南分期标准将上述患者分为5组,即CKD 1期组、CKD 2期组、CKD 3期组、CKD 4期组、CKD 5期组,检测并比较血清HEA的水平。选择其中89例住院接受肾穿刺活检的患者,包括CKD 1期组55例,CKD2期组15例,CKD3期组19例;并根据肾组织病理结果分为肾小球硬化组和无肾小球硬化组,分析肾小球硬化与血清HE4的关系。结果不同CKD分期组之间血清HE4水平差异有统计学意义(P0.01)。肾功能不全患者(CKD 2~5期组)血清HEA水平高于肾功能正常患者(CKD 1期组)(P0.05),其中CKD 2期组血清HEA水平高于CKD 1期组(P0.01),CKD3期组血清HEA水平高于CKD2期组(P0.01),CKD4期组血清HEA水平高于CKD3期组(P0.01),CKD 5期组血清HE4水平高于CKD 4期组(P0.01)。肾小球滤过率与血清HEA呈非线性负相关。在CKD 1~3期组中血清HE4的水平在肾小球硬化组与无肾小球硬化组之间无统计学差异(P0.05)。结论在无妇科肿瘤的女性CKD患者中血清HEA会显著升高,并且HEA的血清水平会随着CKD临床分期的增加而逐渐增高。用HEA辅助诊断妇科肿瘤和评估肿瘤的复发及治疗效果时,应考虑CKD的影响。检测血清HEA水平是否能成为判断无妇科肿瘤的CKD患者肾脏纤维化发生的指标还有待临床研究。     

慢性肾脏病患者甲状旁腺激素水平对肾性贫血的影响

目的 探讨慢性肾脏病（CKD）患者甲状旁腺激素（PTH）升高致红细胞寿命缩短的机制。 方法 以住院初治的CKD患者75例（按eGFR分为1～2期、3～4期和5期）和健康对照组30例为对象。免疫发光法测全段甲状旁腺激素（iPTH）;流式细胞术测红细胞表面磷脂酰丝氨酸（PS）外翻水平及红细胞内钙离子浓度（[Ca2+]i）。 结果 （1）随着肾功能的减退,CKD3～4期及5期患者 iPTH、[Ca2+]i及红细胞表面PS外翻水平逐渐升高、贫血逐渐加重,明显高于CKD1～2期和对照组（均P < 0.05）。（2）CKD3～4期或5期患者Hb与iPTH和红细胞表面PS外翻水平呈负相关（r = -0.830和-0.791,均P < 0.01）;iPTH与 [Ca2+]i和红细胞表面PS外翻水平呈正相关（r = 0.882和0.924,均P < 0.01）,与血钙浓度呈负相关（r = -0.544, P < 0.01）;红细胞表面PS外翻水平与 [Ca2+]i呈正相关（r = 0.923,P < 0.01）,与血钙浓度无相关（r = -0.138,P = 0.365）。（3）[Ca2+]i（Y）对iPTH（X）的直线回归方程：Y=3.327+0.213X（F=21.529,P < 0.05）;红细胞表面PS外翻水平（Y）对iPTH（X1）及[Ca2+]i（X2）的多元线性回归方程：Y=-0.303+0.283X2+0.139X1（F = 6.59,P < 0.01）。 结论 iPTH增加红细胞内钙离子浓度,引起红细胞表面PS外翻增多,致红细胞寿命缩短而加重肾性贫血。     

实脾固肾化瘀方对慢性肾脏病患者营养状态影响的研究

目的:观察实脾固肾化瘀方联合低蛋白饮食对慢性肾脏病(CKD)患者营养状态的影响。方法:选取上海市杨浦区中医医院2016年06月～2017年10月期间在门诊及住院病房确诊为CKD患者随机入选,共随访24周,最终完成疗程且资料完整的CKD(3～4期)患者60例。分复方α酮酸片联合低蛋白饮食组(LPD+KA组,n=29)和实脾固肾化瘀方联合低蛋白饮食组(LPD+中药组,n=31),依据生化指标及临床症状评价实脾固肾化瘀方对CKD患者肾功能、尿蛋白及营养状态的疗效。结果:随访24周后,LDP+KA组与LPD+中药组均可提高患者血清白蛋白及前白蛋白的水平,但LPD+中药组更优于前者(P 0. 05); 24周中血肌酐的变化较为平稳,LPD+中药组降肌酐优势更为明显(P 0. 05)。LPD+中药组症状改善较LPD+KA组明显(P 0. 05)。结论:实脾固肾化瘀方联合低蛋白饮食较复方α酮酸片联合低蛋白饮食可更好的改善CKD患者营养状态、肾功能及临床症状。     

FGF23在不同分期慢性肾脏病患者中的表达水平及其与左心室肥厚、PLSγ/calcineurin NFAT信号通路的关系

目的探究针对慢性肾脏病不同分期患者FGF23水平的表达与左心室肥厚的相关性及对磷脂酶Sγ(PLSγ)/钙调神经磷酸活化T细胞核因子(NFAT)信号通路的影响。方法筛选2016年10月至2018年9月来新疆医科大学第五附属医院就诊的CKD患者,将符合标准的的107例患者按照肾小球过滤率(GFR)将患者划分为2～5期,另选择同期就诊的健康正常人30例作为对照。分别检测GFR、血清成纤维细胞生长因子23(FGF23)、心脏结构和PLSγ/calcineurin NFAT通路信号,分析FGF23与心脏结构相关性及其对PLSγ/calcineurin NFAT信号通路的影响。结果按照健康对照组、CKD 2期组、CKD 3期组、CKD 4期组、CKD 5期组顺序,患者GFR水平依次降低,FGF23水平依次升高,且各组间两指标均存在显著差异(P0.01);随着患者CKD分期数增加,患者心脏右室各参数IVST、LVPWT、LVID、LVM和LVMI水平依次升高,且与健康对照组均存在显著差异(P0.05),CKD 5期患者IVST、LVPWT和LVM均与其他组存在显著差异(P0.05);Spearman相关性分析结果显示,107例CKD患者血清FGF23与LVID、IVS-R、LVPWT、LVM和LVMI呈正相关,相关系数分别为0.256、0.285、0.274、0.433和0.498,与E/A比值呈负相关,r=-0.431;CKD患者血清均表达神经钙蛋白和磷酸化NFAT(pNFAT)。结论 CKD2-5期患者中血清FGF23水平升高普遍存在,与左室肥厚显著相关,同时FGF23水平升高激活PLSγ/calcineurin NFAT信号通路。     

慢性肾脏病患者幽门螺旋杆菌感染率分析

目的:研究慢性肾脏病各期幽门螺旋杆菌(Hp)感染率及分布特征。方法:调查2010年01月~2016年06月在我科门诊及住院的慢性肾脏病(CKD)患者360例及同时期于我院健康体检者100例,测定患者血清幽门螺旋杆菌抗体Ig G及Ig M,利用改良的MDRD公式估算肾小球滤过率(e GFR),比较各组患者Hp现症感染(Hp Ig M阳性+Hp Ig G阳性)率及既往感染(Hp Ig M阴性+Hp Ig G阳性)率,并分析其差异。结果:(1)所有CKD患者血清幽门螺杆菌(Hp)现症感染率57.8%(208/360),既往感染率30%(108/360),二者均与健康成人组(现症感染率43%,既往感染率21%)差异无统计学意义(P0.05)。(2)与健康成人组相比,CKD1期、CKD5期Hp现症感染率差异无统计学意义(P0.05),CKD2期~CKD4期现症感染率显著升高(P0.05),CKD5期既往感染率显著增加(P0.01)。(3)CKD5期患者Hp现症感染率较CKD3期(χ2=3.873,P=0.049)、CKD4期(χ2=11.534,P0.01)降低,但既往感染率(43%)较其他CKD组显著增加(P0.05)。结论:(1)慢性肾脏病患者幽门螺杆菌现症感染随肾功能进展而增加,至尿毒症期,Hp既往感染率增加,现症感染有所降低。(2)建议慢性肾脏病患者及时筛查幽门螺杆菌感染,并积极治疗,提高患者生活质量及改善预后。     

Peripheral neuropathy in diabetic monkeys

Peripheral neuropathy is a significant complication of human diabetes and a source of morbidity. Appropriate experimental models may aid in understanding its pathogenesis and in developing therapeutic strategies. We sought to determine whether spontaneously diabetic obese adult monkeys developed peripheral neuropathy and whether it occurred early or late in relation to the onset of hyperglycemia. We studied nerve conduction in both motor (peroneal, median, and ulnar) and sensory (median and ulnar) nerves in 13 adult male rhesus monkeys, 4 overtly diabetic and 9 nondiabetic (mean age 21 +/- 2 and 16 +/- 2 yr, respectively, NS; mean fasting plasma glucose 14.5 +/- 3.4 and 4.4 +/- 0.6 mM, P = .001). The diabetic animals had significantly reduced motor conduction velocities and prolonged F-wave latencies. Motor-evoked amplitudes did not differ. In the diabetic monkeys, nerve conduction times were increased in motor fibers, which could be identified as early as 2 yr after the onset of hyperglycemia. These abnormalities are similar to those seen in humans and suggest further study of these animals as a primate model of human diabetic neuropathy.     

Effect of low [CaCl2] and high [MgCl2] cardioplegia and moderate hypothermic ischemia on myoplasmic [Ca] and cardiac function in intact hearts

Objective: Cold cardioplegia (CP) protects against ischemic damage in part by reducing [Ca²⁺]_i overload on reperfusion. Hyperkalemic cardioplegic solutions are widely used in coronary artery bypass procedures, and the specific ionic composition of these solutions may contribute to their variable myocardial protective effects secondary to reduced Ca²⁺_i loading. We reported previously that CP decreased the rise in cardiac diastolic (dia) [Ca²⁺]_i observed during 4 h cold storage at 3 °C in Krebs–Ringer's (KR) solution and decreased dia[Ca²⁺]_i and increased systolic (sys) [Ca²⁺]_i and function on reperfusion after cold storage. Our aim here was to determine if low Ca²⁺_o and high Mg²⁺_o adds to the protective effects of high K⁺_o by decreasing [Ca²⁺]_i during ischemia and reperfusion. Methods: We compared effects of 4.5 mM K⁺_o, 2.5 mM Ca²⁺_o and 2.4 mM Mg²⁺_o KR solution with a higher K⁺_o (18 mM), a lower Ca²⁺_o (1.25 mM) and/or higher Mg²⁺_o (7.2 mM) CP solutions on cardiac mechanic function and sys and dia[Ca²⁺]_i during and after moderate hypothermic global ischemia (17 °C for 4 h) in guinea pig intact hearts isolated by the Langendorff technique. Isovolumetric left ventricular pressure (LVP) was measured with a transducer connected to a fluid-filled balloon placed in the LV and [Ca²⁺]_i was measured using indo-1 fluorescence and a fiberoptic cable placed on the LV free wall. Results: For all CP groups compared to the KR control group after 60 min reperfusion, we observed significant lowering of dia[Ca²⁺]_i by 47%, left ventricular diastolic pressure (diaLVP) by 55%, and infarct size by 43%. We also found significant elevation of sys[Ca²⁺]_i by 25%, d[Ca²⁺]_i/dt_max and d[Ca²⁺]_i/dt_min by 33 and 34%, sys–diaLVP by 55%, dLVP/dt_max and dLVP/dt_min by 34 and 40%, coronary flow by 31%, cardiac efficiency by 21%, and MVO₂ by 25%. These results indicate that CP reduces myoplasmic Ca²⁺ loading and improves mechanical and metabolic function on warm reperfusion compared to KR. However, there were no differences in these indices of Ca²⁺_i cardiac function or metabolism among any CP group after warm reperfusion with KR solution. Conclusion: Increasing K⁺_o to produce cardiac arrest was the most cardioprotective effect of CP against ischemia reperfusion injury; lowering Ca²⁺_o or raising Mg²⁺_o did not add to this protective effect or additionally alter [Ca²⁺]_i.     

Effect of erythropoietin therapy on polyneuropathy in predialytic patients

BACKGROUND: Peripheral neuropathy commonly develops in patients with advanced chronic renal failure. The uremic neuropathy is often subclinical and detectable only by electrophysiological studies. Receptors to erythropoietin (EPO) have been described on non-hematopoietic cells including neuronal cells. METHODS: In order to evaluate the effect of five months' EPO therapy on polyneuropathy in predialytic patients, nerve conduction studies (NCS) were done in 46 anemic predialytic patients without neurological complaints. In 22 (twelve non-diabetic and ten diabetic) neuropathy was detected and these patients were included in the study. After five months of subcutaneous EPO therapy NCSs were repeated. RESULTS: Hemoglobin increased significantly (p=0.0001) with no significant increase in plasma creatinine. Motor nerve conduction velocity (MNCV) and compound muscle action potentials (CMAP) of the ulnar nerve were normal before EPO therapy and at the end of the study. MNCV of the median, peroneal and tibial nerves improved significantly (p<0.05). CMAP of the median nerve rose significantly, to the normal range (p=0.01). Sensory nerve conduction velocity (SNCV ) and sensory nerve action potentials (SNAP) were reduced in all sensory nerves and did not improve. The improvement in non-diabetic patients was better than in diabetic patients. No significant correlation was found between the increase in hemoglobin and the improvement in MNCV. CONCLUSIONS: Subcutaneous EPO therapy improved motor polyneuropathy in uremic patients, especially non-diabetic individuals. The improvement in MNCV may reflect remyelination. This non-hematopoietic effect may be related to some direct action through EPO receptors on peripheral neuronal cells.     

远端神经变性对神经再生放大规律的影响

目的 探讨应用正常供体神经修复预变性受体神经时,再生神经纤维放大的效果.方法 将雄性SD大鼠12只,随机分为变性组、对照组,所有动物均实行手术.变性组应用部分正常腓总神经修复变性8周胫神经远端;对照组应用部分正常腓总神经修复即刻损伤后胫神经远端.术后3个月进行神经电生理测量、肌力测量、组织学观察、神经锇酸染色及有髓神经纤维计数,并计算两组神经再生放大率.结果 变性组和对照组神经传导速度分别为(16.992±3.737)m/s和(23.092±2.788)m/s;肌肉强直收缩力恢复率为(39.642±5.865)%和(71.098±6.778)%;再生有髓神经纤维数分别为1718.2±282.0和3340.0±506.5;神经再生放大率1.581±0.329和3.098± 0.642;以上指标变性组均低于对照组(P＜0.05).结论 应用正常神经修复8周变性神经远端时,神经纤维再生放大率降低,说明损伤远端神经较长时间变性,接受再生神经纤维长入的能力降低.     

Alkaline Phosphatases in Endochondral Ossification of Rats Low in Calcium and Vitamin D Deficient

Young rats fed a low calcium and vitamin D deficient diet for 2 weeks developed hypocalcemia and increased alkaline phosphatase activity in serum. The serum alkaline phosphatase activity (pNPPase) was found to be of skeletal origin. In accordance, the total non-specific alkaline phosphatase (pNNPase) activity in the microsomal fraction of tibial epiphyseal cartilage and metaphysis increased in the deficiently fed group when compared to the normal group. An increased activity in the microsomal fraction of tibial epiphyseal cartilage and metaphysis was shown both for inorganic pyrophosphatase and total ATP-degrading enzyme activity in the deficient group. This was also found in the presence of R 8231, indicating an increased activity of Ca²⁺-ATPase, shown to be present in both the epiphyseal plate and the metaphysis. These increased enzyme activities were consistent with the known effects of hypocalcemia and/or parathyroid hormone (PTH) on bone alkaline phosphatase activity. The increase in Ca²⁺-ATPase might, however, be a direct response to the hypocalcemia present in the deficient animals. Furthermore, the findings in the present study support the view that the same alkaline phosphatase iso-enzyme is present at different calcification loci.     

神经电生理检查对足趾背屈功能障碍的诊断价值

目的 探讨神经电生理检查对无明确外伤史足趾背屈功能障碍的诊断价值.方法 对66例(77侧)无明确外伤史且以足趾背屈功能障碍为主诉的患者行神经电生理检测,内容包括:腓肠神经、腓总神经感觉神经传导速度(sensory nerve conduction velocity,SNCV),胫神经、腓总神经运动神经传导速度(motor nerve conduction velocity,MNCV),胫神经、腓总神经、闭孔神经、臀上神经、臀下神经支配肌及椎旁肌的肌电图(electromyogram,EMG).结果 66例中30例(30侧)腓骨小头处腓总神经卡压,2例(2侧)梨状肌出口处坐骨神经卡压,18例(18侧)神经根处受到腰椎间盘压迫,6例(11侧)累及前角运动神经元病变,6例(10侧)为糖尿病引起的周围神经病变,4例(6侧)所检测指标均在正常范围.神经电生理检测所得结果阳性率为93.9%.结论 神经电生理检查可以为无明确外伤史引起的足趾背屈功能障碍提供客观的检测指标,对该病的病因诊断具有重要的参考价值.     

Experimental study of polarity in reversing cable nerve grafts

To evaluate the effect of cable nerve graft polarity, the bilateral common peroneal nerves in 12 rabbits were excised to create 20-mm nerve gaps. These gaps were repaired with cable grafts using three strands of 20-mm ipsilateral sural nerves. In the left leg, the sural nerves were grafted with the original orientation. In the right leg, the nerve graft polarity was reversed 180 degrees. Six months later, motor conduction velocities were evaluated, and the bilateral anterior tibial muscles and extensor digitorum longus muscles were measured. The nerves were harvested and analyzed histologically. Motor conduction velocity was 37.4+/-4.1 m/s in the reversed group, and 36.6+/-5.5 m/s in the control group. The weight of the muscles was 7.2+/-0.8 g in the reversed orientation, and 7.0+/-1.0 g in the original orientation. None of the differences was statistically significant. Histologically, the axon counts and the axonal density distal to the nerve graft also showed no differences between groups. The sural nerves used did not have a major branch and their diameter was almost the same throughout its length. Reversing nerve graft polarity of a cable graft did not affect nerve regeneration electrophysiologically or histologically.     

Sacral nerve terminal motor latency after ileal J pouch-anal anastomosis for ulcerative colitis

Using a new transcutaneous magnetic stimulation technique, sacral nerve terminal motor latencies (SNTML) were measured after ileal J pouch-anal anastomosis in eight patients with ulcerative colitis, and the results were compared with those obtained from 15 normal subjects. The conduction delay of the SNTML in patients with soiling was significantly longer than that of the continent group as well as that of normal subjects (P<0.01). There were no significant differences in the conduction delay between the continent group and the control subjects. These findings therefore support the hypothesis that such soiling, which is sometimes seen after ileal J pouch-anal anastomosis, is partly due to damage to the sacral nerves.     

清胰陷胸汤联合血液净化对重症急性胰腺炎患者临床疗效及免疫功能的影响

目的:探讨清胰陷胸汤联合血液净化对重症急性胰腺炎患者临床疗效及免疫功能的影响.方法:选取重症急性胰腺炎患者92例,依据随机数表法均分为观察组和对照组.两组均给予常规干预治疗,包括胃肠减压/禁食、抗感染、抑酸、抑制腺体分泌、维持水/电解质平衡、营养支持治疗,必要时给予经口气管插管机械通气.对照组在常规治疗基础上,给予连续...