改良W形回肠代膀胱术的疗效观察(附36例报告)

目的 :探讨改良W形回肠代膀胱术的疗效。方法 :对 36例膀胱肿瘤患者行根治性膀胱切除、W形回肠代膀胱术 ,并对术式进行改进。结果 :36例手术时间平均 4 .2h。术后 31例随访 4～ 19个月 ,平均 10 .6个月 ,无严重并发症 ,均无瘤生存。患者一般于术后 3周自主可控性排尿 ,日间尿控率为 10 0 % ,术后 3、6、12个月夜间尿失禁发生率分别为 2 2 .5 %、11.1%及 6 .2 %。术后 6个月尿动力学检查膀胱容量 (36 0± 30 )ml,最大尿流率 (13.6± 2 .6 )ml/s,剩余尿量 (11.5± 5 .8)ml,充盈期膀胱压力明显低于尿道闭合压。新膀胱造影发现新膀胱呈球形 ,完全位于盆腔 ,未见输尿管反流。B超及IVU检查发现原上尿路积水 4例均明显减轻 ,其余未发现输尿管狭窄和上尿路积水征象。无高氯性酸中毒 ,肾功能正常。结论 :改良W形回肠代膀胱术手术时间短 ,操作简单 ,创伤轻 ,并发症少 ;新膀胱容量大 ,内压低 ,顺应性好 ,功能接近于正常膀胱 ,保持原位排尿 ,明显提高了患者术后生活质量 ,值得临床推广应用。     

Calcium environment in bone mineral determined by EXAFS spectroscopy

Summary Extended X-ray absorption fine structure (EXAFS) spectra were recorded, above the Ca K edge, from powdered mouse femurs. Spectra were interpreted on the basis of a model developed previously to explain the features of the EXAFS spectrum of fully crystalline hydroxyapatite. Eight shells of atoms surrounding Ca out of 0.57 nm were required to explain the appearance of the EXAFS spectrum of bone. Shell radii and Debye-Waller factors were systematically varied to obtain the best fit between observed and theoretical spectra, calculated using exact spherical wave theory. The results were closely similar to those obtained previously from the interpretation of EXAFS spectra from poorly crystalline hydroxyapatite prepared by maturation of amorphous calcium phosphate. However, there appears to be slightly more disorder in bone mineral, perhaps as a result of its accommodating carbonate ions     

Analysis of genomic downsizing on the basis of region-of-difference polymorphism profiling of Mycobacterium tuberculosis patient isolates reveals geographic partitioning

Mycobacterium tuberculosis, the etiological agent of tuberculosis, has lost many coding and noncoding regions in its genome during the course of evolution. We performed region-of-difference (RD) analysis using PCR-based genotyping of 131 M. tuberculosis clinical isolates obtained from four different countries, namely, India, Peru, Libya, and Angola. Our studies revealed that RD patterns are often distinct for strains circulating in specific geographical regions and can be used to trace the descent and spread of an isolate from its original reservoir. We describe our findings, which show that no single isolate from the four countries (n = 131) had all the 15 RDs either deleted or retained. Tuberculosis-specific deletion 1 (TbD1) was found to be conserved in 23% of the Indian isolates, indicating their possible ancient origin. RD9 was the most conserved region, RD11 was predominantly deleted, and RD6 was the most variable among the isolates in our collection irrespective of their geographic region. In contrast to earlier reports, our results demonstrate that the deletion of RD1 does not correlate with a decrease in the virulence potential of M. tuberculosis, as Indian isolates (n = 30) examined by us were from diseased individuals and yet had lost the RD1 region. Our results further illustrated that the intactness of the RD5 region may be associated with increased virulence of the organism. This study highlights that the RDs in M. tuberculosis genomes are geographically distributed and specific and may possibly be associated with virulence spectrum.     

音猬因子的功能受体斑片在培养神经干细胞中的表达

目的　观察在培养的神经干细胞内是否有发育调控分子———音猬因子 (sonichedgehog)功能受体———斑片 (patched)表达。　方法　神经干细胞克隆在体外培养传代后 ,用patched的特异性引物对培养的神经干细胞进行RT PCR分析 ,PCR产物经克隆测序后 ,用地高辛标记克隆的探针 ,对神经干细胞进行原位杂交分析。　结果　神经干细胞克隆内大量的细胞均可表达sonichedgehog的功能受体patched ,patched阳性细胞间未见明显差别 ,克隆边缘与中央的patched分布也未见明显差别。　结论　sonichedgehog信号传导路可能在神经干细胞的增殖与分化过程中起重要作用。     

36例眼部枪弹伤临床分析

[背景 ]观察枪弹及弹壳伤对眼部损害程度及治疗手段 .[病例报告 ]本组 36例 40眼枪弹伤中(有 5例 5眼为弹壳伤 ) ,火枪、猎枪的铁砂弹及弹壳伤 2 1例 2 5眼 (6 0 % ) ,气枪子弹铅弹伤 10例 10眼(2 7% ) ,玩具枪塑料弹伤 5例 5眼 (13% ) .选择手术治疗 2 5例 2 9眼 (6 9% ) ,药物治疗 11例 11眼(31% ) .治疗结果视力提高 0 1以上为 10例 ,总有效率为 2 7% .[讨论 ]枪弹伤严重损害眼部 ,双眼致盲2例 4眼 ,单眼致盲 14例 14眼 (包括摘除眼球 4例 4眼 ) .     

大鼠肾上腺切除后垂体前叶GAP-43免疫阳性神经纤维的发芽过程

目的　阐明大鼠双侧肾上腺切除后垂体前叶生长相关蛋白 43(GAP- 43)免疫阳性神经纤维表达的量与术后时间点的关系 ,即轴突发芽的时间过程 .方法　免疫组织化学ABC法 .结果　大鼠双侧肾上腺切除术后第 4日垂体前叶GAP- 43阳性表达显著增多 ,第 2周有所下降 ,至第 4周基本降至正常水平 .结论　大鼠在双侧肾上腺切除后 ,垂体前叶出现肽能神经纤维发芽 ,并围绕在腺细胞周围 ,该发芽过程于术后 4～ 7d达到高峰 ,第 2周开始下降 ,第 4周基本结束     

颈动脉体化学感受性在pH降低时的传递机制

目的　探讨胆碱能机制在 p H降低时颈动脉体 (CB)功能活动变化中的作用 .方法　在离体灌流条件下 ,记录颈动脉窦神经 (CSN)传入纤维的化学感受性单位放电 .结果　乙酰胆碱 (ACh)抑制单位放电 (n=16 ,P<0 .0 5 ) ,阿托品阻断 ACh的作用 ;尼古丁呈剂量依赖性增加单位放电 (n=10 ,r= 0 .94,P<0 .0 1) ;箭毒可阻断尼古丁的作用 ,对自发放电无显著影响 ;尼古丁并不增加化学感受性单位对 p H降低的放电反应 (n=19) ;p H降低时筒箭毒对化学感受性单位放电变化无显著影响 (n=17) ;硝苯吡啶 (5 mmol· L- 1 )对自发的基础单位放电 (n=8)和刺激诱导的电活动 (n=9)均无明显影响 .结论　胆碱能机制与 p H降低时 CB化学感受性功能活动的改变无直接关系     

AhR基因缺陷与野生型小鼠下丘脑室旁核催产素能神经元的不同形态特征

目的　阐明下丘脑室旁核催产素能神经元与免疫功能之间的联系 .方法　用免疫组织化学方法 ,对具有免疫功能缺陷的芳香烃受体 (Ah R)基因缺陷小鼠下丘脑室旁核催产素能神经元的形态特征进行观察 .结果　 Ah R基因缺陷小鼠与野生型小鼠相比 ,催产素能神经元突起增多、增粗 ,许多粗大的纤维穿行至第三脑室室管膜下 .基因缺陷小鼠的下丘脑垂体束与野生型小鼠相比更加密集 ,纤维增粗 .结论　 Ah R基因缺陷小鼠下丘脑催产素能神经元发生了塑性变化 ,提示催产素能神经元在神经免疫调节中可能具有重要作用     

天麻丸中天麻的显微定量研究

目的 :制定天麻在天麻丸中的显微定量标准。方法 :用显微定量法 ,以天麻的木化厚壁细胞为显微特征物 ,对天麻丸中的天麻进行测定。结果 :天麻含量与每mg特征数呈显著的线性正相关。回归方程为 y =6 2 35x 1 80× 10 -3 (γ =0 9999,a =0 0 5 )。结论 :显微定量法测定天麻丸中天麻的含量是可行的 ,结果可靠。