青年性前部视网膜劈裂锯齿缘断离及视网膜脱离

目的：探讨青年性前部视网膜劈裂锯齿缘断离及视网膜脱离的临床特点、治疗及其预后。方法：对青年性前部视网膜劈裂锯齿缘断离合并视网膜脱离患者10例20只眼进行常规检眼镜眼底及Goldmann三面镜联合巩膜压陷检查，根据不同情况进行激光光凝，或巩膜冷凝外加压手术治疗，并随访1～5年。结果：共lO例，年龄17～32岁，8例为双眼患病，病变位于颞下，双侧对称。11眼同时患有前部视网膜劈裂、锯齿缘断离及视网膜脱离，3眼患有前部视网膜劈裂及锯齿缘断离，1眼仅有前部视网膜劈裂，3眼仅有锯齿缘断离其中2眼合并视网膜脱离。13眼合并视网膜脱离者采用巩膜冷凝外加压术，全部一次治愈，5眼行激光封闭锯齿缘断离及劈裂区。随访期间未见视网膜脱离，视力均有不同程度提高。结论：青年性前部视网膜劈裂锯齿缘断离及视网膜脱离有典型的临床特点，尽早发现、适宜治疗，预后良好。     

Thermafil热熔牙胶、Vitapex临床常用根管充填材料微渗漏比较研究

目的 :对比根充糊剂 牙胶尖、Vitapex 牙胶尖、Thermafil热熔牙胶三种根管充填材料对离体人牙根管的密封性能。方法 :将 5 0个新鲜拔除的人单根管牙 ,在釉牙骨质界处切除牙冠。将所有牙根随机分为 5组 ,每组 10个。 3个实验组分别用上述三种材料充填根管 ;剩余 2组 ,一组根管预备后不进行充填 ,另一组不进行根管预备 ,也不进行根管充填。用印度墨水染色法对比三种根管充填材料对离体人牙根管的密封性能 ,体视显微镜下测量染色线长度并进行统计学分析。结果 :根充糊剂 牙胶尖组、Vitapex 牙胶尖组和Thermafil热熔牙胶组的平均染色线长度分别为 3 .3 6± 0 .42mm、2 .0 9± 0 .19mm、1.0 5± 0 .3 7mm。Vitapex糊剂 牙胶尖或Thermafil热熔牙胶进行根管充填 ,产生的根管封闭性明显优于用根充糊剂 牙胶尖组根管充填 (P <0 .0 5 ) ;而Vitapex糊剂 牙胶尖和Thermafil热熔牙胶比较时 ,统计学无显著性差异 (P >0 .0 5 )。结论 :Thermafil热熔牙胶的密封性能最强 ,Vitapex糊剂 牙胶尖次之 ,根充糊剂 牙胶尖最弱。     

Effects in cats of inhibition of nitric oxide synthesis on cerebral vasodilation and endothelium-derived relaxing factor from acetylcholine.

BACKGROUND AND PURPOSE: We investigated the chemical identity of the endothelium-derived relaxing factor generated by acetylcholine in cerebral microvessels by studying the effects and mechanism of action of inhibitors of nitric oxide synthesis from arginine on the vasodilation and endothelium-derived relaxing factor production induced by topical application of acetylcholine in cerebral arterioles. METHODS: We determined cerebral arteriolar dilation and endothelium-derived relaxing factor production by bioassay in anesthetized cats equipped with cranial windows during superfusion of 10(-7) M acetylcholine before and after administration of either NG-monomethyl L-arginine or NG-nitro-L-arginine, two inhibitors of nitric oxide synthesis. RESULTS: NG-Nitro-L-arginine abolished the vasodilation from acetylcholine and eliminated the production of endothelium-derived relaxing factor in the bioassay experiments. NG-Monomethyl L-arginine had no effect on the response to acetylcholine in the absence of pretreatment. However, after pretreatment with the detergent sodium dodecyl sulfate to increase cell membrane permeability, the inhibitor had effects identical to those of NG-nitro-L-arginine. L-Arginine reversed the effects of the inhibitors of nitric oxide synthesis. Neither inhibitor affected baseline vascular caliber, nor did they generate a vasoconstrictor agent in the bioassay experiments. The two inhibitors of nitric oxide synthesis did not affect the response to nitroprusside or adenosine, showing that the effect on responses to acetylcholine was specific. Also, the blockade of the response to acetylcholine induced by the inhibitors of nitric oxide synthesis was unaffected by treatment with superoxide dismutase and catalase, showing that the effect was not mediated by oxygen radicals. CONCLUSION: The endothelium-derived relaxing factor generated by acetylcholine in cerebral arterioles of cats is either nitric oxide or a nitric oxide-containing substance. The effect of these inhibitors on the response to acetylcholine is mediated by inhibition of the synthesis of nitric oxide. There is no involvement of radicals, and no vasoconstrictor agent is generated.     

老年2型糖尿病患者胰岛素抵抗相关指标的检测和意义

目的:探讨老年2型糖尿病胰岛素抵抗(IR)及其相关性,为老年2型糖尿病的合理防治提供临床依据。方法:选择120例老年2型糖尿病患者,按胰岛素敏感指数(HOMA)胰岛素抵抗(HOMA-IR)50百分位点将患者分为两组:胰岛素相对敏感组(HOMA-IR<3.56)和胰岛素相对抵抗组(HOMA-IR≥3.56),比较体重指数(BMI)、腰/臀比(WHR)、血压、血生化学检查等指标。用年龄>40岁,<60岁的2型糖尿病患者做对照组。结果:两组老年患者在年龄、性别、舒张压、空腹血糖、胆固醇、高密度脂蛋白、糖化血红蛋白、HOMA胰岛β细胞功能方面无差异;但BMI、WHR、收缩压、甘油三脂、空腹胰岛素、HOMA-IR差异具有显著性。多线性回归分析后,只有腰/臀比、收缩压、甘油三脂、HOMA-IR存在统计学差异。老年患者与对照组相比,IR发生率明显增加,且两者腰/臀比、收缩压、甘油三脂方面也差异显著。结论:IR与老年2型糖尿病密切相关,是临床防治糖尿病的重要靶点。     

VEGF在肺癌组织中的表达及临床意义

目的：探讨血管内皮生长因子在肺癌中的表达情况与肺癌病理生物学行为之间的关系。方法：采用免疫组化SP法检测47例肺癌组织和10正常肺组织中VEGF的表达水平。结果：肺癌组织中VEGF的表达明显高于正常肺组织(P＜0．005)，P53、VEGF表达与肺癌的分化程度、淋巴结转移及P—TNM分期密切相关(P＜0．05)，与患者的性别、年龄、肿瘤大小及组织类型无关(P＞0．05)。结论：检测肺癌组织中VEGF的表达水平有助于了解肿瘤的生物学行为，并可作为判断其预后的有价值指标。     

Effect of autocontrol micromotion intramedullary interlocking nail on fracture healing： an experimental study

Objective: To investigate the effect of autocontrol micromotion locking nail ( AMLN ) on experimental fracture healing and its mechanism. Methods: 16 goats undergoing both sides of transverse osteotomy of the femoral shafts were fixed intramedullary with AMLN and Gross-Kempf (GK) nail, respectively. The follow-up time was 7, 14, 28 and 56 days. Roentgenographic, biomechanical, histological, scanning electromicroscopic and biochemical analyses were done. Results: (1) The strength of anticompression, antiflexion and antitorsion in the fractural end in the AMLN-fixed group was higher than that of GK nail-fixed group; whereas, the rate of stress shelter in the fractured end decreased significantly (P<0.01). (2) The content of the total collagen, insoluble collagen, calcium and phosphate in the AMLN-fixed group was higher than that in the GK nail-fixed group (P<0.05). (3) Histological observation and quantitative analysis of calluses revealed that AMLN could promote the growth of bridge calluses and periosteum calluses. Hence the facture healing and remolding process achieved early, which was much better than traditional GK nail fixation. (P<0.05). (4) 7-14 days postoperation, the calluses of AMLN-fixed group was flourish and camellarly arranged and the collagen fibril formed constantly in the absorption lacuna of bone trabecula. 28-56 days postoperation, the collagen fibril was flourish around the absorption lacuna and was parallel to the bone's longitudinal axis. Active bony absorption and formation were seen, so was remolding and rebuilding. Haversian system was intact and the bony structural net was very tenacious because of the deposition of calcium salt. None of the above findings was observed in the GK nailfixed group. Conclusions: The design of AMLN accords well with the plastic fixation theory. As the geometry ametabolic system constituted by the intramedullary fixation instruments and the proximal and distal end of the fracture is very firm and stable, the disturbance to the physical stress distributed in the fractural end is light. The generation and conduct of the intermittent physical stress between the fractural parts could reach the balance between stress conduct and stress protection. The feature that the healing and remolding take place at the same time speeds up the fractural healing process.     

hCG/ATP-induced Leydig cell calcium channel reaction at different extracellular calcium ion concentration

Objective: To study the calcium channel reaction of human Leydig cells induced by hCG/ATP at different extracellular calcium ion concentrations. Methods: The Leydig cell calcium ion concentration was examined with laser confocal microscope, when the cells were stimulated with hCG/ATP at different extracellular calcium contrations. Results: With calcium-containing extracellular fluid, the Leydig cells were sensitive to hCG stimulation and when the extracellular fluid was calcium-free, the Leydig cells did not respond to the stimulation. However, the Leydig cells did respond to ATP stimulation no matter the extracellular fluid contained calcium or not. Conclusion: In human Leydig cells, there are calcium channels sensitive to hCG and ATP. The extracellular calcium ion concentration plays an important role in the regulation of Leydig cell metabolism by hCG/ATP.     

关节镜下采用四股和八股腘绳肌肌腱双束重建前十字韧带的比较研究

目的比较关节镜下采用四股和八股腘绳肌肌腱双束重建前十字韧带的临床效果。方法2001年9月至2002年8月,将76例陈旧性前十字韧带损伤患者随机分为两组进行双束重建。一组采用四股腘绳肌肌腱移植物:取同侧半腱肌肌腱,做成两个两股肌腱移植物,分别重建前十字韧带前、后束;一组采用八股腘绳肌肌腱移植物:取同侧半腱肌肌腱做成一个四股肌腱移植物重建前束,取同侧股薄肌肌腱做成另一个四股肌腱移植物重建后束。按照IKDC、Lysholm和Tegner膝关节评分标准评价疗效。结果四股肌腱移植物组有33例、八股肌腱移植物组有35例获得随访,随访时间1～3年,平均16个月。四股肌腱移植物组KT-1000检查示,双侧膝关节前向松弛度差异<3mm者25例(75.8%,25/33),3～5mm者5例(15.2%,5/33),6～10mm者3例(9.1%,3/33);轴移试验阴性28例(84.8%),阳性5例(15.2%)。八股肌腱移植物组KT-1000检查示,双侧膝关节前向松弛度差异<3mm者33例(94.3%,33/35),3～5mm者2例(5.7%,2/35);轴移试验阴性34例(97.1%),阳性1例(2.9%)。根据IKDC检查标准,四股肌腱移植物组有29例(87.9%,29/33)、八股肌腱移植物组有34例(97.1%,34/35)为正常或者接近正常,Lysholm评分分别为(90.2±2.9)分和(97.3±1.7)分,两组比较差异有统计学意义(P<0.05)。结论关节镜下采用八股腘绳肌肌腱较采用四股腘绳肌肌腱双束重建前十字韧带能够明显提高膝关节稳定性。