The anterior band of the inferior glenohumeral ligament. Assessment of its permanent deformation and the anatomy of its glenoid attachment

Surgical treatment for traumatic, anterior glenohumeral instability requires repair of the anterior band of the inferior glenohumeral ligament, usually at the site of glenoid insertion, often combined with capsuloligamentous plication. In this study, we determined the mechanical properties of this ligament and the precise anatomy of its insertion into the glenoid in fresh-frozen glenohumeral joints of cadavers. Strength was measured by tensile testing of the glenoid-soft-tissue-humerus (G-ST-H) complex. Two other specimens of the complex were frozen in the position of apprehension, serially sectioned perpendicular to the plane containing the anterior and posterior rims of the glenoid, and stained with Toluidine Blue. On tensile testing, eight G-ST-H complexes failed at the site of the glenoid insertion, representing a Bankart lesion, two at the insertion into the humerus, and two at the midsubstance. For those which failed at the glenoid attachment the mean yield load was 491.0 N and the mean ultimate load, 585.0 N. At the glenoid region, stress at yield was 7.8 +/- 1.3 MPa and stress at failure, 9.2 +/- 1.5 MPa. The permanent deformation, defined as the difference between yield and ultimate deformation, was only 2.3 +/- 0.8 mm. The strain at yield was 13.0 +/- 0.7% and at failure, 15.4 +/- 1.2%; therefore permanent strain was only 2.4 +/- 1.1%. Histological examination showed that there were two attachments of the anterior band of the inferior glenohumeral ligament at the site of the glenoid insertion. In one, poorly organised collagen fibres inserted into the labrum. In the other, dense collagen fibres were attached to the front of the neck of the glenoid.     

Latex allergy. An not rare intraoperative event

Latex allergy has become a real problem among both surgical staff (paramedics and physicians) and patients especially pediatric patients with urogenital malformations and spina bifida. Latex allergy is produced from both natural molecules which compose the substance produced from Hevea brasiliensis (rubber tree) and industrial additives contents in latex devices. Diagnosis of latex allergy may be carried out through a preoperative Prik-test. A characteristic of latex allergy reaction is the starting of symptoms (more than 15 minutes after allergen contact). Pathophysiology of latex allergy is the same of all allergic reactions; it is an antigen-antibody reaction and type I or II reaction may occur. There are a lot of devices that surgeons and anesthesists use in the operative theatre and that should not be used in presence of a patient with latex allergy. Guaranteed latex-free devices should always be present in store.     

窥镜下激光治疗前列腺增生症

目的 评价经尿道激光前列腺切除术（ＴＵＬＰ）的疗效及其与前列腺大小的关系。方法 回顾分析了１９８８年至１９９８年１０年,采用ＴＵＬＰ治疗的４６９例前列腺增生症患者对手术技术、手术前后的症关改善情况进行比较,并对２３３例符合条件的患者ＴＵＬＰ手术效果与前列腺大小的相关性进行了研究。结果 ４６９例患者前列腺症状评分（ＩＰＳＳ）平均值由术前的２６．７降到术后的１４．２;最大尿流率平均值由６．２ｍｌ／ｓ上     

甲状腺癌的颈淋巴结转移与血行转移

目的 探讨甲状腺颈淋巴结转移及血行转移的有关因素,提高甲状腺癌的诊断及治疗水平。方法 对１９８４年１月￣１９９２年１２月收治的２２５例甲状腺癌患者的临床特点、治疗方法及病理结果进行了回顾性分析总结。结果 甲状腺癌的淋巴结及血行转移主要现理类型和肿瘤局部浸润程度有关。乳头状癌、鳞状细胞癌主要表现为区域淋巴结转移,转移率分别为４４．７％、３／３,晚期出现血行转移。滤泡状腺癌虽然分化较好,但多表现有血行     

白细胞介素12对肝癌基因治疗的实验研究

目的 研究携带白细胞介素１２（ＩＬ－１２）基因逆转录病毒载体对体内肝癌生长抑制作用,探索基因治疗肝癌新途径。方法 构建携带ＩＬ－１２的逆转录病毒载体,转染逆转录病毒包装细胞系ＰＡ３１７,应用该包装细胞对实验性肝癌大鼠进行治疗,观察抗肿瘤作用,免疫功能变化。     

5-氟尿嘧啶在胰十二指肠切除术患者血液和胰液中的动态分布

探讨５－氟尿嘧啶能否通过胰十二指肠切除术后的残留胰腺组织进入胰液中,并达有效的治疗浓度,为胰腺为临床合理化疗提供理论依据。方法通过观察胰十二指肠切除术患者胰快速推注５－氟尿嘧啶后血液和胰液中药物动态分布及相关性,术后静脉一次性快速推注５－氟尿嘧啶１．０ｇ／ｍ＾２,在给药前后按设计时间点分别采集静脉血和胰液,采用高效液相色谱法测定血浆和胰液５－氟尿嘧啶药物浓度,应用ＰＣＮＯＮＬＩＮ程序程序计算共动态     

Surgical treatment of Ebstein's malformation: report of 108 cases

OBJECTIVE: To review retrospectively the experience of surgical treatment of Ebstein's malformation in 108 patients. METHODS: One hundred and eight patients with Ebsteins malformation underwent surgical correction, including tricuspid valve annuloplasty in 83 patients (73.4%) and tricuspid valve replacement in 30 (5 with redo-operation). Concomitant procedure included division of the abnormal accessory conduction pathway in 8 patients. RESULTS: The overall hospital mortality was 8.8%. The hospital mortality rate was 10.4% before 1990 and 5.5% after that time. There was a significant difference between the two periods (P < 0.05). The main causes of death were low cardiac output, arrhythmias and right heart failure. The mean follow-up time was 6.3 years. The heart function improved to be NYHA class I or II in 92% of the patients. CONCLUSIONS: Early surgical intervention is recommended for patients with Ebstein's malformation, especially for those with symptoms and cardiac enlargement. Tricuspid valve repair should be performed if anterior leaflet of the tricuspid valve well developed. However, tricuspid valve replacement is advocated if anterior leaflet is dysplastic or its origin displaced.     

直肠癌癌旁移行粘膜MTS1基因产物表达的意义

目的 探讨直肠癌癌旁移行粘膜（ＴＭ）的性质及多种种瘤抑制基因（ＭＴＳ１）基因缺失的临床意义。方法 应用粘液组化方法观察了直肠癌旁ＴＭ的范围,免疫组化方法观察了ＭＴＳ１基因产物表达情况,并与正常粘膜及癌组织进行对照 结果 ＭＴＳ１基因产物在正常直肠膜阳性表达率最高,在癌旁ＴＭ、癌组织表达逐渐减少,三者差异有显著意义（Ｐ〈０．０５）;ＭＴＳ１阴性的直肠癌病例,癌旁ＴＭ的明显高于ＭＴＳ１阳性的病例（Ｐ〉     

肉毒碱治疗TPN大鼠肝脂肪变性的研究

目的 探讨在全胃肠外营养（ＴＰＮ）中补充肉毒碱减轻肝脂肪变性的作用。方法 １８只正常Ｗｉｓｔａｒ大鼠和１９只肝硬化Ｗｉｓｔａｒ大鼠分别随机分为６组,Ａ１组、Ａ２组,自由进食和进水（各６只）;Ｂ１组、Ｂ２组,ＴＰＮ（分别６只、７只）;Ｃ１组、 ,ＴＰＮ加肉毒碱（各６只）。各组实验结束后测肝功能,肝脂肪及行肝脏的组织学检查。结果 ＴＰＮ组肝内脂肪显著２,ＴＰＮ＋肉毒碱组肝内脂肪明显减少。结论 在ＴＰＮ     

游离骨膜与复合rhBMP2的异种骨联合移植修复骨缺损的实验研究

目的 探讨复合基因重组人ＢＭＰ２（ｒｈＢＭＰ２）的异种骨与游离骨膜（ＦＰ）联合移植修复节段性骨缺损的效果。方法 将ｒｈＢＭＰ２与去抗原牛松质骨载体（ＢＣＢ）复合,制成ｒｈＢＭＰ２／ＢＣＢ;选用新西兰大耳白兔２８只,制成烧骨干１５ｍｍ缺损动物模型,分别行ＦＰ和ｒｈＢＭＰ２／ＢＣＢ复合移植（ｎ＝６）、ｒｈＢＭ２／ＢＣＢ移植（ｎ＝６）和单纯ＢＣＢ移植（ｎ＝２）;术后４、８、１２、１６周取材,通过Ｘ线、生