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     

急性非淋巴细胞白血病中MGMT与p53基因突变的研究

目的 探讨肿瘤抑制基因ｐ５３、ＭＧＭＴ在急性非淋巴细胞白血病（ＡＮＬＬ）中的改变。方法 用聚合酶链反应－单链构象多态性（ＰＣＲ－ＳＳＣＰ）技术对３１例ＡＮＬＬ患者、２２例正常人ｐ５３基因第５、６、７、８外显子和ＭＧＭＴ基因第１、４外显子进行突变分析。结果 ３１例ＡＮＬＬ中５例存在ｐ５３基因突变、４例存在ＭＧＭＴ基因突变,其中２例ｐ５３与ＭＧＭＴ同时发生突变。结论 ｐ５３基因突变在白血病发生中起一定     

基于小波变换的甲襞微循环图像边缘检测

讨论了小波变换在图像边缘检测、分类与描述中的作用,并根据甲襞微循环图像的特点,利用三次样条二进小波,采用Ｍａｌａｔ快速算法进行小波分解,成功地提取了甲襞微循环图像的边缘。     

Inhibition of GABA-gated chloride channels by 12,14-dichlorodehydroabietic acid in mammalian brain

1. 12,14-dichlorodehydroabietic acid (12,14-Cl2DHA) reduced GABA-stimulated uptake of 36Cl- into mouse brain synaptoneurosomes suggesting inhibition of mammalian GABA(A) receptor function. 2. 12,14-Cl2DHA did not affect the binding of [3H]-muscimol to brain membranes but displaced specifically bound [3H]-EBOB. The inhibitory effect on [3H]-EBOB binding was not reversible. 12,14-Cl2DHA reduced the availability of [3H]-EBOB binding sites (Bmax) without changing the KD of the radioligand for remaining sites. 12,14-Cl2DHA did not affect the rate of association of [3H]-EBOB with its chloride channel receptor, but increased the initial rate of [3H]-EBOB dissociation. 3. 12,14-Cl2DHA enhanced the incidence of EPSCs when rapidly applied to cultured rat cortical neurones. Longer exposures produced block of IPSCs with marked increases in the frequency of EPSCs and min EPSCs. 12,14-Cl2DHA also irreversibly suppressed chloride currents evoked by pulses of exogenous GABA in these cells. 4. Ultimately, 12,14-Cl2DHA inhibited all synaptic traffic and action currents in current clamped cells indicating that, in contrast to picrotoxinin (which causes paroxysmal bursting), it is not fully selective for the GABA(A) receptor-chloride channel complex. 5. The depolarizing block seen with 12,14-Cl2DHA in amphotericin-perforated preparations implicates loss of Ca2+ buffering in the polarity change and this may account for inhibition of spontaneous action potentials. 6. Our investigation demonstrates that 12,14-Cl2DHA blocks GABA-dependent chloride entry in mammalian brain and operates as a non-competitive insurmountable GABA(A) antagonist. The mechanism likely involves either irreversible binding of 12,14-Cl2DHA to the trioxabicyclooctane recognition site or a site that is allosterically coupled to it. We cannot exclude, however, the possibility that 12,14-Cl2DHA causes localized proteolysis or more extensive conformational change within a critical subunit of the chloride channel.     

药流与负压吸宫法的效果和可接受性研究

研究的目的:比较RU486/Cytotec药物和负压吸宫术两种流产方法的效果,以及医学的和个人的可接受性.对象为通过咨询,介绍两种流产方法后,让对象自愿选择而组成.年龄在20～34岁.药物组100例,闭经35～42天,第1天口服RU486 600mg,第3天服Cytotec(PGE1)0.4mg,第17、43天回医院随访.手术组100例,闭经≤56天,负压吸宫术后第14、43天回医院随访.结果:完全流产率药物组为89%,手术组为100%.对象选择这两种流产方法的主要原因:药物组94%的人认为痛苦少,手术组的55%认为手术快、节省时间,而且手术同时可取出或放置宫内节育器(占45%).结论:RU486/Cytotec药物流产和负压吸宫术在各自适合的人群中都具有高度的可接受性.两种方法各具优缺点,不能相互取代,二者相辅相成,取长补短,将使终止妊娠的措施更为安全     

Complications of ultrasound-guided prostate biopsy peripheral zone only versus combined peripheral and transition zone biopsy

The main objectives of this study were to reassess complications associated with transrectal ultrasound-guided biopsies (TRUSBx) of the peripheral zone (PZ) and to compare morbidity of exclusive PZ biopsy to morbidity associated with two additional transition zone (TZ) biopsies. We distributed a self-administered questionnaire assessing TRUSBx complications to 883 consecutive patients who underwent two systematic TZ TRUSBx in addition to systematic sextant PZ TRUSBx, and to 383 consecutive patients who underwent exclusive PZ TRUSBx. Of 316 (35.8%) patients subjects to TZ and PZ TRUSBx, 71% experienced hematuria, 63% hematospermia, 39% rectal bleeding, and 2.2% temperature elevation greater than 38°C. Of 137 (35.8%) patients who exclusively underwent PZ TRUSBx, 57%, 62%, 36%, and 1.4% reported these complications, respectively. Symptom duration and severity were similar in both groups. Although we report a substantially higher incidence of biopsy complications than previously published, these complications are self limited and require no intervention. Furthermore there appears to be no significant difference between complication rates associated with exclusive PZ biopsy compared with those associated with two additional biopsies of the TZ.     

Cochlear degeneration in guinea pigs after repeated hyperbaric exposures.

The effects of repeated hyperbaric exposures on inner ear function and morphology in guinea pigs were investigated with auditory electrophysiological testing, histopathological and electron microscopic techniques associated with enzyme histochemical method. The results showed that repeated hyperbaric exposures, though considered "safe," did cause damage to the cochlear system. Possible causes of the pathology include direct effects of repeated compression and decompression on the ear, and the possibility of inner ear decompression sickness and barotrauma cannot be excluded.     

Reconstruction of the thumb and digit by toe to hand transplantation

Since the rapid development of microsurgery it is feasible to replant most severed thumbs and digits. In certain patients, however, the trauma is so severe that replantation cannot be performed, such as crush or burst injuries where the amputated part is badly smashed or broken into pieces. There are many methods used to reconstruct amputated thumbs or digits. In our hospital reconstruction of the thumb is accomplished by second toe transplantation, nail flap of the great toe transplantation and bone graft, and nail flap of the great toe and skeleton from the second toe transplantation. Reconstruction of fingers is undertaken through second toe transplantation and second and third toe transplantation. After total loss of the hand, double second toe transplant is used for reconstruction.

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Resumen Gracias al rápido desarrollo de la microcirugía, actualmente es factible reimplantar la mayor parte de los pulgares y los dedos de la mano que hay an sido amputados. Sin embargo, en ciertos pacientes el trauma es tan severo que la reimplantación no puede ser realizada, tal como ocurre con las lesiones por aplastamiento o por explosión, donde la parte amputada resulta severamente aplastada o fragmentada en pedazos. Existen muchos métodos de reconstrucción; los siguientes son los utilizados en nuestro hospital.

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Résumé En raison du développement rapide de la microchirurgie, il est possible de réimplanter la plupart des doigts amputés. Chez certains patients, cependant, le traumatisme est tellement important qu'aucune réimplantation ne peut être tentée: dans les accidents par écrasement ou les lésions par souffle dans lesquelles la partie amputée est abîmée ou fracasée. Il existe de nombreuses méthodes pour reconstruire un pouce ou un doigt. Les procédés que nous employons dans notre Hôpital sont: (1) pour le pouce, le transfert du deuxième orteil, le lambeau unguéal du gros orteil avec greffon osseux, le lambeau unguéal et le transfert osseux du deuxième orteil; (2) pour les autres doigts, le transfert du deuxième orteil, seul ou combiné avec celui du troisième; (3) pour la main, le transfert bi ou unilatéral du deuxième orteil; et (4) des prothèses de main à visée esthétique.

     

14例大疱性表皮坏死松解型药疹治疗体会

报告14例大疱性表皮坏死松解型药疹的治疗。以磺胺类药和解热镇痛药引起者居多,各4例。皮损面积按九分法计算,皮损面积80％以上者9例,80％以上者5例,治愈9例,死亡5例,我们认为早期使用足够剂量皮质激素类药物是有效措施。病程中注意防治感染,给予足够的液体以防止水电解质失平衡,局部治疗使用本院中药“五黄油”。