经腹探查改良全腹膜外腹腔镜腹股沟疝修补术

目的探讨经腹探查改良腹腔镜全腹膜外腹股沟疝修补术式（total extraperitoneal repair，TEP）的可行性和优越性。方法从2003年10月至2004年6月，完成了传统TEP术60例。从2004年7月至2007年8月对160例腹股沟疝患者实施了经腹探查改良TEP（即手术开始先行经腹探查）。按术中是否经腹探查分为传统TEP组和改良TEP组。登记患者年龄、性别，记录术中发现对侧隐匿性腹外疝例次、术中漏气与否（是否需要Verres针排放腹腔气体）、术后住院天数、术后恢复日常活动天数以及术后复发情况。结果改良TEP组160例诊断出40例隐匿性腹外疝，包括32例腹股沟疝，8例股疝，而传统TEP组60例中仅发现4例隐匿性腹股沟疝。两组对隐匿性腹外疝的检出比例分别为25％和6．67％，经检验x2=9．167，P〈0．05；比较两组漏气入腹的发生比例19．4％和16．7％，检验x2=0．127，P〉0．05，比较两组患者术后住院天数、恢复日常活动天数，经t检验，P值均〉0．05；改良TEP组回纳经体外不能回纳的大网膜14例，联合行腹腔镜胆囊切除术4例，腹腔镜阑尾切除术3例，与泌尿外科合作同期切除同侧隐睾5例，精索鞘膜积液切除和前列腺电切各1例。传统TEP组有2例复发，腹股沟斜疝和直疝各1例，均位于对侧。结论经腹探查加传统TEP术式是可行的，改良TEP提高了传统TEP术式的效果，扩展了TEP的手术适应症，使TEP联合其它常见腹部外科腹腔镜手术得以实现。     

Comparison of liquid phase radiobinding assay and solid phase ELISA for the measurement of insulin antibodies and insulin autoantibodies in serum

Sera containing insulin antibodies from 20 insulin-treated diabetic patients, sera containing insulin autoantibodies from 20 insulin-naive non-diabetic patients, and from 10 normal controls, were tested at 1:20 dilution in three different radioimmunoassays (RIA) and an enzyme linked immunosorbent assay (ELISA), using a highly purified human insulin ligand. The RIA using insulin radiolabelled at multiple sites detected insulin antibodies in 17/20 and insulin autoantibodies in 13/20 sera. The same RIA using A-14-monoiodinated insulin was sensitive to antibodies and autoantibodies in all the sera. The same RIA using sera after insulin extraction detected only 13/20 diabetic sera and 9/20 autoimmune sera as positive, owing to a substantial rise in non-specific binding of the control sera. ELISA was sensitive to insulin antibodies and autoantibodies in every case. When binding curves for ELISA and the most sensitive RIA were compared using serial dilutions of four insulin antibody containing sera and four insulin autoantibody containing sera, antibody titres varied from 1.1 to 3.8 times higher in ELISA, and autoantibody titres from 10.6 to 28.6 times higher in ELISA. These studies indicate that ELISA is more sensitive than RIA to insulin antibodies, and in particular to insulin autoantibodies.     

Spanish norms for the Harvard Group Scale of Hypnotic Susceptibility, Form A

The results of administering the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. Orne (1962) to a Spanish sample are on the whole consistent with those results obtained in other normative studies, especially Bongartz's work with a German sample, and they confirm HGSHS:A's usefulness in non-Anglophone countries. The Spanish HGSHS:A's reliability and validity remain within the limits reported for other locales, but there are certain discrepancies with respect to the difficulty of two HGSHS:A items.     

Germ cell DNA quantification shortly after IR laser radiation

The immediate effect of IR laser radiation on rat germ cells was studied by cytophotometric quantification of the nuclear DNA content in testicular sections. Two different levels of radiation were studied: one according to clinical application (28.05 J/cm2) and another known to increase the germ cell number (46.80 J/cm2). The laser beam induced changes in the germ cell DNA content depending on the cell type, the cell cycle phase and the doses of radiation energy applied. Following irradiation at both doses the percentage of spermatogonia showing a 4c DNA content was increased, while the percentage of these with a 2c DNA content was decreased. Likewise, the percentages of primary spermatocytes with a DNA content equal to 4c (at 28.05 J/cm2), between 2c and 4c (at 46.80 J/cm2) and higher than 4c (at both doses) were increased. No change in the mean spermatid DNA content was observed. Nevertheless, at 46.80 J/cm2 the percentages of elongated spermatids with a c or 2c DNA content differed from the controls. Data show that, even at laser radiation doses used in therapy, the germ cell DNA content is increased shortly after IR laser radiation.     

Caffeine intensifies taste of certain sweeteners: role of adenosine receptor

Caffeine, a potent antagonist of adenosine receptors, potentiates the taste of some but not all sweeteners. It significantly enhances the taste of acesulfam-K, neohesperidin dihydrochalcone, d-tryptophan, thaumatin, stevioside, and sodium saccharin. Adenosine reverses the enhancement. Caffeine has no effect on aspartame, sucrose, fructose, and calcium cyclamate. These results suggest that the inhibitory A1 adenosine receptor plays an important local role in modulating the taste intensity of certain sweeteners and that several transduction mechanisms mediate sweet taste.     

多层螺旋CT多平面及表面重建对鼻骨骨折的诊断价值

鼻骨骨折是面部外伤最常见的损伤，在多层螺旋CT问世以前，普通x线、普通CT检查均不能完全达到诊断要求。目前，HRCT已经成为诊断鼻骨骨折的首选检查方法，但是对于鼻骨骨折的立体观察以及鼻骨孔的鉴别有一定的局限性[1]，     

骨髓基质细胞移植治疗神经系统损伤现实价值及机制

具有多向分化潜能的骨髓基质细胞(BMSC)在脑神经领域的研究较为深入,其可分化为神经细胞修复脑神经组织损伤及其基础研究成果,为修复脊髓损伤研究提供了部分依据.近年BMSC移植修复脊髓横断伤的动物实验研究也表明其时脊髓损伤有积极意义.根据目前研究成果,推测其可能的修复作用机制有BMSC直接分化为神经元样细胞、分泌神经营养因子、介导免疫清除作用、激活神经细胞自我修复和抑制疲痕过度生成等.该文就相关基础研究作一综述.