铰链式冠外附着体的结构强度分析

目的探讨铰链式冠外附着体设计的合理性.方法采用有限元应力分析的实验方法,分析铰链式冠外附着体阳性结构L形球体的应力分布情况,对其结构强度进行测试.结果在附着体阳性结构L形球体的转角处应力最大,应力值为321.847MPa.结论该铰链式附着体的结构强度符合临床设计要求.     

Nerve growth factor and tyrosine kinase A in human salivary adenoid cystic carcinoma: expression patterns and effects on in vitro invasive behavior.

PURPOSE: Perineural invasion is a frequent occurrence in salivary adenoid cystic carcinoma (ACC) and may prevent complete surgical resection. Studies have indicated that nerve growth factor (NGF) and its high-affinity receptor tyrosine kinase A (TrkA) may play a role in perineural invasion in several malignancies in which perineural invasion is observed. The present study was conducted to investigate the expression of NGF and TrkA in salivary ACC and to examine the effects of NGF on adhesion, migration and invasion capacities of a salivary ACC cell line (SACC-83) in vitro. PATIENTS AND METHODS: Expression of NGF and TrkA was explored using immunohistochemistry in paraffin-embedded tissues of 32 cases of salivary ACC. The effects of NGF on in vitro adhesion, migration, and invasion capacities of the SACC-83 cell line were examined using an MTT assay and a modified Boyden chamber assay respectively. RESULTS: In ACC specimens, 31 (96.9%) and 32 (100%) tumors showed immunoreactivity for NGF and TrkA respectively. Significant correlations were found between NGF/TrkA expression levels and perineural invasion (P < .05). In cell adhesion assay, the percent adherences of SACC-83 cells co-cultured with 25 ng/ml NGF at 1.5 hours and 5, 25 ng/ml NGF at 6 hours were significantly higher than that co-cultured with 0 ng/ml NGF (P < .05). However, high concentration of NGF (500 ng/ml) resulted in a significant inhibition of invasion (P < .05). CONCLUSION: Overexpression of NGF and TrkA in human salivary ACC tissues may constitute a reason for perineural invasion in salivary ACC.     

选择髂内或髂外动脉吻合对移植肾的影响

目的 探讨肾移植动脉重建选择髂外或髂内动脉时移植肾血流参数、肾脏功能和血管并发症的差异。方法 135例初次肾移植患者随机分为2组，2组患者平均年龄、HLA错配数目、淋巴细胞毒试验、冷／热缺血时间差异均无统计学意义（P〉0．05），术后免疫抑制剂应用方案相同。应用髂外动脉端侧吻合66例，髂内动脉端端吻合69例。随访3个月，比较2组患者肾脏功能、彩色多普勒肾脏血流参数和血管并发症发生率。结果 髂内动脉、髂外动脉组2组患者术后3个月时肾功能监测指标（Cr：118．41 vs123．68μmol／L），移植肾主肾动脉、段动脉、大叶间动脉血流及阻力指数差异无统计学意义（P〉0．05）。结论 肾移植动脉重建选择髂内外动脉对移植肾功能及血液流变学无明显影响，动脉选择应根据患者具体情况决定。     

宫腔镜双极汽化电切术临床分析

目的 探讨宫腔镜双极汽化切割术的安全性和疗效。方法 术前宫腔镜诊断均为黏膜下肌瘤和肌壁间凸向宫腔肌瘤36例，在宫腔镜下施行双极汽化电切术。结果 手术成功率100％，手术时间10-70分钟，平均32分钟；出血量12-100ml，平均28ml；标本重15-42g，平均31g。术中、术后无并发症。术后满意率94．4％。结论 宫腔镜双极汽化切割术具有手术时间短、出血少、无并发症等优点，疗效满意。     

葡萄球菌属的分离及耐药性研究

目的　对 1 974株临床分离的葡萄球菌的耐药性进行研究 ,以观察葡萄球菌属的耐药现状。方法　药敏试验采用纸片扩散法 (K -B法 )。结果　临床分离到的葡萄球菌中 ,MRSA的分离率为 2 0 .8% (66/ 31 7) ,MRCNS的分离率为 66 .9% (1 1 0 9/ 1 657) ,MRSA主要来源于生殖道分泌物、痰、伤口分泌物 ,分别占 2 7.3 % ,2 2 .7% ,1 8.2 % ;血液标本中MRSA和MRCNS分别占总分离数的 0 .2 5 %和 4 .9% ,而MRSA只占 0 .2 5 %。MRSA和MRCNS对红霉素、庆大霉素、氯霉素、克林霉素、环丙沙星、复方磺胺甲恶唑、四环素的耐药率分别为 86 .2 %、47.6 %、50 .8%、61 .3 %、54 .5 %、83 .3 %、66 .1 %和 84.9%、37.5 %、45 .9%、53 .7%、58.2 %、84.9%、67.6 % ;MSCNS中环丙沙星、复方磺胺甲恶唑、四环素、氯霉素的耐药率分别为 33 .0 %、64 .1 %、58.5 %、2 7.8%均高于MSSA的 1 4 .6 %、42 .8%、41 .5 %、1 7.7% ,但对于MSS环丙沙星、庆大霉素、氯霉素、克林霉素有较高的敏感性。结论　重视对葡萄球菌的耐药性监测 ,合理使用抗生素、特别是合理使用糖肽类抗生素是非常必要的。     

自体脾静脉移植在门静脉和肠系膜上静脉联合切除的胰十二指肠切除术中的应用

目的：探讨以自体脾静脉重建门静脉系统在联合PV/SMV切除的胰十二指肠切除术中临床应用的可行性。方法：回顾性分析3例胰头癌病人在胰十二指肠切除术中采用脾静脉替代门静脉系移植的应用及其效果。结果：手术均顺利,门静脉阻断时间分别为52min、38min和30min。术后B超随访无脾肿大、腹水等情况,门静脉流量均正常（分别为1450ml/min、1200ml/min和1500ml/min）,术后CTA复查显示重建的血管血流通畅,无血栓形成或狭窄,术后生活质量得到明显改善,黄疸消失,肝功能正常,均痊愈出院。结论：在联合PV/SMV切除的胰十二指肠切除术中采用自体脾静脉替代门静脉系的移植是可行的。     

Polymyxin B antagonizing biological activity of lipopolysaccharide

Objective ： To investigate the mechanism of polymyxin B （ PMB ） antagonizing the biological activity of Hipopolysaccharide （LPS）. Methods： The affinity of PMB for LPS and lipid A was assayed by biosensor, and the neutralization of PMB for LPS （2 ng/ml ） was detected by kinetic turbidimetric limnins test. The releases of TNF-α and IL-6 in murine peritoneal macrophages （PMφ） after exposure to LPS （ 100 ng/ml） were detected, and the expression levels of TLR4, TNF-α and IL-6 mRNA in PMφ induced by LPS （100 ng/ml） were measured by RT-PCR. Results： PMB had high-affinity to LPS and lipid A with dissociation equilibrium constants of 18.9 nmol/L and 11.1 nmol/L, respectively, and neutralized LPS in a dosedependent manner. Furthermore, PMB could markedly inhibit the expressions of TLR4, TNF-α and IL-6 mRNA and the release of cycokines in LPS-stimniated murine PMφ. Conclusions： PMB neutralizes LPS and inhibites the expression and release of cycokines in macrophages, in which the affinity of PMB for lipid A plays an important role.     

计算机导航在骨科手术中的应用

目的将计算机导航技术应用于骨科手术,并对其进行初步分析。方法2004年2～12月,计算机导航系统辅助下共行134枚椎弓根螺钉固定,51枚股骨颈骨折空心钉内固定,58枚交锁髓内钉远端交锁螺钉固定。结果所有病例全部在导航下完成手术,术中明显减少C型臂X线机透视次数,未发生血管和神经损伤并发症。结论计算机导航手术安全有效,更有利于微创手术的开展。     

三维CT脑血管造影在脑动脉瘤诊断中注意点

目的探讨三维CT脑血管造影(3D-CTA)在诊断脑动脉瘤时的注意事项。方法回顾总结3D-CTA检查的106例蛛网膜下腔出血(SAH)病例,其中14例初次3D-CTA显示动脉瘤不清或发现颅内非动脉瘤样血管异常者,对其进行DSA脑血管造影检查。结果初次3D-CTA检查正确诊断脑动脉瘤92例,其中16例为多发脑动脉瘤,共检出115个。余14例因诊断不明确进而实施DSA脑血管造影检查,其中确诊动脉瘤合并烟雾病2例、严重脑血管痉挛致动脉瘤显示不清2例、脑动静脉畸形1例(此5例与3D-CTA所见一致);在3D-CTA扫查范围外发现脑动脉瘤2例。对上述阳性诊断的99例进行手术,并得到证实。另7例在3D-CTA和DSA检查未发现引起SAH的原因病灶,给予保守治疗。结论在脑动脉瘤诊断中,3D-CTA具有较好的精确性。在判断动脉瘤与颅骨位置关系、操作的便捷性和经济性等方面明显优于DSA。在应用3D-CTA对脑动脉瘤进行诊断时,有必要根据患者和设备的具体情况进行个性化设计,方能减少漏诊、误诊。     

新生儿缺氧缺血性脑病的MRI表现

目的:探讨新生儿缺氧缺血性脑病(HIE)的MRI表现。材料和方法:对87例临床确诊为HIE的患儿行MRI扫描,并对其MRI表现进行分析。结果:87例HIE患儿中,74例(85.1%)可见皮层、皮层下及深部白质T1WI迂曲条状、点状高信号;69例(79.3%)显示基底节、丘脑T1WI异常高信号及内囊后肢高信号消失;62例(71.3%)出现弥漫性脑水肿;58例(66.7%)可见颅内出血,包括蛛网膜下腔出血、硬膜下出血、脑室内出血及脑实质出血;19例(21.8%)可见侧脑室周围白质软化;7例(8.0%)可见脑梗死。结论:MRI在HIE正确诊断和早期治疗中具有重要临床价值。