多巴酚丁胺负荷对缺血性扩张型心肌病患者左心室充盈的影响：病理生理学及预后意义

目的：本研究旨在探讨多巴酚丁胺对缺血性心肌病（ICM）患者左心室（LV）充盈功能的影响，并确定峰值负荷时限制性充盈型（RFP）是否具有预后预测价值。背景：ICM患者峰值负荷时RFP的预后价值尚属未知。方法：在静息和负荷情况下，采用多普勒超声心动检查研究了69例ICM患者；RFP定义为跨二尖瓣E／A比≥1．0、等容舒张时间（IVRT）〈80ms及E波减速时间（EDT）〈120ms。结果：69例患者中有42例静息时出现RFP，其中有24例患者负荷情况下转变为非RFP（EA），18例患者RFP持续存在（EE）；69例患者中27例静息和峰值负荷时均无RFP（AA）。     

常温与低温体外循环心脏直视手术对细胞因子及补体的影响

目的探讨常温及低温体外循环心脏直视手术对细胞因子及补体的影响。方法选择先天性和风湿性心脏病患者40例,随机分为常温组及低温组各20例,分别于术晨、体外循环结束时及术后1、4、7、14 d抽取患者静脉血标本,测定血浆TNF、IL-2、C3、C4值。结果两组术前各项检查指标无显著差异。(1)两组术后1~4 d的IL-2水平较术前显著下降,至术后7 d恢复正常。体外循环结束至术后4 d,低温组IL-2显著低于常温组。(2)体外循环结束时以及术后1、4、7 d,常温组TNF水平显著低于低温组。两组体外循环结束时及术后1、4 d均高于术前,常温组至术后7 d、低温组术后14 d恢复正常。(3)体外循环结束时及术后1、7 d,常温组C3水平高于低温组,术后4 d两组无差别;常温组及低温组于体外循环结束时、术后1、4 d均低于术前,至术后7 d常温组恢复正常,低温组至术后14 d恢复至术前水平。(4)两组体外循环结束时及术后1、4 d C4水平均低于术前。体外循环结束时、术后1 d,常温组C4水平高于低温组。结论常温体外循环心脏直视手术对细胞因子及补体的影响显著轻于低温组,因而对术后机体的恢复优于低温方法。     

Could bipolar vessel sealers prevent bile leaks after hepatectomy?

BACKGROUND AND AIMS: The aim of this work was to test the feasibility of using a bipolar low thermal acting system inducing collagenic sealing but not protein coagulation to secure hepatic parenchyma cutting. MATERIALS AND METHODS: Thirty consecutive hepatectomies were carried out using kellyclasy plus ligatures and clips (controls), while the following 50 hepatectomies used kellyclasy plus bipolar vessels sealer (BVS). Blood loss, duration of hepatic pedicle clamping, length of hospital stay, and complications were recorded. RESULTS: There was no statistically significant difference in blood loss and duration of clamping between controls and BVS. Specific complications (9/21 in the control group vs 1/49 for the BVS group, p<0.00045) and length of hospital stay (14 days in the control group vs 11 days in the BVS group, p<0.014) were statistically lower in BVS group than in the controls, mainly due to prevention of bile duct leakages. CONCLUSIONS: Our data suggest that BVS may be particularly efficient to achieve bilistasis leading to the highest level of safety in performing hepatectomies. Further studies are now needed to confirm its superiority on the classical biliary ducts occlusion techniques.     

Expression of neuron-specific enolase and olfactory marker protein in the developing olfactory mucosa of human fetuses]

OBJECTIVE: To study the expression of neuron-specific enolase (NSE) and olfactory marker protein (OMP) in the developing olfactory mucosa of human fetuses. METHOD: The expression of NSE and OMP in the olfactory mucosa of 6 human fetuses (12, 16, 20, 24, 28 and 34 weeks) was studied using the technique of immunohistochemistry. RESULTS: NSE immunological positive reactions were seen in all 6 fetal mucosa from gestational 12 (G12) to G34, with plenty of positive-stained dual-pole neuron cells. At G12, the positive cells aligned tightly, the cell bodies were localized in the lower portion of olfactory epithelium and the positive-stained area occupied upper 2/3 of fetal nasal mucosa. With the development, the positive cells gradually became multilayer, but the density and the relative area of positive-cells reduced. At G34, the positive cells were located only in upper 1/3 of nasal mucosa. OMP-positive reactions were localized in a few dual-pole neurons at G12, the number was much less than NSE-positive cells in the same fetus. With the development, the OMP-positive cells gradually increased with most of the cell bodies located in the upper portion of epithelium, but number still relatively less than the NSE-positive cells at the same age. CONCLUSION: At G12, there were lots of olfactory neuron in the olfactory mucosa and only a few olfactory neurons had became mature. With the development, the olfactory epithelial area reduced but the number of mature olfactory neurons increased. At the last trimester, fetal olfactory sensor was almost matured.     

湘西自治州1995～2002年男性劳教人员法定性病监测报告

目的 了解湘西自治州重点人群性病患消长趋势，为性病防治工作提供科学依据。方法 从1995年起，采用统一的表格，每年对湘西州劳教所新入教人员进行一次法定性病监测。结果 三种法定性病平均患病率为14．64％(4．96～26．7％)，以1995年最低，1997年最高，8年未发现HIV／AIDS，患病率以20～39岁的性跃期人群为最高，汉族患病率高于其它民族；化程度越高，患病率越低。结论 男性劳教人员作为性病患病的高危人群，是哨点监测理想的目标人群。