The treatment of associated intracranial aneurysms and arteriovenous malformations.

Cerebral arterial aneurysm associated with arteriovenous malformation (AVM) has been described with a variable incidence, averaging 10% of AVM cases. The present series includes 39 patients with this association, derived from a total of 400 patients with AVM's evaluated and treated since 1970. The aneurysms are classified into four major groups, each carrying particular therapeutic implications. Optimum treatment of these lesions is based in part on a knowledge of the hemodynamic alterations associated with the AVM's. In most of these cases, the symptomatic lesion was treated first; occasionally, when feasible, both lesions were treated during the same operation. All patients had some form of treatment, either surgical or endovascular, directed to at least one of the two types of lesions. All symptomatic lesions were treated and all ruptured aneurysms were obliterated. There were no deaths in this series.     

壮骨肾宝对实验性小鼠高脂血症的影响

目的观察由黄芪、白术、淫羊藿组成的复方制剂(壮骨肾宝)对实验性小鼠高脂血症的影响。方法用蛋黄乳液快速致小鼠单纯性高胆固醇血症和喂养高脂饲料致高脂血症模型 ,观察预防性给予不同剂量的壮骨肾宝后对血清总胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL -ch)的影响。结果壮骨肾宝中、高剂量能使血清TC降低(P<0.05),HDL -ch升高(P<0.01) ,但对TG的影响不大。结论壮骨肾宝有一定降血脂作用 ,并与剂量有关     

角膜溃疡穿孔的修复与修复材料的选择

总结２１例用不同材料修复角膜穿孔的病例，修复材料分别为结膜瓣、硅胶板、断层自体皮片和同种异体角膜。结膜瓣遮盖仅２／３保存眼球，愈合后视力差，并发症多；硅胶板可在穿孔大、情况紧急时作暂时封孔保存眼球之用；自体断层皮片术后不久即溶解，角膜移植者７眼中６眼保存了眼球，且有５例植片透明，视力０．１以上。     

Whole CanA Gene Amplification of Helicobacter pylori and Its Fingerprinting by Restriction Fragment Length Polymorphism

To set up a method of amplification for the whole CagA gene of Helicobacter pylori and its fingerprinting by restriction fragment length polymorphism(RFLP),nested PCR was employed in combination with TD-PCR to amplify the gene and EcoRI and Hind Ⅲ were used to generate the RFLP fingerprinting.Target DNA fragments from 13 of 20 samples were successfully amplified and the relevant RFLP fingerprintings were obtained.It is concluded that the method can be used to amplify the whole CagA gene and CagA gene has apparent diversity of RFLP profile.     

Glyceraldehyde-3-phosphate dehydrogenase: Nuclear translocation participates in neuronal and nonneuronal cell death

Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) protein levels increase in particulate fractions in association with cell death in HEK293 cells, S49 cells, primary thymocytes, PC12 cells, and primary cerebral cortical neuronal cultures. Subcellular fractionation and immunocytochemistry reveal that this increase primarily reflects nuclear translocation. Nuclear GAPDH is tightly bound, resisting extraction by DNase or salt treatment. Treating primary thymocytes, PC12 cells, and primary cortical neurons with antisense but not sense oligonucleotides to GAPDH prevents cell death. Because cell-death-associated nuclear translocation of GAPDH and antisense protection occur in multiple neuronal and nonneuronal systems, we propose that GAPDH is a general mediator of cell death and uses nuclear translocation as a signaling mechanism.     

Acute Renal Allograft Rejection Following Pegylated IFN-α Treatment for Chronic HCV in a Repeat Allograft Recipient on Hemodialysis: A Case Report

Interferon alpha (IFN-alpha) can be effective therapy for patients with chronic kidney disease who have chronic hepatitis C (HCV). However, acute allograft rejection has been reported in association with IFN-alpha following kidney transplantation, and therefore IFN therapy is recommended prior to, rather than after, kidney transplantation whenever feasible. The special case of repeat allograft recipients who contract HCV after the first transplantation presents special difficulties. This report features the case of a repeat allograft recipient who presented with neutropenic fevers after 5 months of pegylated IFN-alpha therapy, initiated 6 months following the functional loss of his third graft and the reinitiation of hemodialysis (HD). Physical exam, radiographic and laboratory findings led to allograft nephrectomy. The pathologic findings supported a diagnosis of acute-on-chronic rejection. This represents a rare case of IFN-alpha induced rejection following allograft failure and return to HD in a repeat allograft recipient. It also calls attention to the need for a high index of suspicion for the development of allograft rejection, which may require allograft nephrectomy even after allograft 'failure'.     

大豆蛋白影响肾损害模型钙摄入和钙排出的实验研究

[目的]研究大豆蛋白对肾损害大鼠钙平衡的影响。[方法]选择3月龄断乳雄性SD大鼠40只．按体质量从小到大排序，采用完全随机化原则分为4组。每组10只。标准饲料对照组：喂食含有14％酪蛋白饲料；大豆蛋白饲料组：喂食含有14％大豆分离蛋白饲料；混合饲料1组：喂食含有7％酪蛋白加7％大豆分离蛋白饲料；混合饲料2组：喂食含有7％酪蛋白加14％大豆分离蛋白饲料。实验期用腺嘌呤灌胃共21d，建立肾损害大鼠模型，各组大鼠喂养相应饲料6周，测饲料消耗量、24h尿蛋白、尿钙、钙表观吸收率、储留钙量。[结果]4组实验大鼠饲料摄入量1d～30d无统计学差异，大豆蛋白饲料组和混合饲料1组实验结束时与另外两组相比，尿钙排泄量低，钙表观吸收率和储留钙量高，差异有统计学意义（P〈0．05）。[结论]蛋白质含量水平在14％条件下，含大豆蛋白的两种饲料对肾损害大鼠钙吸收、钙排泄的影响无统计学差异，有利于促进钙吸收，减少钙排泄。     

炎性肠梗阻15例诊治体会

目的探讨炎性肠梗阻的诊断和治疗。方法分析15例炎性肠梗阻的临床特点和治疗。结果15例经保守治疗,其中1例因肠扭转缺血损伤严重,出现全身性炎症反应综合征致多脏器衰竭死亡外,其他病例均痊愈,平均治愈时间为12.6d。结论炎症性肠梗阻由无菌性炎症致广泛肠粘连引起,应用小剂量激素减缓炎症反应,抗生素防止肠道菌群易位,经内镜逆行置入肠减压管及营养支持治疗,多数病例可保守治愈。     

Locomotor strategies before independent walking: prospective study of 50 mentally retarded children.

To investigate the association between pre-walking locomotor strategies and psychomotor developments in children with mental retardation (MR), 50 children with non-specific MR were included in this study. There were 29 boys and 21 girls, 96% of whom had moderate to severe MR. They were followed from 4-53 months to 25-99 months of age, and their follow-up periods ranged from 10 to 48 months (mean 30 months). According to the pre-walking locomotor strategies, these children were categorized into three groups: the crawling group (n = 34) who used crawling or creeping as their main locomotion pattern before independent walking; the shuffling group (n = 9) who used shuffling prior to independent walking; and the direct-walking group (n = 7) who did not have any other locomotor strategies except rolling. In almost all motor developmental milestones, children in the direct-walking group developed earlier than those in the crawling and shuffling groups. Children in the crawling group had more advanced developments than those in the shuffling group. The difference in the mean ratio developmental quotients of the Bayley Mental Scale among the three groups was not significant. The present study showed that crawling may not be a necessary prerequisite for early ambulation or better cognitive function in MR children.     

骨盆骨折合并阴道损伤（附5例报告）

报告5例女性骨盆骨折合并阴道损伤，占骨盆骨折41例中的12.2%,均为交通事故伤，都合并有失血性休克，开放伤3例，闭合伤2例，治疗作阴道修补术2例，用碘仿纱条填塞阴道2例。未作处理1例，均治愈，阴道损伤表现为四型；横行撕裂伤，纵行撕裂伤，斜行撕裂伤和刺伤，强调早期诊断，及时治疗以防止合并症。