宫腔镜电切术在宫颈疾病中的应用

目的探讨应用官腔镜电切术治疗宫颈病变的临床效果。方法2002年1月～2003年6月，应用宫腔电切镜切除359例各类宫颈病变。结果359例均在门诊一次完成手术，手术时间5～15min，术中出血2-10ml。术后病理诊断慢性官颈炎332例，宫颈上皮内瘤样病变（cervical intraepithelial neoplasia，CIN）Ⅰ～Ⅱ级26例，CINⅢ级1例。335例随访2～12个月，平均9个月。术后2个月308例慢性富颈炎一次性治愈率98．7％（304／308）；237例随访1年宫颈糜烂、宫颈息肉及宫颈肥大未复发；27例CIN术后随访6～12个月未显示CIN病变。结论宫腔镜电切术治疗宫颈病变，疗效肯定，并发症少，值得推广。     

Changes in hippocampal neurons and memory function during the developmental stage of newborn rats with hypoxic-ischemic encephalopathy

BACKGROUND: Under the normal circumstance, there exist some synapses with inactive functions in central nervous system (CNS), but these functions are activated following nerve injury. At the early stage of brain injury, the abnormal functions of brain are varied, and they have very strong plasticity and are corrected easily. OBJECTIVE: To observe the changes of neuronal morphology in hippocampal CA1 region and memory function in newborn rats with hypoxic-ischemic encephalopathy(HIE) from ischemia 6 hours to adult. DESIGN: Completely randomized grouping, controlled experiment. SETTING: Taian Health Center for Women and Children; Taishan Medical College. MATERIALS: Altogether 120 seven-day-old Wistar rats, of clean grade, were provided by the Experimental Animal Center, Shandong University of Traditional Chinese Medicine. Synaptophysin (SYN) polyclonal antibody was provided by Maixin Biological Company, Fuzhou. METHODS: This experiment was carried out in the Laboratory of Morphology, Taishan Medical College between October 2000 and December 2003. ① The newborn rats were randomly divided into 2 groups: model group and control group, 60 rats in each group. Five rats were chosen from each group at postoperative 6 hours, 24 hours, 72 hours, 7 days, 2 weeks and 3 weeks separately for immunohistochemical staining. Fifteen newborn rats were chosen from each group at postoperative 4 weeks and 2 months separately for testing memory ability (After test, 5 rats from each group were sacrificed and used for immunohistochemical staining)② The right common carotid artery of newborn rats of model group was ligated under the anesthetized status. After two hours of incubation, the rats were placed for 2 hours in a container filled with nitrogen oxygen atmosphere containing 0.08 volume fraction of oxygen, thus, HIE models were created; As for the newborn rats in the control group, only blood vessels were isolated, and they were not ligated and hypoxia-treated. ③ Thalamencephal tissue sections of newborn rats of two groups were performed DAB developing and haematoxylin slight staining. Cells with normal nucleous in 250 μm-long granular layer which started from hippocampal CA1 region were counted with image analysis system under high-fold optical microscope (×600), and the thickness of granular layer was measured. The absorbance (A) of positive reactant of SYN in immunohistochemically-stained CA1 region was measured. Learning and memory ability were measured with step through test 3 times successively. ④ t test and paired t test were used for comparing intergroup and intragroup difference of measurement data respectively, and Chi-square for comparing the difference of enumeration data. MAIN OUTCOME MEASURES: Comparison of cytological changes in hippocampal CA1 region and memory ability at different postoperative time points between two groups. RESULTS: Totally 120 newborn rats were involved in the result analysis. ① Cell morphological changes in hippocampal CA1 region: In the control group, with aging, perikaryon, nucleus and nucleolus in cortex of parietal lobe were significantly increased, Nissl body was compacted, the amount of neurons was declined, but the A of SYN positive reactant was relatively increased. In the model group, at postoperative each time point, neurons were seriously shrunk and dark-stained, nucleus was contracted, chromatin was condensed, nucleolus was unclear, even cells disappeared, especially the cells in 6 hours and 24 hours groups. The amount of neurons with normal morphology in hippocampal CA1 region and granular layer thickness in the model group at postoperative each time point were significantly less or smaller than those in the control group at postoperative 6 hours respectively (t =3.002-1.254, P < 0.01). The A value of SYN positive reactant at postoperative 2, 3 and 4 weeks was significantly higher than that at previous time point (t =2.011－2.716,P < 0.05－0.01). ② Test results of learning and memory ability: In the first test, there was no significant difference in the ratio of rats which kept memory ability between two groups (P > 0.05); In the third test, the ratio of rats which kept memory ability in the model group was significantly lower than that in the control group at postoperative 4 weeks and 2 months[53%(8/15)，100%(15/15)；60%(9/15)，93%(14/15)，χ 2=2.863，2.901，P < 0.01]. CONCLUSION: The destroyed hippocampal structure induces the decrease of learning and memory ability of developmental rats. Early interference can increase the quality of neurons and also promote functional development of the nervous system.     

Adherence to continuous positive airway pressure treatment in patients with Alzheimer's disease and obstructive sleep apnea.

OBJECTIVE: This analysis examined whether patients with Alzheimer disease (AD) tolerate continuous positive airway pressure (CPAP). METHOD: Thirty patients with AD were randomized to CPAP or sham CPAP and completed sleep, depression, and quality-of-life questionnaires. Participants could choose to continue treatment after the trial. RESULTS: Patients wore CPAP for 4.8 hours per night. More depressive symptoms were associated with worse adherence (rS=-0.37; N=30, p<0.04). Patients who continued using CPAP had fewer depressive symptoms (t [19]=2.45, p=0.02) and better adherence (t [19]=2.32, p=0.03) during the trial. CONCLUSION: Patients with AD with obstructive sleep apnea can tolerate CPAP. Adherence and long-term use may be more difficult among those patients with more depressive symptoms.     

Aquaporin and Na+ transport of alveolar type II cells in rats with oleic acid-induced acute respiratory distress syndrome]

OBJECTIVE: To evaluate the capacity of active water and sodium transport of alveolar type II (AT II cells in rats with acute respiratory distress syndrome (ARDS). METHODS: AT II cells were isolated and purified from rats with ARDS, and the distribution of aquaporin-1 (AQP-1) on the cells was observed by immunocytochemistry, immunoelectron microscopy and Western blotting. The sodium currents were detected by patch-clamp technique in whole-cell recording mode. RESULTS: Immunocytochemistry showed staining for AQP-1 in rat AT II cells, and immunoelectron microscope demonstrated the presence of AQP-1, which was decreased as shown by Western blotting in comparison with the control group. The whole-cell currents were also decreased, but remained sensitive to terbutalin treatment. CONCLUSIONS: The capacity of active water and sodium transport is damaged, but not totally lost in AT II cells of ARDS rats. Terbutalin can increase the currents even if in pathological conditions. AQP-1 and sodium transport of AT II cells play an important role in pulmonary liquid clearance.     

显微外科技术在尿道下裂修复中的应用

采用显微外科技术行阴囊纵膈皮瓣尿道下裂修复术18例，均获成功。其手术要点为：将阴茎腹侧纤维索条切除，充分伸展阴茎，皮瓣保留足够长度与宽度，克保血运；在显微镜下采用7－0尼龙丝线缝合，形成皮管，不缝皮肤，只缝皮下。硅胶管支架引流，加压包扎阴茎。本文对手术成功的原因进行了初步讨论。     

室旁核注入八肽胆囊收缩素对兔Oddi括约肌肌电的影响

向５６只雄性家兔下丘脑室旁核（ＰＶＮ）内注射微量胆囊收缩素（ＣＣＫ－８），观察对Ｏｄｄｉ括约肌肌电频率的影响。结果：１．向ＰＶＮ注入微量ＣＣＫ－８肌电频率明显增加（Ｐ＜０．０１）；２．向ＰＶＮ先注入ＣＣＫ拮抗剂丙谷胺（ＰＧＭ）后注入ＣＣＫ－８，肌电增加效应被阻断（Ｐ＞０．０５）；３．向ＰＶＮ注入谷氨酸钠（ＭＳＧ）引起肌电频率增加与注入ＣＣＫ－８效应相似（Ｐ＜０．０１）；４．肌电频率增加效应不受心得安影响。用酚妥拉明、阿托品及切断双侧颈迷走神经均可部分抑制其效应。提示下丘脑ＰＶＮ可能是参与控制Ｏｄｄｉ括约肌运动的中枢之一，传出神经可能是交感神经α受体和副交感神经。     

Effect of acupuncture and moxibustion on the high density lipoprotein cholesterol in simple obesity

For the purpose of understanding regulatory effect of acupuncture and moxibustion, we have observed the changes of the obese indices and the lipid indices in 196 sample obesities before and after the acupuncture and moxibustion. The results showed that a good therapeutic effect of acupuncture and moxibustion on obesity was obtained. At the same time, there are the benign regulatory effect of acupuncture and moxibustion on the lipid metabolism and high density lipoprotein cholesterol.     

CA125测定对某些妇科肿瘤的诊断意义

本文对４０名正常妇女和２０２名妇科肿瘤、宫内膜异位症的患者进行了血清ＣＡ１２５的测定。结果表明９８％正常妇女血清ＣＡ１２５水平＜５０ｕ／ｍｌ，行经期水平高于滤泡期、黄体期和绝经期水平。五组妇科疾病患者血清ＣＡ１２５水平也进行了测定，并观察了２１名卵巢癌患者ＣＡ１２５水平的变化情况。卵巢癌患者ＣＡ１２５水平最高，它与其它疾病组及正常对照组有明显的差异。血清ＣＡ１２５的测定在妇科临床上是有价值的。     

选择性括约肌切断术治疗脊髓损伤性膀胱尿道功能障碍

行经尿道选择性括约肌切断术２０例，采用膀胱尿道造影尿流动力学同步检查，定位诊断和选择切断。术前间歇导尿控制尿路感染，术后辅以正确手法排尿。２０例术后随访１２～２５个月。剩余尿量降至３０ｍｌ以下，尿路感染控制，中段尿培养阳性率降至１７．６％；ＢＵＮ正常；１１例肾盂输尿管扩张，积水改善；７例有膀胱输尿管返流者中，４例基本恢复，３例明显减轻；最大尿道闭合压平均下降６．３１ｋＰａ；功能性尿道长度平均缩短１．８９ｃｍ；１１例尿失禁得到控制，６例无明显变化，３例加重。     

冷冻干燥法制备阿糖胞苷冻干脂质体粉针研究

本文采用冷冻干燥法制备阿糖胞苷冻干脂质体粉针，并建立了质量控制标准。在扫描电镜和透射电镜观察下，将此脂质体冻干品加注射用水溶解后，能很快重新形成脂质体。算术平均粒径为０．４７５６±０．０８３３μｍ，包封率约３０％。