无心跳供者腹腔内脏器联合切取术及肾移植效果

目的:总结无心跳供者腹腔内脏器联合切取术的临床经验及对肾移植效果的影响.方法:回顾性分析1993年4月至2001年7月70例无心跳供者腹腔内脏器联合切取和同期501例单纯双肾联合切取的临床资料及其肾移植随访资料.结果:在无心跳供者腹腔内脏器联合切取术组,8～10分钟取出腹内脏器,其肾移植结果与同期单纯双肾联合切取后的肾移植比较,并发症和移植肾1年存活率等方面无统计学差异(P＜0.05).结论:腹腔内脏器联合切取术方法简便、易于掌握,能同时获取多个腹腔内脏器并维护其功能,有效利用了稀缺的供体器官资源.     

大鼠酒精性脑损伤组织中TNF-α的表达

目的探讨酒精致大鼠脑损伤合并内毒素血症过程中,脑组织TNF-α的水平变化及相互关系。方法采用SD大鼠进行酒精灌胃,建立酒精性脑损害的动物模型,用光镜观察各组大鼠脑组织的病理改变,采用偶氮显色法定量检测模型组与对照组血浆中内毒素(ET)的水平;用ELISA法检测各组脑组织匀浆中的TNF-α的水平。结果脑组织病理切片显示,模型组脑组织有严重损伤;模型组血浆中的ET以及脑组织匀浆中的TNF-α水平明显高于对照组(P<0.05)。结论TNF-α在脑组织中的含量增高可能与酒精所致的大鼠脑组织损伤有密切联系。     

Modulation of gastrointestinal afferent sensitivity by a novel substituted benzamide (ecabapide)

The effects of ecabapide, a novel substituted benzamide compound (3-[2-(3,4-dimethoxyphenyl)ethylcarbamoylmethyl]amino-N-methylb enzamide) that has gastrointestinal prokinetic action, were examined on the discharge of extrinsic afferent nerves supplying the stomach and jejunum in anaesthetized rats. Ecabapide (60 and 180 microg kg(-1), i.v.) had no effect on the baseline discharge of vagal gastric distension-sensitive afferents or the stimulus-response profile to gastric distension. Ecabapide also had no effect on either spontaneous jejunal mesenteric afferent nerve discharge or responses to intestinal distension. Ecabapide (180 microg kg(-1)) significantly inhibited the maximum discharge of jejunal afferents induced by cholecystokinin (CCK8; 50 pmol, i.v.), whereas it failed to inhibit the excitatory action of 2-methyl-5-hydroxytryptamine (2Me-5-HT; 10 microg, i.v.), a selective 5-HT3 receptor agonist. A model of acute focal intestinal ischaemia was used to evaluate the actions of ecabapide on the discharge of activated jejunal afferents. Ischaemia produced a substantial increase in afferent discharge which was reproducible when the duration of ischaemia was limited to less than 10 min and repeated every 15 min. Ecabapide at doses of 60 and 180 microg kg(-1) significantly reduced ischaemia-induced increases in afferent discharge. In addition to its therapeutic efficacy as a gastrointestinal prokinetic agent, these findings show also that ecabapide may also have an inhibitory action on the discharge of intestinal afferents activated by ischaemia.     

不同冷冻剂型和稀释保护剂对Beagle犬精液冷冻的影响

目的通过对Beagle犬精液冷冻技术的研究,比较颗粒法以及冻管法(0．5 ml)对冷冻精子复苏率的影响,并比较几种冷冻稀释保护液对犬精液冷冻的影响。方法 5只1岁左右可正常采精的雄性Beagle犬,手握法采集精液,以不同稀释冷冻保护液处理后,分别采用颗粒及冻管法冷冻,检测冻精前的精液量、精子密度、畸形率、解冻后活率、复苏率和顶体完整率。结果采用颗粒法和冻管法的平均冻后活率相应为0．38和0．41,复苏率51．9％和53．9％,顶体完整率36．4％和37．6％, 采用冻管法的效果稍优于颗粒法,但差异不显著。应用冷冻保护剂Ⅲ,冻后活率、复苏率和顶体完整率均优于采用稀释冷冻保护剂Ⅰ和Ⅱ,但只有顶体完整率(40．7％和41．3％)与其它两种保护剂相比达到差异显著的水平。结论采用文献中报道的稀释保护液配方均可获得较好的稀释保护效果。     

1型糖尿病患儿早期胰岛素强化治疗对β细胞功能的影响

目的：观察1型糖尿病（T1DM）患儿行早期胰岛素（INS）持续静脉输注加三餐前皮下注射短效INS强化治疗对胰岛D细胞功能的影响。方法：T1DM并酮症酸中毒（DKA）患儿12例（强化组），采用早期INS持续输注加三餐前皮下注射短效INS强化治疗。连续观察治疗开始及治疗3个月时空腹血糖（FBG）、餐后2h血糖（2hPBG）、糖化血红蛋白（HbA1c）、空腹C肽／FBG（C-P／FBG）及INS用量。比较治疗前后上述指标的差异，TlDM并DKA患儿10例（非强化组），行非持续静脉强化治疗，对比两组治疗开始及治疗3个月时上述指标的差异；观察急性期患儿进入蜜月期的百分率。结果：①治疗3个月时，强化组FBG、2hPBG及HbAlc均较治疗开始时显著改善，且均达到强化治疗目标；C-P／FBG显著升高，达正常范围；3个月时INS用量显著低于急性期；②非强化组FBG、2hPBG、HbA1c均较开始治疗时明显改善，但未达到强化治疗目标；C-P／FBG升高，但未达正常范围；INS用量无明显减少；③两组治疗开始FBG、2hPBG、HbAlc、C-P／FBG比较差异均无统计学意义，但INS用量强化组显著高于非强化组：治疗3个月时强化组2hPBG、HbA1c、INS用量均显著低于非强化组，C-P／FBG显著高于非强化组（约是后者的8．6倍），两者FBG比较差异无统计学意义；④强化组12例中11例进入蜜月期，非强化组仅3例进入蜜月期。两组比较）χ^2=6．50，P〈0．05。站论：早期INS持续输注加三餐前皮下注射短效INS强化治疗儿童T1DM可促进B细胞的修复及再生，使基础C-P／FBG恢复正常。     

混合稀土常乐对肾脏超微结构的影响

目的:研究长期服用混合稀土常乐对肾脏超微结构的影响。方法:健康W istar大鼠120只,随机分成对照组和2m g/kg体重、5m g/kg体重和20m g/kg体重三个剂量的实验组,每天给药1次,每周6d给药,第7d休息,连续给药90d,第91d处死动物,取肾组织制作超薄切片,电子显微镜观察并摄影。结果:2m g/kg体重剂量组滤过膜的厚度均匀,但足细胞次级突起发生融合;5m g/kg体重剂量组滤过膜厚度不均匀,足细胞次级突起融合增多;20m g/kg体重剂量组滤过膜不规则且厚度不均匀,足细胞次级突起融合较多。结论:混合稀土常乐对肾脏滤过膜的结构有影响,5 m g/kg体重和20 m g/kg体重的剂量对滤过膜结构较为明显。     

Pharmacological profiles of selective non-peptidic delta opioid receptor ligands

Several non-peptidic opioids have been synthesized recently as part of a program to develop selective delta receptor agonists. In this study, the affinities of a set of compounds for cloned delta and mu opioid receptors expressed in HEK 293 cell lines were determined by competition analysis of [3H]bremazocine binding to membrane preparations. All compounds studied exhibited high affinity and selectivity, with apparent dissociation constants in the range of 0.6-1.7 nM for the delta opioid receptor and 240-1165 nM for the mu opioid receptor. We next sought to determine which domain of the delta receptor was critical for mediating the highly selective binding by analysis of ligand affinities for mu/delta receptor chimeras. Receptor binding profiles suggested that a critical site of receptor/ligand interaction was located between transmembrane domain 5 (TM5) and TM7 of the delta receptor. Substitution of tryptophan 284, located at the extracellular surface of TM6, with lysine, which is found at the equivalent position in the mu opioid receptor, led to a spectrum of effects on affinities, depending on the ligand tested. Affinities of SB 219825 and SB 222941 were particularly sensitive to the substitution, displaying a 50-fold and 70-fold decrease in affinity, respectively. Activities of the delta receptor-selective agonists were tested in two functional assays. Brief exposure of HEK 293 cells expressing delta opioid receptors with selective ligands induced phosphorylation of MAP kinase, although the non-peptidic ligands were less efficacious than the enkephalin derivative DADL (Tyr-D-Ala-Gly-Phe-D-Leu). Similarly, chronic exposure of HEK 293 cells expressing delta opioid receptors with selective, non-peptidic ligands, with the exception of SB 206848, caused receptor down-regulation, however, the SB compounds were less efficacious than DADL.     

班级管理模式初探

分析各种类型班级管理模式的特点，严管死守型强调他律作用，自我管理型认可学生的自律作用。而综合管理型则是理想的管理模式。     

雾化吸入鱼腥草注射液加生脉注射液治疗慢性支气管炎急性发作42例观察

目的观察雾化吸入鱼腥草注射液配合生脉注射液治疗慢性支气管炎急性发作期的效果。方法治疗组在常规抗感染等措施基础上用鱼腥草注射液雾化吸入配合生脉注射液静滴治疗42例,并设对照组用常规抗感染等措施治疗42例。结果治疗组总有效率为95.2%,对照组总有效率为75.0%,两组疗效比较有显著性差异(P<0.05),治疗组优于对照组。两组氧分压、二氧化碳分压、T淋巴细胞亚群变化疗效比较有显著性差异(P<0.05),治疗组优于对照组。结论鱼腥草注射液雾化吸入配合生脉注射液治疗慢性阻塞性肺病急性发作期患者,可以有效改善症状,缩短病程。     

异基因外周造血干细胞移植治疗造血系统恶性肿瘤的临床研究

目的:探讨异基因外周造血干细胞移植(A llo-PBSCT)治疗恶性血液病的疗效、造血重建及并发症情况。方法:对5例恶性血液病患者进行A llo-PBSCT治疗,包括急性中幼粒细胞性白血病(AML)3例、急性淋巴细胞性白血病(ALL)1例、非霍奇金氏淋巴瘤(NHL)1例,均为供受者HLA配型完全相合,其中同胞间移植4例、无关供者移植1例;4例采用清髓性预处理方案,1例为非清髓性预处理方案。结果:5例患者均获得造血重建,经血型、性染色体和短串联重复序列-聚合酶链反应检测证实均为供者型造血,中性粒细胞≥0.5×109/L的中位时间为移植后+12天,血小板≥20×109/L的中位时间为移植后+8天;5例患者均未发生肝静脉闭塞病;4例患者发生急性移植物抗宿主病(aGVHD);1例患者发生移植后单纯红细胞性再生障碍性贫血(PRCA),其余4例患者仍持续缓解(移植后145~470天)。结论:A llo-PBSCT是治疗恶性血液病的有效手段,尤其是对于复发难治性患者具有较好疗效。