Relationship between air-plethysmographic venous function and clinical severity in primary varicose veins.

AIM: The role of air plethysmography (APG) in the diagnosis of chronic venous insufficiency has not been well established. The purpose of this study was to elucidate the relationship between APG parameters and clinical severity in patients with chronic venous insufficiency. METHODS: Two hundred and ninety-four limbs in 154 patients with primary varicose veins were evaluated by APG. Limbs were categorized according to the clinical classification of chronic venous disease suggested by the Ad Hoc Committee on Reporting Standards in Venous Disease of the North American Chapter of the Society for Vascular Surgery and International Society for Cardiovascular Surgery (SVS/ ISCVS). RESULTS: The venous filling index (VFI) was significantly higher in classes 2, 3, 4, and 5+6 than in class 0 or 1, and did not differ among classes 2, 3, 4, 5+6. The ejection fraction did not differ significantly among the 6 classes, and the residual volume fraction was significantly higher in classes 2, 3, 5+6 than in class 0. CONCLUSIONS: APG is a reasonable method for distinguishing the presence or absence of chronic venous insufficiency, but it cannot discriminate the clinical severity. Among APG parameters, the VFI is the most useful diagnostic parameter in the evaluation of chronic venous insufficiency.     

Human urotensin-II potentiates the mitogenic effect of mildly oxidized low-density lipoprotein on vascular smooth muscle cells: comparison with other vasoactive agents and hydrogen peroxide.

Human urotensin-II (U-II) is the most potent vasoactive peptide identified to date, and may be involved in hypertension and atherosclerosis. We investigated the effects of the interactions between U-II or other vasoactive agents and mildly oxidized low-density lipoprotein (mox-LDL) or hydrogen peroxide (H2O2) on the induction of vascular smooth muscle cell (VSMC) proliferation. Growth-arrested rabbit VSMCs were incubated with vasoactive agents (U-II, endothelin-1, angiotensin-II, serotonin, or thromboxane-A2) in the presence or absence of mox-LDL or H2O2. [3H]Thymidine incorporation into DNA was measured as an index of VSMC proliferation. On interaction with mox-LDL or H2O2, U-II induced the greatest increase in [3H]thymidine incorporation among these vasoactive agents. A low concentration of U-II (10 nmol/l) enhanced the potential mitogenic effect of low concentrations of mox-LDL (120 to 337%) and H2O2 (177 to 226%). U-II at 50 nmol/l showed the maximal mitogenic effect (161%), which was abolished by G protein inactivator (GDP-beta-S), c-Src tyrosine kinase inhibitor (radicicol), protein kinase C (PKC) inhibitor (Ro31-8220), extracellular signal-regulated kinase (ERK) kinase inhibitor (PD98059), or Rho kinase inhibitor (Y27632). Mox-LDL at 5 microg/ml showed the maximal mitogenic effect (211%), which was inhibited by free radical scavenger (catalase), intracellular and extracellular antioxidants (N-acetylcysteine and probucol), nicotinamide adenine dinucleotide phosphate oxidase inhibitor (diphenylene iodonium), or c-Jun N-terminal kinase (JNK) inhibitor (SP600125). These results suggested that U-II acts in synergy with mox-LDL in inducing VSMC DNA synthesis at the highest rate among these vasoactive agents. Activation of the G protein/c-Src/PKC/ERK and Rho kinase pathways by U-II together with the redox-sensitive JNK pathway by mox-LDL may explain the synergistic interaction between these agents.     

弥漫性轴索损伤病人的护理

弥漫性轴索损伤（diffuse axonal injury，DAI）是以胼胝体、脑十等中线部位局灶性病变及脑白质广泛性轴索损伤为主，以原发昏迷时间长而又缺乏神经定位体征为其临床特征的一组原发性弥散性脑损伤。在重型颅脑损伤中占20％，病死率高达42％～62％。最常见于车祸颅脑损伤病人，也可见于高处坠落伤者。病人多合并其他部位损伤，特点为伤情重、变化快、并发症和休克发生率高，且病死率高。护理时矛盾多，易顾此失彼，影响临床治疗效果。为更好地总结对该类损伤病人的救治，     

Atrial septal defect repair through limited lateral thoracotomy in children

Objective We have developed a surgical method for atrial septal defect repair through a limited right lateral thoracotomy in which the incision line begins 2 cm caudal from the lower angle of the scapula and ends at the midaxial line, thereby improving patient satisfaction with the cosmetic results of treatment. Methods We performed a retrospective review of 28 patients who underwent isolated atrial septal defect repair through a limited right lateral thoracotomy between January 2002 and August 2004. The mean age and mean body weight at the time of the operation were 85.8 months (range 9–236 months) and 23.0 kg (range 8.0–56.0 kg), respectively. All repaired defects were the ostium secundum type. Results There was no operative or late mortality and no late morbidity after a mean follow-up of 26 months (range 12–41 months). Echocardiography showed no residual shunt in any of the patients. The mean length of the skin incision was 7.8 cm (range 5.0–11.0 cm), and almost all the patients had satisfactory cosmetic results. Conclusion The atrial septal defect repair through a limited right lateral thoracotomy in pediatric patients showed satisfactory surgical results and excellent cosmetic results.     

经胸门奇静脉断流术的外科解剖学基础(附52例临床疗效分析报告)

观测了１００例成年尸体胃底、贲门及食管区静脉。结果显示：胃左、右静脉的出现率是９６％和９２％，胃小弯侧的静脉分布可归纳为５型：胃左静脉型、胃右静脉型、胃左静脉优势型、胃右静脉优势型和胃左右静脉均衡型。胃后静脉出现率为７３．６％，胃左静脉与左膈下静脉间有相对恒定的吻合，此种情况占４８％。在此基础上作者于１９７６年３月至１９９２年３月对５２例因门脉高压症大出血患者行经胸门奇静脉断流术，急症手术死亡率为４．９％，急症手术止血率为９２．６％，远期再出血率为１１．４％。作者认为彻底断流的关键是识别胃小弯侧静脉分型、胃左静脉汇入部位及属支变化；胃后静脉及门腔吻合。阐述了经胸门奇静脉断流的优越性。     

黄疸出血群赖型017株钩端螺旋体外膜单克隆抗体免疫...

BALB/c mice were immunized intraperitoneally with outer envelopes of serogroup icterohaemorrhagiae lai serovar strain 017 leptospires. Monoclonal antibodies against outer envelopes (IgG, agglutinating titre 1:25,600) were produced by hybridoma technique. The monoclonal antibodies ascites (diluted 1:100) 1 ml administered intraperitoneally 1 hour before the intraperitoneal injection of 2 x 10(8) leptospires of strain 017 and the subsequent daily administration of McAb in similar doses for five days protected 80% of guinea pigs. Survival rates of three control groups which received physiological saline, ascites of BALB/c mouse myeloma cell lines SP2/0, and monoclonal antibodies against Pseudomonas aeruginosa in place of monoclonal antibodies against outer envelopes of strain 017 leptospires were 10%, 20% and 10% respectively. When killed 20 days after challenge, guinea pigs of experiment group were normal at autopsy. Old pulmonary haemorrhage were present in the animals of three control groups. Passive immunoprotection experiments have demonstrated immunoprotection of monoclonal antibodies against outer envelopes of strain 017 leptospires. It will be valuable for separating protective antigen fraction of outer envelopes and studying new vaccine of leptospira.     

棉尘及吸烟对肺功能影响的观察

对８３名接触棉尘的健康者作肺功能测定，并与３９名不接触棉尘的健康者对照。其中男性均为吸烟者；女性均为不吸烟者。结果表明，ＭＭＥＦ、ＰＥＦＲ、Ｖ２５％～７５％均明显低于对照组（分别为Ｐ＜０．０１和Ｐ＜０．０５）．在男性吸烟组，ＶＣ，ＭＢＣ，ＦＥＶ１％也有明显下降（Ｐ＜０．０１），作者认为棉尘对人体的危害主要部位在小气道，吸烟者因损害严重可累及大气道。以往对棉尘反应的肺功能评估仅以ＦＥＶ１％为指标，不能反映早期的变化，有必要进一步完善。     

杂多阴离子对SiO_2细胞毒性的拮抗作用

本文采用离体细胞培养法,以细胞存活率、乳酸脱氢酶活性和酸性磷酸酶活性为指标,研究了几种α-Keggin结构的杂多阴离子对石英粉尘细胞毒性的影响。结果表明,与对照组比较,所用杂多阴离子无细胞毒性(P>0.05),石英尘经杂多阴离子作用后,细胞毒性显著降低,与石英尘组比较,上述三项指标差异均有显著意义(P<0.01),由此表明杂多阴离子对石英的细胞毒性有明显的拮抗作用。     

腹腔镜手术治疗嵌顿性胆囊结石的经验

目的探讨嵌顿性胆囊结石行腹腔镜胆囊切除术（LC）的经验。方法回顾性分析我院1998年1月至2004年12月期间用LC治疗嵌顿性胆囊结石365例的临床资料。结果358例成功施行LC，7例中转开腹，2例术后发生胆瘘，无胃肠道、胆管损伤等并发症，无死亡病例，全部患者均痊愈出院。结论随着腹腔镜技术日臻完善，嵌顿性胆囊结石选择LC，一次性切除病灶，术后恢复快，并发症少。