远隔性小脑出血

远隔性小脑出血极为罕见，可见于多种类型的神经外科手术，一般出现在手术远隔部位，多分布于单侧或双侧小脑沟、蚓部，小脑上部出血也较为多见。远隔性小脑出血总体预后良好，病死率约为10％～15％。     

自锁式防旋自动滑动加压钉板的研制与生物力学研究

目的研制自锁式防旋自动滑动加压钉板（self—locking type pro-rotary auto-sliding＆compression nail plate，LPSC—NP）用于股骨颈骨折内固定，对其进行生物力学性能测试，为临床应用提供依据。方法采集18具新鲜成年股骨近端标本，制成股骨颈骨折，分别用LPSC—NP、3枚空心钉、双头中空加压螺纹钉、动力髋螺钉内固定，并进行生物力学测试，用SPSS统计软件对实验数据进行分析。结果LPSC—NP的承载能力和抗扭转强度、刚度均明显大于后三者。结论LPSC—NP固定股骨颈骨折牢固可靠，符合生物力学要求。该器械结构合理，简单适用，有一定的临床价值。     

内皮细胞生长因子诱导大鼠血管内皮细胞增殖过程中FKBP12的表达

目的探讨内皮细胞生长因子(Endothelial cell growth factor，ECGF)诱导的血管内皮细胞(Vascular endothelial cell，VEC)增殖过程中FK506结合蛋白12(FK506 binding protein 12，FKBP12)表达的变化，为VEC的鉴定提供新的方法。方法培养大鼠VEC并传代。倒置显微镜下观察其在ECGF作用下的增殖情况，检测Ⅷ因子相关抗原、FKBP12和不同时期FKBP12 mRNA水平的表达。结果VEC表达FKBP12；VEC传代后第4天FKBP12 mRNA表达水平达到最高，6—8d下降。结论FKBP12既可作为VEC的标志物，又可反映VEC的增殖情况。     

S-F内固定器治疗胸腰椎爆裂型骨折

目的　探讨使用S -F脊柱内固定器治疗胸腰椎爆裂型骨折的效果。方法　回顾分析从 2 0 0 0年 1月～ 2 0 0 2年 4月使用S-F脊柱内固定器治疗的胸腰椎爆裂型骨折 4 4例 ,比较手术前后的椎体前后缘高度 ,椎管狭窄程度 ,Cobb角及症状恢复情况。结果　经平均 2年左右的随访 ,术后椎体前缘平均高度达正常的 93 8%± 6 2 7% ,较术前增加了 4 2 5 3%。椎体后缘平均高度达到正常的 97 5 9%± 0 0 3% ,较术前增加了 1 6 5 2 %。脊柱后凸Cobb为 4 98°± 3 32°。较术前矫正了 1 4 6 8°。CT片显示椎体后突骨块占椎管前后径的比例为 9 5 9%± 7 2 1 % ,较术前减少 2 7 71 %。统计学分析差异有显著性 (P <0 0 5 )。有神经功能损伤者 ,术后平均改进一级以上。在术后二周与术后一年以上的X线片相比较其椎体前缘的高度平均仅丢失 1 0 % ,椎体后缘的高度平均丢失 0 8% ,Cobb角平均丢失 0 1°。结论　使用S -F脊柱内固定器治疗胸腰椎爆裂型骨折具有操作简单、复位完美、固定牢靠、疗效优良的优点。术中注意不宜过度撑开及双侧不对称 ,对椎板减压者宜作“H”型椎板后路植骨 ,横突间、关节突间植骨融合将提高疗效、减少并发症     

Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation in a diabetic patient with end-stage liver disease]

OBJECTIVE: To study the effect of combined transplantation of the liver and the pancreas in diabetic patients with end-stage liver disease, and explore the optimal surgical procedure. METHODS: Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations were performed in a patient diagnosed as having chronic hepatitis B, hepatocirrhosis, hepatic cellular cancer, and insulin-dependent diabetes. Immunosuppression therapy utilized prednisone, tacrolimus (FK506), mycophenolate mofetil (MMF), and simulect. The function of the liver graft, serum amylase and lipase, blood glucose, and C-peptide were monitored after transplantation. RESULTS: Insulin was withdrawn at the 6th day after operation, good liver allograft functional recovery was achieved, without such complications as pancreatitis, thrombosis, and localized infections. CONCLUSION: End-stage liver disease with concomitant insulin-dependent diabetes is the indication for combined liver-pancreas transplantations, for which simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations may constitute the optimal surgical approaches as the primary choice.     

结直肠癌肝转移的外科手术治疗

目的评价手术治疗对结直肠癌肝转移病人生存率的影响。方法回顾分析2000年1月1日至2004年12月31日复旦大学附属中山医院收治的363例结直肠癌肝转移病人，其中91例为手术病例，评价手术治疗对生存率的影响。结果160例同时性肝转移病人中手术切除肝转移灶22例（13．8％），203例延时性肝转移病人中手术切除肝转移灶69例（34．0％），两者相比差异具有统计学意义（P〈0．000）。同时性肝转移组手术死亡率（4．5％，1／22）高于延时性肝转移组（2．8％，2／69），两者相比差异有统计学意义（P〈0．05）。以2005年6月31日为随访终点，91例病人随访率100％，手术病人中同时性肝转移组1、3、5年生存率和中位生存时间与延时性肝转移组相似（P〉0．05），但术后复发率较高（36．4％vs21．7％，P=0．03）。363例病人中有36例具有手术指征而未手术病例，其1、3、5年生存率分别为47．9％、5．34％和0，明显低于91例手术病例（80．5％、33．0％和22．7％），（P=0．0034）。应用COX比例风险模型，对所有91例手术病人影响生存的因素进行多因素风险分析，得出手术切缘达1cm（β=-0．8351，P=0．0363）和复发后再次手术（β=-0．9428，P=0．0411）是生存的保护性因素，而术后复发（β=0．6471，P=0．0226）是生存的危险因素。结论手术治疗是结直肠癌肝转移的首选治疗措施，可以明显提高病人的术后生存。     

Immunohistochemical and histochemical study on colorectal adenomas and polyps]

Immunohistochemical staining and histochemical approach for mucin were applied in studying 58 cases of colorectal adenomas. Among them, there were 13 cases of multiple adenomas (polyps), 5 cases of inflammatory polyps and 5 cases of juvenile polyps. The results indicated that positive expression of both McAb MC5 and Ulex europaeus agglutinin-1(UEA-1) were correlating with the degree of dysplasia, the histological type and the size of adenomas. The positive expression of peanut agglutinin (PNA) was correlating with the degree of dysplasia. Moderate and heavy stainings were mainly seen in adenomas accompanying with moderate and severe dysplasia, as well as adenomas with early carcinomatous changes. PAT-KOH-PAS method could sensitively reflect the occurrence of dysplasia and malignancy of the adenomas. These findings support the concept of an adenoma(dysplasia)-carcinoma sequence. In comparing multiple adenomas (number of adenomas > 100) with the solitary ones, a notable difference was obtained in the expression of McAb MC5. It's concluded that combined use of certain immunohistochemical and histochemical stainings is well be useful in detecting the malignant potentiality of adenoma.     

联合应用IL-2和IL-3的基因疗法增强骨髓移植后骨髓细胞毒活性及抗肿瘤效果的实验研究

目的：探讨联合应用成纤维细胞介导ＩＬ２和ＩＬ３的基因疗法对骨髓移植（ＢＭＴ）后荷瘤小鼠抗肿瘤作用的效果及机理。方法：将分别转染ＩＬ２基因及ＩＬ３基因的ＮＩＨ３Ｔ３细胞以单独或联合方式移植至ＢＭＴ的荷瘤小鼠腹腔内８ｄ后，取出小鼠骨髓细胞检测杀伤活性的变化以及ＩＬ２受体的表达，并观察荷瘤小鼠的存活期。结果：ＩＬ３基因治疗虽然可加速ＢＭＴ后造血重建过程，但对骨髓细胞的ＮＫ、ＬＡＫ活性具有一定的抑制作用；ＩＬ２基因治疗可明显提高骨髓细胞的杀伤活性；联合应用基因治疗后荷瘤小鼠骨髓ＮＫ、ＬＡＫ活性及骨髓细胞ＣＤ２５表达升高，明显延长大剂量化疗后接受ＢＭＴ的荷瘤小鼠的存活期。结论：联合应用ＩＬ２和ＩＬ３的基因疗法能协同提高骨髓细胞ＩＬ２受体表达水平，提高骨髓细胞毒活性，增强ＢＭＴ后的抗肿瘤效果。     

Molecular cytogenetic study of short arm aberrations in human D, G group chromosomes.

Six cases of Dp+/Gp+, 10 cases of D/G translocation, 1 case of supernumerary marker chromosome, and 1 case of Yqs were studied using molecular and cytogenetic techniques. The Ag-NOR frequencies of the Dp+ and Gp+ groups were found to be higher than those of normal controls, while their satellite association frequencies were lower. Autoradiographic silver grains were not significantly distributed along the p+ part of the marker chromosome as revealed by chromosomal in situ hybridization using an rRNA probe. This result differs from our previous report. It is suggested that there might be different mechanisms for the formation of p+ on acrocentric chromosomes. D/G translocation cases were found to have lost their NOR. A study of supernumerary marker chromosomes and Yqs cases suggested that the marker chromosome and Yqs exerted no phenotypic effect. The mechanism of their formation is discussed.