鼻内镜治疗颅底疾病112例报告

目的探讨鼻内镜径路治疗颅底疾病的价值。方法2002年5月~2006年12月,对112例颅底疾病行鼻内镜径路手术,其中脑脊液鼻漏39例,垂体瘤4例,脑膜膨出或脑膜脑膨出3例,蝶筛囊肿9例,蝶窦炎伴息肉2例,真菌性蝶窦炎12例,内翻性乳头状瘤11例,鼻咽纤维血管瘤6例,骨化纤维瘤2例,骨纤维异常增殖2例,脊索瘤7例,颅咽管瘤2例,鳞癌10例,未分化癌1例,乳头状瘤癌变2例。结果全组均在鼻内镜下处理,其中20例病变为次全切除,包括鳞癌8例、未分化癌1例、脊索瘤7例、颅咽管瘤2例、骨纤维异常增殖2例。脑脊液鼻漏1次手术成功31例(79.5%),2次成功4例,3次成功4例,最终成功率100%。1例脑膜脑膨出术后2个月复发并伴脑脊液漏,内镜下再次手术成功。1例内翻性乳头状瘤术后11个月复发,改行鼻侧切开术。1例真菌性蝶窦炎术后4个月复发行再次内镜手术。1例脑脊液鼻漏术后颅内感染。结论鼻内镜径路可以处理多种颅底疾病,是一种安全、有效、微创的手术方式,但仍需严格掌握手术适应证,特别是恶性肿瘤。     

平阳霉素碘化油乳剂介入治疗面部静脉畸形

目的：探讨平阳霉素碘化油乳剂介入治疗面部静脉畸形的应用价值。方法：利用介入方法将平阳霉素碘化油乳剂注入瘤体内，通过透视及摄取平片，观察对75例面部静脉畸形患者的治疗效果，记录栓塞前后瘤体变化、临床症状和体征的改变及并发症发生情况。结果：75例经2～6次治疗后（平均3．2次）均治愈，瘤体消失，随访6个月，所有病例无严重并发症发生，病情稳定。结论：碘化油乳剂可使药液流动缓慢，平阳霉素碘化油乳剂治疗面部静脉畸形安全有效。     

非创伤性股骨头坏死骨髓水肿与疼痛分级及坏死分期相关性的研究

目的探讨非创伤性股骨头坏死（nontraurnatic ostconecrosis of femoral head，NONFH）骨髓水肿与疼痛分级、坏死分期的相关性，提高对骨髓水肿在NONFH中临床意义的认识。方法2004年10月-2006年10月收治的97例149髋NONFH患者进行回顾性分析。男68例，女29例；年龄19～62岁，平均38．8岁。病程20d～4年。患者骨髓水肿根据MRI表现分为0～2级；疼痛分级按主诉疼痛分级法分为无疼痛（0级）、轻度疼痛（1级）和中重度疼痛（2级）；坏死根据世界骨循环研究学会国际骨坏死分期标准分为Ⅰ～Ⅳ期。分析各级疼痛及各期骨髓水肿的发生率，并将骨髓水肿分别与疼痛分级、坏死分期进行列联表资料x^2检验及多个独立样本比较的秩和检验。结果149髋中109髋发生骨髓水肿，发生率为73．15％。疼痛128髋中108髋（84．38％）存在骨髓水肿，其中2级疼痛34髋中，32髋（94．12％）存在骨髓水肿。疼痛分级与骨髓水肿分级有关（P〈0．001）。各级疼痛间的骨髓水肿差异有统计学意义（P〈0．001），随疼痛程度的加重骨髓水肿分级的平均秩次逐渐加大，0级、1级和2级分别为28．19、78．94和96．12。以坏死Ⅱ期（77．05％）、Ⅲ期（82．81％）患者骨髓水肿最多见且明显。坏死Ⅰ～Ⅲ期与骨髓水肿分级有关（P〈0．001）。Ⅰ～Ⅲ期坏死间骨髓水肿分级比较差异有统计学意义（P〈0．001），且随病变程度的加重，骨髓水肿分级的平均秩次逐渐加大，0级、1级和2级分别为39．07、60．16和86．15。结论骨髓水肿是NONFH发展过程中的一种伴随征象，骨髓水肿发生的几率和程度与NONFH疼痛分级、坏死分期密切相关，骨髓水肿的情况可作为评价病情进展及疗效判定的指标。     

A novel small molecule that directly sensitizes the insulin receptor in vitro and in vivo

Insulin resistance, an important feature of type 2 diabetes, is manifested as attenuated insulin receptor (IR) signaling in response to insulin binding. A drug that promotes the initiation of IR signaling by enhancing IR autophosphorylation should, therefore, be useful for treating type 2 diabetes. This report describes the effect of a small molecule IR sensitizer, TLK16998, on IR signaling. This compound activated the tyrosine kinase domain of the IR beta-subunit at concentrations of 1 micromol/l or less but had no effect on insulin binding to the IR alpha-subunit even at much higher concentrations. TLK16998 alone had no effect on IR signaling in mouse 3T3-L1 adipocytes but, at concentrations as low as 3.2 micromol/l, enhanced the effects of insulin on the phosphorylation of the IR beta-subunit and IR substrate 1, and on the amount of phosphatidylinositol 3-kinase that coimmunoprecipitated with IRS-1. Phosphopeptide mapping revealed that the effect of TLK16998 on the IR was associated with increased tyrosine phosphorylation of the activation loop of the beta-subunit tyrosine kinase domain. TLK16998 also increased the potency of insulin in stimulating 2-deoxy-D-glucose uptake in 3T3-L1 adipocytes, with a detectable effect at 8 micromol/l and a 10-fold increase at 40 micromol/l. In contrast, only small effects were observed on IGF-1-stimulated 2-deoxy-D-glucose uptake. In diabetic mice, TLK16998, at a dose of 10 mg/kg, lowered blood glucose levels for up to 6 h. These results suggest, therefore, that small nonpeptide molecules that directly sensitize the IR may be useful for treating type 2 diabetes.     

股骨头缺血性坏死造模的实验研究

目的：制作激素性股骨头缺血性坏死的动物模型。方法：将30只成年三黄鸡随机分实验组、对照组2组,实验组注射马血清后大量使用地塞米松,2组分别进行股骨头内PO2、pH值测定和组织学检查。结果：实验组第6周出现股骨头缺血性坏死,复制成功率33．3％,第12周成功率83．3％,总成功率60．0％。结论：鸡注射马血清后大量使用激素可成功地复制出激素性股骨头缺血性坏死的动物模型。     

急性重症胆管炎大鼠肝肺组织内TNF_α、IL-1β的mRNA表达及活血清解灵的调节作用

目的 :观察大鼠ACST时肝肺组织内TNFα、IL 1β的mRNA变化 ,以及应用活血清解灵进行中西医结合治疗的调节作用。 方法 :通过胆总管远端结扎 ,近端注入菌液并封闭的方法 ,造成大鼠ACST模型。采用单纯胆管减压、胆管减压配合活血清解灵两种不同方法治疗。应用原位杂交的方法检测肝肺组织内TNFα、IL 1β的mRNA表达。 结果 :IL 1β、TNFα 的mR NA杂交信号主要位于巨噬细胞内。模型组明显高于假手术组 ,中药组的阳性细胞数和表达量明显低于模型组 ,减压组与模型组相似。 结论 :ACST时肝肺巨噬细胞释放大量的炎性细胞因子 ,活血清解灵具有显著的免疫调节效应。     

脱脂奶粉勾兑牛奶酒工艺中pH值的影响

探讨了以脱脂奶粉为原料勾兑奶酒的工艺条件,主要研究了牛奶蛋白在乙醇存在下影响其稳定性的一个重要因素——pH值.实验表明,在以脱脂奶粉为原料勾兑奶酒时,酒精应该先进行适量的稀释再加入到复配奶中;随着复配奶pH值的升高,其牛奶蛋白的乙醇稳定性也随之升高.复配奶的pH值决定着勾兑奶酒的pH值,其最适pH值为6.5～7.3,但是酒精的pH对于勾兑奶酒的pH并没有决定性的影响.实验还研究了勾兑奶酒在储存过程中其体系的pH值的变化.     

蒸煮鸡肉的挥发性香气成分

采用同时蒸馏萃取法(即SimultaneousDistillationExtractor,以下简称SDE)提取蒸煮鸡肉中的挥发性香气成分,并采用气相色谱质谱联用法(GC-MS)对香气成分进行了鉴定.结果得到化合物44种,共分成9类,其中羰基化合物最多、芳香族次之.羰基化合物对鸡肉特征香气的形成起重要作用,芳香族和呋喃是蒸煮鸡肉的主要香气成分.     

Differential expression of chemokines and chemokine receptors shapes the inflammatory response in rejecting human liver transplants.

BACKGROUND: Graft rejection after liver transplantation is associated with a lymphocytic infiltrate, the nature of which will be determined by, among various factors, the local activity of chemokines that attract particular subsets of effector cells to the graft. METHODS: The expression of chemokines and receptors in human liver allografts was studied by immunohistochemistry of tissue and flow cytometry of blood and liver-derived lymphocytes. Receptor function was assessed with in vitro chemotaxis. RESULTS: We report increased expression of chemokine receptors CXCR3, CXCR4, and CCR5 on circulating and graft-infiltrating lymphocytes after liver transplantation. Liver-derived T cells responded to the ligands for these receptors in vitro, which suggests that the receptors are functionally active. The chemokine ligands for these receptors were detected in rejecting allografts. CXCR3 ligands interferon-inducible protein 10 and monokine-induced by gamma interferon were detected on sinusoidal endothelium and interferon-inducible T-cell alpha chemoattractant was detected on portal and hepatic vascular endothelium, whereas the CXCR4 ligand, stromal-derived factor (SDF), was restricted to biliary epithelium. CCR5 ligands have previously been shown on portal endothelium. An in vitro model of T-cell alloactivation demonstrated a similar pattern of expression of functional CXCR3, CXCR4, and CCR5 on T cells. Increased expression of chemokine receptors, especially CCR3 and CCR5, was associated with redistribution of activated Kupffer cells in rejecting grafts. CONCLUSIONS: The patterns of chemokine expression in liver allografts during rejection suggest that the recruitment and positioning of lymphocytes is mediated by specific chemokines. Although ligands for the receptors CXCR3 and CCR5 are important for recruitment, the restriction of SDF to bile ducts suggests that CXCR4 may be involved in the retention of alloactivated lymphocytes at sites of graft damage.