第一掌背动脉双叶皮瓣在手外科中的应用

我们设计主要以第1掌背动脉为蒂的手背双叶皮瓣,同时修复两个部位的手部皮肤缺损和拇指再造,共10例均获成功。皮瓣面积最小10cm×3cm,最大13cm×5cm,蒂宽1.5cm×2.5cm。皮瓣每叶面积最小为3.5cm×2cm,最大6cm×3cm。文中介绍了本皮瓣的解剖学基础,并对其手术适应证和优缺点进行了讨论。     

65例脑脊液鼻漏患者不同治疗方法的疗效对比分析

回顾分析 65例脑脊液鼻漏病例。随访 3个月～ 1 0年 ,其中 2 6例经保守治疗痊愈 ,治愈率 40 %。 3 9例经保守治疗无效的患者 9例自动离院 ;行开颅手术修补 7例 ,其中 3例治愈 ;行鼻外入路修补术 3例 ,全部治愈 ;经鼻内镜修补术 2 0例 ,其中 1次手术治愈 1 9例 ,2次手术治愈 1例。经鼻内镜脑脊液鼻漏修补术的成功率为 1 0 0 % ,其中 1次修补成功率为 95 %。结果提示 :鼻内镜下脑脊液鼻漏修补术是外科治疗脑脊液鼻漏的首选术式     

The effect of 2,4-diamino-6-hydroxy-pyrimidine on postburn Staphylococcus aureus sepsis in rats

GTP-cyclohydrolase I (GTP-CHI) is the first and rate-limiting enzyme for the de novo biosynthesis of biopterin. The present study was to observe the effect of 2,4-diamino-6-hydroxy-pyrimidine (DAHP),an inhibtor of GTP-CHI, on the development of postburn Staphylococcus aureus sepsis. Methods: 56 male Wistar rats were randomly divided into four groups as follows: normal control group (n= 10), scald control group(n= 10),pos tburn sepsis group (n= 20) and DA HP treatment group (n= 16). In the scald control group, rats were subjected to a 20% total body surface area (TBSA) Ⅲ° scald injury, then sacrificed at 24 hrs. In the postburn sepsis group (n=20), rats were inflicted with 20% TBSA Ⅲ° scald followed by Staphylococcus aureus challenge, and they were further divided into 2 and 6 hrs groups. In the DAHP treatment group (n= 16), animals were intraperitoneally injected with a dose of 1g/kg DAHP prior to Staphylococcus aureus challenge, and then further divided into 2, 6 hrs groups. Tissue samples from liver, kidneys, lungs and heart were collected to determine GTP-CHI, inducible nitric oxide synthase (iNOS) and tumor necrosis factor-α (TNF-α) mRNA expression. Meanwhile, biopterin and nitric oxide (NO) levels in these tissues were also measured. Results: After the scald injury followed by Staphylococcus aureus challenge, GTP-CHI mRNA expression and biopterin levels significantly elevated in various tissues such as liver, heart, kidneys and lungs, so did the values of iNOS mRNA expression and NO formation (P＜0.01). Pretreatment with DAHP could significantly reduce GTP-CHI/biopterin induction (P＜0. 05～0. 01), and the up-regulation of iNOS/NO was also suppressed. Furthermore, DAHP administration could also inhibit the gene expression of TNF-α. 2 hrs after septic challenge, TNF-α mRNA expression in liver, kidneys and lungs in DAHP-treated group were 35.7%, 37.3% and 33.0% of those in postburn septic group, respectively. Additionally, in animals without DAHP treatment, the 6-hour mortality was 55.6% (20/36), while it was only 25.0% in DAHP-treated animals (4/16, P=0. 08). Conclusions: Early treatment with DAHP might be a potential strategy to prevent the development of postburn Staphylococcal sepsis, which appears to be associated with down-regulation of biopterin and NO formation by DAHP.     

益肾化浊注射液对慢性肾功能衰竭大鼠残余肾中细胞因子含量的影响

通过观察益肾化浊注射液对5／6肾切除大鼠残余肾中细胞因子含量的影响，益肾化浊注射液延缓慢性肾功能衰竭（CRF）模型大鼠肾功能减退的作用机理。结果显示：益肾化浊注射液可以降低5／6肾切在鼠血清肌,尿素氮（P＜0．01），下调肾组织中白细胞介素－1（IL－1）（P＜0．05），白细胞介素－8（IL－8）（P＜0．05）及肿瘤坏死因子（TNF）（P＜0．05）的总体水平，说明益肾化浊注射液可以通过下调5／6肾切除大鼠残余肾中相关细胞因子含量，抑制促炎细胞因子对肾脏的损害，从而延缓CRF的进展。     

高强度聚焦超声及其医学应用

HIFU技术的研究在国内外已掀起了热潮．到目前为止．HIFU技术已得到广泛的实验和临床支持。本文将对HIFU治疗设备的总体结构做一阐述．并讨论其在医学领域中的应用及发展方向。     

2型糖尿病患者载脂蛋白E基因多态性的研究

目的：探讨中国人2型糖尿病患者载脂蛋白E（apoE)基因多态性及其与血脂和载脂蛋白水平的关系。方法：采用聚合酶链反应－限制性酶切片段长度多态性法，分别对74例2型糖尿病患者及191例血脂、血糖正常且无糖尿病史者的apoE基因型、空腹血脂及载脂蛋白AI、AⅡ、B100、CⅡ、CⅢ及E进行全面分析。结果：2型糖尿病患者的血清甘油三酯（TG）、总胆固醇（TC），低密度脂蛋白胆固醇（LDLC），非高密度脂蛋白胆固醇（nHDLC),载脂蛋白B100、CⅡ、CⅢ、E水平及TG／HDLC比值较对照组显著升高（P＜0．01）；血清高密度脂蛋白胆固醇（HDLC），apoE/apoCⅢ比值显著降低（P＜0．05）。2型糖尿病组与对照组apoE基因频率分布无显著性差异（P＞0．05）。携带ε2等位基因组血清TG／HDLC比值较E3／3基因型显著降低；而携带ε4等位基因组血清apoAⅡ水平较E3／3基因型及携带ε2等位基因组显著升高（P＜0．001）。结论：2型糖尿病患者apoE基因多态性与血TG／HDLC及apoAⅡ有一定关联。     

淋巴细胞亚群微核表达的辐射效应研究

简述了淋巴细胞亚群微核检测方法、淋巴细胞亚群自发微核率和影响因素，以及关于电脑射效应的研究现状，为微核法用于辐射生物剂的未来发展提供了有益信息。     

中位含氯取代环己烯桥环硫三碳菁染料的合成及性能

采用2-甲基噻唑季胺盐与2-氯-1-甲酰基3-羟亚甲基环己烯,合成了五种题示染料。经IR及~1H-NMR谱确认了产物的结构,测定了电子吸收光谱、溶解度及稳定性,发现在染料苯环上引入甲氧基能改进染料溶解度,苯环上有氯取代的染料具有较高的光稳定性。     

乳癌病人单次卡铂和阿霉素化疗诱发的染色体损伤和细胞生物学毒性

应用常规染色体畸变分析和胞浆分裂阻滞微核（ｃｙｔｏｋｉｎｅｓｉｓｂｌｏｃｋｍｉｃｒｏｎｕｃｌｅｉ，ＣＢＭＮ）法对１０例接受单次卡铂（平均剂量为４６２．９ｍｇ／ｍ２）和单次阿霉素（平均剂量为４８．１ｍｇ／ｍ２）化疗的乳癌病人血样进行了淋巴细胞染色体畸变（ｃｈｒｏｍｏｓｏｍｅａｂｅｒａｔｉｏｎ，ＣＡ）和微核（ｍｉｃｒｏｎｕｃｌｅｉ，ＭＮ）的观察分析，并通过有丝分裂指数（ｍｉｔｏｔｉｃｉｎｄｅｘ，ＭＩ）及核分裂指数（ｎｕｃｌｅａｒｄｉｖｉｓｉｏｎｉｎｄｅｘ，ＮＤＩ）观测了细胞毒性。结果表明，单次卡铂和阿霉素化疗均引起了ＣＡ和ＭＮ显著性增加，所观察到的ＣＡ主要为单体畸变，其中单体间隙（ｃｈｒｏｍａｔｉｄｇａｐ，ｃｔｇ）的增加最为显著，染色体型畸变未见显著性变化；卡铂引起ＭＩ明显减低，阿霉素对ＭＩ的影响不显著；两种化疗药物均未对ＮＤＩ产生显著性影响；通过ＭＩ及ＮＤＩ测量的细胞毒性之间显著性相关，但ＣＡ分析和ＣＢＭＮ法测得的染色体损伤之间缺乏相关性。