大,巨型垂体腺瘤的手术入路选择

自１９９０年以来收治直径在２－５．６ｃｍ的大、巨型垂体腺瘤３３例。依肿瘤生长形态与扩展范围将其简略分为三种类型。Ａ型：瘤体位于鞍内或侵入蝶窦；Ｂ型；瘤体呈椭圆形或哑铃向鞍上扩展，三脑室明显移位抬高；Ｃ型：瘤体巨大侵入三脑室阻塞室间孔或明显的鞍周扩展。     

中国三城市儿童步行者道路交通安全状况回顾性研究

目的了解北京、上海、广州三城市儿童步行安全状况及相关因素,为加强儿童道路交通伤害预防、干预提供科学依据。方法回顾性收集2000~2004年三城市交管部门14岁以下儿童步行者交通伤害发生资料。结果三城市5年间儿童步行者道路交通伤害发生率为14.93/10万,男女比例为1.79∶1,5~9岁为高发年龄,儿童步行者发生道路交通伤、亡的主要责任方为行人,受伤害儿童43.0%为轻伤,46.6%为重伤,10.4%为死亡。结论道路交通伤害严重威胁儿童安全与健康,儿童步行者发生道路交通伤害与多种因素有关,需社会各个部门参与预防。     

Glucokinase and cytosolic phosphoenolpyruvate carboxykinase (GTP) in the human liver. Regulation of gene expression in cultured hepatocytes.

Glucokinase and phosphoenolpyruvate carboxykinase are key enzymes of glucose metabolism in the rat liver. The former is considered to be instrumental in regulating glucose hepatic release/uptake according to the glycaemia level, and cytosolic phosphoenolpyruvate carboxykinase is a major flux-generating enzyme for gluconeogenesis. The level of expression of both enzymes and the regulation of their mRNAs in the human liver cell were investigated. Surgical biopsies of liver from patients undergoing partial hepatectomies and parenchymal hepatocytes derived from the biopsies were used to assay glucokinase, hexokinase and phosphoenolpyruvate carboxykinase activities. Hepatocytes were placed in culture and the actions of insulin, glucagon and cAMP on glucokinase and phosphoenolpyruvate carboxykinase mRNAs were studied. The main results are: (a) glucokinase accounts for 95% of the glucose phosphorylation activity of human hepatocytes, although this fact is masked in assays of total liver tissue; (b) glucokinase activity is set at a lower level in human hepatocytes than in rat hepatocytes, and vice-versa for the gluconeogenic enzyme phosphoenolpyruvate carboxykinase; and (c) as previously shown in rat liver, glucokinase and phosphoenolpyruvate carboxykinase mRNAs are regulated in a reciprocal fashion in human hepatocytes, insulin inducing the first enzyme and repressing the latter, whereas glucagon has opposite effects. These data have interesting implications with respect to metabolic regulation and intracellular hormone signaling in the human liver.     

消炎痛对hCG诱发家兔排卵抑制的形态学研究

应用非甾体抗炎药消炎痛(20mg/kg)抑制hCG 诱发的家兔排卵,注射后的6、9、12、72小时剖腹观察排卵数,并取材进行透射电镜观察和酶组织化学观察。甾体激素合成酶类的组织化学和颗粒细胞内某些细胞器的电镜立体定量学测定结果表明:消炎痛抑制了排卵,却不影响颗粒细胞向黄体细胞的转变。透射电镜观察表明:在排卵前,实验组和对照组最明显的不同是:实验组的外膜和白膜很少见到胶原溶解现象,且表面上皮细胞内含的致密小体不释放其内容物。结果提示:消炎痛主要作用于排卵前卵泡顶部的成纤维细胞和表面上皮细胞,这可能与其抑制了某些与排卵有关的酶的释放有关。     

膝关节盘状半月板损伤患者关节镜术后疼痛的列线图预测模型构建

目的 分析膝关节盘状半月板(DLM)损伤患者关节镜术后疼痛的危险因素,并构建列线图预测模型。方法 收集2017年1月至2021年12月行关节镜手术治疗的217例DLM损伤患者临床资料。依照NRS数字分级法评估术侧膝关节及髌周疼痛情况,将患者分为疼痛组(≤4分,n=26)和非疼痛组(≥4分,n=191)。采用受试者工作特征(ROC)曲线分析获取有统计学意义的连续性变量的最佳截断值。采用多因素logistic回归模型分析DLM损伤患者关节镜术后疼痛的危险因素。构建预测DLM损伤患者关节镜术后疼痛的列线图预测模型,采用校正曲线对列线图预测模型进行内部验证和性能评价,决策曲线对列线图预测模型的预测效能进行临床净收益评估。结果 疼痛组患者年龄、关节软骨损伤比例、术后无冷敷比例均高于非疼痛组(P<0.05),术后负重时间早于非疼痛组(P<0.05)。ROC曲线分析显示：年龄、术后负重时间的AUC分别为0.767、0.774;最佳截断值分别为54岁、7 d。年龄(>54岁)、关节软骨损伤(有)、术后负重时间(≤7 d)是DLM损伤患者关节镜术后疼痛的独立危险因素,术后冷敷(有)是D...     

经皮射频消融与手术切除治疗直径≤ 3 cm原发性小肝癌的疗效分析

目的 分析经皮射频消融（PRFA）与手术切除治疗直径≤3 cm原发性小肝癌的疗效。方法 选取2015年1月—2017年6月兰州市第二人民医院收治的原发性小肝癌患者78例。将36例接受PRFA治疗的患者作为观察组,另外42例行手术切除的患者作为对照组。采用全自动生化分析仪检测血清谷草转氨酶（AST）、谷丙转氨酶（ALT）、总胆红素（TBIL）水平,电化学发光全自动免疫分析仪检测血清甲胎蛋白（AFP）水平。结果 观察组手术时间、术中出血量、住院时间均少于对照组（P <0.05）;观察组治疗前后AST、ALT、TBIL、AFP的差值均高于对照组组（P <0.05）。两组术后并发症比较,差异无统计学意义（P>0.05）;两组治疗后1、2、3、5年的生存率和复发率比较,差异均无统计学意义（P>0.05）。结论 与手术切除比较,PRFA治疗直径≤3 cm原发性小肝癌可缩短手术时间,减少术中出血量,促进肝功能恢复,但两者术后并发症发生率、生存率和复发率接近。     

神经重症患者非惊厥性癫痫持续状态的早期预防及分步治疗研究进展

神经重症监护病房的患者通常具有非惊厥性癫痫持续状态发作的高风险,但其症状通常不典型,常导致诊断和治疗延迟,使发生非惊厥性癫痫持续状态患者的残疾率、病死率增加。目前连续脑电图的使用推动了非惊厥性癫痫持续状态的早期识别,并提出了治疗的分步方法。笔者总结了神经重症监护病房中非惊厥性癫痫持续状态早期预防及当前的治疗进展,并概述了进一步研究的领域。     

The role of pioneer neurons in the development of mouse visual cortex and corpus callosum

The primordial plexiform neuropil is very critical to neocortical development. The pioneer neurons, mainly Cajal-Retzius cells in the marginal zone, and subplate neurons in the subplate, differentiate from the primordial plexiform neuropil. In this study, the development of corpus callosum, visual cortex, and subcortical pathways has been observed in C57BL/6 mice with various methods, such as DiI labeling in vitro and in vivo, DiI and DiA in vitro double labeling, immunocytochemistry, and in vivo BrdU and Fast Blue labeling. As early as E14, the primordial plexiform neuropil can be found in the telencephalic wall, and it contains many pioneer neurons. On E15 the primordial plexiform neuropil differentiates into the marginal zone and the subplate. Cajal-Retzius cells exist in the marginal zone, and subplate neurons are in the subplate. Either Cajal-Retzius cells or subplate neurons have long projections toward the ganglionic eminence, suggesting that they migrate tangentially from the ganglionic eminence. Cajal-Retzius cells are involved in radial migration, and subplate neurons participate to guide pathfinding of subcortical pathways. This study reveals how the pioneer neurons, through radial and tangential migration, play an important role in neocortical formation and in the pathfinding of the corpus callosum and subcortical pathways. Furthermore, DiI labeling in vivo has demonstrated the presence of pioneer neurons all along the corpus callosum pathway, especially in the midline. This suggests that pioneer neurons may also play a role in guiding the pathfinding of the corpus callosum. Accepted: 31 July 2001     

血管透明化与粒子图像测速技术在旁路血管内血流流场研究中的应用

探索采用血管透明化技术结合粒子图像测速技术(PIV)来研究搭桥血管内血流流场的可行性.结果显示血管透明化技术能完整地保留搭桥血管段在体内的真实立体几何构形,从而更准确地反应搭桥血管段在体内的血流流场,而PIV能很好地获得血流流场的信息.因此,将血管透明化技术与PIV相结合有可能使我们对旁路搭桥术后血管内膜增生的血流动力学成因进行更深入地研究.