创伤性肾动静脉瘘的介入治疗

目的 评价用介入技术治疗创伤性肾动静脉瘘(RAVFs)的安全性和疗效。方法 对8例不适宜做外科治疗的RAVFs患者进行了介入治疗，其中外伤性损伤4例，医源性损伤4例。6例行经导管超选择性肾动脉内钢丝圈栓塞术，2例行被覆膜支架置入患侧肾动脉内封闭瘘口。结果 血管造影显示肾内型动静脉瘘4例，累及肾动脉段-亚段级分支；主干(肾外)型动静脉瘘4例。治疗均获成功，治疗结束时复查血管造影显示瘘口被封闭。轻微并发症1例。医源性RAVFs患者术后失血症状迅速改善，肉眼血尿消失；4例术前存在心脏负荷过度症状患者，闭塞动静脉瘘后症状迅速改善，血管杂音消失。术后肾功能测定均属正常范围，其中2例肾动脉被覆膜支架置入患者，同位素肾扫描显示患侧肾脏形态、功能正常。术后随访10～42个月，2例分别于术后10，18个月死于与RAVFs无关的疾病。6例仍然生存，一般情况良好，未再针对RAVFs进行外科或介入治疗。结论 介入技术，包括经导管超选择性肾动脉内栓塞术和被覆膜支架置入术，是治疗创伤性、复杂型RAVFs的安全、有效的方法。     

静脉溶栓联合导管碎栓和切栓治疗急性大面积肺栓塞

目的评价静脉溶栓联合导管碎栓和切栓治疗急性大面积肺栓塞的临床疗效和安全性。方法对19例急性大面积肺栓塞患者，采用下腔静脉滤器置入、肺动脉导管碎栓和静脉溶栓加低分子肝素抗凝治疗，19例中4例加用了Straub Rotarex导管血栓旋切术。结果19例共行21次治疗。18例经介入治疗后胸闷、紫绀症状均明显改善，肺动脉中央分支血流恢复通畅，血氧饱和度由术前平均86％（74％～96％）上升到治疗后的平均97％（94％～100％）。肺动脉压力从术前的（334-5）mmHg（1mmHg=0．133kPa）下降到术后的（254-5）mmHg（t=13．2，P〈0．01）。l例双侧肺动脉主干大块血栓栓塞的患者，介入治疗无效，后经胸外科手术取栓未能成功，患者死亡。4例成功地采用了Straub Rotarex旋切治疗肺动脉血栓，未出现并发症。结论采用导管碎栓和血栓旋切等介入技术联合静脉溶栓抗凝治疗，是治疗急性大面积肺动脉栓塞的有效而且安全的方法。     

注射自体成纤维细胞除皱的临床应用

目的观察体外培养的自体成纤维细胞注射的面部除皱临床效果,探讨其在面部年轻化治疗中的意义。方法取10例睑袋及上睑松弛手术切除的皮肤行体外培养,细胞数量扩增至108后注射入面部不同治疗部位皮肤的真皮深层,共注射3次,每次间隔2周。结果10例随访6~12月,各例皱纹均得到明显改善,未出现免疫排斥、肉芽肿等并发症。结论应用培养的自体成纤维细胞注射去除面部浅表皱纹,治疗过程简便、创伤微小、安全、效果确实,是一种较好地填充除皱方法。由于尚缺乏更长期的随访结果,远期疗效还有待进一步观察。     

Ischemia and reperfusion reduce the endogenous basic fibroblast growth factor in rat skeletal muscles: an immunohistochemical study.

Polyclonal antibodies directed against human recombinant basic fibroblast growth factor were used in immunohistochemical studies to localize this growth factor in normal and wounded rat skeletal muscles. According to the intensity of the stain, three main classes of fibers could be identified: the strongly, moderately, and weakly stained fibers. Basic fibroblast growth factor immunoreactivity was found mainly in the extracellular matrix, primarily in the endomysium, which includes the heparin-containing basal lamina, and also in the capillary basal membrane of both normal and wounded muscles; however, the signal intensity was much stronger in normal muscles. The distribution of basic fibroblast growth factor in wounded muscles became markedly heterogeneous and sparse. After 4 hours of ischemia, about 40% of skeletal muscle fibers lost their basic fibroblast growth factor immuno-reactivity. Muscles which underwent 4 hours of ischemia and 24 hours of reperfusion had only a diminished basic fibroblast growth factor immunoreactivity. The pathologic results supported the concept of destroyed cell connection and fiber necrosis in ischemic and reperfused muscles. Potential mechanisms involved in this reduced concentration of basic fibroblast growth factor in wounded muscles may include oxygen free radical activation, a generalized effect of the inflammatory response, and reduced secretion of endogenous basic fibroblast growth factor. These results are only partially compatible with the established mitogenic role of this growth factor and suggest that a reduction of endogenous fibroblast growth factor may partly contribute to a delay in wound healing.     

Protective effect of Re-LPS antiserum on experimental multiple system organ failure.

This study examines the possible beneficial effect of Re-LPS (F515) antiserum on experimental multiple system organ failure (MSOF) in rabbits. The results showed that the plasma LPS level was significantly decreased, and it took a shorter period to clear up LPS in experimental than in control rabbits after receiving Re-LPS antiserum. Pretreatment with antiserum can markedly improve the function of the liver, lungs, kidneys, blood and gastrointestinal tract. The MSOF incidence in the group of rabbits receiving immune sera was only 11.2% and the survival rate was raised by about 40.0%. The results suggest that early passive immunotherapy may neutralize gut-derived endotoxin, inhibit endotoxin-induced mediators release and prevent development of severe complications due to sepsis. It is therefore postulated that LPS core antiserum may provide a prophylactic effect on the development of experimental MSOF.

     

尖锐湿疣中乳头瘤病毒感染与P53和ki-67表达的关系

目的　探讨尖锐湿疣中乳头瘤病毒 (HPV)感染与 P5 3和 ki- 6 7的关系。　方法　采用免疫组织化学方法对 82例尖锐湿疣的 HPV感染、P5 3和 ki- 6 7的表达进行观察。　结果　 HPV阳性者 2 4例 (2 9.3% ) ,P5 3阳性表达 2 0例 (2 4 .4 % ) ,ki- 6 7阳性表达 2 1例 (2 5 .6 % )。2 4例 HPV阳性者中 ,P5 3阳性表达 10例 (41.7% ) ,ki- 6 7阳性表达 11例 (45 .8% ) ,经关联分析 ,皮损中 HPV感染与 P5 3(χ2 =4 .2 4 7,P<0 .0 5 )和 ki- 6 7(χ2 =5 .6 8,P<0 .0 5 )阳性表达均有显著关联 ;而 P5 3与 ki- 6 7两者均阳性者仅有 6例 (χ2 =0 .98,P>0 .0 5 ) ,无明显关联。　结论　在尖锐湿疣中 HPV感染伴随 P5 3和 ki- 6 7表达的增加     

人大肠癌细胞株（HT29）与人多器官血管内皮细胞粘附数目及形态学观察

为了模拟体内癌细胞与血管内皮粘附的过程，用人大肠癌细胞与人多器官血管内皮细胞共同培养，观察到与不同血管内皮粘附的癌细胞数有显著性统计学差异（Ｐ＜０．０５—０．０１）。与门静脉、肠系膜静脉内皮粘附的癌细胞数多，细胞表面微绒毛多，丝状突起细长，伪足多且长；与大隐静脉内皮粘附的癌细胞数少，细胞表面突起也细小。这表明不同的血管内皮对癌细胞的粘附是具有选择性的。     

植酸磷的测定──离子交换法

介绍用离子交换法测定植酸磷的含量。对消化终点、最适的提取时间、离子交换树脂的分离效果进行了试验。黄豆粉、窝窝头、豆腐干植酸测得值的变异系数分别为２．１６％、４．９２％、１．７８％，回收率依次为１０３．３８％、１０２．８１％、１０３．４１％。植酸标准品的植酸含量理论值为５７．６４％，本法测定值为５５．２３％，相对误差为２．１４％。本法的精密度及准确度均符合要求。     

后勤社会化医院增活力--一家地方医院的后勤社会化改革路径

改革医院后勤管理模式,是现代医院发展的需求。通过深化后勤社会化服务,将有效促进医院整体水平的提升。