延长前臂骨间背侧逆行皮瓣的一种方法

目的：提出一种延长骨间背侧逆行皮瓣和增加其可靠性的方法。方法：保留较多的皮肤穿支,将皮瓣包埋部分去表皮以保留真皮下血管网,从而提供皮瓣远端充足的血供以及静脉回流。结果：利用本方法修复掌指关节以远和掌侧缺损12例,皮瓣血运良好,无远端坏死。结论：本方法可增加皮瓣切取的长度,提高其可靠性,也可避免出现纵行瘢痕,为骨间背侧逆行皮瓣的应用提供了一种可选方法。     

狗中度冲击伤复合高速破片致伤的损伤特点研究

本研究初步探讨了狗中度冲击伤复合单侧后肢高速破片伤的致伤特点。结果表明,冲击伤,破片伤及两者复合伤后PaO_2均有降低,而PAP则有所升高,以复合伤后变化的幅度最大。且复合伤后24h肺体指数与肺含水率明显高于冲击伤后及破片伤后。形态学的改变显示:复合伤动物多数发生重度肺损伤,冲击伤动物多数为中度肺损伤,而破片伤动物仅少数出现轻度肺损伤。结果提示:狗肢体高速破片致伤对中度冲击伤的肺损伤具有加重作用。     

昆明小鼠angiostatin基因的克隆与真核表达载体的构建

目的:从昆明小鼠肝组织中克隆血管抑素(angiostatin)基因,并构建真核表达载体pcDNA3.1( )-angiostatin.方法:从昆明小鼠肝组织中提取总RNA,经RT-PCR扩增出angiostatin基因,连入pGEMT载体后测序,并采用定向克隆构建出真核表达载体pcDNA3.1( )-angiostatin.结果:测序表明angiostatin基因与Gene Bank上的基因序列相比有2个碱基变异,其中之一编码氨基酸由组氨酸变成精氨酸.该基因序列已被Gene Bank收录(Accession Number:AY424276).结论:成功构建了昆明小鼠真核表达载体pcDNA3.1( )-angiostatin,在肿瘤抗血管生成治疗中有潜在应用价值.     

Inhibiting effect of antisense hTRT on telomerase activity of human liver cancer cell line SMMC-7721

Objective: To induce changes in biological character of human liver cancer cell line SMMC-7721 by blocking the expression of telomerase genes hTRT and to explore its value in cancer gene therapy. Methods: The vehicle for eukaryotic expression of antisense hTRT was constructed and then transfected into SMMC-7721 cells. The effects of antisense hTRT gene on telomerase activity, cancer cell growth and malignant phenotypes were analyzed. Results: The obtained transfectants that could express antisense hTRT gene stably showed marked decrease in telomerase activity;the shortening of telomere was obvious; cells presented contact growth inhibition; in nude mice transplantation, the rate of tumor induction dramatically decreased. Conclusion : Antisense hTRT gene expression can significantly inhibit telomerase activity of cancer cells and decrease malignant phenotypes in vitro and in vivo. Therefore, as a telomerase inhibitor, antisense hTRT gene may be a new pathway for cancer therapy.     

左肝外侧叶切除术在肝内胆管结石治疗中的作用

目的 了解左肝外侧叶切除术在胆道结石中的治疗作用。方法 总结分析过去14年行左肝外侧叶切除治疗肝内胆管结石51例。结果 疗效优良率87.5％。结论 左肝外侧叶切除不但能切除病灶,而且可经左肝断面的扩张胆管为“借路”,取除其他部位肝内、外胆管的结石,以及便于肝门部狭窄胆管的整形。该手术操作简便、可行,在肝内胆管结石的治疗中可广泛应用。     

GM1对脊髓损伤后神经细胞凋亡的影响

目的:观察神经节苷脂(ganglioside,GM1)对脊髓损伤后神经细胞凋亡的影响。方法:中度脊髓损伤大鼠随机分为对照组及治疗组,在蛛网膜下腔注射生理盐水或神经节苷脂,采用原位末端标记检测凋亡细胞DNA(TUNEL)、流式细胞仪磷脂结合蛋白V/碘化丙啶(AnnexinV/PI)双标检测凋亡细胞及荧光酶联测定法测定半胱氨酸天冬氨酸酶3(Caspase3)的活性。结果:对照组及治疗组均发现凋亡细胞阳性表达,且均在3d达到高峰,但GM1治疗组阳性表达显著低于对照组(P<0.05)。结论:神经节苷脂有阻断神经细胞凋亡的作用,对损伤脊髓组织有明显保护作用。     

晚期肝门胆管癌的经腹减黄治疗

目的 总结晚期肝门胆管癌减黄治疗的经验。方法 对43例晚期肝门胆管癌施行不同的内引流术并进行分析及随访。结果 术后并发应激性溃疡出血37例，无胆瘘及腹腔感染，无死亡病例，术后两周黄疸明显减轻30例，完全消退7例，随访36例，术后生存期最短4个月，最长43个月，至今存活6例，生存期分别达21、16、11、9、8和7个月。结论 术前影像检查为术式的选择提供直接的依据；术式选择视患者营养状况及梗阻部位和术中探查情况而定，置管架桥内引流术操作简单，肝断面空肠Roux-Y吻合减黄效果好。     

Predicting Complications after Bariatric Surgery using Obesity-Related Co-morbidities

BACKGROUND: To determine which (if any) pre-surgery obesity-related co-morbidities predict complications after bariatric surgery. METHODS: Claims data are analyzed for 1,760 patients aged 18-62 who were covered by one of seven New York State health plans and underwent bariatric surgery during 2002-2005. Data covered 6 months before to 18 months after surgery. Pre-surgery obesity-related comorbidities studied include: diabetes, hyperlipidemia, hypertension, asthma, arthritis, sleep apnea, GERD, and depression. Specific post-surgery complications examined are: stenosis, complications associated with the anastomosis, dumping syndrome, and sepsis. RESULTS: Obesity-related co-morbidities prior to surgery are significantly correlated with the probability of developing complications up to 180 days after bariatric surgery. For example, sepsis was significantly more likely in patients who had diabetes, arthritis, or sleep apnea prior to surgery. An additional pre-surgery comorbidity is associated with a 27.5% higher likelihood of dumping syndrome, 24.5% higher likelihood of complications associated with the anastomosis, and 23.5% higher probability of sepsis in the first 180 days after surgery. Among the individual co-morbidities studied, sleep apnea and GERD are most predictive of complications. CONCLUSION: Patients who exhibit multiple obesity-related co-morbidities prior to bariatric surgery are at significantly elevated risk of post-surgery complications and merit closer monitoring by health care professionals after bariatric surgery. Limitations of this study include nonexperimental data and an unknown degree of under-reporting of pre-surgery co-morbidities in claims data.