The muscular vascular index. Analysis of the vascularization of the muscles of the forearm]

The results of an anatomic study based on 50 fresh adult cadaver upper extremities are analysed. All the arterial pedicles of each forearm muscle were counted, and each muscle was weighed. Each forearm contained an average number of 264 muscular pedicles. The relative mass fraction of each muscle was calculated, as was its "muscular vascular index" or MVI (number of pedicles divided by the weight of the muscle in grams). Half of the forearm muscles had a significant statistical relationship between their weight and their number of vascular pedicles. The other half had no statistical relationship. These two statistical muscular groups (with and without a statistical relationship) did not clearly correspond to anatomic or functional groups. No muscular group based on the average of MVI was found. Each of the 20 forearm muscle had finally its own characteristics of weight, number of pedicles, and MVI. The average MVI was 0.9 (from 0.4 to 1.8). The global muscular vascular index (GMVI) is the division of the total number of muscular pedicles of a forearm by the total muscular weight of this forearm. The average GMVI was 0.8 (from 0.4 to 1.6). In spite of its theoretical and practical limits, the MVI concept approximately reflects the high vascular density of the forearm muscles.     

小儿耳蜗植入后电诱发复合动作电位的阈值及其临床应用

目的：研究应用神经反应遥测（neural response telemetry,NRT)技术，测试电诱发复合动作电位（electrically-evoked compound action potential,ECAP)阈值以指导小儿人工耳蜗映射调图的策略与时机。方法：应用NRT3．0软件对辐值增长函数进行线性拟合，确定ECAP阈值。比较6例儿童植入者在术后1、2、3个月ECAP阈值的变化，同时比较了7例儿童术中、术后ECAP阈值的差异。结果：ECAP幅值增长函数在接近阈值或进入饱和时不再呈线性。术后ECAP阈值保持稳定。各导电极的术中ECAP阈值比术后阈值平均高约15CL，二者有显著性相关（R2＝0．9154）。结论：应选取幅值增长函数的直线段部分进行拟合以确定ECAP阈值。术后应用ECAP阈值指导小儿映射调图时，测试一次ECAP阈值即可。术中ECAP阈值可用作开机时映射图的C值。     

三种细菌生物被膜中超广谱β-内酰胺酶的检测

目的检测肺炎克雷伯氏菌、大肠埃希氏菌、铜绿假单胞菌三种细菌的生物被膜(biofilm,BF)中超广谱β-内酰胺酶(Extended-spectrumβ-lactamases,ESBLs)的产生。方法用改良平板培养法在硅胶膜上建立肺炎克雷伯氏菌、大肠埃希氏菌、铜绿假单胞菌BF的体外模型。用银染法及扫描电镜对BF进行鉴定。用双纸片试验检测ESBLs,等电聚焦电泳测定β-内酰胺酶的等电点。结果三种细菌的各30株中,BF肺炎克雷伯氏菌组(A2组)中ESBLs的产生率最高(14株,46.7%),其浮游菌组(A1组)检出8株(26.7%);BF大肠埃希氏菌组(B2组)有10株(33.3%)产生ESBLs,其浮游菌组(B1组)检出6株(20.0%);BF铜绿假单胞菌组(C2组)有3株(10%)产ESBLs,其浮游组(C1组)为2株(6.7%)。浮游菌组中ESBLs的产生率低于BF菌组,其中肺炎克雷伯氏菌及大肠埃希氏菌的BF组和浮游菌组的检出率之间有显著差异(P<0.05)。A2组共检出14株产生ESBLs,有4种ESBLs,等电点分别为8.2(4株)、7.6(8株)、6.3(1株)和5.6(1株),A1组检出8株产生ESBLs,为3种ESBLs,等电点分别为8.2(2株)、7.6(5株)和5.6(1株);B2、B1组检出2种相同等电点分别为7.6(B1组4株,B2组6株)、8.2(B1组2株,B2组4株)的ESBLs;C1、C2组检出一种等电点为6.4的ESBLs(C1组2株,C2组3株)。以pI为7.6的β-内酰胺酶的检出率最高,其     

腹腔镜与腹腔镜辅助乙状结肠代阴道术治疗MRKH综合征

目的 :总结使用全腹腔镜和腹腔镜辅助下乙状结肠阴道成形术各成功治疗1例Mayer Rokitansky Kuster Hauser综合征 (MRKH综合征 )的经验。方法 :全腹腔镜下使用腔镜闭合切割器切断乙状结肠的近端和远端。自肛门插入腔内圆型吻合器 ,将降结肠与直肠吻合。经会阴于尿道膀胱与直肠之间造穴。将带血管蒂的乙状结肠牵入穴道 ,完成阴道成形。腹腔镜辅助下阴道成形中 ,腔镜闭合切割器切断乙状结肠的远端后 ,于左下腹壁做一辅助切口 ,将近端乙状结肠经此切口拉出至腹腔外。切断乙状结肠近端 ,将乙状结肠的远端开口缝合 2层 ,使之成盲端。近侧端开口置入吻合器之钉钻 ,再行荷包缝合送回腹腔 ,用吻合器行肠吻合。其余步骤同全腹腔镜手术步骤。术后根据临床检查或磁共振成像测量新成形阴道的长度和宽度。结果 :全腹腔镜手术新成形的阴道长 18cm ,宽 4cm。腹腔镜辅助手术新形成的阴道长 19cm ,宽 4cm。两例新形成的阴道黏膜湿润 ,呈粉红色。无术中和术后并发症的发生。结论 :经腹腔镜乙状结肠移植段的长度完全能达到开腹手术的要求。与开放手术比较 ,全腹腔镜乙状结肠代阴道手术在腹壁上不留手术瘢痕 ,美容效果理想。而腹腔镜辅助下阴道成形 ,虽腹壁留有小手术疤痕 ,但操作简便 ,手术时间短 ,手术费用低     

地塞米松体外诱导宫颈癌细胞株凋亡及其机制的研究

目的 :研究地塞米松 (Dex)体外能否诱导宫颈癌细胞株 (HeLa细胞 )发生凋亡及其机制。方法 :采用透射电镜、DNALadder、流式细胞仪等方法进行凋亡检测 ,用ECLWesternblot方法检测凋亡过程中相关基因表达的变化。结果 :地塞米松体外作用于HeLa细胞后 ,透射电镜观察到了凋亡小体 ;DNALadder法也检测到了凋亡时DNA降解形成的梯带 ;流式细胞仪检测到了细胞凋亡峰 ,且峰值随着处理时间的延长而增高。在凋亡过程中 ,凋亡相关基因bcl 2表达下调 ,而p5 3基因表达无明显改变。结论 :地塞米松体外能诱导HeLa细胞发生凋亡 ,其机制与bcl 2基因的表达下调有关     

Radio frequency transmyocardial revascularization enhances angiogenesis and causes myocardial denervation in canine model

BACKGROUND AND OBJECTIVE: Transmyocardial revascularization (TMR) relieves angina and improves exercise tolerance in patients. Angiogenesis and myocardial denervation have been proposed as factors contributing to these benefits. To test whether radio frequency transmyocardial revascularization (RF-TMR) enhances angiogenesis and causes myocardial denervation. STUDY DESIGN/MATERIALS AND METHODS: RF-TMR channels were created in 12 dogs which survived up to 4 weeks. Bromodeoxyuridine was administered subcutaneously to mark proliferating cells as an assay of angiogenesis. Western blot analysis of tyrosine hydroxylase and blood pressure response to topical bradykinin were used as indices of myocardial denervation. RESULTS: RF-TMR increased local vascularity by an average of 50%, whereas the rate of vascular cell proliferation was tripled over that of the untreated region. Changes in mean arterial pressure with bradykinin and tyrosine hydroxylase content were significantly decreased in RF-TMR regions as compared with normal myocardium in the same hearts. CONCLUSION: RF-TMR enhances angiogenesis and causes myocardial denervation in canine myocardium as with laser TMR.     

Cardiac anomalies in chronic renal failure

PRINCIPAL CARDIOVASCULAR COMPLICATIONS IN END STAGE RENAL DISEASE: Cardiovascular diseases are the leading causes of morbidity and mortality in end stage renal disease patients. Very often, complications observed are left ventricular hypertrophy and various forms of arterial degenerative lesions involving coronary arteries, less frequently pericarditis and calcifying valvulopathy are diagnosed. THE REASONS ARE COMPLEX: Risk factors can be either specific of uremia per se such as anemia, overhydration, fistula or the same as in the general population. Hemodynamic alterations including tensile stress or blood flow play a major role associated to various locally or generally generated substances whose role remains currently to be determined. THEIR TREATMENTS: Treatments of cardiovascular complications are not specific in this end stage renal disease population but are more often the treatment of the etiology: reduction of fistula blood flow, increase of hemoglobin, best control of weight gain between two hemodialysis sessions or blood pressure control.     

细胞凋亡及增殖细胞核抗原在肝癌组织中的表达及意义

目的探讨经肝动脉化疗栓塞(TACE)后肝癌细胞中增殖细胞核抗原(PCNA)广凋亡细胞比值与肝细胞肝癌分化程度的关系。方法应用原位末端标记法(TUNEL)及免疫组化双染色技术，对60例肝细胞肝癌石蜡包埋组织进行检测。结果不同分化程度癌组织中细胞凋亡和PCNA的阳性率不同。分化程度高，细胞凋亡阳性率高、PCNA阳性率偏低；分化程度低，细胞凋亡阳性率偏低、PCNA阳性率高。随分化程度的降低，PCNA广凋亡细胞的比值显著增加，两者有相关性。结论PCNA/凋亡细胞的比值可作为评估肝细胞肝癌分化程度的指标。     

F-actin fiber distribution in glomerular cells: structural and functional implications

BACKGROUND: Glomerular distention is associated with cellular mechanical strain. In addition, glomerular distention/contraction is assumed to influence the filtration rate through changes in filtration surface area. A contractile cytoskeleton in podocytes and mesangial cells, formed by F-actin-containing stress fibers, maintains structural integrity and modulates glomerular expansion. In this study, the glomerular cell distribution of F-actin and vimentin filaments was studied in normal control and nine-month streptozotocin-diabetic rats. Results in situ were compared with observations in tissue culture. METHODS: Microdissected rat glomeruli were perfused to obtain a physiological 25% glomerular expansion over the basal value. Fixation was done without change in glomerular volume. Dual fluorescent labeling of F-actin and vimentin was carried out, and samples were examined by confocal laser scanning microscopy. RESULTS: The podocyte cell bodies and their cytoplasmic projections, including the foot processes, contained bundles of vimentin-containing fibers. Except for a thin layer at the base of foot processes, they did not demonstrate F-actin. While mesangial cells in culture had F-actin as long stress fibers resembling tense cables, mesangial cells stretched in situ contained a maze of short tortuous F-actin fibers organized in bundles that often encircled vascular spaces. This fibrillar organization was disrupted in diabetic glomeruli. CONCLUSION: Mesangial cells, but not podocytes, contain a cytoskeleton capable of contraction that is disorganized in long-term diabetes. Together with previous observations, the distribution of this cytoskeleton suggests that mesangial cell contraction may be involved in the redistribution of glomerular capillary blood flow, but not substantially in the modulation of glomerular distention. Disorganization of stress fibers may be a cause of hyperfiltration in diabetes.