脑动脉瘤手术麻醉处理体会

我院自2002年2月至2003年10月期间施行脑动脉瘤手术18例。现将麻醉处理体会，并结合文献总结如下。     

中老年男性部分雄激素缺乏综合征诊治进展

<正>中老年男性部分雄激素缺乏综合征(Partial androgen deficiency in the aging male,PADAM),长期以来没有引起公众注意。而且PADAM的临床表现比较微妙,使得人们容易忽视它,仅认为是老龄化的必然结果。1998年联合国指出, 到2050年,60岁以上的人口将首次超过15岁以下的儿童人口,13个国家的80岁以上人口将超过总人口的10％。年     

兔动静脉短路环法诱导组织工程骨支架材料血管生成的初步研究

Objective To compare the effects of 2 vascular carriers, arteriovenous loop and arteri-ovenous bundle, on inducing angiogenesis in coral scaffold of vascularized tissue-engineered bone in animal models.Methods Thirty-six adult male New Zealand rabbits were randomized into 2 even groups.In group A, an arteriovenous loop (AVL) was formed by microsurgical anastomosis at the proximal ends between the femoral poptiteal artery and vein, and placed in the circular side groove of the coral block (6 mm × 8 mm × 10 mm) .In group B, flow-through vessels bundles of both femoral artery and vein were placed in the side grooves of the coral block.All the implants in 2 groups were wrapped by a micro-porous expand-ed-polytetrafluoroethylene (ePTFE) membrane, and fixed subcutaneously by suturing.Evaluation methods included gross morphological observations, histological examinations, India ink perfusion and vascular casting after 2, 4, 6 weeks.The density of blood vessels was analyzed by the statistical software SPSS 10.0.Results All the corals were encased by newly formed fibrovascular tissues in 2 groups.Ink-stained vessels distributed the surfaces and side grooves, and invaded the interspaces of corals.The degree of vascularization increased over the course of experiment.Blood vessel density demonstrated a significant continuous increase between 2 and 6 weeks after implantation in group A.The mean value of blood vessel density in group A (2 weeks 276.60±4.67, 4 weeks 517.20±10.66, 6 weeks 707.00 ±11.87) was significantly higher than in group B (2 weeks 153.60 ±7.16, 4 weeks 269.40±6.80, 6 weeks 279.20±6.53) (P <0.01).Vascular casting showed that in group A, significant blood vessels sprouted from all areas of the loop, espe-cially at the entrance of the arteriovenous pediele where the small tubes were densely interconnected.In group B, however, no blood vessels sprouted from the arteriovenous bundles and only some small vessels grew from the entrance and exit.Conclusions A vascularized coral model can be constructed by inserting an ar-teriovenous loop or an arteriovenous bundle, useful in vascular bone tissue engineering.The former, however, have stronger abilities to induce angiogenesis than the latter.     

试尖对根管充填质量影响的研究

目的：了解试尖对侧向加压法根管充填质量的影响因素。方法：随机提取我院1998年10月至2004年12月所完成的根管充填病例的X线片1000例，按试尖与未试尖，分别对前牙、前磨牙和磨牙根管充填质量进行分析。结果：在482例未试尖根管充填病例中，前牙、前磨牙和磨牙的适充比例分别为46％、37％和23％，欠充为20％、29％和47％。超充为34％、33％和29％：在518例试尖病例中，前牙、前磨牙和磨牙的适充比例分别为68％、62％和51％，欠充为6％、12％和13％，超充为25％、24％和36％。结论：在侧向加压法根管充填中，试尖可明显改善充填质量。     

Hemoglobin constant spring defined by specific oligonucleotide hybridization and hemoglobin D Punjab (beta 121----Gln) in a Batak Indonesian family

A Batak Indonesian from North Sumatra with hemoglobin (Hb) D Punjab (alpha 2 beta 2 121----Gln) and hemoglobin Constant Spring (Hb CoSp) is described. The 24-year-old man did not have clinical symptoms, and his hematological indices were normal. However, he had a persistent slight elevation of fetal hemoglobin level. His mother and his brother were heterozygous for Hb D Punjab; his father had Hb CoSp trait. A sister did not have any abnormal hemoglobin. To show the exact molecular defect leading to the synthesis of Hb CoSp in this family, genomic DNA from the father was analyzed by hybridization with synthetic oligonucleotides. Genomic DNA was digested with Sst I and Hind III producing a 1.05-kb fragment from the 3' end segment of the alpha 2-globin gene, including the termination codon. Two nonadecamers were synthesized to serve as probes: one, entirely homologous to the normal 3' end of alpha 2A-globin gene sequence, including the termination codon TAA, the other different from it by a replacement of the T in the termination codon TAA with C, changing it to CAA, the codon for the amino acid glutamine. DNA from normal controls gave a positive signal with the normal alpha 2TAA oligonucleotide probe but negative with the alpha 2 CAA probe. The father of propositus who had Hb CoSp trait gave a positive signal with the normal alpha 2TAA oligonucleotide probe as well as with the alpha 2CAA oligonucleotide probe, showing him to be heterozygous for the alpha 2CAA-globin gene. This result shows that the Hb CoSp in the Batak family is indeed due to a replacement of T by C in the TAA termination codon of the alpha 2-globin gene changing it to CAA the condon for glutamine. This explains the resulting readthrough of the untranslated sequence of the mRNA.     

结核分枝杆菌Ag85B/GST融合蛋白表达载体构建及在大肠杆菌中的表达

目的 构建结核分枝杆菌Ag85B／GSF融合蛋白表达质粒，并在大肠杆菌(E．coli)中诱导表达。方法 以质粒pUC18／Ag85B为模板，用PCR法扩增结核杆菌Ag85B基因，扩增的Ag85B上游含有EcoR Ⅰ酶切位点，下游含有SalⅠ酶切位点；将Ag85B基因定向插入质粒pGEX-4T-1中，构建原核表达质粒pGEX-Ag85B并转化E．coli B121，筛选阳性重组子，限制性内切酶切鉴定和DNA序列测定，异丙基硫代半乳糖苷(IPTG)诱导表达，SDS-PAGE和Westem blot鉴定结果。结果 成功构建原核表达质粒pGEX-Ag85B并表达出Mr约56000大小的Ag85B／GSY融合蛋白，表达量占总菌体的30％。结论 为进一步进行纯化Ag85B蛋白和研究其在膀胱肿瘤治疗中的作用奠定了基础。     

RAT-BITE FEVER IN KWEIYANG REPORT OF 2 CASES

Rat-bite fever, called "sodoku" meaning "rat-poison" (1) in Japan, is usually considered a rare and interesting disease contracted from the bite of an infected rat. In regions where careful investigations have been made, the causative organism, Spirillum minus, has been found in a high percentage of rats (2). It is primarily a disease of rats, transmissible to other rats, to cats, dogs (3) and other rodents (4) and to man by their bite. T!ie comparative rarity of the disease can be accounted for by the fact that, under ordinary circumstances, men are only exceptionally bitten by rats. The factor of great importanceis the degree of infesta- tion of rats in a given locality. Considering the prevalence of the offending organism among these rodents, rat-bite fever would probably develop in most instances following its bite. It is not surprising, therefore, that rat-bite fever has a wide distribution the world over     

体外循环浅低温心脏不停跳心内直视手术的临床研究

目的:探讨体外循环浅低温心脏不停跳心内直视手术的方法、疗效评价及其对心肌保护作用。方法:总结2004年3月～2008年12月间12例施行浅低温心脏不停跳心内直视手术病例,并行循环不阻断主动脉,鼻咽温维持在32～35℃,阻断上、下腔静脉,完成心内直视手术。结果:全组无围手术期死亡,心脏手术结束能顺利停机,术后血流动力学平稳,无严重心律失常,血尿发生率0%,无1例发生空气栓塞。1例心房切口缝合针眼渗血,行再次开胸止血,1例术后第32h发生急性肺梗塞,均经治疗痊愈。结论:浅低温心脏不停跳心内直视手术技术安全可行,是一种接近生理状态的心肌保护方法,可避免再灌注损伤,有较理想的心肌保护效果。     

连续切片加免疫组化染色法在乳腺癌微灶转移检测中的应用

目的：推荐一种检测恶性肿瘤微灶转移的方法。方法：应用连续切片的免疫组化法回顾研究50例乳腺癌的淋巴结微灶转移情况，将结果与常规病理切片法进行配对资料的卡方检验，并统计微灶转移率。结果：常规病理切片法的转移灶检出率为30％，连续切片的抗细胞角蛋白免疫组化法的转移灶检出率为50％，二者间差异有显著性。连续切片法发现的微灶转移率为28．5％。结论：对于肿瘤的微灶转移的发现，连续切片的的免疫组化法更有优势，它是一种敏感的检测微灶转移的方法。     

微格教学法在经外周静脉置入中心静脉导管维护模拟教学中的应用

s teaching was also significantly higher in the study group than in the control group(97.37% vs.64.71%,P＜0.05).Conclusion Micro-teaching can effectively improve the quality of clinical teaching.