改良犬原位背驮式肝移植的解剖学观察

目的观察犬肝脏解剖学特点,探索建立改良的犬同种异体原位背驮式肝移植模型。方法对15只杂交犬的肝脏进行活体和尸体标本的解剖观察。结果犬肝共分7叶,门静脉分左右支进入肝脏,门静脉左支供应约70%肝组织(Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ叶),门静脉右支供应约30%肝组织(Ⅵ、Ⅶ叶),分别阻断门静脉左、右支后5 min左右门静脉压力达到峰值,并迅速回复至门静脉正常压力值上限范围内;肝动脉和胆管与门静脉分支伴行进入各肝叶;左肝静脉粗大,可以作为肝静脉重建的流出道,其余3~6支肝静脉可以分别结扎,肝后下腔静脉易于与肝脏分离。结论犬肝的解剖学特点适宜于建立改良的原位背驮式肝移植模型。     

Body mass index, percent body fat, and bone mass in a cohort of Chinese twins aged 6 to 18 years

Introduction This report examines the relationship of body mass index (BMI), percent body fat (%BF), and bone mass in a cohort of male and female twins recruited from Anhui province, China, ages 6–18 years—577 male pairs (mean age = 11.4) and 478 female pairs (mean age = 11.6). Methods Whole body bone mineral content (WBMC) in (g), whole body bone area (WBA) in (cm²), and %BF were measured using DEXA (Lunar Prodigy, USA). Regression analysis of within-pair differences was used to assess the strength of the association, and the analysis was stratified by gender and age group, where age cut-offs were based on ages at spermarche or menarche estimated from large population based studies in China. Males were stratified at ages before 14 and age 14–18, and females at ages prior to 12 and age 12–18. Results Univariately, BMI and %BF were associated with WBMC and WBA in the younger males and females, and in older males; %BF was significant only in older females. Multivariate models included both BMI and %BF. Among the younger males, age < 14, BMI and %BF were significantly associated with WBMC and WBA. In the younger females, age < 12, %BF was only significant to WBA. In the older age group, only BMI was significant to WBMC and WBA in females, but in males, BMI was positively associated, and %BF was negatively associated with both bone measures. Discussion These findings show that association between BMI and %BF and bone mass differ across gender and developmental stages, and %BF appears to be beneficial at younger ages, but detrimental or non-beneficial at older ages of development.     

针灸治疗坐骨神经痛38例

近几年来，笔者对38例坐骨神经痛患者进行了针灸治疗，疗效显著，现报告如下。     

Sympathetic skin response in patients with myasthenia gravis★ A comparative analysis

BACKGROUND: The examination of sympathetic skin response is an important index for assessing the autonomic nerve function, and patients with myasthenia gravis are always accompanied by dysautonomia. Therefore, it will be important to know whether sympathetic skin response can be used as the index for the clinical evaluation of myasthenia gravis. OBJECTIVE: To investigate the diagnostic value of sympathetic skin response in the damage of autonomic nerve function of patients with myasthenia gravis. DESIGN: A case-controlled comparative observation. SETTING: Department of Neurology and Room of Nerve Electromyogram, the Affiliated Hospital of North Sichuan Medical College. PARTICIPANTS: Thirty outpatients or inpatients with myasthenia gravis were selected from the Department of Neurology, the Affiliated Hospital of North Sichuan Medical College from May 2006 to May 2007, including 9 males and 21 females, aged 8–72 years with a mean age of (28±5) years old. They were all accorded with the diagnostic standards of myasthenia gravis, accompanied by different severity of autonomic nerve symptoms, including poor skin nutrition, sweating of hands and feet, pyknocardia, persistent hypotension, abdominal pain, constipation, etc. They all had not taken any drug affecting the autonomic nerve function before the examination. Informed consents were obtained from all the patients. Meanwhile, 30 healthy physical examinees were enrolled as the normal control group, including 10 males and 20 females, aged 10–75 years with a mean age of (31±5) years old. Approval was obtained from the hospital ethic committee. METHODS: After admission, the patients were examined with sympathetic skin response using DANTEC keypoint 2.0 electromyography evoked potential apparatus (Danmark). The changes of the latency and wave amplitude of sympathetic skin response were observed. The subjects in the normal control group were examined with the same methods at physical examination. Abnormality was judged by the disappearance of wave form, latency longer than that in the normal control group by Mean±2.5SD, or wave amplitude lower than the average value in the normal control group by 50%. MAIN OUTCOME MEASURES: The results of the latency and wave amplitude of sympathetic skin response were compared between the patients with myasthenia gravis and normal controls. RESULTS: All the 30 patients with myasthenia gravis and 30 healthy physical examinees were involved in the final analysis of results. There were no significant differences between the left and right upper and lower limbs in both the myasthenia gravis group and normal control group (P > 0.05). In the myasthenia gravis group, the abnormal rate of sympathetic skin response was 37% (11/30), the latency was prolonged and the wave amplitude was decreased as compared with those in the normal control group, and there were significant differences (P < 0.01). CONCLUSION: Sympathetic skin response can be used as an electrophysiological index for judging the damages of autonomic nerve function in patients with myasthenia gravis.     

Complex segregation analyses of bone mineral density in Chinese

China has the largest population in the world; approximately 7% of the total population suffers from primary osteoporosis. Osteoporosis is mainly characterized by low bone mineral density (BMD). In the present study, familial correlation and segregation analyses for spine and hip BMDs have been undertaken for the first time in a Chinese sample composed of 401 nuclear families with a total of 1,260 individuals. The results indicate a major gene of additive inheritance for hip BMD, whereas there is no evidence of a major gene influencing spine BMD. Significant familial residual effects are found for both traits, and heritability estimates (±SE) for spine and hip BMDs are 0.807(0.099) and 0.897(0.101), respectively. Sex and age differences in genotype‐specific average BMD are also observed. This study provides the first evidence quantifying the high degree of genetic determination of BMD variation in the Chinese.     

电视硬质气管镜治疗大气道良性肿瘤

目的探讨电视硬质气管镜在大气道良性肿瘤治疗中的价值.方法2002年9月～2005年4月,我院应用电视硬质气管镜治疗大气道良性肿瘤7例,其中气管1例,隆突1例,左主支气管3例,右主支气管2例.手术采用静脉全身麻醉,喷射通气供氧,探查评估气道后,首先冷冻或电凝肿瘤,破坏肿瘤血供,再以活检钳分块取出,蒂部采用冷冻或氩气凝固处理;对于宽蒂肿瘤,内镜下将肿瘤主体清除后中转开胸行气管局部切除吻合术.结果7例手术均顺利,无一例死亡和严重并发症发生.6例气管窄蒂良性肿瘤镜下完整摘除,1例气管膜部宽蒂平滑肌瘤先内镜清除肿瘤主体后中转开胸行气管局部切除.术后病理为错构瘤2例,平滑肌瘤3例,嗜酸性肉芽肿性腺瘤1例,炎症组织1例.7例随访3～36个月,平均17.3月,无肿瘤复发.结论电视硬质气管镜治疗大气道良性肿瘤安全可靠.     

大肠海绵状血管瘤的诊治（附8例报告）

目的 探讨大肠海绵状血管瘤的临床特点、诊治原则和疗效。方法回顾1997年至2004年收治的8例大肠海绵状血管瘤患者的临床资料。结果8例患者平均年龄18岁．其中直肠海绵状血管瘤4例．直肠和乙状结肠海绵状血管瘤3例．金大肠海绵状血管瘤1例。临床表现为反复发作的无痛性便血和贫血。术前行电子结肠镜、腹部X线平片、气钡双重对比造影、CT和MRI等检查明确诊断。昕有患者均行于术治疗．平均随访36月（10～96月）．全部治愈。结论增强对本病的认识．重视电亍二结肠镜仵大肠海绵状血管瘤的首诊作用．影像学检杏进一步确定病变部位和血管瘤的范围,手术治疗是有效的治疗手段。     

李乾构教授应用四君子汤经验

万物生长皆赖于土地,人体生长皆因于脾胃.脾胃为后天之本,气血生化之源.如<金匮要略>日:"四季脾旺不受邪."故治病首先要固本,固本首先要健脾.     

Innate Immunity and Organ Transplantation: The Potential Role of Toll-like Receptors

Traditionally, the recognition and tolerance of transplanted grafts has been considered to be within the realm of the adaptive immune system. Innate immunity, on the other hand, as the first line of host defense, plays a role in fighting against invading microorganisms. Recently, with the discovery of the Toll-like receptors (TLRs), the role of innate immune responses in the control of adaptive immunity has become a new area of interest. Emerging evidence suggests that in addition to responding to pathogen-associated molecular patterns of microorganisms, TLRs can be activated by endogenous ligands, expressed by mammalian cells. These 'danger signals' may participate in ischemia-reperfusion related organ damage and subsequently influence function and survival of transplanted grafts. Furthermore, it has been suggested that adaptive immune responses can enhance the acute inflammatory responses controlled by innate immunity in organ transplantation. This review addresses the potential involvement of TLRs in different stages of organ transplantation. Intriguing and controversial findings are presented and discussed in order to stimulate more attention to this emerging and potentially important area of research in organ transplantation.