自体髂软骨及松质骨移植在牙槽突裂同期行鼻畸形整复术中的应用

目的　探索牙槽突裂与鼻畸形同期整复的新方法。方法　对 4 2例牙槽突裂患者采用自体髂骨及松质骨充填牙槽裂隙 ,髂嵴软骨片覆盖并充垫塌陷的梨状孔外缘及鼻侧区 ,同时利用鼻前庭黏膜软骨复合组织瓣V Y推进法整复鼻畸形。结果　 9～ 11岁患者牙槽突高度恢复平均为86 7% ,厚度恢复平均为 89 6 % ,牙槽突外形和功能为Ⅰ、Ⅱ级 ,尖牙在骨移植区萌出 ,梨状孔外缘鼻侧区低陷处高度恢复 ,鼻翼塌陷畸形恢复 ,鼻孔形态对称 ;12岁以上患者牙槽突高度恢复平均为70 1% ,厚度恢复平均为 71 7% ,牙槽突外形和功能为Ⅱ级、Ⅲ级 ;2例 18岁患者鼻背长轴、鼻端偏斜未能改善。结论　利用自体松质骨和软骨来修复牙槽突裂并同时进行鼻畸形整复 ,既能保证牙槽突高度、牙弓连续性的恢复 ,鼻畸形的改善 ,又能防止鼻背、鼻端长期畸形发展而造成难以矫正的偏斜 ,同时也能尽早消除因畸形给患者带来的心理障碍 ,是一种比较理想的整复方法     

The use of acoustic microscopy to study the mechanical properties of glass-ionomer cement.

OBJECTIVES: The aim of the study was to investigate the relationship between microstructure, acoustic and mechanical properties of hardened dental cement samples, prepared with different powder/water ratios. METHODS: Glass-ionomer dental cement samples, prepared with a standard amount of cement powder and different amounts of water have been examined after being hardened. Surface microstructure and ultrasound, longitudinal and shear velocities were obtained with a scanning acoustic microscope. Conditional effective elastic modulus and Poisson's ratio have been calculated using longitudinal and shear sound velocity values. Then on the same samples elastic modulus and microhardness have been determined by standard tests. Additional samples have been used to determine compressive strength. RESULTS: Density; conditionally instantaneous elastic modulus; high-elasticity modulus and compression strength of the samples decrease when large amounts of water were used for their preparation. At the same time porosity and microhardness of the cement matrix increase. Acoustic parameters and parameters of elasticity, calculated on the basis of sound velocity, demonstrated changes, similar to those obtained in standard mechanical tests. SIGNIFICANCE: The established relation between microstructure, acoustic and mechanical parameters demonstrated a high capacity of acoustic microscopy application for non-destructive characterization of dental materials. A particular advantage of the acoustic microscopy is the opportunity to evaluate microstructure and mechanical properties on the same sample.     

短期用药对幽门螺杆菌检测结果的影响

目的：研究短期不规则用药对幽门螺杆菌(Hp)检测结果的影响。方法：136名慢性胃炎及消化性溃疡的住院患，根据病史分为服药组即Hp检查前一周内接受过铅剂、抑酸剂治疗的患，共四例。对照组即Hp检查前未接受过药物治疗的患考，共37例。Hp检查方法包括①血清学方法；②快速尿素酶试验(RUT)；③组织学方法；④13c—尿素呼气试验(13C—UBT)。结果：服药组RUT，组织学，13C—UBT方法Hp检出率分别为9．0％，21．2％，27．3％，均显低于对照组相应Hp检出率37．8％、40．5％、48．6％(P＜0．01，P＜0．05，P＜0．05)。两组血清学方法Hp IgG、IgM阳性率各为48．5％，51．5％和54．1％，54．1％(P＞0．05)。单独服用质子泵抑制剂组RUT，组织学方法Hp检出率4．0％，16．0％显低于对照组相应方法Hp检出率(P＜0．01，P＜0．05)。单独服用枸橼酸铋钾、H2受体拮抗剂患中各方法Hp检出率与对照组检出率无显性差异(P＞0．05)。单独服用枸橼酸铋钾、H2受体拮抗剂、质子泵抑制剂三组Hp感染率14．3％、15．0％、16．0％均显低于对照组Hp感染率46．0％(P＜0．05)。结论：Hp检查前短期使用铋剂、抑酸剂可导致Hp检出率下降，短期使用质子泵抑制剂可显降低RUT、组织学方法Hp检出率；各方法中快速尿素酶试验检出率最低。血清学方法检测Hp抗体不受药物影响。     

LPS信号转导分子TLR4表达与小鼠肝损伤的关系

目的：探讨脂多糖(1ipopolysaccharide，LPS)信号转导分子，TLR4(Toil-like receptor 4,TLR4)与肝脏损伤的关系。方法：小鼠腹腔注射LPS后不同时间点取肝脏组织，HE染色观察病理改变，RT-PCR法检测肝组织，TLR4 mRNA的表达。结果：腹腔注射LPS后24h小鼠肝脏出现明显炎性浸润、坏死，肝组织TLR4 mRNA的表达在注射LPS后6，12h明显抑制，24h则基本恢复。结论：LPS致肝损伤呈时间依从性；LPS信号转导分子TLR4在介导LPS肝损伤中起重要作用。。     

Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation in a diabetic patient with end-stage liver disease]

OBJECTIVE: To study the effect of combined transplantation of the liver and the pancreas in diabetic patients with end-stage liver disease, and explore the optimal surgical procedure. METHODS: Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations were performed in a patient diagnosed as having chronic hepatitis B, hepatocirrhosis, hepatic cellular cancer, and insulin-dependent diabetes. Immunosuppression therapy utilized prednisone, tacrolimus (FK506), mycophenolate mofetil (MMF), and simulect. The function of the liver graft, serum amylase and lipase, blood glucose, and C-peptide were monitored after transplantation. RESULTS: Insulin was withdrawn at the 6th day after operation, good liver allograft functional recovery was achieved, without such complications as pancreatitis, thrombosis, and localized infections. CONCLUSION: End-stage liver disease with concomitant insulin-dependent diabetes is the indication for combined liver-pancreas transplantations, for which simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations may constitute the optimal surgical approaches as the primary choice.     

舒芬太尼或芬太尼复合丙泊酚对喉显微手术血流动力学和应激反应的影响

目的 比较芬太尼复合丙泊酚与舒芬太尼复合丙泊酚用于喉显微手术患者的血流动力学和应激激素变化.方法 200例患者行支撑喉镜下声带手术,患者随机均分为芬太尼复合丙泊酚组(F组)和舒芬太尼复合丙泊酚组(S组).F组、S组分别静脉注射芬太尼3.0μg/kg或舒芬太尼0.3μg/kg、丙泊酚2.0mg/kg、琥珀胆碱1.5mg/kg实施麻醉诱导.记录和测定两组诱导前(T0)、插管即刻(T1)、插管后1min(T2)、置支撑喉镜后1min(T3)及拔管后1min(T6)的SBP、DBP、HR、去甲肾上腺素(NE)、皮质醇(Cor)、血糖(Glu)的变化和丙泊酚用量、麻醉恢复情况及不良反应.结果 F组T1、T2、T3时SBP、DBP高于、HR快于T0和S组(P<0.05).F组T1～T3时NE、Cor、Glu分别显著高于T0和S组(P<0.05).术中丙泊酚追加量和总用药量F组显著高于S组(P<0.05),麻醉恢复时间S组稍长于F组,但差异无统计学意义.结论 舒芬太尼复合丙泊酚麻醉对血流动力学和应激反应影响小,是喉显微手术中比较理想的麻醉配伍组合.     

肠道T细胞淋巴瘤临床分析

本文总结报告了3例肠道T细胞淋巴瘤(intestinal T-cell lymphoma，ITCL)的诊治资料，并结合文献复习，发现IT—CL多见于中年男性，以腹痛、血便、发热、体质量下降为主要症状，治疗效果差，预后不良。病理改变以肠道溃疡形成为特点，溃疡形态呈多形性、多灶性、不规则，镜下瘤细胞明显异型、弥漫性浸润，中至大细胞多见。肿瘤细胞呈T细胞表型。ITCL临床少见，缺乏特异性临床表现，极易误诊。故临床医师应重视对ITCL临床病理特征、免疫表型和基因型的研究，注意识别，促其早期诊治。     

维A酸对T淋巴细胞作用的研究进展

维A酸类药物广泛用于治疗各类皮肤病，且其适应证还在不断扩大。近年来越来越多的证据表明，维A酸具有免疫调节作用。首先，维A酸与皮肤免疫有密不可分的联系，其次，维A酸对机体T淋巴细胞的增殖、凋亡、趋化以及Th1／Th2细胞的极化都产生明显及确实的作用，但是维A酸发挥药理学作用涉及的蛋白调控、细胞因子分泌及信号传导的精确机制目前尚不清楚。     

Complicated transseptal puncture during intervention catheter ablation on atrial fibrillation concomitant with straight back syndrome

Straight back syndrome (SBS) is a thoracic deformity with absence of upper thoracic spine kyphosis and heart compression. The anatomic abnormity of SBS may raise the difficulty of introcardial operation and increase the complicated risk of intervention performance. Here we report a case of SBS with complicated transseptal puncture during intervention catheter ablation of atrial fibrillation.