跨步或不跨步下的前弓步和侧弓步动作中的髌股关节压力与应力(二)

结果 髌股关节的压力与应力随膝关节屈曲角度的增加而升高,随膝关节屈曲角度的减小而降低(图3～8).不同膝关节屈曲角度下弓步变化和跨步变化的髌股关节压力见表1.     

保留肾单位手术治疗早期小肾癌21例临床分析

OBJECTIVE: To evaluate the clinical effects of nephron-sparing surgery in patients with early-stage small renal cell carcinoma. METHODS: Nephron-sparing surgery was performed in 21 patients with renal cell carcinoma including 1 with solitary kidney, 3 with unilateral tumor and contralateral renal compromise, and 17 with unilateral tumor and normal contralateral kidney. The diameter of the tumors ranged from 1.5 to 6.0 cm, with a mean of 2.8 cm. The tumor diameter in 17 patients with normal contralateral kidney was less than 4 cm (mean 2.5 cm) and the average diameter in 4 patients with contralateral renal compromise was 4.2 cm. Sixteen cases were in stage T(1), 4 in stage T(2), and 1 in stage T(3). Of the 21 patients, 4 underwent tumor enucleation, 10 polar nephrectomy and 7 wedge resection. RESULTS: All patients were followed up for an average of 40.8 months (7 to 66 months). One patient suffered a right lung and mediastinum metastasis 3 years after the surgery later and 1 with chronic glomerulonephritis required dialysis 27 months after the operation. No surgical complication or local recurrence were found in other patients. CONCLUSION: As a safe and effective therapy for early-stage small renal cell carcinoma, nephron-sparing surgery can be considered as the gold-standard therapy for patients with lesions less than 4 cm in T(1) and T(2) stages of localized unilateral tumor with normal contralateral kidney.     

按阴阳辨证分类组方联合拉米夫定治疗慢性乙型肝炎临床研究

目的:观察按阴阳辨证分类组方联合拉米夫定治疗慢性乙型肝炎(CHB)的临床疗效。方法:90例CHB患者,随机分治疗组及对照组各45例,对照组除一般保肝、对症治疗外,加用拉米夫定抗病毒治疗,疗程6个月。治疗组在对照组用药基础上,按阴阳辨证法则分类组方治疗。口苦、便干、尿黄、苔黄腻、舌尖红、脉弦数或滑数均为有热属阳,用肝炎I号方治疗(茵陈,栀子,滑石,公英,二花,连翘,贯众,虎杖,柴胡,赤芍,郁金,当归,川芎,枳壳,甘草),无阳热征象即按阴湿类用肝炎II号方治疗(党参,白术,茯芩,黄芪,仙灵脾,山药,熟地,山萸肉,柴胡,升麻,干姜,甘草,虎杖),疗程与对照组相同,前3个月每天1剂,后3个月隔日1剂,水煎2次取汁400ml,分早晚服。疗程结束时,观察两组患者肝功能、乙肝病毒标志物及HBVDNA的变化。结果:治疗组与对照组患者血清谷丙转氨酶(ALT)正常率分别为91%与75.5%,两组相比,差异有显著性(P<0.05);HBeAg、HBVDNA阴转率分别为29%、14%及31%、21%,两组相比差异有显著性(P<0.01或P<0.05);未见明显不良反应。结论:按阴阳辨证分类组方联合拉米夫定治疗CHB有改善肝功能和抑制乙肝病毒复制的功效,且辨证指标明确,易于在临床推广。     

Lipid extract from completely sporoderm‐broken germinating Ganoderma sinensis spores elicits potent antitumor immune responses in human macrophages

Ganoderma sinensis has been used widely in Oriental countries for the prevention and treatment of various diseases including cancer. Previous studies have shown that the lipid extract from Ganoderma exhibits direct cytotoxicity against tumor cells. Here, it is reported that the lipid extract from germinating G. sinensis spores, at lower concentrations that have no direct tumoricidal activity, induce potent antitumor immune responses in human monocytes/macrophages. Upon stimulation with the lipid extract, monocytes/macrophages exhibited markedly increased production of proinflammatory cytokines and surface expression of costimulatory molecules. Conditioned medium from stimulated cells effectively suppressed the growth of tumor cells. Apparently, the lipid extract triggered macrophage activation via a mechanism different from that associated with LPS. Moreover, it was observed that the lipid extract could partially re‐establish the antitumor activity of the immunosuppressive tumor‐associated macrophages. These results indicated that in addition to its direct tumoricidal activity, the lipid extract from G. sinensis spores could exert antitumor activity by stimulating the activation of human monocytes/macrophages. Copyright © 2008 John Wiley & Sons, Ltd.     

Patterns of membrane potentials and distributions of the medullary respiratory neurons in the decerebrate rat

We analyzed the membrane potential of 161 respiratory neurons in the medulla of decerebrate rats which were paralyzed and ventilated. Three types of inspiratory (I) neurons were observed: those displaying progressive depolarization in inspiration (augmenting I neurons), those which gradually repolarized after maximal depolarization at the onset of inspiration (decrementing I neurons) and those exhibiting a plateau or bell-shaped membrane potential trajectory throughout inspiration (I-all neurons). Three types of expiratory (E) neurons were also encountered: those in which the membrane potential progressively depolarized (augmenting E neurons), those in which the membrane potential repolarized during the interval between phrenic bursts (decrementing E or post-I neurons) and those exhibiting a plateau or bell-shaped membrane potential trajectory throughout expiration (E-all neurons). Axonal projections of these medullary neurons were identified in the cranial nerves (n = 34), or in the spinal cord (n = 19) as revealed by antidromic stimulation and/or by reconstruction following horseradish peroxidase (HRP) labeling. The other 108 neurons were not antidromically activated (NAA) by the stimulations tested, or had their axons terminating inside the medulla as revealed by HRP labeling. All these respiratory neurons, except for 3 which were hypoglossal motoneurons, had their somata within the ventrolateral medulla, in the region of the nucleus ambiguus, homologous to the ventral respiratory group (VRG) of the cat. No dorsal respiratory group (DRG) was detected within the medulla of the rats. Due to this absence of a DRG, it is concluded that the neural organization of respiratory centers is quite different in cats and rats.     

原位杂交法检测BP1基因在乳腺癌组织中表达

目的探讨BP1同源盒基因在乳腺癌中的表达及其与临床病理指标的关系。方法收集165例乳腺癌临床和病理资料,采用原位杂交法检测BP1的表达,同时用二步法进行ER、p53、PCNA、bcl2、cerbB2免疫组化染色。结果BP1基因表达率为67.88%,免疫组化:ER70.30%、p5349.09%、PCNA74.55%、bcl253.33%、cerbB275.52%。BP1与bcl2具有相关性(P<0.01),且均与ER相关(P<0.05),与p53呈负相关(P<0.05)。BP1与PCNA、cerbB2、患者年龄、组织学类型、淋巴结转移等无相关性。结论BP1可能通过某种非依赖p53基因调控机制,与bcl2、ER协同抑制肿瘤细胞的凋亡而参与乳腺癌的发生。     

Premercapturic acid metabolites of bromobenzene derived via its 2,3- and 3,4-oxide metabolites

1. A new premercapturic acid metabolite of bromobenzene was isolated from the urine of beta-naphthoflavone-induced rats; using 1H-n.m.r., FAB mass spectrometry and chemical degradation it was identified as S-(2-hydroxy-3-bromocyclohexa-3,5-dienyl)-N-acetylcysteine. 2. Two regioisomeric premercapturic acids apparently derived from bromobenzene-3,4-oxide were isolated as an inseparable 1:1 mixture from the urine of phenobarbital-induced rats and characterized by similar means. 3. Acid dehydration of bromobenzene 3,4- and 4,3-premercapturic acids (mixture) afforded only p-bromophenylmercapturic acid, whereas acid dehydration of 3,2-premercapturic acid gave both o- and m-bromophenylmercapturic acids. This implies a shift of sulphur in acid dehydration of the 3,4- and 3,2- but not the 4,3-premercapturic acids. 4. Base dehydration of the 3,4- and 4,3-premercapturic acid mixture gave a mixture of p- and m-bromophenylmercapturic acids, whereas base dehydration of the 3,2-premercapturic acid gave only m-bromophenylmercapturic acid. This indicates these premercapturic acids dehydrate by direct elimination without rearrangment. 5. The 3,2-premercapturic acid was detected only in the urine of BNF-induced animals, whereas the 3,4- and 4,3-premercapturic acids were detected in the urines of untreated as well as PB- and BNF-induced animals. 6. Together with earlier reports of the isolation of the 2,3-dihydrodiol, the isolation of the 3,2-premercapturic acid as a urinary metabolite of bromobenzene implies that bromobenzene-2,3-oxide is a discrete metabolite of bromobenzene and not merely a hypothetical intermediate.     

可调节型充气体位垫的制作和应用

手术中常用体位垫来调整体位及预防褥疮,但以往使用的软垫、海绵垫等却不可根据手术及术中的要求来调节高度,我科对其进行研究并利用现有材料,将其改进制成可调节型充气体位垫,投入临床试用,效果较好。现介绍如下。1材料与制作取上海百特医疗用品有限公司生产的3L容量的氯化钠溶液软包装袋一个,将其中一个出口封闭,使其不漏气。将一根长30cm~50cm长的橡胶管固定于另一个出口,使其不漏气,并将输血器调节器穿于橡胶管上,调节滚轴,起开关作用。连接气压止血器充气,即成可调节型充气调节体位垫。2使用方法根据手术要求将橡胶管连接于气压止血器…     

喉癌患者术后的适应性研究

喉癌是头颈部最常见的恶性肿瘤,目前手术仍是治疗喉癌的主要手段.通过对喉癌术后患者的适应状态、适应测量及影响适应的因素进行综述,提出对喉癌术后适应干预的研究应该针对患者的年龄与性别、个性特征提供不同的应对、治疗方式、术后时间、社会支持和信息等方面知识.     

不同情期大鼠血浆神经降压素含量的变化

本文试图阐明不同情期大鼠血浆神经降压素含量的变化。血浆神经降压素以无水乙醇提取后采用放射免疫分析法测定。间情期、动情前期和动情期大鼠血浆内神经降压素样免疫活性物质的含量依次分别为92.1±7.7ng/L,118.0±9.4ng/L 和144.3±10.2ng/L。动情期大鼠血浆神经降压素样免疲活性物质的含量较间情期大鼠有极显著差异(P<0.01)。