16层螺旋CT及其三维重建与多平面重组在胫骨平台骨折诊断中的应用

目的探讨16层螺旋CT(16层SCT)及其三维重建(3-D)与多平面重组(MPR)在胫骨平台骨折诊断中的应用价值。方法39例胫骨平台骨折病例经膝关节常规X线平片检查后，采用16层SCT进行膝关节的多层面螺旋CT扫描，在工作站上作3D及MPR影像后处理，就胫骨平台骨折的平片与16层SCT影像进行比较及综合分析。结果39例胫骨平台骨折中，X线平片漏诊1例髁间隆突骨折、1例内髁骨折及1例双髁骨折，此3例(7．69％)平片漏诊的骨折均为16层SCT予以诊断。16层SCT的3-D影像可清晰显示胫骨平台骨折的立体形态；MPR影像则可明确显示胫骨平台内部的骨质损伤情况如骨折的具体部位、关节面碎裂及塌陷程度、骨折移位距离。结论16层SCT能够显示X线平片难于诊断的胫骨平台隐匿性骨折；3-D及MPR成像技术十分有利于全面观察胫骨平台骨折的形态变化，是16层SCT横轴位扫描的重要补充。     

端粒酶活性检测在乳腺癌诊断中的意义

[目的 ]探讨细针穿刺乳腺肿瘤组织的端粒酶活性检测在乳腺癌诊断中的意义 .[方法 ]用聚合酶链反应 酶联免疫吸附测定法检测 79例术前乳腺肿瘤细针穿刺活检标本和大体标本的端粒酶活性 ,并与病理诊断进行比较 .[结果 ]乳腺癌 6 5例中穿刺组织端粒酶呈阳性的为 5 7例 ,阳性率为 88% ;大体组织端粒酶呈阳性的为 5 4例 ,阳性率为 83% .淋巴结转移者端粒酶活性高于无淋巴结转移者 .乳腺良性疾病 14例中端粒酶呈阳性的为 2例 ,阳性率为 14 % .[结论 ]术前乳腺肿瘤穿刺组织的端粒酶活性检测有利于乳腺肿瘤的早期诊断及鉴别诊断 .     

关木通引起慢性间质性肾炎7例报告

目的　观察关木通所致慢性肾损伤的临床和病理改变特点。方法　本组 7例中 ,男 5例 ,女 2例。 3例服关木通汤药 ,4例服含关木通成药。分析服用时间、累积总量与肾损害首发症状及症状出现时间、肾功能和肾病理改变的关系。结果　汤药组 :服药时间平均 3 3 3个月 ,累积总量平均 82 9 3 g ,首发症状为乏力 3例 ,夜尿增多 2例 ,平均时间为 8 3个月 ,Cr平均 40 2 μmol/L。肾病理 :3例均为重度寡细胞性肾间质纤维化 ,肾小管广泛萎缩。成药组 :服药时间平均 7 5个月 ,累积总量平均 13 6g ,乏力 3例 ,夜尿增多 1例 ,恶心呕吐、头痛头晕 1例 ,平均18 8个月 ,Cr 3 62 8μmol/L。肾病理为重度寡细胞性间质纤维化和灶状纤维化各 2例 ,肾小管灶状萎缩 3例 ,广泛萎缩 1例。结论　汤药组关木通积累大 ,发病时间早 ,肾病理改变重。提示关木通所致肾损其临床表现、病理改变与服用关木通时间、剂量相关。     

Duchenne型肌营养不良治疗的研究进展

自从法国医学家Guillaume-Benjamin-Amand Duchenne于1861年首次详细描述Duchenne型肌营养不良（DMD）以来，不少临床医学家和遗传学家对该病进行了系统而深入的研究，虽然已在诊断和遗传咨询方面取得了重大进展，但在治疗上却停滞不前．仍然无法阻止患者进行性加重的肌萎缩和在20岁左右死亡的命运。这是一种既令人感兴趣又使人悲伤的疾病．感兴趣的是其特殊的临床特征和神秘的疾病本质，悲伤的是虽然进行了艰苦的努力但仍无法阻止病情的进展，肌萎缩随着儿童的发育而逐渐进展，随着年龄的增长而加重，在青春期或青年期无一例外地走向生命的终点。[第一段]     

支气管结核在纤维支气管镜下治疗方法的探讨

目的 :探讨支气管结核在纤维支气管镜下治疗的方法及价值。方法 :对 2 5例支气管结核病人 ,在全身抗结核治疗的同时分别实施镜下注药治疗、微波接触式辐射治疗和球囊扩张术 局部注药治疗。结果 :在全身抗结核治疗的同时运用上述几种镜下治疗方法 ,支气管局部病灶较镜下治疗前均有明显好转。结论 :利用纤维支气管镜对支气管结核病人进行局部治疗 ,可加快病灶的吸收和症状的改善 ,值得推广应用     

Comparative effects of dietary wheat bran and its morphological components (aleurone and pericarp-seed coat) on volatile fatty acid concentrations in the rat

Adult male rats were fed on diets containing 100 g dietary fibre/kg either as alpha-cellulose or wheat bran or the pericarp-seed coat or aleurone layers prepared from that bran by sequential milling and air elutriation and electrostatic separation. After 10 d, concentrations of total volatile fatty acids (VFA) in caecal fluid were significantly different between groups and fell in the order: aleurone greater than wheat bran greater than pericarp-seed coat greater than cellulose. This ranking probably reflected the ease of fermentation of fibre polysaccharides by colonic bacteria which also resulted in a considerably higher faecal bacterial mass in the aleurone group. Because of the differences in the volume of caecal digesta, the mass of caecal VFA was considerably the highest in the aleurone group, intermediate with wheat bran and equally low in the pericarp-seed coat and cellulose groups. The diet based on aleurone gave a relatively higher proportion of propionate but with both pericarp-seed coat and wheat bran the contribution of butyrate was raised. VFA concentrations in hepatic portal venous plasma were proportional to caecal concentrations with very high (greater than 3 mM) values being recorded in the aleurone group. The findings are discussed in relation to the apparent susceptibility of the morphological components of wheat bran to fermentation by large bowel bacteria.     

4-Aminopyridine induces the release of neuropeptide Y (NPY) to produce an atropine- and tetrodotoxin-resistant contraction in rabbit isolated jejunum

4-Aminopyridine (4-AP) induced an atropine- and tetrodotoxin (TTX)-insensitive contraction (resistant contraction), in a concentration-dependent manner, in the isolated jejunum of rabbits. The failure of specific antagonists of histamine, serotonin and substance P to affect this resistant contraction ruled out the participation of histamine, serotonin and/or substance P. Antiserum against neuropeptide Y (NPY) reduced this resistant contraction in a concentration-dependent manner and inhibited the action of 4-AP totally at a high concentration (1.25% dilution) whereas normal serum lacked this ability. This suggested that the release of NPY was involved in this 4-AP-induced resistant contraction. Radioimmunoassay of NPY-like immunoreactivity in isolated synaptosomal preparations indicated that 4-AP possessed the ability to induce the release of NPY. However, guanethidine did not affect the actions of 4-AP, indicating that NPY is released mainly from non-adrenergic nerves. Our results indicate that 4-AP induces the release of NPY from non-adrenergic nerves to produce an atropine- and TTX-resistant contraction in the isolated jejunum of rabbits.     

21例心内直视术后急性心包填塞的临床分析

目的:分析21例心内直视术后急性心包填塞的临床特点,探讨其发生原因、预防、救治及其二次开胸的早期指征。方法:对1991年1月-2005年12月心内直视术(共1096例)后21例急性心包填塞二次开胸(发生率1．92％)病例进行总结分析。结果:急性心包填塞患者经二次剖胸解除心包填塞后17例痊愈出院,4例死亡,二次剖胸手术死亡率为19．05％。二次剖胸手术者所患疾病包括先天性心脏病6例,瓣膜病13例,大血管手术1例,心脏移植1例。结论:减少心内直视术后出血、渗血是避免术后发生急性心包填塞的关键,早期诊断并尽早行二次剖胸手术可明显降低围手术期死亡率。     

Monokines produced by macrophages stimulate the growth of osteoblasts

We have previously reported that the J774A.1 macrophage-like tumor cell line produces two potent monokines which stimulate the growth of osteoblasts and chondrocytes. These growth factors, which have an affinity for heparin-agarose, have been termed HEP I (a 30 Kd PDGF-like molecule) and HEP II (an approximately 20 Kd molecule), respectively, based on their elution profile. Unlike HEP I, HEP II does not stimulate the growth of fibroblasts. Extensive biological and chromatographic studies disclosed that HEP II appears to be a unique bone cell mitogen unlike any known growth factor, including the FGFs, IL-1s, and TNFs, EGF, IGF-I and -II, TGF-beta, beta 2 microglobulin, G-CSF, CSF-1 and GM-CSF. To characterize more fully the effects of the macrophage-derived monokines on osteoblast growth and function, clones were derived from calvaria explant cultures. Two clones, SDFRC-2.05 and SDFRC-3, were developed and found to exhibit osteoblastic characteristics, including high levels of alkaline phosphatase, synthesis of type I but not type III collagen, and an increased intracellular cAMP production in response to PTH. The SDFRC-3 cells exhibited a polygonal morphology like that of the explant-derived cells while SDFRC-2.05 cells exhibited a more fibroblastic morphology. When tested on the explant cultures and clones, HEP I and HEP II were found to stimulate DNA synthesis and increase protein per culture, but decreased alkaline phosphatase activity. Clone SDFRC-3 was found to be more responsive to HEP II than clone SDFRC-2.05. Both monokines were found to be more potent mitogens for bone cells than TGF-beta. HEP II, but not HEP I or TGF-beta, induced a transformation of bone cells from a polygonal to a fibroblastic morphology, suggesting the induction of migration prior to proliferation. Thus, macrophages may be responsible not only for bone repair but also for ensuring the linkage of bone formation to resorption during physiological remodeling.