神经移植端侧缝合颈5/7神经根与上干桥接治疗产瘫

目的：探讨一种不影响残存神经自行恢复的产瘫臂丛神经修复新方法。方法：将上干损伤部位行松解,不切除神经瘤,将其近端的颈5或颈7神经根和神经瘤远端的臂丛上干的神经束膜切开窗口,取颈丛皮支或前臂外侧皮神经前成多段（一般每段长约2．0－2．5cm）,两端分别与颈5神经根和上干的神经束膜行端侧缝合,结果：8例患儿经术后1－11年（平均3年）的随访,4例的三角肌和肱二头肌骨力达4级和4^-级,4例达3例。3例后期进行了肩关节松解和旋前圆肌肌腱切断,结论：该方法既提供了可使损伤近端颈5神经根的新生纤维生长至上干的神经通道,又未阻断神经瘤内残存神经纤维的自行恢复,是治疗产瘫特别是Tassin2型的新术式。     

侵及邻肺叶的非小细胞肺癌与可手术的T4患者的术后生存比较

目的 分析经手术治疗的直接侵犯邻肺叶的非小细胞肺癌(NSCLC)的预后情况,并与经手术治疗的纵隔重要结构受侵犯的T4患者的预后情况进行比较,为更合理地对直接侵犯邻肺叶的周围型NSCLC进行T分期提供线索.方法 所有患者均接受手术治疗,并且均为术前临床分期和术后病理分期均为NOMO的NSCLC患者.从1997年3月到2006年10月,广州中山大学肿瘤防治中心共有49例患者符合入组条件.其中28例直接侵犯邻肺叶的周围型NSCLC归于A组,21例直接侵犯纵隔重要结构的T4患者归于B组.对这两组患者的临床病理资料,中位生存期和长期生存率进行计算和比较.两组间生存率的比较用Log-Rank检验.结果 两组的性别、年龄、病理类型、肺功能和术后辅助治疗情况具有较好的均衡性.A组有1例发生围术期死亡.A组的2年、3年和5年生存率分别为68.7%、61.1%和40.7%;B组的2年、3年和5年生存率分别为64.7%,58.2%,43.7%;A组和B组中位生存期分别为54个月和49个月,两组问生存期的差异无统计学意义(P=0.931).结论 直接侵犯邻肺叶的周围型NSCLC的预后与可手术的侵犯纵隔重要结构的T4患者的预后相似.对部分患者,手术治疗可以取得较为理想的疗效.对于邻近肺叶受侵的NSCLC患者,手术方案应该按照同期双原发肺癌的治疗原则来制定.尚需进一步研究来探讨邻近肺叶受侵的NSCLC的T分期.     

热化疗对人体结肠癌LoVo细胞中一氧化氮含量的影响

Aim To study the effect of nitric oxide (NO) on LoVo cells after hyperthermia combined with MMC and their mechanisms. Methods The levels of NO were determined in cell culture medium of LoVo cells by Cu-Cd reduction method.Results The levels of NO in control (45.9±16.12) μmol/L group were lower than those in chemohyperthermy(92.3±24.30) μmol/L and hyperthermia (67.67±15.48)μmol/L group (P＜0.01,P＜0.05 respectively). Levels of NO in chemohyperthermy and hyperthermia groups were higher than those in chemotherapy(47.03±16.32)μmol/L(P＜0.01,P＜0.05 respcevtively). The levels of NO in chemo-hyperthermy group were higher than those in hyperthermia group(P＜0.05), and those in chemotherapy group higher than in control group but without statistical significance.Conclusion Chemohyperthermy and hyperthermia could remarkably enhance the levels of NO produced by LoVo cells. NO levels could also be enhanced by chemotherapy. It could be concluded that Nitric Oxide Synthase (NOS) in tumor cells might be activated by hyperthermia, chemohyperthermy and chemotherapy, and increased NO level which induced cytotoxic reaction. This may be one of the mechanisms of treatment with chemohyperthermy.     

聚羟基丁酯酯缓释微球的制备及性能

用溶剂蒸发法制备了以新型生物可降解材料聚羟基丁酸酯为载体、以安定为模药的缓释微球,讨论了药物与载体之比对药物含量与包封率的影响,以及制备微球条件对药物释放性能的影响;微球平均粒径为３０～４０μｍ,粒径分布在１～１．５之间,最大载药量为１９．５１％;最高包封率为６７．１１％;体外累积释放曲线呈“两相”释放特征并拌随初始的“突释效应”。扫描电镜观察微球表面呈皱缩表观形态结构,微球内部横断面具有孔道与孔     

8例B细胞淋巴瘤的T细胞基因CD4 V4突变及其相关蛋白的表达

【目的】检测B细胞淋巴瘤组织中T细胞的CD4V4基因突变情况及其相应病例的Fas/FasL、CD4、bcl 2和CyclinD1蛋白表达特征。【方法】PCR SSCP技术筛选检测 5 6例B细胞淋巴瘤CD4分子的V4外显子突变状况。用免疫组化方法检测有突变的B细胞淋巴瘤组织中L2 6 ,UCHL1,CD3,Fas ,FasL ,bcl 2和CyclinD1蛋白表达情况。【结果】 8例 / 5 6例(14 2 % )T细胞CD4V4外显子有变异。其中小淋巴细胞性淋巴瘤 (smalllymphocytelymphoma,SLL)和淋巴母细胞性淋巴瘤(lymphoblasticlymphoma ,LBL)的Fas,FasL和CD4蛋白均为弱或无表达 ;滤泡性淋巴瘤 (follicularlymphoma ,FL) 3项均强表达 ;3例弥漫性大B细胞淋巴瘤 (diffuselargeBcelllymphoma ,DLBL)和 1例套细胞淋巴瘤 (mantlecelllymphoma ,MCL)Fas和FasL强表达 ,CD4无或弱表达。Fas和FasL双强表达的 4例 ,均有bcl 2和 /或CyclinD1过表达。【结论】B细胞淋巴瘤中CD4V4基因有突变 ,并提示这种突变与细胞死亡和细胞周期调控异常有关。     

肾功能分级在成人心脏术后肾功能衰竭的应用

Objective To evaluate the ability of the RIFLE classification to predict hospital mortality in adult patients who underwent cardiac surgery. Methods From October Ist 2006 to December 31st 2006, five hundred and nine adult patients who underwent coronary artery bypass grafting and/or valve operation were enrolled in this study. Renal function was assessed daily according to the RIFLE classification, meanwhile, APACHE Ⅱ score and SOFA score were also evaluated, as well as the maximum scores were recorded. Results Mean duration of ventilation support was 18(14 - 19) hours, the time of ICU stay was 1.4 ± 1.0 days, and the time of postoperative hospital stay was 12. 0(10.0- 15.0) days. 167 patients (32. 8%) incurred postoperative ARF according to the RIFLE classification. The overall mortality was 4. 3% (22/502). A significant increase (P < 0. 01) was observed for mortality based on RIFLE classification. By applying the area under the receiver operating characteristic curve, the RIFLE classification had more powerful discrimination power [0. 933, (95% CI 0. 872 -0. 995) ,P <0. 001]. Conclusions ARF is one of the major complications in postcardiotomy patients. Analytical data suggested the good discriminative power of the RIFLE classification for predicting inpatient mortality of adult postoperative patient with ARF, and the RIFLE classification is simple and practically performed. According to the RIFLE classification, patients with RIFLE class I or class F incur a significantly increased risk of in-hospital mortality compared with those who never develop ARF.     

冠心病患者冠状动脉内成形及支架术前后QT离散度的变化

目的 体表心电图ＱＴ离散度（ＱＴｄ）增大在冠心病患者是预测室性心律失常事件的有用指标。旨在估价冠心病患者经皮冠状动脉腔内成形主支架术（ＰＴＣＡ＋ｓｔｅｎｔ）前后对ＱＴ离散度的影响。方法 对６０例冠心病患者行ＰＴＣＡ＋ｓｔｅｎｔ术前后ＱＴ离散度进行分析。男性４６例,女性１４例,平均年龄５７岁,患者为单支血管病变３６例,多支血管病２４例。本组对ＰＴＣＡ＋ｓｔｅｎｔ术前后同步３导联的标准１２导联心电图Ｑ     

心脏停搏液pH值对大鼠未成熟心肌的影响

目的　探讨心脏停搏液 p H值对离体未成熟大鼠心肌的影响 .方法　采用 SD幼鼠 (18～ 2 1d)离体工作心模型 ,14℃低温缺血 12 0 min,缺血前分别以 p H为 6 .40 ,7.0 0 ,7.2 5 ,7.40 ,7.80和 8.2 0的 St.Thomas' 液单次灌注 ,观察记录缺血前后心功能的变化及心肌 CPK漏出量 .结果　1缺血再灌注 30 m in后主动脉流量恢复百分比依次为 (6 2±5 ) % ,(72± 4) % ,(83± 4) % ,(78± 3) % ,(70± 3) %和 (5 8±4) % ,以 p H 7.2 5组保护效果最好 .2心肌 CPK漏出量各组间无显著差异 .结论　 p H值为 7.2 5的弱酸性心脏停搏液对大鼠未成熟心肌可提供良好的保护作用 ,同时大鼠未成熟心肌可耐受较大范围的 p H变化 .     

PEG6000沉淀结合差速离心方法浓缩水中脊髓灰质炎病毒

建立一种简便,有效的从细菌培养物中纯化ＰＶ１病毒的方法用于水病毒消毒实验。方法ＰＶ１Ｈｅｎａｎ株在Ｈｅｐ－２细胞中增殖后用聚乙二醇６０００沉淀结合差速离心的方法纯化病毒,ＲＴ－ＰＣＲ和透射电镜鉴定提纯病毒的形态学和分子生物学特性。结论ＰＥＧ６０００结合差速离心的方法较之蔗糖密度梯度区带离方法易于操作且比单独ＰＥＧ沉淀有更高的纯化系数,是一种简便,有效的方法。     

七氟醚和异氟醚心血管效应的比较

目的　比较不同浓度七氟醚和异氟醚的心血管效应 .方法　 2 0只健康杂种犬随机分为七氟醚组和异氟醚组 .监测有创动脉压 ;经大静脉置入漂浮导管测定肺动脉楔压、中心静脉压、心输出量 .吸入麻醉药 (七氟醚或异氟醚 ) ,维持其呼气末浓度在 14.5 m L· L- 1 或 8.5 m L· L- 1 ,10 min后测定上述参数值 .结果　七氟醚和异氟醚 :1对心率均没有显著影响 ;2均可呈剂量依赖性地降低体循环血压和血管阻力 ,对心功能也有剂量依赖性的抑制作用 ,两药之间的差异没有显著性 ;3七氟醚降低肺动脉压的作用强于异氟醚 ,但与浓度大小无明显关系 .结论　七氟醚和异氟醚具有相似的心血管效应 ,除七氟醚降低肺动脉压的作用强于异氟醚外 ,二药对心血管系统功能均有剂量依赖性的抑制作用 .