腰椎间盘突出症术后下腰痛及再突出的临床分析

[目的]探讨腰椎间盘摘除术后下腰痛以及腰椎间盘再突出的情况。[方法]在采用后路腰椎板开窗突出椎间盘摘除手术的患者中，随机选择200例，对其中获得5a以上随访的84例患者进行回顾性分析，对手术前后下腰痛JOA评分以及影像学结果进行统计处理。[结果]（1）79．8％的患者残留下腰痛，其中14．3％患者存在严重的下腰痛（JOA 1），75％的严重下腰痛患者在35岁以下；（2）13例患者行二次手术，其中12例为腰椎间盘再突出，1例为腰椎不稳，13例患者中主要是50岁以下的成年男性。[结论]年轻患者更易发生严重的下腰痛以及腰椎间盘再突出，在年轻患者首次手术时可以根据情况适当考虑脊柱融合。     

bcl-2/bax mRNA在三氧化二砷体外诱导人胆管癌细胞株凋亡中的表达

目的 观察bcl-2、bax mRNA在三氧化二砷(As2O3)诱导人类胆管癌株QBC939、RBE细胞凋亡中的表达.方法 Rhodamine123染色检测线粒体膜通透性变化;逆转录-聚合酶链反应(RT-PCR)检测bcl-2、bax mRNA的表达.结果 As2O3干预,实验组Rhodamine123荧光染色强度较对照组明显减弱;凝胶成像检测bcl-2/β-actin mRNA A比值,QBC939、RBE细胞对照组分别为0.41±0.03、0.84±0.03;24 h实验组为0.01±0.01、0.43±0.02.bax/GAPDHmRNAA比值QBC939、RBE细胞对照组分别为0.21±0.01、0.42±0.04;24 h实验组为1.44±0.16、1.15±0.21,对照组与实验组比较差异均有统计学意义(P＜0.01).结论 As2O3可能增加胆管癌细胞株线粒体膜的通透性,下调bcl-2mRNA表达,上调bax mRNA的表达,可能启动了线粒体凋亡信号传导途径.     

CAG repeat polymorphism within the KCNN3 gene is a significant contributor to susceptibility to anorexia nervosa: a case-control study of female patients and several ethnic groups in the Israeli Jewish population.

The human small-conductance Ca(2+)-activated potassium channel gene KCNN3 has been involved in mechanisms underlying neuronal function and plasticity. A multiallelic CAG repeat polymorphism within the KCNN3 has been associated with schizophrenia and bipolar disorder. We have previously reported in a family-based study that longer CAG repeats are preferentially transmitted to patients with anorexia nervosa (AN). The present study extends the analysis of KCNN3 allele distribution to a larger series of AN female patients and control groups, incorporating information on ethnicity and co-morbidities associated with AN. The data analysis is presented while considering separately the two alleles of each individual, namely a minor (shorter) and a major (longer) allele. This study has found that the KCNN3 allele distribution in the general Israeli population does not differ significantly in at least four Jewish ethnic groups of Ashkenazi, North African, Iraqi, and Yemenite origin. These have been used as control groups in a matched case-control analysis that has demonstrated a significant over-representation of KCNN3 alleles with longer CAG repeats among AN patients (P < 0.001 for the major allele and P = 0.035 for allele sum). Under dichotomization, a significantly higher prevalence of the L allele (>19 repeats) has been observed among AN patients (P < 0.001). While considering AN and co-morbid phenotypes, a tendency towards longer (L) alleles has been observed in the subset of patients with obsessive-compulsive disorder (OCD) co-morbidity. These findings further implicate KCNN3 as a significant contributor to predisposition to AN.     

振动对急性缺氧小鼠肺损伤的影响

本文观察了频率为20Hz、振幅为0．67mm和作用时间为40min的振动预处理对急性缺氧小鼠肺损伤的影响。结果发现实验组的肺组织匀浆脂质过氧化物LghdPeroxde（LPO）、支气管肺泡灌洗液（BALF）中蛋白含量和白细胞数明显低于对照组（P＜0．05）。这表明在特定率数的振动作用下能明显减轻急性缺氧小鼠肺的损伤。     

Emergency aortic valve replacement for critical aortic stenosis

Objective: To demonstrate that emergency aortic valve replacement can be successfully performed in patients with critical aortic stenosis and reduced left ventricular function even in cardiogenic shock with associated severe multiple organ failure. Design: Retrospective, consecutive case series. Setting: Multidisciplinary intensive care unit of a tertiary care university hospital. Patients: Five patients admitted to the intensive care unit with critical aortic stenosis (aortic valve area 0.56 ± 0.13 cm²) and greatly reduced left ventricular ejection fraction (20 ± 3 %) in prolonged cardiogenic shock and associated multiple organ failure (Multiple organ failure score 6.8 ± 0.5; Acute Physiology, Age, and Chronic Health Evaluation III score 91 ± 27). Intervention: Emergency aortic valve replacement. Results: All patients survived with full recovery of organ function. At follow-up (18 ± 10 months) all patients were in New York Heart Association functional class I or II with improvement of left ventricular ejection fraction to 48 ± 25 %. Conclusions: This excellent outcome suggests that emergency aortic valve replacement should be strongly considered in patients with critical aortic stenosis even in cardiogenic shock and multiple organ failure.     

Long-term stability of prism correction of heterophorics and heterotropics; a 5 year follow-up. Part I: Heterophorics

Twenty heterophoric and 10 heterotropic patients with long standing severe visual symptoms were corrected with prisms for permanent wearing using the full-correction method of H.-J. Haase. The patients were reexamined 1 and 5 years after completion of treatment. Stable corrections obtained by stepwise optical full-correction were also maintained during a follow-up period of 5 years. Sensory and motor adaptations were largely removed and asymptomatic binocular vision was obtained for nearly all patients. A few cases of partly irreversible amblyopia were indicated, but even in these cases largely normal binocular functions were attained. When glasses were suspended, sensory and motor readaptations took place.     

EFFECTS OF STROPHANTHIDIN ON THE SLOW INWARD CURRENT IN GUINEA-PIG ISOLATED VENTRICULAR MYOCYTES

1. The effect of strophanthidin on the slow inward current (Isi) and on contractile force were studied in guinea-pig isolated ventricular myocytes and intact papillary muscles, respectively. In myocytes, both low (10 nmol/L) and high (1-10 mumols/L) concentrations had small or no effects in either direction on Isi whereas norepinephrine (10-100 nmol/L) increased it. To determine whether the same results are obtained after decreasing or increasing intracellular calcium or sodium, the same concentrations of strophanthidin were tested in different procedures that are known to (i) increase [Ca]i and decrease [Na]i (high [Ca]o, 3.6-5.4 mmol/L; low [Na]o, 112 mmol/L; (ii) decrease [Ca]i and increase [Na]i (low [Ca]o, 0.45-1 mmol/L; Sr, 1 mmol/L; (iii) decrease [Ca]i and [Na]i (Cd, 0.1-0.2 mmol/L); and (iv) increase [Ca]i and [Na]i (veratridine, 0.2 mumol/L). High [Ca]o and veratridine increased whereas low [Ca]o and Cd decreased Isi. In contrast, during these various procedures, strophanthidin had small and inconsistent effects at a low or high concentration. In intact papillary muscles, low strophanthidin decreased whereas high strophanthidin increased contractile force. It is concluded that strophanthidin has little direct or indirect effect on Isi and that the decrease in force by low and increase in force by high concentrations in intact muscle are probably related to demonstrated decrease and increase, respectively, in intracellular sodium activity.     

岛津数字胃肠机IF OVER故障产生的原理及维修

分析了岛津3200数字胃肠机IFOVER故障产生的原因，并结合实际故障现象，具体介绍了排除方法。     

直肠癌全直肠系膜切除术后直肠阴道瘘原因与防治

本文通过分析近5年来我院18例女性直肠癌全直肠系膜切除术后直肠阴道痿的临床资料。发现直肠阴道痿多发生于中低位直肠癌行全直肠系膜切除保肛手术的患者。痿的发生与肿瘤的位置、肿瘤的分期、肿瘤距肛门口的距离．以及手术技巧、手术难度、引流方法有关。而与是否进行预防性造口，以及是否采用腹腔镜手术无关。预防上强调应重视术中直肠前壁的锐性分离、结肠直肠吻合以及术后盆腔的负压引流。治疗上应首先进行保守治疗，即肠内营养，阴道冲洗。早期配合肠外营养、及全身或局部抗炎治疗，大部分直肠阴道痿通过保守治疗可以治愈。保守治疗无效时考虑结肠或回肠末端造口。若长期不愈应考虑吻合口肿瘤复发的可能。