Correlation between levels of serum immunoglobulin、complement and immunopathology in glomerular disease

目的 探讨肾小球疾病免疫球蛋白、补体水平与免疫病理的相关性.方法 112 例肾小球疾病患者,14 例健康人测定血清免疫球蛋白及补体,112 例肾小球疾病患者,112 例患者行肾活组织病理检查.结果 112 例肾小球疾病患者 IgG 升高 11 例(9.82%),降低 29 例(25.89%),IgA 升高 33 例(29.46%),降低 2 例(1.79%).IgM 升高 7 例(6.25%),降低 3 例(2.68%),三种免疫球蛋白的变化有显著差异(x2=70.587,P=O.000);C3 减低 29 例(25.89%),C4减低 32 例(28.57%),两者比较无显著差异(X2=0.203,P=0.653).免疫荧光阳性率依次为C3(50%)>lgA(49.11%)>IgG(40.18%)>lgM(21.43%)>C4(14.29%)(x2=49.303,P=0.000);免疫荧光 IgA 阳性者血清 lgA 水平较阴性者高(P=0.042),C3、CA阳性者血清 C3、c4 水平较阴性者低(P=0,P=0.007),IgG、IgM 阳性者血清 IgG、lgM 水平与阴性者比较无差异(P=0.136,P=0.383).结论 肾小球疾病存在体液免疫紊乱,测定血清免疫球蛋白、补体及行肾组织免疫病检有助于了解体液免疫状况,估计疾病活动度,判断疗效,但两种检查之间无明显的相关性,可相互补充,不能相互替代.     

严重脊柱侧凸矫形患者围术期的舒适护理

对28例严重脊柱侧凸患者行矫形手术，结果手术均获成功，松解术后1周行后路矫形内固定加植骨融合术，术后Cobb角平均为40．8°，侧弯矫正率平均为52．0％。术后随访6～30个月，均无并发症发生。提出在做好脊柱侧凸矫形手术常规护理的同时，加强患者心理、体位、呼吸、镇痛、排便等方面的舒适护理，可增强患者舒适感，为手术获得成功和患者顺利康复提供有力保障。     

聚环氧氯丙烷／液晶复合富氧膜的研究

研究了聚环氧氯丙烷(PECHCH)/N(4-乙氧基苄叉)4-丁基苯胺(EBBA)复合膜对氧气和氮气的透过性和选择性。用示差扫描量热计(DSC)、解偏振光强仪(DLI和偏光显微镜考察了复合膜的形态结构。结果表明,当PECH/EBBA复合膜处于液晶的向列相转变温度时,有较高的气体透过性和选择性。发现只有复合膜中EBBA含量在30wt％以上,PECH和EBBA呈非均相混合时,才有较明显的富氧效果。当EBBA含量达50wt%时,氧氮分离系数α=3.78。     

Lithium and haloperidol differentially alter the dynorphin A (1-8) and enkephalin levels in the neurointermediate lobe of rat pituitary

Repeated administration of the antimanic drug lithium (4 mEq/kg/day for 2, 4 or 6 days, i.p.) to rats produced a progressive decline and eventual depletion of dynorphin-A (1-8) (DYN) concentration whereas Met5-enkephalin (ENK) was only marginally decreased in the neurointermediate lobe of the pituitary (NIL). Administration of a neuroleptic haloperidol neither affected ENK and DYN levels nor influenced lithium-induced changes. The study reveals that lithium produces a preferential perturbation in the dynorphin system relative to the enkephalin system. These results taken together with other evidence, indicate that dynorphin is possibly coreleased with vasopressin following lithium administration and provide a pharmacological support to the previously described colocalization and corelease of these endogenous peptides in the NIL.     

Liver and lung resection for colorectal metastasis

Aim: To examine the survival benefit of liver and lung resection for colorectal metastasis and the potential prognostic factors that affect patient survival. Methods: All patients who had resection of lung or liver metastasis for colorectal metastasis in Queen Elizabeth Hospital, Hong Kong from 1995 to 2004 were retrospectively reviewed. The overall and disease‐free survival was analysed, in particularly between liver and lung metastasis. All factors that may have affected the survival were entered into Cox's proportional hazards regression model to identify significant variables associated with survival. Results: At 5 years, the overall survival of patients who had resection of lung and liver metastasis was 44% and 38%, respectively; the disease‐free survival was 26% and 24%, respectively. Overall and disease‐free survival of patients with resection of lung metastasis was comparable to those with resection of liver metastasis. The differentiations of primary tumour and time to metastasis were shown to be significant prognostic factors influencing overall survival. Those patients with systemic chemotherapy after resection of colorectal metastasis demonstrated a significantly higher probability of overall survival. Conclusion: Resection of lung and liver metastases from colorectal origin was safe and both procedures improved survival. The use of chemotherapy after resection of metastasis significantly improved the overall survival.     

延迟一期修复外周神经损伤38例报告

目的 探讨应用显微外科技术延迟一期修复四肢外周神经损伤的治疗体会。方法 应用显微外科技术延迟一期修复各种原因所致的四肢外周神经损伤38例41条，手术方法包括神经瘢痕松解、神经直接缝合术等。结果 术后随访6个月～7年，平均33个月，优良率为81．6％。结论 对失去一期修复手术治疗机会的周围神经损伤患者应尽早行延迟一期手术，可取得较好疗效。     

妊娠高血压综合征尿蛋白的丢失对新生儿出生体重的影响

目的: 几乎没有研究报道妊娠高血压综合征 (妊高征 ) 患者尿蛋白对新生儿出生体重的影响, 该研究欲探讨妊高征患者不同水平尿蛋白对新生儿出生体重的影响关系。方法: 1997年 1月 ~2004年 6月期间, 住院分娩患中、重度妊高征产妇 136例, 对新生儿出生体重与各种因素进行回归分析及t检验分析。结果: 单变量回归分析尿蛋白、孕龄分别与新生儿出生体重有高度显著性关系 (P<0. 01); 尿蛋白和孕龄一起进入多元回归分析, 校正影响因素, 尿蛋白和孕龄仍然是影响新生儿出生体重显著性因素 (P<0 .01); 与妊高征尿蛋白 ( +) 比较, 尿蛋白 无显著性影响新生儿出生体重 (P>0. 05), 尿蛋白 有显著性影响新生儿出生体重 (P<0. 01)。结论: 新生儿出生体重与妊高征患者尿蛋白丢失有关, 尿蛋白 丢失将严重影响新生儿出生体重。     

骨性AngleⅡ类2分类错正畸治疗前后硬组织的变化

目的:采用直丝弓矫治器矫治成年患者骨性AngleⅡ类2分类错牙合,以研究正畸治疗前后牙、颌硬组织变化,评价正畸矫治效果。方法:本文选择了8例AngleⅡ类2分类错牙合成年患者,男3例,女5例,年龄19~27岁,平均23.6岁。拔除双侧上颌第一双尖牙,运用直丝弓矫治器进行治疗,拍摄治疗前后X线头颅定位侧位片,进行治疗前后的X线头影测量研究。结果:治疗后SNA角减小,ANB角减小,U1-SN角增大,L1-MP角增大,U1-L1角减小。上颌切牙牙根及上颌基骨明显腭向移动,减小了上颌骨突度;下颌切牙牙冠明显唇向倾斜,代偿了下颌骨后缩。结论:骨性AngleⅡ类2分类错牙合患者经过上颌拔牙矫治后,面形有所改善,取得了理想的矫治效果。     

A pathologic study of adenohypophyseal growth hormone cells in the rabbit after severe burn

The growth hormone(GH), produced by the growth hormone cell in pars distalis of the adenohypophysis, acts on the sugar, protein and fat metabolism in various degrees. After trauma, the GH has relations with the energy supply, the maintenance of nitrogen balance, the tissue repair and the body resistance. However, pathological study on the GH cell after burn injury is rare in the literature so far. The purpose of the present investigation is to take a dynamic observation on the ultrastructural changes of the rabbit GH cell after napalm burn within one week. 46 male rabbits were used and divided into two groups, napalm burn group (N = 36) and control group (N = 10). The former is inflicted with 3rd degree burn covering 30% TBSA. The animals of former group were sacrificed at 3, 6, 12, 24, 48, 72, 96, 120, 168 hours postburn respectively. Using the light and electron microscopy and stereological method, the results revealed that: (1) the synthesis activity in GH cell was enhanced, the process of secretion was rapid, and the rate of granule maturation was increased; (2) the nude GH granules were found both in the sinusoids and the endothelial cells; (3) the newly formed mitochondria may be originated from the Golgi complex, and the newly formed Golgi complex from the reutilization of the plasma membrane components; (4) some endothelial cells manifested degeneration, and the others showed in active condition; (5) under the light microscopy, the distribution of the lower tint-phil GH cells had its regional-characteristics.     

Hematopoietic effects in mice exposed to arsine gas

Arsine gas is a potent hemolytic agent. Concern about semiconductor workers prompted an in-depth study of arsine at the National Institute of Environmental Health Sciences to determine the hematopoietic effects of prolonged exposure to this gas. Female B6C3F1 mice were exposed by inhalation to 0, 0.5, 2.5, and 5 ppm arsine, 6 hr/day for 14 days. Body weights of exposed mice were comparable to those of controls, but a marked, concentration-related splenomegaly was observed. Higher level arsine exposure produced statistically significant decreases in red blood cells, hematocrit and hemoglobin, with increases in white blood cell counts and mean corpuscular volume of red blood cells. Erythropoiesis as measured by quantitation of erythroid precursors in culture revealed a marrow reduction of colony-forming unit erythroids/femur cells for all treated groups on Day 3 postexposure and only at the 5 ppm dose group on 24 days postexposure, while splenic erythropoiesis increased at higher concentrations of arsine. There was no alteration in bone marrow cellularity and a less significant effect on granulocyte-macrophage progenitors. A 12-week study of arsine at 0, 0.025, 0.5, and 2.5 ppm (6 hr/day) by inhalation showed similar effects on hematopoiesis in mice. In conclusion, arsine exposure at low concentrations produces a stress on the hematopoietic system characterized by hemolysis, which persists for a prolonged period following exposure.