烤瓷贴面修复20例临床观察

目的评价烤瓷贴面的修复效果。方法选择20例患者制作烤瓷贴面92个。复诊时对烤瓷贴面的边缘适合性,边缘着色及颜色进行评价;同时采用牙龈出血指数和菌斑指数评价治疗前后的牙周状况。观察时间为12～18个月。结果5颗牙烤瓷贴面失败,成功率为95.7%;烤瓷贴面治疗前后牙龈出血指数无显著性差异(P>0.05),治疗后菌斑指数降低(P<0.01)。结论烤瓷贴面具有较好的治疗效果。     

测定血浆心钠素对小儿心功能不全的诊断意义

采用放射免疫法测定60例心血管病患儿的血浆心钠素,结果,在心功能不全,先天性心脏病、心肌炎者,明显高于正常组;心功能不全组明显高于非心功能不全组。非心功能不全的心血管疾患(如:先天性心脏病、心肌炎)之间无显著差异。说明血浆心钠素测定可作为心功能不全判断指标,并可指导治疗。     

全胃切除ρ形空肠代胃治疗胃癌64例报告

报告全胃切除ρ形空肠代胃治疗胃癌６４例。术后无吻合口瘘与手术死亡，无返流性食管炎和倾倒综合征，生存质量满意。术后１、３、５年生存率分别为７１．８％、４２．２％和３４．４％。本组结果表明：此种改良后的ρ形空肠代胃、空肠原位间置术式，安全、简便、省时，使常见的手术并发症和远期后遗症均可得到较好预防和纠正，术后生存质量高，是一种满意的代胃术。     

Gene expression of human sperm component related to A4 amyloid precursor protein.

Monoclonal antibodies were raised against a specific human sperm protein and designated as the YWK-II mAb. The partial cDNA encoding the protein was isolated from a rat testis lambda gt11 expression library and the amino acid sequence of the protein was deduced. The cytoplasmic-transmembrane domains of the deduced protein had high homology with the A4 amyloid precursor protein of Alzheimer's disease. To evaluate the stage of spermatogenesis when the gene was expressed, single-stranded 35S-labeled RNA probes were prepared from the cDNA. By an in situ hybridization technique the mRNA for the antigen was detected in germ cells at all stages of spermatogenesis. The finding that the gene is expressed in spermatogonia suggests possible involvement in the initiation of germ cell differentiation or in the detachment of spermatogonia from the basement membrane.     

Segmental fixation with U-shaped rod in the treatment of spondylolisthesis

Summary From 1987 to 1990 the authors treated 20 cases of spondylolisthesis by an improved operative procedure including excision of the medial part of the superior articular processes of the slipped vertebra, excision of the soft tissue between the ununited isthmi, and excision of the ligamentum flavum between the intervertebral space above the slipped segment. In some instances the lower portion of the lamina over the slipped vertebra should be resected. A U-shaped rod was used to hold sublaminar fixation of two segments above and below the slipped vertebra, with the slipped vertebra spared. Utilizing the U-shaped rod as support, bone strips were placed along the lateral and anterior sides of the rod to bridge the gap between the laminae of the displaced vertebra. Other bone grafts were focused on the facet joints. The patients were allowed ambulation early postoperatively. 19 cases could be evaluated at preliminary follow-up. All showed satisfactory results.     

Experimental study of the effect on the liver of cortisol after diverting the adrenal venous circulation into the portal circulation

In order to evaluate the operation of the adrenal autotransplantation into omentum with arterio-venous anastomosis, the right adrenal of fifteen dogs was preliminarily removed and then the left adrenal vein was diverted into the portal circulation by micro surgical technique. Before and after the diversion, the serum cortisol taken from portal vein, hepatic vein, inferior vena cava and peripheral vein was analysed by radioimmunoassay. The dog's adrenal cortex, pituitary were removed for light and electron-microscopic examination. The experimental results demonstrate that the cortisol inactivation effect of the liver was not statistically different before and after the procedure (P greater than 0.05). Thus, we believe that the omentum which has obvious absorbability and revascularity is a reasonable site for adrenal transplantation. And we also found the adrenal cortex left appear slight hypotrophy and pituitary hypertrophy after the diversion. The cause however, requires further research.     

Local cerebral blood flow responses in rats to hypercapnia and hypoxia in the rostral ventrolateral medulla and in the cortex.

The effects of hypercapnia and hypoxia on two local cerebral blood flows in the parietal cortex (PC-BF) and rostral ventrolateral medulla (RVLM-BF) were examined using laser Doppler flowmetry in anesthetized rats. Hypercapnia for 45 s duration at the end-tidal CO2 between 5% and 10%, induced by increasing inspiratory CO2, increased both cerebral blood flows and systemic blood pressure in a degree-dependent manner. The response of RVLM-BF was significantly stronger than that of PC-BF. Both cerebral blood flow responses to hypercapnia were not influenced by cutting peripheral chemoreceptor afferent nerves. Hypoxia for 45 s duration at the end-tidal O2 between 12% and 6%, induced by decreasing inspiratory O2, produced an increase of similar magnitude in both RVLM and PC local blood flows in a degree-dependent manner and a decrease in systemic blood pressure. The responses of both PC-BF and RVLM-BF to hypoxia were significantly diminished after cutting peripheral chemoreceptor afferent nerves. It is concluded that: (1) the RVLM-BF is much more sensitive to hypercapnia than the PC-BF; and (2) activation of peripheral arterial chemoreceptors possibly contributes to hypoxia-induced increase in the RVLM-BF and PC-BF.     

内镜治疗老年总胆管结石30例体会

目的：探讨内窥镜治疗老年总胆管结石的安全性和有效性。方法：对我院普外科收治的30例70岁以上的老年总胆管结石患者进行回顾性分析，所有患者均经B超或螺旋CT明确诊断并接受内镜治疗，治疗方法包括逆行胰胆管造影（endoscopic retrograde cholangiopancreatography,ERCP)，鼻胆管引流（endoscopic nasobiliary drainage,ENBD)，乳头括肌切开（endoscopic shincterotomy,est)和取石术，碎石术，测定患者内镜治疗前后的生化指标变化。结果：30例老年总胆管结石患者行ERCP检查，成功率100％，28例行EST，总胆管结石直径＜1.0cm者成功率100％，结石直径1.0-1.5cm者成功率86％，结石直径≥1.5cm者需进行机械碎石取石，成功率75％；另有2例患者植入塑料支架作长期引流。1例患者发生与内镜有关的并发症，死亡例，30例患者治疗后各项生化指标较治疗前均有明显改善（P＜0．001）。结论：内镜治疗老年总胆管结石成功率增高，避免了手术创新，安全性好，缩短住院时间，是当前治疗老年总胆管结石的首选方法。