肉毒碱治疗TPN大鼠肝脂肪变性的研究

目的 探讨在全胃肠外营养（ＴＰＮ）中补充肉毒碱减轻肝脂肪变性的作用。方法 １８只正常Ｗｉｓｔａｒ大鼠和１９只肝硬化Ｗｉｓｔａｒ大鼠分别随机分为６组,Ａ１组、Ａ２组,自由进食和进水（各６只）;Ｂ１组、Ｂ２组,ＴＰＮ（分别６只、７只）;Ｃ１组、 ,ＴＰＮ加肉毒碱（各６只）。各组实验结束后测肝功能,肝脂肪及行肝脏的组织学检查。结果 ＴＰＮ组肝内脂肪显著２,ＴＰＮ＋肉毒碱组肝内脂肪明显减少。结论 在ＴＰＮ     

对肝外胆管梗阻时“软藤征”的再认识

本文回顾性分析了48例“软藤征”的病因,其中恶性疾病28例(占58.3％),良性疾病20例(占41.7％)。据本文资料,作者认为“软藤征”是肝管分叉部及肝外胆管急性完全(或接近完全)性梗阻时肝内胆管扩张的特征性X线表现,并非恶性梗阻特有,良性梗阻亦常见。作者指出,只要肝内胆管无或仅有轻度炎症,胆管具有良好的弹性和扩张性,不论良、恶性病变都可出现“软藤征”。那种认为当梗阻病变未显示时,仅根据“软藤征”即可作出恶性梗阻诊断的观点很值得商榷。作者认为,“软藤征”的定性及病因诊断主要应根据PTC或ERCP,或二者联合显示梗阻局部病变的形态学特征来确定。     

Intracellular signaling pathways that regulate dendritic spine morphogenesis

Rac is a member of the Rho family of small GTPases and acts as a molecular switch. When GTP-bound, Rac binds specific effectors to induce downstream signaling events, including actin cytoskeletal rearrangements (Hall, Science 1998;279:509-514). Herein we review the recent evidence suggesting that Rac is involved in the morphogenesis of dendritic spines (Luo et al., Nature 1996;379:837-840; Nakayama et al., J Neurosci 2000; 20:5329-5338). In addition, we discuss how Rac activity is regulated by guanine nucleotide exchange factors, which may be further regulated by extracellular factors. Thus, the Rac signal transduction pathway may provide links between extracellular ligands or synaptic activity and the regulation of the actin cytoskeleton in spine morphogenesis.     

P波离散度对急性心肌梗死并发房颤的意义

目的　探讨P波离散度 (Pd)对急性心肌梗死并发房颤的预测价值。 方法　 选 36例急性心肌梗死并发房颤的患者 ,观察其P波离散度 ,P波最大时限 (Pmax)。选 80例单纯急性心肌梗死的患者 ,作对照分析。 结果　急性心肌梗死并发房颤的Pd、Pmax与对照组比较有明显差异 (P <0 .0 1)。 结论　P波离散度可作为急性心肌梗死患者并发房颤的一预测指标。     

电针治疗对老年性痴呆大鼠血清β淀粉样蛋白及生长因子水平的影响

目的:观察电针对老年性痴呆(AD)模型大鼠β-淀粉样蛋白及转化生长因子(TGF-α)的影响,揭示针灸治疗的作用机理和针灸治疗AD的免疫基础。方法:建立AD大鼠模型,随机分为电针组、喜得镇组、模型自然恢复组、假手术组,观察血清β-AP和TGF-α水平。结果:电针组和喜得镇组大鼠血清β-AP水平明显下降(P<0.05),但仍明显高于假手术组。结论:电针能降低AD模型大鼠血清中β淀粉样蛋白及TGF-α。     

腹腔镜手术治疗特殊部位异位妊娠11例报告

目的 探讨特殊部位异位妊娠的临床特点与腹腔镜手术治疗的可行性与安全性。方法 回顾分析1998年1月至2003年1月间经腹腔镜手术治疗的特殊部位异位妊娠的临床资料,包括输卵管间质部妊娠4例,卵巢妊娠4例,腹腔妊娠3例。结果 11例特殊部位异位妊娠的临床特点:平均停经时间以卵巢妊娠较短,而间质部妊娠时间较长;血β-HCG值以卵巢妊娠和腹腔妊娠较低,而间质部妊娠较高;腹腔镜手术治疗特殊部位异位妊娠效果:平均手术时间为(45.0±13.8)min,平均术中失血为(81.0±80.6)mL,平均住院时间为(3.0±0.6)d,腹腔镜手术成功率为91％。结论 腹腔镜手术治疗特殊部位异位妊娠是可行且安全的,但是应根据其特点选择术式并预防并发症。     

芬太尼透皮贴剂治疗中重度癌痛433例临床观察

目的:进一步评价芬太尼透皮贴剂治疗中、重度疼痛的疗效、安全性及对生活质量的影响,为临床合理用药提供参考资料.方法:采用多中心随机开放方法,对433例中、重度疼痛患者使用芬太尼透皮贴剂进行观察,芬太尼的初始剂量是2.5mg或参照吗啡芬太尼折算表计算,贴膜每3日更换1次,在使用期间根据疼痛情况进行剂量调整,直到患者无痛或基本无痛.结果:可评价患者336例,其癌痛缓解率100%,41.6%的患者第1次使用后未再进行剂量调整,57.3%的患者调整过1～3次.芬太尼的中位剂量7.5mg,其中92.9%患者在2.5～10mg之内.不良反应轻,主要为恶心、便秘、头晕、呕吐、嗜睡、排尿困难等.治疗后生活质量有明显改善.结论:芬太尼透皮贴剂治疗中、重度疼痛的疗效显著,使用方便,不良反应轻,能明显改善患者的生活质量,绝大多数患者的调整次数在3次以内,大多数患者的使用剂量在每3天2.5～10mg.     

Compromised kidney graft rejection response in Vervet monkeys after withdrawal of immunosuppressants tacrolimus and sirolimus

BACKGROUND: In nonprimates, organ allografts are often not rejected after withdrawal of immunosuppression. In this study, we examined whether such a phenomenon also occurs in primates. METHODS: Vervet monkeys were transplanted with renal allografts and treated for 60 days with tacrolimus, or tacrolimus plus sirolimus. The drugs were totally withdrawn on day 61. The survival of the monkeys was monitored, and their response to donor- or third party-derived alloantigens was examined in vivo and in vitro. RESULTS: The majority (80-100%) of the grafts survived for at least additional 30 days with no signs of acute rejection. The compromised rejection is donor-specific, because recipient monkeys failed to reject a donor-derived skin graft, but a third-party skin graft was rejected. In vitro mixed lymphocyte reaction and interleukin-2 production in the mixed lymphocyte reaction between the recipients and their donors or between the recipients and a third party had no discernable patterns, and thus did not reflect the in vivo status of the immune system. Although the recipients could not reject the graft acutely after drug withdrawal, the kidney grafts and the donor-derived skin grafts had pathological findings of chronic rejection. CONCLUSIONS: The rejection response of the monkeys to an established graft after withdrawal of immunosuppression is compromised. The compromised rejection is specific and is not due to a permanent alteration of the immune system by the initial drug treatment. The allografts are not inert but have low levels of interaction with the recipient immune system.