断指再植术前及术中可能出现的问题

<正> 93年以来,我们收治了特殊情况下的断指再植42例78指,术后经随访8个月以上,成活率达73.1％,根据临床不同情况,可能存在的不同问题现讨论如下。1 临床资料1.1 一般情况 本组共42例78指,男29例53指,女13例25指,年龄16～58岁,平均24.7岁,致伤原因分别为菜刀砍伤、铡刀切伤、电锯伤、切纸机伤以及机器绞榨伤。离断平面:末节离     

骨疏康治疗原发性骨质疏松症疗效观察

为了观察骨疏康颗粒的疗效，将1999年10月～2005年2月收治的107例中医辨证为肾阳虚证的骨质疏松症患者，随机分为两组，以仙灵骨葆胶囊为对照进行了对照观察，现将观察结果总结如下。     

颈动脉支架置入术中颈动脉窦反应的原因分析及对策

<正>心脑血管疾病是我国第一位的死亡原因,其中缺血性脑血管疾病占重要比重,对个人、家庭和社会造成极大的经济负担[1]。颈动脉狭窄被公认为是脑卒中的主要危险因素,有20%～30%的脑梗死是由于颈内动脉狭窄引起的[2]。     

同时测定乳香中杂质和挥发油含量

目的 建立同时测定乳香中挥发油和杂质含量的方法。 方法 以能将乳香中杂质以外的部分全部溶解为目标,对提取溶剂数量和种类进行考察。同时,以杂质以外的部分全部溶解所需时间为指标,对比超声提取和回流提取,确定最佳溶剂、溶剂用量和回流时间。 结果 单纯一种溶剂不能将乳香中杂质以外的部分全部溶解。建立的挥发油和杂质测定方法为：取一定量乳香,加入水,采用水蒸气蒸馏法提取挥发油,滤过,药渣再加入乳香量1.25倍的丙酮,回流提取5 min,滤过,不溶残渣即为杂质。收集的11个批次乳香及制乳香中挥发油含量范围为1.25%~4.24%,杂质为0.75%~2.4%。乳香挥发油含量比制乳香高,杂质含量无明显差异。 结论 建立了一种同时测定乳香与制乳香中挥发油和杂质含量的方法,为质量标准的制订提供了参考。     

显微睾丸取精结果对非梗阻性无精子症患者勃起功能的影响

目的 探讨显微睾丸取精(TESE)结果对非梗阻性无精子症患者勃起功能的影响.方法 我院门诊筛选出68例拟行试管婴儿需TESE的非梗阻性无精子症患者,平均年龄为33.6岁(23～52岁).根据取精成功与否分成两组:A组为取精成功者,B组为取精失败者.手术前后,分别采用国际勃起功能指数调查问卷(IIEF-5问卷)评价两组受试者的勃起功能状况,同时采用焦虑自评量表(SAS问卷)及抑郁自评量表(SDS问卷)调查受试者精神状态,并检测血清中睾酮(T)、黄体生成素(LH)及卵泡刺激素(FSH)的含量,比较手术前后两组受试者各项指标是否存在差异.结果 68例受试者中,27例(39.7％)取精成功.显微睾丸取精后,IIEF-5问卷评分、SAS及SDS问卷评分与术前相比,A组评分无显著性差异,B组IIEF-5评分显著下降,SAS及SDS问卷评分显著增高(P＜0.05);两组患者术后血清T水平均显著降低,LH及FSH水平均显著升高(P＜0.05).结论 TESE术后,B组勃起功能显著下降,并存在明显的焦虑抑郁状态,A组勃起功能及焦虑抑郁状态无明显改变,两组受试者血清T水平较术前均显著降低.精神障碍可能是导致TESE失败患者勃起功能障碍的主要原因.     

甲泼尼龙预干预脊髓缺血再灌注损伤对Caspase-3表达的影响

目的 探讨甲泼尼龙(MP)预处理脊髓缺血再灌注损伤(SCII)对Caspase-3的影响.方法 取健康纯种成年雄性SD大鼠120只,随机分成3组:对照组(A组)只暴露腹主动脉,不做模型;SCII组(B组)夹闭腹主动脉30 min后松开,再灌注3 h建立SCII模型,然后处死大鼠,取腰段脊髓标本;MP组(C组)于建立SCII模型前30 min尾部静脉注射MP(30 mg/kg).通过HE染色观察损伤节段脊髓病理形态学变化,用免疫组织化学染色方法观察脊髓组织Casepase-3的表达.结果 A组神经元细胞轮廓清晰、极性存在、核圆、核仁清楚,尼氏体呈网状均匀排列于细胞核周围,胞浆均匀深染,组织结构完整清楚,无中性粒细胞浸润,无出血、水肿等异常现象;B组神经元细胞肿胀,数目减少,极性变钝,核仁轻度萎缩,尼氏体呈颗粒状、淡染,组织中有中性粒细胞浸润;C组部分神经元细胞轻度水肿,核仁尚清,组织中未见中性粒细胞浸润.B组脊髓组织内Caspase-3大量表达,与对照组比较差异有统计学意义(P<0.05);C组脊髓细胞内Caspase-3轻度增加,与B组比较差异有统计学意义(P<0.05).结论 MP预处理可降低大鼠SCII中Caspase-3的表达,预防性应用MP能减轻SCII,保护脊髓神经功能.

Abstract：

Objective To investigate the effect of methylprednisolone (MP) pretreatment of ischemia-reperfusion injury of spinal cord (SCII) on expression of caspase-3 in rats. Methods One hundred and twenty healthy, purebred, adult male SD rats were randomly divided into 3 equal groups (n = 40).Croup A was a normal one in which only the abdominal aorta was exposed without establishing an injury model. Croup B was an SCII model in which the abdominal aorta was first obstructed for 30 minutes and then relaxed and next reperfused. After reperfusion for 3 hours, the rats were killed to harvest samples of lumbar spinal cord. Group C was an MP pretreatment one in which tail intravenous injection of MP (30mg/kg) was conducted 30 minutes before establishment of an SCII model. Pathological changes of the injured spinal cord were observed by HE staining, and expressions of caspase-3 in the spinal cord tissue were observed by immunohistochemical staining. Results In group A, the outlines of neuronal cells were clear with polarity and a round nucleus. Ramified Nissl bodies were evenly arranged around the nucleus. Cytoplasm was stained uniformly dark. Organizational structure was integrated and clear without neutrophile granulocyte infiltration,hemorrhage or edema. In group B, neuronal cells were swelling and decreased in quantity, with blunt polarity and mild atrophy of nucleolus. Cranuloses of Nissl bodies were observed with pale staining. There was neutrophile granulocyte infiltration. In group C, mild edema was observed in part of neuronal cells, nucleoli were still clear and there was no neutrophile granulocyte infiltration. Caspase-3 was highly expressed in the spinal cord tissue in group B, with significant differences compared with group A ( P < 0. 05). Expression of caspase-3 in the spinal cord was slightly increased in group C, but the difference was significant compared with group B (P < 0. 05) . Conclusion Since MP pretreatment can reduce expression of caspase-3 in SCII rats, preventive use of MP may alleviate SCII and help protect neural function of the spinal cord.     

雄激素补充对老龄大鼠勃起功能及阴茎海绵体nNOS表达的影响

目的 探讨雄激素补充对老龄大鼠勃起功能及阴茎海绵体神经型一氧化氮合酶(nNOS)表达的影响.方法 20只18个月龄SD大鼠随机均分成A、B两组,10只2个月龄SD大鼠为C组.A组给予十一酸睾酮[20 mg/(kg·d)]灌胃,B、C组给予相同剂量的生理盐水灌胃,均8周.于8周末观察阿朴吗啡(APO)皮下注射与大鼠海绵体...     

大剂量肠虫清治疗脑囊虫病临床观察

观察大剂量肠虫清治疗脑囊虫病的临床效果。方法：５４例脑囊虫病患者,随机分为二组,观察组应用肠虫清６０ｍｇ／ｋｇ／ｄ,分三次口服;对照组应用吡喹酮２０ｍｇ／ｋｇ／ｄ,分二次口服,采用全国脑囊虫病学订会议制定的标准出疗效评价。     

胸大肌移位重建肩外展及屈肘功能

目的　总结胸大肌移位一期重建肩外展及屈肘功能的临床效果。方法　1986年～1997 年对12 例臂丛神经损伤晚期后遗肩外展及屈肘功能障碍者施行胸大肌移位术,即锁骨部重建肩外展、胸肋部代二头肌重建屈肘功能。结果　术后经5～18 个月随访,功能恢复良好。结论　臂丛神经损伤者肩、肘关节被动活动正常或接近正常,胸大肌肌力4 级以上者,采用此手术,具有操作简便,一次完成,效果肯定的优点。