内镜经鼻入路和经上颌窦入路中翼腭窝的应用解剖

目的为涉及翼腭窝的内镜经鼻和经上颌窦入路手术提供解剖学资料。方法对5具福尔马林固定的头颅湿标本,采用内镜经鼻和内镜经上颌窦入路,按手术步骤对翼腭窝进行应用解剖学研究,并辅以显微镜下经颅外侧颞下窝解剖,观察并描述翼腭窝解剖结构及其与毗邻结构之间的解剖关系。结果在内镜经鼻和内镜经上颌窦入路中,切除腭骨垂直板和上颌窦后壁后可显露翼腭窝内部解剖结构;翼腭窝内主要的动脉结构为上颌动脉及其终支蝶腭动脉和腭降动脉;翼腭窝内的主要神经结构为上颌神经、翼管神经和翼腭神经节;循解剖标志去除翼腭窝周围的骨性结构后可显露翼腭窝与海绵窦、眶尖、颞下窝等区域的解剖关系。结论内镜经鼻入路和内镜经上颌窦入路可有效显露和处理翼腭窝内解剖结构。     

不同浓度葡萄糖对大鼠大脑皮层神经元凋亡的影响

目的探讨不同浓度葡萄糖对大鼠大脑皮层神经元凋亡的影响。方法取新生1 d内SD大鼠的大脑皮层,皮层神经元经原代培养,通过胰蛋白酶消化法获取单细胞悬液,免疫荧光染色鉴定神经元纯度,然后随机分为正常组(葡萄糖浓度为25 mmol.L-1)及50、75、100 mmol.L-1葡萄糖组,Hoechst染色检测细胞凋亡,噻唑蓝比色法检测各组神经元活性。结果与正常组和50 mmol.L-1葡萄糖组相比,75、100 mmol.L-1葡萄糖组大鼠大脑皮层神经元凋亡率明显升高(P<0.01),活性显著下降(P<0.01);且100 mmol.L-1葡萄糖组大鼠大脑皮层神经元凋亡率高于75 mmol.L-1葡萄糖组(P<0.01),大鼠大脑皮层神经元活性低于75 mmol.L-1葡萄糖组(P<0.01)。结论高浓度的葡萄糖可引起大鼠大脑皮层神经元的凋亡,且神经元的凋亡情况呈剂量依赖关系。     

Expression of ABCG2,SFRP2,BRMS1 and HPA in benign and malignant lesions of the gallbladder and their clinicopathological significances

Objective To study the expression of ABCG2, SFRP2,BRMS1 and HPA and detect their clinicopatho-logical significances in the benign and malignatnt lesions of the gallbladder. Methods EnVisiom immunohisto-chemical method for determining the expressions of AB-CG2,SFRP2,BRMS1 and HPA was used in     

新式剖宫产术中胎头娩出困难的临床分析

目的探讨新式剖宫产术中胎头娩出困难的原因及相应的处理方法。方法回顾2001年1月-2010年1月在我院住院的226例产妇采取新式剖宫产术中胎头娩出困难的原因,与同期新式剖宫产术中未发生胎头娩出困难的2419例孕产妇进行对比,筛查出影响胎头娩出困难的因素及对母婴产生的不良后果。结果胎头娩出困难原因中以胎头高浮为主要原因,其次为胎头深嵌、切口过小、切口位置不当、术者助手配合不佳、麻醉不满意、产妇肥胖等多种因素,它使产后出血、子宫切口裂伤、新生儿窒息率等明显增加。结论新式剖宫产术前应正确评估胎儿及产道情况,预测各种可能发生胎头娩出困难的原因,并根据评估及预测制定科学合理的处理方案,避免给母婴造成不良后果。     

活体肝移植治疗儿童胆道闭锁44例

目的 观察活体肝移植治疗儿童胆道闭锁的效果,总结其临床经验.方法 2006年10月至2010年12月间共有44例胆道闭锁患儿接受了活体肝移植,其中男性26例,女性18例,年龄(12.1±9.0)个月,中位数为9个月(6～60个月);44名供者全部为患者直系亲属,年龄(32.7±8.0)岁,中位数为31岁(20～54岁).供、受者ABO血型相容,供肝均为供者肝脏的左外叶.对供、受者术前评估过程、手术方法、术后管理以及预后等临床资料进行总结.结果 术后对全部供者进行系统随访,随访时间(17.5±13.3)个月,无供者发生严重并发症和死亡,所有供者均恢复健康.44例受者中,死亡9例,死因分别为门静脉栓塞3例、肝动脉栓塞1例、胆道并发症2例、切口感染1例、腹腔出血1例及肺部感染1例,其余35例健康存活.术后1年和2年累积存活率分别为81.2%和76.1%,无一例受者接受再次肝移植.术后主要并发症有门静脉血栓、肝动脉血栓、胆汁漏及逆行性胆管炎、肺部感染、切口感染及急性排斥反应等.结论 活体肝移植是治疗儿童胆道闭锁的有效方法,预后良好.完善缜密的术前评估,熟练精细的手术操作以及精心的术后管理是改善受者预后的关键因素.

Abstract：

Objective To observe the outcomes of living donor liver transplantation (LDLT) for children with biliary atresia (BA) and to summarize the clinical experiences. Methods Forty-four BA patients (26 boys and 18 girls) underwent LDLT between October 2006 and December 2010. Mean (SD) and median (range) age at operation was (12.1 ± 9.0) months and 9 (6-60) months,respectively. The 44 donors were lineal relatives to the consorted recipients. Their mean (SD) and median (range) age at operation was (32. 7 ± 8. 0) months and 31 (20～54) years, respectively. All donor graft types were the left lateral segments with compatible ABO blood groups. Clinical data,including pre-operative evaluations, surgical technique, postoperative management and outcomes in all donors and recipients were retrospectively analyzed. Results All donors were followed up for (17. 5 ± 13. 3) months. No donor mortality was encountered, with a minimal morbidity and no long-term sequelae. Nine out of 44 recipients died. Three patients died of portal vein thrombosis (PVT), one of hepatic artery thrombosis (HAT), two of biliary complications, one of surgical site infections, one of abdominal bleeding and one of pulmonary infection. The overall 1-year and 2-year cumulative survival rate in recipients was 81. 2% and 76. 1 %, respectively. No re-transplantation was done. Postoperative complications included PVT, HAT, biliary leakage and refluxing cholangitis, pulmonary infections,surgical site infections and acute rejection. Conclusion LDLT has been the effective treatment for pediatric recipients with BA and provides favorable prognosis. To improve prognosis of recipients, the key points are pre-operative evaluations, surgical technique, and postoperative management     

急性肝衰竭大鼠载肝细胞生长因子纳米粒子肝细胞移植后有丝分裂指数和Ki-67表达变化及意义

目的 探讨急性肝衰竭(ALF)大鼠载肝细胞生长因子(HGF)的聚乳酸-氧-羧甲基壳聚糖(PLA-O-CMC)纳米粒子肝细胞移植后有丝分裂指数和Ki-67抗原的表达变化及意义.方法 D-氨基半乳糖腹腔内注射制作大鼠ALF模型,48 h后分别将Ⅰ型胶原(Ⅰ组)、PLA-O-CMC纳米粒子(Ⅱ、Ⅳ组)、载HGF的PLA-O-CMC纳米粒子(Ⅲ组)培养的大鼠肝细胞(均为5×107个,5 ml)移植到ALF大鼠腹腔内.以每日静脉注射HGF 10μg/kg×7 d(Ⅳ组)、5 Ml RPMI 1640腹腔内注射(Ⅴ组)作为对照.观察其14 d存活率、血清及肝组织HGF浓度、肝组织病理及有丝分裂指数(MI)、Ki-67变化.结果移植后14 d Ⅰ～Ⅴ组ALF大鼠的存活率分别为50.00％、68.75％、81.25％、75.00％、18.75％.各纳米移植组高于V组.Ⅲ组3 d时肝组织HGF浓度最高,平均为5882.91 μG／L.Ⅲ组肝组织结构恢复更快,5 d时平均MI 10.20％0、7 d时平均MI 10.20‰、7 d时Ki-67平均标记指数16.8‰,均高于Ⅴ组.结论 应用载HGF的PLA-O-CMC纳米粒子培养的大鼠肝细胞腹腔内移植治疗ALF大鼠能促进肝再生相关抗原表达.

Abstract：

Objective To evaluate the change and significance of Ki-67 antigen expression follow ing hepatocyte transplantation using hepatocyte growth factor (HGF) loaded polylactic acid-O-carboxymethylchitosan (PLA-O-CMC) nanoparticles in rats with acute liver failure (ALF). Methods ALF models of rats were established by D-galactosamine intraperitoneal injection. Rat hepatocytes type Ⅰ collagen suspension (group Ⅰ ),rat hepatocytes co-cultured with PLA-O-CMC nanoparticles ( groups Ⅱ ,Ⅳ ) and rat hepatocytes co-cultured with HGF loaded PLA-O-CMC nanoparticles ( group Ⅱ ) (5 × 107 cells each group,5 ml) were transplanted into the abdominal cavity of SD rats at 48 h after D-Gal injection. Intravenous injection of HGF ( 10 μg/kg for 7 days) ( group Ⅳ ) and RPMI 1640 injection (group Ⅴ ) were used as the negative groups. The 14th-day survival rate of rats,pathological change and mitotic index of liver,Ki-67 antigen labeling index of ALF rat livers were observed. Results The 14th-day survival rate in groups Ⅰ -Ⅴ was 50.00％,68. 75％,81.25％,75.00％,18.75％,and that in nano-transplanted groups was higher than in group Ⅴ. At the 3rd day,the concentration of HGF in liver tissue of group Ⅲ,average 5882. 91 μg/L was the highest. The hepatic lobules structure in group Ⅲ recovered faster. The average mitotic index in group Ⅱ at the 5th day was 10. 20‰ and the average Ki-67 labeling index at the 7th day was 16. 8‰,which were all higher than in group Ⅴ. Conclusion Intraperitoneal transplantation of HGF loaded PLA-O-CMC nanoparticle-attached hepatocytes for treatment of ALF can promote the liver regenerationassociated antigen expression.     

老年猫初级视皮层细胞对视觉刺激空间频率调谐反应的选择性下降

目的 探讨猫的初级视皮层(V1)细胞对视觉刺激空间频率的选择性是否受年龄影响.方法 采用在体细胞外单细胞记录技术分别记录青、老年猫V1神经元对不同空间频率光栅刺激的调谐反应.结果 数据统计分析结果显示,诱导老年猫V1神经元出现最大诱发反应幅度的平均最优刺激空间频率(optimal spatial frequency,O...     

4NQO诱导小鼠舌癌前病变模型的研究

目的 使用4NQO诱导并建立C57BL/6J小鼠舌癌前病变模型.方法 46只6～8周龄C57BL/6J小鼠,随机取16只作为阴性对照,不做任何处理,分别于8、12、16周末处死.实验组30只饮用50μg/ml 4NQO水溶液,分别于8、12、16周末处死.处死前2小时腹腔注射BrdU (50mg/kg),肉眼及组织病...     

喜树碱及其衍生物在眼科应用的研究进展

喜树碱是从我国南方特有的植物喜树中分离出来的一种五环类生物碱,南丁其存实验和临床研究中表现出的强大抗肿瘤效应,而引起临床医生的广泛关注。喜树碱类药物已经被公认为是21世纪最主要的抗肿瘤药物之一。近年来有研究表明喜树碱类药物除了抗肿瘤外,在其它临床科窀如：眼科、皮肤科、血液科等也有一定的应用。本文就喜树碱及其衍生物在眼科的应用,包括眼科手术中的应用及术后应用做一综述。     

脐尿管囊肿感染伴局限性腹膜炎1例

脐尿管瘘及囊肿是少见的先天性畸形,大部分是因胚胎期的尿囊管残余在发育过程中未能自行纤维化闭塞所引起的先天性疾病,以男性居多,临床上易误诊,多采用开腹手术切除,现报道我院近期收治的1例脐尿管囊肿感染伴局限性腹膜炎病例.