海风藤酚、甲基海风藤酚、海风藤醇A和海风藤醇B对兔血小板聚集的影响

海风藤酚、甲基海风藤酚、海风藤醇Ａ和海风藤醇Ｂ均有抑制血小板激活因子（ＰＡＦ）诱导的兔血小板聚集作用，ＩＣ_（５０）分别为１７．９、９．２、１４２．０、１４．０μｍｏｌ·Ｌ~（－１）。经阿司匹林（ＡＳＡ）、磷酸肌酸／磷酸肌酸激酶（ＣＰ／ＣＰＫ）预处理的兔洗涤血小板，甲基海风藤酚和海风藤醇Ｂ仍能抑制ＰＡＦ诱导的兔血小板聚集，ＩＣ_（５０）为９．０、１６．５μｍｏｌ·Ｌ~（－１）。同时，４种成分对于二磷酸腺苷（ＡＤＰ），花生四烯酸（ＡＡ）诱导的血小板聚集抑制作用较弱，海风藤Ｂ能使ＰＡＦ诱导血小板聚集量－效曲线平行右移，ＥＣ_（５０）由１．５９ｎｍｏｌ·Ｌ~（－１）升为２０．６ｎｍｏｌ·Ｌ~（－１）。结果表明：４种成分能选择性拮抗ＰＡＦ对兔血小板的聚集作用。     

Serum erythropoietin levels and blood component therapy after autologous bone marrow transplantation: implications for erythropoietin therapy in this setting.

To determine the potential impact of recombinant human erythropoietin (EPO) therapy in patients undergoing autologous bone marrow transplantation (BMT) and colony-stimulating factor therapy, we assayed endogenous serum EPO levels and noted blood transfusion requirements in relapsed non-Hodgkin's lymphoma patients treated with high-dose chemo-radiation therapy and autologous BMT. Hematocrit and reticulocyte counts were determined daily, and hematocrit was maintained in the 25-30% range by transfusion according to criteria established by our hospital transfusion committee. EPO levels were measured by radioimmunoassay and were determined at baseline, throughout therapy, and 2 and 3 months after BMT. Serum EPO levels increased more than 25-fold above baseline in most subjects after initiating chemoradiation therapy. No correlation was noted between serum EPO and hematocrit, reticulocyte count or serum creatinine. Total red blood cell units transfused ranged from 4 to 15 (mean 7.7). Mean total donor exposures (red blood cell plus platelet units transfused) were 83.6 units (range 16-175). Serum EPO levels increased early in the course of preparation for autologous BMT and remained elevated for at least 2-3 weeks thereafter although at a lower level. Red blood cell transfusions were required despite very high EPO levels after BMT. Red cell transfusions, moreover, accounted for only 9.2% (69 of 746) of total donor exposures and only 5.8% (42 of 746) of donor exposures during the interval when pharmacologic doses of erythropoietin might be of benefit. In contrast to the potential benefit of colony-stimulating factors such as G-CSF and GM-CSF in BMT, our study suggests limited value for erythropoietin therapy in this setting.     

Migrating calcified enterolith and chronic anemia: an unusual case presentation of a Meckel's diverticulum.

Meckel's diverticulum is the most common congenital anomaly of the small intestine, occurring in about 2 % of the population. The most common complications associated with a Meckel's diverticulum include obstruction, bleeding, and inflammation (7, 9, 11, 18-20). The estimated lifetime risk of developing symptoms with a Meckel's diverticulum is 4-6 % (16), with the risks of complications decreasing with age. Stones within Meckel's diverticulum are recognized as a rare complication in the adult population (13,15). However, it has not been reported in the pediatric age group. The authors describe a 19-month-old male who presented with intermittent abdominal pain and vomiting, chronic microcytic anemia and a calcified stone in the lower abdomen, who was found to have a Meckel's enterolith.     

抑肽酶对大鼠血肿周围脑组织炎症反应和细胞凋亡的影响

目的 通过抑肽酶干预,研究大鼠血肿周围脑组织炎症和细胞凋亡的关系,以探讨脑出血后继发性损伤的机制.方法 采用立体定向手术脑尾状核胶原酶注射诱导大鼠脑出血模型,用抑肽酶进行干预,于不同时相点测定TUNEL阳性细胞,用组织病理学HE染色观察不同时相点的炎症浸润情况,用免疫组织化学测定IL-1β的蛋白表达水平.结果 模型组TUNEL阳性细胞造模后6h即出现,24h明显增加,3d达到高峰,7d时仍有较多表达;HE染色见6h血肿内及周围有少量散在白细胞,24h明显增加,48h到高峰,3d时稍减少,7d时仍有较多的白细胞浸润.模型组血肿周围脑组织的IL-1β阳性细胞数在6h即有增加,48h左右达高峰;抑肽酶组与模型组比较,TUNEL阳性细胞在24h、48h、72h时明显减少(P＜0.01);HE染色可见浸润白细胞数目在24h、48h、72h时明显减少(P＜0.01).抑肽酶组IL-1β相应各时间点的阳性表达明显减少,尤以48h、72h较为明显.结论抑肽酶能明显抑制脑出血后的炎症反应和细胞凋亡;而抑制炎症反应很可能是减少脑出血神经细胞凋亡的有效途径之一.     

X线引导下经皮通用脊柱系统内固定治疗胸腰椎骨折

目的探讨X线引导下经皮通用脊柱系统(USS)内固定治疗胸腰椎骨折的可行性.方法 2002年10月～2004年5月对无须减压胸腰椎骨折8例采用后路经皮USS椎弓根螺钉植入,在椎旁肌深层置入固定棒行伤椎复位固定.结果手术时间120～240 min,平均140 min.术中出血量20～90 ml,平均40 ml.后凸Cobb's角术前(21.5±4.3)°、术后(2.7±1.5)°(t=17.541,P=0.001),椎体塌陷术前18.5%±4.1%、术后2.4%±1.0%(t=16.504,P=0.001).术后3周佩戴腰围支具下床,复查Frankel分级,C级恢复至D级2例,D级恢复至E级1例,保持D级1例,保持E级4例.结论经皮USS内固定治疗无须减压的胸腰椎骨折创伤小,恢复快,但技术难度高,X线暴露时间长.     

经子宫动脉氨甲蝶呤灌注及栓塞 在宫颈妊娠保守治疗中的应用

目的探讨经子宫动脉氨甲蝶呤灌注化疗及栓塞术在宫颈妊娠保守治疗中的应用价值.方法 6例宫颈妊娠患者,孕龄36～68天,经阴道超声检查明确诊断后,行双侧子宫动脉氨甲蝶呤灌注及栓塞治疗.结果所有患者均一次治疗成功,术后患者的阴道出血明显减少或中止,血β-HCG水平迅速下降.患者的宫颈形态及月经周期于治疗后4个月内恢复正常.结论子宫动脉氨甲蝶呤灌注化疗及栓塞术是保守治疗宫颈妊娠的有效方法.     

股骨远端骨折治疗方案的探讨

股骨远端骨折是创伤骨科治疗领域内的一个难点。主要原因是治疗方案的混乱和远期膝关节的病损。自1998-2005年采用经皮股骨远端髓内钉(DFN)内固定、切开复位接骨板内固定的方法治疗股骨远端骨折共59例,分析如下。1临床资料经皮DFN共27例,男19例,女8例;年龄19~75岁,平均35岁。交通伤19例,老年跌伤6例,砸伤2例。按AO分型:A1型10例,A2型8例,A3型6例,C1型3例。伴有开放性损伤4例,多发骨折3例,前交叉韧带损伤1例。切开复位接骨板内固定共32例,男21例,女11例。年龄18~79岁,平均36岁。交通伤21例,老年跌伤6例,砸伤4例,炸伤1例。按AO分型:B1型…     

缺氧／复氧对兔肾动脉内皮依赖性舒张功能的影响

目的 探讨缺氧／复氧对肾动脉内皮依赖性一氧化氮(NO)和内皮衍性超极化因子(EDHF)途径舒张功能的影响。方法 采用器官槽法，以兔肾动脉环为研究对象，首先抑制PGI2舒张途径，然后再分别抑制NO和EDHF舒张途径，对给与血管环以缺氧／复氧处理，观察缺氧／复氧分别对NO和EDHF舒张途径的影响。结果 缺氧／复氧使NO途径的内皮依赖性舒张功能减退．而缺氧／复氧对EDHF途径的内皮依赖性舒张功能无变化。结论 缺氧／复氧导致兔肾血管内皮衍性NO途径的舒张损伤．而对EDHF途径的舒张无影响。