Distribution of rat facial motoneurons and its reorganization following nerve reinnervation]

OBJECTIVE: To examine the distribution of rat facial motoneurons contributing different branches under normal situation and when nerve reinnervation occurred following facial nerve axotomy. METHODS: The normal distribution of motoneurons innervated both buccal and marginal mandibular branches and its reorganization after facial nerve reinnervation was observed using retrograde labeling with fluorescein. RESULTS: Under normal situation, the motoneurons contributing buccall and marginal mandibular branches were primarily distributed in the intermedial and lateral subnucleus in facial nucleus and almost completely overlapped. The two types labeled neurons organized closely, but there were no double-labeled neurons. Although the motoneurons contributing buccall and marginal mandibular branches were primarily overlapped 4 month post-anastomosis, the number of the labeled neurons obviously decreased and the organization got more scattered. There were 10% of buccall branches, 5% of marginal mandibular motoneurons in the dorsal subnuleus, 1% of buccall and 4% of marginal mandibular in dorsal ventral and medial subnucleus. The distribution pattern of the motoneurons 6 month post-anastomosis was similar to that of 4 month post-anastomosis, but the number of the labeled neurons increased, and there were 1%-2% double-labeled neurons. CONCLUSION: The distribution pattern of motoneurons innervated both buccal and marginal mandibular branches indicates that it should exist wide-spread communicating branches, and its reorganization after facial nerve reinnervation suggests that misdirected regeneration occurs among motoneurons innervating different branches.     

PPH加黏膜柱状缝合、直肠周围高位注射治疗完全性直肠脱垂(附15例报告)

目的：探讨PPH加黏膜柱状缝合、直肠周围高位注射治疗完全性直肠脱垂的手术效果。方法：对15例完全性直肠脱垂（Ⅰ～Ⅱ度）患者，采用PPH加黏膜柱状缝合、直肠周围高位注射治疗。结果：治愈15例，无复发。结论：该术式操作简单，近期疗效好，远期效果有待进一步观察。     

经输尿管镜钬激光碎石治疗输尿管结石

目的探讨经输尿管镜钬激光碎石治疗输尿管结石的临床效果. 方法 90例输尿管结石,经尿道、膀胱置入10°输尿管镜抵达结石处,将光纤头直抵结石,设置工作能量0.8～1.5 J,频率8～10 Hz,采用连续脉冲方式粉碎结石. 结果3例进镜失败(输尿管镜无法到达结石部位)改开放手术,1例输尿管穿孔改开放手术;86例碎石成功,单次钬激光碎石成功率为95.6%(86/90).手术时间30～80 min,平均55 min.术后住院1～5 d,平均2.5 d.86例随访1～3个月,69例病程＜6个月、肾积水＜4 cm,肾积水完全消失;17例病程＞6个月、肾积水＞4 cm,术后患肾均有不同程度积水,但较术前明显改善. 结论经输尿管镜钬激光碎石治疗输尿管结石效果理想,创伤小,并发症少,可作为输尿管中、下段结石的首选治疗方法.     

Expression, purification and molecular modeling of recombinant fibrinogenase [IV], a metalloproteinase from Deinakistrodon acutus venom.

A novel metalloproteinase, recombinant fibrinogenase IV (rFIV(a)), was expressed and purified from Deinakistrodon acutus venom. It was a single chain protein with an apparent molecular weight 27 kDa and an isoeletric point of pH 7.1. RFIV(a) cleaved preferentially the Aalpha-chain and also cleaved Bbeta, gamma-chains of fibrinogen when the incubation time was prolonged. The proteolytic activity was inhibited by EDTA, l-cysteine, and DTT, indicating rFIV(a) was a metalloproteinase requiring disulfide bonds for its activity. It kept above 85% of the initial activity from pH 4.5-11, showed an equal maximum activity at the temperature range from 30 to 50 degrees C, and was inactivated by Zn2+, Cu2+ and Cd2+. Homology modeling of rFIV(a) showed that two highly conserved disulfide bonds (Cys159-Cys164 and Cys117-Cys197) was maintained from its structure, and it exhibited the characteristic conserved motif H142E143XXH146XXGXXH152, whose three histidine residues were involved in binding of the catalytically essential zinc ion. This work demonstrates the expression, purification and characterization of recombinant fibrinogenase IV, which belongs to class P-I metalloproteinase from D. acutus venom.     

老年患者不稳定性股骨转子间骨折的术式选择

目的探讨不同的内固定方式在老年患者不稳定性股骨转子间骨折治疗中的应用。方法参照Evans分型,85例老年患者股骨转子间骨折,不稳定性77例,稳定性8例,分别应用不同内固定治疗,其中Gamma钉20例、重建钉25例、动力髋部螺钉(DHS)和动力髁部螺钉(DCS)40例。结果术后随访79例,均获得骨折愈合,愈合时间4～7个月,平均5.2个月,其中大于5°髋内翻者有12例。根据患者骨折愈合、关节活动、主观感觉与生活能力恢复等因素制定疗效评定标准,优良率为84.8%(67例)。未发生因本手术所致内科合并症加重或患者死亡。结论髋内翻是老年患者不稳定性股骨转子间骨折内固定术后的主要并发症。Evans分型对选择内固定具有指导意义。结合老年患者骨质疏松情况,针对不同骨折类型选用适当的内固定器械,可以提高不稳定性转子间骨折的疗效。     

系统性红斑狼疮女性患者血清CA125,CA199化学发光法测定的临床应用

目的 :探讨系统性红斑狼疮 (SLE)女性患者血清肿瘤标志物CA12 5 ,CA199含量变化及临床意义。方法 :用化学发光法测定 30例正常女性和 38例SLE女性患者血清中CA12 5 ,CA199含量。结果 :正常组CA12 5含量为 11.14± 6 .4 8U/ml,CA199含量为 3.75± 2 .89U/ml;SLE组CA12 5 ,CA199分别为 2 2 .5 6± 2 0 .4 6U/ml,9.5 7± 9.34U/ml。SLE患者CA12 5 ,CA199阳性率分别为 2 1.1% ,7.89%。结论 :SLE患者血清CAl2 5 ,CA199含量较正常组增高 (P <0 .0 5 )。CA12 5 ,CA199在SLE女性患者中可出现阳性 ,对临床诊断SLE有一定价值。     

MRI在颅内生殖细胞瘤诊断中的作用

目的：探讨MRI对颅内生殖细胞瘤的诊断价值。方法：对19例经手术和病理证实的颅内生殖细胞瘤患者的MR表现进行分析。结果：19例中，10例位于鞍区，其中男性5例，女性5例，6例位于松果体区，3例位于丘脑基底节区，均男性，其MR表现为（1）T2WI等或稍低信号，T2WI等或销高信号，鞍区和松果体区肿瘤无水肿，丘脑基底节区肿瘤轻至中度水肿和占位效应；（2）Gd-DTPA增强扫描肿瘤呈不均匀或均匀明显强化。结论：MRI的多轴位成像及Gd-DTPA应用有助于颅内生殖细胞瘤的诊断与鉴别诊断；病人性别，发病年龄和肿瘤部位，大小、形态及信号强度具有一定的特点，在多数情况下是可以做出术前诊断的。     

甲醛固定源同种异体骨移植材料的体外实验研究

OBJECTIVE: To conduct an in vitro study to assess the preliminary possibility of using formalin-fixed, instead of fresh, human bone tissues for allografting. METHODS: Fresh cadaveric bone tissues were fixed by formalin for more than 6 months and dissected into 5 mmx5 mmx5 mm pieces and 5 mmx5 mmx40 mm sticks, followed by chemical treatments to prepare the allograft bone materials. When alls treatments were completed, the bone grafts were centrifuged and their properties and cellular compatibility assessed in comparison with the currently used bone grafts clinically. RESULTS: The residual formaldehyde of the fixed allograft bone material was much below the controlled level and no significant differences were noted between the bone graft materials tested in regard to the chemical and mechanical properties and biocompatibility. CONCLUSION: This material we have prepared may meet the clinical demands for bone grafting, with good biocompatibility and less chance for infection by pathological agents.     

宫颈鳞癌中erbB3、erbB4基因蛋白表达与细胞凋亡和增殖的相关性研究

目的　探讨原癌基因erbB3、erbB4与细胞凋亡和增殖的关系 ,为该基因作用机制提供新线索。方法　分别采用免疫组化、DNA末端标记技术 (TUNEL法 )和HE染色检测 5 0例宫颈鳞癌中erbB3、erbB4基因蛋白表达及凋亡指数 (AI)和增殖指数 (MI)。结果　宫颈鳞癌中erbB3、erbB4表达率分别为 5 2 .5 %、44 .0 % ,AI、MI值分别为 5 .5 0± 4.10和 4.18± 3 .63 ,随着宫颈癌恶性程度增高、FIGO分期进展、肿瘤体积的增大和淋巴结转移组 ,erbB3、erbB4表达率增加 ,AI、MI值也增高 ,但差异仅在分化程度上有显著性 (P <0 .0 5 )。双变量相关分析显示erbB3、erbB4表达与AI、MI间无相关性 (r3=0 .10 98、0 .12 3 6,r4 =0 .2 15 1、0 .2 5 5 8,P >0 .0 5 )。结论　erbB3、erbB4和AI、MI预示着宫颈癌恶性潜能 ,但不能作为预后有用指标。erbB3、erbB4的作用机制可能不是通过细胞凋亡或增殖起作用     

重症急性胰腺炎大鼠肺组织中LIF的表达变化及意义

目的:观察重症急性胰腺炎(SAP)大鼠白血病抑制因子(LIF)在肺组织中表达的时相变化, 探讨LIF在SAP病程及肺损伤中的意义．方法:36只♂SD大鼠随机分为正常对照组(N 组,n=6)、假手术组(Sham组,n=6)和重症急性胰腺炎组(SAP组,n=24)．采用胰管逆行灌注50 g/L牛磺胆酸钠的方法复制大鼠SAP模型．用RT-PCR法检测肺组织中LIF mRNA的表达水平,免疫组织化学方法检测NLIF在肺组织中的表达变化．结果:SAP组3 h后肺组织LIF mRNA的表达量明显高于对照组和假手术组(灰度值:1．018± 0．065 vs 1．451±0．067,1．322±0．072,P<0,05), 并且6,12,24 h持续升高(0．853±0．058,0．635 ±0．064,0．582±0．089)(P<0．01)．同样,SAP组 LIF蛋白表达在3和6 h后明显高于对照组和假手术(127．36±2．76,122．53±2．43 vs 159．46 ±2．78,156．35±3．12,P<0．05),并且12,24 h后也维持在很高的水平(109．37±2．87,102．42± 2．27)．结论:LIF作为促炎症因子参与了SAP肺组织的炎症反应．