Differential contribution of the factors determining long-term renal function after partial nephrectomy over time

PurposeTo define how much of renal function was determined by the preserved renal parenchymal volume and the ischemic insult during partial nephrectomy (PN) long after surgery.MethodsWe analyzed the data of 530 consecutive patients who had undergone PN. For all patients, renal function was measured preoperatively and again at 3 postoperative months, then annually using ^99mTc-diethylenetriaminepentaacetic acid renal scan. Perioperative variables potentially affecting the long-term ipsilateral glomerular filtration rate (GFR) and their time-varying contribution were assessed using a linear mixed model.ResultsThe mean preoperative ipsilateral GFR was 42.9 ml/min, which decreased by 27.3% at 3 months but began to recover thereafter continuing until 4 years (Δ% GFR at 1, 2, 3, 4, and 5 years: 22.3%, 18.5%, 14.7%, 10.0%, and 9.6%, respectively). Parenchymal volume reduction and ischemic time were significantly associated with postoperative ipsilateral GFR throughout observation period unvarying with time. Diabetes and proteinuria were not significant determinants of ipsilateral function at 3 months but became significant at 5 years. In multivariate analysis regarding recovery slope, volume reduction (β = ?0.026, SE 0.006, P < 0.0001), preoperative ipsilateral GFR (β = ?0.021, SE 0.007, P = 0.0012), proteinuria (β = ?0.942, SE 0.372, P = 0.0116), and diabetes (β = ?0.396, SE 0.197, P = 0.0447) were independently significant.ConclusionIpsilateral renal function continued to improve until 5 years after PN. Parenchymal volume loss was the major determinant and its impact on long-term ipsilateral renal function remained constant while ischemic time affected early GFR reduction with its impact diminishing over time. Patient-related factors including diabetes and proteinuria gained significance over time and became independent determinants of recovery slope.     

跟骨骨折成因的力学分析

目的 通过理论分析方法和实验方法研究跟骨骨折的成因。方法 应用材料力学中的弯曲强度理论、剪切强度理论和主要应力理论分析跟骨的应力情况；应用动量原理研究跟骨受冲击时的载荷情况；应用静态压力试验方法测定跟骨的破坏载荷。结果 跟骨上凹坑尖角附近是跟骨最薄弱的环节；跟骨的破坏载荷约为体重的24倍；当人从1.5m高处跳下，足跟先着地时，作用在跟骨上的冲击力可达体重的36倍。结论 当人从高处跳下，足跟先着地时，作用在跟骨上的冲击力非常大，高度越高，则冲击力越大；人从高处跳下时所具有的初速度对作用在跟骨上的冲击力影响也非常大。     

Interleukin-6 in bronchoalveolar lavage fluid from patients with COPD

目的　本研究通过检测支气管肺灌洗液 (BALF)中及肺泡巨噬细胞 (AM)产生的IL 6 ,揭示IL 6与慢性支气管炎(COPD)肺气肿发生的关系 ,为IL 6提供新的研究领域。方法　检测 6名正常无吸烟人及 2 1名COPD患者BALF中及AM释放的IL 6 ,根据正常人组BALF中IL 6的 95 %正常值可信区限 ,将COPD患者分为二组 ,在正常值可信区限内为第一组 ,在正常值可信区限外为第二组。结果　表明 2组中AM产生的IL 6第二组明显高于第一组 ,且 2组患者肺功能 (Dlco ,FEV1,FEV1/FVC和RV/TLC)有明显差异结论　AM产生的IL 6可能与COPD患者肺功能变化有关 ,在COPD患者肺气肿发生发展过程中发挥重要作用     

紫绀型先天性心脏病的超声诊断价值

本研究回顾性分析了我科 1986年以来资料完整的各种紫绀型先天性心脏病 197例 ,旨在评价超声在各种紫绀型先心病中的诊断价值。1　资料与方法　　经手术证实的 197例紫绀型先心病患者 ,男 10 3例 ,女 94例 ,平均年龄 (10 .5± 6.2 )岁。简要询问病史 ,常规心脏听诊。超声心动图除常规检查外 ,重点观察流出道、肺动脉瓣、肺动脉发育情况 ,主动脉起源、有无骑跨 ,瓣膜位置 ,腔静脉汇入情况。少数病例进行静脉声学造影 ,以判断左右心房方位。2　结果　　本组病例包括以下畸形 :法乐氏四联症 (Ｆ4)、法乐氏三联症 (Ｆ3 )、三尖瓣下移畸形 (Ｅｂ…     

溶栓后早期T波的变化与冠脉再通的关系

目的 探讨急性心肌梗塞溶栓后早期Ｔ波的变化与闭塞冠脉再通的关系。方法 对８０例接受静脉溶栓治疗的ＡＭＩ患者进行前瞻性研究,根据溶栓后２４小时内有无Ｔ波倒置分为两组。依据临床间接判断冠脉再通的标准观察两组血管再通情况。结果 Ｔ波倒置组与未倒置组血管再通率分别为９３．１％和１１．３％（Ｐ〈０．０１）。结论 溶栓后早期Ｔ波倒置可作为判定梗塞相关血管再通的参考指标。     

Study on sensitivity of neuroglioma to chemotherapeutic drugs]

In this study, the chemosensitivity of 36 cases' fresh neuroglioma specimens was examined in vitro with MTT assay. The separation method for single tumor cell, the number of planting of cells, and the dosage and acting time of drugs, which have effects on the results of MTT assay, were studied systematically. On the basis of this experiment, we established a screening method for the chemosensitivity of neuroglioma; it is accurate, rapid, and simple. At the same time, the results showed that neuroglioma was more sensitive to the chemotherapeutic drugs Vm26, DDP and MMC, and the sensitivity varied with not only the drugs but also the individuals.     

鼻咽癌组织中微血管的分布

目的：观察鼻咽癌组织中微血管的分布及存在状况,探讨其与鼻咽癌的临床病理联系。方法：采用免疫组织化学Ｓ－Ｐ法,检测血栓调节蛋白在鼻咽癌血管内皮细胞的表达,进行微血管的定性半定量研究。结果：鼻咽癌组织中微血管的分布不均匀。极性消失。血管呈分支芽状弥漫分布于癌组织中,或呈条索状围绕癌细胞团。微血管的数目与癌细胞的增殖指数屯预后正相关。结论：鼻咽癌组织中微血管数与患者的生存期有关。     

脑外伤后脑干组织中血管内皮细胞及血浆蛋白分布改变的免疫？…

目的:探讨脑外伤后脑干组织中血脑屏障和神经细胞的病理学改变.方法:采用免疫组化染色显示人体脑干组织中的血管内皮细胞(CD31)和某些血浆蛋白(白蛋白及 IgM).结果:1.在正常脑干组织中, CD31阳性物呈连续的线条状,围成规则的血管腔,其周围无明显间隙;血浆蛋白位于血管内,未见到血浆/蛋白阳性神经细胞或神经纤维.2.脑外伤后,脑干中的 CD31阳性物呈不规则弯曲的小片段状,围成不规则的血管腔,其周围间隙明显增宽;同时可见到白蛋白及IgM阳性神经细胞和神经纤维.结论:脑外伤后,脑干组织中的血脑屏障受到了破坏,而且神经细胞也有不同程度的损伤.