异体胸腺的解剖、组织学及吻合血管移植治疗晚期恶性骨肿瘤的研究

本文对20例20～36周引产死胎胸腺进行了解剖学,组织学观察,并应用吻合血管胎儿胸腺移植治疗晚期恶性原发及继发骨肿瘤12例。结果表明,胎儿胸腺的血供主要来自胸廓内动脉,其次为甲状腺下动脉和心包膈动脉胸腺支,7～8个月胎儿胸腺静脉血管壁较厚,适合作血管吻合,胸腺细胞发育成熟,组织结构正常,已有分泌胸腺素及转化免疫细胞的功能,在解剖学,组织学,免疫学方面均具备了良好的移植条件。12例接受吻合血管胎儿胸腺移植的晚期恶性骨肿瘤患者,其临床症状、体征、X线、免疫指数均有明显改善,患者生存6个月至37个月以上。     

Haloperidol-sensitive (+)[3H]SKF-10,047 binding sites (sigma sites) exhibit a unique distribution in rat brain subcellular fractions

The distribution of haloperidol-sensitive (+)[3H]N-allylnormetazocine ((+)[3H]SKF-10,047) binding sites (sigma sites) in subcellular fractions of rat brain homogenates was extensively characterized. In synaptosomal fractions, enriched in choline acetyltransferase activity, sigma sites were present in lower concentrations than in whole brain homogenates. On the other hand, microsomal and myelin fractions were found to be enriched in sigma sites. A similar pattern of enrichment was seen for 5'-nucleotidase activity, a general plasma membrane marker. However, subsequent experiments in which microsomes were subfractionated on linear sucrose gradients led to the recovery of sigma sites over a significantly lower density range than 5'-nucleotidase activity or ATP-stimulated [3H]ouabain binding, an additional plasma membrane marker. In addition, previously reported distributions of a number of other subcellular markers, including those for endoplasmic reticulum, were found to contrast with the observed distribution of sigma sites. It is concluded that rat brain sigma sites are not concentrated at synaptic regions of plasma membrane. However, the possibility that sigma sites are localized to specialized areas of nonsynaptic plasma membrane cannot be excluded.     

小儿手烧伤瘢痕畸形的整形外科治疗

Background: Cicatricial deformation in child burn of hand often leads to severe squaelae. According to different causes of disease , different plastic surgery were adopted .The key of operation lies in skin repairing , articulation dealing, and thumb correcting, which aim is to resume normal longitudinal and transverse arcs ,holding and clenching ability.     

肛管鳞癌的诊断与治疗(附15例分析)

目的探讨肛管癌诊断、治疗和预后的相关因素。方法北京医院1984-1998年间收治15例肛管鳞癌,首次诊断为肛管癌者仅5例。15例中行放疗化疗11例,8例行Miles手术。结果病理均证实为鳞癌。根据NCCN(2003年)分期,Ⅰ期6例,Ⅱ期4例,ⅢA期2例,ⅢB期3例。免疫组织化学染色显示肿瘤组织间质纤维化(+++)者4例,(++)者7例,(+)者4例。随诊最长10年,平均生存期(47±27.6)个月。结论肛门指诊是发现和诊断肛管癌的重要手段。放疗以及以放疗为主,化疗、手术为辅的综合治疗是肛管癌的主要治疗方法。肿瘤分期、腹股沟淋巴结转移、治疗方法以及肿瘤组织间质纤维化对病人的预后均有影响。     

老年腰椎间盘突出症的手术治疗

目的 探讨老年腰椎间盘突出症的特点与手术治疗效果.方法 对62例老人腰椎间盘突出症患者的临床与病理特点进行分析.均行腰椎后路椎板减压髓核摘除术,其中小切口开窗35例,半椎板切除20例,全椎板切除7例,根据手术前后JOA评分评价手术疗效.结果 老年腰椎间盘突出症病理以髓核组织的脱水,纤维环的破裂,小关节囊、周围韧带及软骨终板退变为主要特点.临床特点为下肢疼痛多发,腰部活动受限较多;双下肢神经系统检查肌力下降明显,生理反射改变明显.62例平均随访1.9年,JOA评分术后平均改善率为68.9%,手术前后JOA评分比较差异有显著性意义(P＜0.05).结论 老年腰椎间盘突出症患者病程长,体征多,病理改变明显,行腰椎后路椎板减压髓核摘除术,手术效果满意.     

冰点下降法测定血、尿渗透压的临床应用及注意事项

本文应用溶液冰点下降法测定了178例正常血清渗透压。结果为287±13毫渗量/kg水。并对20例尿崩症病人在限水加压素试验过程中测定血清,尿渗透压。尿崩症病人尿渗透压明显低于正常人。注射加压素后,尿渗透压升到正常。在多尿症的鉴别诊断中,此法是一种简便,灵敏的手段。有重要的诊断价值。     

高血压鼠局部脑梗塞后脑超微结构改变动态观察

本文选用肾血管性高血压鼠(RHR)复制大脑中动脉闭塞(MCAO)模型,其后2h至7d分8次取不同区域脑组织进行透射电镜动态观察超微结构的改变。显示局部脑梗塞后发生全脑性改变,其损害程度和出现时间梗塞区最早,以坏死为主,呈完全不可逆性损害;边缘区稍后,主要是微血管塌陷和微血栓形成及部分脑细胞坏死,呈部分可逆性损害,远隔区和镜区最迟,以内皮和星形细胞水肿为主,呈可逆性损害,认为用RHR复制MCAO,更接近于高血压性脑血管损害基础上发生脑梗塞的临床病理改变,全脑超微结构的动态性改变中微血管损害起着重要作用。     

Superior mesenteric artery is more important than inferior mesenteric artery in maintaining colonic mucosal perfusion and integrity in rats

Mucosal hemodynamics (by reflectance spectrophotometry) and mucosal damage (by histologic examination) following acute colonic ischemia were evaluated in different anatomic locations in the colon of anesthetized rats. The reflectance spectrophotometer provides an index of mucosal hemoglobin concentration (IHB) and an index of oxygen saturation of hemoglobin (ISO₂). The patterns of ischemia without congestion (IHB, ISO₂) during superior mesenteric artery occlusion, and ischemia with congestion (IHB, ISO₂) during portal vein occlusion, previously demonstrated in the stomach and duodenum, are also applicable to the colon. The significant linear correlations between changes (as percent of baseline) in IHB, ISO₂, and hydrogen gas clearance suggest that changes in these indices are adequate indicators of changes in colonic mucosal perfusion. Superior mesenteric artery ligation produced significant reductions in both indices, and an increase in damage in the mucosa of the cecum, transverse colon, splenic flexure, and left colon, but not the rectum. Inferior mesenteric artery ligation produced only slight reduction in these indices and minimal damage only in the mucosa of the splenic flexure. These results support the hypothesis that the superior mesenteric artery is more important than the inferior mesenteric artery in maintaining colonic perfusion and colonic mucosal integrity in the rat.Supported by the American Society for Gastrointestinal Endoscopy Career Development Award (H850208, H870212), Veterans Administration Medical Research Funds; and in part by research grants (0162-01, 0162-02; 0291-01) from the Smokeless Tobacco Research Council, Inc.; and by funds provided by the Cigarette and Tobacco Surtax Fund of the State of California through the Tobacco Related Disease Research Program of the University of California.     

Intracellular mechanisms of halothane's effect on isolated aortic strips of the rabbit

The intracellular mechanisms of halothane action were examined in vascular smooth muscle from the aorta. Medial layers of the aorta from rabbits were mounted on photodiode tension transducers, stretched to 20 mg resting tension, and "skinned" with saponin. The skinned fiber preparations were then immersed in bathing solutions to study the effects of halothane (0.5-2%) on Ca2+ activation of the contractile proteins, and Ca2+ uptake and release from the sarcoplasmic reticulum (SR) using caffeine-induced tension transients. For comparison, isolated intact aortic rings were mounted on Blinks' dual tissue bath and attached to force transducers. The preparations were contracted with either 40 mM KCl, or norepinephrine (NE) followed by acetylcholine (ACh)- or sodium nitroprusside (SNP)-induced relaxation. At steady state contraction or relaxation, the effects of halothane (1-3%) were studied. The steady state tension during halothane was expressed as a percentage of the steady state tension before administration of halothane. In the isolated intact aortic rings, halothane (1-3%) produced biphasic effects on KCl-induced tension, i.e., an initially slight increase followed by decreases, independent of endothelium. Halothane markedly increased tension in the ACh- or SNP-relaxed state. The effects were dose-dependent. In the skinned aortic strips, halothane slightly decreased maximum Ca2+-activated tension development of the contractile proteins. Halothane decreased Ca2+ accumulation in the SR and increased Ca2+ release from the SR in a dose-dependent manner. The halothane-induced increases in Ca2+ release from the SR were blocked by ryanodine, an SR Ca2+ release channel blocker. It is concluded that halothane directly causes vascular contraction or relaxation, depending on the condition, and that halothane's effects on the SR may play a role.