白细胞进入腹腔是引起蛋白质经腹腔丢失的关键

目的为了研究细菌性腹膜炎时经腹腔蛋白质丢失的机制,阐明白细胞移行与蛋白质丢失的关系。方法给兔腹腔内注射大肠杆菌(E.coil)4×106CFU+生理盐水(35ml/kg),做成急性腹膜炎动物模型。通过测定实验6或8h期间腹透液中白细胞总数(WBC)及中性粒细胞(PMNs)计数情况以及腹膜对蛋白质的通透性(蛋白质D/P比值)。设立了两个系列的实验系列一,应用氮介(mustine),1.2mg/kg,实验前3天静脉注射,以耗尽循环血中的白细胞;系列二,用单克隆抗体(mAb)60.32mg/kg,实验前5min静脉注射,以阻滞PMNs上的粘附分子CD18,从而抑制PMNs向腹腔移行。同时设立了阳性对照组(即腹膜炎组)及阴性对照组(无腹膜炎组)。结果系列一中mustine降低87%循环血中白细胞及93%循环血中PMNs,此时即使腹腔内注射细菌,白细胞向腹腔的移行及腹腔蛋白质的渗出均较未注射mustine的腹膜炎组明显降低,而与无腹膜炎的正常对照组结果相似。系列二,静脉注射mAb60.3同样也明显降低白细胞及PMNs向腹腔的移行及经腹腔蛋白质的丢失。结论急性细菌性腹膜炎时白细胞向腹腔移行导致了经腹腔蛋白质的丢失。     

乳腺髓样癌的超声检查与组织病理的相关性分析

目的:探讨超声检查在诊断乳腺典型髓样癌中的临床意义。方法:按严格的病理诊断学标准将病例重新分类为乳腺典型髓样癌和非典型髓样癌,比较两者间声像学特征的异同。结果:32例中有13侧重新诊断为乳腺典型髓样癌;另外19例为非典型髓样癌。13例典型髓样癌患者中的10例边界整齐光滑;全部19例非典型髓样癌病人没有一例边界光滑,或者边界呈锯齿状(16例),或者边界光滑伴局部不规则(3例)。非典型与典型髓样癌间肿瘤边界的规则性有明显的差异。结论:如果超声检查提示肿瘤边界呈锯齿状或肿瘤边界光滑伴局部不规则,应行整个肿瘤的病理评估防止典型髓样癌的过诊断。     

家兔急性实验性面神经损伤的组织病理观察

目的　观察家兔面神经急性损伤后髓鞘和轴索的组织病理变化。方法　用丝线结扎茎乳孔以外的面神经总干 ,观察结扎后 1天、3天及 5天面神经的组织病理改变。结果　家兔面神经受损后 ,先后在髓鞘和轴索出现轻重不等、程度不同的形态学改变。结论　结扎家兔面神经后 ,其髓鞘及轴索会出现相应的病理改变 ,且随着结扎天数的增加 ,面神经损伤亦呈加重的趋势     

Risk factors of uterine contraction after ureteroscopy in pregnant women with renal colic

International Urology and Nephrology - Ureteroscopy is widely applied in pregnant women with renal colic, but such patients are easy to experience uterine contraction after surgery. There are many...     

Lycium barbarum polysaccharide fraction associated with photobiomodulation protects from epithelium thickness and collagen fragmentation in a model of cutaneous photodamage

Lasers in Medical Science - Ultraviolet radiation (UVR) is the major etiologic agent of cutaneous photoaging, and different strategies are used to prevent and treat this condition. The...     

Distal rectus femoris surgery in children with cerebral palsy: results of a Delphi consensus project

PurposeThe purpose of this study was for an international panel of experts to establish consensus indications for distal rectus femoris surgery in children with cerebral palsy (CP) using a modified Delphi method.MethodsThe panel used a five-level Likert scale to record agreement or disagreement with 33 statements regarding distal rectus femoris surgery. The panel responded to statements regarding general characteristics, clinical indications, computerized gait data, intraoperative techniques and outcome measures. Consensus was defined as at least 80% of responses being in the highest or lowest two of the five Likert ratings, and general agreement as 60% to 79% falling into the highest or lowest two ratings. There was no agreement if neither threshold was reached.ResultsConsensus or general agreement was reached for 17 of 33 statements (52%). There was general consensus that distal rectus femoris surgery is better for stiff knee gait than is proximal rectus femoris release. There was no consensus about whether the results of distal rectus femoris release were comparable to those following distal rectus femoris transfer. Gross Motor Function Classification System (GMFCS) level was an important factor for the panel, with the best outcomes expected in children functioning at GMFCS levels I and II. The panel also reached consensus that they do distal rectus femoris surgery less frequently than earlier in their careers, in large part reflecting the narrowing of indications for this surgery over the last decade.ConclusionThis study can help paediatric orthopaedic surgeons optimize decision-making for, and outcomes of, distal rectus femoris surgery in children with CP.Level of evidenceV