输卵管积水处理方式对体外受精-胚胎移植临床结局的影响

目的探讨输卵管积水的不同腹腔镜手术处理方式对体外受精-胚胎移植(IVF-ET)临床结局的影响。方法回顾性分析2006年1月至2007年7月因输卵管因素在本中心行常规IVF-ET治疗的294例不育患者的资料,按IVF-ET前腹腔镜下输卵管积水处理方式分组:A组:双侧输卵管近端结扎术28例;B组:双侧输卵管造口术42例;C组:双侧输卵管切除术64例;D组:输卵管阻塞不伴积水80例;E组:单或双侧输卵管积水80例。比较5组患者在IVF-ET周期中卵巢对超排卵的反应性及临床结局的影响。结果C组的窦卵泡数少于B组,发育的卵泡数及获卵数少于其他4组,均有显著性差异(P<0.05);与其他4组相比,C组使用促性腺激素(Gn)的支数最多,但无显著性差异(P>0.05);E组的胚胎植入率为15.9%,临床妊娠率为27.5%,为各组间最低,其中胚胎植入率与A、C和D组比较有显著性差异,临床妊娠率与A和D组比较有显著性差异(P<0.05);各组流产率E组最高(22.7%),其次为B组(14.4%),E与C组(4%)比较有显著性差异(P<0.05);异位妊娠率E组最高,其次为B组,但各组间无显著性差异(P>0.05)。结论输卵管积水对IVF-ET结局有负面影响,对输卵管积水进行适当预处理有助于改善其临床结局。输卵管近端结扎术不降低卵巢反应性,异位妊娠率及流产率低,是IVF-ET前输卵管积水预处理较理想手术方式。     

A new Le Fort I internal distraction device in the treatment of severe maxillary hypoplasia.

PURPOSE: The purpose of this pilot study was to test a new Le Fort I internal distraction device. PATIENTS AND METHODS: A new internal Le Fort I distraction device designed by 1 of the authors was used in 3 patients with cleft lip and palate and severe maxillary hypoplasia who needed maxillary advancements in excess of 12 mm. Presurgical planning used CASSOS (SoftEnable Technology, Ltd, Hong Kong SAR, China) prediction tracing software and a stereolithographic model to calculate the distraction vector. The distractors were pre-bent and installed on the stereolithographic model and activated to advance the maxilla. Surgery was performed in a conventional manner, and distraction was started after a 7-day latency phase at the rate of 1 mm/day and continued until the presurgical plan was achieved. The distractor was removed after a 3-month consolidation phase. Cephalometric radiographs were taken at the completion of each phase. RESULTS: This new Le Fort I internal distraction device successfully distracted the maxillae as planned in all 3 patients. At the end of the distraction phase, the maxillary advancement was measured at 15.8 mm, 15.8 mm, and 13.5 mm, respectively. In each patient, a clockwise rotation of the maxilla was observed with a tendency to a posterior open bite. Postoperative radiographs also showed that the actual distraction vectors differed from the planned vectors. After the consolidation phase, radiographs showed a relapse of 2.6 mm, 0 mm, and 5.0 mm, respectively. There was no further relapse on 3-month follow-up radiographs. Each case showed radiographic evidence of excellent new bone formation at the osteotomy sites. CONCLUSION: The new Le Fort I internal distraction device produced the necessary advancement in all 3 patients. The study also showed that the actual distraction vector differed from the planned vector. This discrepancy was caused by a clockwise rotation of the maxilla during the distraction. Finally, the study showed a variable relapse rate not previously reported in maxillary distraction.     

卡马西平片体外溶出度与体内吸收相关性

目的：考察卡马西平（ＣＢＺ）片溶出度与体内吸收的相关性。方法：应用ＺＲＳ－４溶出度仪测定卡马西平片的溶出度。４名男性健康志愿性ｐｏ单剂量２００ｍｇＣＢＺ用ＴＤｘ分析仪测定血药浓度，并按照Ｗａｇｎｅｒ－Ｎｅｌｓｏｎ公式计算药物吸收分数。结果：体外溶出度与体内药物吸收分数的相关系数ｒ＝０．９２６１，体外溶出度与体内药物吸收分数的相关系数ｒ＝０．９９７７。结论：ＣＢＺ片体外溶出度与体内吸收有较好的相关性     

手部烧伤后重度虎口挛缩虎口重建术

自１９８９年２月～１９９５年３月，对２３例手部烧伤后重度虎口挛缩行瘢痕切除及虎口开大后，选用带旋髂浅血管蒂的腹股沟皮瓣移植重建虎口，术后均取得了满意效果。虎口挛缩的程度为０°～２５°。虎口开大后达８０°～９０°。虎口区瘢痕切除后皮肤缺损最小８ｃｍ×５ｃｍ，最大１２ｃｍ×６ｃｍ，平均１０ｃｍ×５ｃｍ。皮瓣切取面积最小１４ｃｍ×７ｃｍ，最大１８ｃｍ×８ｃｍ，平均１６ｃｍ×７ｃｍ。术后皮瓣断蒂时间为２～３周，２３例皮瓣均完全成活。对重度虎口挛缩应用带旋髂浅血管蒂的腹股沟皮瓣移植重建虎口是一种简单易行、成功率高的方法。因其具有供区部位隐蔽，皮肤质量好，不损伤肢体重要血管及可早期断蒂等优点，极易被患者接受。     

复方环丙氟哌酸鼻腔膜的研制及临床疗效观察

本文以明胶海绵为衬底,用环丙氟哌酸和氢化考的松、云南白药酊、达克罗宁制备的鼻腔消炎止血药膜,制备简便,质量稳定。临床观察结果证明,具有给药方便、疗效高、疗程短、药物作用持久,无毒副作用等优点。     

重庆地区近五年小儿菌痢菌群变化及耐药状况

我院近五年收治小儿菌痢２０３１例，培养分离出痢杆菌９８５珠，其中福氏９０４株，占９１．７８％，全部为福氏２ａ型，宋内氏８１株，占８．２２％。常见抗菌药物如氨苄青霉素、氯霉素、痢特灵的耐药性均达９５％以上，庆大霉素、吡哌酸、氟哌酸、丁胺卡那霉素、卡那霉素的耐药性逐年升高；头孢噻肟、环丙沙星耐药率也迅速增加。目前重庆地区治疗小儿菌痢宜推荐先锋霉累Ｖ、环丙沙星、头孢噻肟、卡那霉素，待有药敏试验结果后结合临床效果进行调整。     

Chronic Ethanol Inhibits Inositol Metabolism in Specific Brain Regions

Many neurotransmitters and hormones in the nervous system transmit signals through receptors coupled to the poly-phosphoinositide (PI) signaling pathway. In this study, an in vivo protocol with (³H]inositol was used to examine the effect of chronic ethanol administration on inositol metabolism and poly-PI turnover in the cerebral cortex, hippocampus, and cerebellum of mouse brain. C57BL/6 mice were given a nutritionally complete liquid diet containing either ethanol (5%, w/v) or isocaloric sucrose for 2 months. Mice were injected intracerebrally with ^rH]inositol; after 16 or 24 hr, they were injected intraperitoneally with lithium (8 mEq/kg body weight) to inhibit the inositol monophosphatase (IP₁) activity. All mice were decapitated 4 hr after lithium injection. Labeled inositol phospholipids accounted for 16 to 23% of total labeled inositol in different regions of control mouse brain, and the percentages in the hippocampus were consistently higher than the cerebral cortex and cerebellum. In control mice, the percentages of labeled IP, after a 4-hr lithium treatment were 11.5%, 9.9%, and 3.7% for cerebral cortex, hippocampus, and cerebellum, respectively. Chronic ethanol feeding resulted in a significant (p < 0.05) decrease in the percent of labeled IP₁ and inositol phospholipids, and this effect was observed in the cerebral cortex and, to a lesser extent, hippocampus but not cerebellum. When ratios of labeled IP₁ were expressed against labeled inositol phospholipids as an index of the poly-PI turnover activity, significant decreases in IP/lipid ratios were observed in the cerebral cortex, but not the hippocampus or cerebellum. Although mice killed 24 + 4 hr after the last ethanol feeding would have experienced an 8-hr period of ethanol withdrawal, compared with the 16 + 4-hr group, no differences in IP/lipid ratios were observed between the two time groups. These results illustrate regional differences in the effect of chronic ethanol on inositol metabolism in the brain, but no difference in poly-PI turnover in brain due to ethanol withdrawal.     

维生素 D_3对大鼠的免疫调节作用研究

观察多次注射维生素 D_3对大鼠的免疫调节作用,结果证明维生素 D_3对抗体产生有双相调节作用,并可增强单核巨噬细胞的分泌功能。连续使用大剂量维生素 D_3可使 T 细胞数量减少。     

Characterization of the CAMPATH-1 (CDw52) antigen: biochemical analysis and cDNA cloning reveal an unusually small peptide backbone.

The CAMPATH-1 (CDw52) antigen has been purified from human spleen. The antigenic epitope is heat stable but sensitive to mild alkali treatment. Experiments with phosphatidylinositol-specific phospholipase C indicate that it is anchored by a glycosylphosphatidylinositol (GPI) anchor. An N-terminal sequence of 11 amino acids was determined, followed by an abrupt stop. Using short overlapping mixed oligonucleotide primers, cDNA synthesized from the mRNA of a human B cell line was amplified by the polymerase chain reaction. The product was used to isolate cDNA clones and the full amino acid sequence of the CAMPATH-1 antigen was deduced. It consists of 37 amino acid residues plus a 24-residue signal peptide. It has all the features expected for a GPI-anchored membrane protein except that the predicted mature protein is remarkably short, comprising no more than 18 residues and possibly as few as 12 (depending on the GPI linkage site). Potential attachment sites for carbohydrate are present and it is shown that the antigen contains N-linked oligosaccharide(s). This structure accounts for the known properties of the antigen, though the exact reasons why it is such a good target for cell lysis in vitro and in vivo are not yet clear.     

左室肥厚对急性心肌梗塞时心肌酶的影响

通过２０例有左室肥厚和２３例无左室肥厚患者发生急性心肌梗塞时ＣＰＫ值的比较，发现在梗塞部位相同的情况下，心肌肥厚组的酶值水平高于非心肌肥厚组（１３．２±４．８比９．０±４．６Ｕ／ＬＰ＜０．０１），这可能与肥厚组酶活力增强和心肌梗塞体积增大有关。