与腹部外科疾病相关的肝功能异常解析

肝脏是人体最重要的合成代谢器官，除肝脏本身的疾病外，任何全身其他脏器的疾病都可以累及肝脏，造成肝功能改变。本文将对与腹部外科疾病相关的肝功能异常进行解析。     

采用羊膜移植行结膜囊成形术的临床研究

目的　评价保存人羊膜移植在结膜囊成形术中的疗效。方法　 31例无眼球结膜囊狭窄患者行结膜囊成形术时 ,结膜缺损用羊膜移植。结果　术后 2 2～ 30天移植的羊膜被结膜上皮覆盖 ,随访 12～ 36个月 ,无继发感染及排异反应 ,2 7例放置正常大小义眼片 ,外观满意 ,4例于术后 3～ 5个月出现结膜囊收缩。结论　保存人羊膜移植治疗结膜囊缩窄取材方便 ,疗效显著     

毛蚶水解液对小鼠实验性肝损伤的保护作用

小鼠ｉ毛蚶水解液１０ｇ／ｋｇ、２０ｇ／ｋｇ，氯化碳、硫国酰胺（ＴＡＡ）和强的松龙引起的血表谷丙转氨酶（ＳＧＰＴ）活性长高均有明显的降低作用（Ｐ〈０．０１），其能缩短戊巴比舀钠诱导的正常小鼠和四氯化碳肝 务小鼠的睡眠时间（Ｐ〈０．０５）。结果表明，ＨＡ对小鼠实验性肝损伤具有显著的保护作用。     

云南省健康人群肺炎支原体抗体水平调查

云南省十七个州、市的2267名健康人血清肺炎支原体(Mp)抗体调查结果表明:Mp感染在云南全省广泛存在,各地均检出抗体。阳性率在2.52~45.74%之间,总阳性率为16.1%,其中以怒江州最高,保山专区最低。Mp抗体的GMT在1:8.74±1.48~1:24.68±2.82之间,总GMT为1:13.56±2.04,以楚雄州、曲靖专区最高,西双版纳州最低。不同地区、年龄、职业组间阳性率和GMT间均有显著性差异,而性别间差异不明显。Mp抗体多见于10~30岁的人群(17.19~22%)。散发的现症病例分布于30~50岁的人群中。军人和学生是Mp的主要侵袭对象(34.43%和26.97%)。     

A 1.5-megabase yeast artificial chromosome contig from human chromosome 10q11.2 connecting three genetic loci (RET, D10S94, and D10S102) closely linked to the MEN2A locus.

The genetic loci RET, D10S94, and D10S102 from human chromosome 10q11.2 are very closely linked to a locus responsible for the multiple endocrine neoplasia type 2 (MEN2A and MEN2B) and medullary thyroid carcinoma (MTC1) familial cancer syndromes. We have constructed a 1.5-megabase contig consisting of six genomic yeast artificial chromosome clones which include these loci and define their physical order. A critical crossover event has been identified within the map interval; this event places the MEN2A locus centromeric to D10S102 and defines the orientation of the physical map on the chromosome. The orientation of the contig and order of the markers are centromere-RET-D10S94-D10S102-telomere. In addition, a microsatellite repeat polymorphism with a heterozygosity of 71% at the RET locus and a restriction fragment length polymorphism with a heterozygosity of 42% detected by a lambda clone from the D10S94 locus have been developed for high-resolution genetic linkage mapping and predictive diagnostic testing. These data place three important markers on a contiguous physical map, narrow the MEN2 disease locus interval, and provide a framework for further candidate gene identification efforts. Placement of these genetic loci along a clone-based map and continued expansion of the contig will also facilitate efforts to determine the relationship of physical to genetic distance near the centromeres of human chromosomes.     

Review of traumatic diaphragmatic hernia associated with pelvis fractures

Objective: To review the epidemiological feature, clinical and diagnostic data of post-traumatic diaphragmatic hernia (TDH) associated with pelvis fracture reported in recent 10 years. Methods: A 10-year retrospective study was undertaken to analyze the incidence, diagnosis, management, morbidity and mortality of patients with traumatic diaphragmatic hernia associated with pelvis fractures. A total of 46 cases in our country were reviewed. Results: The incidence of TDH associated with pelvis fractures was relatively rare and the diagnosis was often delayed or missed. A total of 72.34% of these patients were diagnosed as TDH associated with pelvis fractures after injury for 36 hours to 1 week. Although the trans-thorax approach was preferred for surgical closure in the acute phase, its mortality still reached 8.51%. Conclusions: TDH associated with pelvis fractures is difficult to be diagnosed because of its varied clinical and radiological signs and the patients may not present with symptoms for a long time after injury. In clinical, a high index of suspicion with appropriate examination is the mainstay of management, which can be helpful in prognosis.     

负压吸引后兔玻璃体四种氨基酸浓度的动态变化

目的测定准分子激光原位角膜磨镶术(LASIK)中眼压急剧升高对兔眼玻璃体谷氨酸(GLU)、天门冬氨酸(SP)、γ-氨基丁酸(GABA)和甘氨酸(CLY)浓度的影响。方法将LASIK术中使用的负压环置于兔眼,瞬时眼压≥65mmHg,分别持续45s和3min,于术后不同时间(即刻、7、10、14d及1个月)摘除眼球。利用邻苯二甲醛柱前衍生法,高效液相色谱仪测定各组兔眼玻璃体中氨基酸的浓度。结果负压吸引持续45s组,玻璃体GLU水平与实验对照组相比差异无显著性(P=0.16429,P>0.05)。负压环吸引持续3min组,玻璃体GLU水平较持续45s组显著升高(t=3.541,P<0.05),术后10d达高峰,与吸引持续45s组有显著差异(t=5.9814,P<0.01)。负压环吸引持续3min组,在GLU升高的同时,GABA也升高,二者有正相关性(r=0.8569,P<0.05)。ASP和GLY在实验过程中虽也有不同程度的升高,但无统计学意义的变化。仅做激光治疗的实验对照组与空白对照组的GLU浓度比较无差别。结论LASIK术中常规负压吸引45s引起的急性眼压升高不会导致玻璃体氨基酸浓度变化,负压吸引持续时间延长(如3min)及其恢复正常眼压早期均可导致玻璃体GLU浓度显著升高。     

Neural regulation of the structure of myosin

Mammalian skeletal muscle responds metabolically both to neural influences and to the demands of work. For example, the soleus exhibits increased speed of contraction when reinnervated by the peroneal nerve that normally supplies fast muscles, but this change can also be brought about merely by peroneal transection (a procedure which denervates the muscles antagonistic to soleus). We have investigated the effects of these two operative procedures on soleus myosin. Seven to eight months after reinnervation of rat soleus with peroneal nerve, the myosin Ca²⁺-ATPase had increased in specific activity, alkaline stability, and susceptibility to tryptic digestion. Tryptic digestion (25 C, 10 min, myosin: trypsin = 200:1) followed by SDS-gel electrophoresis produces seven distinct peptide bands in the case of normal soleus myosin. An additional peptide band (88,000 daltons) is characteristic of fast muscle myosin. This 88,000 dalton band is demonstrable in myosin prepared from cross-reinnervated soleus muscles. Qualitatively identical changes were produced in all of these properties of soleus myosin by transecting the peroneal nerves 7–8 months previously. However, the magnitudes of the changes were less than those occurring after cross-reinnervation. Cross-reinnervation experiments have been used as evidence for neurotrophic control of skeletal muscle myosin; however, the conversion of slow myosin to fast myosin when the peroneal nerve is merely transected renders this argument questionable. Since fast and slow muscle myosin heavy chains differ in primary or tertiary structure (or both), their changes after cross-reinnervation or after inactivation of antagonistic muscles must result from a qualitative transformation of myosin which is presumably accomplished by the regulation of myosin biosynthesis.     

髋关节外科脱位入路在髋关节良性疾病的应用

目的  探讨髋关节外科脱位入路在髋关节良性疾病应用的早期临床疗效。方法  选取2013年1月-2014年12月中南大学湘雅二医院收治的27例髋关节良性疾病病例。所有病例均在术前收集详细的病历资料并行放射学检查,由同一高年资关节外科医生运用髋关节外科脱位入路进行手术。术后6、12及24个月均行X-Ray检查以明确是否出现股骨头缺血坏死、病变复发以及继发性骨关节炎。所有病例均获得至少1年的最终随访,并行Harris髋关节功能评分。结果  术后证实,26例（27髋）髋关节良性疾病包括：13例髋关节后脱位并股骨头骨折,8例髋股撞击综合征,3例滑膜软骨瘤病,1例股骨头骨骺滑脱（双侧）和1例化脓性关节炎。平均随访18个月,所有病例均未出现复发、大粗隆截骨不愈合以及股骨头缺血坏死等,术后Harris髋关节功能评分均为优良。结论  应用髋关节外科脱位入路治疗髋关节良性疾病能获得良好的显露,并能最大程度保护股骨头血运,早期临床疗效满意。

     

Management of symptomatic hemifacial spasm or trigeminal neuralgia

Hemifacial spasm (HFS) or trigeminal neuralgia (TN) is a kind of hyperactivity disorder of cranial nerves caused by vascular compression. However, sometimes, the disease may arise from nerve damage produced by tumors, which was called as symptomatic HFS/TN. Until now, little is known about the exact mechanism and the necessity of microvascular decompression (MVD) regarding the tumor-induced HFS/TN, which is necessary to be retrospectively analyzed in a considerable sample. Among the 4021 patients who underwent MVD in our department between 2006 and 2014, 44 were finally diagnosed as symptomatic HFS or TN. These patients were focused in this study and their clinical features as well as intraoperative findings and postoperative outcomes were retrospectively investigated. Data analysis exhibited the symptomatic HFS/TN cases accounted for 1.1 % in the study, which were caused by epidermoid in 18 (40.9 %) and meningioma in 15 (34.1 %) followed by neuroma in 7 (15.9 %) as well as aneurysm in 2 (4.5 %) and arteriovenous malformation in 2 (4.5 %). Compared to those with idiopathic HFS/TN, younger females were more susceptible (p?<?0.05). After resection of the neoplasm, the offending vessel was identified in 26 (59.1 %), which were followed by MVD process. Postoperatively, the symptoms relief rate was 88.6 %. Our study showed that surgical management of patients with symptomatic HFS/TN may lead to a satisfactory result, yet those primary lesions should be removed firstly. In some cases, a microvascular decompression process might be unnecessary afterward, but the entire nerve root should be checked to exclude any vessel in contact with.