阴茎血流电脑分析检测仪的临床应用(附508例体会)

目的 进一步探讨血管性ED和功能性ED的诊断与鉴别诊断。方法 用我院自行研制的阴茎血流电脑分析检测仪,对508例自诉有勃起功能障碍到我院就医的患者进行了检查,该检查是在阴茎海绵体内注射试验的基础上,检测6条阴茎动脉的血流量,并与自身的肱动脉血流量进行比较,以鉴别动脉性ED、静脉性ED、混合性ED和功能性ED。结果 功能性ED159例,静脉性ED206例,动脉性ED38例,混合性ED105例获得诊断。结论 本仪器是诊断血管性ED的有效仪器。     

先天性马蹄内翻足以胫后肌外移为主的手术治疗长期随访结果

先天性马蹄内翻足是足部常见畸形,病因不明,但有学者认为肌发育不良而引起的肌力不平衡是本病的主要原因[1～4].导致肌力失衡的软组织挛缩包括胫后肌腱、跟腱、足的内在肌、内侧跗跖关节囊、胫前肌,三角韧带及跟舟韧带等,其中胫后肌腱是造成马蹄内翻足的主要因素之一.自1988年12月以来,共手术治疗先天性马蹄内翻足病人41例60足,均采用胫后肌外移为主的矫正手术,取得了良好的效果.     

Adult-onset hypothyroidism impairs paired-pulse facilitation and long-term potentiation of the rat dorsal hippocampo-medial prefrontal cortex pathway in vivo

Thyroid hormones are critical for the maturation and function of the central nervous system. Insufficiency of thyroid hormones in the adulthood causes a wide range of cognitive dysfunctions, including deficits in learning and memory. The present study investigated whether adult-onset hypothyroidism would alter synaptic functions in the dorsal hippocampo-medial prefrontal cortex (mPFC) pathway, a neural pathway important for learning and memory. Adult hypothyroidism was induced by oral administration of 1% (g/l) antithyroid acting drug 6-n-propyl-2-thiouracil (PTU) to adult male Sprague-Dawley rats for 4 weeks. Postsynaptic potentials (PSP) were recorded in the mPFC by stimulating the dorsal hippocampal CA1 region in vivo. Basal synaptic transmission was evaluated by comparing input-output relationships. Paired-pulse facilitation and long-term potentiation were recorded to examine short- and long-term synaptic plasticity. Adult-onset hypothyroidism did not change the basal synaptic transmission, but significantly reduced paired-pulse facilitation and long-term potentiation of PSP. These inhibitions can be restored by thyroid hormone replacement. The results suggest that such alterations in synaptic plasticity of the dorsal hippocampo-mPFC pathway might contribute to understanding basic mechanisms underlying learning and memory deficits associated with adult-onset hypothyroidism.     

Abnormal neural activity in children with attention deficit hyperactivity disorder: a resting-state functional magnetic resonance imaging study

In this study, a newly reported regional homogeneity approach was used to analyze blood oxygen level-dependent functional magnetic resonance imaging data on resting state in boys with attention deficit hyperactivity disorder. Boys with attention deficit hyperactivity disorder showed decreased regional homogeneity in the frontal-striatal-cerebellar circuits, but increased regional homogeneity mainly in the occipital cortex. Our findings are consistent with the hypothesis of abnormal frontal-striatal-cerebellar circuits in attention deficit hyperactivity disorder. The regional homogeneity approach may be a potentially useful method in exploring the pathophysiology of attention deficit hyperactivity disorder.     

糖尿病小鼠胰腺干细胞转分化为胰岛样细胞

目的 观察链脲佐菌素所致糖尿病小鼠胰腺干细胞是否能转分化为胰岛样细胞.方法 以链脲佐菌素建立糖尿病小鼠模型,分离培养其胰腺导管上皮细胞,经体外扩增及诱导培养后,以细胞免疫化学方法检测PDX1表达,行STZ染色和葡萄糖刺激的胰岛素释放试验鉴定其功能.结果 糖尿病小鼠胰腺干细胞经体外培养和诱导分化后,PDX1阳性,并形成胰岛样细胞团;胰岛样细胞对高糖刺激(15.0 mmol/L)的胰岛素释放较低糖(5.6 mmol/L)时增加了1.4倍(37.2±11.2比25.9±7.6,t =2.830,P＜0.05),DTZ染色阳性.结论 链脲佐菌素所致糖尿病小鼠胰腺干细胞在体外培养条件下可转分化为胰岛素分泌细胞.     

大肠癌患者VEGF和Endostatin的表达及其与临床病理特征的关系

目的：探讨大肠癌患者手术前后血清血管内皮生长因子（VEGF）和Endostatin的动态变化规律及其与临床病理特征的关系。方法：ELISA法检测大肠癌患者（大肠癌组）术前及术后2周血清VEGF和Endostatin水平,并与大肠腺瘤患者（大肠腺瘤组）和健康对照者（对照组）进行比较。结果：1）大肠癌组术前血清VEGF水平显著高于大肠腺瘤组及对照组（P均〈0.01）。2）大肠癌组术前血清Endostatin水平显著高于大肠腺瘤组及对照组（P均〈0.01）。3）大肠癌组术前血清VEGF、Endostatin水平与原发肿瘤大小、细胞分化程度、区域淋巴结转移、肝转移及Dukes分期密切相关（P均〈0.05）,与性别、肿瘤部位等因素无关（P〉0.05）。4）大肠癌组术后2周血清VEGF水平较术前显著下降,而血清Endostatin水平较术前升高（P均〈0.01）。结论：大肠癌患者血清VEGF和Endostatin水平升高,且与原发肿瘤大小、细胞分化程度、区域淋巴结转移、肝脏转移及Dukes分期等因素有密切关系;血清VEGF和Endostatin水平是评价大肠癌恶性行为、预测浸润和转移程度的有效指标。     

第2代(温控)射频消融子宫内膜切除术

目的探讨第2代（温度控制）射频消融子宫内膜切除术的疗效、安全性和可行性。方法2004年9月-2006年2月由上海市4家医院联合开展一项多中心、前瞻性研究,完成功能性子宫出血温控射频消融子宫内膜切除术81例。在超声监护下,射频治疗以温度控制模式输出功率50 W、温度设定85℃,按照两侧宫角、宫底、宫体、下段部位顺序射频消融子宫内膜。每个治疗点治疗时间为4 min。结果81例术后随访4-17个月。术后6个月随访70例,其中闭经48.6%（34/70）,点滴状月经41.4%（29/70）,少量月经10%（7/70）,总有效率为100%（70/70）。术后12个月随访67例,其中闭经56.7%（38/67）,点滴状月经29.9%（20/67例）,少量月经9.0%（6/67）,正常月经量3.0%（2/67）,月经量过多1.5%（1/67）,总有效率98.5%（66/67）。结论温控射频消融子宫内膜切除术不仅使患者的异常子宫出血在保留子宫的情况下得到有效的治疗,同时具有操作方便、治疗时间短、并发症少、术后恢复快等特点。     

Neonatal intracranial aneurysms: Case report and review of the literature

Neonatal intracranial aneurysms are rare. The authors report a 1‐month‐old male who presented with focal seizure. Computed tomography scan demonstrated a right frontoparietal intraparenchymal haematoma. A distal right middle cerebral artery aneurysm of 1 cm in diameter was identified intraoperatively and excised. The patient had no neurological deficit at 15 months postoperation. There are only 22 cases of neonatal intracranial aneurysms reported in the literature. Intraparenchymal haematoma is present in 56% of the cases. Distal middle cerebral artery aneurysms account for 35% of the aneurysms. Considering the rareness of neonatal intracranial aneurysms, non‐invasive imaging techniques such as magnetic resonance angiography and computed tomography angiography are the first choice for neonates with intracranial haemorrhage.     

肾精亏虚对雄性小鼠及其雄性仔鼠生育力的影响

目的:观察肾精亏虚对雄性小鼠及其雄性仔鼠生育力的影响。方法:将30只6周龄雄性昆明小鼠随机均分为正常对照组、模型组和补肾组3组。模型组和补肾组采用房劳加惊恐的复合伤肾法制造肾精亏虚模型。补肾组每天给予0.16ml/10g体重的补肾填精方浓缩液灌胃。正常对照组及模型组予等量生理盐水灌胃,造模并给药21d。从造模结束次日起,所有小鼠与正常动情期雌鼠配对饲养5d后检测其精子密度及活动率。取出雌鼠待其分娩,分别计算各组配对雌鼠妊娠率和每胎生产数(仔鼠总数/妊娠并分娩的雌鼠只数)以评估父代小鼠生育力。雄性仔鼠饲养至6周龄时每组随机取出10只检测其精子密度及活动率。结果:模型组每胎生产数[(7.00±1.73)只]明显比正常对照组[(9.43±1.27)只]和补肾组[(8.80±1.10)只]低(P<0.05);模型组小鼠精子密度[(9.70±1.45)×106/ml]及活动率[(66.72±10.12)%]均明显低于正常对照组[(14.08±1.15)×106/ml,(81.75±3.56)%]和补肾组[(12.20±1.55)×106/ml,(78.55±4.38)%],P<0.01,而正常对照组与补肾组之间则没有差异(P>0.05);模型组仔鼠精子密度[(10.1±1.79)×106/ml]及活动率[(71.86±7.48)%]均低于正常对照组[(15.30±1.83)×106/ml,(79.86±5.68)%]和补肾组仔鼠[(14.20±2.21)×106/ml,(81.92±2.51)%],P<0.05,正常对照组与补肾组仔鼠之间没有差异(P>0.05)。结论:"惊恐、房劳"可以明显降低小鼠生育力,其仔鼠生育力亦可受累。补肾法可以阻断这种损伤的发生。     

结直肠癌性肠梗阻术前经肛门置肠梗阻导管的临床研究

为探讨结直肠癌性肠梗阻患者术前经肛门置肠梗阻导管的应用价值,对2008年3月至2013年3月我院收治的70岁以下且未合并严重慢性病的60例结直肠癌性肠梗阻患者,于内镜引导下经肛门放置肠梗阻导管,引流肠内容物并行肠道准备,拟行一期结直肠癌切除肠管吻合术。结果显示,60例患者中,58例肠梗阻导管放置成功,另2例因肿瘤处肠腔过度狭窄,且位于肠管弯曲处,导管无法通过而致治疗失败。成功放置肠梗阻导管的58例患者经4～5d治疗肠梗阻完全缓解,再经2～3d肠道准备拟行一期结直肠癌根治肠管吻合术,术中发现2例患者肠道准备欠佳,遂行预防性肠造口,其中1例术后发生吻合口漏,经保守治疗治愈,其他患者一期手术成功,术后未发生并发症。结果表明,结直肠癌性肠梗阻患者术前经肛门置肠梗阻导管可解除肠梗阻,为一期手术治疗创造条件,避免或减少患者二次手术机会,减轻患者痛苦及经济负担,具有较高的应用价值。