不育症患者精子dna碎片化指数与精子常规参数关系的研究

目的:近年研究认为精子dna碎片化是评价精子质量的重要指标,本研究主要运用吖啶橙实验(acridine orange test,aot)检测不育症患者精子dna 碎片化指数(dna fragmentation index,dfi)与精子常规参数之间的关系?方法:收集本院男科门诊376例不育症患者的精液标本,采用改良的neubauer血细胞计数板人工分析精子密度,计算机辅助精液分析(casa)分析精子活力?精子形态分析采用shorr染色法,分析标准采用who推荐的tygerberg严格标准?采用aot检测精子dna碎片化程度?结果:dfi与精子密度呈负相关(r=-0.150,p=0.003)?与精子总活动率呈负相关(r=-0.114,p=0.028)?与精子前向运动率无统计学相关性(r=-0.089,p=0.085)?与精子正常形态率呈负相关(r=-0.155,p=0.003)?结论:精子dna碎片化指数与精子的密度?总活动率及精子正常形态率具有负相关性,aot检测的dfi值为男性不育症的诊疗提供了一个新的指标?     

The use of Integra "artificial skin, dermal regeneration template" and the reverse radial forearm fasciocutaneous flap in the primary reconstruction of a septic hand injury

Reconstruction was performed on the back of a hand following a poorly managed septic hand injury leading to skin and extensor apparatus necrosis using a reverse radial forearm fasciocutaneous flap and a bilayer artificial skin substitute. Case demonstration: Authors report on the first Hungarian case using Integra dermal regeneration template. Integra was placed on the back of the hand on an area left uncovered by the reverse radial forearm fasciocutaneous flap as well as on the flap harvest area. After biointegration of the regeneration template, the outer silicon layer was removed and a split thickness skin graft was applied. Conclusion: The take-rate on the donor area was 100% for Integra and 99% for the skin graft, and 90% for both Integra and the skin graft on the back of the hand, providing a good functional and aesthetic result.     

螺旋CT血管造影在盆腔血管病变的临床应用

目的:探讨螺旋CT血管造影(SCTA)对盆腔血管病变诊断的临床应用价值。材料与方法:10例盆腔血管行SCTA及三维重建(5例肾移植术后,3例盆腔肿瘤术后,1例右髂总动脉血管吻合术后,1例腹主动脉、髂总动脉及双侧髂内动脉多发动脉瘤),三维重建方法包括:表面遮盖成像(SSD)和最大强度投影(MIP)。结果:5例肾移植术后,4例SSD显示髂外动脉从其起始处缺失及其侧支循环血管,1例显示髂外动脉与肾移植血管吻合口处巨大动脉瘤,2例同时显示下腔静脉、双髂总静脉、髂内外静脉及其分支。3例盆腔肿瘤术后SSD及MIP成像显示双侧髂总动脉、髂内外动脉及其大分支、双侧股动脉上部大小形态,未见狭窄、阻塞。1例右髂总动脉血管吻合术后SSD显示右侧髂总动脉血管吻合处表面稍变形。1例SSD成像显示腹主动脉下段,左侧髂总动脉及双侧髂内动脉多发动脉瘤。结论:SCTA及三维重建是诊断与评价盆腔大血管病变的有效方法,对肾移植患者术前及术后了解盆腔血管情况有重要临床意义。     

MicroRNAs在冠状动脉粥样硬化性心脏病中的研究进展

microRNAs(微小核糖核酸)是一类广泛存在于动物和人类中的内源性小分子非编码单链RNA,由具有发夹结构约70-90个碱基大小的单链RNA前体(pre-miRNA)经过Dicer酶加工而来的内源性的长度约为18-25个碱基的单链小分子RNA。近年来研究发现,部分microRNAs在冠状动脉粥样硬化性心脏病患者中特异性表达,其在冠状动脉粥样硬化性心脏病的发生发展中发挥着重要的作用。     

Diagnosis and treatment of thromboembolic diseases of the right heart

Right heart thrombosis (RHT) was found by 2D-echocardiography in 8 cases. Clinical suspicion of RHT could be documented in only 3 patients, while in the other 5 cases syncope, low output syndrome, essential pulmonary hypertension, cerebral embolism or congestive heart failure was the clinical diagnosis on first presentation. Out of the 4 cases of mobile RHT of extracardiac origin 1 patient had an emergency operation, 2 patients died shortly after the 2D-echo diagnosis before treatment could have been started and 1 patient improved on anticoagulant treatment. RHT of intracardiac origin was due to a central line or a ventriculoatrial shunt in 3 cases and no source could be found in 1 patient. Complete recovery was achieved in 2 cases by medical, in one case by surgical management and in 1 patient medical and surgical treatment resulted in clinical improvement. In conclusion authors 1. consider 2D echocardiography necessary in the clinical setting of acute or chronic pulmonary embolism or "primary" pulmonary hypertension and 2. they recommend emergency operation in case of mobile large RHT detected by 2D-echocardiography.     

难复性肱骨外科颈骨折三种治疗方法的比较

我院从1985年6月至1998年4月,采用三种不同的治疗方法治疗难复性肱骨外科颈骨折69例,现报告如下.     

酪氨酸激酶抑制剂在抗肿瘤领域的研究进展

酪氨酸蛋白激酶是多种肿瘤最常见的生长因子受体,是信号转导过程中的首要关键步骤。通过阻断酪氨酸激酶可破坏肿瘤细胞的信号传递,从而达到治疗肿瘤的目的。近年来,有关酪氨酸激酶抑制剂的研究非常活跃,出现了诸如C225,C11033,PKI-166,OSI-774,ZDl839,STl571等一批新药。OSI-774和ZDl839已使难治性非小细胞肺癌患者的病情减缓。C225可提高化、放疗的疗效,STl571在慢性粒细胞性白血病和胃肠间质性肿瘤治疗中取得了突破性进展。酪氨酸激酶抑制剂已成为抗肿瘤疗法中的一个新的有希望的侯选药物。     

柯萨奇B3病毒亲心肌株与非亲心肌株感染小鼠心肌细胞的实验比较

柯萨奇Ｂ３非亲心肌株病毒（ＣＶＢ３ｏ）是否引起心肌炎还缺乏直接的实验依据。我们采用柯萨奇Ｂ３亲心肌株（ＣＶＢ３ｍ）和ＣＶＢ３ｏ感染鼠培养心肌细胞，对两株病毒感染细胞的特性进行了比较，结果表明，ＣＶＢ３ｏ与ＣＶＢ３ｍ在乳鼠心肌细胞培养液中的滴度，１２小时和２４小时无明显差别，４８小时后ＣＶＢ３ｍ的滴度变化不大，而ＣＶＢ３ｏ有所下降；两株病毒均能使鼠心肌细胞死亡，但随着时间的延长ＣＶＢ３ｍ感染后心肌细胞死亡率明显高于ＣＶＢ３ｏ；ＣＶＢ３ｏ不能阻断ＣＶＢ３ｍ对心肌细胞的感染。因此我们认为，ＣＶＢ３ｏ能感染心肌细胞，但其程度低于ＣＶＢ３ｍ。     

A missing sphincteric component of the gastro-oesophageal junction in patients with GORD

Abstract  It was recently shown that the tonic pressure contribution to the high-pressure zone of the oesophago-gastric segment (OGS) contains the contributions from three distinct components, two of which are smooth muscle intrinsic sphincter components, a proximal and a distal component [ J Physiol 2007; 580.3 : 961 ]. The aim of this study was to compare the pressure contributions from the three sphincteric components in normal subjects with those in gastro-oesophageal reflux disease (GORD) patients. A simultaneous endoluminal ultrasound and manometry catheter was pulled through the OGS in 15 healthy volunteers and seven patients with symptomatic GORD, before and after administration of atropine. Pre-atropine (complete muscle tone), postatropine (non-muscarinic muscle tone plus residual muscarinic tone) and subtracted (pure muscarinic muscle tone) pressure contributions to the sphincter were averaged after referencing spatially to the right crural diaphragm and the pull-through start position. In the normal group, the atropine-resistant and atropine-attenuated pressures identified the crural and two smooth muscle sphincteric components respectively. The subtraction pressure curve contained proximal and distal peaks. The proximal component moved with the crural sling between full inspiration and full expiration and the distal component coincided with the gastric sling-clasp fibre muscle complex. The subtraction curve in the GORD patients contained only a single pressure peak that moved with the crural sphincter, while the distal pressure peak of the intrinsic muscle component, which was previously recognized in the normal subjects, was absent. We hypothesize that the distal muscarinic smooth muscle pressure component (gastric sling/clasp muscle fibre component) is defective in GORD patients.     

Effect of acute aprotinin (Gordox) therapy on hemostasis in heart surgery patients, with special reference to hyperfibrinolysis]

Authors have studied the effect of Gordox-therapy on haemostasis after open heart surgery in a prospective clinical trial. Thirty seven patients (pts) undergoing cardiac surgery due to their valve disease were randomly assigned either to control-group (20 pts) or to Gordox-group (17 pts). The patients in the Gordox group were given Gordox according the following scheme: 2 M IU within 20 min. after induction of anaesthesia followed by 0.5 M IU/hour infusion until the end of the operation. One M IU also was given into the oxygenator before starting the extracorporeal circulation. The postoperative chest tube drainage was less in Gordox-group (534 +/- 260 ml vs. 987 +/- 583 ml, p less than 0.005), and donor blood and fresh frozen plasma requirement was also lower in this group (534 +/- 633 ml vs. 935 +/- 718 ml p less than 0.05; 70 +/- 153 ml vs. 211 +/- 245 ml p less than 0.05, respectively). There was no significant difference between the two groups concerning the postoperative activated partial thromboplastin time, prothrombin time, thrombin time values. The authors could document significantly higher fibrinogen concentration and significantly lower fibrinolytic activity postoperatively in the Gordox-group (p less than 0.05). Gordox therapy has advantageous effect on haemostasis after open heart surgery which can be documented both by clinical and laboratory examination.