经皮脊柱内镜椎间孔入路治疗腰椎椎体后缘离断症临床研究

目的 观察经皮脊柱内镜椎间孔入路治疗腰椎椎体后缘离断症的临床疗效.方法 回顾性分析本科自2016年4月～2019年1月收治的62例腰椎椎体后缘骺环离断症患者,均采用经皮脊柱内镜经症状侧单侧椎间孔入路手术治疗,采用VAS评分、Oswestry功能障碍指数及改良MacNab标准评估临床疗效.结果 经过6～30个月的随访,中位时间16个月.所有患者术后1个月和末次随访的VAS评分和ODI指数均较术前显著降低,差异均有统计学意义(P<0.05);末次随访时,采用MacNab标准评价疗效:优50例,良6例,可4例,差2例,优良率为90.3％.结论 经皮脊柱内镜经椎间孔入路手术治疗腰椎椎体后缘离断症的疗效确切,具有创伤小、康复时间短,不破坏脊柱的生物力学结构等优势.经椎间孔入路在切除离断组织的同时,对椎间盘后方纤维环及后纵韧带损伤大,术前应根据离断骨块需切除范围选则最佳适应证.     

主动脉瘤25例的影像诊断

目的探讨螺旋CT(SCT)和MRI对主动脉瘤的诊断价值。方法25例主动脉瘤,13例行MRI检查,12例行SCT及三维重建技术检查。三维重建方法采用表面阴影显示法(SSD)、最大密度投影(MaxIP)及多层面重建法(MPVR)。结果13例主动脉夹层MRI和SCT均较好显示主动脉夹层内膜片和真假腔,SCT显示内膜破口5例,MRI无一例显示;SCT及三维重建较好地显示了主动脉夹层的内膜撕裂的范围、真性主动脉瘤(TAA)瘤壁的厚度及钙化、附壁血栓的情况及与邻近大血管分支的关系。结论SCT及三维重建技术的联合应用较低场MRI更能明确主动脉瘤的病变,对帮助和指导手术更具有价值。     

Short-Term Toxicity of Bitumen Upgrading Products in the Rat Following Repeated Dermal Exposure

Light gas oil (B-LGO), heavy gas oil No. 1 (B-HGOI), and heavygas oil No. 2 (B-HGOII) fractions of bitumen upgrading products(BUPs) were applied on the dorsal skin of rats at 25 mg/kg bw/day(low dose), 100 mg/kg bw/day (intermediate dose), and 400 mg/kgbw/day (high dose) for 4 weeks. Control animals received normalsaline while positive controls received a medium boiling coalliquefaction product (CLP) at 100 and 400 mg/kg bw/day. Reducedfood consumption and growth suppression were observed in malesand females treated with B-HGOI, B-HGOII, and CLP, but onlyin males receiving B-LGO. Increased relative spleen, kidney,and liver weights were observed in animals treated with B-HGOI,B-HGOII, and CLP, but not in control or LGO groups. A dose-relatedincrease in absolute and relative liver weight was most markedin animals receiving B-HGOII where a significant increase wasobserved starting at the low dose, followed by those receivingB-HGOI and CLP. Appearance of pale foci on the splenic capsuleand increases in spleen/body weight ratio were limited to animalsreceiving B-HGOI and B-HGOII. Decreases in hematocrit and RBCand increase in percentage of reticulocytes were observed inanimals of both sexes receiving B-HGOI and B-HGOII. Female ratsappeared to be more severely affected because significant decreasesin hemoglobin and RBC were observed in animals receiving thelow dose of B-HGOII and the intermediate dose of B-HGO-I. Increasedserum cholesterol was observed in B-HGOII-treated females atall dose levels, and in males starting at the intermediate dose.Histological changes were observed in the thymus gland, wheremoderate to marked cortical atrophy was noted in male and femalerats receiving the high dose of B-HGOI and B-HGOII, and in thebone marrow, where the most significant abnormality was thepresence of focal myelofibrosis in some male rats treated withB-HGOI and B-HGOII. Mild to moderate histological changes werefound in the thyroid, liver, and spleen of rats of all treatmentgroups. Changes in the skin included moderate hyperkeratosisin fe males receiving high doses of B-LGO and in animals ofboth sexes receiving high doses of B-HGOI, and moderate to markedepidermal hyperplasia in rats receiving high doses of B-HGOI.Based on these multiple endpoints, the severity of systemictox icity was B-HGOII > B-HGOI > CLP B-LGO. The NOEL wasabout 25 mg/kg bw/day for B-LGO and lower than 25 mg/ kg bw/dayfor B-HGOI and B-HGOII.     

Subchronic Toxicity of 3,3',4,4',5-Pentachlorobiphenyl in the Rat: I. Clinical, Biochemical, Hematological, and Histopathological Changes

The systemic, toxicity of 3,3',4,4',5-pentachlorobiphenyl (PCB126) following subchronic dietary exposure was investigatedin Sprague-Dawley rats. PCB 126 was administered to rats ofboth sexes at concentrations of 0.1, 1.0, 10, or 100 ppb intheir diet for 13 weeks. Another group of rats received a loadingdose of 5 µg PCB/kg body wt at the start of the feedingperiod followed by exposure to 10 ppb PCB diet for the sameperiod of time as the other groups. Growth suppression and decreasedfood consumption were observed in the highest dose groups ofboth sexes. Increased organ/body weight ratios for the liveroccurred in the 10 and 100 ppb groups of both sexes. Rats ofboth sexes exposed to the highest dose of the PCB also exhibitedincreased relative kidney, spleen, and brain weights. Hematologicaland most serum biochemical changes were confined to the 100ppb groups. These included elevated alkaline phosphatase, bilirubin,cholesterol, and aspartate aminotransferase, and decreased serumglucose, hemoglobin, erythrocytes, hematocrit, and platelets.A dose-dependent increase in liver ethoxyre-sorufin-O-deethylaseactivity was observed in rats of both sexes starting at 0.1ppb. A dose-dependent increase in liver uroporphyrin levelswas observed in both sexes and significant changes occurredin the female rats at 1.0 ppb and higher dose groups. Decreasedliver vitamin A was observed in the 10 ppb group and higherin both sexes. Kidney vitamin A was elevated in the 100 ppbgroup. No statistically significant changes were noted in concentrationsof brain biogenic amines. PCB 126 residues were 10-fold higherin liver than in fat. Treatment-related histopathological changeswere observed in the thymus, thyroid, bone marrow, and liverof rats exposed to the 10 ppb diet, but increased frequencyof mild changes was observed in most of these tissues at the1.0 ppb level. Based on the above data, the no adverse effectlevel was judged to be 0.1 ppb in the diet or 0.01 µg/kgbody wt/day.     

高度近视眼白内障手术疗效观察

目的　分析高度近视眼白内障手术效果。方法　高度近视合并白内障病例共１９１ 例（２７９ 只眼）,行白内障术后３ｍｏ以上,随访视力、眼屈光度及并发症,计算测量误差及ＳＲＫ－ＩＩ公式误差。结果　术后矫正视力０ ．５ 者２００ 只眼,占７１．７ ％ ;矫正视力＜ ０．１ 者１３ 只眼,占４ ．７ ％ － 眼轴越长,近视性眼底病变越重。术后发生视网膜脱离２ 只眼（０ ．７％） 。眼轴长度测量误差值平均为０．５３ｍｍ ,ＳＲＫ－ＩＩ公式计算的平均绝对屈光误差值为１．１２Ｄ。结论　高度近视眼白内障手术效果较一般人群差,且眼轴越长效果越差。     

小剂量尿激酶与低分子肝素钙治疗不稳定性心绞痛

目的观察小剂量尿激酶+低分子肝素钙治疗不稳定性心绞痛(UAP)的临床疗效。方法将80例UAP患者随机分为尿激酶、低分子肝素钙组(A组)43例,尿激酶10万U溶于100ml生理盐水静脉滴注,连续12d,低分子肝素钙5000U皮下注射,1次/d,共12d;常规治疗组(B组)37例,硝酸甘油10mg溶于5%葡萄糖500ml静脉滴注,共12d,复方丹参20ml溶于5%葡萄糖200ml静脉滴注,共12d。观察两组治疗UAP总有效率及出血等不良反应的发生率,治疗前后测定血小板计数(BPC)、激活全血凝固时间(ACT)、纤维蛋白原定量(FB)。结果两组UAP治疗总有效率分别为88.4%和62.2%(P<0.05),轻微出血发生率两组间及治疗前后BPC、ACT、FB均无显著性差异(P>0.05)。结论小剂量尿激酶+低分子肝素钙治疗UAP疗效显著,且用药安全。     

甘糖酯对实验糖尿病大鼠粘附分子-CD54、CD106、CD62p的影响

目的观察糖尿病大鼠肾脏、主动脉等粘附分子的变化及甘糖酯干预的影响,为早期防治糖尿病并发症提供科学依据.方法实验分正常对照、糖尿病对照、高、低剂量甘糖酯共4组,通过免疫组织化学方法观察大鼠肾脏和主动脉CD54和/或CD106的表达,应用流式细胞仪测定血中单个核细胞表面CD54、血小板表面CI)62p的表达水平;应用甘糖酯治疗8周后,观察上述指标的变化.结果(1)血单个核细胞表面CD54测定表明高剂量甘糖酯组有明显降低,(CD54高=36.04±11.01%,VS CD54DM=65.09±14.92%,P＜0.05),而低剂量甘糖酯组降低不明显;甘糖酯时血小板表面CD62P表达影响不大;(2)肾脏和主动脉CD54、CD106免疫组化显示甘糖酯能降低其表达并减轻组织病理变化,且与剂量有关.(3)甘糖酯有降低血糖的作用,并与剂量有关(高剂量组BG治疗前=20.93土4.22mmol@L-1,BG治疗后=15.76±2.39mmol@L-1,P＜0.05;低剂量组BG治疗前=17.35±1.13mm0l@L-1,BG治疗后=13.52±6.24mmol@L-1,P＞0.05).结论糖尿病粘附分子的增加可能是糖尿病肾病和大血管病变的重要发病因素,甘糖酯可降低CD54、CD106对糖尿病并发症有延缓和改善作用.     

藻酸双酯钠注射液细菌内毒素检测

目的:建立藻酸双酯钠注射液的细菌内毒素检查法。方法:参照中国药典2000年版二部细菌内毒素检查法要求进行试验。结果:该药在 0.125g·L~(-1)下无干扰作用。结论:该药采用内毒素检查法进行检查是可行的。     

反相高效液相色谱法测定发酵液中梅岭霉素

目的:建立了发酵液中梅岭霉素的定量测定方法。方法:反相高效液相色谱法,Hypersil-C_(18)柱(4 mm×125mm,5μm),流动相为乙腈-水(78:22),流速1.2mL·min~(-1),检测波长238 nm,室温测定。结果:在1O.2～163.2μg·mL~(-1)范围内梅岭霉素浓度与峰面积呈良好线性关系,r=0.999 7,回归方程为Y=25.44X+2.72。样品的日间 RSD≤1.8％,高中低浓度样品的日内RSD≤2.5％(n=8)。平均回收率为96.9％(n=8,RSD<3.0％)。结论:本方法快速、准确、简便、稳定,为定量分析提供了可靠的依据。