下腹部多个真皮下血管网皮瓣在手外伤修复中的应用

目的：应用下腹部多个真皮下血管网皮瓣修复手外伤，方法：在下腹形成以旋髂浅血管为蒂的髂腰部皮瓣及以腹壁浅血管为蒂的下腹部皮瓣，二皮瓣共蒂形成双叶皮瓣，同时将其修薄，形成有轴心血管的真皮下血管网皮瓣，修复两指完全脱套伤。在下腹部形成多个真皮下血管网的任意皮瓣，修复多个指背皮肤缺损伴有肌腱及骨外露的创面。供区如不能直接拉拢缝合，可取断层皮片修复供区创面.结果：本组10例中，8例采用下腹部双叶真皮下血管网轴型皮瓣修复，2例采用下腹部真皮下血管网任意皮瓣修复，术后效果。结论：采用多个真皮下血管网皮瓣修复手外伤的创面，伤指不需并指，去脂，分指，术后外形佳，是目前较理想的修复手外伤的手术方法。     

铍针治疗颈肩部皮神经卡压综合征

目的：探讨皮神经卡压综合征的发病机制和铍针的治疗机制。方法：采用铍针治疗78例颈肩部皮神经卡压综合征的患者，枕大皮神经卡压综合征18例，枕小皮神经卡压综合征5例，肩胛上皮神经卡压综合征27例，颈横皮神经卡压综合征4例．锁骨上皮神经卡压综合征24例。其中男35例，女43例；年龄19～63岁，平均39．8岁。根据治疗前后患者颈肩部疼痛的改变判定疗效。结果：临床痊愈54例；显效16例；有效8例。结论：通过铍针对皮下组织、筋膜和肌肉的切割，使筋膜表面张力降低，松解粘连，消除瘢痕，消除感觉神经末梢所受的刺激和压迫，缓解疼痛。     

促红细胞生成素对海马CA1区缺血神经元凋亡和bcl-xl表达的影响

目的 :探讨促红细胞生成素 (Erythropoietin ,EPO)预处理的神经保护机制。方法 :采用 4-VO法制作大鼠全脑缺血模型。将SD大鼠随机分为假手术组、生理盐水组、EPO组。全脑缺血前 3h ,EPO组大鼠脑室立体定向注射重组人促红细胞生成素(rHu -EPO) 5μl,生理盐水组则给予等体积生理盐水 ,假手术组只进行假手术处理。观察缺血后 2 4h海马CA1区bcl -xl蛋白表达和缺血后 72h细胞凋亡。结果 :缺血后 2 4h ,EPO组海马CA1区bcl -xl蛋白表达与假手术组比较有显著差异 (P <0 .0 1) ,较生理盐水组表达增强 (P <0 .0 1)。缺血后 72h ,EPO组海马CA1区较生理盐水组有较少的凋亡细胞 (P <0 .0 1)。结论 :EPO预处理减少缺血海马细胞凋亡 ,促进bcl -xl蛋白表达可能参与了这种保护机制     

Internal and external information processing by lateral hypothalamic glucose-sensitive and insensitive neurons during bar press feeding in the monkey

Single neuron activities in the lateral hypothalamic area (LHA) were recorded during bar press feeding task in the monkey. First registered neurons were sorted into 2 groups, glucose-sensitive (GS) and glucose-insensitive (GIS) neurons, depending on their glucose sensitivity. Then firing variations to feeding, electrophoretically applied catecholamines and opiate, and to odor and taste stimuli were investigated. GS neurons responded to dopamine, noradrenaline and morphine more often than GIS neurons. In feeding task GS neurons responded during bar press (BP) and reward (RW) periods with long-lasting inhibition of firing and at cue tone (CT) with transient inhibition, while GIS neurons responded during BP and RW periods mainly with excitation and at cue light (CL) with excitation. A majority of GS neurons responded to both odor and taste stimuli more often than GIS neurons. Data suggest that these two kinds of neurons in the LHA may be involved in different functional aspects of feeding: GS neurons, mainly in internal information processing and reward mechanism, and GIS neurons, in external information processing and motor aspects.     

老年患者不同靶浓度罗库溴铵肌松效应的比较

目的比较老年患者不同靶浓度罗库溴铵的肌松效应。方法择期全麻老年患者100例,ASAⅡ级,随机分为4组(n=25),A组、B组和C组麻醉诱导气管插管时效应室靶浓度(Ce)为3μg/ ml,术中维持Ce分别为0.6、0.8、1.0μg/ml;D组麻醉诱导气管插管时Ce为3.3μg/ml,术中维持Ce为0_8μg/ml。记录肌松起效时间、恢复时间和恢复指数。评价气管插管条件和术中肌松程度。记录手术及TCI时间、罗库溴铵总用药量和期间用药量[总用药量,(体重×TCI时间)]。结果4组均可顺利完成气管插管,D组起效时间较A组、B组和C组缩短(P<0.05);A组肌松满意率低,B组、C组和D组均可维持满意肌松,但C组罗库溴铵用量较多,术中肌松程度较大,术后恢复时间较长(P<0.05)。结论麻醉诱导气管插管时罗库溴铵Ce为3.3μg/ml、术中麻醉维持Ce为0.8μg/ml,可产生满意的肌松条件,且有利于术后肌松恢复,是一种适用于老年患者合理的TCI给药方案。     

Anatomic and spiral computed tomographic study of the genial tubercles for genioglossus advancement.

OBJECTIVE: To measure and compare Chinese mandibular genial tubercles measured anatomically and with computed tomography (CT). STUDY DESIGN AND SETTING: Spiral CT scans were taken of 40 adult human skulls; the superior genial spines were measured using anatomic and CT methods. RESULTS: The height and width of the superior genial spines, mandible thickness, and distance from the menton to the inferior and superior margins of the superior genial spines were 5.82 +/- 0.71, 6.98 +/- 1.35, 11.95 +/- 1.59, 11.08 +/- 2.05, and 16.91 +/- 2.30 mm from anatomic measurements and 6.17 +/- 0.71, 7.01 +/- 1.13, 12.19 +/- 1.64, 10.41 +/- 1.55, and 15.73 +/- 2.12 mm using spiral CT, respectively. The anatomic and CT measurements were correlated. CONCLUSION: Spiral CT of the genial tubercles can help locate the osteotomy in genioglossus advancement. SIGNIFICANCE: This study acquired reference data on Chinese genial tubercles demonstrating that CT measurements of the genial tubercles reflect their anatomy, which should allow accurately locate the osteotomy.     

Synthesis and polymerization behavior of 2,3-dihydro-1,4-dioxin-2-one and its 3-methyl derivative

The hitherto unknown 2,3-dihydro-1,4-dioxin-2-one ( 7 ) and its 3-methyl derivative 8 have been synthesized for the first time. The olefinic double bond is inserted into the saturated 1,4-dioxanone precursors 3 and 6a/b by a retro-Diels-Alder reaction in the last step of the synthesis. The 1,4-dioxanone systems of 3 and 6 are prepared by reacting a vicinal dialkoxide with α-halogenated acyl halides, thus forming the ester and the ether bond in a one-pot reaction. Monomers 7 and 8 are polymerized by cationic initiation. The resulting products undergo fragmentation to form oligomers in the presence of protic solvents, indicting that ring-opening polymerization of the δ-lactone apparently leads to polyester chain segments.     

Changes of hepatic and systemic haemodynamics following somatostatin administration in patients with hepatitis B-related cirrhosis

Abstract Somatostatin has been used to effectively control acute variceal haemorrhage, with conjectured mechanisms on portal hypertension. We, therefore, evaluated the effects of somatostatin on hepatic and systemic haemodynamics in 15 patients with hepatitis B-related cirrhosis and portal hypertension. All patients received an intravenous, continuous infusion of somatostatin 250 μg/h, following a bolus injection of 250 μg. In systemic haemodynamics, the mean arterial pressure (MAP) increased ( P < 0.05), associated with a reflex bradycardia within 3 min following bolus injections, compared with basal values. The right atrial pressure, pulmonary capillary wedge pressure, inferior vena cava pressure, cardiac index, and systemic vascular resistance remained unaffected after drug infusion. In hepatic haemodynamics, the wedge hepatic vein pressure remained unchanged after drug administration. However, there was an increase in free hepatic vein pressure (FHVP; P < 0.05), and a trend toward a decrease in the hepatic vein pressure gradient (HVPG; P = 0.063), within 3 min after bolus injection. Furthermore, the hepatic blood flow decreased significantly at 10 and 30 min after somatostatin infusion ( P < 0.05). The effective sinusoidal perfusion assessed by indocyanine green infusion also decreased progressively at 10 min ( P = 0.057) and 30 min ( P < 0.05). We concluded that somatostatin, at the dose used in this study, caused a transient and bolus-related vasoconstrictive effect, resulting in increases in MAP and FHVP, a decrease in heart rate, and a trend toward lower HVPG. In addition, somatostatin reduced the hepatic blood flow and effective sinusoidal perfusion which may be hazardous to cirrhotic patients during variceal haemorrhage.     

“美容牌”染发剂对雄性小鼠生殖细胞非程序DNA合成的诱导

本文应用雄性小鼠生殖细胞非程序DNA合成(UDS)检测方法研究了“美容牌”染发剂对雄性生殖细胞DNA的损伤作用。发现该染发剂诱发的UDS与药物剂量呈线性正相关。提示此类染发剂对雄性生殖细胞DNA有损伤作用。其遗传毒理效应应引起注意。     

玄胡索散通过下调粒细胞集落刺激因子抑制脾脏髓源抑制细胞分化发挥抗乳腺癌作用

目的:探讨玄胡索散抑制乳腺癌小鼠脾脏髓源抑制细胞(MDSC)分化的作用机制。方法:4～5周龄BALB/c雌性小鼠48只,其中6只为正常对照组,其他42只采用小鼠左侧第二对乳腺皮下脂肪垫接种4T1细胞构建乳腺癌荷瘤小鼠模型,分为粒细胞集落刺激因子(G-CSF)对照组、G-CSF敲减组、模型对照组、玄胡索散小剂量组、玄胡索散中剂量组、玄胡索散大剂量组和环磷酰胺组,每组6只。其中G-CSF对照组和G-CSF敲减组分别采用shRNA慢病毒转染联合嘌呤霉素构建相应4T1稳转细胞模型。各组造模48 h后,玄胡索散小剂量组、玄胡索散中剂量组、玄胡索散大剂量组分别按2、4、8 g·kg^-1·d^-1玄胡索散灌胃,每天一次;环磷酰胺组按30 mg/kg腹腔注射环磷酰胺,隔天一次;其他组给予等体积0.5%羟甲基纤维素纳。各组连续给药25 d。苏木精-伊红染色观察脾脏组织病理学改变,流式细胞术测定脾脏MDSC亚群比例,免疫荧光法检测脾脏CD11b、Ly6G共表达,酶联免疫吸附测定外周血G-CSF浓度。在体外,建立荷瘤小鼠脾脏与4T1稳转株共培养体系,玄胡索散(30μ...