腮腺外面神经颊支的应用解剖研究

目的:观测面神经颊支出腮腺后的各级分支,为相关外科手术提供解剖学依据。方法:10例(20侧)防腐人头标本,描述面神经颊支出腮腺后的走行、定位及层次。结果:面神经颊支出腮腺后分为2～4支,均走行在SMAS筋膜下;颊Ⅰ、颊Ⅱ恒定出现,其一级分支距腮腺导管分别为(1.1±0.5)cm及(0.5±0.3)cm,且分别向前走行(1.3±0.9)cm及(1.8±0.5)cm后发出二级分支。结论:面神经颊支较为恒定,在面瘫治疗中健侧面神经颊支的二级分支可以作为受体神经,可不损伤面神经颊支主干。面神经颊支的分布及走行也可指导除皱术、扩张器植入、瘢痕切除等手术的剥离范围,不致产生并发症。     

重度烧伤患者休克期血浆B型钠尿肽含量变化及意义

Objective To study the plasma content of B-type natriuretic peptide (BNP) in patients with severe burn during shock stage and probe its clinical significance. Methods Forty-two patients aged 18-60 years, with total burn surface area ≥30%TBSA or full-thickness burn area ≥10% TBSA, hospital-ized within 4 hours after burn, were divided into A group (with total burn surface area 30% -50% TBSA or full-thickness burn area 10% -20% TBSA, n = 21 ), and B group (with total burn surface area 50% TB-SA or full-thickness burn area > 20% TBSA, n = 21 ). Twenty patients admitted during the same time for plastic surgery were enrolled as control group. The plasma levels of BNP, creatine kinase (CK), CK-MB, troponin I (Tnl) of all patients were determined on admission. The levels of BNP, Tnl and fluid resuscita-tion volume were examined at 8, 16, 24, 48 post burn hour (PBH) in A and B groups. Analysis of correla-tion between BNP and fluid resuscitation volume was performed. Results On admission: BNP level in A group (68±19 ng/L) and B group (99±38 ng/L) , respectively, was increased as compared with that in control group (17±7 ng/L, P <0.01 ). Tnl level in A group (2.13±0.67 μg/L) and B group (2.98± 0.58μg/L), respectively, was increased as compared with that in control group (0.12 ± 0.03 μg/L, P < 0.01). There was no obvious difference in CK, CK-MB levels among A, B, and control groups ( P > 0.05). BNP levels in A, B groups continuously rose during 8 - 48 PBH, and they were positively correlated with fluid resuscitation volume. TnI level peaked at 24 PBH, and decreased at 48 PBH. Conclusions The plasma level of BNP is sensitive to reflect changes in myocardial ischemia and hypoxia as a rise in level of TnI in shock stage of severe burn, and it was positively correlated with fluid resuscitation volume. BNP can be used to guide fluid resuscitation during shock stage.     

Loss of cables, a novel gene on chromosome 18q, in ovarian cancer.

Cables, a cyclin-dependent kinase (cdk) interacting protein, has recently been identified and mapped to human chromosome 18q11. Cables appears to be primarily involved in cell cycle regulation and cell proliferation. Overexpression of Cables in Hela and other cell lines inhibits cell proliferation and tumor formation. We hypothesize that loss of Cables expression is associated with ovarian cancer. To test our hypothesis, we examined Cables expression in the four most common subtypes of ovarian carcinomas: serous, endometrioid, mucinous, and clear cell. In addition, mucinous and serous borderline tumors were also included. Loss of Cables expression was observed at high frequency in ovarian serous (11 of 14 cases, 79%) and endometrioid (5 of 10 cases, 50%) carcinomas. In contrast, strong Cables staining was detected in all clear cell carcinomas (10 cases) and mucinous tumors (5 carcinomas and 5 borderline tumors). The majority of serous borderline tumors (11 of 14 cases, 79%) showed positive Cables staining, with the rest showing focal loss of Cables expression. Furthermore, RT-PCR revealed the lack of Cables mRNA in a human ovarian cancer xenograft. No correlation was noted between loss of Cables and histologic grade, tumor stage, and survival. In conclusion, our results indicate that loss of Cables is common in ovarian serous and endometrioid carcinomas and imply that Cables may be involved in the pathogenesis of these two types of ovarian carcinomas.     

Chronic Kidney Isograft and Allograft Rejection

In this study antigen-independent factor in the pathogenesis of chronic rejection of organ transplants was examined.Kidney isografts and allografts were transplanted orthotopically into bilaterally nephroectomized rat recipients and studied functionaaly,morphologically and immunohistologically,at serial intervals up to 52 weeks after transplantation.Allograft recipients developed progressive proteinuria after 12 weeks,with gradual renal failure ultimately leading to death.At the same time,morphological changes,including progressive arteriosclerosis and glomerulosclerosis ,tubular atrophy and interstitial fibrosis,developed.Immunohistologically,macrophages infiltrated glomeruli during this period and cytokines became unregulated.Our results showed that antigen-independent functional and morphological changes occurred in long-tern kidney isografts and mimicked those appearing much earlier in allografts that reject chronically.Initial injury and extent of functioning renal mass is suggested to be important factor for such late changes.     

无创正压通气不同压力支持水平对正常人呼吸做功的影响

目的 :观察无创正压通气 (NIPPV)不同压力水平对正常人呼吸做功的影响 ,为临床合理地应用NIPPV提供理论依据。方法 :选择 9例正常人行NIPPV并寻找出“最舒适”的吸气压力水平 (IPAP) ,在此压力基础上增加或减少 2 5 %的压力 ,构成低IPAP、最舒适IPAP和高IPAP三个压力水平 ,每一IPAP水平通气 15min以上 ,比较不同压力水平呼吸做功改变。结果 :受试者认为“最舒适”的IPAP为 (11.33± 3.2 0 )cmH2 O ,EPAP为 (4 .5 6± 0 .88)cmH2 O[相当于PSV水平为 (6 .77± 3.2 0 )cmH2 O]。与自主呼吸相比 ,NIPPV增加VE的同时 ,总的呼吸做功(Wtot)明显增加 (P <0 .0 5 ) ,而受试者吸气肌做功占总的吸气做功的百分比 (Wi,p/Wi)明显减少 (P <0 .0 5 )。在最舒适IPAP时 ,Wi,p/Wi降低到基础值的 14 %± 9%。这种变化趋势与IPAP的水平相关。结论 :NIPPV可以显著降低吸气肌肉做功。吸气肌做功减少的比例与IPAP的水平相关。研究的结果为NIPPV时PSV的参数设定提供了生理学的依据。     

Breast Volume Measurement in Young Chinese Women and Clinical Applications

The authors carried out research on breast volume and body surface anatomy of 125 women. As a result, an average breast volume for Chinese women was obtained (325.36 ± 12.66 ml), and a table with several linear equations for calculating breast volume was derived. The authors applied these results to their clinical work and succeeded in making mammaplasty more precise in 178 patients.     

城市一般人群艾滋病相关知识、态度及其影响因素调查

目的 了解城市一般人群对艾滋病知识的认识、态度情况。以确定城市一般人群艾滋病知识水平及其影响因素，为今后在一般人群中采取针对性的艾滋病知识宣传策略提供依据。方法 于2002年12月1日在广州市商业区采用街头随机拦截的方式，对一般人群采用匿名自填问卷的方法调查其艾滋病相关知识和态度。结果 本次调查共发放问卷200份，收回有效问卷147份。结果显示，艾滋病知识总知晓率为63．3％；传播途径知识总知晓率为59．2％；预防知识知晓率为46．9％；对艾滋病感染／患正确态度率为49．7％。多因素Logistic回归分析显示，艾滋病知识知晓率的影响因素为年龄、性别、化程度和婚姻状况。30～39岁年龄组(OR=0．101，95％CI：0．015～0．678)和40岁及以上年龄组(OR=0．060，95％CI：0．007～0．498)艾滋病知识总知晓率低于15～20岁年龄组；女性艾滋病知识知晓率(OR=0．230，95％CI：0．099～0．532)低于男性；化程度初中(OR=14．161。95％CI：2．195～91．364)、高中(OR=23．455，95％CI：4．568～120．434)、大专以上(OR=35．378,95％CI:6．001～208．571)艾滋病知识知晓率高于小学及以下组；已婚(OR=5．761，95％CI：1．589～20．893)高于未婚。结论 目前城市一般人群的艾滋病知识水平仍然很低，因此应进一步加强对一般人群的艾滋病知识的宣传，尤其是针对化程度低、未婚及女性人群开展艾滋病知识的宣传教育。     

蝮蛇抗栓酶-3治疗糖尿病并发症94例

应用腹蛇抗栓酶-3治疗94例糖尿病患者并发的脑血栓形成、高脂血症、动脉硬化、神经病变和心绞痛取得较好的疗效。脑血栓形成急性期采用冲击疗法,瘫痪肢体功能恢复迅速、合并神经病变者,治疗后症状消失、神经功能改善。TG、TC、β-脂蛋白水平和TC/HDL比值均降低(P<0.01),HDL水平上升(P<0.01),对比治疗前后血6-Keto-PGF_(1α)、TXB_2和纤维结合素FN的水平改善,具有统计学意义(P<0.01)。     

杏仁内侧核微量注射AVP和AVPMcAb对兔ET性发热效应的影响

在杏仁内侧核微量注射精氨酸加压素（ＡＶＰ）和精氨酸加压素单克隆抗体（ＡＶＰＭｃ－Ａｂ），观察其对兔内毒素（ＥＴ）性发热效应的影响。结果表明，杏仁内侧核微量注射ＡＶＰ能明显抑制兔ＥＴ性发热效应，注射ＡＶＰＭｃＡｂ则能明显提高兔ＥＴ性发热效应；而将ＡＶＰ和ＡＶＰＭＣＡｂ注射到杏仁外侧核则对兔ＥＴ性发热效应无明显影响。提示：杏仁内侧核也是ＡＶＰ抗热作用的一个重要作用部位。     

大肠癌组织p53基因突变及其与临床病理关系的探讨

应用非同位素标记ＰＣＲ－ＳＳＣＰ技术对３４例大肠癌组织ｐ５３基因第五外显子突变进行了检测。结果：５０％（１１／２２）结肠癌，８．３％（１／１２）直肠癌存在ｐ５３基因突变，低分化腺癌高于高、中分化腺癌（Ｐ＜０．０５），ＤｕｋｅｓＢ、Ｃ期高于ＤｕｋｅｓＡ期（Ｐ＜０．０５），ｐ５３基因第五外显子突变在已发生淋巴转移的大肠癌组织中呈现较强的趋势。提示：检测结肠癌原发灶ｐ５３基因第五外显子突变，对指导结肠癌的诊断、治疗及预后判断具有一定意义