甲磺酸罗比卡因与盐酸罗比卡因用于硬膜外阻滞的效应比较

目的 评价甲磺酸罗比卡因用于硬膜外阻滞的效应和安全性。方法 45例择期行下腹或下肢手术病人,随机分别接受用甲磺酸罗比卡因(8.94 mg/ml,观察组)或盐酸罗比卡因(7.5mg/ml,对照组)施行的硬膜外阻滞。观察两组在感觉阻滞、运动阻滞、镇痛和肌肉松弛方面的效果,同时观察用药前后肝肾功能变化。结果 观察组和对照组感觉阻滞平面达到T6以上的病例分别为84.3％和76％(P>0.05),Bromage≥3级的病例分别90％和92％(P>0.05)。两组感觉阻滞平面固定时间、Bromage达到最大级别时间、最大级别维持时间和运动阻滞维持时间均无显著性差异(P>0.05)。两组镇痛及肌松满意率无显著性差异。观察组术中2例发生低血压,2例发生心动过缓,而对照组仅1例发生低血压。两组术后24 h天冬氨酸氨基转移酶(AST)、天冬氨酸转氨酶(ALT)、尿素氮(BUN)和肌酐(Cr)均在正常范围。结论 甲磺酸罗比卡因与盐酸罗比卡因行硬膜外阻滞的效应基本相同,且无明显毒性。     

Angiopoietin1/Tie2 and VEGF/Flk1 induced by MSC treatment amplifies angiogenesis and vascular stabilization after stroke.

Bone marrow stromal cells (MSCs) increase vascular endothelial growth factor (VEGF) expression and promote angiogenesis after stroke. Angiopoietin-1 (Ang1) and its receptor Tie2 mediate vascular integrity and angiogenesis as does VEGF and its receptors. In this study, we tested whether MSC treatment of stroke increases Ang1/Tie2 expression, and whether Ang1/Tie2 with VEGF/ vascular endothelial growth factor receptor 2 (VEGFR2) (Flk1), in combination, induced by MSCs enhances angiogenesis and vascular integrity. Male Wistar rats were subjected to middle cerebral artery occlusion (MCAo) and treated with or without MSCs. Marrow stromal cell treatment significantly decreased blood-brain barrier (BBB) leakage and increased Ang1, Tie2, and occludin (a tight junction protein) expression in the ischemic border compared with MCAo control. To further test the mechanisms of MSC-induced angiogenesis and vascular stabilization, cocultures of MSCs with mouse brain endothelial cells (MBECs) or astrocytes were performed. Supernatant derived from MSCs cocultured with MBECs significantly increased MBEC expression of Ang1/Tie2 and Flk1 compared with MBEC alone. Marrow stromal cells cocultured with astrocytes also significantly increased astrocyte VEGF and Ang1/Tie2 expression compared with astrocyte culture alone. Conditioned media from MSCs alone, and media from cocultures of MSCs with astrocytes or MBECs, all significantly increased capillary tube-like formation of MBEC compared with control Dulbecco's modified Eagle's medium media. Inhibition of Flk1 and/or Ang1 significantly decreased MSC-induced MBEC tube formation. Knockdown of Tie2 expression in MBECs significantly inhibited MSC-induced tube formation. Our data indicate MSC treatment of stroke promotes angiogenesis and vascular stabilization, which is at least partially mediated by VEGF/Flk1 and Ang1/Tie2.     

The upregulation of glial glutamate transporter-1 participates in the induction of brain ischemic tolerance in rats.

Glial glutamate transporter-1 (GLT-1) plays an essential role in removing glutamate from the extracellular space and maintaining the glutamate below neurotoxic level in the brain. To explore whether GLT-1 plays a role in the acquisition of brain ischemic tolerance (BIT) induced by cerebral ischemic preconditioning (CIP), the present study was undertaken to observe in vivo changes in the expression of GLT-1 and glial fibrillary acidic protein (GFAP) in the CA1 hippocampus during the induction of BIT, and the effect of dihydrokainate (DHK), an inhibitor of GLT-1, on the acquisition of BIT in rats. Immunohistochemistry for GFAP showed that the processes of astrocytes were prolonged after a CIP 2 days before the lethal ischemic insult, which could protect pyramidal neurons in the CA1 hippocampus against delayed neuronal death induced normally by lethal ischemic insult. The prolonged processes extended into the area between the pyramidal neurons and tightly surrounded them. These changes made the pyramidal layer look like a 'shape grid'. Simultaneously, the prolonged and extended processes showed a great deal of GLT-1. Western blotting analysis showed significant upregulation of GLT-1 expression after the CIP, especially when it was administered 2 days before the subsequent lethal ischemic insult. Neuropathological evaluation by thionin staining showed that DHK dose-dependently blocked the protective role of CIP against delayed neuronal death induced normally by lethal brain ischemia. It might be concluded that the surrounding of pyramidal neurons by astrocytes and upregulation of GLT-1 induced by CIP played an important role in the acquisition of the BIT induced by CIP.     

老年人与青年人皮肤血流量比较研究

目的 判定增龄对皮肤血流量的影响。方法 用PIM2-LDPI检测皮肤血流量。结果 老年组前额、左手指背、命门穴部位皮肤血流量分别为:(1.94±0.86)V,(1.92±0.52)V和(0.71±0.19)V,与青年组比较差异无显著性。但是,老年男性在命门穴的皮肤血流量明显高于青年男性(P<0.05),老年女性前额的皮肤血流量明显降低(P<0.01)。男性比女性的皮肤血流量高。结论 皮肤血流量的差异无年龄相关性,男性组的皮肤血流量比女性组高。     

Association of the expressions of platelet-derived growth factor receptor and c-Fos with the biological characteristics of bladder cancer.

OBJECTIVE: To elucidate the relation of platelet-derived growth factor receptor (PDGFR) and c-Fos protein expressions with human bladder transitional epithelial cell carcinoma (BTCC). METHODS: The expressions of PDGFR and c-Fos were investigated in 11 normal bladder tissue samples, 14 adjacent non-carcinoma tissues and 43 BTCC tissues by means of SP immunohistochemical technique. RESULTS: The c-Fos expression was found in the cell nuclei and cytoplasm, and PDGFR in the nuclear membrane, cytoplasm, and cellular membrane. PDGFR and c-Fos were detected in 81.40% and 48.83% of the BTCC tissues respectively, at the rates both significantly higher than those in normal and adjacent non-carcinoma tissues (P<0.05). Correlation between the expression of c-Fos and the tumor grading was noted (P<0.05). The expressions of PDGFR and c-Fos in tumor blood vessels were significantly higher than those in normal vessels. CONCLUSIONS: The expressions of PDGFR and c-Fos might be involved in the development of BTCC, possibly related to the angiogenesis of the tumors. c-Fos expression can indicated the cell proliferative status of the BTCC.     

腹腔注射高渗盐水对下丘脑室旁核加压素能神经元的兴奋作用

目的探讨外周高渗刺激激活下丘脑室旁核(PVN)神经元的细胞类别。方法以腹腔注射高渗盐水作为外周高渗刺激。细胞外记录PVN神经元单位放电的变化，并用免疫细胞化学方法观察PVN中los的表达及los表达阳性神经元的性质。结果腹腔注射高渗盐水使PVN的位相型放电神经元兴奋，PVN内los表达明显增加，特别是PVN大细胞中大量的los阳性神经元同时表达精氨酸加压索(AVP)。结论外周高渗刺激能够激活PVN内的加压索(VP)能神经元。     

诱导型一氧化氮合酶在前列腺增生组织中表达的研究

目的：探讨诱导型一氧化氮合酶(iNOS)与前列腺增生(BPH)病理生理变化的关系。方法:用免疫组化法检测10例正常和30例有膀胱出口梗阻的BPH患者膀胱和前列腺组织中iNOS的表达。结果：BPH组前列腺组织中iNOS呈阳性染色，主要分布于前列腺的上皮细胞及上皮下组织中，间质平滑肌组织中均为阴性；对照组的膀胱壁、膀胱颈部和前列腺组织中均无iNOS阳性染色。结论：iNOS仅在BPH患者前列腺组织中有特异性表达，提示它参与了前列腺增生的病理生理过程。     

Ureteral obstruction caused by L-asparaginase-induced pancreatitis in a child with acute lymphoblastic leukemia.

L-asparaginase, an effective antileukemia and antilymphoma agent, is toxic to many organ systems. We report a case of ureteral obstruction caused by L-asparaginase via the inflammatory complication of acute pancreatitis. The patient was an 11-year-old boy with acute lymphoblastic leukemia. Six days after completing a 4-week induction therapy containing 9 doses of L-asparaginase, severe left abdominal pain developed. Abdominal computed tomography showed phlegmon formation anterior to the pancreatic head and in the left posterior pararenal space. The strands of inflammatory soft tissues encased the upper third of the left ureter, causing left hydroureter and left hydronephrosis. The ureteral obstruction resolved after insertion of a double-J catheter that remained in place for 66 days. This case suggests that L-asparaginase may play a role in the pathogenesis of ureteral obstruction in children receiving chemotherapy.     

The application of vitrification in human blastocyst cryopreservation: Analysis of clinical outcome of 117 cycles

Objective: To summarize the clinical outcomes of 117 human vitrified blastocyst transfer cycles and to determine the impact factors.Methods: In IVF-ET cycles, supernumerary embryos were cultured to 5-Day(D5) or 6-Day(D6), blastocysts of various stages were cryopreserved by vitrification using cryoloops. Survival rate and clinical pregnancy rate were observed.Results: A total of 312 blastocysts were thawed in 117 frozen embryo transfer cycles, the survival rate was 90.7% (283/312) after thawing. After the transfer of 230 blastocysts in 115 cycles, 69.6% (80/115) of the women got clinically pregnant, and 17.5% (14/80) of them suffered from miscarriage, 39 healthy babies were born in 28 deliveries, and the other 38 pregnancies are ongoing. The implantation rate was 47.4% (109/230). In 107 transfer cycles with 2 hatched blastocysts transferred in each cycle, 72.9% (78/107) got clinically pregnant, while in 8 cycles with 1 or no hatched blastocysts in the two transferred blastocysts, the clinical pregnancy rate is 25%(2/8). The clinical pregnancy rates were not statistically different between natural (77.4%, 24/31) or artificial endometrium preparation (66.7%, 56/84) cycles. Conclusions: These findings suggest that blastocyst vitrification is effective in terms of implantation rate and pregnancy outcome. Transferring of two hatched blastocyst can achieve a higher pregnancy rate.     

准分子激光角膜切削术治疗近视的并发症

为分析准分子激光角膜切削术（ＰＲＫ）治疗近视的并发症，对１３９例（２５７眼）ＰＲＫ术后随访半年至一年。结果表明：术后一年，低中度和高度组各有１眼最佳矫正视力丢失二行，分别占２．５％和３．３％；低中度和高度组的角膜上皮下１级混浊分别为１０．８１％和１５．１６％，２级混浊分别为２．７３％和０％；激素性高眼压，在发生率最高的３个月时，可分别达２４．３７％和２５．３２％，但这种反应性的眼压升高只是暂时的，容易控制；过矫和散光增加的发生率均较低，主要与术者的经验有关。随着术者经验的提高、手术设计的完善及术后用药的研究，这些并发症会降到最低水平。ＰＲＫ是安全、有效的。