不同种属脱细胞真皮与自体皮复合移植的比较性研究

目的　观察不同种属脱细胞真皮基质 (acellulardermalmatrix,ADM)与自体皮复合移植的效果 ,为异种ADM的临床应用提供理论依据。　方法　本地产白色小猪 6头 ,分为异种 (人 )ADM +自体刃厚皮组 (A组 )、同种异体 (猪 )ADM +自体刃厚皮组 (B组 )、单纯自体刃厚皮组 (C组 )及单纯自体中厚皮组 (D组 )。观察术后 2、4、8、12、2 4周内移植物存活率 ,以及移植皮片收缩程度、移植区组织学变化等情况。　结果　A、B组移植后皮片外观光滑、有弹性 ;两组均获得了满意的皮片成活率 ,并可迅速诱导成纤维细胞、血管内皮细胞等宿主修复细胞的长入 ;两组移植皮片收缩面积有大于C、D组的趋势 (P <0.0 5);术后 2 4周移植区组织与单纯中厚皮移植组织结构一致。　结论　在观察期内(复合移植后 2 4周 ) ,与自体皮复合移植时 ,同、异种ADM具有相近的生物学作用 ,异种来源的ADM可能具有更广阔的应用前景     

Ⅱ型浮膝损伤术后膝关节功能康复

目的:总结Ⅱ型浮膝损伤患者的治疗方法和手术后膝关节功能康复疗效。方法:回顾分析经治的68例患者,男57例,女11例;年龄17~60岁。68例共74侧肢体的Ⅱ型浮膝损伤-膝关节内骨折病例,其中双侧肢体Ⅱ型浮膝骨折6例。根据患者骨折类型、是否存在开放性损伤、软组织损伤程度分别采用内固定(髓内钉、解剖钢板)和支架外固定方法,术后均采用统一、系统的康复治疗。术后对治疗结果采用Karlstrom和Olerud的浮膝损伤治疗标准进行评价;使用χ2检验对两种固定方法治疗后膝关节功能康复效果差别进行显著性分析。结果:所有病例均得到1~4年的随访,平均24个月。内固定组优良率64.29%,支架外固定组优良率80.43%。内固定组与支架外固定组比较,膝关节活动受限度指标有统计学差异(P<0.05),说明Ⅱ型浮膝损伤应当注重对关节内骨折的复位和减少对膝关节周围软组织的破坏。结论:①早期功能恢复期支架组优于内固定组;②牵引后及术后早期系统的康复治疗有利于膝关节功能恢复和减少并发症;③伸膝功能锻炼应当在牵引治疗后即开始,膝关节屈伸功能锻炼在手术后3d进行。     

影响胃平滑肌肉瘤预后的因素及外科处理

本文分析了５０例经手术治疗的胃平滑肌肉瘤患者的临床病理特点及影响预后的因素，结果发现，胃平滑肌肉瘤的主要临床症状为腹痛和消化道出血。通过ＣＯＸ回归模型参数估计及显著性检验方法证实，本病预后与肿瘤大小、有无浸润邻近器官或转移，以及病理组织学分级明显相关，而与手术类型、切除范围、年龄、性别、局部浸润程度及肿瘤位置无密切关联。广泛的胃切除根治术中加宽无瘤边界以及区域淋巴结清扫并不优于局部切除术。     

预移植在胚胎移植中的意义

目的 :评价预移植在胚胎移植中的作用。　方法 :在超声波引导下胚胎移植 114个周期 ,其中 10 1个周期进行预移植。比较预移植与未预移植周期临床妊娠率和胚胎种植率 ;按预移植与实际胚胎放置深度差值分组 ,并比较两组妊娠率和胚胎种植率。　结果 :预移植周期与未预移植周期临床妊娠率和种植率统计学差异无显著性(5 9.4 1%和 6 1.5 4 % ,35 .81%和 31.4 3% ,P均 >0 .0 5 ) ;按预移植与实际胚胎放置深度差值分组后 ,两组妊娠率和种植率统计学差异也无显著性 (6 1.5 4 %和 5 8.6 7% ,4 0 .79%和 34.0 9% ,P均 >0 .0 5 )。　结论 :在胚胎移植技术中 ,预移植不能准确指引胚胎移植深度     

等密度硬膜下血肿的CT诊断(附47例分析)

本文分析了47例等密度硬膜下血肿的CT表现,观测的各种CT征象,发现(1)bolus增强扫描显示的血肿、血肿膜及表面移位血管;(2)中线结构的特征性偏移;(3)表面脑回聚拢内移;(4)脑灰白质界面内移;(5)侧脑室变形和脑—脑室指数变小,对等密度硬膜下血肿的诊断和鉴别诊断有重要意义。     

Allergic contact dermatitis from grasses

This study attempts to demonstrate the existence of allergic contact dermatitis from grass, and to develop a patch test series to screen patients with grass intolerance. 6 common grass species from lawns and military training areas were collected. Solvent extracts of polar. non-polar and volatile fractions were prepared and used for patch testing in 20 control subjects and 46 patients with a history of grass intolerance. The 20 control had negative responses to patch testing. 5 out of 46 patients had positive patch tests to Axonopus compressus (carpet grass). Ischaenmum muticum (sea-shore centipede grass). Imperata evlindrica (lalang). Panicum maximum (Guinea grass) and Pennisetum purpureum (elephant grass). Reactions to the non-polar fraction for all 5 species were noted. This study demonstrates the existence of allergic contact dermatitis from various common species of grass. In our series, this is seen in 11% of those with a history of grass intolerance.     

五型病毒性肝炎的暴露因素与临床表现的比较

比较急性病毒性肝炎患者感染打危险因素，同时比较五型肝炎的症状和体征。连续收集急性病毒性肝炎患者血清２９３份，用ＥＬＩＳＡ法检测了五型肝炎病毒的病原学指标，并进行了流赞美同学调查。暴露因素：丙肝的肠道外暴露外明显多于甲肝；甲肝和戊肝有较高的“甲肝”患者接触史；乙肝，丙肝和丁肝有高的“乙肝”接触史，与甲肝，戊肝相比差异显著。     

Jugular foramen neuromas: a review of 14 cases

We present 14 patients with jugular foramen neuromas treated in the professorial unit at the National Hospital, Queen Square, in the 20-year period from 1969 to 1989. The growth characteristics and associated symptomatology of these tumors are variable, and often they do not give rise to a typical jugular foramen syndrome, making differentiation from other low cerebellopontine angle tumors difficult and occasionally impossible. One tumor presented mainly in the neck, but the remaining 13 were predominantly intracranial and their anatomical relationships as defined radiologically determined the surgical approach used. Nine tumors were resected using a posterior fossa approach, three required a combined posterior fossa and neck dissection, and one a combined supratentorial and infratentorial craniotomy. The aim of operation was total excision of the tumor, which was achieved in 10 patients; the remaining three all suffered recurrence. There was no operative mortality and little long-term disability.     

多官能度活性橡胶增韧环氧树脂的研究：Ⅲ.三元共混增韧环氧树脂

本文研究了双酚A对多官能度环氧基和羧基聚丙烯酸正丁酯橡胶增韧环氧树脂的影响。结果表明,加入双酚A,拉伸断裂能有大幅度提高,同时不降低弹性模量。这可能是由椽胶提高断裂伸长与双酚A提高屈服应力产生协同效应的结果。对羧基橡胶增韧的三元共混体系,拉伸断裂能随羧基官能度上升而增加。断裂面的形态研究表明,由于羧基橡胶与双酚A的酯化反应,大大减少了羧基橡胶聚集对增韧的不利影响。     

Outcome of frozen embryo replacement cycles following elective cryopreservation of all embryos in women at risk of developing ovarian hyperstimulation syndrome

Aim: Our aim was to compare the outcome in subsequent frozen embryo replacement cycles in four groups of patients who had elective cryopreservation of all their embryos because they were considered to be at increased risk of developing severe ovarian hyperstimulation syndrome. Design: Sixty-two (91%) of 68 IVF cycles (68 patients) in which elective cryopreservation of all embryos was performed were analyzed. All patients continued on the GnRH agonist, buserelin, after oocyte recovery until the onset of vaginal bleeding. Frozen embryo replacement occurred in a hormone replacement cycle that started either on day 3 of the withdrawal bleed (group I;N=15) or after serum estradiol levels had fallen to <100 pmol/L (group II;N=16). The other patients commenced a frozen embryo replacement cycle several months later in either a hormone replacement (group III;N=15) or a natural (group IV;N=16) cycle. Results: Two patients developed severe ovarian hyperstimulation syndrome. There were no significant differences among the four groups regarding demographic variables, the dose of hMG used, and the clinical outcome. There was a higher but not significantly different clinical pregnancy rate in group I (26.7%), compared to group II (12.5%), group III (13.3%), and group IV (18.8%). Conclusions: Several options exist for the timing and protocol used for frozen embryo replacement in patients who had elective cryopreservation for the prevention of ovarian hyperstimulation syndrome, none of which was found to be clearly superior in this observational report.Presented at the 1994 Annual Conference of the American Fertility Society.