介入手术治疗异位妊娠12例临床分析

目的：探索一种治疗输卵管妊娠的微创介入手术，解决因其腹腔出血不能接受保守治疗或保守治疗失败的难题。保持输卵管完整及通畅，满足有生育需求的患。方法：对12例输卵管妊娠妇女行对侧股动脉穿刺，将导管超选择插至子宫动脉以甲氨喋呤(MTX)进行灌注及明胶海绵栓塞术。结果：本组病例中，术后10dB超复查孕囊脱落、吸收消失，栓塞后盆腔活动性出血停止。结论：介入治疗宫外孕输卵管妊娠，能有效杀灭胚胎组织，栓塞破裂血管止血效果明显，且能保持输卵管通畅。     

Effect on peripheral nerve vivo with human insulin-like regeneration by transgene in growth factor-1

BACKGROUND: Human insulin-like growth factor (hIGF-1) has been successful in treating peripheral nerve injury, but it is still unclear whether hIGF-1 after transgene in vivo has the effect on promoting the regeneration of peripheral nerve. OBJECTIVE: To observe the effect of hIGF-1 on the regeneration of peripheral nerve by transgene in vivo with electrophysiology, histological morphology and ultromicro morphology. DESIGN: A univariate design. SETTINGS: Jilin Institute of Surgery, China-Japan Friendship Hospital Affiliated to Jilin University; School of Basic Medical Sciences, Jilin University. MATERIALS: Thirty male adult Wistar rats of grade Ⅱ, weighing 200-250 g, were provided by the Animal Experimental Center of Jilin University [certification number: SCXK-(Ji)20030001]. The rats were raised in the environment at the temperature of 25 ℃ and humidity of 70%. All the rats were randomly divided into hIGF-1-treated group, treatment control group and blank control group, 10 rats in each group. Positive liposomes (mass concentration of 2 g/L) and pcDNA3.1 (mass concentration of 1 g/L) were purchased from Beijing Yuanpinghao Company; pcDNAhIGF-1 (mass concentration of 1 g/L) was provided by Dr. Shen from the School of Public Health of Jilin University. The liposomes were mixed with plasmids with the mass ratio of 1.5 to 10.Operative microscope was made by Jiangsu Zhenjiang Microsurgical Instrument Factory; EMB-5304K electromyogram (EMG) evoked potential meter by Nihon Kohden Corporation. HPIAS-1 000 high-acuity color pathological imaging analytical system (Japan) and JEM-1200EX transmission electron microscope (Japan) were also used. METHODS: The experiments were carried out in Jilin Institute of Surgery from April to June in 2004. ① All the rats were anesthetized, and the right sciatic nerve was exposed, and it was clipped with a clip at 5 mm below the piriform muscle for 3 times, 10 s for each time. The pressed width was 3 mm, and formed as membrane under operating microscope (×6). Rats in the hIGF-1-treated group were subepineurially injected with the mixture of pcDNAhIGF-1 and positive liposomes (10 μL) immediately, those in the treatment control group were injected with the mixture of pcDNA3.1, positive liposomes and distilled water (10 μL), and those in the blank control group were not given any injection. ② The sciatic nerve functional indexes (SFI) were measured within 56 days postoperatively according to the methods used by Shen et al. ISFI=0 was taken as normal, and ISFI=-100 as completely damaged. EMG evoked potential meter was used to record the electrophysiological changes of the regenerated nerve fibers. The indexes of histological morphology in 5 randomly selected sights were determined with the color pathological imaging analytical system, and the ultrostructures of the regenerated nerve fibers were also observed. MAIN OUTCOME MEASURES: ① Comparison of the SFI within 56 days postoperatively; ② Comparison of the electrophysiology, histological morphology and ultrastructure of the regenerated nerve fibers 56 days postoperatively. RESULTS: All the 30 Wistar rats were involved in the analysis of results. ① SFI: The SFI values were gradually increased as time prolonged in all the three groups, and the changes were more obvious after 24 days, the SFI values recovered better at each time point in the hIGF-1-treated group than in the other two groups. ② Eelectrophysiological results of right sciatic nerve: The latency of motor evoked potential (MEP) was close between the treatment control group and the blank control group [(2.55±0.36), (2.65±0.55) ms, P > 0.05], but higher in the hIGF-1-treated group [(2.14±0.22) ms] than in the blank control group (P < 0.01). The amplitude and conduction velocity of MEP in the treatment control group [(6.67±0.69) mV, (29.57±4.06) m/s] were close to those in the blank control group [(6.60±0.59) mV, (29.22±3.20) m/s, P > 0.05], but those in the hIGF-1-treated group [(7.81±0.84) mV, (36.91±4.37) m/s] were larger or faster than those in the blank control group (P < 0.01). ③ Results of the pathological image analysis of the regenerated nerve fibers: The axonal diameter, thickness of myelin sheath of the regenerated nerve fiber and the number of myelinated nerve fiber in the treatment control group [(2.28±0.33) μm, (1.08±0.18) μm2, (71.80±8.25) fibers] were close to those in the blank control group [(2.18±0.29) μm, (1.03±0.15) μm2, (68.60±8.55) fibers] (P > 0.05), and those in the hIGF-1-treated group [(3.03±0.35) μm, (1.65±0.24) μm2, (88.20±8.82) fibers] were obviously larger or more than those in the blank control group (P < 0.01). ④ Ultrastructure of the regenerated nerve fibers of sciatic nerve: In the hIGF-1-treated group, the regenerated fibers of sciatic nerve were more and mature, manifested by thicker nerve fibers, thicker and evener myelin sheath, which were better than those in the other two groups. CONCLUSION: The results of the quantitative parameters of the electrophysiology, gross histological morphology and ultrostructural changes in the process of repairing damaged peripheral nerve indicate that transgene in vivo with hIGF-1 can promote the neural regeneration after peripheral nerve injury.     

Electron microscopical demonstration of horseradish peroxidase by use of tetramethylbenzidine as chromogen and sodium tungstate as stabilizer (TMB-ST method): a tracing method with high sensitivity and well preserved ultrastructural tissue.

Until now methods using tetramethylbenzidine (TMB) for electron microscopy (TMB-EM methods) are all unable to provide a maximum demonstration of transported horseradish peroxidase (HRP) while maintaining good ultrastructural tissue preservation. In order to solve this problem, we have attempted to adapt a newly developed, highly sensitive TMB method using sodium tungstate (ST) as the stabilizer (TMB-ST method) for HRP electron microscopic retrograde and anterograde fiber tracing. The present study shows that the TMB-ST method combined with diaminobenzidine-cobalt (DAB-Co) is more sensitive than existing TMB-EM methods and that ultrastructural details are well preserved with this combined method. The resultant reaction product complex after osmication is stable and is observed as characteristic crystal-like structures which are extremely electron dense and often aggregated into clumps. In contrast, the TMB-ST method without the DAB-Co step frequently produces a moderate electron-dense reaction product. Therefore, we recommend the TMB-ST method combined with DAB-Co for HRP electron microscopy.     

Hemangioma of the adrenal gland. Apropos of a case

A case of adrenal hemangioma is reported, displayed by computed tomography and confirmed by pathologic investigation. This rare tumor poses a difficult diagnostic challenge and rejoins the problem of incidentally discovered adrenal masses.     

抗蝮蛇毒磷酸二酯酶单克隆抗体的制备及鉴定

从蝮蛇毒中提取磷酸二酯酶,用此酶免疫BALB/c小鼠,取其脾细胞与小鼠骨髓瘤细胞Fo融合,以间接ELISA检测杂交瘤细胞培养上清液和小鼠腹水中的特异性抗体,其效价分别为1∶128和1∶51 200.抗原阻断试验结果表明,此抗体对蛇毒磷酸二酯酶具有特异性.该杂交瘤细胞株定为G_8,该株单抗属鼠IgG_(2a)亚型,经体外持续培养6个月,其分泌抗体性能稳定.     

Current usage of nonionic contrast

All physicians who had billed Pennsylvania Blue Shield for at least three intravenous contrast studies during 1989 were surveyed on their use of nonionic versus ionic contrast. This surveyed group represents a diversity of hospital sizes, practice types, and group sizes. Of the 383 physician groups surveyed, responses were obtained from 285. The majority of the responding groups were radiologists (94.0%). Nonionic contrast is utilized in 41.3% of all intravenous studies. Radiologists use nonionic contrast in a much greater proportion than nonradiologists (P < 0.0001), with 17.6% of radiologists utilizing nonionic contrast in all of their patients. Conversely, 75% of nonradiologists utilize ionic contrast in all of their patients. For all physician groups surveyed, 40.3% utilize nonionic for at least 50%, while 27.6% use nonionics for more than 75% of their patients. The routine use of steroid premedication prior to the injection of ionic contrast is not a common practice. The increased utilization of nonionic contrast found in this survey may reflect the cross-section of physicians and practice types surveyed or may represent changing practice patterns among physicians utilizing contrast material.     

A second look at second-order belief attribution in autism

Compared the performance of autistic and mentally retarded subjects, all of whom had passed a standard first-order test of false belief, on a new second-order belief task 12 autistic and 12 mentally retarded subjects, matched on verbal mental age (assessed by PPVT and a sentence comprehension subtest of the CELF) and full-scale IQ were given two trials of a second-order reasoning task which was significantly shorter and less complex than the standard task used in all previous research. The majority of subjects in both groups passed the new task, and were able to give appropriate justifications to their responses. No group differences were found in performance on the control or test questions. Findings are interpreted as evidence for the role of information processing factors rather than conceptual factors in performance on higher order theory of mind tasks.This study was supported by a grant from the National Institute of Deafness and Other Communication Disorders (1RO1 DC 01234). We thank Jason Barker for his extensive help with this study. We are also very grateful to the schools where the study was conducted including the League School, and the public school systems in the following towns in Massachusetts: Hanover, Hanson, Hingham, Milton, Plymouth, and Rockland. We offer special thanks to Alan Dewey, Mary Dollar, Sandy D'Giacomo, Herman Fishbein, William Griffin, Nancy Kearns, Judy Monahan, Debbie Newhall, Cay Riley, Robert Sherman, and Kathy Staska for their continued support of our research.     

Ebstein畸形82例心血管造影分析

报道我院1958～1992年期间的 Ebstein 畸形82例。平片表现可归纳为球型、方型和不典型4种心脏形态。介绍该畸形的心血管造影方法,所见征象和相应的病理基础。主要造影征象有:1.心脏膈面双切迹征;2.帆样征:3.房化心室:4.三尖瓣闭锁不全。本文结合文献对本病病理,X 线表现进行了系统的讨论,并着重突出了我们的观点。