胫骨延长术后的功能康复程序初探

胫骨延长术是矫治小儿麻痹后遗症下肢短缩最常见的术式，但如何恢复或改善术后的功能，目前尚无一套系统的程序。本文作者根据自行设计的胫骨延长休后功能康复的临床观察，作较系统地介绍，并就该程序的合理性，进行了讨论与论证。     

Chronic opioid treatment of neuroblastoma X dorsal root ganglion neuron hybrid F11 cells results in elevated GM1 ganglioside and cyclic adenosine monophosphate levels and onset of naloxone-evoked decreases in membrane K+ currents

Prolongation of the action potential duration of dorsal root ganglion (DRG) neurons by low (nM) concentrations of opioids occurs through activation of excitatory opioid receptors that are positively coupled via G_s regulatory protein to adenylate cyclase. Previous results suggested GM1 ganglioside to have an essential role in regulating this excitatory response, but not the inhibitory (APD-shortening) response to higher (μM) opioid concentrations. Furthermore, it was proposed that synthesis of GM1 is upregulated by prolonged activation of excitatory opioid receptor functions. To explore this possibility we have utilized cultures of hybrid F11 cells to carry out closely correlated electrophysiological and biochemical analyses of the effects of chronic opioid treatment on a homogeneous population of clonal cells which express many functions characteristic of DRG neurons. We show that chronic opioid exposure of F11 cells does, in fact, result in elevated levels of GM1 as well as cyclic adenosine monophosphate (AMP), concomitant with the onset of opioid excitatory supersensitivity as manifested by naloxone-evoked decreases in voltage-dependent membrane K⁺ currents. Such elevation of GM1 would be expected to enhance the efficacy of excitatory opioid receptor activation of the G_s/adenylate cyclase/cyclic AMP system, thereby providing a positive feedback mechanism that may account for the remarkable supersensitivity of chronic opioid-treated neurons to the excitatory effects of opioid agonists as well as antagonists. These in vitro findings may provide novel insights into the mechanisms underlying naloxone-precipitated withdrawal syndromes and opioid-induced hyperalgesia after chronic opiatf addiction in vivo. © 1995 Wiley-Liss, Inc.     

CT-guided transcutaneous fine-needle aspiration biopsy. A report of 350 cases.

CT-guided transcutaneous fine-needle aspiration biopsies were done in 350 patients. They involved the abdomen in 226 patients (liver 75, pancreatic and abdominal masses 51, kidney 96, adrenal gland 3, spleen 1), thorax 90, musculoskeletal system 32, and brain 2. The accuracy varied with different locations. The accuracy of liver biopsy was 94%, kidney 95.8%, pancreatic and abdominal masses 88.2%, thorax 90%, and musculoskeletal system 96.5%. The occurrence rate of complications was 2.3%. Pneumothorax occurred in 7 patients having thorax biopsy, and gastric perforation in one patient after abdominal biopsy. The proper selection of fine needles, the method and technique, the influential elements of the accuracy, and the application of CT-guided aspiration biopsy were detailed in this paper.

     

铜绿假单胞菌全细胞脂肪酸气相色谱分析及应用

本研究用计算机控制，可程序升温的毛细管柱气相色谱（ＧＣ）仪分析４８株铜绿假单胞菌标准株和临床株、部分常见假单胞菌、肠杆菌的细胞脂肪酸。结果表明：月桂烯酸（Ｃ１２：１），月桂酸（Ｃ１２：０）、十三碳烯酸（Ｃ１３：１）、十三碳酸（Ｃ１３：０）、肉豆劳动脑酸（Ｃ１４：１）、十七碳稀酸（Ｃ１７：１）、十七碳酸（Ｃ１７：０）、硬脂酸（Ｃ１８：０）和花生四烯酸（Ｃ２０：４）是铜绿包菌有鉴别意义的脂肪酸，组成与     

Identification of cultured male epidermal allografts by detecting Y chromosome DNA fragments in female burn victims

ltiswellknownthattheskinofextensivelyburnedcasesthemselvesisinsufficienttoprovidecoverageforwounds.Thoughallogeneicskincancoverthewoundstemporari1y,itwillberejectedwithin2-3weeks.Thiscanthreatenthepatient'slifeifthereisnoenoughautogenousskintoreplacetherejectedoneontime.GreenetalL1]reportedthattheburnwoundsofpatientswithextensiveburnscouldbetreatedbytransplantingepidermalautograftsafterautologousepidermalcellsmulti-plyforthousandsoftimesinvltrowithinashortperiodoftime-Butittakesatleast2-3weeks…     

脐血LAK细胞生物学特性影响因素的研究

采集２３名产妇的脐带血和８名正常成人的外周血制备ＬＡＫ细胞，随机分为４组，在培养第３，５，７，１４天，分别利用ＭＴＴ法和＾１２５Ｉ－ＵｄＲ释放法对４组ＬＡＫ细胞的增殖力和杀伤活性进行了测定，同时用细胞毒方法测定培养７天的ＬＡＫ细胞的免疫表型。结果发现，在不同培养时间，脐血来源的ＬＡＫ细胞增殖力显著高于成人血ＬＡＫ细胞（Ｐ〈０．０５或Ｐ〈０．０１），成人血清组，脐血血清组，红细胞组ＬＡＫ细胞增殖力有     

第Ⅲ段肝管空肠吻合解除肝门部胆管恶性梗阻

肝门部胆管恶性梗阻的治疗仍然十分困难。若不解除胆道梗阻,病人很快因肝细胞功能衰竭而死亡。由于肿瘤在肝门部侵润性生长,直接经肝门的手术往往不可能实现。1980～1993年间,我们采用第Ⅲ段肝管空肠吻合术姑息治疗28例肝门部胆管恶性梗阻的黄疸病人。24例为肝门部胆管癌,2例为胆囊癌,2例为胃癌肝门部淋巴结转移。术后19例病人恢复顺利;5例发生并发症,4例病人手术后死亡。24例存活病人中,19例黄疸完全消退3月以上,手术有效率为79％。4例黄疸再次出现,2例因胆管炎需要入院治疗。作者认为:第Ⅲ段肝管空肠吻合术能有效解除不能切除的肝门部恶性肿瘤病人的胆道梗阻。     

地尔硫卓联合地高辛治疗心力衰竭并慢性快速房颤分析

目的观察地尔硫卓联合小剂量地高辛对心力衰竭并慢性快速房颤患者血压、心室率和心功能的影响。方法 :心功能Ⅱ～Ⅲ级慢性房颤患者 10 6例 ,随机分为二组 ,对照组 5 0例 ,单用地高辛 ,治疗组 5 6例 ,地尔硫卓与地高辛联用 ,其余治疗二组相同 ,7～ 10d为一疗程 ,观察治疗前后血压、心率、左室射血分数 (LVEF)、心输出量 (CO)。结果 :治疗组较对照组心室率明显下降 ,控制满意 ,血压、LVEF及CO变化二组相似。结论 :地尔硫卓联合小剂量地高辛治疗心衰并慢性快速房颤患者心室率较单用地高辛效果更好 ,且较为安全。     

血管夹对大鼠股动静脉损伤的实验研究

用１００、４５、１５ｇ力的血管夹，夹闭大白鼠股动静脉２０、６０和１２０ｍｉｎ，２４ｈ后观察其通畅情况，并经扫描电镜和光学显微镜观察股动静脉内皮细胞的损伤程度和血管内血栓形成。结果显示：前两种压力的血管夹在对股动脉只产生轻微损伤的情况下，对伴行股静脉可造成内皮细胞脱落，微小血栓形成等病理损伤。随夹闭血管时间的延长，内皮细胞损伤加重，血小板沉积和微血栓增多。血管夹对静脉的损伤和对其通畅率的影响尤应引起注意。     

nm23基因在前列腺癌中的表达与癌转移的关系

应用ＬＳＡＢ免疫组织化学染色方法，研究转移抑制基因ｎｍ２３表达产物二磷酸核苷激酶（ＮＤＰＫ）在前列腺癌中的表达及其意义。结果表明，ＮＤＰＫ／ｎｍ２３在前列腺癌中有较高的表达，阳性率为５００％（２０／４０）。无前列腺癌转移者其阳性率为６６７％（１２／１８），有前列腺癌转移者其阳性率为３６４％（８／２２），两者比较差异有显著性（Ｐ＜００５），并与前列腺癌分化程度和临床分期有显著相关。因此，ｎｍ２３基因可能在前列腺癌形成及转移过程中起不同的调节作用，其表达程度与前列腺癌转移呈负相关，有可能成为评价前列腺癌病人预后的一项新指标。