99TCm-RBC显像在下消化道出血诊断中的应用

目的　研究 99TCm-RBC显像诊断下消化道出血的临床价值。方法　对 2 5例下消化道出血患者行 99TCm-RBC显像 ,并与手术及病理检查结果作比较。结果　99TCm-RBC显像诊断下消化道出血阳性率为 80 .0 %,定位诊断率为 68.0 %,特异性为 85 .0 %。结论99TCm-RBC显像可作为下消化道出血诊断及定位的一种有效方法。     

Foley尿管气囊压迫治疗骶前静脉丛大出血的评价(附6例报告)

目的:评价直肠癌根治术中用Foley尿管气囊压迫治疗骶前静脉丛大出血(MPVP)的临床价值。方法:分析1995~2005年用Foley尿管气囊压迫治疗骶前静脉丛大出血6例的临床资料。结果:6例骶前大出血中全部用Foley尿管气囊压迫控制出血,术中出血量为800~1700mL,Foley尿管于术后4d拔除3例,5d1例,6d2例,均无再出血,会阴切口均一期愈合。结论:Foley尿管气囊压迫治疗骶前静脉丛大出血是一种简单安全有效的治疗方法。     

The CLDN5 locus may be involved in the vulnerability to schizophrenia.

The present study was designed to detect three single nucleotide polymorphisms (SNPs) located on 22q11 that was thought as being of particularly importance for genetic research into schizophrenia. We recruited a total of 176 Chinese family trios of Han descent, consisting of mothers, fathers and affected offspring with schizophrenia for the genetic analysis. The transmission disequilibrium test (TDT) showed that of three SNPs, rs10314 in the 3'-untranslated region of the CLDN5 locus was associated with schizophrenia (chi(2) = 4.75, P = 0.029). The other two SNPs, rs1548359 present in the CDC45L locus centromeric of rs10314 and rs739371 in the 5'-flanking region of the CLDN5 locus, did not show such an association. The global chi-square (chi(2)) test showed that the 3-SNP haplotype system was not associated with schizophrenia although the 1-df test for individual haplotypes showed that the rs1548359(C)-rs10314(G)-rs739371(C) haplotype was excessively non-transmitted (chi(2) = 5.32, P = 0.02). Because the claudin proteins are a major component for barrier-forming tight junctions that could play a crucial role in response to changing natural, physiological and pathological conditions, the CLDN5 association with schizophrenia may be an important clue leading to look into a meeting point of genetic and environmental factors.     

青年性前部视网膜劈裂锯齿缘断离及视网膜脱离

目的：探讨青年性前部视网膜劈裂锯齿缘断离及视网膜脱离的临床特点、治疗及其预后。方法：对青年性前部视网膜劈裂锯齿缘断离合并视网膜脱离患者10例20只眼进行常规检眼镜眼底及Goldmann三面镜联合巩膜压陷检查，根据不同情况进行激光光凝，或巩膜冷凝外加压手术治疗，并随访1～5年。结果：共lO例，年龄17～32岁，8例为双眼患病，病变位于颞下，双侧对称。11眼同时患有前部视网膜劈裂、锯齿缘断离及视网膜脱离，3眼患有前部视网膜劈裂及锯齿缘断离，1眼仅有前部视网膜劈裂，3眼仅有锯齿缘断离其中2眼合并视网膜脱离。13眼合并视网膜脱离者采用巩膜冷凝外加压术，全部一次治愈，5眼行激光封闭锯齿缘断离及劈裂区。随访期间未见视网膜脱离，视力均有不同程度提高。结论：青年性前部视网膜劈裂锯齿缘断离及视网膜脱离有典型的临床特点，尽早发现、适宜治疗，预后良好。     

Effects in cats of inhibition of nitric oxide synthesis on cerebral vasodilation and endothelium-derived relaxing factor from acetylcholine.

BACKGROUND AND PURPOSE: We investigated the chemical identity of the endothelium-derived relaxing factor generated by acetylcholine in cerebral microvessels by studying the effects and mechanism of action of inhibitors of nitric oxide synthesis from arginine on the vasodilation and endothelium-derived relaxing factor production induced by topical application of acetylcholine in cerebral arterioles. METHODS: We determined cerebral arteriolar dilation and endothelium-derived relaxing factor production by bioassay in anesthetized cats equipped with cranial windows during superfusion of 10(-7) M acetylcholine before and after administration of either NG-monomethyl L-arginine or NG-nitro-L-arginine, two inhibitors of nitric oxide synthesis. RESULTS: NG-Nitro-L-arginine abolished the vasodilation from acetylcholine and eliminated the production of endothelium-derived relaxing factor in the bioassay experiments. NG-Monomethyl L-arginine had no effect on the response to acetylcholine in the absence of pretreatment. However, after pretreatment with the detergent sodium dodecyl sulfate to increase cell membrane permeability, the inhibitor had effects identical to those of NG-nitro-L-arginine. L-Arginine reversed the effects of the inhibitors of nitric oxide synthesis. Neither inhibitor affected baseline vascular caliber, nor did they generate a vasoconstrictor agent in the bioassay experiments. The two inhibitors of nitric oxide synthesis did not affect the response to nitroprusside or adenosine, showing that the effect on responses to acetylcholine was specific. Also, the blockade of the response to acetylcholine induced by the inhibitors of nitric oxide synthesis was unaffected by treatment with superoxide dismutase and catalase, showing that the effect was not mediated by oxygen radicals. CONCLUSION: The endothelium-derived relaxing factor generated by acetylcholine in cerebral arterioles of cats is either nitric oxide or a nitric oxide-containing substance. The effect of these inhibitors on the response to acetylcholine is mediated by inhibition of the synthesis of nitric oxide. There is no involvement of radicals, and no vasoconstrictor agent is generated.     

应用自体静脉套和脑细胞生长肽对面神经损伤恢复影响的临床研究

目的研究采用自体静脉管套入吻合口并注入脑细胞生长肽的方法,对面神经损伤后功能恢复的影响.方法吻合神经断端后用自体静脉管套入吻合口并注入脑细胞生长肽.分析肌电图和观察表情肌功能恢复,比较两种方法对损伤的面神经功能恢复的影响.结果自体静脉管套入吻合口并注入脑细胞生长肽的方法,比传统方法表情肌功能恢复时间明显缩短,且一期修复比二期修复功能恢复时间明显缩短,差异具有非常显著性意义(P＜0.01).两种方法修复面神经损伤,表情肌功能恢复后检测面神经传导速度差异无显著性意义(P＞0.05).结论自体静脉管套入吻合口并注入脑细胞生长肽的方法是一种比较有前途的面神经修复方法.     

老年2型糖尿病患者胰岛素抵抗相关指标的检测和意义

目的:探讨老年2型糖尿病胰岛素抵抗(IR)及其相关性,为老年2型糖尿病的合理防治提供临床依据。方法:选择120例老年2型糖尿病患者,按胰岛素敏感指数(HOMA)胰岛素抵抗(HOMA-IR)50百分位点将患者分为两组:胰岛素相对敏感组(HOMA-IR<3.56)和胰岛素相对抵抗组(HOMA-IR≥3.56),比较体重指数(BMI)、腰/臀比(WHR)、血压、血生化学检查等指标。用年龄>40岁,<60岁的2型糖尿病患者做对照组。结果:两组老年患者在年龄、性别、舒张压、空腹血糖、胆固醇、高密度脂蛋白、糖化血红蛋白、HOMA胰岛β细胞功能方面无差异;但BMI、WHR、收缩压、甘油三脂、空腹胰岛素、HOMA-IR差异具有显著性。多线性回归分析后,只有腰/臀比、收缩压、甘油三脂、HOMA-IR存在统计学差异。老年患者与对照组相比,IR发生率明显增加,且两者腰/臀比、收缩压、甘油三脂方面也差异显著。结论:IR与老年2型糖尿病密切相关,是临床防治糖尿病的重要靶点。     

神经导航辅助显微手术治疗脑功能区肿瘤

目的探讨神经导航系统辅助下脑重要功能区肿瘤显微手术的治疗效果和应用价值。方法1999年12月～2002年6月应用StealthStation神经导航系统辅助切除邻近脑重要功能区肿瘤10例,对神经导航系统术中应用的优越性、精确性等进行分析。结果本组平均注册误差为(2.8±0.9)mm,肿瘤和重要解剖功能结构定位准确,肿瘤全切除率77.8%。术后神经功能未受明显影响,无手术并发症及死亡。结论神经导航系统对于切除邻近脑重要功能区肿瘤具有定位准确,动态示踪和实时导航,侵袭性小,安全、可靠等特点,有助于提高肿瘤全切率及降低手术并发症。