应用局部皮瓣修复上睑全层缺损一例报告

目的探讨局部皮瓣修复上睑全层缺损的价值。方法2007年3月,对一例狗咬伤所致的右侧上睑全层缺损进行急诊局部皮瓣修复手术。结果术后随访45d,右侧上睑外形满意,功能良好。结论应用局部皮瓣急诊修复眼睑全层缺损,术后效果满意,可避免Ⅱ期手术和睑缘缝合。     

小脑后下动脉动脉瘤的诊断和治疗

目的探讨小脑后下动脉动脉瘤的临床特征、诊断、鉴别诊断和治疗。方法回顾性分析12例小脑后下动脉瘤的临床表现、影像学特征、手术效果及诊治过程中存在的相关问题。结果12例中有11例因动脉瘤破裂出血而发病,单纯第四脑室出血4例,全脑室系统出血2例,小脑半球出血3例,小脑蚓部伴第四脑室出血1例,侧脑室伴第三脑室出血1例,以后颅窝占位病变表现1例。8例术前行DSA检查明确诊断,4例术中明确诊断。12例均行后颅窝开颅显微手术治疗,其中动脉瘤颈夹闭9例,孤立切除2例,动脉瘤加固术1例,术后2例因脑积水加重行脑室-腹腔分流术。12例中除1例术后留有轻偏瘫外,其余11例恢复良好。结论小脑后下动脉瘤多以第四脑室出血发病,少数以小脑半球或蚓部出血发病,及早治疗效果满意。手术方式应尽量夹闭动脉瘤颈,对于小脑后下动脉末端动脉瘤,可以采用孤立切除术。     

Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities

Objective:To explore the effect of thrombolysis with anticoagulation treatment forearly stage of deep vein thrombosis of lower extremity.Methods:The clinical data of 10 patients at the early stage of deep vein thrombosis(DVT)in the lower extremuites treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively.Results:The thrombolytic effect was significant.After treatment,the deep veins were recanalized without regurgitation in 75.3% of the patients.The total effective rate was 100%.Only three patients had hemorrhagic complication,but none of the patients died.Conclusion:Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.     

一种稳定的急性胰腺炎胰腺外多器官损伤大鼠模型

目的研究一种病理进程平稳的急性胰腺炎胰腺外多器官损伤动物模型.方法应用小剂量中等浓度胆盐、胰管内低压注射的方法,动态观察实验大鼠胰腺、肺、肝脏及肾脏的功能和病理改变.结果这种新的急性坏死性胰腺炎大鼠模型具有胰腺外持续、稳定的肝、肾损伤.结论这种急性坏死性胰腺炎大鼠模型适合于多器官功能损伤的病理机制及治疗学研究.     

Alpha-smooth muscle actin in pathological human disc nucleus pulposus cells in vivo and in vitro

That a contractile actin isoform has been found in cells of other cartilage tissues in healing and disease states prompted this investigation of the presence of alpha-smooth muscle actin (alpha-SMA) in pathological human intervertebral disc tissue. The presence of this isoform has been reported in human intervertebral disc specimens obtained at autopsy from subjects for whom there were no reported symptoms. An objective of this study was to evaluate the cell density and percentage of alpha-SMA-containing cells in pathological nucleus pulposus tissue obtained from lumbar disc surgery from 17 patients. Additionally, explants of nucleus pulposus material were cultured to determine how alpha-SMA expression changed with time in vitro. Seventy-six 5-mm diameter explants (approximately 2 mm thick) pooled from six lumbar surgeries were cultured for 1, 2, 4, or 6 weeks. Microtomed sections of paraffin-embedded specimens were stained with hematoxylin and eosin or a monoclonal antibody to alpha-SMA. Histologically, cells were categorized as to alpha-SMA phenotype (positive or negative), and the areal cell density was determined. The evaluation of the cultured nucleus pulposus explants also included documentation of the percentage of cells that were round or elongated and the percentage of the cells that were part of a group (group: >/= 2 cells). Every nucleus pulposus section exhibited the presence of alpha-SMA-containing cells, which accounted for approximately 24 percent of the cells in vivo. In vivo, the cell density was significantly higher in older individuals (p = 0.02). The average time for cell outgrowth from the explants was 8.6 days. Approximately 10-15 percent of the cells in the explants stained positive for alpha-SMA. The time in culture had no significant effect on any of the outcome measures except the percentage of alpha-SMA-containing cells that were round (p = 0.008), with values decreasing through 4 weeks and then slightly rising at 6 weeks. The role of alpha-SMA in intervertebral disc pathology warrants further investigation.     

散发型Creutzfeldt-Jakob病的MRI表现

目的探讨散发型Creutzfeldt-Jakob病（sCJD）的MR特点。方法回顾性分析3例临床诊断为sCJD的患者资料，MR采用SE T1 WI、快速自旋回波（FSE）T2 WI、扩散加权成像（DWI）扫描，观察其MR表现特征。结果3例SE TI WI和FSE T2 WI序列对基底节区和皮质的病变显示不佳，DWI则可清晰地显示病变，额、顶、枕叶皮质最常受累，表现为高信号，病变可对称，也可不对称，皮层下区脑白质信号未见异常。双侧尾状核、丘脑也可受累，DWI上呈高信号。晚期脑实质广泛萎缩，以皮质为著。结论sCJD采用DWI序列结合其特征性的临床表现可作出较为准确的诊断。     

不同深度糖尿病大鼠烫伤模型的制备

目的探讨恒温恒压电热烫伤仪制作糖尿病大鼠不同深度烫伤模型的可行性。方法链脲佐菌素诱导正常SD大鼠制作糖尿病大鼠模型，诱导成功1、2、3、4周检测皮肤晚期糖基化终产物、胶原含量，以正常SD大鼠作为对照，判断典型糖尿病性皮肤改变所需的时间。以恒温恒压烫伤仪制作烫伤模型，制模条件为0．5kg压力下，80℃，分别作用时间4．6、12s，48h后取材行苏木素-伊红（HE）染色检测烫伤深度。结果糖尿病大鼠诱导成功后4周，皮肤晚期糖基化终产物含量为（31．40±3．45）U／mg、胶原含量为（12．60±0．57）mg／g，与正常对照组比较差异有统计学意义（P〈0．05），并出现典型的糖尿病性皮肤改变。HE染色烫伤时间4、6、12s时深度依次为浅Ⅱ度、深Ⅱ度和Ⅲ度。结论恒温恒压电热烫伤仪制作糖尿病大鼠不同深度烫伤模型简单、方便，重复性高，为研究糖尿病创面愈合提供较为理想的模型。     

深静脉血栓形成患者凝血因子ⅩⅢ Val34Leu基因多态性检测

目的:探讨凝血因子ⅩⅢ(FⅩⅢ)Val34Leu基因多态性与中国人群深静脉血栓形成(DVT)发病的相关性.方法:利用聚合酶链反应和限制性片段长度多态性(PCR-RFLP)方法,检测了103例DVT患者与106例正常对照的FⅩⅢVal34Leu基因多态,并加以对照分析.结果:103例DVT患者FⅩⅢVa134Leu基因型均为野生型V/V,未见突变类型;106例对照组中发现1例突变杂合子V/L.2组基因型频率、等位基因频率相互比较,差异均无统计学意义(P＞0.05).结论:FⅩⅢVal34Leu对中国人群DVT有保护作用的可能性极小.     

支气管哮喘患者白细胞介素4和白细胞介素13测定的临床意义

目的:探讨血清中白细胞介素4(IL-4)和白细胞介素13(IL-13)在支气管哮喘发病中的作用.方法:本研究对临床确诊的支气管哮喘46例,与正常对照组46例,分别抽取血清采用 ELISA 法测定其 IL-4、IL-13的含量.结果:支气管哮喘急性发作期病人和对照组正常人血清中的 IL-4水平分别为(460.84±27.11)和(132.97±24.66) ng/L,二组经 t 检验后 P＜0.001.两组 IL-13 的水平分别为(23.76±5.44)和(12.61±2.49) ng/L,二组经 t 检验后 P＜0.001.结论:哮喘病人 IL-4、IL-13 明显高于对照组,提示 IL-4、IL-13 对哮喘发病有一定的调控作用,对支气管哮喘气道非特异性炎症和局部免疫反应起重要作用.     

经导管封闭治疗小儿继发孔房间隔缺损

目的探讨应用经导管封闭治疗小儿房间隔缺损的临床效果.方法 16例ASD患儿.男6例,女10例;年龄2～14(8±4)岁,体重10～40(23±9)Kg.先行右心导管用球囊导管测量ASD大小,选择适合的封堵器,在X线及超声引导下释放封堵器堵闭ASD,术后随访疗效,追踪残余分流率和并发症.结果应用此法封闭16例ASD,全部成功.手术时间为(70±30)血n,透视时间(13±8)min,术中无明显并发症.术后随访右房、右室径较术前明显缩小,恢复正常(P＜0.05);无残余分流发生.结论经导管封闭治疗小儿房间隔缺损术具有创伤小,成功率高,安全性好的优点,但其长期疗效需进一步随访观察.