新式剖宫产与传统下段剖宫产对比分析

我院自1998年10月开展新式剖宫产,取得了良好效果,现分析报道如下。1　资料与方法自1998年10月份我院住院有剖宫产指征的145例孕妇进行了新式剖宫产,年龄23～35岁,平均27岁,孕37～42Ｗ,其头盆不称45例,胎儿宫内窘迫30例,巨大儿6例,臀位28例,胎膜早破12例,宫颈难产11例,妊高征13例。进行传统下段剖宫产112例,其年龄、孕次,孕周及剖宫产指征与新式组无明显差异。所有剖宫产均采用连续硬膜外麻醉。新式剖宫产采用Ｊｏｅｌ-Ｃｏｈｅｎ切口位置即双侧髂棘连线下8ｃｍ,未弧形,长14～16ｃｍ,切开皮肤,撕开皮下脂肪组织,剪开腹肌前筋膜,分开腹直肌后…     

老年病人麻醉期间氧供需平衡的研究

目的:研究老年病人麻醉期间氧代谢变化,并分析其原因,提出保护老年病人麻醉期间氧供需平衡的方法.方法:选择上腹部手术老年病人(年龄＞65岁)30例,按数字随机法分为全麻组(n＝15)和硬膜外麻醉组(n＝15),并随机选择青壮年上腹部手术病人10例,作全麻对照组.监测麻醉期间老年病人氧供(DO2)、氧耗(VO2)、氧摄取率(ERO2)、混合静脉血氧饱和度(SVO2)和动脉血乳酸含量(ABL)等指标动态变化的情况.结果:老年病人全麻组与硬膜外麻醉组比较:前者麻醉诱导后至术毕DO2、VO2、ERO2均小于后者,并且SVO2、ABL均大于后者,它们之间均有显著性差异或非常显著的统计学意义(P＜0.05或P＜0.01).而老年全麻组与青壮年全麻对照组比较:前者DO2、VO2、ERO2小于后者,SVO2、ABL大于后者,而且它们之间也有显著性差异(P＜0.05).结论:上腹部手术老年病人全麻期间存在氧供需平衡障碍,出现明显的组织缺氧.根本的原因可能是老年病人微循环障碍的存在,而硬膜外麻醉有改善老年病人微循环障碍,纠正氧供需平衡失调的作用.     

Individual Variability of Carbonyl Reductase Activity for Acetohexaminde in Human Erythorcytes

Acetohexamide, an oral antidiabetic agent, is metabolized by carbonyl reductase to hydroxyhexamide, which has a higher hypoglycemic potency than the parent compound. In the present study, interindividual variability of carbonyl reductase activity in erythrocyte was examined. Enzyme activity in 31 healthy subjects (23.9 plus minus 3.4 years, mean plus minus SD) was monitored by measuring formation of hydroxyhexamide using HPLC methods. Using 0.5 mM acetohexamide as substrate, reductase activity of 6.06 plus minus 0.06 nmol min(minus sign1) gHb(minus sign1) (range: 5.9--6.2) with a coefficient of variation of 15% was observed in erythrocytes. Acetohexamide-reducing activity in erythrocytes showed a normal distribution and the interindividual variability of the reductase activity was found to be small, implying that the large variability reported for the acetohexamide plasma half-life is not caused by the amount of reductase enzyme in erythrocytes.     

The effect of surgical glove powder on proliferation of human skin fibroblast and monocyte/macrophage

The effect of surgical glove powders (Biosorb, Keoflo, and CaCO3) and Hydrocote (powder-free lubricating agent, Biogel) was examined on human skin fibroblasts and monocyte/macrophage cell lines (U937 and HL-60). Glove powders (0.1-100 micrograms/ml) in the presence of 10% fetal bovine serum (FBS) had no significant effect on the rate of 3H-thymidine uptake and proliferation of these cells after 48 h and 7 days of exposure, respectively. However, they inhibited HL-60 growth after 10 days, and Biosorb and CaCO3 inhibited U937 after 10-21 days of exposure compared with control. In the presence of low serum (0.5%), Biosorb, but not Keoflo, CaCO3, and Hydrocote, inhibited HL-60 cells after the third day of exposure (p < 0.05), whereas they were without any effect on U937 cells. Further incubation resulted in a significant decrease in cell density in all treatments, as well as controls, because of cell death. In the presence of 2% serum, glove powder-treated HL-60 significantly increased in cell numbers during the first 3 days, and the cells became stationary thereafter, whereas Keoflo and CaCO3-stimulated U937 reached a maximal by 9 days of treatment. Coculturing of fibroblasts directly with macrophages (0.4-5 x 10(5) cells per dish) or incubation with macrophage culture-conditioned media (CCM) stimulated quiescent fibroblast growth equal to that induced by 10% and 0.5% serum, respectively (p < 0.05). However, incubation of fibroblasts with glove powder-treated HL-60 CCM (except CaCO3) inhibited (p < 0.05) and CCM from Biosorb-treated U937 stimulated (p < 0.05) fibroblast proliferation. The CCM from glove powder-treated HL-60 and U937 did not have any significant effect on the rate of 3H-thymidine incorporation into fibroblasts compared with controls. The present observations suggest that glove powder action on fibroblast and macrophage growth in vitro depends on both the serum concentration of the culture medium and the length of exposure. The results imply that glove powders may have an adverse effect in vivo by directly influencing the biologic activity of macrophages, as well as other cell types, leading to alterations in the early phases of wound healing.     

Preliminary evaluation of pelvic vascular bed isolation chemotherapy in the treatment of advanced cervical carcinoma

ＰｒｅｌｉｍｉｎａｒｙｅｖａｌｕａｔｉｏｎｏｆｐｅｌｖｉｃｖａｓｃｕｌａｒｂｅｄｉｓｏｌａｔｉｏｎｃｈｅｍｏｔｈｅｒａｐｙｉｎｔｈｅｔｒｅａｔｍｅｎｔｏｆａｄｖａｎｃｅｄｃｅｒｖｉｃａｌｃａｒｃｉｎｏｍａＪｉａｎｇＳｅｎａｎｄＰｏｓｔｇｒａｄｕａｔｅ...     

Cloning of the human homolog of mouse transmembrane tryptase

BACKGROUND: Three functionally distinct tryptases have been identified in the mouse, one of which encodes an unusual protease that possesses a membrane-spanning domain located in its C terminus. METHODS AND RESULTS: Using the deduced nucleotide sequence of this mouse transmembrane tryptase (mTMT) gene in a polymerase chain reaction approach, cDNAs were isolated from a number of tissues which encode its human homolog. The amino acid sequences of hTMT and mTMT are 74% identical, and the human tryptase also has the novel membrane-spanning domain. CONCLUSION: The discovery that the human genome contains a large number of homologous, but distinct, tryptase genes suggests that the individual members of this family of proteases evolved to carry out discrete functions in mast cell-mediated allergic reactions.     

Mutational analysis of the PTEN/MMAC1 gene in primary oesophageal squamous cell carcinomas.

AIM: To investigate whether PTEN/MMAC1 mutations play a role in the carcinogenesis of oesophageal squamous cell carcinoma. METHODS: A panel of 33 primary oesophageal squamous cell carcinoma tumour samples and 20 corresponding morphologically normal tissues was examined for mutations in all nine exons of the PTEN/MMAC1 gene by means of polymerase chain reaction single strand conformational polymorphism analysis (PCR-SSCP) and direct DNA sequencing methods. RESULTS: Only one of 33 oesophageal squamous cell carcinomas showed an aberrant SSCP band. Further sequencing analysis of this sample revealed an 802 -29 T-->C substitution in intron 7. PTEN/MMAC1 mutations were not found in the mutational "hot spot" in exon 5, even after direct sequencing of six oesophageal squamous cell carcinoma samples and three normal tissues. However, a deletion of one nucleotide T at position 492 +8 in intron 5 was seen in all samples. CONCLUSION: These results suggest that PTEN/MMAC1 mutations do not play a major role in the carcinogenesis of oesophageal squamous cell carcinoma.     

侧柏叶乙酸乙酯提取物对豚鼠离体气管平滑肌的作用

用离体豚鼠气管条,探讨侧柏叶乙酸乙酯提取物对气管平滑肌作用。结果表明,侧柏叶乙酸乙酯提取物能抑制乙酰胆碱,氯化钾所致气管平滑肌收缩,而且能使乙酰胆碱收缩气管平没肌的量效曲线右移,并抑制最大效应,其作用为剂量依赖性心肌肥厚提示侧柏叶乙酸乙酯提取物松驰气管平滑肌作用机制可能与影响Ｃａ＾２＋的跨膜转运有关。