无张力性吊带术治疗女性压力性尿失禁

目的探讨无张力阴道吊带术(tension-free vaginal tape，TVT)治疗女性压力性尿失禁的疗效。方法13例经尿动力学检查证实为压力性尿失禁在连续硬膜外麻醉下经阴道前壁行无张力阴道吊带术，低平截石位，经阴道前壁向上穿刺尿道两侧间隙，从耻骨上腹壁引出TVT吊带，调整张力，关闭切口。结果手术时间15～45min，平均35min。13例随访6～24个月，平均13个月，12例治愈，1例改善，无尿失禁复发或排尿困难。结论TVT操作简单，创伤小，手术时间短，术后恢复快，治疗压力性尿失禁疗效好。     

徐元庚老中医治疗肛肠疾病学术经验简介

徐元庚老中医是我院肛肠科奠基人之一,徐老年逾花甲,幼年攻读中医典籍,博采众长,徐老积40余年丰富临床经验对肛肠疾病治疗确有独到之处,发表论文40余篇,并编著《痔瘘疾病临床指南》一书。现就笔者往昔随师学习的点滴体会简述如下:1 熟读经旨,著书立说徐老出身于中医世家,幼承庭训,勤奋研读经典,深究其理,对《内经》、《伤寒》、《金匮》至今仍能背诵如流。在治学方面,主张志于医者,在熟读经典,而后逐步参悟经旨,阅读诸家医集,抱着实事求是的客观态度,掌握取长舍短,去粗存精的学习方法,以防食古不化,或断章取     

一种基于μ子进行核材料探测成像的模拟系统

宇宙射线斗子成像检测技术具有穿透力强、对高Z材料敏感等特点，特别适合检测特殊核材料，是监控核材料走私的有效方式之一。在搭建μ子成像检测硬件系统的同时，我们开发了一套针对实际硬件系统的模拟系统，并利用该系统开展斗子成像方法的研究。本文将介绍该模拟系统的有关情况，并给出利用该系统得到的仿真结果。相信这一工作将对实际宇宙射线μ子成像系统的设计给出指导意见。     

细胞周期蛋白E在瘢痕疙瘩不同区域中的表达及意义

目的探讨细胞周期蛋白E在瘢痕疙瘩形成过程中的作用及意义。方法应用免疫组织化学链霉亲和素-过氧化物酶（SP）法检测瘢痕疙瘩不同区域和正常皮肤组织成纤维细胞（fibro-blast,FB）中细胞周期蛋白E的表达。结果在瘢痕疙瘩周边部FB中存在细胞周期蛋白E的高表达;而在瘢痕疙瘩中央部阳性表达的FB数量少,8例标本FB中细胞周期蛋白E表达阴性。正常皮肤FB中细胞周期蛋白E表达阴性。经统计学处理,周边部与正常皮肤组及中央部比较,差异有统计学意义（P〈0.01及P〈0.05）;中央部与正常皮肤（NS）组比较差异无统计学意义（P〉0.05）。结论细胞周期蛋白E在瘢痕疙瘩周边部FB中的高表达,不仅可能促进了瘢痕疙瘩的形成,并可能是瘢痕疙瘩侵犯周围正常组织,呈浸润性生长的原因之一。     

上尿路梗阻性急性肾功能不全内、外引流的选择

目的探讨内、外引流在上尿路梗阻急性肾功能不全时的选择和效果。方法25例各种原因引起的上尿路梗阻（15例肿瘤性梗阻,10例非肿瘤性梗阻）合并急性肾功能不全,分别或先后对12例行输尿管内置双J管（doub le J,D J）内引流15次,对19例行经皮肾穿刺造瘘（percutaneous nephrectomy,PCN）外引流23次。结果引流成功23例,PCN外引流成功率86.9%（20/23）,双J管内引流成功率60.0%（9/15）,PCN术后继发出血1例。结论对于盆腹腔进展期或广泛转移肿瘤导致的梗阻,PCN解除梗阻优于输尿管支架内引流;非肿瘤性梗阻宜先尝试D J内引流。     

Synergistic Deposition of C4d by Complement-Activating and Non-activating Antibodies in Cardiac Transplants

The role of non-complement-activating alloantibodies in humoral graft rejection is unclear. We hypothesized that the non-complement-activating alloantibodies synergistically activate complement in combination with complement-activating antibodies. B10.A hearts were transplanted into immunoglobulin knock out (Ig-KO) mice reconstituted with monoclonal antibodies to MHC class I antigens. In allografts of unreconstituted Ig-KO recipients, no C4d was detected. Similarly, reconstitution with IgG1 or low dose IgG2b alloantibodies did not induce C4d deposition. However, mice administered with a low dose of IgG2b combined with IgG1 had heavy linear deposits of C4d on vascular endothelium. C4d deposits correlated with decreased graft survival. To replicate this synergy in vitro, mononuclear cells from B10.A mice were incubated with antibodies to MHC class I antigens followed by incubation in normal mouse serum. Flow cytometry revealed that both IgG2a and IgG2b synergized with IgG1 to deposit C4d. This synergy was significantly decreased in mouse serum deficient in mannose binding lectin (MBL) and in serum deficient in C1q. Reconstitution of MBL-A/C knock out (MBL-KO) serum with C1q-knock out (C1q-KO) serum reestablished the synergistic activity. This suggests a novel role for non-complement-activating alloantibodies and MBL in humoral rejection.     

肝移植后单一拉米夫定干预下HBV再感染及其相关因素分析

目的　探讨在单一拉米夫定 (LMV)干预下乙型肝炎相关性肝病肝移植后HBV再感染的发生 ,并分析其发生的易感因素。方法　随访 1999～ 2 0 0 3年接受肝移植并采用单一LMV防治HBV再感染的 6 3例乙肝相关性肝病患者 ,术后定期进行乙肝标志物、肝功能及HBVDNA定量检测 ,调查HBV再感染发生率并采用Logistic回归分析方法就术前诊断、病毒学资料及抗病毒治疗等分析其可能的易感因素。结果　在不同时期共出现HBV再感染 17例 ;各时间段HBV再感染率分别是 :6个月内9.5 % (6 / 6 3,其中 5例术后HBV标志物一直未阴转 ) ,6个月～ 1年 13.2 % (7/ 5 3) ,1～ 2年 2 7.8% (10 /36 ) ,2～ 3年 4 1.2 % (7/ 17) ,3年以上 6 0 .0 % (3/ 5 ) ;患者术前HBVDNA阳性及长期服用LMV与术后再感染呈正相关 (P <0 .0 5 ) ,而术前诊断、性别、年龄及血清HBsAg和HBeAg状态与HBV再感染则未发现显著相关性。结论　单一LMV预防HBV再感染对大多数肝移植者仍有效 ,但随术后存活时间的延长HBV再感染率呈现上升 ;术前使HBVDNA阴转及建立针对LMV耐药性变异的监测对防治再感染是必要的。     

Effects of penetrating cornea injury combined with seawater immersion on the levels of aqueous humor TNF-α in rabbits

Objective To observe effects of penetrating cornea injury combined with seawater immersion on the levels of aqueous humor TNF-α in rabbits. Methods 10 adult healthy grey rabbits were used for the experiment. The rabbit eye model of comea blast injury was developed by using a single firecracker. For each rabbit, the right eye was the experimental eye (seawater was injected into the anterior chamber through the cornea incision, simulating seawater immersion) and the left eye was the control (treated with 0.9% sodium chloride). Levels of aqueous humor TNF-α were detected by using double-antibody sandwich ELISA on the 1st, 2nd, yrd, 4th, 5th, and 7th days following seawater immersion or 0.9% sodium chloride injection. Results Following development of the model, levels of aqueous humor TNF-α in the experimental eye on the 1st, 2nd, 3rd days were 190.338, 156. 107,117.018 ng/L respectively, and significant differences could be seen when comparisous were made between the experimental and control eyes. The level of aqueous humor TNF-α on the 1st day was the highest and obviously reached the peak. Conclusions Level of aqueous humor TNF-α in the experimental eye with penetrating cornea injury combined with seawater immersion was significantly higher than that of the control eye, indicating that TNF-α was clearly involved in the pathological change and it played an important role in the process.     

顺糖氨铂(Ⅱ)的合成

以氯铂酸钾为原料，经硫酸氨铂(Ⅱ)中间体制得抗肿瘤药物顺糖氨铂(Ⅱ)，操作简便，总收率46．1％。