颈阔肌的应用解剖

用手术显微镜对50例成人的颈阔肌作了观察和测量。将每侧颈部分为9个区,颈阔肌位于前6区。肌的内侧界约相当于颏舌骨连线中点稍下到锁骨胸骨端稍外侧处的连线,左右侧肌夹有40°角;外侧界为下颌角稍后到锁骨肩峰端内侧3cm处的连线;下界在第一肋间隙平面,有的肌下份出现一些较宽的裂隙;上界在下颌骨体,并与某些表情肌相连续。肌的面积约150cm~2,锁骨上部约占120cm~2。后份肌纤维略呈S形弯曲。肌与深层结构联系较松。本文还对面神经和颈丛与颈阔肌有关的分支,进行了观察。对和颈面部临床应用等有关的问题进行了讨论。     

看病难和看病贵问题:基于居民角度的实证分析

从居民角度对上海市看病难和看病贵问题进行了实证分析.研究共调查了上海市长宁区的3636位居民.居民调查结果进一步印证了整体研究中患者调查的部分结果,同时也发现了一些与患者调查不同的结果,提示患者调查存在的局限性.     

兔心缺血预处理对肺缺血再灌注损伤的影响

观察１６只大白兔心脏缺血预处理对肺缺血再灌注损伤的影响。结果显示，实验组肺泡内白细胞浸润减少，血氧分压在再灌注６０ｍｉｎ内明显高于对照组、肺含水量低于对照组（Ｐ〈０．０１）。表明兔心缺血预处理能减轻肺缺血再灌注损伤。     

小切口椎板间开窗治疗腰椎间盘突出症

目的　探讨小切口椎板间开窗髓核摘除术的疗效及适应证。方法　从 1998年 5月～ 2 0 0 1年 9月采用小切口椎板间开窗髓核摘除术治疗腰椎间盘突出症 72例。全部患者都有腰痛和一侧或双侧下肢疼痛及麻木。结果　获得随访 65例 ,随访时间最长 2 6个月 ,最短 6个月 ,平均 13个月 ,按Nakai标准评定治疗优良率为 93 .8%。结论　小切口椎盘间开窗髓核摘除术具有适应证较广、手术时间短、出血少、创伤小、手术优良率高、后期并发症少、不损害脊柱稳定性等优点 ,是治疗腰椎间盘突出症较为有效和可靠方法之一     

重症肌无力抗乙酰胆碱受体单链抗体基因的构建

[目的 ]构建重症肌无力抗乙酰胆碱受体主要免疫原区单链抗体A 7基因 .[方法 ]应用PCR技术及基因克隆技术分两步完成重链和轻链可变区基因的克隆 ,再对构建的单链抗体A 7基因进行序列测定检测其核苷酸序列 .[结果 ]构建的重组质粒经序列分析 ,重链可变区基因长度为 36 9bp ,轻链可变区基因长度为 32 1bp ,单链抗体基因长度为 735bp ;单链抗体A 7基因正确地插入在载体质粒pHEN 2开放读码框架内 .[结论 ]成功地构建重症肌无力抗乙酰胆碱受体主要免疫原区单链抗体A 7基因 ,为进一步制备基因工程抗体奠定了基础 .     

Gains of chromosomes 7, 17, 12, 16, and 20 and loss of Y occur early in the evolution of papillary renal cell neoplasia: a fluorescent in situ hybridization study.

It has been suggested that gains of chromosomes 7 and 17 and loss of Y occur in renal papillary adenoma and that progression to papillary renal cell carcinoma is marked by gains of additional chromosomes, most frequently 12, 16, and 20. Previous studies have included very few lesions of <5 mm in diameter, a requirement of the present definition of papillary adenoma. Ten papillary adenomas (ranging from 1 to 5 mm in diameter) from autopsy material and 10 surgically resected papillary renal cell carcinomas were studied with fluorescence in situ hybridization in paraffin sections using centromeric probes for chromosomes 7, 12, 16, 17, 20, and Y diluted 1:100 with tDenHyb1 buffer. The signals in 50 to 150 nuclei were counted in each tumor. Controls for all the probes were normal renal tissues from the same patients. Three or more signals per nucleus were frequently observed in papillary adenomas: chromosome 7 (range, 10 to 50%; > or = 30% in 9 of 10), 17 (range, 10 to 47%; > or = 30% in 7), 16 (range, 1 to 63%; > or = 10% in 5), 12 (range, 0 to 32%; > or =10% in 4), and 20 (range, 5 to 49%; > or = 10% in 5). Loss of the Y chromosome was observed in 80 to 90% of nuclei in 9 adenomas from males. Three or more signals were frequent in papillary renal cell carcinomas: chromosome 7 (range, 32 to 63%; > or =30% in 10 of 10), 17 (range, 28 to 61%; > or = 30% in 7), 16 (range, 0 to 45%; > or = 10% in 6), 12 (range, 1 to 37, > or = 10% in 5), 20 (range, 2 to 44%; > or = 10% in 4). No signal for Y was observed in 12 to 88% (> or = 81% in 6) of nuclei in 7 carcinomas from males. Statistical analysis showed no difference between adenomas and carcinomas. Gains of chromosomes 7, 17, 16, 12, and 20 and loss of the Y chromosome occur early in the evolution of papillary renal cell neoplasia in tumors that are only a few millimeters in diameter. Progressive gains of these chromosomes do not appear to correlate with the transition from adenoma to carcinoma.     

Changes in total sodium intake do not lead to proportionate changes in total sodium removal in CAPD patients.

BACKGROUND: Dietary salt and fluid restriction is important in controlling fluid balance in patients on continuous ambulatory peritoneal dialysis (CAPD). However, it is often difficult to monitor patients' dietary total sodium intake (TSI). Usually, total sodium removal (TSR), the sum of urinary sodium removal (USR) and dialysate sodium removal (DSR), is suggested to represent TSI. In the present study, we investigated the reliability of using TSR as a surrogate to TSI in CAPD patients. METHODS: 40 clinically stable CAPD patients were closely followed for 3 months. Their TSI, USR, DSR, and fluid status were measured twice: at baseline and at the end of this study respectively. Fluid status was evaluated by bioimpedance analysis. Patients with increased sodium intake (group ISI) or decreased sodium intake (group DSI) (both >0.5 g/day or >21.74 mmol/day elemental sodium) were included in this study. RESULTS: There were 15 patients in group ISI and 9 patients in group DSI. During the follow-up, although TSI increased in group ISI and decreased in group DSI (p < 0.05), there were no significant changes in USR, DSR, or TSR in either group. No relationship was found between TSI and TSR. Changes in weight, blood pressure, urine volume, ultra-filtration, and small solute removal (Kt/V and creatinine clearance) were not statistically significant between the two groups. Fluid status deteriorated in group ISI and improved in group DSI (p < 0.05). CONCLUSIONS: Our study suggests that changes in total sodium intake do not lead to proportionate changes in total sodium removal in CAPD patients. Therefore, TSR (the sum of USR and DSR) should be used cautiously to monitor TSI in this patient population.     

In vitro growth inhibition of neoplastically transformed cells by non-transformed cells: requirement for gap junctional intercellular communication

We examined whether the inhibition of neoplastically transformedcell growth by co-cultured non-transformed cells involved gapjunctional intercellular communication (GJIC). The growth ofpoorly communicating (