双极射频电热固缩治疗前交叉韧带松弛临床研究

目的:对15例前交叉韧带双极射频电热固缩治疗进行回顾性研究,评估其临床疗效。方法:从2000年1月至2005年1月采用双极射频对16例前交叉韧带松弛的患者进行电热固缩治疗。完整随访者15例,男性11例,女性4例,平均年龄29岁。12例前交叉韧带部分损伤,3例为自体绳肌重建术后。电热射频设备输出功率为284W,组织内作用温度为65℃。术后患者采用支具制动,康复计划与前交叉韧带重建术后基本相同。结果:随访时间平均15·6个月(4~25个月)。Lysholm评分,术前74·27±5·51分(66~84分),术后3个月89·6±7·11分(72~99分),两者相比有显著性差异(P<0·01);术后最终评分83·33±11·81分(56~95分),虽仍显著高于术前评分(P<0·05),但与术后3个月比较有所降低。KT-1000测量结果,术前两侧胫骨前移差值为5·47mm±1·61mm(3·5mm~10mm),术后3个月为2·67mm±1·35mm(2~7mm),与术前测量值对比存在显著性差异(P<0·01);最终测量结果为3·8mm±1·96mm(2~9mm),虽仍显著低于术前测量值(P<0·05),但较术后3个月有所增加。所有患者均未出现明显的术后并发症。2例患者(13·3%)术后失效,接受了二期重建手术。结论:电热固缩治疗前交叉韧带松弛可获得较好的短期主、客观疗效,但长期随访疗效有所下降。建议慎重选择手术适应症。     

Immunomodulators from Paris formosana Hayata.

Eight glycosides PF-1 to PF-8 were isolated from the leaves and stems of Paris formosana Hayata (Liliaceae), of which PF-3 (III) was the main compound. It was found that PF-1 to PF-3 (I-III) caused proliferative responses of mouse lymphocytes to concanavalin A and augmentation of mouse granulocyte/macrophage colony forming cells in mouse fibroblast cell L929 conditioned medium. PF-4(IV) and PF-8 showed significant immunomodulatory effects with very low toxicity: they not only caused the same immune responses as PF-1, 2 & 3 but also enhanced the proliferative response of human peripheral whole blood to phytohemagglutinin. PF-5 (V) also increased 3H-thymidine incorporation in ConA-stimulated lymphocytes and in PHA-stimulated human peripheral whole blood, and enhanced the proliferative response of granulocyte/macrophage colony stimulating activity. PF-6(VI) and PF-7(VII) augmented 3H-thymidine incorporation in granulocyte/macrophage colony-forming cells and mitogenic response of PHA-stimulated human peripheral whole blood cells from healthy adults. However, PF-1, 2 and 3 showed hemolytic action, while PF-4 to PF-8 had no hemolytic action at all. On the other hand, the hemolytic action of PF-3 derivatives was reduced as compared with PF-3 but their immune responses did not equal those of PF-3, only showing granulocyte/macrophage colony stimulating activity.     

Status and trend of HIV-1 infection and AIDS in Taiwan, December, 1991.

From May 1, 1985 to December 31, 1991, a total of 4,962,707 serum samples from 8 population groups in Taiwan were tested for anti-human immunodeficiency virus type 1 (anti-HIV-1). In total, 256 samples were seropositive; of these individuals, 43 developed acquired immunodeficiency syndrome (AIDS): 29 were homosexuals; 5 were hemophiliacs; 8 were heterosexuals and 1 was of unknown risk. Although the prevalence of HIV-1 infection and AIDS remains low compared with other countries, since 1988 the increase has been rapid. Before 1977 the majority were homosexuals and hemophiliacs; thereafter the risk groups diversified, with a trend away from homosexuals and hemophiliacs towards heterosexuals and intravenous drug abusers (IVDAs). A few patients have caused serious social problems for the public, health care workers and families. Active community efforts are needed to achieve future success in the control of HIV-1 infection and AIDS in Taiwan.     

超细纤维乳管镜引导下乳管内肿瘤切除术

目的探讨超细纤维乳管镜引导下乳管内肿瘤切除术的应用价值。方法对312例乳头溢液进行乳管镜检查，其中乳管内发现肿瘤者行手术治疗。利用乳管镜冷光源的皮肤透照点定象限，乳管扩张器探针定乳管走行方向，亚甲蓝染色定乳管末梢的分布。结果78例导管内发现肿瘤：单发性乳头状瘤68例，乳头状瘤病5例，导管内癌5例。28．2％（22／78）的病灶位于总导管，48．7％（38／78）位于导管Ⅰ级分支，17．9％（14／78）位于Ⅱ级分支，位于Ⅲ级和Ⅳ级分支病灶仅占3．8％（3／78）和1．3％（1／78）。病灶距乳头开口的平均距离为2．5cm（1～5cm）。78例均行手术治疗。术后病理诊断证实：65例乳头状瘤，8例乳头状瘤病，5例为导管内癌。乳管镜诊断符合率：乳头状瘤96％（65／68），乳头状瘤病100％（5／5），导管内癌100％（5／5）。单纯导管切除术65例，区段切除术8例，保乳根治术3例，改良根治术2例。结论通过光、针、色三位一体的方法定位以最小的切除范围达到最准确的切除目的，实现乳管内肿瘤的微创治疗。     

胰腺黏液非囊性癌9例临床分析

目的探讨胰腺黏液非囊性癌的组织学特点、生物学特征、治疗方法及预后。方法回顾性分析复旦大学附属中山医院普外科2000~2005年间收治的9例胰腺黏液非囊性癌病人的临床特点、影像学改变、病理学特征、治疗经过及随访资料。9例胰腺黏液非囊性癌病人,男7例,女2例,年龄平均(63·1±8·7)岁。肿瘤位于胰头8例,胰体尾1例。行胰十二指肠切除术8例,其中4例合并扩大淋巴结清扫术,1例行胰体尾切除。结果术后病理报告:瘤体平均4·3cm×4·3cm×4·4cm。镜下见8例胰头肿瘤均侵犯十二指肠,侵犯肠系膜上静脉4例。肿瘤侵犯神经3例,淋巴结转移2例。镜下肿瘤表现明确的间质黏液湖及其上漂浮较少的恶性上皮细胞。随访8例,死亡5例。术后存活5~23个月,平均存活11个月,均死于肿瘤复发和肝转移。结论胰腺黏液非囊性癌应是胰腺恶性肿瘤的一个独立的类型,其生物学特征有待进一步研究。     

前臂逆行骨间背侧皮瓣的临床应用

目的总结前臂逆行骨间背侧皮瓣的临床疗效。方法回顾性分析42例前臂逆行骨间背侧皮瓣，并结合文献阐明其变异程度及变异的处理。结果骨间背侧血管在前臂中1／3缺如1例．皮瓣边缘坏死；皮瓣向近端延伸超过4cm者4例，远端坏死，延迟愈合；其余均一期愈合：结论虽然前臂骨间背侧血管有变异，但前臂逆行骨间背侧皮瓣仍是修复手背中等大小创面较为理想的方法，以近点皮肤穿支向近端延伸皮瓣不要超过4cm。     

凋亡敏感基因在短暂性缺氧再复氧复注血清后的大鼠星形胶质细胞中的表达及其意义

目的研究一种新发现的抗氧化蛋白质--凋亡敏感基因(SAG)在短暂性缺氧再复氧复注血清诱导的细胞坏死和凋亡中的作用.方法用短暂性缺氧再复氧复注血清来诱导原代培养的大鼠大脑皮质星形胶质细胞损伤,用免疫细胞化学方法检测凋亡敏感基因的表达,并作图像分析;用流式细胞仪检测胶质细胞在短暂缺氧再复氧复注血清后不同时间点的凋亡率.结果凋亡敏感基因在缺氧15 min再复氧复注血清5 h后表达最高,在复氧复注血清16 h后恢复至对照组水平;细胞凋亡率在缺氧15 min再复氧复注血清1h时达到最高,而在再复氧复注血清5 h后降至对照组水平.结论凋亡敏感基因具有抗凋亡的作用,可减轻星形胶质细胞的缺血再灌注损伤.     

耒阳市1093例不同年龄人群缺锌状况的调查分析

[目的]探讨人体内锌缺乏与年龄是否相关。[方法]采集头发用强酸消化后，利用北京振教科贸有限公司产WL-3微量元素分析仪进行检测。[结果]我们发现儿童的缺锌率高于青少年和成人人群，具有显著的统计学意义（P〈0．05），其中3～5岁时的儿童的缺锌率达到了79．1％。而青少年与成人之间的缺锌率并无差异（P〉0．05），分别为20．5％和18．4％。[结论]因膳食结构不当引起锌缺乏在儿童中常见，由此我们应当根据不同年龄阶段特点进行不同的补锌措施。     

金钱白花蛇及其混淆品的鉴别

从原动物形态、药材性状、显微特征及理化方面对金钱白花蛇（银环蛇Ｂｕｎｇａｒｕｓｍｕｌｔｉｃｉｎｃｔｕｓ）及其３种混淆品水赤链游蛇Ｎａｔｒｉｘａｎｍｕｌａｒｉｓ，赤链蛇Ｄｉｎｏｄｏｎｒｕｆｏｚｏｎａｔｕｍ，金环蛇Ｂ．ｆａｓ－ｃｉａｔｕｓ进行了对比鉴别。     

RELATIONSHIP BETWEEN THE CLINICAL USE OF ANTIBIOTIC AND PRODUCTION OF ESBLS

Extended -spectrum β -lactamases(ESBLs)aremainlyproducedbymembersofthefamilyEnter obacteriaceaewhichcanhydrolyzeβ -lactamantibi oticsincludingthethird - generationcephalosporinandaztreonam ,theESBLs- producingbacillishowedmedian -highresistancetoceftazidimeandaztreonamparticularly[1] .NowadaystheprevalenceofESBLs -producingstrainshavebeenreportedinmanyareasaroundtheworld[2 ] .ButthereisfewinformationabouttherelationshipbetweentheuseofantibioticandtheproductionofESBLs .Weperformedastud…