大理地区正常人血清TT_3、TT_4水平

对比大理地区健康汉族人与白族人血清总三碘甲状腺原氨酸（ＴＴ３）、总甲状腺素（ＴＴ４）含量,建立本地区健康人ＴＴ３、ＴＴ４正常参考值。方法：对１００７例健康人（汉族６９１例,白族３１６例）进行血清ＴＴ３、ＴＴ４、ＲＩＡ检测。结果：健康汉族人与白族人血清ＴＴ３、ＴＴ４测定值相近,经统计学处理无显著性差异（Ｐ＞００５）;６０～７５岁年龄组的健康老年人血清ＴＴ３、ＴＴ４含量比其他年龄组明显降低（Ｐ＜００１）。结论：经检测得出的各年龄ＴＴ３、ＴＴ４水平,不论白族或汉族,男性或女性,均可作为正常参考值;６０岁以上健康老人ＴＴ３、ＴＴ４含量低于其他年龄是老年人正常的生理变化。     

D-amphetamine-induced depletion of energy and dopamine in the rat striatum is attenuated by nicotinamide pretreatment

The present study examined the effects of nicotinamide on the D-amphetamine (AMPH)-induced dopamine (DA) depletion and energy metabolism change in the rat striatum. In chronic studies, co-administration of AMPH with desipramine, a drug that retards the metabolism of AMPH, (10 mg/kg, intraperitoneal [i.p.], respectively) caused a significant decrease of striatal DA content measured 7 days later. Pretreatment with nicotinamide (500 mg/kg, i.p.), the precursor molecule for the electron carrier molecule nicotinamide adenine dinucleotide (NAD), attenuated this effect of AMPH, whereas itself exerted no long-term effect on striatal DA content. In acute studies, a decrease in striatal adenosine triphospate/adenosine diphosphate (ATP/ADP) ratio was found 3 h after co-injection of AMPH and desipramine. However, nicotinamide pretreatment blocked the reduced striatal ATP/ADP ratio and resulted in a striking increase in striatal NAD content in AMPH-treated rats. Furthermore, nicotinamide was noted to increase striatal ATP/ADP ratio and NAD content in saline-treated rats. These findings suggest that nicotinamide protects against AMPH-induced DAergic neurotoxicity in the striatum of rats via energy supplement.     

两种LASIK微型角膜刀的临床应用探讨

目的　比较ＫＮ－ ５０００ 型微型角膜刀与Ｍｏｒｉａ 微型角膜刀在ＬＡＳＩＫ 术中制作角膜瓣时的优缺点。方法　选用连续病例５６ 例１０３ 眼,随机分ＫＮ 组和Ｍｏｒｉａ 组,ＫＮ 组２８ 例５３眼,术前近视度数平均为－ ９－２１±７－４１Ｄ,散光≤－５－００Ｄ,Ｍｏｒｉａ 组２８ 人５０ 眼,术前近视度数平均为－１０－４７±３－７３Ｄ,散光≤－２－５０Ｄ,术中分别用ＫＮ－５０００ 微型角膜刀和Ｍｏｒｉａ 微型角膜刀制作角膜瓣。结果　两组病例角膜瓣边缘整齐。基质面：ＫＮ组全部术眼光滑、规则,Ｍｏｒｉａ 组部分术眼有“搓衣板”现象。瓣异常：ＫＮ组游离瓣２ 眼,Ｍｏｒｉａ 组不全瓣５ 眼。ＫＮ组角膜瓣质量优于Ｍｏｒｉａ 组,瓣异常率低于Ｍｏｒｉａ 组。结论　ＫＮ－ ５０００ 微型角膜刀在ＬＡＳＩＫ术中制瓣时性能及安全性、稳定性优于Ｍｏｒｉａ 组微型角膜刀。ＫＮ－ ５０００ 微型角膜刀还具有良好的易学性和进行ＬＡＳＩＫ角膜板层移植的功能。     

腹腔镜与腹腔镜辅助乙状结肠代阴道术治疗MRKH综合征

目的 :总结使用全腹腔镜和腹腔镜辅助下乙状结肠阴道成形术各成功治疗1例Mayer Rokitansky Kuster Hauser综合征 (MRKH综合征 )的经验。方法 :全腹腔镜下使用腔镜闭合切割器切断乙状结肠的近端和远端。自肛门插入腔内圆型吻合器 ,将降结肠与直肠吻合。经会阴于尿道膀胱与直肠之间造穴。将带血管蒂的乙状结肠牵入穴道 ,完成阴道成形。腹腔镜辅助下阴道成形中 ,腔镜闭合切割器切断乙状结肠的远端后 ,于左下腹壁做一辅助切口 ,将近端乙状结肠经此切口拉出至腹腔外。切断乙状结肠近端 ,将乙状结肠的远端开口缝合 2层 ,使之成盲端。近侧端开口置入吻合器之钉钻 ,再行荷包缝合送回腹腔 ,用吻合器行肠吻合。其余步骤同全腹腔镜手术步骤。术后根据临床检查或磁共振成像测量新成形阴道的长度和宽度。结果 :全腹腔镜手术新成形的阴道长 18cm ,宽 4cm。腹腔镜辅助手术新形成的阴道长 19cm ,宽 4cm。两例新形成的阴道黏膜湿润 ,呈粉红色。无术中和术后并发症的发生。结论 :经腹腔镜乙状结肠移植段的长度完全能达到开腹手术的要求。与开放手术比较 ,全腹腔镜乙状结肠代阴道手术在腹壁上不留手术瘢痕 ,美容效果理想。而腹腔镜辅助下阴道成形 ,虽腹壁留有小手术疤痕 ,但操作简便 ,手术时间短 ,手术费用低     

1314例育龄妇女缺铁性贫血发病现状调查

目的 :研究育龄妇女缺铁性贫血 (IDA)的发病现状及营养状况与IDA的关系。方法 :检测青岛市城市及农村 1314例妊娠期和非妊娠期育龄妇女的外周血红蛋白浓度 (Hb)、平均红细胞体积 (MCV)、平均红细胞血红蛋白量 (MCH)、血清铁蛋白 (SF) ,并进行个人问卷调查 ,应用营养计算软件评价膳食营养。结果 :1314例育龄妇女IDA发病率为 2 0 .4 0 % ,其中非孕妇的发病率高于孕妇。农村育龄妇女的发病率明显高于城市。孕妇中孕≥ 2 8周组发病率最高 (4 0 % ) ,与其他孕周组相比差异有高度显著性 (P <0 .0 1)。营养评价结果显示非孕妇组热量、维生素A、E、B1、B2 、PP、C的缺乏率高于孕妇组(P <0 .0 0 1)。结论 :农村育龄妇女及孕 2 8周以上的孕妇为IDA高发人群。应加强对农村育龄妇女的膳食营养宣教及指导 ,对孕晚期的孕妇及时采取有针对性的干预措施。     

Compromised kidney graft rejection response in Vervet monkeys after withdrawal of immunosuppressants tacrolimus and sirolimus

BACKGROUND: In nonprimates, organ allografts are often not rejected after withdrawal of immunosuppression. In this study, we examined whether such a phenomenon also occurs in primates. METHODS: Vervet monkeys were transplanted with renal allografts and treated for 60 days with tacrolimus, or tacrolimus plus sirolimus. The drugs were totally withdrawn on day 61. The survival of the monkeys was monitored, and their response to donor- or third party-derived alloantigens was examined in vivo and in vitro. RESULTS: The majority (80-100%) of the grafts survived for at least additional 30 days with no signs of acute rejection. The compromised rejection is donor-specific, because recipient monkeys failed to reject a donor-derived skin graft, but a third-party skin graft was rejected. In vitro mixed lymphocyte reaction and interleukin-2 production in the mixed lymphocyte reaction between the recipients and their donors or between the recipients and a third party had no discernable patterns, and thus did not reflect the in vivo status of the immune system. Although the recipients could not reject the graft acutely after drug withdrawal, the kidney grafts and the donor-derived skin grafts had pathological findings of chronic rejection. CONCLUSIONS: The rejection response of the monkeys to an established graft after withdrawal of immunosuppression is compromised. The compromised rejection is specific and is not due to a permanent alteration of the immune system by the initial drug treatment. The allografts are not inert but have low levels of interaction with the recipient immune system.