冷冻异体手指复合组织移植再造拇指200指

对１９７例拇指Ⅲ～Ⅳ级缺失者，采用自体姆甲瓣游离移植包裹冷冻异体手指的复合组织（骨、关节、肌腱、腱鞘）再造拇指２００指。笔者认为冷冻能降低异休手指组织的抗原性，术前、后不用抑制排异反应的制剂与激素，无急性排异反应发生。手术成功率９６．４％，异体手指存活率９１．５％。术后３个月感觉恢复，测定对掌功能１４４例，优良率为９１．６％。平均随访时间４年５个月，部分病例远期出现异体骨吸收及关节变性，可能与骨片未镶嵌好，术后活动过早及慢性排异有关；但主要是移植组织未及时恢复神经血管的营养支配有关。为此取■甲瓣时内附着趾关节２块骨片，挖去异体指骨内骨髓，植入自体新鲜红骨髓及松质骨，有利于血管长入异体骨及促进宿主对其爬行替代。提出合理设计供足阳趾胫侧的保留皮瓣，尽量维持趾长度，供皮瓣区中厚皮片植皮，保存第１背侧跖骨肌及跗内外侧血管及足背皮神经，可减少足的并发症。     

皮肤软组织扩张术在四肢的应用

目的　应用皮肤软组织扩张术修复四肢的瘢痕、黑痣、文身等病损。方法　应用皮肤软组织扩张术 ,将扩张器置入四肢处且在与病损相邻的正常皮肤下 ,扩张后修复病损 5 2例。术中采用的扩张器大小及数量依病损面积而定 ,按每修复 1cm× 1cm缺损需扩张器容量 5ml计算。扩张后皮瓣的设计以横向滑行推进为主 ,少设计异位皮瓣 ,以防皮瓣血运障碍。纤维包膜尽量剥除 ,尤其位于基底部的纤维环 ,妨碍皮瓣向前推进 ,应将其切开、剥除。结果　本组 5 2例 ,其中 2 5例将病损完全切除 ,余 2 7例有部分病损遗留 ,但均无继发畸形。术后 6～ 12个月随访 12例患者 ,切口瘢痕轻度增生 ,效果满意。结论　在四肢上有可供扩张的正常皮肤时 ,扩张术仍然是修复四肢病损切除后创面的较好的方法。     

吻合腓肠浅动脉的游离小腿后侧皮瓣修复手掌软组织及神经缺损

目的 探讨修复手掌软组织及神经同时缺损的新方法。方法 利用吻合腓肠浅动脉的游离小腿后侧皮瓣修复手掌软组织及神经缺损6例。结果 临床应用6例，全部成活，术后10～13个月随访，皮瓣外形近似正常手掌，两点辨别觉为5mm，感觉为S4；患指感觉恢复为S3两例，S4四例。结论 利用吻合腓肠浅动脉皮瓣修复手掌软组织及神经缺损是理想的方法。     

微量沙眼衣原体组织培养法的建立及临床应用

建立了微量沙眼衣原体组织培养法，并应用于不同人群的生殖道标本的沙眼衣原体培养。结果生殖道沙眼衣原体培养的阳性率：男性尿道炎患者１４７％（９／６１）；正常孕妇３３％（７／２１０）；急性和亚急性盆腔炎女性患者６７％（７／１０４）；性病门诊患者１８２％（４９／２６９）。由于９６孔培养板及倒置荧光显微镜的应用，微量培养法试剂用量少、过程简化；自制的抗沙眼衣原体单克隆抗体大大降低了培养后的染色成本，适用于大宗标本。     

Principles for reconstruction of traumatic ear defects

Summary Traumatic defects of the auricle are quite common. The eventual success of the repair is considerably influenced by the initial treatment. The different parts of the auricle require different approaches. This paper presents our methods for repairing damage to the cartilaginous frame using autologous ear cartilage grafts, and local flaps from the mastoid region to cover soft tissue defects.     

Inhibition of tissue factor surface expression in human peripheral blood monocytes exposed to cytokines

Interleukin (IL)-4, IL-10, IL-13 and transforming growth factor beta (TGF-β) are known to regulate several monocyte functions, including inhibition of the synthesis of different cytokines. Using quantitative RT-PCR and flow cytometry analysis we investigated the effects of these cytokines on bacterial lipopolysaccharide (LPS)-induced tissue factor (TF) expression in human monocytes. The effects of IL-4 and IL-10 on monocyte chemoattractant protein-1 (MCP-1)- and C-reactive protein (CRP)-induced TF expression were also studied. A direct comparison revealed that IL-4, IL-10 and IL-13 all down-regulated LPS-induced TF expression in a concentration-dependent manner without the need for priming. In contrast, TGF-β required 4 h of priming to inhibit TF expression induced by LPS. IL-10 was the most powerful inhibitor, causing almost complete inhibition at 5 ng/ml. IL-4 and IL-13 exhibited a significantly lower inhibitory capacity even at concentrations of 100 ng/ml. IL-4 and IL-10 showed similar concentration-dependent inhibition of MCP-1- and CRP-induced TF expression. We also showed that the regulatory effect of the interleukins occurred at the mRNA level. In vivo , these inhibitory cytokines may play an important regulatory role in preventing thrombosis. IL-10, in particular, may be a possible candidate as a TF-preventing drug.     

Ultraviolet Laser-Induced Fluorescence Spectroscopy Diagnosis of Human Stomach Malignant Tissues

To evaluate the potential of laser-induced autofluorescence spectroscopy for the detection of premalignant lesions of human stomach, fluorescence properties of stomach tissues have been investigated in vitro and in vivo. A specially made optical fibre probe and the multichannel fluorescence collection system have been used successfully in our research. Paper received 26 June 1997; accepted in revised form 31 October 1997.     

组织工程化肌腱研究进展

对组织工程化肌腱领域中目前研究的主要成果进行综述，着重阐述了肌腱细胞外基质替代物、肌腱细胞生物学性质及肌腱细胞与细胞外基质材料复合研究中的主要问题。认为，研制适于肌腱细胞生长、粘附和发挥功能的细胞外基质材料；建立生长、增殖可调控的肌腱细胞系；在模拟体内力学条件下，进行肌腱细胞三维培养，将是研究具有特定修复功能的组织工程化肌腱的重要问题。     

Determination of tissue optical properties by steady-state spatial frequency-domain reflectometry

A new non-invasive method to measure the optical properties of biological tissue is described. This method consists of illuminating the investigated sample with light which is spatially periodically modulated in intensity. The spatial modulation of the backscattered light and the diffuse reflectivity of the sample, both detected with an imaging technique, are used to deduce the absorption and reduced scattering coefficient from a table generated by Monte Carlo simulations. This principle has three major advantages: Firstly, it permits the immediate acquisition of the average values of the optical coefficients over a relatively large area (typ. 20 mm in diameter), thus avoiding the perturbations generated by small tissue heterogeneities; It also provides good flexibility for measuring the optical coefficients at various wavelengths and it does not require the use of a detector with a large dynamic range. The method was first validated on phantoms with known optical properties. Finally, we measured the optical properties of human skin at 400 nm, 500 nm, 633 nm and 700 nm in vivo.     

Tissue distribution metabolism and excretion of 2,2′,4,4′, 5-pentachlorodiphenyl ether in the rat

The tissue distribution, metabolism and excretion of ¹⁴C-2,2,4,4,5-pentachlorodiphenyl ether (PCDE) were studied in the rat. Radioactivity was distributed in all tissues examined, with the highest concentrations being found in the fat followed by the skin, liver, kidney and muscle. Most of the radioactivity found in the tissues was due to unchanged PCDE. Decay of PCDE in the blood was fitted to a four-compartment pharmacokinetic model, and the last compartment had a half-life of 5.8 days. A total of 55% and 1.3% of an orally administered dose was excreted in feces and urine, respectively, in 7 days. More than 64% of the fecal radioactivity was due to unchanged PCDE, while hydroxylated PCDE accounted for 23%.