海洛因依赖者前额叶皮质及杏仁核1H-MR波谱研究

Objective To explore the characteristic findings of 1H-MR spectroscopy(1H-MRS) in the prefrontal cortex and amygdala of patients with heroine dependence(HD), and the relationship to total cumulative dose of inhaled heroine.Methods Fourteen male HD patients and 12 healthy controls (HC) underwent 1H-MRS at the prefrontal cortex and amygdala regions.The total cumulative in haled heroin dose was (852±341) g in HD.Ratios of N-acetylaspartate/creatine(NAA/Cr) and choline/creatine (Cho/Cr) were respectively measured in the prefrontal cortex and bilateral amygdale regions.The student's t test and the linear correlation were employed for statistical analysis.Results Compared to HC group, HD patients had a significant lower ratio of NAA/Cr in the prefrontal cortex (1.44±0.46 vs 1.50±0.75, t=1.77 ,P <0.05), left amygdala region (1.32±0.08 vs 1.42±0.08, t=3.41, P < 0.05), and right amygdala region (1.34±0.09 vs 1.44±0.10, t=2.63, P <0.05), the HD patients had a significant increased ratio of Cho/Cr in the prefrontal cortex (0.92±0.06 vs 0.86±0.08, t=2.31, P < 0.05), left amygdala region (1.20+0.12 vs 1.07±0.04, t=3.60,P<0.05) and right amygdala region(1.26±0.15 vs 1.12±0.11,t=2.60,P <0.05).There was a negative linear correlation between the total cumulative inhaled heroine dose and the ratio of NKA/Cr in the prefrontal cortex (r=-0.9159, P < 0.01), left amygdala region (r=-0.8756, P < 0.01), and right amygdala region (r=-0.9399, P < 0.01) respectively.Conclusions The study indicates that neuronal damage and glial proliferation may occur in the prefrontal cortex and amygdala region, which suggests the abnormalities of executive function and emotion in patients with HD.A relationship exists between the heroin-induced metabolic abnormality and the total cumulative dose of inhaled heroine.     

防损伤套管在空心钉微创内固定术中的应用

以微创的术式，用空心钉治疗股骨颈骨折已有较多的报道。我院在术中使用一种自制的专利器械，能使同类型手术所致的创伤降低到最小程度，术中出血量减小到最少程度。现将我院1999～2003年治疗的58例情况报道如下。     

两法提取皮质骨Ⅰ型胶原的比较研究

[目的]通过对两种方法提取的骨胶原产量及特性的比较,推荐一种较为理想的提取皮质骨I型胶原的方法。[方法]以猪皮质骨为原料,去除软组织后劈成小骨块,经酒精梯度脱水、无水乙醚脱脂、盐酸脱钙、甲醇:氯仿(1:1,v/v)再脱脂处理后,骨块软化。然后将软化的骨块在高速粉碎机上粉碎成脱钙骨基质粉。分别采用传统的碱溶法和自建的增强酶解法对脱钙骨基质粉处理,经溶解、离心、透析、冻干等操作提取皮质骨胶原。最后对增强酶解法所得产物进行鉴定,并对两种提取方法的效率及得到的产物的外观、黏度、凝胶固化性进行比较。[结果]增强酶解法所得胶原的氨基酸组成、蛋白电泳、相对分子量大小、最大光吸收波长均符合I型胶原特征;和碱溶法比较,提取率由(57.8±4.96)%提高到(94.04±0.55)%;其相同浓度(0.03%,w/v)醋酸溶液黏度测定,增强酶解法为3.71,碱提法为2.81;在37.0℃,pH值7.35～7.45条件下行凝胶固化性检测,增强酶解法所提胶原凝胶液约10min可固化形成凝胶块,而碱提法所提胶原的溶液仍为黏性液体。[结论]增强酶解法提取的骨胶原是I型胶原;相对于碱提法,该法提取效率高,所得胶原纯度高、黏性好、固化性好,是一种较好的从猪皮质骨中制备I型胶原的方法。     

可控制性卵巢刺激治疗中促性腺激素释放激素激动剂降调节与卵巢过度抑制

基于促性腺激素释放激素激动剂(GnRH-a)短时给药对垂体的激发作用引起血清黄体生成素(LH)和卵泡刺激素(FSH)升高有利于增加卵泡募集,而长期给药导致垂体局部受体脱敏与消耗而有效地抑制排卵前LH峰出现和降低卵泡晚期血清LH水平,从而减少卵泡过早黄素化和取消周期、改善卵子质量     

健康男性睾丸及血清雄激素生物活性测定

由于对人类精子发生的调控知之甚少，所以就精子发生异常而导致的男性不育的治疗至今没有取得突破。在大鼠及人类睾酮是睾丸内重要的类固醇激素。以往的研究表明大鼠睾丸内维持精子发生所必需的睾酮浓度远高于血液总睾酮浓度，这说明睾丸内大多数睾酮可能没有生物活性。同大鼠相比，人们尚不知道人类精子发生所需要雄激素的浓度。直到近来，部分原因是因为还没有用于从人睾丸获取睾丸内液的创伤小的合适方法。     

皮质—纹状体—脊髓变性1例并文献复习

患者，女，61岁。因进行性意识障碍伴四肢不规则抽动2年、发热1周于2007年7月10日入院。2005年7月始，患者出现记忆力下降及行为异常，语无伦次，烦躁易怒，并间断性右手无力，曾在上海华山医院检查脑电图正常，脑MRI示脑萎缩、腔隙性脑梗死，给予活血及营养神经治疗2周后未见明显改善。2006年初以来，患者逐渐出现四肢不自主抽动，行走不稳，视物模糊，记忆力锐减。     

股骨髁间骨折35例治疗分析

股骨髁间骨折是较常见但治疗较为困难的骨折类型。骨折通常呈粉碎性，这与该处骨皮质较薄，髓腔宽大，以松质骨为主，软组织附着少等有关。本院于1998年9月至2003年9月手术治疗股骨髁间骨折共35例，获得良好效果。     

75例不同胎龄早产儿肾上腺皮质功能初探

同足月儿一样早产儿血皮质醇生后递减约１周至稳态，其正常值有日龄差异，且较足月儿显先低而后高，胎龄愈小，交叉愈早，波动愈大，稳态愈迟，说明早产儿皮质功能本不如足月儿，但在宫外又代偿易激。     

Correlation between Steroids and Prostaglandins in the Plasma and Peritoneal Fluid Collected from Women with Pelvic Pain after Sterilization

Estradiot (E2), progesterone (P), prostagtandin F2a (PGF2a ), prostagtandin E (PGE), 6-keto-prostaglandin F1a (6-keto-PGF1a ) and thromboxane B2(TxBe) levels in ptasma and peritoneal fluid were determined in 44 women with pelvic pain after tubal ligation and 15 women with normal pelvis as well as 11 women requesting reversal of fertility after sterilization. The results showed that the correlation between E, and PGF2a was positive and the correlation between E2 and TxB2, P and PGF2a was negative in plasma. Ee was negatively, correlated with PGF2a and TxB2 in peritoneal fluid. Some PG levels in peritoneal fluid collected from patients suffered from endometriosis, pelvic pain but without visible lesion and pelvic congestion were significantly higher than those from other groups. The results suggested that PGs levels in plasma and peritoneal fluid were influenced by steroids, and they were also related to pelvic pain.