动态旋转系统构建组织工程化血管模型中血管内皮细胞分泌功能监测

目的 比较静态和动态旋转系统中构建组织工程化血管模型中血管内皮细胞分泌功能。方法新型可降解材料聚羟基丁酸酯(PHB),用胶原包埋,形成多孔状PHB 胶原管形支架。分离传代、分化人脐静脉内皮细胞,接种于PHB管型支架内腔面,分别在静态、动态旋转系统中培养14 d后,测定血管内皮细胞分泌一氧化氮(NO)、前列环素(PGI2)水平。结果 在动态旋转系统构建组织工程化血管模型中血管内皮细胞分泌NO、PGI2水平显著高于静态系统,在11 d NO分别为(120.52±3.83)μmmol／L、(80.98±5.98)μmmol／L,PGI2分另9为(20.48±1.52)μg／L,(16.59±1.29)μg／L,与静态系统相比,差异有显著性(P<0.05)。结论胶原包埋PHB支架有利于细胞的黏附和生长,可作为组织工程化血管的支架材料。在动态旋转系统构建组织工程化血管模型中血管内皮细胞,具有与正常血管类似的"生理功能"。     

胃癌根治术病人围术期异体输血后外周血单核细胞CD40L表达的变化

目的 研究胃癌根治术病人围手术期异体输血外周血单核细胞(PBMCs)白细胞分化抗原40配体(CD40L)表达的变化。方法 胃癌根治术病人30例,随机分为3组,每组10例。A组围术期不输血,B组围术期输入去白细胞的全血,C组围术期输入异体全血。另选10例健康人作为对照。分别在手术前、术后2、5、10 d采外周静脉血5 ml,用Ficoll分离液梯度离心法分离出PBMCs和血浆,将PBMCs置于自身血浆环境中,并在植物血凝素(PHA,20 mg/L)的刺激下进行培养,48 h后收获细胞,用流式细胞术检测CD40L表达。结果 健康人外周血未受PHA刺激时检测不到CD40L的表达,经PHA刺激后CD40L 细胞占CD4 T细胞的百分数为1.7％±0.4％,与三组胃癌病人术前比较差异无显著性(P>0.05)。与术前比较,B组术后2 d PBMCs CD40L表达升高(P<0.05),C组术后各时点升高(P<0.05);与A组比较,B组术后2 d升高(P<0.05),C组术后各时点升高(P<0.05);与B组比较,C组术后各时点升高(P<0.05)。结论 围手术期异体输血可造成免疫抑制,输异体血后CD40L表达增加,且输全血比输去白细胞的全血更明显。围手术期成分输血优于输注全血。     

Measurement of blood loss at childbirth and postpartum.

OBJECTIVE: To accurately measure blood loss during childbirth in a developing country. METHOD: The alkaline hematin technique was used to quantify blood lost during delivery and 24 h postpartum in 158 women in Pemba Island, Zanzibar. RESULT: Women were found to lose less blood during childbirth and 24 h postpartum than previously reported. Compared with laboratory values, nurse-midwives approximated blood loss accurately (mean difference, i.e., mean underestimation by nurse-midwives, 4.90 mL); however, their imprecision was greater for higher laboratory values. CONCLUSION: This study may prompt further investigation, as no comparable data exist for developing countries where maternal mortality is high and severe anemia prevalent.     

ABO血型不合的异基因造血干细胞移植--2例报告附文献复习

探讨ABO血型不合的异基因造血干细胞移植 (Allo -HSCT)的造血问题。方法 :对 2例患者分别进行异基因外周血造血干细胞移植 (Allo -PBSCT)及脐血造血干细胞移植 (CBSCT) ,用血细胞分离机或 6 %羟乙基淀粉去除移植物中的红细胞 ,定期检测受者血型 ,根据情况输注血细胞。结果 :2例患者全部获得造血重建 ,未出现溶血反应。结论 :ABO血型不合可以进行Allo -HSCT ,去除供者移植物中的红细胞能有效地防止急性溶血反应的发生 ,定期检测受者血型 ,及时调整输血方案有重要的临床意义。     

Postnatal formation of the blood-testis barrier in the rat with special reference to the initiation of meiosis

Summary Postnatal formation of the Blood-Testis Barrier (BTB) in the rat was studied by either fixation in hypertonic fixative or employing lanthanum tracer. After 15 days of age, meiosis has reached different stages of spermatogenesis in differnt zones of the seminiferous cords. Only in those parts where germ cells are in the pachytene stage of meiosis do Sertoli cells form an effective barrier or tight compartment. Between 16 and 19 days of age, final formation of the BTB, which is to be found in the adult rat testis, occurs by zygotene and then leptotene stages successively entering the tight compartment. Thus, formation of a BTB by Sertoli cells does not occur synchronously along the length of the seminiferous cord but in accordance with the stage of meiosis of the associated germ cells.     

急性脑梗死血压和颅压的控制

脑梗死急性期对血压和颅压的控制极为重要，若措施得当，可大大降低病死率和致残率。笔者结合临床工作经验总结体会如下：脑梗死急性期对血压和颅压的控制极为重要，若措施得当，可大大降低病死率和致残率，笔者结合临床工作经验总结体会如下。     

Albumin Adsorption and Retention on C18-Alkyl-Derivatized Polyurethane Vascular Grafts

The short-term albumin affinity and thrombo-resistance of a polyether polyurethane vascular graft have been improved. The method is based on the C18 alkylation of the polymer. Thrombus formation by a planimetric technique and albumin retention on wire-reinforced polyurethane tubes, both C18 alkylated and untreated, were measured in short-term (4-h) exposure at femoral arterial sites in the dog. 125I-Albumin was preabsorbed on tubes and then exposed to blood for successive 2-h periods. Albumin uptake on alkylated tubes prior to blood exposure and retention following 2 h of blood exposure were significantly greater than on controls. Following a fast desorption phase in blood, the remaining albumin was more slowly desorbed from alkylated than from control tubes. Reincubation with albumin and blood reexposure produced a similar tendency, suggesting blood conditioning does not reduce the albumin affinity-enhancing property of C18 alkylation in the short term. Blood-preconditioning experiments suggested endogenous albumin has a high affinity for the C18-alkylated surface. Scanning electron microscopic examination showed thrombus and platelet densities were higher on control than on alkylated surfaces. These results suggest in vivo albumin affinity is increased for C18-alkylated polyurethane, which may be linked to decreased thrombus formation on these surfaces.     

肛周按揉及温水足浴对腹部手术后患者肛门排气时间的影响

目的探讨肛周按揉及温水足浴对腹部手术后患者肛门排气时间的影响。方法选择普外科180例腹部手术后患者，随机分为A组（肛周按揉＋温水足浴组＋常规护理）90例和B组（常规护理组）90例。比较2组肛门排气时间及腹胀情况。结果首次肛门排气时间A组早于B组，2组比较差异有统计学意义（P＜0．01）；腹胀症状A组较B组轻。结论肛周按揉结合温水足浴可显著缩短腹部手术术后患者肛门排气时间，减轻术后腹胀症状。     

自体脾静脉移植在门静脉和肠系膜上静脉联合切除的胰十二指肠切除术中的应用

目的：探讨以自体脾静脉重建门静脉系统在联合PV/SMV切除的胰十二指肠切除术中临床应用的可行性。方法：回顾性分析3例胰头癌病人在胰十二指肠切除术中采用脾静脉替代门静脉系移植的应用及其效果。结果：手术均顺利,门静脉阻断时间分别为52min、38min和30min。术后B超随访无脾肿大、腹水等情况,门静脉流量均正常（分别为1450ml/min、1200ml/min和1500ml/min）,术后CTA复查显示重建的血管血流通畅,无血栓形成或狭窄,术后生活质量得到明显改善,黄疸消失,肝功能正常,均痊愈出院。结论：在联合PV/SMV切除的胰十二指肠切除术中采用自体脾静脉替代门静脉系的移植是可行的。