Sperm number and condition affect the number of basal cells and their expression of macrophage antigen in the murine epididymis

Unilateral ligation of the mid-corpus epididymis, the proximal vas deferens and imposition of an abdominal temperature for 6 days as well as bilateral castration for 3, 6 or 14 days, resulted in a change in epithelial composition of the adult murine epididymis with regard to the number and antigen expression of basal cells. There were fewer basal cells per tubule cross-section with fewer expressing F4/80 antigen when spermatozoa were absent from the proximal lumen following short-term castration. Conversely, more basal cells with more of them demonstrating macrophage antigen expression were evident when more or damaged spermatozoa were in the proximal lumen after corpus ligation and exposure to abdominal temperature or in the cauda after long-term withdrawal of androgen support. By contrast, ligation of the vas deferens did not lead to tubule distension, and hence sperm accumulation, and did not alter the basal cell population in the cauda epididymis. The data suggest that epididymal basal cells respond in number and macrophage antigen expression to the presence of sperm autoantigens in the lumen with little dependence on circulating androgens. These changes may represent responses to minimise the interaction of sperm autoantigens with the immune system and the risk of immunological infertility.     

医源性脾损伤28例诊治分析

目的 分析医源性脾损伤的原因及有关的治疗手段。方法 回顾分析28例脾损伤和有关文献报道的病例。结果 脾损伤与胃十二指肠溃疡、胃癌、食管癌、肝肿瘤手术等有关；心肺复苏和纤维结肠镜检查也可致脾损伤；自发性脾破裂可发生在白血病等疾病的发病过程中。结论 根据损伤原因及损伤分级不同，采取不同的治疗方式。可提高保脾手术成功率。     

Epidermoid cyst in a wandering spleen

A wandering spleen and splenic cysts are uncommon conditions in children. A combination of both entities has only rarely been reported in the literature. Another case of this complex pathology in 12-year-old girl is presented. She was initially referred for evaluation of a large abdominal mass. Diagnostic studies raised the suspicion of a hematoma in an abnormally located spleen, but the definitive diagnosis was established at laparotomy. Successful surgical management consisted of total cystectomy and splenopexy. Accepted: 6 November 1997     

Spontaneous Splenic Rupture in a Patient with Acute Lymphoblastic Leukemia of Burkitt Type

We describe a case of spontaneous splenic rupture occurred in a patient with acute lymphoblastic leukemia of Burkitt type before starting cytotoxic chemotherapy. Left hypochondrial pain radiating to the homolateral shoulder was the only clinical symptom. Emergency computed tomography showed splenic laceration and hemoperitoneum. The patient underwent immediate laparotomy with splenectomy and experienced an uneventful postoperative recovery. Eight days after surgery, chemotherapy could be administered and complete remission was achieved. Although spontaneous rupture of the spleen is rare in leukemia and related disorders, this diagnosis should be taken in account also when clinical symptoms are mild. Following immediate operative management, patients may completely recover and receive cytotoxic chemotherapy with substantial possibilities of achieving complete remission.     

退变性腰椎管狭窄症伴Ⅰ度滑脱的手术治疗

目的观察退变性腰椎管狭窄症伴Ⅰ度滑脱经椎弓根钉系统及腰椎管减压融合内固定术的治疗效果。方法回顾分析退变性腰椎管单平面狭窄症伴Ⅰ度滑脱病例56例，患者平均年龄63．4岁，平均病程51个月。病变节段：L4-5，40例，L5-S1 16例。手术方式采用全椎板减压加植骨融合及椎弓根钉内固定，术后功能采用北美脊柱外科协会的腰椎功能障碍指数（Oswestry Disability Index）评定。结果本组35例获得随访，随访时间8个月～4年，平均随访27个月。术后改善率为优26例、良5例、可3例、差1例，优良率为88．6％。随访过程中3个月内植骨融合者29例（包括5例椎间植骨融合者），6个月内植骨融合4例，出现假关节2例，其中1例发生内固定断裂。结论对退变性腰椎管狭窄症伴Ⅰ度滑脱，采用椎管减压植骨融合内固定术，短期内可保证脊柱融合，达到稳定脊柱、解除症状的目的。     

120例脾脏损伤治疗方法的选择

目的探讨急性脾脏创伤如何恰当地选择治疗方法。方法对120例急性脾创伤患者的治疗方法进行了回顾性的总结。结果全组15例行保守治疗，腹腔镜探查止血术5例，脾修补术23例，脾修补加脾动脉结扎术5例，脾部分切除术5例，全脾切除术67例。术后出血再手术2例，死亡2例。结论急性脾创伤后有选择性地施行非手术疗法或保留脾脏手术是安全可行的。     

一种新型颈椎椎弓根置钉定位器的研制

介绍一种可三维调节的颈椎椎弓根置钉定位器,该装置作为钻模应用于颈椎椎弓根的钻孔定位,实现个体化置钉。给出了设计原理、使用方法,推导出椎弓根术前影像学数据与定位器钻套调整角的关系,并编制了计算应用软件。进行了功能评价和误差分析。     

套扎和硬化夹心联合与单纯硬化治疗食管静脉曲张出血的对比研究

目的了解套扎与硬化夹心联合法治疗食管静脉曲张出血(EVB)能否获得优于单纯硬化(EIS)的疗效。方法84例肝硬化EVB患者随机接受夹心法或单纯EIS治疗(夹心法组43例,EIS组41例)。EIS组硬化剂采用血管旁、内的联合注射法,夹心法组每条曲张静脉结扎2个皮圈,并于其间曲张静脉内注射1～3mL硬化剂。间隔7～12d重复1次内镜治疗,直至静脉曲张消除。结果夹心法组与EIS组静脉曲张消除率相似(93.0%比92.7%),但夹心法组达到消除的平均治疗次数明显减少(1.8±0.6比3.8±1.1),所需平均时间显著缩短[(17.1±7.1)d比(36.5±15.7)d],再出血率与并发症率明显下降(9.3%比31.7%;8.4%比26.8%)。随访期内两组静脉曲张复发率比较差异无显著性(11.6%比14.6%)。结论内镜下套扎与硬化夹心联合法治疗食管静脉曲张出血的疗效优于单纯硬化治疗的疗效。     

单枚椎间融合器并对侧经皮椎弓根螺钉固定的生物力学研究

目的对单枚融合器联合单侧钉棒系统固定的生物力学性能进行评价。方法5具新鲜小牛腰椎标本,建立以下力学模型：A组：双侧开窗＋双枚融合器置入＋双侧椎弓根钉棒固定;B组：单侧小关节切除＋单枚融合器斜向置入＋同侧椎弓根钉棒固定;C组：单侧开窗＋单枚融合器置入＋同侧椎弓根钉棒固定;D组：单侧开窗＋单枚融合器置入＋对侧椎弓根钉棒固定。在生物力学平台上测试各试验组在不同工况下的ROM值。结果A组的固定最稳固,各工况下ROM值最低。B组的前后抗弯ROM值与A组差异无显著性,其左右侧弯和旋转方向的稳定性较A组有所降低。与B组比较,D组的前后弯曲性能与B组差异无显著性,其左右侧弯方向的ROM低与B组。两组的抗旋转ROM值差异无显著性。C组的左右抗弯及抗旋转性能均差于B、D组。结论单枚椎间融合器联合对侧椎弓根钉棒固定是一种力学性能较为优良组合,可以替代单侧斜向融合器并同侧椎弓根钉棒技术用于下腰椎微创手术。