提上睑肌缩短术联合 Mustarde 双 Z 形切除术矫正儿童小睑裂综合征

目的探讨提上睑肌缩短术联合 Mustarde 双 Z _62;切除术矫正儿童小睑裂综合征（blepharophimosis-ptosis-epicanthus inversus syndrome，BPES）的疗效。方法2015 年 3 月—2017 年 6 月，采用提上睑肌缩短术联合 Mustarde 双 Z _62;切除术一期矫正 26 例儿童双眼 BPES。其中，男 16 例，女 10 例；年龄 4～14 岁，平均 7 岁。均有典型的小睑裂四联征。7 例伴有鼻梁低平，20 例伴有弱视和斜视。睑裂长度（19.5±4.5）mm，睑裂宽度（2.5±1.6）mm，内眦间距（42.1±6.5）mm，提上睑肌肌力（5.5±1.3）mm。结果术后切口均Ⅰ期愈合。23 例获随访，随访时间 2～12 个月，平均 10 个月。其中 2 例矫正不足、3 例过度矫正，6 例眼睑线弧度欠佳，均无眼睑内外翻和角膜炎发生。其余患儿均�6210;功矫正上睑下垂和内眦赘皮，眼睑线弧度自然。术后 7 d 测量睑裂长度（27.2±1.9）mm，睑裂宽度（12.5±1.3）mm，内眦间距（29.4±2.6）mm；以上指标均较术前显著改善，差异有统计学意义（t=0.127，P=0.042；t=0.341，P=0.029；t=0.258，P=0.038）。术后无因睑裂宽度、长度回退导致的�6210;角畸_62;发生。 结论提上睑肌缩短术联合 Mustarde 双 Z _62;切除术能达到一期矫正儿童 BPES 目的，可获得较好临床疗效。     

开放楔形胫骨高位截骨术治疗膝关节内侧间室骨关节炎疗效观察

目的探讨开放楔_62;胫骨高位�622a;骨术（open wedge high tibial osteotomy，OWHTO）治疗膝关节内侧间室骨关节炎的效果。方法回顾分析 2015 年 1 月—2017 年 1 月采用 OWHTO 治疗的 61 例膝关节内侧间室骨关节炎患者临床资料。男 14 例，女 47 例；年龄 44～60 岁，平均 52.8 岁。体质量指数为 19.1～34.7 kg/m²，平均 25.3 kg/m²。左膝 27 例、右膝 34 例。病程 1～9 年，平均 5.3 年。骨关节炎分期：Ⅱ期 33 例，!62;期 28 例。术前膝关节美国特种外科医–62;（HSS）评分为（56.0±3.7）分，行走时膝关节疼痛视觉模�62df;评分（VAS）为（4.6±1.0）分。 结果�624b;术时间为 49～85 min，平均 66.5 min；切口长度为 10～13 cm，平均 11.0 cm；总显性失血量为 80～210 mL，平均 139.1 mL；术后卧床时间为 1～10 d，平均 4.7 d。患者均获随访，随访时间 12～24 个月，平均 17.3 个月。术后 3 个月 X 线片测量示胫骨平台负重区为 60.3%～66.8%，平均 63.4%。术后 3、6 个月，膝关节 HSS 评分分别为（79.1±4.2）、（85.3±3.1）分，VAS 评分分别为（1.7±0.7）、（0.6±0.5）分，差异均有统计学意义（P<0.05）。 结论OWHTO 治疗膝关节内侧间室骨关节炎疗效确切，力线纠正理想，并发症较少，但应注意术前需要精确测量术中张开角。     

血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂RGDS对血小板释放反应的影响

 【目的】观察血小板膜糖蛋白Ⅱb/Ⅲa（GPⅡb/Ⅲa）拮抗剂——四肽Arg-Gly-Asp-Ser（RGDS）对血小板聚集和CD62p表达的作用,探讨RGDS对血小板聚集和释放反应的影响。【方法】检测二磷酸腺苷（ADP;终浓度5μmol/L,下同）诱导血小板聚集的最大聚集率（rPA,max）、静息血小板和ADP诱导的血小板CD62p表达,检测不同浓度RGDS对ADP诱导的rPA,max的抑制率和血小板CD62p表达的抑制率,进行回归分析。【结果】5种浓度（50、100、200、400、800μmol/L）的RGDS对rPA,max均有显著抑制作用。正常人静息血小板CD62p表达率为（3.5±0.6）%;ADP激动的血小板CD62p表达率为（65.6±13.8）%,两组比较有显著性差异（P〈0.01）;50、100μmol/L的RGDS对血小板CD62p表达无抑制作用;当RGDS浓度≥200μmol/L时（200、400、800μmol/L）,其可抑制血小板CD62p的表达;RGDS对rPA,max的抑制作用和其对血小板CD62p表达的抑制作用相关。【结论】RGDS浓度〈200μmol／L时，对ADP诱导的血小板释放反应无影响；RGDS浓度≥200μmol/L时，可抑制ADP诱导的血小板释放反应；与RGDS显著的抗聚集效应相比，其对血小板释放反应的影响比较小：RGDS抑制血小板释放反应的作用与其抗血小板聚集有关。     

Effect of Surgically-Induced Weight Loss on Leukocyte Indicators of Chronic Inflammation in Morbid Obesity

Background: Recent evidence suggests that morbid obesity is a chronic inflammatory condition that may be associated with immune dysfunction.To test this hypothesis, we investigated several leukocyte cell surface markers of chronic inflammation and followed their response to surgically-induced weight loss. Methods: 26 patients having Roux-en-Y gastric bypass (RYGBP) for morbid obesity (BMI>40) were compared to 10 normal controls (BMI<25). Relative monocyte and neutrophil frequencies and expression of the activation antigens CD11b (adhesion molecule), CD16 (Fc receptor), and CD62L (Lselectin), were evaluated by flow cytometry preoperatively and at 1, 3, 6 and 12 months after RYGBP. Cases served as their own controls but were also compared to non-obese controls. The results were statistically analyzed using Student's t-test and ANOVA for parametric values and Mann-Whitney along with Kruskal-Wallis ANOVA for nonparametric values Results: The control group had mean age 37 ± 7.6 with mean 23 ± 2.5 and no comorbidities. The mean age of the sample group was 40.36 ± 13.7 with mean BMI 52 ± 8.2. The neutrophil and monocyte relative frequencies of CD11b (monocytes and neutrophils), and CD16 (neutrophils only) were comparable to controls at baseline and did not change significantly with weight loss throughout the study period. However, a significant reduction of CD62L (Lselectin) expression was noted in monocytes and neutrophils at baseline (neutrophils 103 vs 240 gmf, p<0.001) (monocytes104 vs 246 gmf, P<0.001) when compared to normal controls. Levels of L-selectin normalized by 6 months in both monocytes and neutrophils, and by 12 months had become abnormally elevated in monocytes (monocytes 391 gmf, P=0.007); in neutrophils, there was an upward trend that did not reach significance.The expression of the LPS receptor CD14 in the study group was elevated significantly compared to controls at baseline (1129 vs 719 gmf, P=0.004); this marker appeared to return to normal by 3 months. Monocyte CD14+/CD16+ subset percentage were also elevated significantly at baseline (14.3% vs 5.25%, P <0.001), declined throughout the time period but was still significant at 1 year (8.8%, P<0.001). Eosinophil percentages were elevated at baseline (3.3% obese vs 1.8% controls, P=0.003) and remained so throughout the time period. Conclusion: Deficiencies in the immune system of morbidly obese individuals include elevated levels of eosinophils, monocyte CD14, and monocyte CD14+/CD16+ subsets, with depression of monocyte and neutrophil CD62L. These abnormal levels reverse rapidly with surgically-induced weight loss. RYGBP is not only a weight loss operation but also appears to be an immune restorative procedure.     

Mechanism of the inhibitory effect of histamine on amygdaloid-kindled seizures in rats

PURPOSE: The mechanism of the inhibitory effect of histamine on amygdaloid-kindled seizures was investigated in rats. METHODS: Under pentobarbital anesthesia, rats were fixed to a stereotaxic apparatus, and bipolar electrodes were implanted into the right amygdala. A guide cannula made of stainless steel tubing was implanted into the right lateral ventricle. Electrodes were connected to a miniature receptacle, which was embedded in the skull with dental cement. EEG was recorded with an electroencephalograph; stimulation of the amygdala was applied bipolarly every day by a constant-current stimulator and continued until a generalized convulsion was obtained. RESULTS: Intracerebroventricular (i.c.v.) injection of histamine at doses of 2-10 microg resulted in a dose-related inhibition of amygdaloid-kindled seizures. I.c.v. injection of calcium chloride at doses of 10-50 microg and A23187 at doses of 2-10 microg also caused dose-dependent inhibition of amygdaloid-kindled seizures. Calcium chloride at a dose of 10 microg, which showed no significant effect on amygdaloid-kindled seizures when used alone, significantly potentiated the effect of histamine. Similar findings were observed with A23187 at a dose of 2 microg. In addition, EGTA and EGTA/AM antagonized the inhibition of kindled seizures induced by histamine. Moreover, the inhibition of kindled seizures induced by histamine was antagonized by KN62. However, calphostin C did not antagonize the inhibitory effect of histamine. CONCLUSIONS: These results indicated that histamine-induced inhibition of amygdaloid-kindled seizures may be closely associated with a calcium calmodulin-dependent protein kinase II activation pathway.     

子痫前期患者血中循环内皮祖细胞数量改变的研究

目的:探讨子痫前期患者与正常同孕周的妇女外周血中内皮祖细胞数量的变化.方法:选择30例子痫前期患者为子痫前期组,30例相同孕周的妇女为对照组,采用Beckman-Coulter Epics XL型流式细胞仪检测两组孕妇外周血中循环内皮祖细胞表达情况.结果:子痫前期组CD34+/CD45+和CD62P+总数占外周有核细胞总数的百分比,明显高于正常相同孕周的妇女,两组比较差异有统计学意义(P＜0.05).结论:子痫前期的发病机制可能与内皮祖细胞数量的改变有关.     

急性冠脉综合征血小板GMP-140检测的临床意义

目的探讨急性冠脉综合征（ACS）患者血小板α颗粒膜蛋白（GMP-140）的变化及临床意义。方法分别采用ELISA中的双抗体夹心法和流式细胞法检测70例ACS患者（其中AMI35例，UAP35例）、SAP患者32例和健康成人38例的血清血小板GMP-140（可溶性P-选择素）水平及其在血小板膜上的表达（CD62P）水平。结果流式细胞法测定CD62P阳性率在AMI、UAP、SAP和正常组分别为（21．69±9．40）％、（8．41±3．02）％、（4．16±1．50）％和（3．12±1．29）％；ELISA法测定GMP-140在AMI、UAP、SAP和正常组分别（49．53±10．04）ng／ml、（24．92±7．64）ng／ml、（16．11±4．07）ng／ml和（14．96±3．82）ng／ml，ACS组两种方法测定结果均高于SAP组和健康组（P均〈0．01），AMI和UAP组两种方法测定结果比较均有显著性差异（P〈0．01），且与ACS的严重程度呈正相关。结论ACS患者GMP-140显著升高，P-选择素水平有助于ACS的严重程度判定，CD62P阳性表达可作为血小板活化程度的判定。     

氯比格雷和阿司匹林干预非瓣膜病房颤患者血小板活化因子水平的研究

目的　分析房颤患者血小板因子CD6 2p、CD4 1水平变化及应用阿司匹林 75mg、阿司匹林 32 5mg和氯比格雷 75mg +阿司匹林 32 5mg对房颤患者血小板因子水平的影响。方法　选择 5 8例房颤患者和 30名健康对照者为研究对象 ,应用CD6 2p -FITC、GPⅡb Ⅲa -FITC单克隆抗体检测血小板CD6 2p、CD4 1表达量 ,分析阿司匹林75mg、阿司匹林 32 5mg及阿司匹林 32 5mg+氯比格雷 75mg对CD6 2p、CD4 1水平的影响。结果　房颤患者血浆CD4 1和CD6 2p水平显著高于对照组 ,阿司匹林 32 5mg和阿司匹林 32 5mg +氯比格雷 75mg组用药后血小板CD6 2p水平较用药前显著降低 (P <0 0 5 ) ,而CD4 1水平仅在后者有显著变化 (P <0 0 5 )。结论　房颤患者血小板因子CD4 1和CD6 2p水平异常升高 ;用氯比格雷 75mg+阿司匹林 32 5mg对房颤患者血小板活性有明显抑制作用。     

Inhibition by antiarrhythmic and β-sympatholytic drugs of serotonin uptake by human platelets: Experimentsin vitro andin vivo

Summary The effects of prenylamine, verapamil, propranolol, INPEA, and pindolol on the uptake of serotonin by human platelets were investigatedin vitro andin vivo. Serotonin uptakein vitro was diminished by these drugs. Their order of potency, according to IC 50 values estimated from the dose response curves was: propranolol > prenylamine > verapamil > INPEA > pindolol. The inhibitory activity of these drugsin vivo was also studied by measuring serotonin uptake by platelets isolated 90 min after oral administration to healthy volunteers of 10 µmoles of propranolol, INPEA and prenylamine, all approximately 3 mg/kg; verapamil, approximately 5 mg/kg; and 2 µmoles/kg (0.5 mg/kg) of pindolol. In agreement with the degree of inhibition observedin vitro, propranolol was more effective than verapamil and INPEA, and, as predicted from thein vitro experiments, pindolol showed no measurable membrane activity. Prenylamine, an effective inhibitor of serotonin uptake by human plateletsin vitro, was activein vivo only after repeated oral doses of 10 µmoles/kg. It is concluded that measurement of the uptake of serotonin by human platelets is a sensitive method for investigating non-specific effects of drugs on membrane functionsin vivo as well asin vitro.Supported by a grant from the Deutsche Forschungsgemeinschaft.A preliminary report of this work has been presented at the 12. Frühjahrstagung der Deutschen Pharmakologischen Gesellschaft, Mainz 1971 (Grobeckeret al., 1971).