去卵巢骨质疏松模鼠DPD及1,25-(OH)2D3与骨质量的相关性研究

目的：探讨雌性SD大鼠切除卵巢后机体尿DPD及血1，25-（0H）2D3变化与骨质量的相关性。方法：40X雌性SD大鼠随机分为卵巢切除组（OVX组）和假手术组（Sham组），分别于术后12、24周取材。运用双能X线骨密度仪测L1、股骨、股骨颈骨密度，ELISA法测尿DPD浓度，激素放免法测血1，25-（OH）2D3浓度，光测弹性仪测L1压缩强度极限、弹性模量及右侧股骨弯曲破坏栽荷，不脱钙骨切片技术观察胫骨上段骨组织形态结构并计量分析，对实验数据进行相关性分析。结果：术后OVX组除尿DPD／Cr明显升高外，其他检测指标均较Sham组低，且随术后时间推移持续下降，差异有统计学意义。相关分析显示：尿DPD／Cr与腰椎、股骨密度、椎体压缩强度极限、股骨弯曲破坏荷载和骨小梁面积均呈负相关。血清1，25-（OH）2D3水平与腰椎、股骨、股骨颈密度、骨小梁面积、椎体压缩强度极限和股骨弯曲破坏荷载呈正相关。结论：大鼠卵巢切除后尿DPD、血1，25-（0H）2D3水平变化与骨质量显著相关，可以通过检测尿DPD、血1，25-（0H）2D，水平变化预测骨质量。     

五种生物基质对鼠乳腺肿瘤细胞生长和克隆形成的影响

本文研究结果表明,应用无血清培养体系对鼠中孕期乳腺组织细胞(COMMA-1D细胞)、鼠乳腺肿瘤细胞(FUKU细胞)以及CD8F1细胞的原代培养中。BM Matrigel是一良好的细胞附着和细胞生长的促进剂,而Ⅳ型胶原、昆布胺酸和Vitrogen 100对上述细胞的附着和生长也有一定的作用。BM Matrigel和昆布胺酸对FUKU细胞的克隆产率也有显著的促进作用,而昆布胺酸应用方便,价格较低,更适于在实验研究中推广应用。     

Massive Immune Hemolysis Caused by Anti-D After Dual Kidney Transplantation

Massive immune hemolysis due to passenger lymphocyte-derived anti-D has not been reported in renal transplantation. A 50-year-old (B-positive) male received a dual deceased-donor kidney transplant (B-negative) for diabetic renal failure. Two weeks post-transplant, the patient developed severe hemolytic anemia. The donor anti-D titer was 1:8. The recipient anti-D titer (zero pre-transplant) increased from 1:4 to 1:16 over 4 days. Rapid hemolysis caused severe anemia, minimum Hb = 4.2 g/dL, while selectively lysing the patient's autologous red cells during this time. The hemolytic anemia did not impair the allografts and subsided without monoclonal B-cell pharmacotherapy or apheresis. The anti-D titer decreased to barely detectable levels at four months and had cleared when checked 2 years post-transplant. Transfusion support subsided after two months. If complications of anemia can be avoided, the deleterious effects of hemolysis may be well tolerated by renal allografts using antigen negative transfusion alone.     

螺旋CT三维重建成像在先天性高肩胛症手术方式选择中的作用

[目的]探讨螺旋CT三维重建技术在先天性高肩胛症分度和手术方式选择中的作用。[方法]22例先天性高肩胛症术前应用螺旋CT对病变部位进行扫描并三维重建，测量以肩胛骨肩胛冈内侧缘为参照点，两侧肩胛骨高度差。根据测量结果依据Cavendish分度将其分类，并根据三维重建成像选择不同的矫形手术术式。[结果]本组22例病人，随访2—4年，外观及功能均有不同程度的改善，未出现神经、血管和椎体等的损伤。[结论]根据螺旋CT扫描和三维重建检查结果，术前即可直观的明确先天性高肩胛症的病变程度，相互关系，伴发畸形，患侧肩胛骨与正常对侧肩胛骨的外观差异等，便于手术操作方案的制定，避免了手术操作的盲目性，减少医源性并发症的发生。     

The efficacy and safety of laparoscopic nephrectomy in patients with three or more comorbidities

OBJECTIVES: Laparoscopic surgery for kidney treatment is a common procedure. However, the efficacy of this procedure in patients with several comorbidities has not been well investigated. We conducted a retrospective comparison of results of laparoscopic surgery between patients with several comorbidities and patients with no comorbidity to access the efficacy and safety of this procedure. METHODS: The subjects were 20 patients with three or more comorbidities (group A) and 46 patients with less than three comorbidities (group B). These 66 patients were 48 men and 18 women with a mean age of 62.3 years (age range, 24-83 years). The data from these two groups were compared for American Society of Anesthesiology (ASA) physical status score, previous surgical history, duration of surgery, estimated blood loss, tumor size, complications during and after surgery, conversion rates, time to oral intake, and length of hospital stay. RESULTS: The initial ASA score and age were significantly higher for the patients with comorbidities (P < 0.0001, P = 0.0008, respectively). All other variables before, during, and after surgery were similar for both laparoscopic groups. However, the incidence of atelectasis of laparoscopy was higher than that of open surgery. CONCLUSIONS: Laparoscopic nephrectomy for patients with comorbidities is safe and minimally invasive. Further investigation to prevent atelectasis is necessary.     

Chronic acid ingestion promotes renal stone formation in rats treated with vitamin D3

OBJECTIVE: Although hypercalciuria, a well-established adverse effect of vitamin D3, can be a risk factor of renal stone formation, the risk of nephrolithiasis has not been well defined. The consumption of a diet high in acid precursors is often cited as a risk factor for the development of calcium-based kidney stones. In the present study, we investigated the effect of chronic acid ingestion on kidney stone formation in rats treated with calcitriol (1-25[OH]2 D3). METHODS: Control rats (C-C), calcitriol-treated rats (C-V; three treatments of 0.5 microg of calcitriol per week) and acid-ingested (water containing 0.21 mol/L NH4Cl), calcitriol-treated (three treatments of 0.5 microg of calcitriol per week) rats (A-V) were fed in metabolic cages. After 1 month, urine, blood, kidney and bone samples were analyzed. RESULTS: The A-V rats exhibited elevated serum calcium concentrations, urinary calcium and phosphate excretion, urinary type I collagen cross-linked N-peptide (NTx)/creatinine values, mRNA expression of osteopontin in the kidney, and renal calcium contents as well as decreased bone mineral densities, compared with the C-C and C-V rats. Urinary citrate excretion was lower and NaDC-1 mRNA expression in the kidney was higher in the A-V rats than in the C-C and C-V rats. Calcium phosphate kidney stones were found in the A-V rats. CONCLUSIONS: The ingestion of NH4Cl, an acid precursor, promotes calcium phosphate kidney stone formation in calcitriol-treated rats. The chronic intake of a diet rich in acid precursors may be a risk factor for the development of kidney stones in subjects who are being treated with calcitriol.     

Impact of unilateral interposition sural nerve graft on the recovery of sexual function after radical prostatectomy in Japanese men: A preliminary study

PURPOSE: To determine the effect of an interposition nerve graft on sexual function after radical prostatectomy. METHODS: This study includes 64 patients, without hormonal therapy, who underwent a radical prostatectomy and intraoperative electrophysiological confirmation of cavernous nerve preservation. Twelve patients underwent a unilateral interposition sural nerve graft (UNG) for the resected neurovascular bundle. Twenty-one and 31 patients underwent bilateral nerve-sparing (BNS) and unilateral nerve-sparing (UNS) surgery without a nerve graft, respectively. As the age of patients was significantly younger in the UNG group than in the other groups, age-matched analysis also was conducted. Sexual function, evaluated by a self-administered questionnaire using the University of California Los Angeles-Prostate Cancer Index, was compared statistically among the three groups. RESULTS: In the age-matched analysis, the postoperative sexual function (SXF) score of the UNG group showed an intermediate level of recovery between those of the BNS and UNS groups at 12 months and reached the same level as the score at 12 months of the BNS group at 18 months postoperatively. The difference in the SXF score between the UNG and UNS groups began to appear after 6 months postoperatively and increased steadily with time. However, the background factors, such as the baseline SXF score, the usage rate of phosphodiesterase 5 inhibitors, and the rate of comorbidities were different between the UNG and UNS groups. CONCLUSIONS: The difference of the SXF score between the UNG and UNS groups increased with time after 6 months postoperatively. However, it might be difficult at present to attribute a better recovery of the SXF score to the nerve graft because of the difference in the background factors between the groups.     

Stereophotogrammetric measurement of the nasolabial fold in repose: a study of age and posture-related changes

The nasolabial fold is a significant facial landmark. Its size, shape, and symmetry are important in facial reanimation surgery, while effacement is an important goal in rejuvenation surgery. However, quantitative data for the nasolabial fold volume (NLFV) and depth is still unavailable. We present a new method of measurement using 3D color speckle stereophotogrammetry and its application in the assessment of NLFV. The VECTRA-3D system was validated to determine its minimum resolution and accuracy. Normal volunteers aged 13–84 years (n = 87) were imaged in repose. Mother–daughter pairs (n = 15, aged 13–61) were imaged in the upright and supine positions. All data were processed using custom software and analyzed by linear regression and nonparametric tests as appropriate. NLFV varied from 0.0026 to 0.2306 ml. There was significant correlation between NLFV and age (r = 0.7269, p < 0.0001). Men had significantly higher NLFV than women across all ages. There was no significant difference between the left and right NLFV. NLFV altered significantly from upright to supine in all subjects (p = 0.0012). However, the mothers increased their NLFV by 32% from supine to upright postures, which was a greater change than observed in their daughters. We have demonstrated a rapid, objective, and non-invasive assessment tool for facial reanimation and rejuvenation surgery. We have quantified the effects of age and posture on NLFV, and the efficacy and longevity of rejuvenation procedures are currently under investigation.     

大鼠维生素D受体蛋白表达载体的构建及遗传性高钙尿性结石大鼠十二指肠维生素D受体cDNA序列分析

目的构建大鼠维生素D受体（VDR）蛋白表达载体，测定并分析遗传性高钙尿性结石（GHS）大鼠VDRcDNA序列。方法采用半定量逆转录-聚合酶链反应（RT—PCR）方法扩增含VDR蛋白编码基因序列，将扩增产物克隆至真核表达载体pcDNA3．1／Zero（＋），对5只GHS大鼠和4只正常尿钙对照（NC）大鼠十二指肠VDRcDNA序列进行测序分析。结果琼脂糖凝胶电泳示PCR扩增产物碱基数目与目的片段大小一致。对重组质粒的分析表明，插入片段的序列与发表的VDR基因编码序列相同。5只GHS鼠和4只NC鼠肠VDR cDNA序列均有3个相同的位点不同于已公布的大鼠肠VDR cDNA序列：在256bp位点：C取代G；569bp位点：G代替A；1658位点：A替代G。另外，GHS鼠在1795bp位点发生改变，G取代A，而NC鼠则无改变。结论大鼠维生素D受体蛋白编码序列被成功地克隆至表达载pcDNA3．1／Zero（＋）上。GHS大鼠基因编码区的序列组成同NC大鼠相一致，但GHS鼠1795bp位点的碱基改变未见于NC鼠。