子宫动脉开口摄影角度分析

目的 探讨子宫动脉开口在DSA图像上的“最易显示角度区间”.方法 对12例患者子宫动脉开口部CTA三维容积重建(VR)、最大密度投影(MIP)成像进行标准正位和旋转观察,在正位分析出子宫动脉开口与其附着动脉的内外关系,在左右斜位获得能清晰显示子宫动脉开口的小角度区间.对27例患者子宫动脉开口部用同样方法于DSA造影过程中验证这个区间的准确性.结果 41支子宫动脉开口位于附着动脉外侧,向对侧倾斜10°～40°可显示清晰;13支开口位于附着动脉内侧,向同侧倾斜30°～50°显示清晰;24支开口位于附着动脉前方,大角度倾斜40°～60°显示清晰.结论 “最易显示角度区间”能很轻易、清晰显示子宫动脉开口.     

胰管开口炎性病变导致的慢性阻塞性胰腺炎的诊断和外科治疗

目的 探讨胰管开口部位炎性病变导致的慢性阻塞性胰腺炎的诊断和外科治疗方式.方法 对我院自2002年1月至2010年11月收治的28例慢性阻塞性胰腺炎患者的临床资料进行回顾性总结.其中13例患者血清淀粉酶和脂肪酶升高伴有反复急性腹痛,经影像学检查显示胰管全程扩张改变,外科探查明确诊断为胰管开口部位炎性病变导致的慢性阻塞性胰腺炎.对此13例患者的临床表现、诊断方法、手术探查发现和治疗方法进行分析,并对术后的状况包括疼痛复发、生活质量、胰腺的影像学变化和血清胰腺酶学进行随访观察.结果 13例患者均具有典型的慢性阻塞性胰腺炎的临床表现,但12例患者的影像学表现有别于十二指肠乳突、壶腹或胰腺导管内肿瘤导致的慢性阻塞性胰腺炎的图像特征,手术探查和影像学揭示多数患者的胆胰共同通道过短或存在胰腺分裂畸形,对12例患者实施十二指肠乳突、壶腹及胰管开口切开成形术或副乳突切开成形术,术后随访结果显示均未再伴有胰腺酶学升高的急性腹痛发作.结论 以胰管扩张为主而不伴有胆管慢性梗阻是胰管开口炎性病变导致的慢性阻塞性胰腺炎的影像学特征,十二指肠乳突炎症或副乳突炎症时容易在过短的胆胰共同通道或胰腺分裂畸形的患者中引发胰管开口的狭窄而发生慢性阻塞性胰腺炎,纠正胰管开口狭窄、改善胰管引流的局部成形术是简单、有效的治疗方法.     

Evaluation of the 20-day pubertal female assay in Sprague-Dawley rats treated with DES, tamoxifen, testosterone, and flutamide.

The Endocrine Disrupter Screening and Testing Advisory Committee (EDSTAC) has recommended the rodent pubertal female assay as a Tier I test to detect potential endocrine disrupters (EDs). This assay is designed to screen estrogenic activity in immature rats exposed to chemicals during sexual maturation. The aim of this study was to evaluate whether this assay can detect the EDs with effects brought about through various mechanisms. Immature Sprague-Dawley female rats (21 days of age) were dosed daily for 20 days by oral gavage (DES, tamoxifen, and flutamide) or sc injection (testosterone). The mean age at vaginal opening (VO) was 32.3 +/- 0.5 days in control rats. Although VO was unaffected by DES at doses of 0.2 and 1.0 microg/kg, a high dose of DES (5.0 microg/kg) significantly advanced the age at VO to 24 days. Both tamoxifen (50 and 200 microg/kg) and flutamide (25 mg/kg) also significantly accelerated VO to 27.8 +/- 0.5, 25.1 +/- 0.1, and 26.1 +/- 0.1, respectively. However, testosterone dose-dependently delayed VO (exposure to 1.0 mg/kg extended VO to 37.3 +/- 0.8 days, and VO did not occur in 2 of 10 animals by the time of necropsy at 41 days of age). Estrous cyclicity was monitored in rats from VO to necropsy. Irregular cycles were observed in the groups treated with DES (5.0 microg/kg), tamoxifen (200 microg/kg), testosterone (1.0 mg/kg), and flutamide (25 mg/kg). High dose of DES showed a persistent estrus state throughout the entire observation period. In addition, the number of days in diestrus was increased by tamoxifen (200 microg/kg) and flutamide (25 mg/kg) treatments. Significant decreases in ovarian weight were observed in 5.0 microg/kg DES (64% of control), 25 mg/kg flutamide (76% of control), and 200 microg/kg tamoxifen (47% of control). Testosterone also significantly decreased the ovarian weights in all treatment groups. Uterine weights were also decreased significantly at high doses of tamoxifen (200 microg/kg, 39% of control) or testosterone (1.0 mg/kg, 47% of control). In hormone analysis, tamoxifen significantly increased serum E(2) levels at 50 microg/kg. The mean serum levels of TSH were significantly increased in tamoxifen (10 and 50 microg/kg), testosterone (0.2 mg/kg), and flutamide (1.0 and 25 mg/kg) treatment groups compared with the control. However, serum T(4) levels were significantly reduced by testosterone. Furthermore, serum T(3) levels were significantly increased in DES, tamoxifen (10 and 50 microg/kg), testosterone (1.0 mg/kg), and flutamide (1.0 and 5 mg/kg). Our data demonstrate that the rodent pubertal female assay is useful for identifying potential EDs having not only estrogenic/antiestrogenic but also androgenic/antiandrogenic activities. However, further validation study is necessary to identify chemicals that operate through other action mechanisms, including steroid biosynthesis inhibitors and thyroid inhibitors. Moreover, additional data on other compounds with weak endocrine disrupting activity will be required to further characterize the sensitivity of the female pubertal assay.     

阴道壁囊肿激光开窗术与造口术疗效比较

目的：探讨阴道壁囊肿激光窗术与造口术的疗效。方法：用激光在囊肿壁最薄处将囊肿开窗－长约（0．5－1．0）cm创口直至囊腔，使粘稠透明液体流出，用2％甲硝唑注射液20ml 庆大霉素8万单位冲洗囊肿两次，创面涂碘伏以观察效果。结果：阴道壁囊肿激光开窗术优于造口术。结论：激光手术对临近组织影响轻微，且保持阴道内腺体功能，无干燥感，是一种简便快捷、无痛苦、治疗后无复发、不易感染及瘢痕形成的较好的治疗阴道壁囊肿的方法。     

替牙列期骨性前牙反(牙合)与正常(牙合)的下颌运动轨迹研究

目的观测替牙列早期骨性前牙反者与正常者的下颌运动轨迹,并比较两者的差异。方法采用下颌运动轨迹超声波记录系统(ARCUSdigma系统),对处于替牙列早期的32例骨性前牙反者和19例正常者的空载开口和前伸运动进行比较。结果在空载运动中,处于替牙列早期的骨性前牙反组运动中心的典型运动轨迹较正常平坦,在运动的初始阶段出现向上位移,在矢状位上的垂直向及水平向最大位移均小于正常组,但差异不显著;在空载开口运动中,骨性前牙反组切点的典型运动轨迹为先垂直下降,然后前移一段距离后再垂直下降,与正常组存在差异,在矢状位上的水平向最大位移与正常组存在显著差异。在空载前伸运动中,处于替牙列早期的骨性前牙反组运动中心的典型运动轨迹较正常组平坦,在矢状位上的垂直向及水平向最大位移均小于正常组,但差异不显著;在空载前伸运动中,骨性前牙反组切点的典型运动轨迹较正常组平坦,在矢状位上的水平向最大位移显著小于正常组。结论处于替牙列早期的骨性前牙反与正常研究对象运动中心及切点的空载开口和前伸运动轨迹存在差异。这些差异是由于研究对象牙颌前部不同的咬合状态所造成的。     

烷基化螺吡喃吲哚的合成及光学性质研究

为了增加螺吡喃吲哚与透明聚合物（ＰＭＭＡ）的相溶性，在螺吡喃吲哚分子中引入长烷基链，合成了１′－「十八烷基」－３′，３′－二甲基－６－硝基－８－「二十二酰氧基」－螺「２Ｈ－１－苯并吡喃－２，２′－二氢吲哚」，并用ＮＭＲ确定各中间体和最终产物的结构，ＨＰＬＣ显示产物中烷基化螺吡喃吲哚含量在９７％以上。将烷基化螺吡喃吲哚与ＰＭＭＡ制成厚度为５００ｎｍ左右的膜，研究该膜对紫外光的响应，获得烷基化螺吡喃吲哚开环和紫外吸收的关系，以及Ｊ－耦合构型与陈化的关系。     

中重度急性有机磷农药中毒气道开放时机与预后的相关性研究

目的研究气道开放时机与中重度急性有机磷农药中毒(AOPP)患者预后的相关性。方法选择中重度AOPP患者96例,随机分为治疗组(56例)、对照组(40例),治疗组在常规治疗基础上预防性提前开放气道,对照组在常规治疗基础上,只有当发生呼吸衰竭,需要机械通气时才开放气道。结果与对照组比较,治疗组ARDS、吸入性肺炎、呼吸衰竭等并发症明显减少(P<0.01,P<0.05),病死率显著降低(P<0.01).住院天数缩短(P<0.05)。结论在中重度AOPP救治中,预防性气道开放能改善患者预后。降低病死率,缩短住院天数,值得推广。     

Controlled ROMP Synthesis of Ferrocene‐Containing Amphiphilic Dendronized Diblock Copolymers as Redox‐Controlled Polymer Carriers

Novel well‐defined redox‐responsive Ferrocene (Fc)‐containing amphiphilic dendronized diblock copolymers are synthesized by the ring‐opening metathesis polymerization technique using Grubbs’ third‐generation olefin metathesis catalyst as the initiator. These dendronized block copolymers can self‐assemble into spherical micelles in aqueous solution. The size of self‐assembled micelles can be modulated by the composition (namely, the ratio of hydrophobic and hydrophilic segments) and concentration of the dendronized copolymers. The obtained micelles show reversible redox‐controlled self‐assembly behaviors using FeCl₃ as oxidant and glutathione as reductant. Furthermore, the model molecule Rhodamine B is successfully loaded in these micelles, and the oxidation‐triggered controllable release is achieved by changing the type of oxidants (FeCl₃ and H₂O₂) and their concentrations. This is the first example of redox‐responsive micelles self‐assembled by novel amphiphilic dendronized Fc‐containing block copolymers, and the present micelles are visualized to be potential candidates in many fields, especially in stimuli‐responsive drug delivery systems.