经尿道前列腺电切术围术期血液流变学的变化

目的 从血液流变学角度探讨经尿道前列腺电切术(TURP)患者围术期的管理。方法 择期行TURP手术32例，于术前、术中、术毕和术后4h，抽取静脉血检测血液流变学各项指标。结果 低切粘度、血浆粘度、低切还原粘度、中切还原粘度在术毕和术后4h时比术前显著升高；术中、术毕、术后4h与术前比较，红细胞刚性指数增高，变形指数下降。结论 TURP围术期应注意降低血液粘度、保护红细胞。     

左旋硝基精氨酸诱导高血压大鼠心肌肥大

一氧化氮合酶（ＮＯＳ）抑制剂Ｎ－左旋硝基精氨酸（Ｎ－ＬＮＡ）诱导持续性高血压大鼠１２只，随机分成２组测右颈动脉压，ＮＯ代谢物亚硝酸盐（ＮＯ２）浓度，心肌组织胶原蛋白含量及丝裂活化蛋白激酶（ＭＡＰＫ）活性，观察左心室心肌病理变化，发现与高血压比较，自然归组大鼠动脉血完全逆转（Ｐ〈０．０１）；ＮＯ２水平及ＭＡＰＫ活性轻度逆转，但均未达到正常对照组水平（Ｐ〈０．０１），胶原蛋白含量，心脏及左心室相对重量     

A theoretical consideration of extensions of the Z-plasty principle

For the release of congenital or posttraumatic webs a variety of local skin flap techniques have been described. Confusion exists on how much lengthening may be obtained by each of these techniques, as well as on how much lateral slack is needed for the flaps to be shifted. These techniques and the results they provide are reviewed, calculated, and visualized by diagrams. It is concluded that the Z-plasty and its modifications lead to superior lengthening-to-narrowing ratios. Combined YV-plasties have their advantage in that resection of scarred skin will be obtained. Position, extent and orientation of the scar or web will generally indicate which technique is to be used in each individual case.     

前列腺增生伴逼尿肌无力患者的电切术治疗

目的 :探讨良性前列腺增生 (BPH)伴有逼尿肌无力 (ACD)患者的治疗方法和效果。方法 :对尿动力学检查确认有ACD的 12例BPH并发膀胱出口梗阻 (BOO)的患者 (A组 )进行经尿道前列腺电切术 (TURP)或加膀胱颈内切开术 (TUIBN) ,同时与逼尿肌功能正常或高于正常的行TURP的BPH患者 2 4例 (B组 )进行对照分析。结果 :A组术后 7～ 30d复查 ,国际前列腺症状评分 (IPSS)为 12 .5 8± 0 .70分 (P <0 .0 0 1) ,最大尿流率 (Qmax)为11.0 5± 0 .85ml/s (P <0 .0 5 ) ,均比术前有改善 ,但术后效果不如B组明显 (P <0 .0 0 1)。术后 3、6个月复查IPSS及Qmax,两组略有改变 ,但差异无显著性意义 (P >0 .0 5 ) ,剩余尿测定也均在正常范围。术后 3个月对ACD的 5例复查逼尿肌收缩力 ,无明显改善。结论 :对ACD并伴有BOO的BPH患者可以采取电切术治疗     

Neurogenic muscle hypertrophy in radiculopathy

The course of radiculopathy is sometimes associated with weakness and wasting of muscles. Very rarely in such cases, however, is hypertrophy of muscle fibres observed. Three cases are presented of sciatica with enlarged calves caused by hypertrophy of type 1 or types 1 and 2 muscle fibres. In light of the literature and the results obtained, an attempt is made to explain the cause of rare clinical symptoms and draw attention to diagnostic and therapeutic difficulties.     

大黄对实验性糖尿病大鼠肾脏肥大及高滤过作用的影响

肾脏肥大和高滤过是糖尿病肾病出现最早的病理生理特征。本研究利用中药大黄抑制糖尿病的肾脏肥大,试图达到控制其高滤过现象。实验结果表明,大黄能明显地抑制糖尿病肾脏肥大及其组织中蛋白质、DNA含量的增加;大黄治疗组的菊粉清除率明显低于非治疗组;此外,大黄还能使糖尿病血清甘油三酯、胆固醇水平降低。结论:大黄可以通过影响糖尿病肾病肾脏肥大,降低高滤过和纠正血脂代谢紊乱,治疗实验性糖尿病肾病动物模型。     

Modulators of growth in primary culture of rat proximal tubular cells II

Summary: The present studies assessed the effects of manipulating extracellular sodium (Na) concentration and Na transport on cellular hypertrophy and hyperplasia in primary culture of rat proximal tubular cells. A concentration-dependent effect on thymidine incorporation and protein content was observed with cell culture media Na concentration of 130, 140 and 150 mmol/L. This effect was independent of osmolality (matched with mannitol) and no stimulatory effect occurred if choline was substituted for Na. Cells derived from sham-operated (Sx) animals exposed to a higher media concentration of Na (150 vs 140 mmol/L) had both stimulated thymidine incorporation to 186.8 ± 35.41% (P<0.05) and enhanced cell protein content to 134.7 ± 135% (P<0.05). This effect was more pronounced in cell cultures derived from unilaterally nephrectomized (Nx) animals, being 212.8 ± 31.5% (P<0.01) for thymidine incorporation (P<0.05 vs cells from sham-operated animals grown in high Na media) and 114.4 ± 3.2% (P<0.001) for protein content (P=0.11 vs sham-operated cells grown in similar conditions). the addition of 10^?4 mmol/L ethylisopropyl amiloride hydrochloride (EIPA) to Nx cells in a normal or high Na concentration media resulted in a decrease in cellular protein content to 82.6 ± 6.8% (P<0.05) and 85.5 ± 0.2% (P<0.0001) compared to respective controls. 10^?4 mol/L EIPA in media supplemented with insulin-like growth factor (IGF-1) blocked the proliferative response normally seen in response to this growth factor from 156.6 ± 13.7 to 27.5 ± 3.1% (P<0.0001) compared to control. However, the presence of EIPA did not abrogate the hypertrophic response elicited by IGF-1 (cell protein content 128.1 ± 13.1% of control with IGF-1 vs 124.9 ± 12.5 with IGF-1 and EIPA; P= n.s.). Addition of 10^?4 mol/L EIPA to 10% serum derived from either Sx or Nx animals blocked the growth response to the sera, limiting the cellular protein content to 76.6 ± 5.5% (P<0.0001) and 89.7 ± 4.4% (P<0.0001) and thymidine incorporation to quiescent levels of 0.2 ± 0.1% (P<0.0001) and 0.4 ± 0.1% (P<0.0001) compared to respective controls. In summary, rat renal proximal tubular cell growth is influenced by Na concentrations in the cell culture environment and inhibited in the presence of EIPA. This supports a role for altered epithelial transport in the cellular growth response to a number of stimuli.     

会阴部瘢痕挛缩畸形45例整复治疗

目的　讨论、总结会阴部瘢痕挛缩畸形整复治疗的经验。方法　我科自 1989年以来对 4 5例会阴部瘢痕挛缩畸形患者进行了整复治疗。术前强调肠道清洁和局部瘢痕清洗 ;术中根据瘢痕挛缩畸形的具体情况 ,联合采用局部皮瓣及中厚皮片移植 31例 ,全厚皮片移植 8例 ,单纯用局部皮瓣移植 6例 ;术后注意保持创面的清洁干燥和进行及时有效的功能锻炼。结果　患者在接受整复治疗后形态、功能均获得良好恢复 ,总优良率达 95 .5 %。结论　根据会阴部瘢痕挛缩畸形的特殊性 ,重视术前准备及术后处理 ,合理设计、选择手术方法 ,才能够获得满意的治疗效果     

哺乳期营养对室间隔心肌细胞发育的影响——游离心肌细胞的形态测量

在心肌细胞分化性生长时期,改变新生鼠的哺乳期营养条件对这些鼠的空间隔心肌细胞将会产生暂时性作用和持久性影响。哺乳期高营养的暂时性作用是增加空间隔心肌细胞的大小和数量;而低营养的暂时性作用则是减慢室间隔心肌细胞的生长。哺乳期高营养的持久性作用是限制室间隔心肌细胞的过度肥大;而低营养则促进成熟鼠的室间隔心肌细胞的过度肥大。