肾移植患者术前抗体水平的分析

对肾移植术前患者血清４５９份进行了抗体水平的分析。发现４０７例首次移植前的患者血清中８４例（２０．６％）有抗淋巴细胞抗体。再次移植前５２例中３９例（７５％）有抗淋巴细胞抗体。在阳性患者血清中对全淋巴细胞有抗体的占６８．３％，而仅对Ｂ淋巴细胞有抗体的占３１．７％。在性别上，女性产生抗体阳性率均高于男性。结果表明，初次移植肾患者输血和妊娠是致敏的重要因素，再次移植的患者移植物刺激是致敏的重要因素之一。Ｂ淋巴细胞抗体在移植物排斥的关系中可能具有保护移植物的作用。     

Molecular cytogenetic characterization of Thinopyrum and wheat--Thinopyrum translocated chromosomes in a wheat--Thinopyrum amphiploid

The wheat--Thinopyrum amphiploid 'Agrotriticum # 3425' (AT 3425), which is highly resistant to Cephalosporium stripe, was identified to carry seven pairs of Thinopyrum chromosomes, three pairs of wheat--Thinopyrum translocated chromosomes and 18 pairs of wheat chromosomes. Fluorescence genomic in situ hybridization (FGISH), C-banding, sequential C-banding and FGISH, and denaturing polyacrylamide gel electrophoresis (SDS-PAGE) were used to characterize and identify the chromosomes. The Thinopyrum chromosomes in AT 3425 were designated as T1 through T7 based on their C-banding patterns. The FGISH and C-banding patterns of mitotic chromosomes in AT 3425 and meiotic chromosomes in the hybrid between AT 3425 and wheat cultivar 'Chinese Spring' (CS) revealed that wheat chromosomes 1D, 2B and 3D were involved in the three wheat-Thinopyrum chromosome translocations designated as (W-T)1, (W-T)2, and (W-T)3 respectively. The analysis of high-molecular-weight glutenin subunits in single seeds of AT 3425 confirmed the involvement of wheat chromosome 1D in the translocation (W-T)1. The designations 1DSuu.1DL-1TL, 2BSuu.2BL-2TL and 3DSuu.3DL-3TL were suggested for the wheat--Thinopyrum translocated chromosomes (W-T)1, (W-T)2 and (W-T)3 in AT 3425 respectively.     

耳廓复合组织瓣连续法修复鼻翼缺损

目的观察耳廓复合游离组织瓣连续法修复鼻翼缺损的疗效，以探讨鼻翼缺损的有效修复手段。方法耳廓复合游离组织瓣2次连续法修复鼻翼缺损7例，移植物面积0．5cm×0．7cm～0．8cm×1．2cm。结果7例耳廓复合游离组织瓣移植后全部成活。术后随访6～18个月，移植物无明显回缩，鼻外形满意。结论耳廓复合游离组织瓣连续移植修复鼻翼缺损，适合较严重鼻翼缺损，手术成功率高，术后鼻外形满意，双侧分次取材，耳廓外形双侧对称无畸形。     

羊膜建库及其临床应用研究

目的 :制备与保存羊膜 (Amnioticmembrane,AM ) ,为临床移植治疗眼表泪液 (Ocularsur face&Teardisease ,OSTD)提供新鲜羊膜 (Freshamnioticmembrane ,FSAM )、冻干羊膜 (Frozenam nioticmembrane ,FZAM )并观察其眼表重建的特点与临床疗效。方法 :采用目前国际公认的羊膜制备与保存方法 ,制备FSAM、FZAM并进行保存研究 ,经组织染色和电子显微镜检查 ,观察保存羊膜的形态及其活性 ;并将FSAM、FZAM应用于 12例OSTD患者 ,行患眼FSAM或FZAM移植术。通过术后印迹细胞学追踪观察移植后AM上皮细胞存活与移行、替代时间 ,评估AM移植重建眼表的临床疗效。结果 :FSAM、FZAM在光镜和电镜下均与正常球结膜组织结构相近 ,主要结构为胶原纤维和网状纤维。 12例OSTD患者行羊膜移植术 (Amnioticmembranetransplantation ,AMT)后均未见明显急性排斥反应 ,术后 1～ 2周可见少量新生血管长入植片 ,AMT后印迹细胞学追踪检查 ,术后 3个月为阴性 ,4个月出现阳性反应。所有患者术后随访 5～ 18个月 ,平均 11个月 ,AM在术后 4～ 9个月逐渐溶解、消失 ,移植区眼表的色泽与结构基本恢复正常。结论 :FSAM、FZAM是目前理想的结膜替代材料并可有效地用于重建角、结膜表面 ,减轻炎症反应 ,减少新生血管的生成 ,抑制纤维组织增生 ,防止     

一期再造全长指的实验研究

目的 通过实验探索一期再造全长指的手术设计和方法。方法 在6只食蟹猴上，在掌指关节处切除示指，应用带足背皮瓣和跖骨的第2足趾复合移植一期再造全长示指。结果 再造12个全长指术后全部成活，后因感染仅4个再造指存活，随访12个月，存活再造指恢复大部分功能及较好的外观。结论 利用带足背皮瓣和跖骨的第2足趾复合移植再造全长示指的方法可行，但需设法提高存活率。     

足背动脉跨区供血的足背及足底内侧联合皮瓣的解剖研究与临床应用

目的探讨应用同一血管蒂（足背动脉）跨供区（足背与足底内侧）联合皮瓣游离移植的可行性。方法对足背和足底内侧2个皮瓣进行解剖学研究。采用10只成人新鲜足标本分别从足背动脉（5只）、足底内侧动脉（5只）加压灌注碳素墨汁甲醛。在足底和足背不同部位取全层皮肤做脱水透明标本处理，在显微镜下对0．3-0．5mm厚铺片进行观察，以确定不同动脉的供血范围。设计以足背动脉供血的跨足背与足底内侧2个皮瓣供区的新皮瓣移植术式，并用来修复手部大面积皮肤缺损。结果足背皮瓣与足底内侧皮瓣存在丰富的交通血供区，从足背动脉灌注碳素墨汁甲醛，其分布范围除整个足背外，在足底分布如下：以足底中线纵轴为基线可及中线外侧（1．7±0．5）cm；以足底中线横轴为基线，上可及中线上（4．5±1．5）cm，下可及中线下（3．8±0．9）cm。从足底内侧动脉灌注碳素墨汁甲醛，其分布范围除整个足底内侧区域外，在足背区可及躅长伸肌外侧（0．6±0．5）cm。以足背动脉供血的跨区联合皮瓣血供丰富，临床应用12例全部成功。结论以足背动脉供血的跨区联合皮瓣切取面积大，血供可靠，可以用来修复手部大面积皮肤缺损。     

丝裂霉素C在翼状胬肉切除联合自体结膜瓣移植术中的应用

目的 讨论安全有效浓度下，丝裂霉素C在翼状胬肉切除联合体自体结膜移植术中的应用，观察对翼状胬肉的复发的防治效果。方法 对54例64眼原发性胬肉者施行显微镜下胬肉切除带蒂结膜瓣转位移植联合术中或术后丝裂霉素C（mitomycin C MMC)的应用，经5－12月随诊，与单纯手术组（27例33眼）原发性胬肉术后复发情况作对比分析。结果 复发率要术中用药组为3．33％，术后用药组5．88％，对照组18．18％，经X^2检验，术中、术后用药与对照组 差异有显著性（P＜0．05），而术中或术后应用MMC的复发率差异无性，均可降低胬肉的复发率。结论 适时、适量应用MMC对有效防止翼状胬肉的复发有着非常重要的意义。     

创面异体移植培养表皮细胞后存活的判定

应用４种方法判定烧伤创面异体移植的培养表皮细胞存活情况：１．聚合酶链反应（ＰＣＲ）查Ｙ染色体特异性ＤＮＡ片段；２．ＰＣＲ扩增ＰＭＣＴ１１８长度多态性基因位点；３．ＰＣＲ／ＳＳＯＨＬＡ－ＤＱａ分型；４．ＤＮＡ指纹。共检测１６例病人的２７个活检标本，均证实有供者的ＤＮＡ，最长时间为移植后９２天。初步实验结果表明：培养表皮异体移植后可存活较长时间。     

A case of Prader – Willi syndrome arising as a result of familial unbalanced translocation t(11;15)(q25;q13)

We report on a case of Prader-Willi syndrome (PWS) with a true reciprocal unbalanced translocation, 45,XX,-15,der(11)t(11;15)pat. The proposita was diagnosed clinically as having severe PWS. Molecular studies revealed loss of the paternal methylation pattern at locus D15S63 and a deletion encompassing the loci from at least D15S10 to D15S97 of paternal chromosome 15. FISH studies confirmed the deletion of 15q11-q13 region and the presence of two telomeres on all chromosomes. The proposita's father, the father's sister and their mother are all carriers of the same balanced translocation t(11;15)(q25;q13). By genomic imprinting we would expect that if the father's sister were to give birth to a child with the same unbalanced translocation as the proband, it would be affected by Angelman syndrome.
To date, a similar familial unbalanced translocation due to loss of the small chromosome 15 derivative has not been described.     

A reciprocal translocation (X;11) in a female with gonadal dysgenesis

A 24-year-old female patient was referred for evaluation of primary amenorrhea. Endocrine studies showed elevated gonadotropins, consistent with gonadal failure. At laparoscopy, a normal nulligravid uterus, normal fallopian tubes, and bilateral streak gonads were observed. Histologic studies showed that the left gonad consisted entirely of fibrous tissue, confirming the presence of streak gonads. Chromosome banding studies of peripheral blood and cultures of tissue from the left gonad demonstrated a 46,X,rcp(X;11)(q22;q13) karyotype. A review of reports of X-autosome reciprocal translocations indicated that abnormal gonadal development is associated with break-points in the mid-region of the long arm of the X chromosome.