病理生理学教学中培养学生综合素质的探索

病理生理学是基础医学和临床医学之间的桥梁学科。针对既往教学过程中存在的问题，进行病理生理学教学方法改革与探索，从而培养学生的综合素质，提高教学质量。     

Pathophysiology of renal function and its effect on isotope studies in the workup of hydronephrosis

Understanding renal maturation and growth is essential before adequate interpretation of radionuclide renal studies can be done. The expectation that an immature kidney draining into a dilated renal pelvis will show good washout on a diuretic renogram within 20 or 40 min is unreasonable. A physiological explanation for this is given.     

Increased vasoconstrictor reactivity and decreased endothelial function in high grade varicocele; functional and morphological study

The pathophysiology of human varicocele is not fully understood. We investigated vasoconstrictor reactivity, endothelial function and morphological changes in different grades of varicocele to clarify the pathophysiology. Contractile responses to phenylephrine, norepinephrine, serotonin and histamine were determined in isolated human varicose spermatic veins using the organ bath technique. Endothelial function was tested with acetylcholine-induced relaxation after phenylephrine-induced precontraction in the absence and presence of nitric oxide synthase inhibitor, L-NAME, and cyclooxygenase inhibitor, indomethacin. The cyclic guanosine monophosphate (cGMP) level was measured in the spermatic vein and peripheral plasma. Morphological changes were evaluated with light microscopy. Phenylephrine, norepinephrine, serotonin and histamine induced concentration-dependent contractions. The maximum contractions for all of these agents except norepinephrine were significantly higher in grade III than grade I and II (P<0.05). The sensitivity to phenylephrine was significantly higher in grades II and III than in grade I (P<0.05). In the presence of L-NAME and indomethacin, the difference from respective control phenylephrine-induced contractions was higher in grade I and II than grade III. Acetylcholine did not induce stable relaxation but the level of cGMP, which is responsible for the vasorelaxant effect of NO, in veins was lower in grades II and III than grade I (P<0.05). Vessel wall thickness increased in grade II and dilatation developed in grade III when compared to grade I (P<0.05). Our findings suggest that endothelium produces less vasorelaxant which results in the more enhanced effects of vasoconstrictor substances in grade III, indicating that endothelial dysfunction develops at high grades of varicocele.     

病理生理学实验教学改革探索

第三军医大学病理生理学教研室对传统病理生理学实验教学进行了改革，在实验教学方法改进、实验内容优化、实验教材改革与更新、实验设计课程开设以及综合考核评价体系建立等方面进行了有益的探索，取得良好的效果。     

The aetiology of prolapse

Female pelvic organ prolapse is a common condition that is said to be multifactorial in aetiology. While a number of risk factors such as vaginal childbirth, obesity and ageing are commonly accepted, it is not clear as to how these risk factors affect the development of prolapse-that is, which pathophysiologic mechanisms are responsible for disease manifestation. Measures used in epidemiological studies, such as presentation for surgical treatment, are generally confounded by other conditions, and evidence is lacking for some of the most frequently quoted aetiological factors. In this paper, I will try to summarise the available evidence in order to separate hearsay and hypothesis from available research findings and to suggest a way forward for diagnosis and treatment.     

Anaesthesia for Conn''s syndrome

We describe the peri-operative management of two patients undergoing bilateral adrenalectomy for Conn's syndrome; one using an open surgical approach and the other a laparoscopic technique. The first patient, aged 64 years, died of a myocardial infarction 5 days postoperatively; the second, aged 29 years, had an uneventful recovery. The pre-operative preparation, peroperative management and postoperative care of these patients are detailed, and the pathophysiology and clinical management of Conn's syndrome are reviewed.     

Burn treatment in the elderly

The population of elderly patients is expected to rise continuously over the next decades due to global demographic changes.     

活血化瘀药对CCL4所致小鼠急性肝损伤的保护作用

用25％CCL-4复制小鼠急性肝损伤,分别给小鼠复方丹参(A组,n=10)、川芎嗪(B组,n=9)和生理盐水 (C组,n=9)预处理3d。与C组比较,A组的肝受损程度较轻(P<0.05),肝坏死灶的平均直径较小(P<0.01);B组则无显著性差异(P>0.05),血清及肝组织匀浆中的MDA,红细胞内SOD的含量,三组间差异无显著性意义。提示复方丹参对急性肝损伤有一定的保护作用(川芎嗪则无),其保护机理与减轻体内脂质过氧化反应无关。     

Mechanical pathophysiology of some heart diseases: a theoretical model study

Sarcomere dynamics are related to the global left ventricular (LV) function in some representative pathological states, by using a theoretical model which combines sarcomere function, LV fibrous structure and geometry with the haemodynamic loading conditions. The analysis shows that pressure (concentric) hypertrophy due to hypertension or aortic stenosis is associated with an increase of the normal endocardial-to-epicardial gradient(s) of oxygen demand, which may be one of the causes for the development of endocardial fibrosis. The analysis also indicates that sarcomere shortening is relatively normal in compensated volume (eccentric) hypertrophy. Mitral stenosis demonstrates a case of decreased LV function, secondary to a chronic decrease in LV end diastolic volume, with sarcomeres that operate at their lowest length range. Conversely, the sarcomere function is depressed in cardiomyopathy; the heart's pumping function is maintained by appropriate adjustment mechanisms. However, the sarcomeres show minimal shortening and function at their highest length range with low (or zero) functional reserve. The study thus provides a quantitative tool that relates global LV function to local sarcomere dynamics in various pathological states.