新时期戏剧艺术探索的成就与困顿

八十年代初中期 ,中国戏剧积极拓展我国传统戏剧的时空观、写意性特征 ,大胆借鉴西方现代戏剧的荒诞化、意象性技巧 ,出现了探索创新、多元发展的崭新局面。其中对“三一律、一堵墙”戏剧观的突破 ,运用意识形象外显人物的内心世界 ,嫁接多种艺术手段将现实时空转化为艺术时空 ,是新时期戏剧艺术探索最突出的三项成就。而过分强调形式技巧 ,脱离观众欣赏习惯 ,致使演出市场萎缩 ,观众锐减 ,无疑是新时期戏剧艺术探索中面临的最大困顿。     

Research review: DNA polymerases as molecular markers of the regenerating capacity of hepatocytes

Hepatocyte regeneration has been widely investigated, with the mitotic index and the incorporation of [³H]thymidine being used as regeneration markers. We focused on the induction of DNA replication enzymes, particularly DNA polymerases (pol) α, δ, and ε. Using rat models, we have shown that the activity of pol α in crude liver extract well represents the regenerating capacity of hepatocytes. Using pol α as an indicator, we analyzed liver regeneration in rat models under various conditions: obstructive jaundice, external or internal biliary drainage, and the obstruction of portal vein branches. It has been revealed that the ligation of the common bile duct alone induces a certain amount of hepatocyte proliferation. It was striking that external biliary drainage suppressed regeneration capacity in cholestatic rat liver after partial hepatectomy. The strong regeneration in nonligated lobes induced by portal branch ligation was similar to the liver regeneration seen after partial hepatectomy with respect to the induction of DNA polymerases. Taken together, the aspects of DNA replication, particularly the induction of DNA polymerases, may contribute to shedding new light on the regeneration of human liver. This work was supported in part by a Grant-in-Aid for General Scientific Research and for Cancer Research from the Ministry of Education, Science and Culture, Japan, and by grants from the Uehara Memorial Foundation     

Diagnosis and treatment of thoracic outlet syndrome

Patients who develop symptoms of thoracic outlet syndrome (TOS) have a predisposing anatomic abnormality. In most patients with TOS, the symptoms are caused by entrapment of the brachial plexus and they do not arise from compression of the subclavian artery, as was previously thought. The tests advocated for diagnosing this common syndrome (i.e., evaluating the positional compression of the artery when the arms are raised, the neck is turned, or the shoulders are braced) cannot accurately diagnose this syndrome. There are two reasons for this. The symptoms of TOS are not related to the compression of the artery in the outlet in 98% of patients, and 75% of normal individuals without symptoms show diminished radial pulse on various provocation tests. We employed four timed provocation tests (minute tests) to diagnose TOS: the timed Morley test, timed Wright test, timed Eden test, and elevated arm stress exercise, all of which are very sensitive. In normal individuals without symptoms, 20% experience transitional symptoms such as slight pain and tiredness, on these tests indicating a subclinical state. TOS is treated by keeping the thoracic outlet wide, this being done either conservatively or surgically. In 1993 and 1994, we conservatively treated 418 of 422 patients with TOS by means of active exercise, a brace, and by block therapy. These measures did not reduce the symptoms in 23 of these patients, so surgical treatment was indicated. In the remaining 4 of the 422 patients, conservative treatment was not indicated and surgery was performed directly. All the patients showed significant clinical improvement of varying degree. Presented at the 69th Annual Meeting of the Japanese Orthopaedic Association, Tokyo, April 12, 1996     

Hemophagocytic syndrome and T-cell lymphoma after kidney transplantation: a case report

Lymphoma in immunocompromised transplant patients is a feared cause of morbidity and mortality. Superimposed on the lymphoma and the transplantation immunosuppression is a rare condition: hemophagocytic syndrome (HS). HS is characterized by fever, hepatosplenomegaly and lymphadenopathy, skin rashes, jaundice, coagulopathy, and phagocytosis of blood elements with pancytopenia. Here we describe a rare but fatal case of a kidney transplant patient who developed T-cell lymphoma and HS, without evidence of EBV replication. A short review of the diagnosis, treatment, and prognosis of HS is given. Received: 4 March 1997 Received after revision: 6 June 1997 Accepted: 30 June 1997     

应用同种动脉治疗主动脉根部病变

报告５例采用同种动脉（ＨＡＶ）治疗５例主动脉根部病变（主动脉瓣狭窄１例，关闭不全４例）。男３例，女２例；年龄１３～４７岁。病因为细菌性心内膜炎２例（包括先天主动脉瓣二瓣化畸型１例），Ｍａｒｆａｎ综合征２例，风湿性主动脉瓣关闭不全１例。术中采用同种主动脉全根置换３例（Ｂｅｎｔａｌｌ手术），其中１例用ＨＡＶ上的二尖瓣前叶加宽主动脉瓣环（Ｍａｎｏｕｇｕｉａｎ手术），余２例用自体肺动脉移置主动脉根部，另取同种肺动脉做原位移置（Ｒｏｓｓ手术）。结果死亡１冽，４例存活，且无并发症发生。术后超声心动图提示主动脉根部良好，无主动脉瓣反流。随访２．５～３．５年疗效满意。     

风心病并发脑栓塞病人的瓣膜替换术

报告６４例风心病并发脑栓塞病人的瓣膜替换术。术前心功能Ｉ级１０例、ＩＩ级３８例、ＩＶ级１６例。伴房颤者５４例。脑栓塞史半年以上者４４例，６个月以内２０例，其中２个月以内者１４例。３４例有程度不同的脑栓塞后遗症。行二尖瓣替换术４７例、双瓣膜替换术１７例，同期行三尖瓣环环缩或成形术４３例。术中证实有左房血栓２５例（３９％）。手术死亡率６．２５％。术后并发颅内出血和栓塞各１例。结果表明风心病并发脑栓塞病人的手术效果良好。作者指出，脑栓塞２个月以上者应尽早手术，２个月以内者则应根据脑栓塞程度、恢复情况及有无左房血栓，选择手术时机。并介绍了围术期的处理经验。     

复合带瓣人工血管替换升主动脉和主动脉瓣(24例报告)

报告２４例升主动脉瘤伴主动脉瓣关闭不全行升主动脉和主动脉瓣替换及冠状动脉开口移植术（Ｂｅｎｔａｌ术２２例，底盘法２例）。１３例伴有升主动脉夹层分离，对其中８例ＤｅＢａｋｅｙＩ型者，以Ｔｅｆｌｏｎ毡条内外加固主动脉切端后吻合。１３例用人工血管周围间隙与右心耳吻合以控制升主动脉吻合之外的出血。３例以人工血管片环包主动脉吻合口控制局部广泛渗血及出血。２例术毕不能脱离体外循环死亡，手术死亡率８３％。随访平均２１８个月，２例死于蛛网膜下腔出血，１例右股动脉栓塞经手术治愈；其余病人康复良好，心功能（ＮＹＨＡ）Ｉ～ＩＩ级。     

房间隔入路的解剖学研究及临床应用

对３３具尸体的房间隔的大小、构成及周围重要组织结构进行观察和测量。提出房间隔切开时的正确方向、安全长度及可能发生的危险。结合４６６例临床应用，讨论了避免切口合并症发生及发生后的正确处理方法。     

电脑控制连续式料位仪的研制

论述了电脑控制连续式料位仪的原理及性能，研制了一种先进可靠的物料料位测量工具。     

小儿肾脏疾病血,尿内皮素的变化

目的研究小儿肾脏疾病血、尿内皮素（ＰＥＴ、ＵＥＴ）的水平及其相互关系。方法采用同位素放免方法检测了肾病综合征（ＮＳ），肾小球肾炎（ＧＮ），肾功能衰竭（ＲＦ）共７２例患儿血及尿中ＥＴ，血心钠素（ＡＮＰ）水平。结果ＮＳ，ＧＮ，ＲＦ三组的ＰＥＴ及ＵＥＴ值明显高于对照组，尤其ＲＦ组（Ｐ＜００５，Ｐ＜０．０１）。ＡＮＰ值在ＧＮ组和ＲＦ组明显高于对照组（Ｐ＜００１）。８例ＡＲＦ患儿恢复期血ＥＴ水平下降，６例ＣＲＦ患儿虽经治疗，但血ＥＴ水平不降或上升。结论ＥＴ在小儿肾脏疾病发病机理及病情进展中可能起重要作用，其值高低与病情严重程度及预后有关。