Vascular Relaxant Effects of Toborinone on the Isolated Canine Internal Mammary Artery

This study was conducted to evaluate the vascular relaxant effects of toborinone on canine internal mammary ring preparations. We determined the concentration–contraction curves for various vasoconstrictors, namely norepinephrine, serotonin, U46619, endothelin-1, phenylephrine, and KCl in internal mammary artery (IMA) preparations, then assessed the vascular relaxant effects of the test drugs. As models, preparations with and without functional endothelium were used. As vasorelaxants, we used milrinone, papaverine, and nitroglycerin. Toborinone produced concentration-dependent relaxation in preparations precontracted with norepinephrine and serotonin. However, the vascular relaxant effect of toborinone on KCl-induced contraction was weaker than those on norepinephrine- and serotonin-induced contraction. Toborinone produced concentration-dependent relaxation in preparations with, and those without functional endothelium. There was no difference in the potency between the preparations with, and those without functional endothelium. The relaxing effect of toborinone on norepinephrine-induced contraction (EC₅₀ = 1.3 × 10⁻⁶ M) was significantly weaker than that of nitroglycerin (EC₅₀ = 7.8 × 10⁻⁸ M), equal to that of papaverine (EC₅₀ = 2.2 × 10⁻⁶ M), and significantly stronger than that of milrinone (EC₅₀ = 3.3 × 10⁻⁶ M). These results demonstrate that toborinone produces relaxant effects on canine IMA preparations, and that it may be effective in the treatment of IMA malperfusion syndrome. Received: December 7, 2000 / Accepted: May 15, 2001     

胸部小切口冠状动脉搭桥术66例报告

目的：探讨胸部小切口冠状动脉搭桥术的临床效果。方法2002年1月～2013年1月采用胸部小切口取左乳内动脉（ left internal mammary artery,LIMA）心脏不停跳冠状动脉搭桥术66例。胸骨下段小切口59例,采用全麻、单腔气管插管,平卧位,倒“L”胸骨下段切口;胸骨旁小切口5例,采用全麻、双腔气管插管,平卧位左胸抬高30＆#176;,左前外侧第4或第5肋切口,用特制牵开器（法国圣骑士公司）牵开肋骨,游离乳内动脉,使用冠脉固定器下行冠脉吻合;2例胸腔镜辅助下完成乳内动脉与左前降支的吻合。结果66例均完成左乳内动脉至前降支的吻合,2例追加大隐静脉降主动脉至第一对角支的吻合。无围术期死亡。60例随访0．5～8年,（5．5±2．5）年,心绞痛症状消失42例,明显减轻24例。术后冠状动脉CT检查16例,冠脉造影12例,LIMA与左前降支（ left anterior descending, LAD）吻合口满意率100％,支架内再狭窄1例,大隐静脉桥血管闭塞1例。结论胸部小切口冠状动脉搭桥术主要适用于心脏前壁冠状动脉尤其是前降支的的再血管化,安全可靠,中期疗效好,在合并高危因素或常规冠状动脉搭桥术和经皮冠状动脉介入术效果不满意者中应用更佳。     

甲状腺肿瘤腹腔镜手术与传统手术的疗效对比分析

目的甲状腺肿瘤腹腔镜手术与传统手术的疗效对比分析。方法取96例符合手术标准的甲状腺肿瘤患者,分为观察组和对照组,观察组运用胸乳人路行腹腔镜甲状腺肿瘤切除术治疗,对照组运用传统行开放手术甲状腺切除术治疗。观察术后出血量、手术时间、住院时间、并发症等情况,对比运用腹腔镜甲状腺切除术和传统甲状腺切除术的优越度。结果腹腔镜手术与传统手术相比,手术时间短,术中出血量少,住院时间短,术后并发症发生率低,差异具有统计学意义（P〈0．05）。结论腹腔镜甲状腺肿瘤切除手术具有恢复快、安全可靠等优点,具有极佳的美容效果,是良性甲状腺疾病的理想术式。     

Correlation between pathological types of parathyroid and clinical manifestations in patients with renal secondary hyperparathyroidism

Objective To analyze the correlation between the pathological types of parathyroid and clinical manifestations in patients with renal secondary hyperparathyroidism (SHPT), so as to improve the efficacy and safety of treatment. Methods The pathological and clinical data of 130 patients with renal SHPT and maintenance hemodialysis (MHD) who had undergone total parathyroidectomy with autotransplantation (TPTX+AT) were collected. A total of 545 parathyroid glands were obtained and 998 slices were made and read. According to the pathological types of parathyroid hyperplasia, the patients were divided into diffuse hyperplasia (DH) group, diffuse between hyperplasia and nodular hyperplasia (DH/NH) group as well as nodular hyperplasia (NH) group. The clinical and biochemical characteristics of different groups before and after operation (1-, 3-, 6-, 9-, 12-month) were compared and analyzed by statistical tests. Results (1) The preoperative status: the dialysis age, serum calcium as well as incidence of bone pain, skin itching and shorten height in the NH group were significantly higher than those in the DH group (all P＜0.05), and the serum phosphorus and iPTH in the NH group were significantly higher than those in DH and DH/NH group (all P＜0.05). (2) The postoperative status: the serum calcium of the NH group at 1-month was lower than that of the DH group, and the incidence of hypocalcemia of the NH group at 1-month was higher than that of the DH group (P＜0.05); the serum phosphorus at 3-, 6-, 9-month and iPTH at 1-, 3-month of the NH group were significantly lower than that of the DH group (all P＜0.05), and the serum phosphorus at 3-month and iPTH at 1-month of the NH group were lower than that of the DH/NH group (all P＜0.05). Among the 3 groups the serum phosphorus change from 1 to 12 months had difference (F=3.241, P=0.042), while the differences of serum calcium and iPTH changes were statistically insignificant. Conclusions The clinical manifestations, serum calcium, phosphorus and iPTH in patients with renal SHPT before and after TPTX+AT are closely related to the pathological types of parathyroid hyperplasia. Compared with the DH patients, before the operation the NH patients have longer dialysis age, more serious the clinical symptoms such as bone disease, higher calcium, phosphorus and iPTH, while greater reduction of the serum calcium, phosphorus and iPTH in the short term after operation.     

柠檬酸对分化型甲状腺癌患者首次131I治疗后唾液腺功能的保护作用

目的：探讨柠檬酸对术后首次行¹³¹I治疗（简称清甲治疗）的分化型甲状腺癌（DTC）患者唾液腺功能的影响,阐明柠檬酸对¹³¹I治疗的甲状腺癌患者唾液腺功能的保护作用。方法：经患者知情同意,随机选择准备首次行¹³¹I治疗的68例甲状腺乳头状癌患者,随机分为对照组和柠檬酸组,每组34例。对照组患者无特殊准备,柠檬酸组患者于¹³¹I治疗前1周及治疗后3周内每天含柠檬酸1 min（0.2 g/次）后吐出。2组患者分别于¹³¹I治疗前24 h及¹³¹I治疗后3个月行2次^99mTcO^4-唾液腺显像检查,计算第15分钟摄取指数（15 min UI）和排泌分数（SR）,评估唾液腺功能。结果：与¹³¹I治疗前比较,对照组患者¹³¹I治疗后右侧腮腺和双侧颌下腺15 min UI差异无统计学意义（P>0.05）,左侧腮腺15 min UI降低（P<0.05）;与¹³¹I治疗前比较,柠檬酸组患者¹³¹I治疗后双侧腮腺及双侧颌下腺15 min UI差异无统计学意义（P>0.05）;与对照组比较,柠檬酸组患者¹³¹I治疗前后双侧腮腺和双侧颌下腺15 min UI差异均无统计学意义（P>0.05）。与¹³¹I治疗前比较,对照组患者双侧腮腺治疗后SR降低（P<0.05）,双侧颌下腺SR差异无统计学意义（P>0.05）,柠檬酸组患者双侧腮腺和双侧颌下腺治疗后SR差异无统计学意义（P>0.05）;与对照组¹³¹I治疗后比较,柠檬酸组患者双侧腮腺SR升高（P<0.05）,双侧颌下腺SR差异无统计学意义（P>0.05）。结论：DTC患者术后首次¹³¹I治疗后唾液腺排泌功能可能受损,短期口含柠檬酸对唾液腺具有保护作用,可以减轻唾液腺的放射性损伤。     

P53蛋白雌孕激素受体在乳腺癌中的表达及相关性研究

目的：探讨乳腺癌中P53蛋白，雌激素受体（ER），孕激素受体（PR）的表达及相关性研究。方法：采用免疫组化技术（S-P法）检测40例乳腺癌中P53突变蛋白、ER、PR的表达。结果：在ER、PR阳性者中PTE突变蛋白明显增多为30%。结论：P53突变蛋白、ER、PR表达与乳腺癌有关，是有价值的预后因子。     

改良小切口皮下修剪法腋臭根治术的并发症分析及临床疗效评估

目的:探讨改良小切口皮下修剪法腋臭根治术的手术及术后包扎方法对并发症的发生及临床疗效的影响。方法:对80例腋臭患者采用小切口皮下修剪法根治,根据术后包扎方法分为3组:常规包扎组、常规包扎+负压引流组、弹力绷带包扎组,分析各组出现皮下积血、皮片坏死等并发症的情况,并通过随访评估其临床疗效。结果:负压引流或弹力绷带包扎可明显减少皮下积血及皮片坏死的发生率,减少瘢痕形成,而去除异味效果无显著区别,综合临床疗效提高。结论:改良小切口皮下修剪法腋臭根治术的手术方法、术后包扎及护理方法可明显减少并发症的发生,提高临床疗效。     

乳内动脉行心中静脉动脉化改善心肌缺血的作用与机制

目的采用猪右乳内动脉在非体外循环下行选择性心中静脉动脉化(CVBG),评价其疗效并对其机制进行初步探讨。方法将12只右冠状动脉重度弥漫性狭窄的中华实验小型猪[雌雄不限,月龄7～10个月,体重(40±5)kg]按随机数字表法分为两组,每组6只。实验组:采用右乳内动脉行CVBG;对照组:单纯开胸。右冠状动脉内膜剥脱术后8周对两组猪行超声心动图检查,术后6 h、3个月行冠状动脉造影、移植血管血流量测定及超声心动图检查,术后3个月处死动物前行非放射性彩色微球检测,观察两组猪心功能、移植血管血流量、移植血管通畅性和缺血心肌微循环再灌注情况。结果右冠状动脉内膜剥脱术后8周,两组左心室功能无差异。实验组行CVBG术后6 h和3个月心脏收缩和舒张功能均较对照组有所改善(术后3个月射血分数:52%±6%vs.44%±5%,t=-2.500,P=0.031)。实验组术后6 h、3个月移植血管血流量分别为(44.50±5.86)ml/min、(43.33±5.01)ml/min(P=0.718),搏动指数(PI)分别为0.73±0.14、0.80±0.14(P=0.858)。实验组术后6 h和3个月行冠状动脉造影显示:乳内动脉桥及吻合口均能顺利通过造影剂,无狭窄;施行CVBG后,经非放射性彩色微球法检测可见心肌各层的血流量均较对照组有所增加[穿壁心肌:(0.33±0.05)ml(/g min)vs.(0.19±0.03)ml(/g min),P<0.05],尤其是心内膜下心肌。结论采用乳内动脉行CVBG,可改善心肌缺血的近、中期疗效,其机制可能是通过改善心肌微循环而实现的。     

Eph and Ephrin Signaling in Mammary Gland Morphogenesis and Cancer

The Eph family of receptor tyrosine kinases and their membrane-bound ligands, the ephrins, play a central role in pattern formation during embryonic development and there is growing evidence that they are also instrumental in the control of tissue dynamics in the adult. The mammary gland is a paradigm for morphogenic processes occurring in the adult, since the gland develops predominantly postnatally and is subjected to continuous cyclic remodeling according to functional demands. Thus, pattern formation and the establishment of a functional organ structure are permanent themes in the mammary gland life cycle. In this paper we summarize the experimental evidence and discuss possible mechanisms by which Ephs and ephrins are modulating mammary epithelial cell adhesion, communication, and migration. Furthermore, we speculate on the different aspects of their influence on normal mammary gland development, function, and carcinogenesis.     

数字乳腺摄影与彩色多普勒超声及二者联合应用对乳腺癌的诊断价值

目的 用受试者操作特性(ROC)曲线评价数字乳腺摄影与彩色多普勒超声及二者联合应用对乳腺癌的诊断价值.方法 采用完全随机法选取经手术病理证实的50例女性乳腺癌和50例乳腺良性病变,患者术前均同时经数字乳腺摄影和彩色多普勒超声检查.患者全部数字乳腺像(100份)为第1组;彩色多普勒超声图像(100份)为第2组;每例患者的数字乳腺与其超声的组合图像(共100份),为第3组.3名诊断医师分别对3组图像进行诊断,用5分法:肯定是、可能是、不确定、可能不是、肯定不是,独立诊断是否为乳腺癌.将3名医师阅片结果的平均值用SPSS 11.0版ROC曲线软件进行统计分析,3种诊断方法的ROC曲线下面积(Az)行Z检验.结果 3名医师用数字乳腺像、彩色多普勒超声图像及组合图像诊断乳腺癌的平均例数分别为42、38、48例;诊断乳腺良性病变的平均例数分别为40、43、47例.数字乳腺像诊断乳腺癌的敏感度为84%(42/50),特异度为80%(40/50);彩色多普勒超声图像诊断乳腺癌的敏感度为76%(38/50),特异度为86%(43/50);组合图像诊断乳腺癌的敏感度为96%(48/50),特异度为94%(47/50).3种方法ROC曲线下平均面积(Az值)分别为0.852、0.825、0.952.2种方法联合应用诊断乳腺癌的ROC曲线Az值较单独使用数字乳腺摄影或单独使用彩色多普勒超声诊断乳腺癌的ROC曲线Az值显著增大(Z1=2.183,Z2=2.581,P值均＜0.01).结论 数字乳腺摄影与彩色多普勒超声联合应用对乳腺癌诊断的敏感度和特异度均最高,诊断价值最大,有助于乳腺癌的早期发现与诊断.