Legg-Perthes病动物模型设计与评价

目的：设计制作静脉回受阻Legg-Perthes病动物模型，并对其进行观察评价。方法：选择健康杂种幼犬20只，雌雄不拘。采用自身对照方法，一侧髋用来实验，一侧髋作为对照，应用套针经皮大于转子下方穿入股骨颈中央达股骨头颈部骺板远侧，注入1ml医用TH胶，于实验不同时期行骨骺后内压、X线、CT检查，组织标本行常规病理检查，结果：实验制作了影像及组织病理变化类似于人类Legg-Perthes病的动物模型。结论：此模型设计合理，制作方法简单，重复性较强。     

晚期胃癌新辅助化疗的初步临床研究

目的：评价晚期胃癌新辅助化疗的近期疗效，并比较静脉化疗和介入化疗的效果。方法：取20例术前分期为Ⅲb或Ⅳ期的胃癌病人，随机分为两组，分别接受静脉化疗或介入化疗，化疗方案为LV/5-FU CDDP THP,2－4个疗程后作超声胃镜及螺旋CT等复查，重新分期和评价临床疗效，并视情况进行手术治疗。对切除的胃癌标本进行病理学研究，并与临床分期相近的10例未行化疗者进行比较。结果：20例胃癌病人中，10例化疗后TNM分期降低（50％），14例获手术切除（70％）。介入化疗组的临床疗效优于静脉化疗组，但差别无显著意义（P＞0．05）；病理学检查提示介入化疗组的组织学疗效（87．5％）明显优于静脉化疗组（33．3％）及对照组（20．0％）（P＜0．05），而后两者之间无明显差异（P＞0．05）。结论：（1）新辅助化疗在降低晚期胃癌的临床分期和提高手术切除率方面有一定作用；（2）初步结果表明，介入化疗的效果优于静脉化疗。     

CD1-dependent natural killer (NK1.1(+)) T cells are required for oral and portal venous tolerance induction

BACKGROUND: Local antigen presentation via either the oral (PO) or the portal venous (PV) routes results in suppression of systemic delayed-type hypersensitivity (DTH). The responsible cell populations are not well defined. Because NK1.1(+) T cells express the Fas ligand and produce high levels of the immunosuppressive cytokine, IL-4, they may play a role in both activated T-cell apoptosis and a Th1 to Th2 immune shift, thus promoting tolerance induction. METHODS: C57BL/6 mice were tolerized to BALB/c alloantigen by PV or PO spleen cells (25 x 10(6)) on Day 0. Subcutaneous (SQ) challenge with 10 x 10(6) BALB/c cells on Day 7 was followed by footpad injection of 10 x 10(6) BALB/c cells on Day 14. Footpad swelling was measured 24 h later. A single injection of the NK1.1(+) cell-depleting antibody, PK-136, was given IP (10 mg/kg) 2 days prior to PV or PO antigen. Flow cytometry evaluated NK1.1(+) cell depletion. CD1 knockout (KO) mice, lacking NK1.1(+) T cells, were also challenged with PV and PO Balb/c in parallel experiments. RESULTS: The DTH to BALB/c antigen was markedly suppressed in C57BL/6 mice when this alloantigen was given by either PO or PV routes (P < 0.001, P < 0.001). The maintenance of an unaltered response to third-party C3H/HeJ demonstrated alloantigenic specificity. Administration of the anti-NK1.1 T cell monoclonal antibody, PK-136, resulted in complete restoration of in vivo DTH responsiveness in PO tolerance (P < 0.01), and partial restoration in PV tolerance (P < 0.05) in C57BL/6 mice. FACS confirmed virtually complete depletion of liver, splenic, Peyer's patch, and mesenteric lymph node NK1.1(+) lymphocytes. Development of both PO and PV tolerance was prevented in CD1 KO mice. CONCLUSION: NK1.1(+) T cells play an essential role in antigen-specific suppression of the DTH response mediated by both oral and portal venous tolerance.     

愈疡灵软膏治疗下肢静脉性溃疡的临床研究

目的：探讨中药愈疡灵软膏治疗下肢静脉性溃疡的效果有作用机理。方法：将60例静脉性溃疡患者随机分为治疗组和对照组，治疗组40例，外用愈疡灵软膏创面换药；对照组20例，外用大黄沙纱创面换药。观察溃疡面愈合情况。结果：治疗组有效率为95％，对照组有效率为75％，两组比较有显著性差异（P＜0．05）。结论：愈疡灵软膏具有改善创面血液循环、抑菌、抗炎及促进创面愈合的作用。     

Clinical observation of tempofilter Ⅱ inferior vena cava filter in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis

Objective The aim of this study was to evaluate our experience with the retrievable Tempofilter Ⅱ inferior vena cava (IVC ) filter with regard to insertion, efficiency, ease of retrieval, and any associated complications. Methods A retrospective review was performed of 112 patients (44 female,64 male,mean age 52. 3 years) who underwent Tempofilter Ⅱ IVC filter insertion. Filter insertion was successful in all patients. The filter was placed in via the jugular vein of 112 cases with acute deep vein thrombosis (DVT) and (or) PE;after drug treatment, it was observed whether there existed PE symptoms and if the change of the filter location occurred and associated complications. Results All the inferior vena cana filters were successfully emplaced,and DVT responded well to the filters;no clinical relevant pulmonary embolism occurred;The mean dwell time of successfully retrieved filters was 19. 3 days ( range 8-69 days). The thrombus was trapped in 54 cases (48. 2% ). One vena cana filter was escaped. Conclusion Tempofilter Ⅱ vena cana filter is of exact curative effect in the p revention of PE and high value of clinical application.     

复发性下肢静脉曲张再手术原因分析

目的:探讨分析复发性下肢静脉曲张再手术的原因。方法:总结63例复发性下肢静脉曲张患者的临床资料,应用彩色多普勒和顺行静脉造影了解下肢深静脉和交通支瓣膜功能。结果:63例中52例为下肢深静脉瓣膜功能不全,11例为交通支瓣膜功能不全伴隐静脉主干及其部分属支残留。结论:有效修复深静脉瓣膜功能,结扎和离断相应属支及交通支,阻断静脉的反流,纠正3个静脉系统及溃疡周围的血液滞留,是防治下肢静脉曲张术后复发的主要措施。     

并发静脉癌栓的肾细胞癌中VEGF的表达及临床意义

目的：探讨血管内皮生长因子（VEGF）的表达与肾细胞癌（RCC）并发静脉癌栓（VTT）的关系。方法：采用免疫组织化学MaxVision^TM快捷法检测57例并发或未并发VTT的RCC组织和10例远离肿瘤的正常肾组织中VEGF的表达状况。实验分为三组,A组：并发VTT的RCC组织27例;B组：未并发VTT的RCC组织30例;C组：远离肿瘤的正常肾组织10例。结果：VEGF在三组中的阳性表达率分别为81．5％、63．3％和20．0％,其中A组和C组差异有统计学意义（P〈0．01）,A组和B组差异无统计学意义（P〉0．05）,B组和C组差异有统计学意义（P〈0．05）。结论：VEGF的异常表达可能在RCC并发VTT的形成中发挥重要作用,以抑制VEGF蛋白及其受体作用的靶向治疗药物在RCC并发VTT的治疗中应有良好效果。     

Azoospermia and maturation arrest: malfunction of valves in erect poster of humans leads to hypoxia in sperm production site

Maturation arrest (MA) of spermatogenesis is diagnosed on histology as interruption of spermatogenesis before the final stage without impairment of Sertoli or Leydig cells. It is considered a condition of irreversible or absolute infertility. Varicocele, which represents impairment in the testicular venous drainage system, has been shown to be a bilateral disease. Malfunction of the valves increase the hydrostatic pressure in the testicular venous system that exceeds the pressure in the arterial system leading to hypoxia in the testicular microcirculation and in the seminiferous tubules, the sperm production site. Sperm production deteriorates, and ultimately progresses to azoospermia. Our prediction was that MA, if genetic factors are excluded, is the final stage of long standing hypoxia. This would indicate that MA is not always an independent disease entity, but may represent progressive process of deterioration of the testicular parenchyma beyond azoospermia. By histology and electron microscopy, our prediction confirmed, at least partially, that MA is associated with degenerative ischaemic changes in the seminiferous tubules. Adequate treatment of bilateral varicocele by microsurgery or super-selective sclerotherapy of the internal spermatic veins including associated network of venous bypasses, vertically oriented, may resume the flow of oxygenated blood. If irreversible damages did not occur and ischaemia is not too long standing, limited sperm production may be restored, at least partially.     

全凭静脉麻醉下过度通气对颈内静脉血氧饱和度的影响

目的评价神经外科患者全凭静脉麻醉下不同PETCO2水平对颈内静脉血氧饱和度(SjvO2)的影响。方法择期行幕上颅内肿瘤切除术患者12例,ASAⅠ或Ⅱ级,全凭静脉麻醉下根据计算机产生的随机表,按随机顺序将PETCO2分别控制到如下水平:25、35、45mmHg;稳定10min后同时取动脉血和颈静脉球部血进行血气分析,并同时记录MAP、HR、食管温度(TESO)、脑电双频指数(BIS)等参数。结果PETCO2为25、35和45mmHg时,SjvO2分别为(53.7±2.5)%、(69.3±3.8)%和(81.8±2.0)%,组间比较差异有统计学意义(P<0.01)。结论神经外科患者全凭静脉麻醉下随着PCO的降低,SjvO也明显下降。     

长脉冲Nd:YAG激光非侵入性治疗皮肤浅表静脉畸形

目的前瞻性研究长脉冲1064nm Nd:YAG激光非侵入性治疗皮肤浅表静脉畸形的疗效。方法22例不同部位皮肤浅表静脉畸形患者接受长脉冲1064nm Nd:YAG激光治疗,6mm直径光斑,7～8ms双脉宽,脉冲间隔20ms,140～150J/cm2能量,接触式冷却,治疗间隔3周至1个月,治疗后1、6个月随访,评价病灶清除率分为五级。结果22例患者完成治疗,最多治疗5次。随访6个月,96.3%浅表静脉畸形获得76%～100%的清除,37%获得病灶的完全清除,未见复发。治疗部位无一例发生紫癜,治疗后8例(38.1%)出现红斑,1d至1个月消退。无色素改变和形成。结论长脉冲1064nm Nd:YAG激光能有效安全地治疗皮肤浅表静脉畸形,选择性地清除浅表血管,并使用接触冷却系统保护表皮,减少紫癜发生及色素改变和瘢痕的形成,达到理想的美容效果。