吡啶斯的明试验对评价垂体hGH储备功能的价值

垂体hGH分泌受中枢神经介质调控。兴奋胆碱能系统可使hGH增加。本文试用胆碱酯酶抑制剂吡啶斯的明兴奋hGH,并与胰岛素兴奋试验进行比较,观察了13名正常青少年和10名垂体性侏儒症患者对两种兴奋试验的反应。结果显示口服吡啶斯的明2mg/kg体重能迅速有效地兴奋垂体hGH释放。其作用较胰岛素兴奋试验更强,是一项值得推荐的判定青少年垂体hGH储备功能的试验。     

小脑梗死的临床研究现状

小脑动脉属椎、基底动脉的长旋支 ,供血范围主要包括小脑、脑干外侧部及被盖部。小脑梗死好发于 6 0～ 80岁男性 ,根据影像学改变可分为区域性和非区域性两大类。缺血机制不同 ,临床表现及预后差异较大。本文重点阐述小脑梗死的发病机制、各小脑动脉闭塞时的临床 -解剖相关性和预后。     

多节段颈椎间盘脱出的脊髓型颈椎病治疗的回顾性分析

目的：研究多节段颈间盘脱出症术式选择、减压范围及植骨的处理。方法：对48例患者的发病因素、病程及影像学表现特征进行分析。本组均采用颈椎前路减压自体髂骨植骨融合术,术后随访最平均4．7年。结果：治疗效果优：28例（58．3％）良：11例（22．9％）。可：6例（12．5％）,差：3例（6．3％）。结论多节段间盘脱出症减压手术应首先考虑前路手术。如临床症状不缓解,可待植骨愈合后再后后路减压手术。一般两个节段的间盘摘除基本可以解决多间盘脱出的颈椎病。有的原则是务必保持椎间高度。     

大鼠肾上腺切除后垂体前叶GAP-43免疫阳性神经纤维的发芽过程

目的　阐明大鼠双侧肾上腺切除后垂体前叶生长相关蛋白 43(GAP- 43)免疫阳性神经纤维表达的量与术后时间点的关系 ,即轴突发芽的时间过程 .方法　免疫组织化学ABC法 .结果　大鼠双侧肾上腺切除术后第 4日垂体前叶GAP- 43阳性表达显著增多 ,第 2周有所下降 ,至第 4周基本降至正常水平 .结论　大鼠在双侧肾上腺切除后 ,垂体前叶出现肽能神经纤维发芽 ,并围绕在腺细胞周围 ,该发芽过程于术后 4～ 7d达到高峰 ,第 2周开始下降 ,第 4周基本结束     

Immunohistochemistry of anterior proliferative vitreoretinopathy

Anterior proliferative vitreoretinopathy is characterized by epiretinal proliferation that extends anteriorly over the vitreous base, and may, in addition to the cells usually contributing to proliferative vitreoretinopathy, also contain cells of ocular structures located in that area. We examined 11 complete globes with aPVR that were enucleated after previous severe trauma or perforating injuries (n=8) and complicated retinal detachment (n=3) by a panel of immunohistochemical markers. We found presence of RPE, glial cells, macrophages and fibrocytes, as consistently reported in PVR membranes. In addition, T-cell lymphocytes were present in 6 of the cases, and cells expressing the common leucocyte antigen on 8 cases. Cells staining positive for the intracytoplasmic contractile filament-smooth muscle actin were present in 5 cases and cells staining for desmin in one case. Collagen type IV was part of most of the membranes, and vessels with leakage of plasma factors were present in more than half of the cases.This paper was presented in part at the First Annual Meeting of the European Community Ophthalmic Research Association (ECORA), Bonn, Germany, 6.10.1993.     

Inferior ST segment depression as a useful marker for identifying proximal left anterior descending artery occlusion during acute anterior myocardial infarction

To determine whether or not ST segment deviation on admissionelectrocardiograms can identify patients with anterior acutgemyocardial infarction due to proximal left anterior descendingartery occlusion, the magnitude and location of ST segment elevationor depression were compared between patients with proximal leftanterior descending artery occlusion (group A, n=47) and thosewith distal left anterior descending artery occlusion (groupB, n =59). ST segment depression in each of the inferior leadswas significantly greater in group A than in group B. The incidenceof ST segment depression 1 mm in each of the inferior leads(II; 81% vs 27%, III; 85% vs 54%, aVF; 87% vs 47%, P<0·01)was significantly higher in group A than in group B. In addition,the incidence of ST segment depression 1 mm in all of the inferiorleads was significantly greater in group A than in group B (77%vs 22%, P<0·01). In group A, maximal ST segment elevationwas more frequent in lead V alone (43% vs 14%, P<0·01).Group A had greater ST segment elevation in lead a VL than groupB, and the incidence of ST segment elevation 1 mm in lead aVL was significantly higher in group A than in group B (66%vs 47%, P<0·05). ST segment depression 1 mm in allof the inferior leads was most valuable for identifying groupA patients (77% sensitivity and 78% specificity). In contrast,the maximal ST segment elevation in lead V₂ alone or ST segmentelevation 1 mm in lead a VL had a low diagnostic value (43%sensitivity and 86% specificity, 66% sensitivity and 53% specificity,respectively). In conclusion, this study indicates that analysisof ST segment deviation in the inferior leads is useful foridentifying patients with acute anterior myocardial infarctiondue to proximal left anterior descending occlusion.     

臂丛下干的应用解剖观察

目的了解斜角肌间隙内臂丛下干与邻近组织结构及胸１神经干与第１肋的关系,为临床诊治臂丛下干卡压症提供解剖学依据。②方法在２１具４２侧成人标本上观测臂丛下干与邻近结构的位置关系。③结果在４２侧标本的斜角肌间隙内,有３３侧在前斜角肌的后内侧存在孤立的肌束,臂丛下干分别从其前下方（２３侧）或后上方（１０侧）通过;组成臂丛下干的胸１神经干在斜越第１肋前内侧面时部分穿行于骨纤维管内。④结论该肌束的压迫或拱抬均可成为臂丛下干受压的因素之一;组成臂丛下干的胸１神经干在越过第１肋时易受压迫。     

Sexually dimorphic expression of sst1 and sst2 somatostatin receptor subtypes in the arcuate nucleus and anterior pituitary of adult rats

The pattern of growth hormone (GH) secretion and rate of somatic growth are markedly sexually dimorphic, but the underlying neuroendocrine mechanisms are far from clear. In the present study, we tested the hypothesis that the sexual dimorphism of GH secretion may be due to gender-related differences in the transduction of somatostatin's actions in brain and/or pituitary. To accomplish this, we compared the distributional pattern and level of expression of two somatostatin receptor subtypes, sst1 and sst2, in the brain and pituitary of adult male and female rats by in-situ hybridization using 35S-labelled antisense riboprobes. In the brain, the hybridization pattern and labelling density of sst1 and sst2 mRNA-expressing cells, as revealed by computer-assisted image analysis, in areas including the cerebral cortex, medial habenula (MHb) and ventromedial hypothalamic nucleus (VMN), were similar in male and female rats. In contrast, there was a marked sex-related difference in sst1 expression in the arcuate nucleus of the hypothalamus; both the number and labelling density of sst1 mRNA-expressing cells were two- to threefold greater in males than in females and this significant increase was homogenous throughout the rostrocaudal extent of the nucleus. No gender-related differences in arcuate sst2 mRNA levels were found. At the level of the anterior pituitary, the labelling density of sst2 mRNA in males was significantly higher than that of females. No sex-related difference in pituitary sst1 mRNA was observed. These results demonstrate a sexual dimorphism in the expression of two somatostatin receptor subtypes, sst1 and sst2, at the level of the arcuate nucleus and anterior pituitary, respectively. Such dimorphism suggests a differential involvement of sst1 and sst2 in GH regulation with respect to gender, and may imply roles for sst2 and sst1 in transducing somatostatin's actions on pituitary somatotrophs and GH-releasing hormone-containing arcuate neurones, respectively, to generate the lower basal and higher GH pulse levels characteristic of the male rat.     

晶状体和玻璃体切除术后二期前房型人工晶状体植入

探讨晶状体,玻璃体切除术后二期前房型人工晶状植入的适应证,手术方法和疗效。方法,对我院行晶状体,玻璃体切除术后的２６例,分别在术３月－２年,行前房型人晶状体植入,术后随访６月以上。     

Kinetics of d-tubocurarine disposition and pharmacologic response in rats

After bolus intravenous dosing of d-tubocurarine (d-TC) to rats, the twitch heights of the tibialis anterior muscle indirectly stimulated were followed, and its decrease was defined as pharmacologic response of d-TC. The relation between dose and response intensity was found to be well described with Hill's equation. According to a theory proposed by Smolen, Hill's equation was also applicable to the biophase d-TC concentration-response relation; the time courses of the relative biophase d-TC concentration indicated linear kinetics with dose levels 0.15 mg/kg and the occurrence of dose-dependent disposition with 0.30 mg/kg. After bolus i.v. dosing of³H-d-TC, plasma d-TC concentration obeyed a dose-independent two compartment model with doses 0.15mg/kg, but not with 0.30 mg/kg. This finding matched the above estimated with pharmacologic data. The active metabolite was not found in plasma and urine. The extent of d-TC plasma protein binding was independent of the wide range of plasma levels and its mean (±SD) value was 30.5 (±3.8). Plasma d-TC levels and pharmacologie response intensity were well correlated by Hill's equation and a three compartment model (the general two and the biophase compartments) in the dose range 0.15 mg/kg.This work was presented at the First Japanese-American Symposium on Pharmacokinetics and Biopharmaceutics, Tokyo, July 1981, which was held in memory of Dr. Sidney Riegelman.