体外培育牛黄镇痛作用的电生理机制

目的探讨体外培育牛黄(calculus bovis sativus,CBS)镇痛作用的电生理机制。方法在蟾蜍坐骨神经干和培养大鼠三叉神经节(TRG)细胞上,分别记录复合动作电位和电压依赖性钠通道电流。结果CBS(>0.4g.L-1)可以抑制复合神经动作电位,4g.L-1CBS对其抑制率为(42.5±17.6)%。CBS(0.2~20mg.L-1)可以剂量依赖性的抑制大鼠TRG细胞电压依赖性总钠通道电流(INa-T)和TTX不敏感型钠通道电流(INa-TTX-r),20mg.L-1CBS对INa-T和INa-TTX-r的抑制率分别为(55.8±7.8)%和(39.3±5.7)%。结论CBS对钠电流的阻滞作用可能是其镇痛作用机制之一。     

Bladder Paraganglioma with a Calculus： A Case Report

A 61-year-old female visited our department reporting intermit-tent microscopic hematuria.     

腹腔镜与胆道镜联合在胆管结石手术治疗中的临床应用

目的探讨胆道镜在腹腔镜胆管结石手术中应用的价值。方法利用胆道镜灵活的转向、柔和的弯曲性,对腹腔镜下剖开胆总管的远端及肝内胆管进行探查、术中取石、狭窄胆管的治疗。结果本组72例胆管结石患者均术中应用胆道镜探查,单纯胆总管结石51例,术中取净47例;单纯肝内胆管结石12例,术中取净5例;肝内外共存结石9例。术中取净4例;伴有肝内胆管狭窄2例,Oddi括约肌狭窄1例。对2例肝内胆管狭窄及1例Oddi括约肌狭窄进行球囊导管扩张治疗。结论胆道镜在腹腔镜胆管结石手术中的应用,提高了术中结石取出率及取净率;同时可以对胆管及Oddi括约肌狭窄进行诊断和术中治疗,提高了腹腔镜胆管结石Ⅰ期治愈率,达到微创的目的。     

肾结石治疗方法随机对照试验的Meta-分析

目的 客观评价体外冲击波碎石术、经皮肾穿刺造瘘碎石取石术治疗肾结石的疗效。方法 采用电子检索和手工检索进行文献初检,电子检索数据库有Medline data-base（1980年1月-2006年6月）、中国期刊全文数据库（CNKI,1980年1月-2006年6月）、中国循证医学/Cochrane中心数据库（CEBM/CCD）、Cochrane图书馆,手工检索近期《中华泌尿外科杂志》等4种杂志,鉴定有关随机对照试验,并采用RevMan4.2进行Meta-分析。结果 我们共收集纳入2个随机对照试验进行了结石清除率的比较,177例病人符合纳入标准,Meta-分析结果显示经皮肾穿刺造瘘碎石取石术治疗肾结石（直径〈3cm）在结石清除率方面明显高于体外冲击波碎石术。结论 经皮肾穿刺造瘘碎石取石术治疗肾结石方面显示出了巨大的优势。     

白萝卜提取物对大鼠胃排空、肠推进及豚鼠离体回肠平滑肌的影响

目的 研究白萝卜提取物（ Raphanus sativus extract）对在体大鼠胃排空及肠推进的影响及对豚鼠离体回肠平滑肌条收缩活动的影响。方法 通过旋转蒸发的方法，制备得到白萝卜提取物；将32只SD大鼠随机分为白萝卜提取物高剂量组（3ml／kg）、中剂量组（1ml／kg）、低剂量（0．3ml／kg）组及空白对照组（生理盐水）4个组，每组8只，通过灌胃给药的方法，以胃肠内标记物葡聚糖蓝-2000在大鼠胃内色素相对残留率及肠推进比为指标，观察各组对大鼠胃排空及肠推进的影响，进一步在离体条件下，以豚鼠回肠平滑肌肌条的收缩幅度和频率为指标，通过不同浓度的白萝卜提取物作用于豚鼠离体回肠平滑肌，观察提取物对离体回肠平滑肌收缩活动的影响。结果白萝卜提取物在0．3ml／kg，1．0ml／kg，3ml／kg剂量下都能够提高大鼠胃排空率，与空白对照组相比，差异具有显著性（P〈0．01）；通过小肠推进比的比较，发现0、3ml／kg、1ml／kg剂量的提取物可明显促进小肠推进，与空白对照组相比，差异具有显著性（P〈0．01）；而3ml／kg剂量下的提取物未表现出明显的促进小肠推进作用，与空白对照组相比，差异无显著性（P〉0．05）。在离体条件下，提取物在0．1mg／ml下对豚鼠离体回肠平滑肌的张力和收缩频率均无明显影响，但可增加其收缩幅度（与给药前相比，P〈0．05）；而在0．3mg／ml，1．0mg／ml，3．0mg／ml剂量下，均可使豚鼠离体回肠平滑肌的张力、收缩幅度增加（与给药前相比，P〈0、01），但不改变收缩频率（与给药前相比，P〉0．05）。结论 白萝卜提取物对动物胃肠动力具促进作用，并存在一定的剂量一效应关系。     

体外冲击波碎石治疗膀胱结石39例

目的探讨ESWL治疗膀胱结石的技术要点和治疗效果。方法回顾分析本院2001年6月～2005年8月采用ESWL治疗泌尿系结石1825例中的39例膀胱结石的治疗资料。结果39例患者中一次碎石成功8例，2次碎石排尽19例，3次排尽10例。2例转为开放手术治疗。2例有结石碎块堵塞后尿道，用尿道探子推入膀胱后重新碎石获得成功。结论ESWL在膀胱结石的治疗中。具有损伤小，痛苦少，可重复使用的特点，可以作为治疗膀胱结石众多方法中的主要选择之一。     

Identification of distinct lymphocyte subsets responding to subcellular fractions of Mycobacterium bovis bacille calmette-Guérin (BCG)

In order to investigate the ability of Mycobacterium bovis BCG vaccination to induce immune responses toward different classes of mycobacterial antigens and the cell populations involved in such responses, proliferation of distinct human lymphocyte subsets from BCG-vaccinated donors in response to different subcellular fractions of BCG was analysed and compared with that of not sensitized subjects. Proliferation of different cell subsets was evaluated by flow cytometric determination of bromodeoxyuridine incorporated into DNA of dividing cells and simultaneous identification of cell surface markers. Although a certain degree of variability was observed among different donors, after 6 days of in vitro stimulation BCG-vaccinated subjects displayed, as a mean, a stronger blastogenic response to all the classes of antigens compared with non-sensitized ones. PPD, culture filtrates and membrane antigens induced a predominant proliferation of CD4+ T cells. In contrast, preparations enriched in cytosolic antigens elicited strong proliferation of gammadelta+ T cells which, as a mean, represented 55% of the proliferating cells. Although to a lesser extent, proliferation of gammadelta+ T cells was also elicited by preparations enriched in membrane and cell wall antigens. In response to the latter preparation proliferation of CD4+ T cells and CD16+/CD3- (natural killer (NK)) cells was observed, as well. In particular, cell wall antigens were found to induce significantly higher levels of proliferation of NK cells compared with all the other classes of antigens.     

肾窦内肾盂及肾实质切开取石治疗复杂性肾结石

目的探讨复杂性肾结石的手术治疗方法。方法采用肾窦内肾盂及肾实质切开取石治疗复杂性肾结石。结果89例复杂性肾结石经肾窦内肾盂及肾实质切开取石治疗,平均手术时间约130min,术中出血平均约200mL,取尽结石86例,术后常规B超或KUB检查,3例残留单个小结石。结论肾窦内肾盂及肾实质切开取石符合肾动脉及其分支的解剖,距结石较近,该手术操作简便、手术野暴露好、结石残留率低、无需阻断肾血流、出血少、肾组织损伤轻,对肾功能影响小,是治疗复杂性肾结石较理想的手术方法。     

人工牛黄与几种新配方的药理学比较研究（Ⅰ）

用比较药理学研究方法，对人工牛黄新配方Ａ、Ｂ、Ｃ和Ｄ与现在药用人工牛黄的主要药效学在同等条件下进行了比较。结果表明，与现在药用人工牛黄一样，人工牛黄新配方Ａ、Ｂ、Ｃ和Ｄ具有镇静、抗惊厥、解热、抗炎、增强非特异性免疫、护肝作用，作用强度与现在药用人工牛黄相近，或更强。     

Effect of dietary administration of Lathyrus sativus pulse on intestinal biochemical parameters in normal and scorbutic guinea pigs

Objective In order to investigate that ascorbic acid deficiency is responcible for lathyrus toxicity, the effect of dietary feeding of lathyrus pulse in normal and scorbutic guinea pigs for 3 months, on intestinal biochemical parameters was undertaken. Methods The intestinal brush border membrane (BBM) marker and xenobiotic metabolising enzymes (XME) were assayed. Results Exposure to 80% lathyrus alone and in scorbutic conditions showed significant inhibition of alkaline phosphatase (28%-30%), sucrase (19%) and γ-glutamyl transpeptidasc (GGT) (15%-27%)enzymes, while Ca2+-Mg2+-ATPase was significantly inhibited (38%) in scorbutic plus lathyrus treated group. The phase Ⅰ XME (AHH) remained unchanged while the phase Ⅱ enzyme glutathioneS-tranferase (GST) was significantly decreased (20%-22%) in lathyrus and scorbutic plus lathyrus treated groups. Quinone reductase (QR) activity was found to be significantly decreased in lathyrus exposed group (20%). The intestinal biomarker contents including hexose (25%-34%) and phospholipids (20%-40%) were significantly reduced in lathyrus and scorbutic plus lathyrus exposed animals, while sialic acid showed a significant decrease (28%) in scorbutic plus lathyrus treated group. However, cholesterol levels were signifcantly enhanced (15%-28%) in lathyrus and scorbutic plus lathyrus treated animals. Conclusion The results indicate that oral feeding of lathyrus pulse to guinea pigs can alter BBM parameters as well as XME, which may result in the intestinal toxicity.Further, ascorbic acid deficiency could be one of the pre-disposing factors of lathyrus toxicity.