大鼠带皮质细胞的肾上腺被膜与单纯肾上腺被膜对自体移植…

对大鼠带皮质细胞的肾上腺被膜与单纯肾上腺被膜进行自体肾被膜下移植，通过组织学检查与血皮质酮测定结果发现，带皮质细胞的肾上腺被移植有五变怀，部分坏死而后再生的过程，而纯肾上腺被膜种植则无此过程，而是直接再生。前者明显较后者再生迅速，完全，功能好。     

老年人脑皮质下斑点状病灶的MRI病理基础研究

本文对29例脑标本行 MRI-病理对照研究,其中18例脑标本 MRI 检查阳性,发现脑皮质下斑点状病灶(Subcortical Patchy Lesions,SPLs)95个。该病灶分两大类:第一类(64个)位于脑皮层下白质、基底核、小脑和脑干,其病理基础主要为血管周围间隙扩大(83%),小梗塞灶(11%),其他还有小动、静脉畸形(AVM),脱髓鞘灶和胶质增生灶;第二类(31个)位于侧脑室周围白质内,其病理基础为局部组织结构疏松呈空泡状,病灶相应部位的室管膜大片脱落。     

肝VX-2 瘤模型MR扩散成像的实验研究

目的探讨肝VX-2瘤模型MR扩散成像特征.方法新西兰大白兔35只,采用块种植的方法,一期预实验皮下种植14只,肝内种植6只;二期肝内种植12只,另3只做正常对照.对包括二期肝内种植在内的15个肿瘤于种植前后行定期扩散加权成像(DWI) 与MR检查.以表观扩散系数(ADC)值等为指标进行统计分析.结果 (1)一期预实验,皮下种植成功率29%(4/14),肝内种植成功率33%(2/6);二期肝内种植成功率83%(10/12).(2)VX-2瘤在DWI上呈高信号,边缘清楚.正常组与VX-2瘤实验组b值为100和300 s/mm2时ADC值分别为(2.57±0.26)mm2/s、(1.73±0.31)mm2/s、(1.87±0.25)mm2/s与(1.57±0.23)mm2/s(F=43.26,P<0.001).随b值增大,病灶信号降低;ADC图上病灶呈低信号;不同b值之间病灶ADC值差异有统计学意义(P<0.05);b=100 s/mm2病灶与正常肝脏之间ADC值差异有统计学意义(P<0.01).(3)VX-2瘤发展迅速,易发生肺、肝、纵隔等处转移.结论 DWI在反映肝VX-2瘤内部水分子运动、发现与追踪病灶进展等方面有重要价值.     

Rapid effect of stress concentration corticosterone on glutamate receptor and its subtype NMDA receptor activity in cultured hippocampal neurons

Objective: To study the rapid effect of glucocorticoids (GCs) on NMDA receptor activity in hippocampal neurons in stress and to elucidate its underlying probable membrane mechanisms. Methods: Whole-cell patch-clamp recording was used to assess the effect of stress concentration corticosterone (B) on the responses of cultured hippocampal neurons to glutamate and NMDA (N-methy-D-asparatic acid). To make clear the target of B, intracellular dialysis of B(10μmol/L)through patch pipette and extracellular application of bovine serum albumin-conjugated corticosterone (B-BSA, 10μmol/L)were carried out to observe their influence on peak amplitude of NMDA-evoked current. Results: B had a rapid, reversible and inhibitory effect on peak amplitude of GLU-or NMDA-evoked current in cultured hippoeampal neurons. Furthermore, B-BSA had the inhibitory effect on INMDA as that of B, but intraeeUularly dialyzed B had no significant effect on INMDA. Conclusion: These results suggest that under the condition of stress, GCs may rapidly, negatively regulate excitatory synaptic receptors-glutamate receptors (GluRs), especially NMDA receptor (NMDAR) in central nervous system, which is mediated by rapid membrane mechanisms, but not by classical, genomic mechanisms.     

团结奋斗,努力追赶泌尿科学的世界先进水平

泌尿外科(Urology)是研究泌尿、男生殖系统和肾上腺疾病的临床学科，在某些医院也称为泌尿科。泌尿科学是外科学发展较早的一个分支，其研究范畴不仅包括上述疾病的诊断和治疗，也包括它们的病因学、发病机理和流行病学研究。     

肾上腺组合性嗜铬细胞瘤四例报告及文献复习

Objective To discuss the clinical characteristics and management principles of com-posite pheochromoeytoma of adrenal gland (pheochromocytoma-ganglioneuroma). Methods Four cases of composite tumor of adrenal gland diagnosed pathologically were reviewed. All the cases were male, aged 37 to 62 years;three of them had the history of hypertension, one of them accompanied with paroxysmal palpitation, while one case was asymptomatic. Computerized tomography and ultra-sonography showed single tumor in adrenal, the diameter was about 2.5、3.8、6.3、15cm respectively. Two cases showed positive results in 131Ⅰ-metaiodobenzylguanidine (MIBG) scintigraphy. One case showed positive result in 99Tcm-hydrazinonicotinamide-3trysinoctreotide (HTOC) scintigraphy. Twenty-four hours urinary catecholamine examination revealed the average of norepinephrine, epi-nephrine and dopamine were (196.1±92.2)nmol/24 h, (26.6±8.9)nmol/24 h, (1957.9±913.5) nmol/24 h respectively. Two cases were at a little elevated level and the others with normal. All cases were managed with α-adrenergic receptor blocker preoperatively for 2-4 weeks. Results Tumor re-section was performed in all 4 cases, and 3 cases by retroperitoneal laparoscopy, one by open surgery. All 4 cases were diagnosed as composite pheochromocytoma of adrenal (Pheochromocytoma-gangli-oneuroma) by pathology. All patients had no evidence of recurrence or metastasis during follow-up from 15 to 38 months. Two of three cases with hypertension reverted to normotensive. Conclusions Composite pheochromocytoma of adrenal is rare, difficult to be diagnosed preoperatively. Except mild in eatecholamine secretion, which clinical manifestations are similar to pheochromocytoma. Pheochro-mocytoma-ganglioneuroma is no apparent tendency for aggressive behaviors, the results of surgical management are favorable.     

后腹腔镜手术治疗嗜铬细胞瘤

目的探讨后腹腔镜手术治疗嗜铬细胞瘤的适应证及手术安全性. 方法采用后腹腔镜手术治疗肾上腺嗜铬细胞瘤患者15例(双侧2例),腹主动脉旁嗜铬细胞瘤1例.对照组为开放手术治疗的肾上腺嗜铬细胞瘤16例,腹主动脉旁嗜铬细胞瘤1例.结果后腹腔镜手术组16例患者行后腹腔镜手术18例次,17例次取得成功,1例因术中出血改行开放手术.肿瘤最大径2.0～6.5(3.8±1.6)cm.手术时间45～150(85±31)min,出血量10～100(32±22)ml.术后吗啡用量0～40(12.5±7.8)mg;术后恢复进食时间1～3(1.8±0.7)d;下床活动时间2～3(2.3±0.5)d;术后住院时间4～9(6.5±1.3)d.开放手术组肿瘤最大径1.5～6.0(4.3±1.3)cm.手术时间90～240(155±39)min,出血量50～600(273±105)ml,9例输血.术后吗啡用量10～120(61±24)mg;术后恢复进食时间2～4(2.9±0.5)d;术后下床活动时间3～6(4.8±0.7)d;术后住院时间8～11(8.8±0.9)d.结论对于有一定腹腔镜手术经验者,后腹腔镜手术并不增加嗜铬细胞瘤手术的危险性,且具有手术时间短、出血少、创伤小、疼痛轻、康复快等优点.该法有望成为治疗肾上腺嗜铬细胞瘤的首选手术方法.     

第六届全国腔内泌尿外科及ESWL学术会议纪要

第六届全国腔内泌尿外科及ESWL学术会议于2 0 0 3年11月6～9日在武汉市召开。12 0 0余名代表出席会议。会议共收到稿件6 0 6篇,其中特约专题讲座5篇,大会交流15篇,分会交流195篇。会议就腹腔镜、ESWL、经尿道手术、肾、输尿管镜专题进行了热烈讨论。那彦群教授在“未来内窥镜技术的发展方向”的专题报告中指出微创外科的发展在一定程度上依赖于技术的进步。现代内窥镜技术将更清晰逼真的影像、更顺畅有效的无血切割与凝血、主机通用化、器械专科化、集成化和网络化作为追求的目标。尖端的机器人手术也必将与内窥镜技术相结合,创造出精确…     

脾脏结核CT影像诊断

目的探讨脾脏结核的CT影像表现及其诊断价值。方法回顾分析临床证实的25例脾脏结核的CT表现。其中男性15例，女性10例，年龄16-52岁，中位年龄25岁。结果25例脾脏结核CT表现分为脓肿型，粟粒型，混合型及陈旧钙化型。平扫病灶模糊不清，增强后病灶显示清楚，但边缘显示不规则。结‘论当患者具有典型的所述影像表现，如年龄较轻且合并有肺结核或／和肺外结核时，应考虑脾脏结核的诊断。     

心血管活性物质在心肌缺血再灌注中作用的研究

缺血性心脏病是当今危害人类健康的常见病。近年来随着医疗技术的发展，处理的方法由单纯的药物发展到溶栓、经皮腔内冠状动脉成形术(PTCA)、支架植入术、冠状动脉旁路术(CABG)、激光再通、心肌打孔等方法。同时对心肌缺血再灌注(I/R)的实验和临床研究也在不断的前进和发展。心血管活性物质作为在其中起重要作用的一员，研究更是越来越深入，下面就部分心血管活性物质在心肌缺血再灌注中研究进展综述如下。