Improving Prenatal Diagnosis of Coarctation of the Aorta

Background

The purpose of the study was to evaluate the association between fetal echocardiographic measurements and the need for intervention (primary coarctation repair, staged coarctation repair, or catheter intervention) in prenatally diagnosed coarctation of the aorta.

肛门病手术应用低浓度小剂量利多卡因局麻的效果

目的观察低浓度小剂量利多卡因在肛门病手术中的应用效果。方法选择接受肛门病手术者100例,手术时用0．25％盐酸利多卡因5-20ml,根据病情和手术需要作局部浸润麻醉。结果通过100例的肛门手术观察,结果显示麻醉满意顺利83例,麻醉良好17例,无1例麻醉无效失败。总有效率100％。此法麻醉效果确切,未发现严重不良反应。结论此法具有易于掌握,效果好而安全的优越性,适于临床应用和推广。     

Chronic pelvic pain: Psychological features and laparoscopic findings

One hundred three consecutive patients referred for treatment of chronic pelvic pain underwent MMPI testing, and 60 had diagnostic laparoscopy. A physical cause for the pain was found in 45 (75%) of the 60. However, three fourths (34) of patients with an organic cause for the pain also had evidence of psychopathology on the MMPI. Reassurance and education as to the role of stress in causing or exacerbating pain complaints appeared helpful. Most patients improve without major surgery.     

Intimal changes associated with arterial spasm induced by periarterial application of calcium chloride

Arterial spasm was induced by application of calcium chloride to the adventitial surface of the rabbit common carotid artery in vivo. Sodium chloride (NaCl) was applied to the contralateral vessel as control. Vessels were fixed in situ by intravascular perfusion after 15 min, 1 hr, or 24 hr and prepared for light and scanning electron microscopy (SEM). With SEM, the luminal surface at the site of calcium application showed severe longitudinal folding accompanied by endothelial desquamation with extensive platelet deposition on exposed subendothelium. The luminal cross-sectional area was reduced by 53 +/- 19.5% after 15 min and by 44 +/- 12% after 1 hr as compared with the contralateral control. Furthermore, the luminal area at the site of calcium application was found to be reduced by 42 +/- 8% after 1 hr when compared with segments of the same vessel distal to the site of calcium application. Blood flow rate, as measured by electromagnetic flow probe, was not reduced. Vessels examined after 24 hr showed a significant increase in luminal cross-sectional area as compared with contralateral control vessels (136 +/- 70%). Control vessels (NaCl) showed no significant change in luminal cross-sectional area and no endothelial desquamation or platelet deposition after 15 min, 1 hr, or 24 hr. Examination of histologic sections showed calcium precipitation within the attached thrombus after 15 min with calcium deposits also adherent to the adjacent luminal aspect of the internal elastic lamina (IEL). By 24 hr, this precipitation extended throughout the media. Marked deposition of leukocytes was seen after 24 hr which showed a preferential attachment for areas of endothelial damage and discontinuity of IEL.     

Genetically regulated human (T,G)-AL specific helper T cell replacing factors possess HLA-DR and Vh determinants

Human (T,G)-AL specific T cell helper factors secreted by in vitro activated peripheral blood lymphocytes of normal donors were characterized. Factors were passed through columns of Sepharose coupled either to antibodies against human immunoglobulin or antibodies against the variable region of the heavy (V_h) and light (V_l) chains of human immunoglobulin. In addition, the same factors were applied to columns of Sepharose coupled to anti-HLA-DR antibodies or to monoclonal antibodies against human Ia or β₂-microglobulin. The activity of the antigen specific factors was removed by the anti-V_h antibodies and not by anti-V_l or anti-human immunoglobulin antibodies. The factors passed through Sepharose coupled to anti-DR antibodies could be removed and eluted from columns of anti-DR antibodies relevant to the donors' DR antigens. The same factors were also removed by a monoclonal antibody (anti-Ia) which recognizes a monomorphic determinant on HLA-DR, but not by monoclonal anti-β₂-microglobulin. The results suggest that the genetically regulated (T,G)-AL specific helper factors possess HLA-DR as well as V_h determinants in their active moiety.     

Subsensitivity of T lymphocytes to sympathomimetic and cholinergic stimulation in bronchial asthma.

The effect of adrenergic and cholinergic drugs on short incubation “active” E rosette formation was studied in 19 patients with bronchial asthma and 17 healthy controls. Both groups had an equal absolute number of baseline “active” E rosettes, but the asthmatics demonstrated a higher percent baseline value. The beta adrenergic drug isoproterenol (10^?3 M) inhibited the formation of “active” E rosettes in asthmatics by only 18.0% as compared to a 60.8% inhibition in the control group. Carbamylcholine (10^?5 M) a cholinergic agonist, also showed a lower than normal response in asthmatics, 34.3% enhancement of “active” E rosetting compared to a 52.4% enhancement in the controls. The alpha adrenergic agent phenylephrine (10^?5 M) exhibited equal enhancing effects in both groups, 34.2% in the asthmatics and 36.5% in the controls. Isoproterenol (10^?3 M) had a minimal effect on inhibition of long incubation “total” E rosettes in both groups studied. The beta adrenergic abnormality conforms to the beta blockade theory of asthma of Szentivanyi. The cholinergic abnormality is unexplained in view of the hyperresponsiveness of patients with asthma to cholinergic agents in vivo. Patients with bronchial asthma probably have an autonomic dysfunction that may play a role in the pathogenesis of their disease.     

4型腺病毒载体的构建和β－半乳糖苷酶基因的表达

以４型腺病毒疫苗株感染Ａ５４９细胞，提取病毒ＤＮＡ，将ＥｃｏＲＩ消化的Ｄ片段（７０．５－８３．０基因图谱单位）克隆入ｐＵＣ１８质粒，得ｐＡｄ４（７０．５－８３）质粒，质粒ｐＡｄ４（７０．５－８３）和ｐＡｄ４Ｃ１－２５经酶切、系列亚克隆、加接头等方法得到大部分和部分缺失Ｅ３区的重组质粒。聚合酶链反应（ＰＣＲ）法获得ｐｏｌｙ（Ａ），构建约８００ｂＰ腺病毒晚期表达盒，在所构建的腺病毒重组质粒Ｅ３缺失区或Ｅ４与ＩＴＲ间插入表达盒，得到可同时表达２个或２个以上外源基因和保留了Ｅ３区编码分子量为１９３００糖蛋白基因的３种Ａｄ４载体。将ｌａｃＺ基因插入载体表达区，与Ｂｅｌｌ消化的Ａｄ４ＤＮＡＡ片段共转染Ａ５４９细胞，ＯＮＰＧ法检测证实所构建的载体和表达盒功能良好。本项工作对于在国内研究口服活疫苗及开展基因治疗均具有重要意义。     

儿童臀肌挛缩症免疫发病机理的研究

本文对４１例儿童臀肌挛缩症患者外周血及３２例儿童臀肌挛缩症臀肌进行了系统的免疫学研究。结果表明：儿童臀肌挛缩症患者免疫调节功能紊乱，红细胞免疫功能低下，臀肌组织免疫复合物沉积，臀肌小血管数目减少及管壁损伤。由此认为免疫病理因素是儿童臀肌挛缩症的主要发病机理。