无张力阴道吊带术(TVT)在不同年龄人群中应用的效果评估

目的:比较TV T技术在70岁以下年龄组与70岁以上年龄组间的治疗效果与长期发病率。方法:采用单中心回顾性研究,2000年1月至2001年5月对接受TVT技术治疗的患者邮寄调查表,评估患者术后的满意度和功能状态。结果:研究包括154例患者,其中137例(89%)填写了调查表,在这137例患者中,70岁以下者有72例(52.5%),70岁以上者有65例(47.5%),总体满意度为88.3%。70岁以下年龄组中97.5%治愈或改善,而70岁以上年龄组仅为78.5%(P=0.001)。组内研究表明,70～74岁年龄段患者的满意度(92.6%)高于总体满意度,75岁以后满意度(66.7%)低于总体满意度。此种差异与7…     

糖尿病急性代谢紊乱患者的正常甲状腺病态综合征临床分析

目的探讨糖尿病急性代谢紊乱患者正常甲状腺功能病态综合征(ESS)的发病情况及其特点。方法测定58例糖尿病急性代谢紊乱患者的总三碘甲状腺原氨酸(TT3)、总四碘甲状腺原氨酸(TT4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺素(TSH)水平,进行APACHEⅡ评分。结果TT3或FT3降低46例,与健康者比较,血清TT3、TT4、FT3明显降低(P<0.05),不同APACHEⅡ评分组间比较亦有显著性差异(P<0.05)。结论糖尿病急性代谢紊乱患者常合并ESS,反应急性应激对甲状腺轴的影响,有一定的评估病情及预后意义。     

洁悠神治疗Ⅱ期压疮的效果观察

压疮是指局部组织长时间受压，血液循环障碍，局部持续缺血、缺氧、营养不良而导致的软组织溃烂和坏死。近年来，因护理质量不断提高。住院患者很少发生压疮，但由院外带入或入院后因病情不允许翻身所致的压疮仍然时有发生。目前治疗压疮的方法很多，但在临床尚无特效的药物能使Ⅱ期压疮的水疱快速吸收。创面迅速结痂。2003年7月-2006年6月，我科在临床实践中采用洁悠神治疗Ⅱ期压疮32例，取得了满意疗效，现报道如下。[第一段]     

三联药物治疗未破裂异位妊娠的临床研究

目的 :观察甲氨蝶呤(Methotrexate,MTX)、米非司酮(Mifepristron,Ru486)及中药三联用药治疗未破裂型异位妊娠的临床疗效。方法 :对171例未破裂型异位妊娠病人 ,按药物治疗方法不同分为两组进行对照研究 :A组使用MTX注射 +Ru486口服 +中药联合治疗。B组单独使用MTX注射治疗。测定法定期测定两组病人血HCG值以监测血HCG下降情况 ,测量异位妊娠包块三径线值以监测病灶包块缩小情况 ,同时观察临床症状持续时间、副反应发生率及总有效率。结果 :血HCG下降及病灶包块缩小A组较B组明显 ,差异有显著性(p<0 05,p<0 01);临床症状持续时间A组较B组短 ,差异有显著性(p<0 05);副反应发生率两组间无显著差异(p>0 05);A、B两组的总有效率分别为 :95 74%和71 43% ,A组较B组高 ,差异有显著性(p<0 05)。结论 :三联使用甲氨蝶呤、米非司酮及活血化瘀消包块杀胚的中药既有很强的杀胚功能 ,又能消除病灶包块 ,保留生育功能。三联药物联合治疗未破裂异位妊娠具有疗效肯定、安全     

Effects of muscimol inactivation of the cerebellar nuclei on precision grip

A single monkey was trained to perform a grasp, lift, and hold task in which a stationary hand- held object was sometimes subjected to brief, predictable force-pulse perturbations. The displacement, grip, and lifting forces were measured as well the three-dimensional forces and torques to quantify specific motor deficits after reversible inactivation of the cerebellar nuclei. A prior single-cell recording study in the same monkey provided the stereotaxic coordinates used to guide intranuclear injections of muscimol. In total, 34 penetrations were performed at 28 different loci throughout the cerebellar nuclei. On each penetration, two 1.0-microl injections of 5 microg/microl muscimol, were made 1.0 mm apart either within the nuclei or in the white matter just lateral or posterior to the dentate nucleus. Injections in the region corresponding to the anterior interpositus nucleus produced pronounced dynamic tremor and dysmetric movements of the ipsilateral arm when the animal performed unrestrained reaching and grasping movements. In contrast, no relatively short-latency (15-20 min.) deficits were observed after injection in the dentate nucleus, although some effects were observed after several hours. When tested in a primate chair with the forearm supported and restrained at the wrist and elbow, the monkey performed the lift and hold task without tremor or dysmetria. However, with the restraint removed, the forces and torques applied to the manipulandum were poorly controlled and erratic. The monkey's arm was ataxic and a 5-Hz intention tremor was clearly visible. In addition, the animal was generally unable to compensate for the predictable perturbations and the anticipatory grip force increases were absent. However, overall the results suggest that reversible cerebellar nuclear inactivation with muscimol has little effect on isolated distal movements of the wrist and fingers.     

ATP-sensitive K+ and Ca2+-activated K+ channels in lamprey ( Petromyzon marinus) red blood cell membrane

The patch-clamp technique was used to demonstrate the presence of ATP-sensitive K(+) channels and Ca(2+)-activated K(+) channels in lamprey ( Petromyzon marinus) red blood cell membrane. Whole-cell experiments indicated that the membrane current under isosmotic (285 mosmol l(-1)) conditions is carried by K(+). In the inside-out configuration an ATP-sensitive K(+) channel (70-80 pS inward, 35-40 pS outward) was present in 35% of patches. Application of ATP to the intracellular side reduced unitary current with half-maximal inhibition in the range 10-100 microM. A block was obtained with 100 microM lidocaine and inhibition was obtained with 0.5 mM barium acetate. A Ca(2+)-activated K(+) channel (25-30 pS inward, 10-15 pS outward) was present in 57% of patches. Inhibition was produced by 10 mM TEA and 500 nM apamin and sensitivity to Ba(2+) was lower than for ATP-sensitive channels. No spontaneous channel activity was recorded in the cell-attached configuration under isotonic conditions. With hypotonic saline 68% of patches showed spontaneous single-channel activity, and, of 75 active patches, 66 cell-attached patches showed channel activity corresponding to Ca(2+)-activated K(+) channels.     

Angiotensin-(1–7) stimulates water transport in rat inner medullary collecting duct: evidence for involvement of vasopressin V2 receptors

The peptide angiotensin-(1–7) [Ang-(1–7)] is known to enhance water transport in rat inner medullary collecting duct (IMCD). The aim of this study was to determine the mechanism of the Ang-(1–7) effect on osmotic water permeability (P _f). P _f was measured in the normal rat IMCD perfused in vitro in presence of agonists [Ang-(1–7), arginine vasopressin (AVP) and Ang-(3–8)], and antagonists of the angiotensin and the vasopressin cascade. Ang-(1–7), but not Ang-(3–8), increased P _f significantly. The effect of Ang-(1–7) on P _f was abolished by its selective antagonist, A-779, added before or after Ang-(1–7). Prostaglandin E₂ and the protein kinase A inhibitor H8 also blocked the Ang-(1–7) effect. Blockade of vasopressin V₁ receptors by antagonists did not change the Ang-(1–7) effect, but pre-treatment with a V₂ antagonist abolished the effect of Ang-(1–7) on P _f. Similarly, pre-treatment with A-779 inhibited AVPs effect on P _f. Forskolin-stimulated P _f was blocked both by A-779 and by the V₂ antagonist. Finally, Ang-(1–7) increased cAMP levels in fresh IMCD cell suspensions whilst the forskolin-stimulated cAMP synthesis was decreased by A-779 and the V₂ antagonist. These data provide evidence that Ang-(1–7) interacts via its receptor with the AVP V₂ system through a mechanism involving adenylate-cyclase activation.     

Chondromyxoid fibroma resembles in vitro chondrogenesis, but differs in expression of signalling molecules

Chondromyxoid fibroma is a rare benign cartilaginous bone tumour characterized by morphological features that resemble different steps of chondrogenesis in terms of both cellular morphology, ranging from spindled to rounded cells, and the extracellular matrix formed, which ranges from fibrous to cartilaginous. The presence in chondromyxoid fibroma of signalling molecules that regulate the spatial expression of proteins involved in normal cartilage proliferation and differentiation was investigated in samples from 20 patients and compared with articular chondrocytes from 11 normal donors cultivated in 3D pellet culture. Sections were stained with safranin-O and H&E, and immunohistochemistry was performed for p16, cyclin D1, FGFR3, BCL2, p21, PTHLH, PTHR1 and N-cadherin. Expression patterns were analysed using hierarchical clustering. In chondromyxoid fibroma, specific morphological features correlated with a distinct pattern of expression. Comparison with normal chondrocytes in pellet culture showed a striking morphological resemblance, but with an unmistakably different pattern of expression. N-cadherin, PTHLH, and PTHR1 were expressed to a significantly higher level (p < 0.01) in articular chondrocyte pellets but, conversely, there was significantly lower expression of cyclin D1, p16 and BCL2 (p < 0.05) in these cells. Morphological similarities reflect common steps in cartilage differentiation, albeit driven by different molecular mechanisms. The proteins we have found to be differentially expressed seem crucial for neoplastic chondrogenesis.