Transplantation of an eight-organ multivisceraI graft in a patient with frozen abdomen after complicated Crohn's disease

To report an extended multivisceral transplantation (MVTx) including right kidney and ascending colon in a patient with complicated Crohn's disease (CD). A 36-year old female suffering from short bowel syndrome and frozen abdomen due to fistulizing CD after multiple abdominal operations underwent MVTx of eight organs including stomach, pancreatoduodenal complex, liver, intestine, ascending colon, right kidney, right adrenal gland, and greater omentum in November 2003. Immunosuppression consisted of alemtuzumab, tacrolimus and steroids. The patient was off parenteral nutrition by postoperative wk 3. She experienced one episode of pneumonia. The patient recovered completely and discharged 2.5 mo and was doing well 30 mo after MVTx. This is one of the very rare cases in which a complete mulitivisceral graft of eight abdominal organs was transplanted orthotopically.     

Microinjection of an Adenosine A1 Agonist into the Medial Pontine Reticular Formation Increases Tail Flick Latency to Thermal Stimulation

Background: Both pain and the pharmacologic management of pain can cause the undesirable effect of sleep disruption. One goal of basic and clinical neuroscience is to facilitate rational drug development by identifying the brain regions and neurochemical modulators of sleep and pain. Adenosine is thought to be an endogenous sleep promoting substance and adenosinergic compounds can contribute to pain management. In the pontine brain stem adenosine promotes sleep but the effects of pontine adenosine on pain have not been studied. This study tested the hypothesis that an adenosine agonist would cause antinociception when microinjected into pontine reticular formation regions that regulate sleep.

Methods: The tail flick latency (TFL) test quantified the time in seconds for an animal to move its tail away from a thermal stimulus created by a beam of light. TFL measures were used to evaluate the antinociceptive effects of the adenosine A1 receptor agonist N6-p-sulfophenyladenosine (SPA). Pontine microinjection of SPA (0.1 [mu]g/0.25 [mu]l, 0.88 mm) was followed by TFL measures as a function of time after drug delivery and across the sleep-wake cycle.

Results: Compared with saline (control), pontine administration of the adenosine agonist significantly increased latency to tail withdrawal (P < 0.0001). The increase in antinociceptive behavior evoked by the adenosine agonist SPA was blocked by pretreatment with the adenosine A1 receptor antagonist 8-cyclopentyl-1, 3-dipropylxanthine (DPCPX, 0.75 ng/0.25 [mu]l, 10 [mu]m).     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

胸椎海绵状血管瘤一例

中枢神经系统海绵状血管瘤好发于颅内,椎管内海绵状血管瘤临床较为少见,笔者收治胸椎椎体海绵状血管瘤1例,报告如下.     

CLINICAL EXPERIENCE WITH LEVONORGESTREL AND ETHINYL ESTRADIOL IN BEIJING

A combination of levonorgestrel 0.15mg and ethinyl estradiol 0.03mg, an ultra-low dose oral con traceptive in pellet form, was tried out in 9 Beijing clinics. A total of l,035 healthy women of reproduc tive age participated in 9,413 cycles of treatment. Only one pregnancy was attributed to medication failure which resulted in a corrected Pearl index of 0.13/100 women-year. The incidence of breakthrough bleeding and amenorrhea was 0.12% and 0.05% res pectively. Using the life-table method, the net cumulative rate of termination due to medical-related reasons at one year was only 5.93/100 women. The incidence of side effects was low. The most frequent complaints were nausea and drowsiness, which re duced with the increase of treatment cycles. Some metabolic changes were studied. In comparison with other OCs used in China, this formula has the advantages of ultra-low-dose steroids with higher contraceptive efficacy, better cycle control and fewer side effects.     

EXPRESSION OF C-MYC AND N-RAS ONCOGENES IN HUMANHEPATOCELLULAR CARCINOMA AND PANCREATIC ADENOCARCINOMA A BIOCHEMICAL ANDIMMUNOCYTOCHEMICAL STUDY

WiLh RNA-DNA dot blot technique, the expression of c-myc and N-ras oncogenes in human hepato cellular carcinoma was found to be higher than in tie non-cancerous liver tissue adjacent to the carci noma (p<0.01). The expression of both oncogenes was high in the fetal liver and gradually decreased with age during development, indicating a probable co-operation of c-myc and N-ras. Immunocytochemi- cal analysis showed changes in protein products of c-myc hepatocellular carcinoma and its nan cancerous tissue were similar to those in mRNA expression. The same was true for the fetal liver during its development. A comparable study was also made on the ex pression of c-myc and N-ras oncogenes in limited samples of human pancreatic adenocarcinoma and its noncancerous tissue. The results are inconclu sive, and further studies are needed.     

SOME ANATOMICAL DATA RELATED TO THE TRANSNASO- SPHENOIDAL RESECTION OF PITUITARY FOSSA TUMORS

Since the beginning of this century, trans- naso-sphenoidal resection of the pituitary fossa tumors has been widely used clinically. It has more merits than other operative approaches used before. In China it has been adopted by both ENT doctors and neurosurgeons since 1959.1 In order to afford some relevant anatomical data, we measured 137 adult sagittal plane skulls with distinct landmarks.     

Establishment and application of experimental model of human fetal hepatocytes: protective effects of silybin and polyporus umbelalus polysaccharides on human fetal hepatocytes

Ｅｓｔａｂｌｉｓｈｍｅｎｔａｎｄａｐｐｌｉｃａｔｉｏｎｏｆｅｘｐｅｒｉｍｅｎｔａｌｍｏｄｅｌｏｆｈｕｍａｎｆｅｔａｌｈｅｐａｔｏｃｙｔｅｓ：ｐｒｏｔｅｃｔｉｖｅｅｆｆｅｃｔｓｏｆｓｉｌｙｂｉｎａｎｄｐｏｌｙｐｏｒｕｓｕｍｂｅｌａｌｕｓｐｏｌｙｓａｃ...     

A Study on Extension－Flexion Dynamic Lumbar Spine Radiographsin Patients with Lumbar Intervertebral Disc Herniation

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