选择性输卵管造影与再通术在诊治阻塞性不孕中的价值(附200例报告)

目的 :评价选择性输卵管插管造影 (SSG)及再通术 (FTR)在输卵管阻塞性不孕中的诊治价值。材料和方法 :先经宫颈对常规子宫、输卵管造影 (HSG)显示输卵管阻塞的 2 0 0例不孕妇女的 380条输卵管进行插管 ,采用选择性插管至输卵管开口处推注 76 %泛影葡胺造影 ,对证实阻塞者行导丝再通术 ,术后随访 2～ 4个月。结果 :插管成功率 99% ,无严重并发症 ,复通率 90 % ,妊娠率 2 1% (4 2 / 2 0 0 )。结论 :SSG和FTR是目前诊治输卵管阻塞性不孕的最好方法     

Airway troubles related to the double-lumen endobronchial tube in thoracic surgery

Purpose Several case reports indicate critical respiratory complications in relation to the double-lumen endobronchial tube (DLT). A prospective survey for the airway problems in using the DLT is presented. Methods One hundred adult patients undergoing thoracotomy for lung cancer were investigated. Tube malposition and airway obstruction were searched using a fiber-optic scope. The endobronchial cuff was positioned just below the trachcal carina while the trachea was intubated with a DLT (Rüsch). The distances of displacement, from the tracheal carina to the bronchial cuff, were measured during anesthesia using an epidural catheter, which had marks every 5 mm. The distances for correcting the tube position were measured at both the bronchial cuff and the level of the teethPaO₂,PaCO₂ andSPO₂ were also measured. Results Malposition (displacement over 5 mm from the correct position) was found in 42 patients, and 40 of them were in a withdrawal direction, occurring at the postural change and during one-lung ventilation, especially during manipulation of the lung hilum. Correcting distances at the level of the teeth were 15.3–3-times longer than those at the bronchial cuff. Airway deformities and gradual withdrawal of the bronchial cuff were found in association with surgical manipulation. Obstruction occurred at the tips of the tracheal tube in four patients and the bronchial tube in six patients, and at the tip of both in two patients. Hypoxemia (PaO₂<60 mmHg) occurred in four patients and hypercapnea (PaCO₂>60 mm Hg) in two patients. Conclusion Most of the DLT obstructions were associated with withdrawal malposition. Great attention to DLT displacement and airway deformity is advised.     

氨甲喋呤配伍中药治疗未破裂型输卵管妊娠(附86例报告)

目的：探讨用氨甲喋呤（Methotraxate,MTX)配伍中药治疗条件适宜的输卵管妊娠的可行性及疗效。方法：对MTX配伍中治疗的输卵管妊娠86例临床资料进行分析。结果：82例治疗成功，成功率为95．35％，其中，治疗1个疗程69例，2个疗程13例，随访16例妊娠，1例2年后对侧输卵管妊娠，4例治疗失败者改手术治疗，病理见不同程度的滋养细胞溶解，绒毛坏死，出血，结论：使用MTX配伍中药治疗输卵管异位妊娠，方法简便易行，安全有效，副作用少，特别适合于基层医院。     

The role of COX-2 in angiogenesis and rheumatoid arthritis

Recent evidence suggests that cyclooxygenase (COX)-2 is a mediator of angiogenesis, and COX-2 activity is known to be upregulated in the rheumatoid arthritis (RA) synovium. We examined whether mediation of angiogenesis by COX-2 was occuring in cells of the RA synovium and in microvascular endothelial cells (ECs) that are similar to those found in the RA synovium. We demonstrate that rofecoxib, a selective COX-2 inhibitor, acts directly on human dermal microvascular ECs (HMVECs) to inhibit their chemotactic and tube forming ability. Likewise, pretreatment of HMVECs with rofecoxib significantly inhibited their ability to form tubes induced by conditioned media (CM) of activated RA synovial fibroblasts. When RA synovial fibroblasts were pretreated with rofecoxib for 16 h and then stimulated with interleukin (IL)-1beta, their CM induced significantly less HMVEC tube formation when compared with CM from vehicle-treated RA synovial fibroblasts. ELISAs performed on activated RA fibroblast CM for known proangiogenic factors demonstrated a significant reduction in bFGF, in addition to the expected decrease in PGE(2). Our studies suggest that COX-2-induced angiogenic activity is an active mechanism within diseased synovium and may provide an additional rationale for the use of COX-2 inhibitors in RA.     

Effects of ethanol on murine aggression assessed by biting of an inanimate target

The effects of acutely administered ethanol (0, 0.5, 1.0 and 2.0 g/kg, IP) were studied in a tube-restraint/target biting model of aggressive responding using naive group-and individually-housed male Swiss mice. Behavioural measures were the latency to the first bite and the biting frequency. In saline-injected control animals, the levels of responding were significantly higher in group-housed than isolated mice. Animals given alcohol exhibited a dose-dependent suppression of biting frequency, and an increase in biting latency. Mice experienced in the tube-testing situation showed reduced baseline levels of biting, but alcohol produced similar effects to those in naive mice. There was no evidence of a biphasic action of alcohol.     

A Model for Transport and Dispersion in the Circulatory System Based on the Vascular Fractal Tree

Materials are distributed throughout the body of mammals by fractal networks of branching tubes. Based on the scaling laws of the fractal structure, the vascular tree is reduced to an equivalent one-dimensional, tube model. A dispersion–convection partial differential equation with constant coefficients describes the heterogeneous concentration profile of an intravascular tracer in the vascular tree. A simple model for the mammalian circulatory system is built in entirely physiological terms consisting of a ring shaped, one-dimensional tube which corresponds to the arterial, venular, and pulmonary trees, successively. The model incorporates the blood flow heterogeneity of the mammalian circulatory system. Model predictions are fitted to published concentration-time data of indocyanine green injected in humans and dogs. Close agreement was found with parameter values within the expected physiological range. © 2003 Biomedical Engineering Society. PAC2003: 8710+e, 8719Hh, 8719Uv     

Study of platelet-rich fibrin promoting endothelial cell differentiation and angiogenesis induced by transplantation of adipose-derived stem cells

Diabetic patients are characterized by long wound healing time, and adipose stem cells (ADSCs) can secrete growth factors to promote angiogenesis and improve diabetic wound healing. In this research, we attempted to interrogate the impact of platelet-rich fibrin (PRF) on ADSCs in diabetic wound healing. ADSCs were harvested from human adipose tissues and identified through flow cytometry. After pretreatment with cultured medium supplemented with different concentrations of PRF (2.5%, 5%, and 7.5%), proliferation and differentiation capacity of ADSCs were assessed by CCK-8 assay, qRT-PCR and immunofluorescence (IF), respectively. Tube formation assay measured angiogenesis. Western blot analysis analyzed expression of endothelial markers and the extracellular signal-regulated kinase (ERK) and serine/threonine kinase (Akt) pathways in PRF-induced ADSCs. The CCK-8 experiment indicated that PRF enhanced proliferation of ADSCs in dose-dependent manner, relative to normal control group. The expression of endothelial markers and the capacity of tube formation were significantly promoted by 7.5% PRF. The release of growth factors containing vascular endothelial grow factor (VEGF) and insulin-like growth factor-1 (IGF-1) from PRF was increased with the extension of detection time. When the receptors of VEGF or/and IGF-1 were neutralized, ADSCs differentiation into endothelial cells were obviously inhibited. Additionally, PRF stimulated ERK and Akt pathways, and the inhibitors of ERK and Akt attenuated PRF-induced differentiation of ADSCs into endothelial cells. In conclusion, PRF promoted endothelial cell differentiation and angiogenesis induced by ADSCs in diabetic wound healing, which appears to give guidance for treating patients.     

三种诊断输卵管末端黏连梗阻方法对比

目的探讨子宫输卵管造影、B型超声（B超）诊断输卵管末端黏连梗阻的准确性。方法回顾分析2002年4月至2005年12月在本院因输卵管造影提示输卵管末端黏连梗阻而行腹腔镜检查治疗的63例病人的临床资料，采用与腹腔镜检查相对照的方法，比较子宫输卵管造影、B超诊断输卵管末端黏连梗阻的准确性。结果子宫输卵管造影诊断输卵管末端黏连梗阻与腹腔镜诊断符合阳性符合率80．2％（89／111），假阳性率19．8％（22／111）。子宫输卵管造影诊断输卵管通畅与腹腔镜诊断阴性符合率86．7％（13／15），假阴性率13．3％（2／15）。B型超声诊断输卵管梗阻积水与腹腔镜诊断阳性符合率95．0％（38／40），假阳性率5．0％（2／40）。B型超声未发现输卵管异常与腹腔镜诊断阴性符合率48.8％（42／86），假阴性率51．2％（44／86）。结论子宫输卵管造影可作为诊断输卵管黏连梗阻的一线方法，B型超声诊断输卵管积水的准确率较高，腹腔镜检查可明确诊断，决定不孕症的治疗方案。