等离子表面改质技术提高人工关节抗磨损效能的实验研究

目的利用等离子浸没注入技术（PIII）改质钛-铝-钒（Ti-6Al—4V）表面，探讨高温注入及后续退火处理的改性效果。方法将Ti-6Al—4V合金以氮气等离子注入，藉检测表面氮离子的分布、表面结构／粗糙度、材料晶体及摩擦系数等性质，以评估PIII表面改性的效果。结果提高注入温度，表面氮注入层浓度的峰值呈轻度下降；渗透深度则略为上升。硬度与注入层厚度呈良好相关性，但在高温下注入，表面溅射将造成材料的粗化，摩擦系数上升。600—800℃间高温下退火处理，同样可达到提高注入深度及促使TiN及Ti2N晶体生成、提升硬度的效果，同时升温退火处理也会造成粗糙度的微幅上升。结论本研究藉表面物化性及力学性质的量测，初步发现Ti-6Al—4V于室温下以等离子浸没注入技术注入，并于700℃下经30min退火处理，可得到高硬度、低摩擦系数、耐磨损的适用于人工关节应用表面的技术。     

正确认识微创人工全髋关节置换术和髋关节表面置换术

近年来，人工髋关节外科的发展迅速，模型设计、假体材料、生物力学、部件可调换性、手术器械、手术技术等方面都有了很大进步，手术效果和假体存活率令人鼓舞，其中主要的进步之一就是微创全髋关节置换术的开展。微创全髋关节置换包含软组织的微创和骨的微创，而后者就是指髋关节的表面置换。     

诊断性腹腔镜在壶腹部癌的意义评价

壶腹部癌术前使用腹腔镜结合腹腔镜超声检查，可发现一些影像学不能发现的微小转移灶，包括肝表面病灶以及腹腔内的肿大淋巴结和血管浸润等，从而综合判断肿瘤是否能够根治性切除。这项技术已经应用于临床。为了评价诊断性腹腔镜的价值和意义，作者对297例壶腹部癌病例进行了研究。     

多孔型种植体磷酸钙溶胶膜-骨界面的远期观察

目的进一步探讨磷酸钙（CaP）溶胶薄膜对多孔型钛合金（Ti-6Al-4V）种植体表面骨生长的远期影响。方法将表面涂有极薄CaP溶胶膜的多孔型钛合金种植体分别植入8只兔的胫骨。种植区愈合第2周、8周、12周、24周后，各取含种植体的骨组织标本，利用反向扫描电镜摄像技术进行形态观测研究。结果术后第2周SEM显示骨组织直接沿磷酸钙溶胶膜表面生长，而且磷酸钙溶胶膜在种植体表面附着良好；术后第8周与第12周，SEM高倍镜下所见相似，在种植体表面磷酸钙溶胶膜与新生骨组织之间形成富含大量钙和磷酸盐的黏合线样层；术后第24周，种植体表面大部分金属颗粒上的磷酸钙溶胶膜已消失，新生骨组织直接附着在钛合金种植体表面。结论远期观察多孔型种植体表面的磷酸钙溶胶膜，未见涂层界面分离现象。磷酸钙溶胶膜不仅有利于促进种植体早期骨结合，而且即使涂层被吸收后也不会影响种植体的稳固性。     

腹腔镜解剖性肝切除手术切面确定原则

精确确定手术切面是规范实施腹腔镜解剖性肝切除的技术难点。与开腹手术相比，腹腔镜肝切除由于缺乏开放手术的触感、操作空间限制等原因，在如何确定解剖性肝切除的手术切面方面，有其特殊性。本文就腹腔镜解剖性肝切除确定手术切面的常用的方法，进行小结。目前主要方法有：(1)循肝脏表面解剖标志；(2)循肝静脉路径；(3)预先控制目标肝段肝蒂，循缺血界面；(4)目标肝段门静脉穿刺染色。这些方法各有优缺点，适用于不同的肝段切除。临床实践应根据实际情况，综合应用。     

膀胱癌组织形态定量分析和病理学研究：附20例报告

对２０例膀胱移行上皮癌大切片ＨＥ染色，观察肿瘤表面、基部，浸润深部的组织形态特征，运用ＡｇＮＯＲ银染技术和图像分析技术进行了ＡｇＮＯＲ颗粒计数和核形态计量研究。结果表明：膀胱移行上皮癌表面组织与基部组织的分级和恶性程度无显著性差异。肿瘤浸润深部的组织分级与恶性程度比肿瘤表面组织的高。     

噬菌体表面呈现技术及其在肾脏病中的应用

噬菌体表面呈现（phage display）技术是将外源蛋白或多肽与噬菌体壳蛋白融合并呈现于噬菌体表面。这种外源蛋白或多肽可以识别相应的结合分子而被筛选鉴定出来。本文综述了噬菌体表面显现技术的建立，抗体文库、肽文库构建及在肾脏病研究领域的应用与前景。     

增生性瘢痕中TGF—β受体表达的研究

目的：了解TGF－β受体在增生性瘢痕中的表达，进一步认识TGF－β及其受体在增生性瘢痕形成过程中的作用。方法：应用免疫组化技术对正常皮肤用增生性瘢痕中I型和Ⅱ型TGF-β受体染色，并用图像分析系统进行半定量分析。结果：增生性瘢痕Fb中能检测到I型和Ⅱ型受体，而且随着病程的延长，受体表达逐渐减弱，直至消失；正常皮肤Fb未见受体表达阳性者。结论：①在增生性瘢痕形成过程中，不仅TGF－β增高，Fb表面I型和Ⅱ型TGF－β受体也增高，使TGF－β作用放大；②增生性瘢痕和瘢痕疙瘩中Fb出现表型变异，而且Fb表型随病程发生变化。     

缩略语的书写

肉芽肿性血管瘤是一种较常见的血管瘤，可发生于任何皮肤及粘膜表面，手部是这一肿瘤的好发部位。我院自1997年2月-2001年6月收治8例肉芽肿性血管瘤，以下就本病的诊断、治疗、及预后等问题作出分析。     

多层螺旋CT三维重建技术在上颈椎手术中的应用

螺旋CT，尤其是多层螺旋CT（MSCT）多平面重建（multi planar reconstruction，MPR）和三维表面遮盖法重建（surfaee shaded display，SSD）成像技术．在骨关节外伤的临床诊疗中已经得到越来越广泛的应用。其能直观、精确的显示病变的立体形态．详细了解各解剖结构的空间关系，被称为“非损伤性立体解剖”。现总结本院MSCT在上颈椎病变中应用．资料完整者共14例．就MSCT三维重建技术（3D）在上颈椎病变中的应用价值加以探讨。     

慢性前列腺炎诊治中值得关注的几点问题

慢性前列腺炎是泌尿外科最常见的疾病之一,患病率高．治愈率低,易于复发。世界各地报道患病率不同,患暂症状多变。目前,该病病因不明,发病机制不清．缺乏大家公认的诊断标准,治疗方案与疗效判断也存在争议。正确对待慢性前列腺炎．不仅是患者的事情．而且对泌尿外科医生也至关重要。     

微小RNA-140与骨关节炎关系的研究进展

骨关节炎是一种以关节软骨退变为主的退行性疾病,但其具体发病机制目前尚不清楚。微小RNA-140(miR-140)是一种在软骨细胞中特异性高表达的microRNA,为软骨细胞调控信号网络中重要的一员,参与了软骨细胞形成、增殖、分化、衰老及凋亡的调控作用。然而,由于miR-140作用的复杂性,其参与骨关节炎(OA)软骨退变的具体分子机制目前仍不明确。本文针对miR-140在软骨形成与稳态维持、软骨退变及OA早期诊断方面的作用进行综述。     

Surgical treatment of degenerative osteoarthritis of the fingers

Degenerative osteoarthritis of the long fingers is rare and surgical management is often necessary if there is joint pain, however this indication should not only be based on radiographic imaging. The specific anatomical problems of the metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints are described. The surgical approach for each joint is described as well as functional management, in particular that of the extensor apparatus. Mobility should always be preserved for the MCP, arthroplasties are recommended for the PIP except for the index, and arthrodesis for the DIP. The different and most frequently used implants are described as well as the indications and expected results. The indications are discussed in relation to the limited results in the literature as well as the preferences of a panel of French hand surgeons.     

韩式数码重睑术临床应用探讨

目的：探讨一种新式重睑手术方法及新器械的应用价值。方法：收集2008年5月～2009年5月进行过新式重睑手术的案例150例,分析其临床效果。结果：随访2～6个月,满意34例,较满意65例,一般38例,不满意13例,无一例发生严重并发症。结论：新手术方法风险低,满意度高,与埋线法重睑术一样创伤小、恢复快,但形成的重睑更牢靠、持久,适宜人群更广泛。     

Use of cyclosporin A in allotransplantation of rat limbs

An experimental model for limb transplantation as a composite tissue transfer has been developed using two genetically well defined strains of rats, BUF and LEW. The study shows that cyclosporin A (CyA) is very effective as an immunosuppressive agent in preventing rejection of transplanted limbs in rats. It is found to suppress rejection of the homotransplants as long as treatment is continuous. No untoward side effects have been noted at the current experimental dosage of the medication. CyA is superior to the conventional agents, such as azathioprine and prednisolone, which allow rejection of the limbs while treatment is in progress. There is a period of immune tolerance following CyA treatment; however, this period becomes shorter as the length of the treatment is increased. This may indicate that CyA treatment should be continuous and not pulsed at the dosage used in this experimental model. Additional experiments are underway to further elucidate this phenomenon.     

双侧股薄肌代括约肌原位肛门再造术的疗效分析

目的 研究双侧股薄肌代括约肌原位肛门再造术在低位直肠癌术后控制排便的治疗效果。方法 通过近10年来诊治低位直肠癌56例病人,采用双侧股薄肌代括约肌原位肛门再造术,并制定肛门排便功能的临床评定标准,以8分法进行评定,8～6分为优.6～4分为良.4～2分为差.2～0分为无效。术后随访客观分析其疗效。结果 根据评定标准56例病人中优32例,良17例,差5例,无效2例,我们把优及良病例定为有效,总有效率为87.5％。结论 双侧股薄肌代括约肌原位肛门再造术疗效可靠,是人工肛门手术方式中较理想、较科学的术式之一。     

The syndrome of inappropriate secretion of antidiuretic hormone

The physiology of the release of antidiuretic hormone (ADH) from the posterior pituitary is briefly reviewed. The importance of both osmolar and non-osmolar stimuli is emphasised. Osmolar and non-osmolar factors usually reinforce each other; for example, hydropenia leads to hyperosmolality and hypovolaemia, both promoting ADH release, while hydration has the opposite effect. In disease, osmolar and non-osmolar factors may become dissociated leading to baroreceptor-mediated ADH release in the presence of hyponatraemia and hypo-osmolality. Examples include heart failure, glucocorticoid or thyroxine deficiency, hepatic cirrhosis and nephrotic syndrome with or without the superimposed effect of diuretics, i. e. conditions in which circulatory, and in particular effective arterial, volume is reduced. It is dangerous to label such conditions as ‘inappropriate’ secretion of ADH since the maintenance of circulating volume is at least as important a physiological requirement as the defence of tonicity. The syndrome of inappropriate secretion of ADH (SIADH) is uncommon in childhood and should only be diagnosed when physiological release of ADH in response to non-osmolar as well as osmolar factors has been excluded. Criteria for the correct identification of SIADH are discussed; the presence of continuing urinary sodium excretion in the presence of hyponatraemia and hypo-osmolality is essential to the diagnosis. SIADH in children is usually due to intracranial disease or injury. The mainstay of treatment is water restriction which reverses all the physiological abnormalities of the condition. Hypertonic saline is rarely indicated for the short-term control of neurological manifestations such as seizures. Drugs have little or no place in the treatment of SIADH in children. In many situations labelled as SIADH it is only the diagnosis that is inappropriate.     

Reversal of neuromuscular blockade and complications of remaining blocking effect

We Japanese anesthesiologists can now use rocuronium as well as vecuronium. Although the onset of rocuronium is more rapid, the non-depolarizing neuromuscular blocking (NMB) agent has similar characteristics of duration and recovery compared to vecuronium. Reversal of NMB is therefore essential to recover patients safely. Conventional standard of reversal of NMB [train of four (TOF) >0.7] is not enough to have sufficient vital capacity and inspiratory force, resulting in pulmonary regurgitation or atelectasis. Even though the reversal of NMB cannot sufficiently be completed by anti-cholinesterase (ChE) agents such as neostigmine, it is needed to reverse the NMB because of their late spontaneous recovery. We also have to take care of patients with neuromusclar diseases such as Duchenne-type muscle dystrophy, when we use anti-ChE agents. Sugammadex is a novel and unique compound designed as an antagonist of rocuronium and possibly other steroid NMB agents. Sugammadex exerts its effect by forming very tight water-soluble complexes at a 1 : 1 ratio with steroid NMB agents (rocuronium>vecuronium>pancuronium). PhaseIII trials in Japan as well as Europe and the US have just been finished, and it is expected to be used clinically in the near future.     

The inhibitory effects of ATP,ADP, and AMP on the rate of dissolution of calcium hydroxyapatite

Summary ATP is as effective as inorganic pyrophosphate in retarding the rate of dissolution of calcium hydroxyapatite at pH 7, ADP is less effective, and AMP is without effect. The inhibition is due to the adsorption of ATP and ADP units on the crystal surface.     

On the structure of a class of time-optimal trajectories

Planar constant-speed interception of an evader moving along a known trajectory is considered as a time-optimal control problem. The condition which guarantees that the optimal trajectory of the pursuer consists of an initial turn at the maximum turning rate followed by a straight line segment is established. This condition is expressed as an inequality satisfied by the ratio of the minimum turning radius of the pursuer and the initial range, also called the geometrical singular perturbation parameter. The upper bound of this parameter is computed as a function of other non-dimensional parameters of the interception.