原发性肾病综合征并发急性肾功能衰竭临床转归与病理关系

目的:探讨原发性肾病综合征(PNS)并发急性肾功能衰竭(ARF)的临床转归与肾脏病理改变之间的关系.方法:将30例PNS并发ARF按肾小球病变轻重,分为病变轻微组20例和病变较重组10例,用回顾性分析的方法对两组患者的临床特点和病理特征进行总结,分析临床转归与病理改变之间的关系.结果:病变轻微组和病变较重组ARF的临床治愈率分别为85%和60%,两者比较差异无显著性意义(P＞0.05);病变轻微组肾病综合征(NS)完全缓解率为40.0%,与病变较重组比较差异有显著性意义(P＜0.05).结论:ARF的临床转归与肾小管、间质病变的程度密切相关,而NS的临床转归则与肾小球的损害程度密切相关.     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

野生和人工饲养洞庭湖种群东方田鼠血液及血清生化指标的测定

目的 比较野生和人工饲养洞庭湖种群东方田鼠血液及血清生化指标的差异.方法 采用SYSMEX iPOCH血常规测定仪和HITACHI 7020全自动生化分析仪对野生和人工饲养洞庭湖种群东方田鼠部分血液及血清生化指标进行测定和分析.结果 两类东方田鼠部分血液指标和血清中与脂肪代谢相关的部分生化指标有显著差异,部分指标无明显差异,并无明显的变化规律.结论 东方田鼠可作为潜在的脂肪肝动物模型.     

膀胱压、胃内压与腹内压的相关性研究

目的 探讨利用膀胱压、胃内压来间接监测腹内压的可行性．以便于腹腔间隔室综合征(ACS)的诊断。方法 对24例行腹腔镜胆囊摘除术(LC)患者进行前瞻性对照研究。在行LC时，在腹内压为10、15、20及25mmHg时同时测定膀胱压和胃内压。结果 腹内压与膀胱压的回归方程为Y=-10.193 1.228X．相关系数为0.941；腹内压与胃内压的回归方程为Y=-7.408 1.478X，相关系数为0.996。由此表明．腹内压与膀胱压和胃内压呈显著正相关。结论 腹内压与胃内压和膀胱压有很好的相关性，可以利用胃内压和膀胱压来反映实际腹内压。     

巴斯德处理后坐骨神经再生的组织学研究

目的　观察大鼠坐骨神经经巴斯德温热处理后 ,在组织形态学方面的变化。　方法大鼠 12mm长左侧坐骨神经 ,进行 6 0℃、30min的巴斯德处理。分为处理后 1周群、6周群 ,各群分别为 15只。计算各群对照部 (处理部起的中枢 )、处理部以及末梢部 (处理部起的末梢 )中有髓轴突数、有髓轴突直径和有髓轴突面积比率 ,并用电生理和透射电镜进行组织形态学检查。　结果　(1)有髓轴突数 :1周群中 ,末梢部较对照部显著减少 (P <0 .0 1) ;末梢部中 ,6周群比 1周群显著增加 (P <0 .0 1)。 (2 )有髓轴突直径 :1周群中 ,末梢部较对照部显著减小 (P <0 .0 1) ;末梢部中 ,6周群比 1周群显著增大 (P <0 .0 1)。 (3)有髓轴突面积比率 :1周群中 ,末梢部较对照部显著减小 (P<0 .0 1) ;末梢部中 ,6周群比 1周群显著增大 (P <0 .0 1)。 (4 )肌电图 :处理后 1周与正常相比 ,神经传导速度明显延长 ,延长幅度为 13.2 % ;动作电位幅度明显降低 2 .95倍 (3.7mV)。处理后 6周与正常相比 ,神经传导速度仍然有明显延长 ,延长幅度为 8.3% ;6周后动作电位幅度已经恢复正常。 (5 )透射电镜 :1周群处理部中 ,髓鞘明显分层、增厚而凝固坏死 ,轴浆显著减少 ,雪旺细胞基底膜、神经外膜发生变性。 6周群末梢部中 ,显示多数再生有髓轴突。　结论     

内固定应用于脊柱结核治疗的安全性探讨

Objective To investigate the efficiency and safety of instrumentation to treat spinal tu-berculosis. Methods Fifty-one patients of spinal tuberculosis were treated with one-stage or two-stage de-hridement, strut autografting, and anterior or posterior instrumentation with screw rod system, combined with one-year triple agents postoperative antituberculous chemotherapy from April 1985 to May 2005. There were 6 in cervical spine, 19 in thoracic spine, 16 in thoracolumbar spine and 10 in lumbosacral spine. The level of the lesion were 6 cases for single vertebrae, 30 for two vertebrae, 11 for three vertebrae and 4 for more than four vertebrae. All patients were given triple agents antituberculous chemotherapy at least two weeks before operation. The operative procedures included cervical anterior approaches in 6 cases for debridement, fusion and plate-screw fixation, upper lateral transthoracic procedures for debridement, fusion and screw rod fixation in 11, posterior debridement, fusion and transpedicular screw system fixation in 6, two-stage anterior and posterior operation in 18 cases. The instrumentation included 6 Luque, 3 Z-plate, 8 TSRH, 5 Ventrofix, 4 Kenada, 5 Moss-Miami, 6 Isola, 3 CDH, 2 Caspaz, 2 C-D, 1 Zielke, 1 Dick, 1 Oriell, 1 Ozion, 1 Zephir, 1 Tenor, and 1 USS. Results All patients were followed up prospectively for 3.2 to 23.5 years postoperatively. The back pain was obviously relieved postoperatively. Patients with neurological function deficiency im-proved. The solid fusion was achieved in all patients, except one patient due to tuberculosis recurrence. The major complication included one sinus formation and one case with temporary deterioration of neurological function, recovered with appropriate treatment. Average preoperative kyphosis angle was 34.17°, and that was 10.45° immediately after surgery. There was a 3.2° loss of kyphosis correction during follow-up period. Con-clusion Spinal tuberculosis treated with instrumentation is effective and safe.     

普鲁卡因在全凭静脉麻醉中的作用

为探讨普鲁卡因在全凭静脉麻醉中的作用。我们对３０例行静脉全麻电视腹腔镜胆囊摘除术（ＬＣ术）病员随机分为两组：１％普鲁卡因组（Ｐ组）和１０％ＧＳ复合液组（Ｇ组）。比较两组病员麻醉药用量，停药后恢复时间及辅助药使用情况，结果提示Ｐ组用药量明显少于Ｇ组（Ｐ＜００５）恢复时间明显延长（Ｐ＜００５）辅助用药明显少于Ｇ组。表明１％普鲁卡因在全凭静脉麻醉中具有增强麻醉效果，减少麻醉药用量的作用。     

B超诊断胎儿畸形与异常62例

B超在孕妇的产前检查中,可早期发现胎儿畸形与异常,促进优生优育工作.本所应用B超对妊娠妇女进行产前检查,筛查胎儿畸形与异常,现总结如下.     

衰老心肌自噬减退的新机制-转录因子EB的关键作用

目的 探讨转录因子EB（TFEB）在衰老心肌自噬减退中的作用。方法 采用老年（22月龄）雄性C57BL/6小鼠为实验对象,以成年（4月龄）雄性C57BL/6小鼠为对照,分析心肌自噬水平、心肌TFEB表达水平。结果 与成年心肌相比,衰老心肌自噬水平显著降低（P<0.05）。衰老心肌中自噬体标志物Atg5、LC3和Beclin-1,溶酶体标志物LAMP1在蛋白和mRNA水平上均出现降低。与成年心肌相比,衰老心肌TFEB蛋白水平显著降低（P<0.05）,衰老心肌细胞核内的TFEB水平下降更为显著（P<0.05）,提示衰老心肌TFEB转录能力减退。给予小剂量雷帕霉素处理,可提高衰老心肌细胞核内TFEB水平,并且改善LC3及LAMP1的mRNA和蛋白水平,提高衰老心肌自噬水平。结论 本研究发现衰老导致的心肌TFEB水平降低严重影响心肌自噬能力,提示TFEB是心肌自噬增龄性减退机制中的关键调节因子。