外膜

Objective To investigate the clinical features, causes of blindness and diagnosis of Vogt Koyanagi Harada syndrome Methods The data of 157 patients with VKH syndrome were reviewed and analyzed Patients were carefully examined with slit lamp, ophthalmoscope, three mirror lens, fundus fluorescein angiography, indocyanine green angiography and HLA typing Results Headache was noted in 73 5% of these patients Simultaneous involvement of both eyes occurred in 80 8% of these patients Chroiditis,papilledema and edema of the retina adjacent to the optic nerve were noted in 100% of these patients in the posterior uveitis stage, whereas recurrent granulomatous anterior uveitis (98 4%),"sunset glow" fundus (95 8%) and Dalen Fuchs nodules (71 2%) were the common ocular findings in the recurrent anterior uveitis stage The common causes of blindness were papillitis, exudative retinal detachment and complicated cataract in the posterior uveitis stage, anterior uveal involvement stage and its recurrent stage Poliosis (36 3%) and alopecia (35 0%) were the most common extraocular findings Early irregular patches of fluorescence, followed by localized hyperfluorescent spots were the typical findings of FFA Dilation of choroidal vessels and leakage of ICG from the choroidal vessels were the common ICGA findings The prevalence of HLA DR4 and HLA DRw53 in patients (54 9% and 71 8% respectively) was significantly higher than that in controls (14 7% and 38 2% respectively) Conclusions VKH syndrome is characterized by chroiditis, papillitis or neuroretinitis in the posterior uveitis stage, followed by a generalized uveitis with a typical recurrent granulomatous anterior uveitis Extraocular findings and relevant examinations including FFA, ICGA and HLA typing are helpful to the diagnosis of VKH syndrome

目的探讨Vogt-Koyanagi-Harada综合征患者的临床特征、盲目原因及诊断等有关问题。方法对在1996年1月至2000年12月间就诊资料完整的157例VKH综合征患者进行回顾性分析，并对裂隙灯、眼底镜、三面镜、荧光素眼底血管造影(fundus fluorescein angiography，FFA)、吲哚青绿血管造影(indocyanine green angiography，ICGA)及人类白细胞抗原分型等检查结果进行分析。结果 VKH综合征最常见的前驱症状为头痛(102例，73.5%)，双眼同时患病118例(80.8%)；后葡萄膜炎期眼部主要表现为脉络膜炎、视乳头及附近视网膜水肿(100.0%)；前葡萄膜炎反复发作期眼部表现为复发性肉芽肿性前葡萄膜炎(128例，98.4%)、晚霞状眼底改变(95.8%)及Dalen-Fuchs结节(71.2%)；后葡萄膜炎期、前葡萄膜受累期及前葡萄膜炎反复发作期导致盲目的主要原因分别为视乳头炎、视网膜脱离及并发性白内障；毛发变白(36.3%)及脱发(35.0%)是最常见的眼外表现；炎症活动期FFA典型表现为斑驳状高荧光，ICGA发现脉络膜血管扩张、通透性增高等改变；VKH综合征患者HLA-DR4及HLA-DRw53的阳性率(54.9%及71.8%)显著高于正常对照组(14.7%及38.2%)。结论 VKH综合征患者在后葡萄膜炎期眼部典型表现为双侧脉络膜炎、视乳头炎或神经视网膜炎，随后出现以反复发作的肉芽肿性前葡萄膜炎为特征的全葡萄膜炎。眼外症状及相关的辅助检查包括FFA、ICGA 及HLA分型等有助于VKH综合征的诊断。

The notable proliferation was not observed by eyes in the local of injection. The infiltration of inflammation cells and mild proliferation of fibrocyte around dura mater was observed by HE stained in 4 and 8 weeks after injection. Infiltration and exudation of inflammation cells was observed by HE stained in epidural nerve root. Compared with group A, no changes of group B, C and D were observed under specific stained. Proliferation of type Ⅱ collagen fibers around dura mater was seen under immunohistochemical stained in 4 and 8 weeks after injection. There is no significant demyelination changes under LFB stained. The thickness and shape of the myelin sheath in epidural nerve root was not regular under transmission electronic microscopy in 4 and 8 weeks after injection. Fibroblast was also seen there. In nerve endometrium, macrophage could be seen under TEM, myelinated nerve fiber changed significantly, but nonmyelinated nerve fiber changed mildly. When 8 weeks, the changes of group D is smaller than the group B and C.

给药局部肉眼观察未见明显的纤维组织增生；HE染色可见B、C、D三组给药后四周及八周时硬膜内外均有炎细胞浸润，纤维细胞轻度增生，硬膜外神经根内有炎细胞浸润及炎性渗出；特殊染色B、C、D三组同A组相比未见有脊髓及神经根的改变；免疫组化染色，给药后四周及八周时，硬膜内外均有Ⅱ型胶原纤维增生；固兰染色B、C、D三组未见有明显脱髓鞘改变，与A组相比无明显异常改变；电镜观察B、C、D三组在给药后的四周及八周时，表现为硬膜外神经根内髓鞘厚薄不一，形状不规则，可见成纤维细胞，神经内膜中可见有巨噬细胞；粗大的有髓神经纤维变化明显，无髓神经纤维受累较轻；八周时电镜下D组改变较B、C两组为轻。

Methods We adopted four methods that single cpidural block anesthesia or narcotics analgesies were injected into subarachnoid space and epidural space or single narcotics was injected into subarachnoid space (group C fentanly 25μg;group D fentanly 20μg) to study analgesia birth for 130 nullipara women. The analgesia efficacy, side effect, birth time md mode,postpartum haemorrhage and the condition of the fetus and the newborn were compared.

采用单纯硬膜外腔阻滞、蛛网膜下腔-硬膜外腔联合给予低浓度麻醉药及镇痛药、单纯蛛网膜下腔给予低浓度镇痛药(C组芬太尼25μg，D组芬太尼20μg)等四种不同的方法对130例初产妇进行分娩镇痛，比较几组的镇痛效果、不良反应及对产程、分娩方式、产后出血、胎儿及新生儿等的影响，并与40例正常未干预组产妇比较。

Protease treatment of the plasma membranes could abolish the binding but NaIO_4 and glycosidase could not, indicating that nsLTP144 bound to plasma membranes protein without carbohydrate moiety. Using the homobifunctional cross-linking regent bissuberate (BS~3) and rice plasma membranes incubated with ~(125)I-Trx-nsLTP144, we identified, after SDS-polyacrylamide gel electrophoresis and autoradiography, a putative protein receptor on the rice plasma membranes with the molecular mass around 60 kDa. NsLTP144 can not trigger extracelluar alkalization in arabidopsis, but can abolish the extracellular alkalization effect of phytopathogen elicitor cryptogein, suggesting that cryptogein and nsLTP144 may bind to the same membrane protein. In vitro pull-down assay showed that nsLTP144 interacted with OsCaM1, a possible extracellular calmodulin, implying that nsLTP144 and OsCaM1 could function in the same signal transduction pathway. These results shed light on revealing the roles of nsLTP in vivo and make it promising to finally characterize the plasma membranes receptor of nsLTP.

发现~(125)I-Trx-nsLTP144、~(125)I-Trx-nsLTP110与水稻细胞质膜均具有特异性结合，而且结合是饱和性的、可被竞争的，符合配体-受体结合的典型特征，同时用于对照实验的蛋白质~(125)I-Thioredoxin没有此特性，表明水稻细胞质膜上存在nsLTP的受体；利用可氧化糖基的NaIO_4和水解糖基的N\'-糖苷酶F处理水稻细胞质膜，再进行结合实验，结合活性几乎不受影响；而利用胰蛋白酶处理细胞膜则使得结合能力几乎完全丧失，表明其受体为没有经过糖基化修饰的蛋白质；利用交联剂BS~3交联配体一受体后，再进行SDS-PAGE分离和放射自显影，结果显示水稻细胞质膜上的nsLTP受体中有一个60kDa的蛋白质可以与nsLTP144发生特异性的结合，可能是其受体；细胞外碱化实验表明，nsLTP144不能促使拟南芥原生质体细胞培养液的细胞外碱化反应，却能猝灭来自植物病原菌的激发子Cryptogein刺激拟南芥原生质体产生的细胞外碱化反应，表明nsLTP和Cryptogein结合细胞膜上相同的位点，保护了植物细胞免受Cryptogein导致的细胞程序性死亡，并诱导系统获得性抗性的产生；体外Pull-down实验表明，nsLTP144和水稻的OsCaM1具有相互作用，暗示了nsLTP144和OsCaM1可能同在一个信号通路上起作用。

The constant nutritional arteries of the great saphenous vein-saphenous nerve on the medial foot: Perforator at medial side of the tendon of the tibialis anterior ,it is （2.27±0.43）cm distal to the intermalleolar line .it passes across the medial side of the tendon of the tibialis anterior and pierces the deep fascia between the upper and lower bundle of the inferior extensor retinaculum with a diameter of （0.72±0.04）mm;The length of it after piercing the deep fascia is （7.3±0.6）mm,It has an emerging rate of 95%; Perforator between tendons ,it is （3.02±0.39）cm distal to the intermalleolar line;it pierces the deep fascia between the tendons of tibialis anterior and extensor digitorum longus with a diameter of (0.57±0.06)mm ;The length of it after piercing the deep fascia is （7.4±0.6）mm .It has an emerging rate of 94%; A constant distal fascial perforator pierces the deep fascia between abductor hallucis muscle and medial side of first metatarsal bone （1.97±0.23）mm distal to the first metatarsophalangeal joint with a diameter of (0.50±0.03)mm.

足内侧大隐静脉-隐神经营养血管近端来自内踝前动脉较为恒定，外径较大的穿支有：踝间线远端（2.27±0.43）cm，经胫骨前肌腱内侧、伸肌下支持带上、下束间穿出，外径(0.72±0.04)mm ，穿出深筋膜的长度为（7.3±0.6）mm，出现率为95%；踝间线远端（3.02±0.39）cm，经胫骨前肌腱与趾伸肌腱穿出，外径(0.57±0.06)mm，穿出深筋膜的长度为（7.4±1.2）mm ，出现率为94%；3远端来自交通支最为恒定，外径较大的穿支于踇展肌与第一跖骨内侧缘之间穿出深筋膜，距第一跖趾并节近端（1.97±0.23）cm，直径（0.50±0.03）mm，穿出深筋膜的长度为（6.5±0.5）mm，出现率为100%。

The items of respiration and circulation recorded before and 10, 20, 30, 40min after pneumoperitoneum as well as 5 min after deflation abdomen were as follows: blood pressure, heart rate, sphygmus oxygen saturation (SpO_2),...

结果术毕清醒时间硬膜外组明显短于全麻组(P·05)，气腹后20min、30min潮气量硬膜外组明显小于全麻组(P·05)，各时点呼吸频率、分钟通气量、气道压硬膜外组分别明显快于、大于、低于全麻组(P·05)，其余各项指标两组无显著差异。结论在妇科腹腔镜手术中，两种麻醉方式对呼吸、循环的影响无显著差异。

Results The anesthesia range was narrowed and anesthesia duration was shortened with the prolongation of epidural catheter placement,Epidural roentgenography showed that the medium diffused normally within epidural space,biopsy of epidural tissues showed that there were inflammative cells infiltration and fiber proliferation with longer epidural catheter placement（more than 4 weeks）,without significant differences between both groups.Conclusion Epidural corticosteroids can not prevent epidural adhesion from occurrance induced with long-term epidural catheter placement.

结果 随着硬膜外腔置管时间延长，麻醉阻滞范围变窄，麻醉阻滞时间也明显缩短，两组之间没有明显区别；硬膜外腔造影显示：造影剂在硬膜外腔扩散良好，无明显受阻；组织学检查显示：置管时间长(4周以上)的动物，硬膜外组织炎细胞浸润、纤维组织增生、硬膜增厚，而且随置管时间延长，这&种变化更&加显著，但两组之间没有明显区别。

Results 5 cases of ependymocytoma, 3 cases of astrocytoma, 1 medulloblastoma hemangioblastoma in 10 cases of intra-medullary tumor; 36 cases of neurogenic tumor, 11 cases of spinal meningioma in 47 cases of subdural extramedullary tumor; 2 cases of neurogenic tumor strided over scleromeninx;2 cases of extradural metastatic tumor, 1 cestodiasis, 2 cases of epidural hematoma, which were mistaken for hemangioma before surgical operation and 1 vascular malformation in 4 cases of intraspinal nontumorous occupying lesion.

结果：10例髓内肿瘤中，室管膜瘤5例；星形细胞瘤3例；血管母细胞瘤1例；成神经管细胞瘤1例。47例脊髓外硬膜下肿瘤中，神经源性肿瘤36例；脊膜瘤11例。2例跨硬膜内外生长的神经源性肿瘤2例。硬膜外的转移瘤2例。4例椎管内非肿瘤性占位性病变中，椎管内绦虫病1例；硬膜外血肿2例，术前误为血管瘤；血管畸形1例。

Two point spinal punctured,epidural was applied at the T 10 12 interspace,subarachnoid anesthesia was performed at L 2-3 interspace in the lateral position,using a 7gauge spinal needle,to receiving spinally isobaric solution 2-2.2ml of 0.75% bupiva...

采用两点穿刺，先于T10 -12间隙硬膜外穿刺并头端置入硬膜外导管，后用 7号腰穿针于L2 -3 间隙穿刺，有脑脊液流出后，以 0 。1ml/s的速度蛛网膜下腔注入 0 。75 %布比卡因 2 - 2 。2ml，进腹后酌情硬膜外腔追加 2 %利多卡因或 2 %利多卡因- 0 。75 %布比卡因混合液，平均用药量(11.70± 2 。6 3)ml。

The higher surface energy of substrate results in higher effective viscosity and thicker ordered molecular film.

从侧面证明了有序液体模型的正确性，即薄膜润滑的成膜性能与近固体表面润滑剂分子的有序度密切相关；足够大的外电压使无序流体膜有序化，生成较高的有效粘度和较厚的油膜，并且二者随着外电压的增加，逐渐趋于稳定；外电场作用下，摩擦系数增大，切断电源后，摩擦系数减小，但不能恢复到未加电压前的摩擦系数值。

This one mode pays close attention to network credence foundation of the businessman very much.

这一模式非常关注商人的网络信用基础。

Cell morphology of bacterial ghost of Pasteurella multocida was observed by scanning electron microscopy and inactivation ratio was estimated by CFU analysi.

扫描电镜观察多杀性巴氏杆菌细菌幽灵和菌落形成单位评价遗传灭活率。