腹腔镜下输卵管开窗取胚术联合局部注射MTX预防持续性异位妊娠的临床探讨

目的探讨输卵管妊娠行腹腔镜保守手术中使用甲氨喋呤(MTX)预防持续性异位妊娠的临床价值。方法对68例确诊为输卵管壶腹部妊娠的患者行腹腔镜开窗取胚术,将患者随机分为2组实验组(n=34)术中局部应用MTX20mg,对照组(n=34)局部注射等容量的生理盐水。于术前和术后d1、d4、d7、d10、d14查β-HCG及观察临床表现。结果2组术前一般情况和血β-HCG水平差异无显著性,但术后d1差异有显著性(P<0.05),术后d4、d7(P<0.01)和d10、d14(P<0.00)差异有极显著性。实验组无术后持续性异位妊娠(PEP),对照组出现6例术后PEP,二者差异有显著性(P<0.05)。结论在异位妊娠腹腔镜开窗取胚术中局部应用MTX可预防术后PEP的发生。     

EVALUATION OF THE URETER AND URETEROVESICULAR JUNCTION USING HELICAL COMPUTED TOMOGRAPHIC EXCRETORY UROGRAPHY IN HEALTHY DOGS

Abdominal computed tomography (CT) using a protocol designed for evaluation of the ureters was performed on six normal purpose-bred research dogs. After noncontrast CT, a postcontrast scan was performed 3 min post midpoint of injection of 400 mgI/kg body weight of diatrizoate meglumine/sodium. Ureteral and ureterovesicular junction anatomy were readily assessed with minimal patient preparation. The ureters were similar in size to reported values and the renal pelvis, ureter, and ureterovesicular junction were easily identified on both noncontrast and contrast-enhanced scans. There was a significant relationship between bladder volume and interureterovesicular junction distance but not between bladder volume and ureterovesicular junction to internal urethral orifice distance. A reliable bony landmark for the identification of the internal urethral orifice could not be determined. The results of this preliminary study of normal anatomy should facilitate the clinical use of CT in the evaluation of ureteral disease (e.g., ureteral ectopia).     

异位发酵床垫料的直剪切及压缩试验研究

为研究不同含水率的条件下异位发酵床垫料:抗剪强度、黏聚力、内摩擦系数、压缩载荷的变化规律.本研究采用土壤力学试验方法,测定垫料五种不同含水率的相关参数.结果表明:当垫料含水率为29.22％～36.13％时,抗剪强度、内摩擦角系数会随着含水率的增大而增大;当含水率为45.55％～61.11％时,抗剪强度、内摩擦角系数会随...     

Urinary Bladder Herniation through a Vaginal Tear in a Rottweiller with Dystocia

A four-year old female Rottweiler presented with a 34-hour history of dystocia. Physical examination revealed a purple-black, fluid-filled sac protruding from vulva and suspended by a similar colored stalk. Digital vaginal examination indicated that the stalk of tissue extended up into the cervix and beyond. Due to the grossly necrotic appearance, the stalk of tissue was ligated, and the sac was removed. Three puppies were delivered vaginally, but a subsequent caesarian section was required due to uterine inertia likely secondary to exhaustion. Three more live puppies were delivered via the c-section. Further abdominal exploration revealed a tear in the left vaginal wall, one ligated ureter, and the second ureter free at its distal end and leaking urine into the abdomen. The surgical findings indicated that the bladder, ureters, and urethra had herniated through the vaginal tear and prolapsed through the vulva.     

ULTRASONOGRAPHIC FINDINGS IN 14 DOGS WITH ECTOPIC URETER

To evaluate ultrasonography as an alternative to contrast radiography for diagnosis of ectopic ureter in dogs, ultrasonography of the urinary tract was performed prospectively in a series of urinary incontinent dogs anesthetized for contrast radiography. Fourteen dogs had ectopic ureter based on surgical, necropsy or unequivocal contrast radiographic findings. There were eight females and six males of a variety of breeds; five were Labrador retrievers. Mean (range) age at the time of diagnosis was 1.2 (0.2–4) years for females and 3.5 (0.3–5) for males (p < 0.05). Ectopic ureters were unilateral in five dogs (2 left; 3 right) and bilateral in nine dogs. Both ultrasound images and contrast radiographs were positive for 21 (91%) ectopic ureters; the same two ectopic ureters were not detected using either modality. The termination of each of the five normal ureters was visible on ultrasound images; two (40%) were visible on radiographs. Other ultrasonographic findings included dilatation of the ectopic ureter and/or ipsilateral renal pelvis in ten (43%) instances, evidence of pyelonephritis in two dogs (with enlargement of the contralateral kidney in one dog), and urethral diverticuli in one dog. Ultrasonography is a practical diagnostic test for ectopic ureter in dogs. In this series there was close correlation between the ultrasonographic and contrast radiographic findings for each ectopic ureter, but ultrasonography enabled more accurate determination of normal ureteral anatomy.     

Perioperative Occlusion of a Subcutaneous Ureteral Bypass Secondary to a Severe Pyonephrosis in a Birman Cat

A subcutaneous ureteral bypass (SUB) was placed in a 10-year-old Birman cat for management of unilateral ureterolithiasis. Perioperative occlusion of the nephrostomy tube of the SUB device happened secondary to a severe pyonephrosis. Flushing of the system throught the subcutaneous shunting port was made with saline solution after clamping the urinary bladder catheter. Repetitive flushing of the device was performed daily for 3 days to be sure of the remanent patency of the catheter. Repetitive flushing of the SUB device is a successful renal-sparing treatment for pyonephrosis in a cat and may be considered as an effective treatment option for this condition.     

经腹、经阴道及两者联合超声诊断宫外孕200例的对比分析

目的探讨经腹超声（TAS）与经阴道超声（TVS）联合应用诊断宫外孕的临床价值。方法比较分析200例经手术确诊的宫外孕患者的TAS与TVS检查所见。结果TVS及TAS＋TVS对附件区包块、卵黄囊、胎芽、胎心搏动、宫内假孕囊、卵巢的检出率远较TAS高,差异均有统计学意义（P〈0.01）。对宫外孕包块的检出情况进一步分析发现,当宫外孕包块直径大于2.0 cm时,TAS对包块的检出率与TVS相比,差异无统计学意义;而当包块直径在1.5-2.0 cm之间及小于1.5 cm时,TVS对包块的检出率明显高于TAS（P〈0.01）。结论TAS、TVS各有其优缺点,建议对可疑宫外孕者可先行TAS,对TAS检查阴性或可疑阳性而血或尿HCG阳性者,再行TVS检查,这样既能避免患者不必要的负担,又能及时确诊。     

IMAGING DIAGNOSIS—ECTOPIC SPLEEN MIMICKING HEPATIC TUMOR WITH INTRA‐ABDOMINAL METASTASES INVESTIGATED VIA TRIPLE‐PHASE HELICAL COMPUTED TOMOGRAPHY IN A DOG

A 10‐year‐old castrated male miniature dachshund was presented with an abdominal mass. The dog had a history of splenectomy. Triple‐phase helical computed tomography was utilized, revealing a hepatic mass and multiple intra‐abdominal solid masses. In triple‐phase helical computed tomography the images, hepatic mass and two of four intra‐abdominal masses were heterogenous in all phases. Therefore, we diagnosed a malignant hepatic tumor and presumed intra‐abdominal metastases. The masses were surgically removed and were histologically composed of normal spleen tissues, findings which were consistent with ectopic spleen.     

苹果MdFT基因对番茄的遗传转化

 通过RT2PCR扩增, 从苹果叶片cDNA中克隆了^FT基因的同源基因^MdFT, 构建了花椰菜病毒35S启动子驱动的MdFT植物表达载体35S: : MdFT, 并利用根癌农杆菌介导法将其导入番茄栽培品种‘中蔬四号’; 同时转化拟南芥A tFT基因作为阳性对照。从添加卡那霉素的筛选培养基上再生了抗性植株,PCR扩增证明, 外源基因MdFT和AtFT已经整合到转基因番茄的基因组, 半定量RT-PCR则证明它们已经在转基因番茄中得到异位过量表达。形态鉴定发现, 转基因番茄植株比非转基因对照植株开花早, 表明成功地从苹果中克隆了成花素基因MdFT, 该基因具有通过转基因缩短苹果树童期的潜在价值。