寡核苷酸探针在法医学上的应用研究

采用寡核苷酸探针对（ＣＡＣ）５对河南汉族５０名无关个体和两个家系１０名成员进行了ＤＮＡ指纹检验，结果：得到了清晰可辨的寡核苷酸指纹图谱，经统计学处理，无关个体的相关机率为９．８×１０＾－１０，家系调查表明，亲代与子代之间，杂交片段的遗传答合孟德尔法则，提示，寡核苷酸探针（ＣＡＣ）５在法医学个人识别和亲权鉴定中具有重要的实用价值。     

寡核苷酸探针在法医学上的应用研究

采用寡核苷酸探针（ＣＡＣ）_５对河南汉族５０名无关个体和两个家系１０名成员进行了ＤＮＡ指纹检验。结果：得到了清晰可辨的寡核苷酸指纹图谱。经统计学处理，无关个体的相关机率为９．８×１０~（－１０）。家系调查表明，亲代与子代之间，杂交片段的遗传符合孟德尔法则。提示：寡核苷酸探针（ＣＡＣ）_５在法医学个人识别和亲权鉴定中具有重要的实用价值。     

胃癌及乳癌对化疗药物敏感性的测定

目的探讨胃癌、乳癌对常用化疗药物的反应性,筛选针对个体的化疗药物,为临床用药提供依据。②方法采用噻唑蓝（ＭＴＴ）法,对肿瘤组织进行５－氟尿嘧啶（５－ＦＵ）、顺铂（ＤＤＰ）、氨甲喋呤（ＭＴＸ）、丝裂霉素（ＭＭＣ）、长春新碱（ＶＣＲ）、平阳霉素（ＰＹＭ）、足叶乙甙（ＶＰ－１６）敏感性测定。③结果７种化疗药物对胃癌、乳癌抑制率不同,其中ＤＤＰ,５－ＦＵ,ＰＹＭ,ＶＣＲ,ＭＭＣ对胃癌抑制率较高;５－ＦＵ,ＰＹＭ,ＤＤＰ对乳癌抑制率较高。不同个体对化疗药物敏感性差异较大,胃癌病人对ＤＤＰ,５－ＦＵ,ＰＹＭ敏感者居多;乳癌病人对５－ＦＵ,ＰＹＭ敏感者居多。④结论不同肿瘤及同一肿瘤不同个体对化疗药物敏感性有显著差异。     

水痘脑炎合并精神异常1例报告

女，１４岁。因全身疱疹５天，加重伴头痛、恶心、呕吐１天，于１９９７年５月１２日入院。患者在入院前５天轻度发热，Ｔ３７．２℃，全身出现水疱并脓点、痒痛，４天后出现恶心、呕吐、头痛。曾在个体诊所肌注安定，静点病毒唑、维生素Ｃ治疗。当日出现幻觉，胡言乱语，...     

血管紧张素原基因调控序列多态性与原发性高血压相关性分析

应用ＰＣＲ／ＳＳＣＰ分析及ＤＮＡ测序方法分析正常汉族人群和原发性高血压患者血管紧张素原基因多态性。比较３种不同ＳＳＣＰ带型在７３例原发性高血压患者组及７４例正常对照组中的分布频率，发现带型Ｃ在病例组中的比例（５／７３）高于对照组（１／７４）；ＤＮＡ序列分析表明３种不同带型是由于血管紧张素原基因５＇－调控区－２１６位，点存在Ｇ→Ａ的碱基变异所致，而带型Ｃ的个体为－２１６位，点Ａ／Ａ纯合子，提示该碱基变异可能与原发性高血压的发病相关。     

美托洛尔血药浓度与抑制心率效应关系

家兔６只，１０ｍｇ／ｋｇ美托洛尔肌注，药物体内代谢呈二室模型，高血压患者５例，一次口服美托洛尔片剂５０ｍｇ，药物体内代谢呈一室模型。家兔和高血压患者，血药浓度（Ｃｐ）与抑制心率效应（Ｅ）的关系均为Ｅ＝Ｅｍａｘ·Ｃｐ~ｓ／［Ｃｐ~ｓ＋Ｃｐ（５０）~ｓ」。Ｃｐ（５０）为引起半数最大效应的血药浓度，家兔Ｃｐ（５０）个体间相差１７．４５倍，高血压患者Ｃｐ（５０）相差６．０９倍，提示药物浓度监测应注意药效学的个体差异。     

抗T单抗治疗再生障碍性贫血的临床观察

用抗ＣＤ_３和（或）抗ＣＤ_８治疗再障２５例：ＳＡＡⅠ７例、ＳＡＡⅡ１２例、ＣＡＡ６例。共分５组，即１．抗ＣＤ_３５ｍｇ／ｄ×５ｄ，２．抗ＣＤ_３５ｍｇ／ｄ×１０ｄ，３．抗ＣＤ_３８ｍｇ／ｄ×７ｄ，４．抗ＣＤ_８５ｍｇ／ｄ×５ｄ，５．抗ＣＤ_３和抗ＣＤ_８各５ｍｇ／ｄ×５ｄ。随访观察３～１１个月，有效率为６０％，治疗后Ｈｂ、ＷＢＣ和Ｐｌｔ均明显升高，以抗ＣＤ_３８ｍｇ／ｄ×７ｄ效果较好，抗ＣＤ_３和抗ＣＤ_８联合应用能提高疗效，副作用小，可重复应用。     

外周血单个核细胞产生IL—8影响因素的探讨

观察Ｃ５ａ，ＰＭＡ，Ａ２３１８７，ＬＰＳ对ＰＢＭＣ ＩＬ－８产生的影响，为研究减轻Ｃ５ａ致病作用的途径创造条件。方法：用ｒｈＣ５ａ，ＰＭＡ，Ａ２３１８７，ＬＰＳ诱导ＰＢＭＣ，以ＥＬＩＳＡ法测定细胞培养上清中ＩＬ－８。结果。ＰＢＭＣ经ｒｈＣ５ａ，ＰＭＡ，Ａ２３１８７和ＬＰＳ诱导后ＩＬ－８分泌水平较对照组增高。     

树突状细胞和巨噬细胞对外源性抗原内吞路径的比较研究

目的：观察并比较小鼠树突状细胞（ＤＣ）和巨噬细胞对外源性抗原的内吞路径的差异。方法：制备小鼠骨髓ＤＣ有腹腔巨噬细胞，然后让ＤＣ和巨噬细胞与辣根过氧化物酶（ＨＲＰ）－５ｎｍ胶体金共孵育１０ｍｉｎ后再培养０～１２０ｍｉｎ，进行酸性磷酸酶细胞化学反应和组织相容性抗原（ＭＨＣ）Ⅱ免疫胶体金标记，最后在电镜下观察５ｎｍ胶体金的细胞内运行路径。结果：ＤＣ内吞ＨＲＰ－５ｎｍ胶体金１０ｍｉｎ后再培养３０ｍｉｎ，大部分５ｎｍ胶体金进入ＭＨＣⅡ隔室（ＭⅡＣ）中，只有极少数酸性磷酸酶阳性的溶酶体内含少量５ｎｍ胶体金。而与ＤＣ显著不同的是巨噬细胞摄入的大部分５ｎｍ胶体金进入了溶酶体，还有部分５ｎｍ胶体金进入ＭⅡＣ中。内吞后再培养６０ｍｉｎ，ＤＣ内仍有许多５ｎｍ胶体金，而巨噬细胞内已很少见到５ｎｍ胶体金。结论：同一种外源性抗原被ＤＣ和巨噬细胞内吞后，在这两类细胞中的运行路径明显不同。内吞后３０ｍｉｎ，巨噬细胞摄入的大部分抗原进入溶酶体，而ＤＣ则将大部分抗原送入ＭⅡＣ，这可能与ＤＣ独特的抗原提呈功能有关。另外，巨噬细胞对抗原的清除能力比ＤＣ强得多。     

慢性乙肝患者血浆中C_（3）d和SC_（5b－9）的检测及其意义

目的：探讨慢性乙肝患者血浆Ｃ３ｄ和ＳＣ５ｂ－９变化的意义。方法：以ＥＬＩＳＡ双抗夹心法测定３６例ＣＰＨ患者、３９例ＣＡＨ患者及正常对照组血浆Ｃ３ｄ和ＳＣ５ｂ－９含量，并测定补体系统活化的其他有关指标。结果：①ＣＰＨ及ＣＡＨ患者Ｃ３ｄ含量及Ｃ３ｄ／Ｃ３的比值均大于正常对照组，ＣＨ５０、Ｃ３、Ｃ４和ＢＦ水平均小于正常对照组，ＣＡＨ患者ＳＣ５ｂ－９含量大于正常对照组。②ＣＡＨ患者Ｃ３ｄ、ＳＣ５ｂ－９含量及Ｃ３ｄ／Ｃ３的比值均大于ＣＰＨ患者，ＣＨ５０含量小于ＣＰＨ患者。③ＣＡＨ患者ＳＣ５ｂ－９与Ｃ３ｄ、ＣＨ５０分别是正、负相关，且与ＡＬＴ水平呈正相关。结论：测定血浆Ｃ３ｄ、ＳＣ５ｂ－９含量及Ｃ３ｄ／Ｃ３的比值有助于临床上对慢性乙肝病情和预后作出判断。进一步了解ＭＡＣ在肝细胞的存在情况，有助于加深对慢性乙肝发病机理的认识。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.