乳腺癌乳头及乳晕区浸润情况的临床病理观察

目的对180例女性乳腺癌患者乳头及乳晕区浸润情况进行观察。方法采用整个乳头及乳晕区全部取材病检方法检出乳头及乳晕区浸润者29例,总阳性率16.1%,结果其中Ⅰ期乳腺癌受浸率6.9%,Ⅱ期12.6%,Ⅲ期30.4%。观察肿瘤期别、肿瘤位置、乳头大体表现等特征与乳头乳晕受累的密切关系。肿瘤期别与乳头乳晕受累成正比(P<0.05)。肿瘤位置距头越近,乳头受累几率越大(P<0.01)。乳头大体表现一旦异常,镜下多有浸润。结论严格掌握保留乳头乳晕的适应证条件。乳腺癌保留乳房成型术能更加安全。     

吸入皮质类固醇治疗支气管哮喘的不良反应综述

吸入糖皮质激素的口腔沉积率约为 80～ 90 %,是引发局部和全身副作用的主要原因。不良反应多为下丘脑 -垂体-肾上腺轴(HPAA)抑制作用、骨质疏松、局部刺激、真菌感染等。根据病情适量用药,并于用药后及时漱口是防止糖皮质激素各种副作用的有效措施。     

HPLC法测定喘复康软胶囊中2组分含量

目的测定喘复康软胶囊中盐酸麻黄碱和盐酸异丙嗪的含量。方法HPLC法 ,采用shim packVp ODS色谱柱 ,流动相分别为甲醇 0 0 5moL·L-1磷酸二氢钾 三乙胺 (V∶V∶V =2 0∶80∶0 0 2和V∶V∶V =5 5∶4 5∶0 0 2 ,用磷酸调节 pH =3 4 ) ,检测波长分别为 2 0 6nm和 2 5 1nm。结果盐酸麻黄碱在 0 0 18～ 0 10 7mmol·L-1、盐酸异丙嗪在 0 0 14～ 0 0 37mmol·L-1内峰面积与浓度呈良好的线性关系 ,其回归方程分别为Y =3 2 13× 10 4X +2 83× 10 2 (r =0 9999)、Y =8 72 9× 10 4X +3 16 2× 10 3 (r =0 9999) ;回收率分别为 99 3% (RSD =0 6 % )和 99 4 % (RSD =0 6 % )。结论该方法可用于喘复康软胶囊中盐酸麻黄碱和盐酸异丙嗪 2种组分的含量测定     

Molecular epidemiology of enterovirus 71 infection in the Western Pacific Region

BACKGROUND: Recently, there have been large outbreaks of hand, foot and mouth disease (HFMD) mainly caused by enterovirus 71 (EV71) associated with severe neurological diseases in the Western Pacific Region (WPR). To monitor the realtime trend of EV71 transmission throughout the WPR, the authors conducted a molecular epidemiological analysis of EV71 infection. METHODS: Viruses were isolated from clinical samples from patients with HFMD or those with neurological complications. The EV71 isolates were identified by microneutralization assay. The VP4 and/or VP1 regions of recent EV71 isolates were sequenced and subjected to phylogenetic analysis using reference EV71 strains. RESULTS: The phylogenetic analysis of EV71 isolates from the WPR revealed two major genogroups, B and C, based on the nucleotide sequence alignment of the VP1 or VP4 region. These two major genogroups were further divided into subgenogroups, B1, B2, B3, and B4 and C1, C2, C3 and C4, respectively. CONCLUSIONS: The molecular epidemiological analyses of recent and previous EV71 isolates in the WPR indicated that two major genogroups of EV71 are co-circulating in Australia, Malaysia, Singapore, Taiwan and Japan. Recent EV71 isolates in Mainland China constitute a new distinct genetic cluster, subgenogroup C4. Two major lineages of EV71 are the major causative agents of the present HFMD epidemics in the WPR and both are considered to be neurovirulent.     

血清抗脑抗体在小儿颅内感染性疾病中诊断价值的研究

目的　观察小儿颅内感染时血清抗脑抗体 (ABAb)的变化 ,探讨其在诊断中的价值。方法　选取 2 0 0 2年 2月至 2 0 0 3年 9月济南市儿童医院收治的 98例颅内感染患儿 ,分为病毒性脑炎 (病脑 )组 5 0例 ,化脓性脑膜炎 (化脑 )组 37例 ,结核性脑膜炎 (结脑 )组 11例。并选取 2 0例对照组患儿 ,进行血清ABAb检测 ,并与血清降钙素原(PCT)、肿瘤坏死因子 α(TNF α)、白介素 6 (IL 6 )进行对比分析。结果　血清ABAb在病脑组、化脑组、结脑组阳性率分别为 78 0 0 %、5 1 35 %、4 5 4 5 % ,与对照组比较 ,差异均有显著性 (P <0 0 5 ) ;病脑组与化脑组、结脑组比较差异亦有显著性 ( P <0 0 5 )。血清ABAb与血清PCT、TNF α、IL 6呈中度正相关 ;血清PCT、TNF α、IL 6之间呈高度正相关 ,均在化脑时升高明显 ,与其他组比较差异有显著性 (P <0 0 5 )。经多元判别分析 ,诊断病脑或化脑 ,误判率 8 0 4 % ,判别符合率 91 96 %。结论　在小儿颅内感染时 ,血清ABAb可呈阳性 ,病脑阳性率最高 ,结合血清PCT、TNF α、IL 6检查 ,可协助小儿颅内感染的诊断与鉴别诊断     

恒河猴细菌感染性子宫出血模型内膜组织NF-kB活性及TNF-α、IL-1mRNA表达的实验研究

目的:探讨核因子κB(NF-κB)及肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)在恒河猴细菌感染性子宫出血模型中的变化。方法:选择月经正常的雌性育龄恒河猴7只,随机分为模型组4只和正常对照组3只,通过官腔细菌接种制作细菌感染性子宫出血模型。用电泳迁移率改变分析法(EMSA)检测模型组及正常对照组恒河猴子宫内膜组织NF-κB与靶基因DNA的结合活性,用反转录-多聚酶链式反应(RT-PCR)法检测两组恒河猴子宫内膜组织TNF-α、IL-1mRNA的表达。结果:模型组NF-κB活性及TNF-α、IL-1mRNA的表达量均明显高于正常对照组,差异有显著性意义(P<0.01)。结论:NF-κB活化及TNF-α、IL-1mRNA的高度表达可能参与了恒河猴细菌感染性子宫出血发病机制。     

Recombinant human complement C5a receptor antagonist reduces infarct size after surgical revascularization

OBJECTIVES: This study tested the hypothesis that a recombinant human C5a antagonist, CGS 32359, attenuates neutrophil activation and reduces infarct size in a porcine model of surgical revascularization. METHODS: CGS 32359 (0.16-16 micromol/L) dose-dependently inhibited superoxide production by human C5a-activated porcine neutrophils (18 +/- 3.7 vs 1.6 +/- 0.5 nmol/5 min/5 x 10(6) neutrophils; P <.05) and reduced neutrophil adherence to coronary endothelium from 194 +/- 9 to 43 +/- 6 neutrophils/mm(2) (P <.05). The left anterior descending coronary artery was occluded for 50 minutes, after which saline solution (n = 8), mannitol-buffer vehicle (n = 9, 102 mg/kg bolus, 102 mg. kg(-1). h(-1)), or CGS 32359 (CGS, n = 7, 60 mg/kg bolus, 60 mg. kg(-1). h(-1)) was infused. After ischemia, 1-hour arrest was achieved by means of multidose hypothermic (4 degrees C) blood cardioplegia, followed by 2.5 hours of off-bypass reperfusion. The ligature on the left anterior descending artery was released before the second infusion of cardioplegic solution. RESULTS: Area at risk was similar in all groups (saline solution, 27% +/- 2%; mannitol-buffer vehicle, 26% +/- 2%; CGS, 26% +/- 2% left ventricular mass). Infarct size (area necrosis/area at risk) was significantly reduced by CGS (18% +/- 6%, P <.05) versus saline solution (52% +/- 3%) and mannitol-buffer vehicle (60% +/- 4%). Postischemic systolic shortening (sonomicrometry) in the area at risk was significantly improved with CGS (0.8% +/- 0.9%) compared with saline solution (-3.7% +/- 1.1%) and mannitol-buffer vehicle (-6.4% +/- 1.0%). Myeloperoxidase activity from accumulated neutrophils was less in the ischemic zone of CGS (0.014 +/- 0.002 U/100 mg tissue; P <.05) than mannitol-buffer vehicle (0.133 +/- 0.012 U/100 mg tissue). CONCLUSIONS: We conclude that the recombinant human C5a receptor antagonist CGS 32359 inhibits surgical ischemia-reperfusion injury after coronary occlusion.     

韩国医疗服务支付方式改革对我国的启示

随着我国城镇职工基本医疗保险制度改革的深入，支付方式的改革越来越显得重要。我国与韩国一样，在社会医疗保险初期，支付方式都是按服务项目付费、这种支付方式导致服务数量的增加、治疗方案的扭曲，医生更愿意提供收益好的服务。为了寻求解决办法，韩国在1997年尝试实施按诊断相关分组(DRG)的支付方式。通过对韩国支付方式改革的回顾，为我国城镇职工基本医疗保险支付方式的改革提供借鉴。     

Contemporary trends in surgery of adrenal glands

There have been analysed the records of suprarenectomy in 459 patients with Conn' syndrome, syndrome of Icenko-Cushing as well as with androsteroma, pheochromocytoma and other tumors, who were operated in the clinic of abdominal surgery of S.P. Fedorov Russian Military Medical Academy. On the base of retrospective analysis the most actual aspects in surgery of the adrenal glands and the ways of the development of this branch of medicine have been determined. High effectiveness and perspectiveness of endovideosurgical removal of the adrenal glands is shown. Original and tested methods of choice of surgical approach, prophylaxis and treatment for some complications of suprarenectomy (adrenal insufficiency, Nelson' syndrome, etc.) are proposed. Substantiated policy in so-called hormono-inactive tumors of the adrenal glands is proposed.     

生物技术在军事领域的应用前景分析

生物技术是指人们以现代生命科学为基础,结合其他基础学科的科学原理,采用先进的工程技术手段,按照预先设计来改造生物体或加工生物原料,为人类生产出所需产品或达到某种目的。主要包括基因工程、细胞工程、酶工程、发酵工程和蛋白质工程以及克隆技术、纳米技术、基因芯片技术等新技术。这门技术具有鲜明的军、民两用性,随着生物技术在军事领域的深入发展和广泛应用,必将使得武器装备、军队指挥、作战方法、军事后勤等方面发生质的变化。