糖尿病大鼠视网膜血管内皮生长因子与一氧化氮的变化

目的：探讨糖尿病大鼠视网膜血管内皮生长因子（VEGF）与一氧化氮（NO）的变化及其在糖尿病视网膜病变（DR）发生发展过程中的作用。方法：选择健康成年SD大鼠，随机分成正常对照组，糖尿病1月（DM1），糖尿病3月（DM3）和糖尿病5月（DM5）组，一次性腹腔注射链佐菌素（STZ）诱发糖尿病模型，应用免疫组织化学方法观察各组视网膜组织VEGF的表达情况，并检测各组视网膜组织中一氧化氮合酶（NOS）活性和NO含量变化。结果：3个月时，糖尿病大鼠视网膜VEGF表达增强，NOS活性增强，NO含量增高，5个月时，糖尿病大鼠视网膜表达进一步增强，而NOS活性开始减弱，NO含量减少，结论：糖尿病大鼠视网膜VEGF的过度表达和NOS活性，NO含量的变化在DR的发生发展过程中起重要作用。     

保留肾单位手术治疗早期小肾癌21例临床分析

OBJECTIVE: To evaluate the clinical effects of nephron-sparing surgery in patients with early-stage small renal cell carcinoma. METHODS: Nephron-sparing surgery was performed in 21 patients with renal cell carcinoma including 1 with solitary kidney, 3 with unilateral tumor and contralateral renal compromise, and 17 with unilateral tumor and normal contralateral kidney. The diameter of the tumors ranged from 1.5 to 6.0 cm, with a mean of 2.8 cm. The tumor diameter in 17 patients with normal contralateral kidney was less than 4 cm (mean 2.5 cm) and the average diameter in 4 patients with contralateral renal compromise was 4.2 cm. Sixteen cases were in stage T(1), 4 in stage T(2), and 1 in stage T(3). Of the 21 patients, 4 underwent tumor enucleation, 10 polar nephrectomy and 7 wedge resection. RESULTS: All patients were followed up for an average of 40.8 months (7 to 66 months). One patient suffered a right lung and mediastinum metastasis 3 years after the surgery later and 1 with chronic glomerulonephritis required dialysis 27 months after the operation. No surgical complication or local recurrence were found in other patients. CONCLUSION: As a safe and effective therapy for early-stage small renal cell carcinoma, nephron-sparing surgery can be considered as the gold-standard therapy for patients with lesions less than 4 cm in T(1) and T(2) stages of localized unilateral tumor with normal contralateral kidney.     

静脉丙种球蛋白冲击治疗溶血尿毒综合征

目的探讨大剂量静脉用丙种球蛋白(IVIG)治疗儿童溶血尿毒综合征(HUS)的效果,以降低HUS的病死率。方法将本院收治的HUS 30例分为2组。普通组14例,予以综合治疗、甲泼尼龙静脉冲击及透析;冲击组16例,在普通治疗基础上早期联合应用IVIG,400 mg/(kg.d),3-5 d为1个疗程。结果冲击组病死率6.3%(1/16);普通组病死率42.8%(6/14)。两组病死率经统计学处理有显著性差异(P<0.05)。结论IVIG能降低HUS的病死率。     

积极开展客户管理 努力提高健康体检客户满意度

健康体检有利润高、风险小的特征，具有非常好的市场前景。广州新海医院积极进行市场营销，开展客户管理，正确区分客户类型，建立客户资料数据库，合理确定客户组合，整合医院人力资源、业务流程及专业技术，对不同需求和消费层次的客户，采取不同的服务和管理策略，提供个性化、人性化的优质服务，主动搜集客户意见，认真处理客户投诉，不断改进医院健康体检工作方法，完善客户管理工作机制，使客户满意度不断提高，产生了良好的经营业绩，提高了医院的市场竞争力和品牌形象。     

致密性髂骨炎误诊腰突症1例报道

典型病例 患者，女，33岁。间断反复左腰腿痛伴发作性跛行7年，加剧3天。患者由家人搀扶，痛苦表情，跛行步态，并携有腰椎CT片。患者诉7年前首次发作，到某医院骨科就诊，经CT检查并诊断为腰突症。给予牵引、理疗、骶管注射等治疗2周，症状未见明显改善。患者当时终止治疗，回家静养，症状慢慢有所改善。过后时有发作，都以“腰突症”处理，病情缠绵至今。     

A Chinese adolescent girl with Fechtner-like syndrome

We describe a 15-y-old girl with Fechtner-like syndrome, who is the first Chinese reported to have this rare syndrome. She presented with left homonymous hemianopia and neuroimaging revealed haemorrhage in both parietal and occipital lobes. Peripheral blood smear showed macrothrombocytopenia and intracytoplasmic inclusion bodies inside leucocytes. Thrombocytopenia and proteinuria responded to intravenous immunoglobulin and pulsed methylprednisolone. This case illustrates that life-threatening haemorrhage can occur in patients with Fechtner syndrome. Although there was no effective treatment reported in the literature, high dose steroid and immunoglobulin seemed to be useful in our patient. Our patient also had nephritic-nephrotic syndrome with renal insufficiency, which is unusual in adolescent female patients.     

Occurrence of the t(2;5)(p23;q35) in non-Hodgkin's lymphoma

Primary CD30(Ki-1)-positive anaplastic large-cell lymphoma (ALCL) is considered by some to be a distinct clinicopathologic entity associated with the t(2;5) (p23;q35). However, the specificity of t(2;5) for ALCL has not been carefully studied. Therefore, we performed a detailed analysis of all cases of ALCL with abnormal cytogenetics results in the Nebraska Lymphoma Study Group registry, as well as all other cases of non-Hodgkin's lymphoma with t(2;5) in the registry. We found the t(2;5) in only five of 10 cases of ALCL, four of whom were young patients. However, we also found the t(2;5) in 11 other cases of nonanaplastic lymphoma, including eight children with typical peripheral T-cell lymphomas of various types. The t(2;5) was also found in three older adults with B-cell lymphomas of various types. Thus, the t(2;5) was not specific for CD30+ ALCL. However, t(2;5) may define a clinicopathologic entity in children and young adults characterized by variable morphologies with a T-cell or indeterminate phenotype, CD30-positivity, nodal disease with frequent extranodal involvement, advanced stage, and an excellent response to therapy, including bone marrow transplantation for relapsed disease. The clinical relevance of the t(2;5) in older patients requires further study.     

人工晶体植入屈光度的术前预选法：眼科超声仪36例对比研究

根据公认的眼科解剖学数据，提出后房型人工晶体植入屈光度的术前预测方法：IOL（D）=1．02（＋21D＋2X）。经人工晶体专用眼科A超36眼实测对比，无显著差异，认为在地市级医院和县级医院后房型人工晶体植入术推广中具有积极意义。     

菲咯啉铜与脂质体过氧化损伤

目的 :探讨菲咯啉铜配合物与脂质体过氧化损伤的相关性。方法 :采用紫外吸收法和TBA法研究了菲咯啉铜配合物启动的脂质体过氧化反应。结果 :发现菲咯啉 (Phen)与Cu2 + 螯合形成 (Phen) 2 Cu2 + ,还原剂是 (Phen) 2 Cu+介导的脂质体过氧化作用的重要条件。羟基清除剂及EDTA可抑制菲咯啉铜配合物介导的脂质体过氧化反应。结论 :Phen在还原剂存在下与Cu2 + 形成 (Phen) 2 Cu+ 后产生·OH ,·OH可能是 (Phen) 2 Cu+ 引起脂质体过氧化损伤的重要原因     

海正:一条驰逐国际药海的"快鱼"

随着经济全球化的发展和医药科技的日新月异,企业间的竞争不再是“大鱼”吃“小鱼”,而是“快鱼”吃“慢鱼”。在国际医药经济海洋中,谁能最快、最好地研制成功一种新药并成为“第一供应商”,谁就是赢家;谁能最先抢市场制高点,谁就能成为赢家。