肾缺血再灌流过程脂质过氧化损伤及还原型谷胱甘肽的防治

探讨缺血性急性肾功能衰竭的发病机理。选用大鼠一侧肾切除，对侧肾缺血６０分钟动物模型，观察再灌流前，再灌流后１５分钟，２４小时肾组织中超氧化物歧化酶（ＳＯＤ）（包括总ＳＯＤ、锰ＳＯＤ和铜锌ＳＯＤ）和丙二醛（ＭＤＡ）含量的变化及还原型谷胱甘肽（ＴＡＤ）对它们的影响。结果发现，６０分钟肾缺血和再灌流可致肾组织中三种ＳＯＤ活性呈进行性显著降低，再灌流１５分钟、２４小时肾组织中ＭＤＡ含量呈进行性显著增高。给ＴＡＤ能显著减轻肾组织中ＭＤＡ含量的增高，但对降低的ＳＯＤ无影响。结果提示：肾缺血和再灌流可造成肾组织对氧自由基清除能力显著降低，肾组织发生脂质过氧化损伤，ＴＡＤ能显著减轻肾脂质过氧化损伤，线粒体损伤可能是肾脂质过氧化进行性加重的主要因素。     

肝癌介入治疗后患者预后因素的Cox回归模型分析

目的：综合评价各预后因素对接受介入治疗的原发性肝癌患者生存期的影响。材料和方法：对３０８例中、晚期肝癌介入治疗后得到密切随访患者的预后因素进行了Ｃｏｘ回归模型分析。结果：总体１、２、３、４年的生存率分别是５４．５５％、３５．２３％，２２．５６％、９．８４％。单因素分析显示有意义的预后因素是临床分期、肿瘤大小、肝动脉化疗栓塞（ＨＡＥ）次数、门脉癌栓、淋巴细胞转化率；多因素分析为：ＨＡＥ次数、肿瘤大小、肝动脉灌注化疗（ＨＡＩ）次数、性别、淋巴细胞转化率。结论：单纯ＨＡＩ无明显治疗价值，但与ＨＡＥ联合运用则有显著意义；辅以保护和提高机体免疫的综合治疗可进一步提高疗效；对有门脉癌栓患者宜采取更积极的治疗态度     

（99m）~锝－MIBI静息心肌显像及定量分析对冠脉异常程度的判断

为了解核素心肌显像在定位及判断冠状动脉（冠脉）异常部位及程度中的作用，对３４例心肌梗塞患者在１个月内分别进行了９９ｍ锝－ＭＩＢＩ（ＭＢ）静息定量心肌显像及冠脉造影检查。结果表明：当心肌区段的ＭＢ摄取值小于左室峰计数区段的５０％时，８８％的可能性为狭窄大于９０％的冠脉所支配，而局部ＭＢ摄取在正常范围时，８２％为狭窄小于５０％的冠脉所支配；在阻塞冠脉支配区，有侧支循环存在的心肌区段ＭＢ摄取值明显高于无侧支供血的心肌；ＭＢ静息定量心肌显像对明确异常的冠脉（狭窄＞５０％）检测灵敏性为８７％，特异性为９０％。提示：ＭＢ定量心肌显像能较好地鉴别严重狭窄或阻塞冠脉支配区心肌，并有效判断局部侧支循环及存活心肌的可能性     

CLINICAL TRIAL OF LOW DOSE GOSSYPOL REGIMEN

Hypokalemia and irreversible infertility induced by the gossypol treatment have prcvented its clinical use on a large scale as a male contraceptive. In order to avoid these serious side effects, doses of gossypol, both in the loading phase and in the maintenance phase were     

Association of apolipoprotein E 4 polymorphism with cerebral infarction in Chinese Han population

AIM: To study the association between APOE polymorphisms and cerebral infarction through a case-control study among the Chinese Han population. METHODS: First-ever cerebral infarction patients (n=226) whose ages ranged from 40 to 60 years old were recruited from Department of Neurology, Zhongshan Hospital, Shanghai, and Zhejiang Chinese Traditional Medicine Hospital, Zhejiang, China. Unrelated healthy controls (n=201) were selected from the general population in the same area with similar age and sex distribution. APOE was amplified by one-stage PCR using the forward primer: 5‘-GGC ACG GCT GTC CAA GGA GCT-3‘ and reverse primer: 5‘-GAT GGC GCT GAG GCC GCG CT-3′. The PCR product was digested directly with 5 U of CfoI and separated by a 20 % polyacryla-mide (acrylamide: bis-acrylamide=29:1) nondenaturing gel. RESULTS: Both cerebral infarction patient and control groups were in Hardy-Weinberg equilibrium. The allele frequency of APOE*2, APOE*3, and APOE*4 was 4.6 %,81.9 %, and 13.5 % respectively in the patients with cerebral infarction; 5.7 %, 87.3 %, and 7.0 % respectively in the healthy control group. Compared with APOE3/3 subjects, APOE4/4 carriers had a 2.1-fold risk of cerebral infarction (odds ratio 2.1, 95 % confidence limits 1.3 to 3.4). The allele frequency of APOE*4 in the cerebral infarction patient group was significantly higher than that in the control group (13.5 % vs 7.0 %; P=0.002).CONCLUSION: APOE 4 is a risk factor for cerebral infarction among the Chinese Han population.     

经腹腔镜迷走神经切断术治疗十二指肠溃疡的经验

为了进一步探讨腹腔镜高选迷切的操作方法及治疗效果，作者选择１０例具有典型十二指肠球部溃疡病史、且反复消化道出血患者行迷走神经后干切断加胃小弯前壁浆肌层切开缝合术（Ｔａｙｌｏｒ术）。手术前后作胃液分析及胃排空试验。手术操作：（１）采用带气囊胃管在食管上下移动，以利定位；（２）将高位胃小弯向左侧牵拉以显露食管右后壁，游离并切断迷走神经右后干支；（３）用Ｅｎｄｏ－ＧＩＡ３５ｍｍ腔内线型切割吻合器分次钳闭，完成胃小弯前壁浆肌层切开缝合。结果：所有病例近期症状明显改善，均停止服药，体重增加，无胃潴留。胃液分析平均ＢＡＯ、ＭＡＯ、ＰＡＯ分别由术前的６．０ｍｍｏｌ／Ｌ、１８．５ｍｍｏｌ／Ｌ、２３．８ｍｍｏｌ／Ｌ，降至术后的２．８ｍｍｏｌ／Ｌ、７．８ｍｍｏｌ／Ｌ、１１．５ｍｍｏｌ／Ｌ（Ｐ＜０．０１）。胃半排空时间术前４６．１分钟，术后延长至７７．２分钟（Ｐ＜０．０１）。胃镜随访７例溃疡愈合，２例缩小。可以认为腹腔镜Ｔａｙｌｏｒ术对患者损伤小，近期疗效确切。     

血管腔内超声显像三维重建实验研究

血管腔内超声显像三维重建术能够直观地显示血管和动脉粥样硬化斑块的空间结构，提供两维图像所不能得到的信息。本文用表面提取法成功地对人７根正常５根异常离体血管标本进行腔内超声显像和三维重建。结果显示：三维血管图像不仅形态与实际血管相似，而且测值与病理结果高度相关（ｒ＝０．８４～０．９８）。     

三维动态增强磁共振血管成像诊断肝癌患者门脉受侵的价值

评价三维动态增强磁共振血管成像用于诊断肝癌患者门脉受侵的价值。方法共有７７例病人在肝脏手术或门脉造影前接受门脉３ＤＤＣＥＭＲＡ检查。３ＤＤＣＥＭＲＡ用于诊断脉主干,左支和右支是否有肿瘤累及。门脉受累分成包埋,闭塞和癌栓形成三种。以手术或造影为标准,对总共２３１例门脉主干和分支的３ＤＤＣＥＭＲＡ诊断结果做了评价。