男性避孕药研究及其进展

处于研究阶段的男性避孕药主要分为激素类和非激素类,以及针对特异性抗原的男性免疫避孕疫苗。激素类避孕药已经过长期的药效实验研究,现主要集中于雄激素单用、合成雄激素以及雄激素与孕酮合用等方法。非激素避孕药作用的靶点有精子生成、精子活力以及睾丸非生殖细胞（睾丸间质细胞、Sertoli细胞）。非激素避孕药具有靶点专一性特征,使用时可能减少不良反应,并且起效快,但现阶段尚未进入临床应用。发现更多的作用新靶点,将为男性避孕药研发带来希望。     

Toxicity of Danshen Injection in Beagle’s Dogs by Repeated iv Injection

Objective To re-evaluate the potential toxicity of Danshen Injection(DI)in Beagle’s dogs by repeated iv injection.Methods DI was iv given to the dogs at the doses of 0,1.6,5.4,and 16.0 g/(kg·d)(4 per sex per group)for 13weeks.During the test period,the clinical signs,mortality,body weights,food consumption,rectal temperature,ophthalmoscopy,electrocardiography,urinalysis,hematology,serum biochemistry,organ weights,gross findings,and histopathology were examined.Results Dogs iv given with DI at the doses of 0,1.6,5.4,and 16.0 g/(kg·d)for13 weeks had no drug-related changes in mortality,body weight,food consumption,temperature,electrocardiography,ophthalmoscopy,urinalysis parameters,and organ weights.The hematological parameter data showed a significant decrease in red blood cells and hemoglobin concentration in the high-dose group and a significant increase in activated partial thromboplastin time suggesting an effect on haemopoiesis.For biochemical parameters,a significant decrease in glucose and a significant increase in total bilirubin were observed in the high-dose group,and the latter was considered to be toxicologically insignificant as lack of histopathological correlate.However,the histopathological examinations of the injection site showed that DI could cause dose-dependent focal inflammation.Conclusion That the iv injection with DI into dogs at 16 g/(kg·d)for 13 weeks could cause the decreases in red blood cell parameters and glucose,as well as the lesions of the injection site.The no observed adverse effect level is5.4 g/(kg·d),which suggests that safe clinical dosing be possible.     

连续2次原因不明自然流产主动免疫治疗必要性的探讨

目的探讨应用淋巴细胞主动免疫治疗连续2次原因不明自然流产患者的必要性。方法将2003-2008年上海交通大学仁济医院145例连续2次原因不明流产患者作为研究对象(其中主动免疫组41例,非主动免疫组104例),对其妊娠结局进行回顾性分析。结果免疫组妊娠活产率82.9%(34/41),纠正活产率87.2%(34/39);非免疫组妊娠活产率85.6%(89/104),纠正活产率89.0%(89/100);两组相比,差异无统计学意义(P>0.05)。两组间胎儿出生孕周及体重差异均无统计学意义(P>0.05)。结论连续2次原因不明自然流产患者,主动免疫治疗没有必要。     

Signal molecule-mediated hepatic cell communication during liver regeneration

Liver regeneration is a complex and well-orchestrated process, during which hepatic cells are activated to produce large signal molecules in response to liver injury or mass reduction. These signal molecules, in turn, set up the connections and cross-talk among liver cells to promote hepatic recovery. In this review, we endeavor to summarize the network of signal molecules that mediates hepatic cell communication in the regulation of liver regeneration.     

Long-term safety and outcome of a temporary self-expanding metallic stent for achalasia: a prospective study with a 13-year single-center experience

To prospectively evaluate the long-term clinical safety and efficacy of a newly designed self-expanding metallic stent (SEMS) in the treatment of patients with achalasia. Seventy-five patients with achalasia were treated with a temporary SEMS with a 30-mm diameter. The SEMSs were placed under fluoroscopic guidance and removed by gastroscopy 4–5 days after stent placement. Follow-up data focused on dysphagia score, technique and clinical success, clinical remissions and failures, and complications and was performed at 6 months, 1 year, and within 3 to 5 years, 5 to 8 years, 8 to 10 years, and >10 years postoperatively. Stent placement was technically successful in all patients. Complications included stent migration (n = 4, 5.33%), chest pain (n = 28, 38.7%), reflux (n = 15, 20%), and bleeding (n = 9, 12%). No perforation or 30-day mortality occurred. Clinical success was achieved in all patients 1 month after stent removal. The overall remission rates at 6 months, 1, 1–3, 3–5, 5–8, 8–10, and >10 year follow-up periods were 100%, 96%, 93.9%, 90.9%, 100%, 100%, and 83.3%, respectively. Stent treatment failed in six patients, and the overall remission rate in our series was 92%. The median and mean primary patencies were 2.8 ± 0.28 years (95% CI: 2.25–3.35) and 4.28 ± 0.40 years (95% CI: 3.51–5.05), respectively. The use of temporary SEMSs with 30-mm diameter proved to be a safe and effective approach for managing achalasia with a long-term satisfactory clinical remission rate. Supported by the National Key Medical Research and Development Program of China during the 9th Five-year Plan Period (no. 96–907–03–04), Shanghai Nature Science Funds (no. 02Z1314073), Shanghai Medical Development Funds (no. 00419), the National Natural Science Foundation of China (no. 30670614).     

Modified Kugel补片修补腹股沟疝36 例手术体会

目的探讨Modified Kugel补片治疗腹股沟疝的技术操作要点,并评价其疗效。方法回顾性分析2006年6～10月上海交通大学医学院附属第九人民医院应用Modified Kugel补片行开放性前入路腹膜前修补术的36例临床资料。结果手术时间(46±13)min,术后住院(4.7±1.6)d。全组病人伤口一期愈合,无浆液肿及感染发生。术后随访12个月,无复发。结论应用Modified Kugel补片治疗腹股沟疝安全有效,术后恢复快,近期疗效满意。     

Mimics软件在医学图像三维重建中的应用

介绍了Mimics(Materiaise’s interactive medical image control system)软件及医学图像三维重建的方法,并对该软件在医学图像三维重建中的应用现状进行了分析。指出Mimics软件是连接二维断层扫描图像和三维图像的桥梁,其更重视实现可视化之后的后续研究,并且可以实现个人普通计算机上大规模数据的转换处理,无需专业工作站,将二维扫描的数据(CT、MRI)输入该软件可快速生成三维模型并进行编辑,为医生日常临床诊疗以及科研工作使用提供帮助。最后对其应用前景进行了展望。     

利用MRI探讨TMJ关节镜术后咬合恢复的影响因素

目的：利用MRI探讨经颞下颌关节镜下盘复位固定术后患者咬合关系自行恢复的可能影响因素。方法：按关节镜术后4周咬合关系能否自行恢复,将患者分为暂时错及长期错2组,每组包括30例单侧手术病例。所有患者术前均行MRI检查,读片记录2组患者MRI所显示关节盘形态及髁突骨质变化情况,应用SAS6.12软件包比较2组间的差异,探讨术后错恢复的可能影响因素。结果：2组患者的关节盘形态及髁突骨质变化情况存在显著性差异（P〈0.05）,长期错组患者与暂时错组相比,关节盘变形程度及髁突骨质变化情况均显严重。结论：通过术前MRI所显示关节盘形态及髁突骨质变化情况,可以初步预计患者术后咬合关系能否及时恢复,从而及时进行相应的临床干预。