角膜溃疡穿孔的修复与修复材料的选择

总结２１例用不同材料修复角膜穿孔的病例，修复材料分别为结膜瓣、硅胶板、断层自体皮片和同种异体角膜。结膜瓣遮盖仅２／３保存眼球，愈合后视力差，并发症多；硅胶板可在穿孔大、情况紧急时作暂时封孔保存眼球之用；自体断层皮片术后不久即溶解，角膜移植者７眼中６眼保存了眼球，且有５例植片透明，视力０．１以上。     

小儿急性白血病染色体的脆性部位与临床分析

目的　了解小儿急性白血病染色体脆性部位的改变与临床的关系。方法　对临床已确诊的 5 0例小儿急性白血病进行染色体脆性部位检查 ,与 15例正常人对照 ,分析其与临床的关系。结果　染色体脆性部位在小儿急性白血病中高度表达 ,共检出脆性位点 4 3个 ,其中普通型 (C Fra) 34个、罕见的脆位点 (H Fra) 9个 ,与正常对照有明显的区别 (P <0 .0 0 1)。结论　染色体的脆性部位 ,畸变率 ,年龄越小 ,畸变率越高、予后越差。而且脆性部位与癌基因断裂点及癌基因座位相关。     

背部供皮区修复大面积皮肤缺损

目的探讨应用背部供皮区修复大面积皮肤缺损的优点。方法对Ⅲ°烧伤、巨大体表肿瘤切除、四肢皮肤撕脱伤及其他原因造成的大面积皮肤缺损的40例患者,根据缺损的部位和大小,用鼓式取皮机在患者背部切取相应的中厚皮片,移植修复缺损。结果术后随访患者1年,所有移植皮片均成活。背部供皮区愈合良好,瘢痕增生轻微,不影响外观。结论于背部取皮其供皮面积大、部位隐蔽,且背部真皮层较厚,取皮后愈合快,愈合后患者能自行平卧加压,避免瘢痕增生。是较理想的修复大面积皮肤缺损的手术方法。     

肝癌患者血清P-选择素测定及临床意义

目的：研究肝癌患血清P-selection(P-sel)在肝癌复发和转移中的作用。方法：采用ELISA法分别测定原发性肝癌患和对照组血清P-选择素的含量，同时测定AFP含量。结果：肝癌患P-sel含量显高于正常人，且与AFP含量呈线性正相关，术后2周浓度降低；P-sel含量以Ⅰ、Ⅲ和Ⅳ期肝癌患显高于Ⅰ期患；且大肝癌患显高于小肝癌患，有癌栓组、有肝内转移组明显高于无癌栓组和无转移组。结论：P-选择素测定在原发性肝癌的诊断和检测术后复发方面有重要价值，联合检测AFP和sP-sel可提高诊断敏感性。     

A hole in the T cell repertoire specific for a pigeon cytochrome c related peptide associated with amino acid substitutions on I-Ab molecules.

When C57BL/10(B10) mice were immunized with a pigeon cytochrome c related peptide, 50V (AEGFSYTVANKNKGIT), two helper T cell populations with different specificity were activated. A major T cell population reacted with a 50V analog, 50V54A (AEGFSYTVANKAKGIT), more potently than with the immunogen, 50V, in a heteroclitic fashion, whereas the other minor T cell population responded only to 50V. By contrast, when bm12 mice were immunized with 50V, the minor T cell population responding only to 50V could hardly be demonstrated. The apparent deletion of the minor T cell population in bm12 mice seems to be attributable to negative selection under the influence of I-Abm12 molecules, since the minor T cell population was undetectable in both I-Ab and I-Abm12 restricted T cells from (B10 x bm12)F1 mice. Thus, three mutant points on the I-A molecule in bm12 mice appear to be involved in the seemingly negative selection of the certain T cell repertoire. The present finding demonstrates that a T cell repertoire generated under the influence of a MHC product (Ab) on one parental strain is eliminated by a different MHC product (Abm12) on the other parental strain of F1 cross. The mechanism underlying the apparent negative selection is discussed.     

Reversal of dexfenfluramine-induced anorexia and c-Fos/c-Jun expression by lesion in the lateral parabrachial nucleus

The external subdivision of the lateral parabrachial nucleus (LPBE) shows strong Fos-like immunoreactivity (FLI) following anorectic doses of the indirect serotonin agonist dexfenfluramine (DFEN). In an effort to determine the contribution of the LPBE to DFEN-induced anorexia, bilateral ibotenate lesions were made in the LPBE, and the effects of the lesion on DFEN-induced anorexia and FLI as well as c-June-like immunoreactivity (JLI) were examined. It was found that LPBE lesion significantly attenuated DFEN anorexia: in a 1-h food intake test following 24-h food deprivation, DFEN (2 mg/kg) suppressed food intake by 60% in intact rats but only 34% in rats with LPBE lesions. In addition to this behavioral change, LPBE lesion completely abolished DFEN-induced FLI and JLI in the lateral subdivision of the central nucleus of the amygdala (CeL) and laterodorsal subdivision of the bed nucleus of stria terminalis (BSTLD), both of which showed strong FLI and JLI in intact rats. DFEN-induced FLI and JLI in other brain regions were not affected by LPBE lesion, including the ventromedial and lateral hypothalamus, caudate-putamen, and the nucleus of the solitary tract (NST). The parallel loss of DFEN-induced anorexia and FLI/JLI following LPBE lesion raises the novel possibility that LPBE-CeL/BSTLD pathway may be involved in DFEN anorexia.     

Evidence for negative control in protein kinase C substrate specificity

The peptide Leu-Asp-Asp-Ser-Lys-Arg-Val-Ala-Lys-Arg-Lys-Leu-Ile-Glu, which corresponds to sequence 124 to 137 of c-erb-A protein, was synthesized and tested as substrate for protein kinase C (PKC). Although a typical recognition sequence for PKC, consisting of a cluster of basic residues, is found on the C-terminus side of serine, its phosphorylation was totally prevented by the presence of the two acidic residues on the amino-terminus side. Three analogs in which aspartyl residues were successively replaced with alanine were studied and the influence of the acidic side chain in modulating phosphorylation by PKC was thus possible to determine. The results show that the presence of a single aspartyl residue located in positions i-1 or i-2 with respect to the phosphorylable residue can almost totally abolish the positive effect of a highly favorable cluster of basic residues. These observations highlight the role of negative substrate specificity determinants in settling the protein substrate profile of protein kinase C.     

论知情同意权与知情选择权在美容整形外科的应用

目的：通过《医师法《、《医疗机构管理条例》和《医疗事故处理条例》的实施，明确了医疗机构及医务人员告知义务和患者知情同意和知情选择的重要性。方法：向每一位患者进行术前咨询详细介绍手术方法、材料选择、麻醉经过、恢复期的护理、并发症的预防和处理等使患者认识到自己的地位和相关的信息。结果：通过交谈，使医务人员和患者达成共识，从而消除了手术的顾虑，积极主动参与配合治疗，取得了双方满意的效果。讨论：强调预防为主，是医务人员自觉的接受法律的制约和监督，提高医德修养，履行告知说明义务的必要性和重要性，建立符合法律制度的医疗管理体系、规范医疗操作，遵循患者知情同意和知情选择这一受法律保护的基本权力。     

Effect of ACTH,adrenalectomy and the combination treatment on the density of 5-HT2 receptor binding sites in neocortex of rat forebrain and 5-HT2 receptor-mediated wet-dog shake behaviors

The effect of ACTH and/or adrenalectomy on serotonin (5-HT)₂ receptor binding sites was evaluated in the neocortex of rat forebrain. One day after the adrenalectomy or sham operation, ACTH (50 µg/day) was injected subcutaneously into adult male SD rats for 10 consecutive days. Saturation analysis showed that subchronic ACTH treatment significantly increased the B_max values for³H-ketanserin binding without any change in the K_d values. Moreover, this ACTH-induced increase in the B_max values was prevented by adrenalectomy. The concentrations of 5-HT and 5-hydroxyindole acetic acid (5-HIAA) measured by HPLC-ECD were not altered by these manipulations. Ten-day administration of corticosterone (20 and 50 mg/kg) also increased 5-HT₂ receptor density in the neocortex of rat forebrain. 5-HT₂ (and 5-HT_1C) receptor agonist, (±)DOI-induced wet-dog shakes in ACTH and/or adrenalectomy-treated rats were also examined. Ten-day administration of ACTH enhanced (±)DOI-induced wet-dog shakes and this increase was prevented by adrenalectomy. These results indicate that subchronic adrenocorticotropinadrenal axis activation of rats increases both the number of 5-HT₂ receptors in neocortex of forebrain and the wet-dog shake responses induced by (±)DOI.