基于复杂系统中因果关系的单细胞病理学

肿瘤是由肿瘤细胞和周围的微环境组成的复杂生态系统。在病理学上,肿瘤中细胞各异、分布和生理功能千差万别,并且受自身、周围环境和治疗的调节,自成复杂系统。单细胞分析技术为病理学复杂系统的研究提供了更多的信息。利用复杂系统中的因果判定方法,可以揭示单细胞的复杂的调节作用,以及不同类型的肿瘤细胞与患者治疗方案、治疗效果、疾病复发和生存时间的因果关系。     

微量补体反应性溶血测定法

本文报道从酵母多糖活化的急性期患者血浆中分离Ｃ＾－５６复合物，并经ＤＥＡＥ－纤维素ＤＥ－３２阴离子交换层析纯化。利用微孔板和自动微孔板测定仪建立了一种简单，灵敏，准确的微量反应性溶血测定法。     

89例乳腺癌治疗情况分析

回顾性分析我院1995～1998年89例乳腺癌的治疗情况,Ⅰ期7例,Ⅱ期44例,Ⅲ期32例,Ⅳ期6例,各期5年生存率为75％、60.9％、28.6％、0。按病理组织分类;非浸润型4例,浸润型非特殊型72例,浸润型特殊型13例,各类5年生存率为66.6％、46.8％、20％。根治术43例,改良根治术26例,单纯乳腺切除20例。手术+化疗26例,手术+放疗25例,手术+化疗+放疗38例。手术+化疗+放疗的平均生存率为63.7％,较其他组高(P<0.05)术后放、化疗同时进行者3年生存率较术后先放疗者高63.7％,较其他组高(P<0.05),术后放、化疗同时进行者3年生存率较术后先放疗者高(74.2％,56.8％)。因此可以认为:综合治疗是乳腺癌最佳治疗方案;化、放疗同时进行或化疗较早应用,能提高生存率,可减少远处转移率,对病期较晚者尤为如此。     

肺癌骨转移疼痛的综合治疗分析

目的 :本文对 1 996 - 0 1～ 1 998- 0 6收治的有骨痛症状的肺癌骨转移病人作回顾性分析。方法 :本文共 71例 ,治疗分两大组 :综合治疗组 46例 ,分为 3个亚组 ;A组 (化疗 +帕米磷酸钠 ) ,B组 (放疗 +帕米磷酸钠 ) ,C组 (核素 +帕米磷酸钠 ) ;单一疗法组 2 5例 ,分为 2个亚组 :D组 (化疗 ) ,E组 (放疗 )。结果 :综合组镇痛治疗有效率 89 1 % ,单一组 6 4 0 % (P <0 0 5 )。结论 :采用抗癌和破骨细胞抑制剂帕米磷酸钠综合治疗肺癌骨转移引起的疼痛 ,疗效满意 ,不良反应无相加 ,可进一步改善患者的生存质量。     

由复方中单一组分微小效应引发的对中西医结合理论的思考

“霰弹理论”认为中药作用机制和途径表现为多向性、多层面、多靶点的药理学特点 ,这些特点决定了中药复方中任何一种单一组分均可具有微小的生物学效应。在药物组分之间的相互作用中 ,除了少数已证明具有受体效应的组分外 ,多数组分是微效组分 ,即 :中药药效 =A B C …N个微小效应的累加作用。对某一组分不能忽略其生物学的微小效应 ,也不能采用简单的检测手段和数学统计方法分析微小效应。采用细胞培养的方法结合数学概率论将组分的微小生物学效应合并成机体的整体的生物学效应 ,可以解决实验医学与中医结合中遇到的理论与实际相脱节、实验研究结果与临床效果相背离等问题。     

血管内支架在冠状动脉复杂病变成形术中的临床应用

目的探讨血管内支架在冠状动脉复杂病变成形术中的应用效果及价值.方法对冠心病患者复杂冠状动脉病变在经皮穿刺冠状动脉成形术(PTCA)并发急性血管内闭塞、内膜严重撕裂、术后显著残留狭窄及短期内再狭窄等情况下进行了血管内支架植入术(CASI).结果31例患者CASI均获成功,术后急性血管闭塞和内膜撕裂征象消失,残留狭窄及再狭窄解除,未出现出血和穿刺部位血管并发症及CASI后亚急性血栓形成.随访16例,1例术后13天发生猝死;2例因胸痛复发经造影证实支架血管再狭窄,再次球囊扩张后再狭窄改善;余13例冠状动脉造影示支架血管正常.结论冠心病复杂冠状动脉病变行CASI是解除PTCA急性并发症的安全、有效和可行的方法,并有助于PTCA后再狭窄的防治.     

The role of carbon dioxide and atmospheric air in double-contrast barium enema

Background Patient discomfort 0–24 h after double-contrast barium enema (DCBE) was investigated in two ways.Methods In part 1, 139 patients, not previously informed, were contacted by telephone to assess symptom rates without bias. In part 2, designed as a prospective randomized double-blind trial, the effect of carbon dioxide (CO₂) as an insufflating gas was compared with conventional atmospheric air (AA).Results Part 1: 10% experienced severe abdominal pain, and 18% severe abdominal distention. Part 2: Low discomfort rates were found for both severe pain (7% for AA vs. 2% for CO₂) and severe distention (13% for AA vs. 8% for CO₂); the differences were not significant. In both parts of the study, female patients with a history of abdominal discomfort of colon irritabile type were significantly overrepresented in the severely symptomatic groups. Equal numbers of patients experiencing severe abdominal distention for the first time were found in both the AA and CO₂ groups, ruling out AA as the sole cause of these symptoms.Conclusion Abdominal post-DCBE discomfort seems to be less frequent than previously reported and is not effectively eliminated by CO₂. We still find the use of AA in DCBEs justified.     

原裂孔气液交换联合C_3F_8气体眼内填充在玻璃体视网膜手术中的应用

目的：评价视网膜玻璃体手术中利用原裂孔气液交换联合C3F8气体眼内填充治疗复杂性视网膜脱离的效果。方法：对51例（51眼）复杂性视网膜脱离患者采用环扎加压术加玻璃体切除术、利用原裂扎进行气液体交换（Fluid-Airexchange简称FA）后眼内填充C3F8气体,其中22例（22眼）行完全FA术,29例（29眼）行不全FA术。结果：观察术中并发症及术后1周眼内气量、眼压及视网膜复位情况,全FA组与不全FA组比较术后第1天眼内气体充满及始终未充满病例有明显差异（P＜0．05）,其余情况均无明显差异（P＞0．05）。结论：利用原裂孔进行气液交换,并采用不同剂量C3F8眼内填充是一种较为简单可行的手术方法。     

极谱配合物吸附波测定人发中硼

目的：探讨在ｐＨ４．４乙酸－乙酸钠－ＥＤＴＡ－铍试剂Ⅲ底液中用极谱配合物吸附波测定人发中硼。方法：极谱法。结果：线性范围为３．７×１０－７ｍｏｌ／Ｌ～１．８×１０－５ｍｏｌ／Ｌ,变异系数为５．５％～７．４％,样品加标回收率为９２．８％～９８．０％。结论：本法简便快速,灵敏度高,选择性好。     

An angiographically occult arteriovenous malformation in the medial parietal lobe presenting as seizures of medial temporal lobe origin

We present an unusual case of a patient who was diagnosed with temporal lobe epilepsy and whose seizures were reduced markedly after excision of an angiographically occult arteriovenous malformation (AVM) located in the left medial parietal lobe. A 38-year-old man had complex partial seizures characterized by motionless staring with oroalimentary and behavioral automatisms since the age of 15 years. Magnetic resonance imaging (MRI) demonstrated a small lesion extending from the left posterior cingulate gyrus to the precuneus. There was no MRI evidence of mesial temporal sclerosis. Intracranial EEG recordings showed ictal onset from the left medial parietal lobe propagating to the medial temporal lobes. Clinical signs appeared when these discharges reached the temporal lobes. After excision of the lesion (which was histologically confirmed as an AVM), together with the marginal cortex, seizures were reduced significantly. Careful diagnostic evaluation of lesions such as the this one may reveal an epileptogenic lesion (zone) far from the region where scalp ictal discharges seem to arise. In our case, we hypothesize that false localization was due to propagation of ictal discharges from the parietal focus through the limbic system.