药物代谢中的药酶特性与临床研究近况

目的:为了促进药物代谢酶在临床上的深入研究。方法:以近几年国内外大量有代表性的论文为依据进行分析、归纳、整理。结果:药物代谢酶大多具有遗传多态性,其活性受相关药物影响,遗传多态性和药物之间代谢性相互作用是临床药物反应千变万化的重要因素。结论:药物代谢酶的认识和研究有助于临床合理用药和减少药物不良反应。     

糖皮质激素诱导试验与儿童急性淋巴细胞性白血病预后的关系

目的　通过糖皮质激素早期诱导试验评估儿童急性淋巴细胞性白血病的预后。方法　诱导试验是根据初发病时外周血幼稚细胞计数及服用糖皮质激素 (GC) 7d后外周血中幼稚细胞的动态变化。此后 ,所有病例都接受同样强烈的化疗方案。结果　 6 0例患儿中对泼尼松诱导试验敏感 (PGR)者为 4 9例 ,占 81 7% ,其中高危患儿 6例 ,中危患儿 8例 ,低危患儿 35例。在 4 9例PGR患儿中 38例 (77 6 % )处于持续缓解状态 (CCR) ,中位缓解期为 2 2 5个月 ;复发 3例 ,占 6 1%。 6 0例患儿中对泼尼松诱导试验不敏感 (PPR)者为 11例 ,占 18 3%。在PPR 11例中 ,5例早期复发 ,占 4 5 5 % ;2例达CCR ,占 18 2 %。从治疗第 19天、第 30天的骨髓检查 ,PPR组 19dM1、M2 、M3分别为 72 7%、18 1%、9 2 % ;PGR组 19dM1、M2 分别为 96 %、4 % ,无一例为M3 。达CR时间 ,PPR组明显迟于PGR组。结论　GC在用于治疗恶性淋巴细胞增生性疾病中 ,起到了重要作用。     

Misoprostol vs. oxytocin for induction of labor at term.

Efficacy of misoprostol was studied for induction of labor at term. Seventy patients were randomized to Group A (n = 36, oral misoprostol 50 microg four hourly to maximum of 5 doses) and B (n = 34, continuous oxytocin infusion). Induction-delivery interval was shorter with misoprostol (7.7 +/- 2.8 h against 14.3 +/- 4.8 h with oxytocin) but the rates of vaginal delivery, cesarean, neonatal outcome variables were similar. Hence, misoprostol is an effective agent for induction of labor at term.     

Effects of ovulation induction on ovarian morphology: an animal study

OBJECTIVE: The aim of this study was to investigate whether the ovulation induction has relation with postneoplastic lesions. MATERIALS AND METHODS: Seventy-eight female, 90-day-old rats were enrolled for the trial. They were divided into three groups. In the first group, 13 rats received one cycle of ovulation induction with Follitropin Beta and human chorionic gonadotropin. The second group of 13 rats received three cycles of ovulation induction, and the third study group consisted of 13 rats which received six cycles of ovulation induction. Each group had a control group consisting of same number of rats that had not received ovulation induction. At the 12th month after the ovulation induction protocols ended, rat ovaries were extirpated for histopathological examination. In histopathological examination, malignant lesions, ovarian cyst and cyst diameter, epithelial stratification, epithelial tufting, mitotic index, polymorphism of epithelial cells and nucleus, epithelial cell nuclear diameter, chromatin density nuclear atypia, and mitotic activity in ovarian cyst epithelium were evaluated. RESULTS: No malignant ovarian lesion was found in the three groups. Ovarian cyst development was most frequent in the rats that underwent six cycles of ovulation induction. Epithelial stratification and tufting were most frequent in the rats which underwent ovulation induction six times. Significant difference was found between induction and control groups in second and third groups for cellular and nuclear polymorphism, presence of nucleolus, and nuclear chromatin density. CONCLUSIONS: Although development of malignant lesion were not found in any of the rat ovaries after ovulation induction, increase in the prevalence of epithelial dysplasia especially with increase in the number of induction cycles shows that some ovarian pathologies can occur subsequent to ovulation induction.     

人骨髓基质干细胞在不同诱导环境下向软骨细胞的分化

目的：探索重组人骨形态发生蛋白-2（rhBMP-2）诱导建系的人骨髓基质干细胞（hBMSC，专利名缩写为MSCxj）生成软骨的可行性、最佳剂量及适宜的诱导环境。方法：rhBMP-2分为六组：空白组、100ng／ml组、200ng／ml组、400ng／ml组、600ng／ml组和800ng／ml组。血清浓度分为三组：无血清组、2％血清组和5％血清组。根据rhBMP~和血清不同浓度间的组合，设计18种诱导模式。一部分Mscxj制成微球，模拟三维模式进行细胞爬片培养，另一部分MSCxj直接用96孔板培养，10d后，检测MSCxj的数量、总蛋白生成量和碱性磷酸酶生成量，并行甲苯胺蓝染色及Ⅱ型胶原mRNA检测，利用MPS60病理图像软件分析各组Ⅱ型胶原mRNA染色后的灰度，比较各组Ⅱ型胶原mRNA的生成量。结果：血清浓度越高细胞生成的数量越多，细胞合成的总蛋白无显著差异，rhBMP-2对细胞数量和总蛋白的合成无明显影响。2％的血清浓度比其他血清浓度更利于软骨生成。在该血清浓度下rhBMP-2为400ng／ml时，细胞特异性基质Ⅱ型胶原生成最多（F=19．56，P〈0．05）。结论：rhBMP-2能诱导Mscxi生成软骨，在血清浓度为2％、自身浓度为400ng／ml水平下诱导Mscxj生成软骨能力最强。     

Laparoscopic ovarian drilling for women with anovulatory polycystic ovarian syndrome: a district general hospital experience

This is a retrospective study involving 100 anovulatory women with polycystic ovarian syndrome (PCOS) who had laparoscopic ovarian drilling (LOD) between January 1995 and May 2002 at the Royal Berkshire Hospital, Reading, a large district general hospital (DGH). The aim was to evaluate the efficacy of LOD in the treatment of women with anovulatory PCOS in a DGH setting. We also looked at the factors predicting the clinical outcome to be able to counsel the patients pre-operatively. The study showed that the spontaneous pregnancy rate after LOD was 32.46%. A further 28.5% conceived after induction of ovulation with clomiphene citrate (CC) or purified follicular stimulating hormone (Metrodin HP), with a cumulative pregnancy rate of 74%. We did not find a significant difference in the luteinising hormone to follicular stimulating hormone (LH:FSH) ratio of greater than 2.5, LH level of greater than 10 IU/l, body mass index (BMI), age or duration of infertility between the group of women who conceived and those who failed to conceive, in response to LOD.     

Safety of vaginal birth after cesarean delivery.

OBJECTIVE: To compare the outcomes of labor induction in women with a history of 1 cesarean section (CS) who undergo trial of labor. METHODS: A prospective observational study of 702 pregnant women who had 1 previous CS was conducted at Women's Hospital, Hamad Medical Corporation, Doha, Qatar, between April 2003 and April 2004. Those with no history of vaginal delivery were assigned to one group and those with a history of vaginal delivery were assigned to another group, and the latter group was then divided into 2 subgroups according to the results of trial of labor. RESULTS: Of these 702 women with a history of 1 CS, 62.4% also had a history of vaginal delivery. After trial of labor, vaginal delivery occurred more often among women with no history of vaginal delivery (64.8%). Moreover, trial of labor resulted in a vaginal delivery more often in women who were delivered only once and by CS (87.7%) than in women who also had a history of vaginal delivery (79.2%). CONCLUSION: These findings indicate that women who have had a CS should strongly consider natural delivery for subsequent pregnancies.     

MyoD基因诱导大鼠心脏成纤维细胞分化为成肌细胞的实验研究

目的：探讨MyoD基因诱导大鼠心脏成纤维细胞分化为成肌细胞的可能性。方法：将MyoD基因重组腺病毒载体转染大鼠心脏成纤维细胞，观察转染后大鼠心脏成纤维细胞形态的变化；用RT-PCR和Western blot方法检测MyoD和肌细胞生成素的表达；免疫组化检测骨骼肌肌球蛋白和结蛋白的表达。结果：MyoD基因转染后的大鼠心脏成纤维细胞形态和排列方式发生明显变化；RT-PCR可检测出转染后细胞表达MyoD；Western blot结果表明转染后细胞表达MyoD和肌细胞生成素；免疫组化检测骨骼肌肌球蛋白和结蛋白表达均为阳性。结论：MyoD基因可诱导体外培养的大鼠心脏成纤维细胞分化为成肌细胞，为进一步研究MyoD对心肌损伤的修复作用奠定了基础。     

舌下含服米索前列醇配伍米非司酮在终止早孕中的应用

目的 :探讨舌下含服米索前列醇配伍米非司酮用于早孕流产的可行性、安全性及有效性。方法 :将孕周在 7wk内的孕妇随机分为舌下组、口服组各 12 0例。 2组均经米非司酮预治疗后 ,舌下组含服米索前列醇 2 0 0 μg ,1h后重复 ,总量不超过6 0 0 μg ;口服组单次口服米索前列醇 6 0 0 μg。 结果 :舌下组完全流产率比口服组高 ,清宫率比口服组低 (P均 <0 0 1) ,引 -流时间缩短 (P <0 0 1) ,阴道流血及药物不良反应两者无明显差异。结论 :舌下组终止早孕具有简便、有效 ,引 -流时间短等优点