肝癌患者血清12种肿瘤标志物的变化

目的探讨定量测定肝癌患者血清12种肿瘤标志物的临床意义。方法用蛋白芯片技术定量测定42例正常人、46例肝癌、41例肝炎和23例肝硬化患者血清12种肿瘤标志物的变化并对检测效果进行评价。结果42例正常人CA-199(KU/L)、NSE(g/L)、CEA(g/L)、CA-242(KU/L)、Ferritin(g/L)、β-HCG(g/L)、AFP(g/L)、f-PSA(g/L)、PSA(g/L)、CA-125(KU/L)、HGH(g/L)和CA-153(KU/L)的含量分别为12.42±10.62、2.22±1.43、1.28±1.20、5.72±5.73、91.17±79.43、0.64±0.34、2.96±3.93、0.13±0.11、0.61±1.40、5.46±9.65、1.61±2.40、9.83±9.51;46例肝癌患者血清12种肿瘤标志物含量依次为:35.09±39.50、2.83±4.13、2.98±8.72、8.47±23.42、157.50±129.77、0.72±0.72、87.58±63.27、0.15±0.19、0.58±1.88、56.34±102.02、3.63±4.57、15.65±51.09;41例肝炎患者其含量依次为:76.23±96.57、4.12±4.94、2.06±3.92、4.68±6.99、298.76±326.82、1.00±0.74、63.16±91.76、0.11±0.006、0.27±0.94、18.57±36.60、3.63±4.00、6.13±6.86;23例肝硬化患者其含量依次为:49.85±75.60、5.47±14.97、1.71±1.77、12.44±34.55、278.32±326.82、0.70±0.54、52.89±98.28、0.22±0.21、2.24±4.36、111.50±191.99、2.15±0.99、10.51±15.79。该蛋白芯片测定的敏感性为50.0%,特异性为64.2%,阳性预测值为37.7%,阴性预测值为74.7%。结论采用蛋白芯片技术同时测定患者血清多种肿瘤标志物,对普查肿瘤和临床疗效观察有较好应用价值。     

成人正常股骨解剖测量及其在膝关节置换的临床意义

[目的]为膝关节置换准确截骨和获得良好的下肢力线，对中原地区成人股骨干进行相关测量。[方法]（1）选取47根成人正常股骨标本，拍摄正、侧位数码照片，进行定点、划线、测量五角。（2）实体上确定股骨髓内定位杆进针点的位置：[结果]（1）各角度值反映了股骨远端在冠状位和矢状位的解剖形态。（2）进针点与股骨滑车中心水平距离平均为6．21mm，与后交叉韧带止点前缘距离平均为6．70mm。[结论]（1）股骨远端1／3段与股骨近端1／3段向外侧、前侧成角，且前倾角度大于外翻角度。所以股骨远端在决定股骨髓内定位杆的位置时，冠状面上的力线对位和矢状面上的对位均很重要。（2）全膝关节置换术中确定进针点可参考股骨滑车中心和股骨髁后交叉韧带止点的位置。     

肺炎衣原体抗体效价与多发性硬化的相关性探讨

目的 探讨肺炎衣原体（Chlamydia pneumoniae）感染在多发性硬化（MS）发病和进展中的作用和致病机制。方法 选取急性期MS患者31例，缓解期MS患者28例及其他神经系统疾病患者30例，健康对照者30名，应用酶联免疫吸附试验测定患者和对照者血清及脑脊液中肺炎衣原体IgG和IgM抗体水平。结果 急性期MS组、缓解期MS组、其他神经系统疾病组和健康对照组的肺炎衣原体血清IgG分别为48．4％、35．7％、30．0％、23．3％；4组IgM抗体效价分别为12．9％、14．3％、20．0％、10．0％，总体比较差异无统计学意义（P〉0．05）；急性期MS组与其他神经系统疾病组的脑脊液IgG和IgM抗体效价分别为0、6．7％和0、0，差异无统计学意义（P〉0．05）。结论 肺炎衣原体的感染或重复感染与MS发病相关不紧密，可能仅为MS的伴随感染。     

供者表达活化性杀伤细胞免疫球蛋白样受体对造血干细胞移植预后的影响

目的 观察供者表达活化性杀伤细胞免疫球蛋白样受体（aKIR）对受者造血干细胞移植（HSCT）预后的影响。方法 1996年至2001年共行亲缘性人类白细胞抗原（HLA）全相合骨髓移植59例，以序列特异性引物多聚酶链反应法（SSP-PCR）检测供者aKIR的表型。分析供者表达aKIR对受者移植后病毒、细菌和真菌感染及出血、复发、存活情况的影响。结果 供者表达aKIR与受者移植后出血、病毒及细菌感染发生的概率无明显相关性；当供者表达KIR3DS1表型时，发生真菌感染概率增高（X^4．804，P=0．028）。供者表达aKIR对受者HSCT后存活率和白血病复发率均无明显影响。结论 亲缘性HLA全相合HSCT中，供者表达aKIR并不能改善受者的移植效果。     

腔内三维超声检测输尿管下段结石方法探讨

以往均采用经腹超声以充盈的膀胱为透声窗检查下段输尿管结石,经腹超声易受肠道气体、膀胱充盈度、远场声衰减及肥胖者的脂肪散射等影响,多不能获得满意的图像。本研究采用经直肠(阴道)三维成像(TVS-3D、TRS-3D)技术检测下段输尿管,期望利用腔内超声与三维成像的优势,提高下段输尿管结石的诊断符合率。1材料与方法使用美国GE公司Voluson 730型彩色超声诊断仪,腔内探头频率4~9MHz。受检者先经腹部超声(TAS)检查,排尿后采用经阴道(直肠)超声及合并使用三维超声。腔内探头图1 TAS见左输尿管下段扩张,内可见一个大小约10mm×5mm的结石,…     

某地13所医院1997-2001年门诊费用的基本分析与评价

采用回顾性调查分析方法,对某地13所医院1997-2001年门诊费用变动情况进行分析。统计学处理结果提示样本医院5年来门诊费用平均发展速度和平均增长速度加快明显。作者对此提出借鉴国外教训、避免浪费的建议,以应对医疗费飞涨给全局工作带来的各种冲击。     

Expression of CⅡTA Gene in Five Human Malignant Hematological Cell Lines and Its Significance

The role of MHC class Ⅱ transactivator (CⅡTA) in constitutive or IFN-γ inducib|e expression of HLA molecules in human malignant hematological cell lines was investigated. The expression of HLA molecules and CⅡTA protein was detected by Western blot, immunohistochemistry and flow cytometry. The expression of CⅡTA gene was determined by RT-PCR. The capability of peripheral blood T cell reaction stimulated by tumor cells was monitored by mixed lymphocyte reaction. It was found that the HLA Ⅱ-positive tumor cells expressed the CⅡTA quite well, andthe expression of HLA Ⅰ＋Ⅱ was increased in the tumor cells with constitutive or inducible expression of CⅡTA after induced by IFN-γ. The tumor cells which did not express CⅡTA after in-duced by IFN-γ were not response to the expression of HLA Ⅱ promoted by IFN-γ. It suggests a correlation between the inability of some malignant hematological cell lines in response to IFN-γ for HLA expression and the deficiency in the inducible expression of CⅡTA, indicating CⅡTA might take part in the regu|ation of HLA Ⅰ＋Ⅱ expression in the tumor cells, which might p|ay an important role in tumor immunologic escape.     

158例白血病分型分析

目的通过回顾性调查,探讨北海市白血病发病情况. 方法按FAB白血病诊断与分型标准.结果从18年在该院就诊和住院的患者6306435人次中,初发并确诊的各类白血病158例,发病率2.5/105与1988年全国调查的各类白血病发病率2.62/105相近;各类白血病的构成比、性别、年龄以及各类白血病亚型分布等结果分析与全国、上海市等区域的调查分析结果也很近似.结论该文样本量很大,可基本反映北海市白血病发病率的概况.     

The upregulation of glial glutamate transporter-1 participates in the induction of brain ischemic tolerance in rats.

Glial glutamate transporter-1 (GLT-1) plays an essential role in removing glutamate from the extracellular space and maintaining the glutamate below neurotoxic level in the brain. To explore whether GLT-1 plays a role in the acquisition of brain ischemic tolerance (BIT) induced by cerebral ischemic preconditioning (CIP), the present study was undertaken to observe in vivo changes in the expression of GLT-1 and glial fibrillary acidic protein (GFAP) in the CA1 hippocampus during the induction of BIT, and the effect of dihydrokainate (DHK), an inhibitor of GLT-1, on the acquisition of BIT in rats. Immunohistochemistry for GFAP showed that the processes of astrocytes were prolonged after a CIP 2 days before the lethal ischemic insult, which could protect pyramidal neurons in the CA1 hippocampus against delayed neuronal death induced normally by lethal ischemic insult. The prolonged processes extended into the area between the pyramidal neurons and tightly surrounded them. These changes made the pyramidal layer look like a 'shape grid'. Simultaneously, the prolonged and extended processes showed a great deal of GLT-1. Western blotting analysis showed significant upregulation of GLT-1 expression after the CIP, especially when it was administered 2 days before the subsequent lethal ischemic insult. Neuropathological evaluation by thionin staining showed that DHK dose-dependently blocked the protective role of CIP against delayed neuronal death induced normally by lethal brain ischemia. It might be concluded that the surrounding of pyramidal neurons by astrocytes and upregulation of GLT-1 induced by CIP played an important role in the acquisition of the BIT induced by CIP.     

结节性硬化症的磁共振影像学表现

目的　分析结节性硬化症TSC的MRI表现。方法　 13例经临床证实的TSC病例 ,分析其头部MRI特征性改变。结果　MRI主要征象包括 :①室管膜下结节 :13例均发现病灶 ,T1WI发现 71个 ,T2 WI 39个 ,PDWI 5 6个 ;②皮层及皮层下结节 :11例有阳性发现 ,T2 WI和PDWI各发现 114个病灶 ,T1WI 72个 ;③脑白质异常信号 :5例发现白质病变 ,T2 WI和PDWI各发现 10个病灶 ,T1WI无明确显示 ;④室管膜下巨细胞星形细胞瘤 :仅 1例发现。结论　MRI对TSC的中枢神经系统改变敏感 ,是诊断此病的首选影像学检查方法 ,其中T1WI观察室管膜下结节敏感 ,T2 WI和PDWI观察皮层下及白质病变敏感