补钾和保钾药防止棉酚引致的低血钾症的观察

1981～1983年对152例服棉酚志愿者进行临床观察,证实棉酚的主要副作用是低血钾症,棉酚导致低血钾的发病机理尚不清楚。以前的动物和临床研究表明,钾离子丢失是肾性的,在钾盐丰富地区低血钾症少,认为,在服用棉酚时加服钾盐可能防止低血钾。本研究观察服棉酚时加服缓释钾或保钾药(氨苯蝶啶)对棉酚所致低血钾有无防止或减轻作用。     

男用节育药棉酚的临床研究——8806例

男用口服节育药棉酚七年多来经8806例临床试用,其抗生育效果是肯定的。起效量以20毫克每日一次较宜,服75天即可起效,有效率为98.48％。维持量为50毫克每周一次,维持效果为99.07％。服药后的副反应有乏力(12.61％)、消化道反应(4.15％)、性功能改变(5％),这些副反应均在服药早期出现,短期内可自行恢复或服中西药后消失。少数对象出现低血钾肌无力症(0.75％),服用含钾药物可防止其发生或迅速治愈,其发生原因可能系棉酚抑制了肾小管上皮的钠-钾ATP酶活性而导致肾性失钾,但临床观察有很大的地区性差异。停药后生育能力的恢复与服药总剂量、服药时间有关;但也存在个体差异,少数服药时间过长的对象,其精子恢复较慢,有持久性不育的可能。棉酚对子代无致畸影响。     

食用粗制生棉籽油所致男性不育症者生育力自然恢复的流行病学调查

本文对河北邢台产棉区于1969~1971年因食用粗制生棉籽油造成男性不育症患病率最高的两个大队中72名患者,在停止食用生棉油后,生育力自然恢复情况进行了流行病学调查。生育力恢复资料应用了“寿命表”方法,计算生育力自然恢复概率。调查结果表明,棉酚所致的男性不育症,在停用棉油后,生育力还有恢复的可能,其八年的自然恢复概率为31.14%,35岁以下者生育力自然恢复显著。     

去唾液酸糖蛋白受体H1亚单位基因片段的克隆表达及其检测自身免疫性肝炎的价值

Objective To clone and express the human asialoglycoprotein receptor(ASGPR) H1 subunit, purify and identify the immunoreactivity of the recombinant protein, and establish the enzyme linked immunosorbent assay (ELISA) to detect anti-ASGPR antibodies in diagnosis of autoimmune hepatitis. Methods The CRDHI cDNA (435 bp) was subcloned into eukaryotic vector PEGH, and the recombinant protein expression was induced by D (+)-Galactose. The recombinant CRDH1 was purified with Glutathione Sepharose 4B, and its immunoreactivity was identified by SDS-PAGE and western blot as well as MALDI-TOF. ELISA was established to detect the anti-ASGPR antibodies in serum samples of 45 patients with AIH, 30 patients with SLE, 30 patients with RA, 10 patients with SS and 30 normal controls. Results The sequencing of recombinant plasmid showed the CRDH1 gene was successfully inserted to the eukaryotic expression vector with correct sequence and open reading frame. The fusion protein showed a molecular weight of 42 500 Da on SDS-PAGE gel and confirmed to be the human ASGPR by MALDI-MS through peptide mass fingerprint analysis with Mascot in human protein database. It shared 98. 34% homology with ASGPR H1 subunit. Western blot analysis showed that the fusion protein had the same immunoreactivity as human ASGPR. The results of ELISA indicated that the positive rate of anti-ASGPR was 35.6% ( 16/45 ), but the ELISA was negative in other control. There was significant difference of positivity of the autoantibodies between AIH and non-AIH controls (χ2 = 31.85,P < 0. 01 ). Conclusions The human plasmid containing ASGPR is successfully clone into Saccharomyces cerevisiae Y258. The recombinant autoantigen owns good antigenicity and specificity. ELISA established with the purified protein shows good specificity for diagnosis of AIH.     

要以“博”促“专”

对于“又红又专”的“专”应该有正确的理解。现在有些人把“专”理解得很狭窄。认为“专”就是高、精、尖,或者是与其它学问毫不相干的东西,所以就关起门来研究学问,掩耳不听门外事。外科包括的领域很广,有普通外科、胸部外科、泌尿外科、矫形外科、整形外科、神经外科等等。一个青年医师,在刚刚开始做临床工作时,为了培养成为基础较广的医生,他就应该在这些科都轮转工作一段时间,然后才固定在某一个专业;一旦固定了专业,他就开始了“专”的进军。这种培养方法已是多年来沿     

盆腔脏器癌扩大根治术的初步经验

对于盆腔脏器晚期癌瘤,目前仍无满意疗法。采用盆腔脏器癌扩大根治术有一定效果。如果继续改进,手术死亡率和手术后并发症可望继续减低,五年治愈率可能继续有所增高。但是,到目前为止,这种手术的治疗效果仍不能说是满意的(即使手术进行顺利,病人也要因为盆器切除而另外增加一些负担),且病人寿命延长有限,加之这种手术比较复杂,因之这种手术目前仍应在比较严格的控制下进行(严格地选择病人,严格的技术条件)。我们发表这篇文章,是为了提供进一步的研究和改进。本人曾在我市外科学会报告和讨论,现将讨论中的几个发言,摘要附在本文后面,一并供读者参考。     

去唾液酸糖蛋白受体H1亚单位基因片段的克隆表达及其检测自身免疫性肝炎的价值

Objective To clone and express the human asialoglycoprotein receptor(ASGPR) H1 subunit, purify and identify the immunoreactivity of the recombinant protein, and establish the enzyme linked immunosorbent assay (ELISA) to detect anti-ASGPR antibodies in diagnosis of autoimmune hepatitis. Methods The CRDHI cDNA (435 bp) was subcloned into eukaryotic vector PEGH, and the recombinant protein expression was induced by D (+)-Galactose. The recombinant CRDH1 was purified with Glutathione Sepharose 4B, and its immunoreactivity was identified by SDS-PAGE and western blot as well as MALDI-TOF. ELISA was established to detect the anti-ASGPR antibodies in serum samples of 45 patients with AIH, 30 patients with SLE, 30 patients with RA, 10 patients with SS and 30 normal controls. Results The sequencing of recombinant plasmid showed the CRDH1 gene was successfully inserted to the eukaryotic expression vector with correct sequence and open reading frame. The fusion protein showed a molecular weight of 42 500 Da on SDS-PAGE gel and confirmed to be the human ASGPR by MALDI-MS through peptide mass fingerprint analysis with Mascot in human protein database. It shared 98. 34% homology with ASGPR H1 subunit. Western blot analysis showed that the fusion protein had the same immunoreactivity as human ASGPR. The results of ELISA indicated that the positive rate of anti-ASGPR was 35.6% ( 16/45 ), but the ELISA was negative in other control. There was significant difference of positivity of the autoantibodies between AIH and non-AIH controls (χ2 = 31.85,P < 0. 01 ). Conclusions The human plasmid containing ASGPR is successfully clone into Saccharomyces cerevisiae Y258. The recombinant autoantigen owns good antigenicity and specificity. ELISA established with the purified protein shows good specificity for diagnosis of AIH.     

舒芬太尼联合氟比洛芬酯用于膝关节置换术后静脉自控镇痛临床观察

目的 观察舒芬太尼联合氟比洛芬酯用于骨科膝关节置换术后持续静脉镇痛的临床效果.方法 选择骨科单侧膝关节置换手术术后患者72例,随机分为舒芬太尼组(A组)和舒芬太尼加用氟比洛芬酯组(B组).A组:舒芬太尼2.5μg/kg、托烷司琼3 mg加入生理盐水共100 mL;B组:舒芬太尼2.0μg/kg、氟比洛芬酯125 mg、托烷司琼3 mg加入生理盐水共100 mL,行静脉自控镇痛(PCIA)治疗.观察并记录2组术后2 h、4 h、8 h、12 h、24 h、48 h疼痛评分及不良反应情况.结果2组各时间点疼痛VSA评分基本相同,差异无统计学意义(P>0.05);与B组相比,A组不良反应发生率高,镇痛治疗满意率低,差异有统计学意义(P<0.05).结论 氟比洛芬酯联合舒芬太尼用于膝关节置换术后镇痛能减少舒芬太尼用量,安全有效,且副作用较少.     

服棉酚者和其他原因所致的无精症患者血中促性腺激素与甾体激素的变化

本文比较了正常男子(Ⅰ组)、各种无精症患者(包括棉酚服用者。Ⅱ组)、原因不明的无精症者(Ⅲ组)以及Klinefelter 综合征患者(Ⅳ)血浆中FSH、LH、PRL、T、E_2和F 的变化。结果所有无精症患者的平均FSH、LH 水平明显高于Ⅰ组(P<0.001),但PRL、T、E_2及F 的平均值与Ⅰ组无区别(P>0.05)Ⅱ、Ⅲ组患者FSH 水平升高者与正常者各为50%,其余各组明显高于正常。Ⅲ组的LH 及T/LH 比值仍在正常范围内,但T、E_2及F 的平均值升高,PRL 降低;其余各组LH 与FSH 平行升高,T 及T/LH比值明显低于Ⅰ组(P<0.001),但E_2、F 及PRL 则在正常范围内。本实验证实,避孕剂量的棉酚并不损害睾丸合成T 的功能。FSH 过高说明生精上皮损害过度。本文还提出了一些控制棉酚用量的客观指标。     

人类致病病毒属水平基因筛查芯片的制备及其在黄病毒属检测中的初步应用

目的：制备人类致病病毒属水平高通量筛查用基因芯片，并通过检测黄病毒属病毒初步验证其筛查效果。方法：利用Clustal W和BLAST软件设计针对人类致病病毒的属特异性寡核苷酸探针，对探针浓度、杂交温度、杂交时间、不同杂交液及杂交后芯片的洗涤方法进行优化。分别用特异或随机PCR方法从病毒感染的细胞培养上清中扩增病毒核酸，在扩增过程中掺入aa-dUTP并进一步偶联cy5或cy3荧光素进行标记，随后与基因芯片进行杂交，并通过荧光扫描仪对杂交结果进行分析，然后分析检测的特异性和敏感性验证基因芯片的筛查效果。结果：共设计了针对人类医学病毒的1090条寡核苷酸探针及其他阳性、阴性对照探针，其中黄病毒属共46条探针，Tm值为77，67～83．53℃，通过随机或特异PCR扩增8株黄病毒属病毒核酸，在42℃、过夜杂交的条件下，通过基因芯片方法均获得了黄病毒属特异性杂交信号，与其他属病毒之间没有非特异性交叉反应。结论：所制备的基因芯片可用于黄病毒属病毒的快速筛查，本研究为进一步建立大规模病毒性病原体的高通量筛查与鉴定技术平台提供了实验依据。