载脂蛋白E基因多态性与脑梗死的相关性分析

目的　探讨载脂蛋白 E基因多态性与脑梗死的关系。方法　通过聚合酶链反应 -限制性片段长度多态性 (PCR- RFL P)分析结合 DNA直接银染技术检测 6 6例脑梗死 (CI)患者的载脂蛋白 E(Apo E)基因型 (其中家系中有明确脑梗死先证者的家族聚集性脑梗死 (FMACI)亚组 2 6例 ,家系中无脑卒中史的非家族聚集性脑梗死 (NF-MACI)亚组 4 0例 ) ,并与 90例健康对照组比较 ,同时检测血脂、脂蛋白 (a) [L P(a) ]及部分载脂蛋白。结果　脑梗死组ε3/4基因型频率明显高于对照组 (P<0 .0 1) ,ε3/3基因型频率明显低于对照组 (P<0 .0 1) ;两脑梗死亚组之间的ε3/4/ε3/3基因型频率虽有上升 /下降趋势 ,但未发现明显的统计学差异 ;FMACI组高密度脂蛋白 (HDL )水平明显低于 NFMACI组 (P<0 .0 5 )。结论　 Apo E基因多态性与脑梗死的发生有关 ,ε4等位基因是脑梗死的易感因子 ,ε3等位基因对脑梗死的发生有保护作用 ;Apo E基因多态性和 HDL水平双重作用于家族聚集性脑梗死的发生。     

Reduction of adhesion formation in rabbits by intraperitoneal administration of lazaroid formulations

Adhesion formation is a major source of postoperative morbidity and mortality. In this study, the ability of a variety of lazaroid formulations [the antioxidant 21-aminosteroid PNU74006F (tirilazad) and the non-steroidal 2-methylaminochroman derivative PNU83,836E] to reduce i.p. adhesion formation in three rabbit models was examined. In initial studies, PNU83836E was administered via Alzet miniosmotic pump to the site of injury. In the sidewall and double uterine horn models, PNU83,836E was administered via Alzet miniosmotic pump for the entire postoperative interval. In the sidewall model, there was a dose- dependent reduction in the area of the sidewall injury that was involved in adhesions. In the double uterine horn model, PNU83,836E was administered via Alzet miniosmotic pump to the area of injury for 1, 2, 3 or 7 days. Administration for as little as 24 h after surgery significantly reduced the extent of adhesion formation and the reduction was increased if it was administered for longer. Further studies were conducted in which various lazaroid formulations were administered as a bolus at the end of surgery. In both the sidewall and double uterine horn models, administration of either PNU83,386E (in citrate buffer) or PNU74006F (in cyclodextrin or lipid emulsion vehicles) at the end of surgery reduced adhesion formation. Administration of a bolus of PNU74006F 10 min prior to initiation of surgery with or without additional treatment at the end of surgery further increased its efficacy in the reduction of adhesion formation. Administration of a minimum of 1.5 mg before and after surgery (3 mg total) was required for maximal efficacy. These studies demonstrate that pre- and postoperative administration of either a steroidal (PNU74006F) or non-steroidal (PNU83,836E) lazaroid intraperitoneally reduced the formation and reformation of postoperative adhesions in three animal models.      

难治性便秘综合治疗及影响因素的评价

目的评价综合治疗对难治性便秘的疗效及影响因素。方法将84例难治性便秘分为非重叠组和重叠组。应用个体化综合治疗4周,观察便秘症状评分变化及总有效率,分析IC患者的重叠症状和心理障碍状态对疗效的影响。结果(1)84例便秘患者中,重叠组和非重叠组分别占40.5%和59.5%。(2)重叠组和非重叠组的总有效率分别为50.0%和78.0%(P<0.05)。(3)对37例IC患者的心理测试调查显示,59.4%(22/37)有心理障碍状态,重叠组和非重叠组伴有心理障碍状态对治疗的总有效率分别为4.8%和31.5%(P<0.05)。结论适合个体化的综合治疗使多数难治性便秘缓解症状,但伴有重叠症状,尤其心理障碍状态则影响疗效。     

Enzyme activities associated with the demyelinating phase of canine distemper

Summary Canine distemper, a naturally occurring viral disease of dogs which often terminates in parainfectious demyelination, was used as a model to study the role of acid proteinase, neutral proteinase and beta-glucuronidase in demyelination. These enzymes were higher in cerebella of dogs with distemper-associated demyelination than in age-matched controls. The highest elevations corresponded with the most severely demyelinated cerebella. The source of the increased enzymes activities was apparently unrelated to the lymphocytes present in areas of demyelination.The direct effect of distemper virus and serum on these enzymes was tested in canine glial monolayers. Virus infection resulted in lower enzyme activities in cells concomitant with the appearance of cellular lesions. There was a relative increase of beta glucuronidase activity in the media suggesting that distemper virus released pre-formed lysosomal enzymes. Serum which was obtained from dogs with distemper-associated demyelination and had previously demyelinated cerebellar explants, also decreased activities of all 3 enzymesin vitro.The 3 enzymes were measured in gerbil brains at various time intervals following unilateral cerebral infarction to determine if processes other than demyelination also caused these enzymes to be increased. Uncomplicated ischemic necrosis (24 h post infarction) did not alter the activities of these enzymes. Invasion of macrophages to ingest and digest necrotic tissue 10 days after infarction resulted in greatly increased acid proteinase and beta-glucuronidase, but unchanged neutral proteinase, activities.It was concluded that the increased activities of acid proteinase and beta-glucuronidase in demyelinated tissue probably are derived from macrophages ingesting damaged tissue. Neutral proteinase may be more specifically involved in the demyelinating process since this is partially located within myelin and can degrade the basic protein of myelin.Supported in part by Research grant Nos. GM 1052 and Al-09022 from National Institutes of Health Service, U.S. Public Health Service.     

Autologous peripheral blood stem cell transplantation in the patients with hematologic malignancies and solid tumors

Objective To evaluate the long-term therapeutic effects of autologous peripheral blood st em cell transplantation (auto-PBSCT) on the treatment of hematological and soli d tumors. Methods Fifty-one patients were recruited in this auto-PBSCT study, in which several p otentially important parameters were studied including the optimal time for stem cell co llection, the dose of stem cell reinfusion, the time of hematopoietic reconsti tution, the disease free survival (DFS) and overall survival (OS), complication s related to transplantation, and maintenance chemotherapy after auto-PBSCT. Results After APBSCT, 3-year and 5-year survival rates of NHL were 83.3%; those of AM L were 74.7%; those of MM were 37.9% and 19%; those of ALL were 40% and 0% res pectively. Hematopoietic reconstitution was greatly promoted by granulocyte col ony stimulating factor (G-CSF). The mean time for patients’ neutrophil to reco ver up to &gt;0.5×10(9) /L after APBSCT was 11.14 days in the group of the patien ts receiving G-CSF in contrast to 17.6 days in the group receiving no G-CSF. The most common complications of transplantation were fever, liver dysfunction and hypokalaemia, which were curable. No death was due to transplantation related complications.Conclusion Comparing with conventional chemotherapy, our study suggests that auto-PBSCT i s a very important therapeutic option that can significantly improve the prognos is in the patients with hematological and solid tumors, especially in the patien ts with AML and NHL.     

国人无综合征性耳聋患者的线粒体基因组7445A→G突变263例调查

目的 :探讨国人无综合征性耳聋 ( NSD)患者的线粒体 DNA 744 5 A→ G( m t DNA744 5 A→ G)突变的发生情况。方法 :对 32个 NSD家系 12 8例和 135例散发的 NSD患者 ,10 0例正常人 ,以 PCR法检测 mt DNA 744 5 A→ G突变情况。结果 :全部受检者无 mt DNA744 5 A→ G突变发生。结论 :国人 NSD患者的 m t DNA744 5 A→ G突变的发生率较低 ,且明显低于 mt DNA15 5 5 A→ G的突变发生率     

高效液相色谱法测定舒金克喘胶囊中和厚朴酚与厚朴酚的含量

目的：测定舒金克喘胶囊中和厚朴酚与厚朴酚的含量。方法：色谱条件：色谱条件与系统适用性实验：Hypersil ODS2 C18分析柱（150mm 4．6mm，5μm）；流动相：甲醇：水=（78：22），检测波长294nm流速1．0ml／min，室温操作。理论塔板数按厚朴酚计算应不低于3000。结果：和厚朴酚与厚朴酚平均回收率分别为99．62%（RSD=1．34％），98．56％（RSD=1．49%）。结论：方法快速准确，样品处理简便易行。     

外阴白色病变患者用壮阳祛痰法为主治疗结果及与相关因素的临床探讨

目的探讨壮阳祛痰法--消白饮治疗外阴白色病变的结果及对性激素、免疫球蛋白和微量元素的影响.方法对82例外阴白色病变患者经病理检查确诊后,分析病因为肾阳不足,痰湿阻络,阴器失养而致,采用自拟消白饮(由淫羊藿、仙茅、桂枝等药组成),同时分别于治疗前后检测自身血清性激素(FSH、LH、E2、P、T);免疫球蛋白(IgG、IgA、IgM);头发微量元素(Cu、Zn、Fe、Ca、Mg)水平.结果治疗后治愈69例,占85.4%,总有效率100%,治疗后检测FSH、LH、下降,E2、P、T、IgG、IgA、上升,与治疗前比较,有显著性差异(P＜0.05),IgM、微量元素比值与治疗前比较,差异无显著性(P＞0.05).结论壮阳祛痰法对外阴白色病变患者有较好的治疗效果,具有提高E2、P、T水平,增强机体免疫功能的作用.     

医疗纠纷处理经济分析与制度安排

从医患纠纷处理的患方成本入手,对医患纠纷处理进行经济分析,寻找影响患方纠纷处理途径选择的影响因素,并就如何优化医患纠纷处理提出制度安排的方向和原则。