中西医结合要为妇女生殖健康创新页

45年来,复旦大学妇产科医院在中西医结合临床及科研方面取得了可喜的成就.针刺促排卵的研究,通过观察血雌激素和中枢β-内啡肽(β-EP)的关系,提出了针刺通过耗竭中枢β-EP而促排卵的新认识,认为针刺促排卵的主要适应症是青春期月经失调,并将针刺成功地应用于治疗神经性厌食;补肾化痰的俞氏温补方治疗多囊卵巢综合征(polycystic ovary syndrome, PCOS)被证实是通过提高血促卵泡激素(follicle stimulating hormone, FSH)并诱发排卵而起作用;益肾化瘀的天癸方是通过降低患者及动物模型的雄激素和胰岛素,引起以中枢阿片促黑激素皮质素原、神经肽Y和瘦素受体为主的神经-内分泌-代谢网络调节而发挥促排卵和减肥作用,对高胰岛素型PCOS有良效,并在研究中提出了对PCOS分类的新设想;益肾清火的更年春通过提高中枢与周围组织的雌激素受体及其mRNA表达来调节围绝经期妇女的神经-内分泌-免疫-代谢网络而获优越疗效.这些研究表明,疾病是外环境影响下患者生命网络的某些主脉失调所致,而且亚健康状态的妇女具有初步网络失控的现象,中西医结合将为女性生殖医学研究找到捷径,调控生命网络是防病治病的主要思路.     

凝血酶大鼠脑内注射对核因子-κB活性及细胞间黏附因子-1 mRNA表达的影响

目的 探讨凝血酶（TM）大鼠脑内注射对核因子-κB（NF-κB）活性、细胞间黏附分子．1（ICAM．1）tuRNA表达及白细胞浸润的影响及其可能机制。方法TM、TM＋组织蛋白酶G（CATG）、TM＋N．乙酰半胱氨酸fNAC）脑内立体定向注射制作动物模型，在不同的时间点处死动物，应用EMSA技术检测NF-κB活性，RT—PCR技术检测ICAM-1 mRNA表达．测定髓过氧化物酶（MPO）活性来检测中性粒白细胞的浸润情况。结果TM脑内注射后6hNF-κB活性开始增加（P〈0．05），24h时达高峰（P〈0．01），然后逐渐下降。TM脑内注射后24h ICAM-1 mRNA表达开始增加（P〈0．01），48h达高峰（P〈0．01），然后逐渐下降。MPO活性动态变化趋势与ICAM-1 mRNA相似。TM＋NAC组ICAM-1 mRNA及MPO活性与对照组比较差异均无显著性（P〉0．05）。TM＋CATG组NF-κB活性、ICAM-1 mRNA表达及MPO活性与对照组比较差异均无显著性（P〉0．05）。结论 TM通过蛋白酶激活受体-1（PAR-1）激活NF-κB，诱导ICAM-1 mRNA表达．促进白细胞浸润。     

小鼠匹鲁卡品致后海马活化素A、抑制素A蛋白及活化素ⅡA受体mRNA的差异表达

目的 :观察癫持续状态 (SE)后小鼠海马活化素A、抑制素A蛋白及活化素ⅡA受体mRNA表达的变化。方法 :采用匹鲁卡品诱导的SE小鼠模型 ,分别应用Westernblot与RT PCR观察SE后活化素A与抑制素A蛋白及活化素ⅡA受体mRNA表达的动态变化。结果 :①活化素A蛋白于SE后 3h开始增高 ,6h显著增高 ,2 4h至高峰 ,48h仍维持在较高水平 ;而未成SE的小鼠活化素A表达无明显变化。②抑制素A蛋白SE后无明显增加 ,同正常小鼠及未成SE的小鼠比较无显著差异。③活化素ⅡA受体mRNA在SE后表达无明显变化。结论 :SE后海马活化素A、抑制素A蛋白及活化素ⅡA受体mRNA表达存在差异性 ;活化素A可能对性脑损伤的保护与修复具有重要作用。     

侗药复方四血汤治疗骨质增生症38例

1一般资料38例均为男性患者,年龄最大66岁,最小55岁,平均年龄60.5岁;病程最长2年,最短5个月;病情分类:颈椎骨质增生1例,腰椎骨质增生37例。诊断方法:局部疼痛,活动受限,经X光片确诊。2治疗方法血七、大血藤、小血藤各15g、飞龙掌血10g、走马胎20g、九牛藤20g、刺五甲10g、蜈蚣草10g、马蹄风15g配猪脚炖服,喝汤食肉,每剂分3次服,连服5剂为1疗程。3疗效判断及治疗结果显效:自觉症状消失,活动自如,X片复查正常6例,占15.7%。好转:自觉症状减轻,活动稍受限,未摄片复查者28例,占73.7%。无变化:自觉症状无缓解,活动仍受限,未复查4例,占10.6%。总有…     

4-Aminopyridine induces the release of neuropeptide Y (NPY) to produce an atropine- and tetrodotoxin-resistant contraction in rabbit isolated jejunum

4-Aminopyridine (4-AP) induced an atropine- and tetrodotoxin (TTX)-insensitive contraction (resistant contraction), in a concentration-dependent manner, in the isolated jejunum of rabbits. The failure of specific antagonists of histamine, serotonin and substance P to affect this resistant contraction ruled out the participation of histamine, serotonin and/or substance P. Antiserum against neuropeptide Y (NPY) reduced this resistant contraction in a concentration-dependent manner and inhibited the action of 4-AP totally at a high concentration (1.25% dilution) whereas normal serum lacked this ability. This suggested that the release of NPY was involved in this 4-AP-induced resistant contraction. Radioimmunoassay of NPY-like immunoreactivity in isolated synaptosomal preparations indicated that 4-AP possessed the ability to induce the release of NPY. However, guanethidine did not affect the actions of 4-AP, indicating that NPY is released mainly from non-adrenergic nerves. Our results indicate that 4-AP induces the release of NPY from non-adrenergic nerves to produce an atropine- and TTX-resistant contraction in the isolated jejunum of rabbits.     

Monokines produced by macrophages stimulate the growth of osteoblasts

We have previously reported that the J774A.1 macrophage-like tumor cell line produces two potent monokines which stimulate the growth of osteoblasts and chondrocytes. These growth factors, which have an affinity for heparin-agarose, have been termed HEP I (a 30 Kd PDGF-like molecule) and HEP II (an approximately 20 Kd molecule), respectively, based on their elution profile. Unlike HEP I, HEP II does not stimulate the growth of fibroblasts. Extensive biological and chromatographic studies disclosed that HEP II appears to be a unique bone cell mitogen unlike any known growth factor, including the FGFs, IL-1s, and TNFs, EGF, IGF-I and -II, TGF-beta, beta 2 microglobulin, G-CSF, CSF-1 and GM-CSF. To characterize more fully the effects of the macrophage-derived monokines on osteoblast growth and function, clones were derived from calvaria explant cultures. Two clones, SDFRC-2.05 and SDFRC-3, were developed and found to exhibit osteoblastic characteristics, including high levels of alkaline phosphatase, synthesis of type I but not type III collagen, and an increased intracellular cAMP production in response to PTH. The SDFRC-3 cells exhibited a polygonal morphology like that of the explant-derived cells while SDFRC-2.05 cells exhibited a more fibroblastic morphology. When tested on the explant cultures and clones, HEP I and HEP II were found to stimulate DNA synthesis and increase protein per culture, but decreased alkaline phosphatase activity. Clone SDFRC-3 was found to be more responsive to HEP II than clone SDFRC-2.05. Both monokines were found to be more potent mitogens for bone cells than TGF-beta. HEP II, but not HEP I or TGF-beta, induced a transformation of bone cells from a polygonal to a fibroblastic morphology, suggesting the induction of migration prior to proliferation. Thus, macrophages may be responsible not only for bone repair but also for ensuring the linkage of bone formation to resorption during physiological remodeling.     

人工心肺机血液泵监测系统的研制

为避免人工心肺机血液泵转速失控现像的发生，特研制人工心肺机监测系统，通过对血泵转速的实时监测，判断系统是否正常，自动进行相应的处理，提高现有系统的安全性。     

病案质量问题与改进

病案作为记录医疗活动过程的重要载体,包含着各类丰富的信息。医疗服务质量评价有很多内容是通过病案实现的。作者分析了包括"三级医师查房"在内的20余项在病案中反映的医疗服务质量项目,指出影响质量判断的常见因素,并提出解决的对策与措施。