非脱垂子宫经阴道全切除术在肥胖患者中的应用

目的:比较肥胖和非肥胖患者经阴道子宫全切除术的手术结局。方法:因子宫良性病变行子宫全切除者,BM I≥30 kg/m2者为研究组,BM I<30 kg/m2者为对照组。比较两组的出血量、手术时间、排气时间、住院时间、发热率、子宫重量及其他并发症的发生情况。结果:研究组和对照组出血量分别为(184.6±82.7)m l及(179.8±78.2)m l,出血量超过500 m l而需要输血者研究组及对照组分别为4.8%(2例)及4.1%(8例),手术时间分别为(87.4±23.6)m in及(85.9±25.1)m in,排气时间分别为(16.4±3.6)h及(17.1±4.2)h,住院时间分别为(5.7±1.2)天及(5.5±1.1)天,发热率分别为7.1%(3例)及6.1%(12例),子宫重量分别为(261.5±52.8)g及(258.3±48.6)g(P>0.05)。结论:经阴道子宫全切除术可安全应用于肥胖患者。     

尿酶测定用于32例氨基甙类肾毒性早期损害的观察

采用尿N-乙酰氨基-β-D-氨基葡萄糖苷酶(NAG)检测对32例患者进行了用药前、后的连续观察。用庆大霉素前尿NAG的均值为21.98％U/g Cr;用药1d为89.92;用药3d为94.45;经统计学处理,自身配对比较,有显著性差异(用药前后t=3.108,P<0.01),证实NAG是观察庆大霉素早期肾毒性的灵敏指标。     

全身麻醉插管术后院内获得性肺部感染探讨

全身麻醉气管插管术后下呼吸道感染具有较高发生率。分析５２６例手术时间超过４小时普外科病例，经ｕ检验发现全身麻醉气管插管术后患者肺部感染率明显高于持续性硬膜外麻醉术后患者，影响因素主要与全麻插管用具及麻醉机消毒情况有关，也与术前存在慢性阻塞性肺部疾患和术后保留气管插管有关。降低全麻术后肺部感染应重视无菌操作，尽可能对麻醉机管道进行常规消毒。     

上海市外来人员肺结核病分布与临床特征

目的：了解上海市外来人口中肺结核病人的分布和临床特征。方法：对1996年1～12月全市外来人口活动性肺结核病报告登记资料进行分析。结果：外来人员肺结核病人总数达2279人，青壮年占总病例65％以上；男性病例为主；主要来源于江苏、浙江、安徽、四川、江西等省；登记病人来沪暂居地主要集中在市区及城乡地区，外来人口结核病管理重点在市区及城乡地区。病人分型以Ⅲ型为主。查痰率仅60．1％，但排菌率高达40％。外来人。的病例发现工作及治疗管理难度较大，目前登记病例规则化疗仅占10．4％。结论：有必要通过有关部门的共同协作，拟定切实可行的外来人口结核病管理办法。     

Neuropathology in non-human immunodeficiency virus-infected drug addicts: hypoxic brain damage after chronic intravenous drug abuse

Neuropathological studies were carried out on 180 human immunodeficiency virus-seronegative intravenous drug addicts. The findings in victims of acute heroin intoxication (n = 116) were congestion (99.1%), capillary engorgement (68.1%), and/or perivascular bleeding (68.1%) – hemodynamic processes attributable to toxic primary respiratory failure. In a high percentage of these cases (88%), cerebral edema was also present. In 18 cases of acute heroin intoxication who survived for periods of hours or days, the sole postmortem finding was ischemic nerve cell damage, resembling that typically seen in systemic hypoxia. Semiquantitative analysis revealed nerve cell loss in the hippocampal formation and/ or Purkinje cell layer in 26% of the 162 chronic drug abusers. By contrast, in nearly 80% of these cases, the hippocampus showed enhanced expression of glial fibrillary acid protein by astrocytes and/or a proliferation of microglia, demonstrated by CD68 expression. Since such reactive processes are produced by primary neuronal damage, it can be assumed that chronic intravenous drug abuse results in obviously ischemic nerve cell loss. This could be demonstrated in the hippocampus, but it must also occur throughout the whole brain. The demonstration of ischemic nerve cell damage and neuronal loss or secondary reactive alterations has not been described previously. Received: 31 March 1995 / Revised, accepted: 27 November 1995     

Analysis of 8-hydroxydeoxyguanosine 5'-monophosphate (8-OH-dGMP) as a reliable marker of cellular oxidative DNA damage after gamma-irradiation

In order to improve 8-hydroxyguanine (8-OH-Gua) detection in DNA, we digested isolated DNA with nuclease P1 and analyzed for 8-hydroxydeoxyguanosine 5'-monophosphate (8-OH-dGMP) using a high-performance liquid chromatography system equipped with an electrochemical detector (HPLC-ECD). The amount of 8-OH-Gua in the DNA was expressed as the ratio of 8-OH-dGMP to deoxycytidine monophosphate (dCMP). Using this analysis, the background level of 8-OH-Gua in DNA from human lung carcinoma cells (A549) was several-fold lower than that obtained by a previous method. A549 cells were exposed to 20-60 Gy of gamma-radiation and an increase in 8-OH-Gua concentration was observed with increasing gamma-ray dose (0.3 residues per 10(7) dCMP per Gy). Moreover, by an immunohistochemical procedure using a commercial FITC-kit, 8-OH-Gua was clearly detected in A549 cells and the fluorescence intensity of cells with oxidative DNA damage increased with the doses of gamma-irradiation. Using an endonuclease nicking assay, we also found that gamma-rays decreased 8-OH-Gua repair activity. The results indicate that 8-OH-dGMP is a useful and sensitive marker for estimating oxidative damage in DNA.     

Cyclin D1 induced apoptosis maintains the integrity of the G1/S checkpoint following ionizing radiation irradiation

Cell cycle “checkpoints” help to ensure the integrity of normal cellular functions prior to replicative DNA synthesis and/or cell division. Cell kinetic abnormalities, particularly arrests at the G1/S and G2/M cell cycle checkpoints, are induced following exposure to ionizing radiationin vitro. Following irradiation, cellular signaling pathways may lead to G1 arrest and/or apoptosis at the G1/S cell cycle transition point. Transfection of cyclin D1, a G1/S cyclin, into a rat embryo cells (REC) results in cellular populations that overexpress cyclin D1, are transformed morphologically, demonstrate an increased incidence of apoptosis, and are tumorigenic in immune-deficient mice. Despite such phenotypic changes, transfected cell populations maintain the itegrity of the G1 checkpoint following ionizing radiation. The transfected cells overexpressing Cyclin D1 have a statistically significant increase in the incidence of apoptosis as compared to parental REC strains or mock-transfected REC. The work provides further evidence of Cyclin D1 playing a critical role in maintaining the integrity of the G1/S checkpoint, via the activation of apoptotic pathways following exposure to ionizing radiationin vitro.     

咀嚼肌的应用解剖学研究——I.咬肌的动脉与神经

在30具(男23.女7)共60例成人尸体上观察与测量了咬肌的动脉与神经来源、咬肌神经的分支以及肌内构筑、咬肌由上颌动脉咬肌支和邻近动脉肌支供血,面动脉与面横动脉的咬肌支为其主要营养动脉.咬肌神经在肌内可分成单干和双干两型,前者居多,两型中其肌内分支间均有吻合.就结果对有关颌面外科应用问题进行了探讨.     

肝毒清颗粒对大鼠实验性肝纤维化的防治作用

目的 :观察肝毒清颗粒的抗纤维化作用。方法 :将Wistar雄性大鼠随机分成 6组 ,即正常对照组、模型组、肝毒清大、中、小剂量组和乙肝宁阳性组 ,采用四氯化碳诱导肝纤维化模型。于造模第 2个月始给予治疗药物。实验持续 3月后将大鼠处死取血作肝功检查及取肝组织做病理检查。结果 :肝毒清能降低AST ,升高TP、ALB ,与模型组比较 (P <0 .0 5 ) ;减轻肝脂肪变性、减少纤维组织增生、促进肝细胞再生。结论 :肝毒清对大鼠肝纤维化有明显防治作用     

Study on the metastatic mechanisms of human giant-cell lung carcinoma comparison between the strains C and D

The biologic characteristics of the two human giant-cell lung carcinoma strains with high (strain D) and low metastatic potential (strain C) were studied, including karyotype of chromosome, intracellular free calcium ([Ca2+]i), morphologic changes of cell surface and the expression of nm23-H1, p53, ras, c-myc, c-erbB2, bcl-2 genes and PCNA. The correlation between different biologic features and the metastatic potential of the two strains was analyzed. We found: 1) Both strains had the karyotypic abnormality of -13, -14, -15, +20, +21 with seven same marker chromosomes. Only strain D had the karyotypic abnormality of +7, -17, -18, +X, 7p+; 2) [Ca2+]i of the strain C (984.7 +/- 573.8) and D (517.6 +/- 216.6) was significantly different (p < 0.05). The amplitude of intracellular calcium oscillations of strain C was lower than the one of strain D; 3) strain C had more villous-like protrusions on the cell surface, whereas strain D had more bubble-like protrusions; 4) The expression of nm23-H1 and p53 protein of strain C was all higher than that of strain D. The expression of PCNA of strain C was lower than strain D; 5) nm23-H1 mRNA levels of strain C was lower than that of strain D. We consider that the karyotype of chromosomes, intracellular free calcium, the structure of cell membrane and the expression of nm23-H1 gene, p53 gene, PCNA could be closely related to the metastatic potential of human giant-cell lung carcinoma. They could be used as the sign for judging whether the tumor will metastasize in clinical practice as well as in judging the prognoses of patients.