肢端型系统性硬皮病误诊1例

1　病例报告　女 ,45岁 ,因吞咽困难 16 mo伴发热 15 d,于1999- 0 7- 12入院 .于 16 mo前与人争吵后出现吞咽困难 ,以进食馒头、面条为著 ,剑突下有时出现梗噎感 ,随即呕吐 ,呕出所进食物及粘液 ,情绪波动可诱发症状加重 ,伴食欲减退、返酸 .15 d前无诱因出现不规则发热 ,T38～ 39℃ ,上腹痛加重 ,全身酸困不适 ,乏力、头晕、消瘦 .追问病史 ,患者 5 a前双手、足疼痛麻木 ,尤以受凉、精神刺激后明显 ,手指初发白 ,继而发紫 ,变红 ,且麻木疼痛加重 ,手足小关节渐僵硬、畸形 .曾到多家医院就诊 ,诊断 :“雷诺病、类风湿性关节炎”.2 a前出现…     

补阳还五汤对TNFa诱导血管内皮细胞释放vWF及表达组织？…

OBJECTIVE: To study the effects of Buyang huanwu decoction (BHD) on the release of von Willebrand factor(vWF) and the expression of tissue factor(TF) activity induced by tumor necrosis factor alpha (TNF alpha) in cultured bovine aortic endothelial cells (BAECs). METHODS: BAECs from neonatal cox were cultured and 4-8 passages were used. Cells were incubated for 8 hours after addition of different treatments. The supernatant was used to measure vWF and BAECs lysate to determine TF activity. RESULTS: 1. Compared with the control, TNF alpha enhanced the expression of TF activity(12.79 +/- 2.59 vs. 4.69 +/- 0.83, P < 0.01) and the effects were in dose-dependent manner(r = 0.9712, P < 0.01); BHD inhibited the effects of TNF alpha(P < 0.01). 2. Compared with the control, TNF alpha promoted the release of vWF from endothelial cells (13.28 +/- 4.76 vs. 6.42 +/- 2.84, P < 0.01) and BHD inhibited the effect of TNF alpha(P < 0.01). CONCLUSION: BHD can inhibit the expression of TF and the release of vWF induced by TNF alpha.     

Design of a "minimAl" homeodomain: the N-terminal arm modulates DNA binding affinity and stabilizes homeodomain structure.

This report investigates the sequence specificity requirements for homeodomain structure and DNA binding activity by the design and synthesis of a "minimAl" homeodomain (for minimalist design and alanine scanning mutagenesis) which contains the consensus residues and in which all nonconsensus residues have been replaced with alanine. The murine homeodomain Msx served as the prototype for the minimAl homeodomain, Ala-Msx. We show that Ala-Msx binds to DNA specifically, albeit with lower affinity than Msx. A derivative of the minimAl homeodomain, Ala-Msx(NT), which contains a native rather than an alanine-substituted N-terminal arm, has similar DNA binding affinity as Msx. We show that the native N-terminal arm stabilizes the tertiary structure of the minimAl homeodomain. Although Ala-Msx resembles a molten-globule protein, the structure of Ala-Msx(NT) is similar to Msx. The requirement for an intact N-terminal arm is not unique to the minimAl homeodomain, since the N-terminal arm also promotes high-affinity binding activity and appropriate tertiary structure of Msx. Therefore, the homeodomain "scaffold" consists of consensus residues, which are sufficient for DNA recognition, and nonconsensus residues in the N-terminal arm, which are required for optimal DNA binding affinity and appropriate tertiary structure. MinimAl design provides a powerful strategy to probe homeodomain structure and function. This approach should be of general utility to study the sequence specificity requirements for structure and function of other DNA-binding domains.     

喉大部切除术后喉功能重建

为 ２３ 例喉癌患者行喉大部分切除术,采用下列方法重建喉功能,（１）重建声门关闭功能;（２）重建会厌覆盖功能;（３）保留或重建梨状窝;（４）保护喉上神经和喉返神经;（５）保持宽大的下咽部;（６）切断环咽肌。２３ 例中２１ 例获得随访,术后均能发音,术后２～４ 周拔除鼻饲管,无误吸及呛咳。５ 年生存１１ 例,生存率 ４７８％ 。     

化疗在晚期肺腺癌治疗中的作用

目的：探索晚期肺腺癌患者化疗疗效和对化疗的耐受性,化疗后生活质量变化和生存期。材料与方法：回顾分析1992－11~1995-04,经病理确诊为肺腺癌。按UICC分期为Ⅲb、Ⅳ期,Kamofsky评分≥60,连续完成2程以上的以铂类药物为主的联合化疗方案治疗患者。结果：化疗有效率3．1％,化疗后Kamofskv评分不变者43．8％,升高40．6％。下降≥10分15．6％,Ⅲb期中位生存期13月,Ⅳ期10月。结论：全身状况较好无化疗禁忌证的晚期肺腺癌患者,给予适当的联合化疗可使部分患者病情改善,生活质量提高。     

The effect of Rhodiola capsules on oxygen consumption of myocardium and coronary artery blood flow in dogs]

It has been proved that Rhodiola Capsules can obviously decrease the oxygen consumption of myocardium and oxygen consumption index in anesthetic dogs, decrease the coronary artery resistance, but have no marked effect on the coronary artery blood flow. The Capsules also have the function of decreasing blood presure and slowing heart rate.     

头颈部鳞状细胞癌远处转移的相关因素分析

目的探讨头颈肿瘤远处转移的相关影响因素。方法对532例头颈部原发鳞状细胞癌患者的临床病理资料进行回顾性分析。选择性别、年龄、临床分期、T分级、N分级、原发癌部位、原发癌浸润深度、原发癌病理分级、有无颈淋巴结转移、颈阳性淋巴结数目、颈淋巴结转移累及区域、颈阳性淋巴结破膜情况等临床病理因素，用)(2检验和Logistic回归进行单因素和多因素分析，并用．Kaplan-Meier法对发生远隔部位转移患者进行生存分析。结果在532例头颈部原发鳞状细胞癌患者中，60例(11．3％)发生远处转移。单因素分析显示，临床分期(P=0．0126)、T分级(P=0．0082)、原发癌部位(P=0．0011)、原发癌浸润深度(P=0，0005)、有无颈淋巴结转移(P=0．0057)、颈阳性淋巴结数目(P=0．0149)、颈淋巴结转移累及区域(P=0．0034)、颈阳性淋巴结破膜情况(P=0．0118)与发生远处转移有关。多因素分析结果表明，仅原发癌部位、原发癌浸润深度与发生远处转移明显相关。用Kaplan-Meier法进行生存分析，结果显示60例发生远隔部位转移患者的1年生存率、3年生存率、5年生存率分别为51．7％、13．3％、6．5％。结论原发肿瘤部位和浸润深度是发生远处转移的共同决定性因素。而原发癌临床分期、T分级和有无颈淋巴结转移是头颈鳞癌远处转移的影响因素，但不是导致远处转移的初始和根本因素。喉癌、下咽癌以及原发癌侵犯肌肉、骨或软骨患者易发生远处转移。     

Autoradiographic localization of tachykinin and calcitonin gene-related peptide receptors in adult urinary bladder

PURPOSE: In bladder, sensory afferent nerve fibers contain the "sensory neuropeptides" substance P (SP), neurokinin A (NKA) and calcitonin gene-related peptide (CGRP), which interact with tachykinin NK-1 and NK-2 receptors and CGRP receptors, respectively. The purpose of this study was to examine the autoradiographic distribution of these three receptor types in the human bladder, to determine whether the anatomic location of the receptors was consistent with their known functional roles. MATERIALS AND METHODS: Specimens of urinary bladder from 9 patients (58-74 years) were obtained at cystectomy. Frozen sections of dome were labeled with [125I]-Bolton-Hunter [Sar9,Met(O2)11]-SP (NK-1 receptors), [125I]-[Lys5,Tyr(I2)7,MeLeu9,Nle10]-NKA(4-10) (NK-2 receptors) and [125I]-rat CGRP-I. Binding sites were visualized using emulsion autoradiography. RESULTS: NK-1 receptors were found over the endothelium of arterial blood vessels within the detrusor muscle and lamina propria, and over small vessels in the subepithelium. NK-2 receptors were seen over the detrusor muscle and very sparsely over blood vessels, whereas CGRP receptors were expressed densely over the smooth muscle layer of arteries and arterioles, and weakly over collecting venules. NK-1 and CGRP receptors were not observed over the detrusor muscle. CONCLUSIONS: Although the afferent nerves contain all three peptides, not all cell types express receptors for each peptide. The general distribution of receptors is in good agreement with the location of nerves, and with the known actions of SP and CGRP as vasodilator agents, and of NKA (but not SP or CGRP) in contracting the detrusor muscle.     

酸相关性疾病与幽门螺杆菌感染

酸相关性疾病是指一类与胃酸攻击作用密切相关的上胃肠道疾病,包括器质性疾病和功能性疾病。根据病理生理机制的不同,酸相关性疾病主要分为胃食管反流病(GERD)、消化性溃疡病(PUD)和功能性消化不良(FD)三类。尽管目前对酸相关性疾病的发病机制已有了较深入的了解,但幽门螺杆菌(Hp)与其症状之间的关系仍不明确。现简要介绍幽门螺杆菌(Hp)感染在酸相关性疾病发生机制中的作用。