误诊为肉瘤的结节性筋膜炎之临床病理研究

目的：探讨结节性筋膜炎被误诊为肉瘤的原因,方法观察７４例被误诊为肉瘤的结节性筋膜炎临床病理及免疫组化特点,其中对６２例采用ＡＢＣ、ＬＳＡＢ法行免疫组化染色。结果７４例病人临床表现均为良性经过,但镜下组织学极似肉瘤形态,６８例获随访,结果均存活,复发率不足１％,６２例做了免疫组织化学染色,梭形细胞Ｖｉｍｅｎｔｉｎ阳性,ＭＳＡ,ＳＭＡ和ＫＰ１部分病例阳性,Ｋｅｒａｔｉｎ、Ｓ－１００、Ｄｅｓｉｍｉｎ均为     

疝环充填式无张力疝修补40例的疗效观察

目的 观察聚丙烯锥形网塞、网片为疝修补材料行疝修补术的效果。方法 作疝环充填式无张力疝修补４０例,其中单侧斜疝２９例,单侧直疝６例,膀胱滑动疝１例,骑跨疝１例,双侧斜疝２例,双侧直疝１便。４０例中１１例首次复发、１例第４次复发。手术采用美国巴德公司提供的聚丙烯锥形网塞、网片作修补材料。结果 患者伤口均一期愈合,４０一部得到随访,随访时间１￣１５个月,无１例复发,均恢复下沉工作与生活结论 近期疗效满     

内皮素致心律失常作用的电生理特性

目的 :探讨内皮素 1在豚鼠乳头肌诱发异常电活动的特征及其离子机制。方法 :用常规微电极技术引导并记录心肌细胞内电活动 ,分析其各参数。结果 :ET 1浓度依赖地延长乳头肌细胞的APD ,并在低Mg2 + 灌流的条件下诱发EADs。ET 1所诱发EADs的幅度、触发发放时程TBD具有明显的浓度依赖性和刺激周长依赖性。ETA 受体拮抗剂BQ 12 3和Ca2 + 通道阻断剂硝苯吡啶可消除ET 1的上述作用。结论 :ET 1通过ETA 受体激活Ca2 + 通道 ,导致细胞内Ca2 + 超载进而诱发EADs。由于EADs的出现 ,致使心肌细胞复极化异常 ,可能是ET 1致心律失常作用的电生理基础。     

不同浓度乙醇灌流液对蟾蜍离体心脏活动影响的比较分析

用不同浓度乙醇灌流液灌流蟾蜍离体心脏,观察其对离体心脏心率、心肌收缩力和心输出量的变化。结果显示：心率减慢,但在１０ ｍ ｍｏｌ／Ｌ 稍有加快（ Ｐ ＞ ０ ．０５） ,浓度在２０ ｍ ｍ ｏｌ／Ｌ 以上时减慢才明显（ Ｐ ＜ ０ ．０５） ;心肌收缩幅度下降,其表现浓度越大下降越明显（ Ｐ ＜ ０ ．０５ ～０ ．０１） ;心输出量在１０ ｍ ｍｏｌ／Ｌ、１５ ｍ ｍｏｌ／Ｌ 时略有增加,超过３０ ｍ ｍｏｌ／Ｌ 以后心输出量下降,但不明显（ Ｐ ＞ ０ ．０５） 。表明乙醇过量有减慢心率和抑制心肌收缩力的作用,而对输出量影响不大。     

THE OPERATIVE TREATMENT OF SPINAL FRACTURE-DISLOCATION WITHOUT NEUROLOGIC DEFICITS

Objective. To evaluate the results of operative treatment of spinal fracture-dislocation without neumlogic deficits. Metods. Eighteen patients with spinal fracture-dislocation were neurologically intact at the time of injury, and all were treated operatively. The fracture sites were:8 cases in cervical spine, 3 cases in thoracic spine, and 7 cases in lumbar spine. Eight patients with cervical injuries had variant degrees of forward slide and kyphotic deformity. Of the 10 thoracic and lumbar fractures, one had lateral dislocation, 4 cases with kyphotic deformities, 5 cases withspinal canal compromise averaged 50% (ranging from 40% to 70% ).Results. The aveiage period of follow-up was 4.4 years with a range of 11 months to 13 years. All the patients returned to full-time work. No patient developed neurologic deterioration. Kyphotic deformity was corrected in the 4 cases, and no progressive kyphosis was noted. There was no operation-related complication. The averaged post-opera-five hospitalization time was 13 days. Conclusions. Despite the rare incidence of spinal fracture-dislocation without neurologic deficits, we suggested that kind of fracture be considered unstable fracture because of its potential risk of delayed neurologic deterioration and kyphotic deformity, and be treated operatively to restore the sagittal alignment and the stability of the spine.     

INHIBITORY EFFECT OF FLUVASTATIN ON AORTIC INTIMAL THICKENING IN NORMOCHOLESTEROLEMIC RABBITS

Objective, The anti-atherosclerotic effect of fluvastatin at doses insufficient to lower serum cholesterol on the catheter-induced intimal thickening and possible mechanism were investigated in abdominal aorta of rabbits. Methods. Fifty-six rabbits were randomly divided into eight groups( n = 7, each). Fluvastatin was given mixed with food at daily dose of 8mg/kg starting 5 days before catheterization. Light microscope, immanohistochemistry, transmis-sion electron microscope and RT-PCR assay were applied to assess vascular smooth muscle cell (VSMC) proliferation and apoptosis, as well as oncogene expression in vascular wall. Results. At day 10 and day 15 after catheter induced denudation intima/media( I/M) thickness ratio was obviously higher, and also the percentage of PCNA-positive cells and TUNEL-positive cells in media was significantly higher compared with controls. The intimal hyperplasia was mostly composed of α-SM-actin-pesitive cells. In rabbits given flu-vastatin I/M ratio and the percentage of these positive cells significantly decreased compared with those without fluvas-tatin.The overexpression of proto-oncogene H-ras mRNA and decreased expression of anti-oncogene p53 mRNA were found after vascular injury, whereas fluvastatin significantly reduced H-ras mRNA and increased p53 mRNA expres-sion. Conclusion. Proliferation of VSMC in the media and the migration to the intima can be inhibited, and apoptosis of VSMC be induced by short-term use of fluvastatin after balloon catheter denudation, independent of serum lipid change. The underlying mechanism is presumably associated With the influence of fluvastatin on oncogene expression in the injured vascular Wall.     

生命伦理学研究在21世纪医学和社会可持续发展中的作用

简述了生命伦理研究的四个阶段,提出了２１世纪我国生命伦理学研究的重点应是：卫生保健服务的公平性。结合我国现有卫生资源现状,所能提供的卫生服务状况以及人群卫生需求问题,浅析了中国的卫生资源及需求现状,论述了生命伦理学研究在２１世纪医学和社会可持续发展中的作用。     

羊水过少围产儿345例预后及分娩方式探讨

目的：探讨改善羊水过少围产儿预后,降低死亡率的终止妊娠方法。方法：抽取１９８８年３月～１９６６年１月间住院分娩产妇９４７２例,其中羊水过少３４５例,发生率３．６５％。对３４５例羊水过少围产儿预后及分娩方式进行探讨。结果：３４５例羊水过少,经阴分娩１５３例,剖宫产１９２例,剖宫产率为５５．６５％。胎儿窘迫１４３例（４１．２％）,新生儿窒息１８５例（５３．６％）,新生儿死亡１４例（４．１％）。对照组５００例,肥儿窘迫３４例（６．８％）,新生儿窒息３４例（６．８％）,新生儿死亡４例（０．８％）,两组相比羊水过少围产儿发病率显著升高（Ｐ〈０．０５,Ｐ〈０．０１）。结论：羊水过少胎儿窘迫,新生儿窒息及死亡率均高,适时剖宫产能改善围产儿预后。     

肝硬化患者血清丙酮酸激酶活性变化及意义

目的 探讨肝硬化患者血清丙酮酯激酶（ＰＫ）活必级临床意义。方法 应用酶偶联速率法测定９３例肝硬化患者和５３例正常人的血清ＰＫ活性。结果 肝硬化患者血清ＰＫ活性明显降低（Ｐ〈０．００１）,并随肝功能减退而递减,分别与血清白蛋白及镁呈正相关（ｒ＝０．３４６,Ｐ〈０．０１,ｒ＝０．２５２,Ｐ〈０．０５）;伴有腹水者明显低于无伴腹水者（Ｐ〈０．００５）,肝炎后肝硬化明显低于酒精性肝硬化（Ｐ〈０．０１）。结     

谷氨酰胺对大鼠急性坏死性胰腺炎肠道细菌移位的影响

目的 观察谷氨酰胺（ＧＬＮ）对急性坏死性胰腺炎（ＡＮＰ）大鼠肠道细菌称位的影响。方法 将实验大鼠１２０只,随机分成对照组、ＡＮＰ组及ＧＬＮ组,每组各４０只,ＡＮＰ模型采用结扎胰胆管诱发,ＧＬＮ组制作ＡＮＰ后灌入ＧＬＮ,观察３组肠粘膜组织学和ＤＮＡ含量,肠系膜淋巴结,胰腺组织细菌培养及吖啶橙标记菌实验。结果 ＡＮＰ后７２ｈ,肠粘膜出现明显损伤,ＤＮＡ含量下降,肠系膜淋巴结,胰腺组织细菌培养计数明显升