发挥科研优势 促进学科发展

<正> 暨南大学医学院第一附属医院,又名广州华侨医院,经过20年的发展已成为一所集医、教、研为一体的大型三级甲等医院。医院的科研发展始终坚持"以学科建设为基础,人才培养是关键"的科研办院思路,从建院初期以调入人才为主到目前的以人才引进为辅、培养人才为主,20年来培养了一批中青年学术带头人,形成了一批技术力量强大的学科群。从建院初期仅有眼科学、内科学(血液病专业)2个硕士学位授与点发展到现在拥有眼科学、内科学、妇产科学3个博士学位、14个硕士学位授权点,1998年还被国家教委批准为临床医学专业学位授与点的试点单位。在各类学术期刊上发表文章3089篇,主编及参与编写171部专著,承担各级科研课题695项,获国家科技进步奖1项,省部级成果奖25项,厅局级科技进步奖69项,获专利9项。医院在培育科研优势的同时更注意发挥学科优势促进学科的发展。     

联合VEGF-AON和PDGF-TFO对大鼠脑胶质瘤增殖和细胞凋亡的作用效果

目的观察PDGFB链基因的TFO和VEGF的反义寡核苷酸AON对荷瘤大鼠脑胶质瘤增殖和细胞凋亡的影响。方法所有大鼠均在立体定向导引下行右尾状核区微量灌注20μL生理盐水中含1×106C6胶质瘤细胞。在细胞接种后第8天,实验Ⅰ组原位注射含TFO1·0mg的20μL生理盐水,实验Ⅱ和Ⅲ组则分别原位注射含TFO1·0mg AON0·125mg和TFO1·0mg AON0·250mg的20μL生理盐水。以后每隔72h原位注射相同剂量的药物,共注射3次。对照组仅在相同时间原位注射20μL生理盐水。实验3周时处死所有的大鼠,观察肿瘤的生长情况,流式细胞仪观察PDGFB链基因(PDGF-B)、VEGF、PCNA及细胞凋亡的变化。结果实验Ⅰ组的成瘤抑制率为53·1%,实验Ⅱ组为81·4%,实验Ⅲ组为93·1%,三组肿瘤体积比较差异有统计学意义,P<0·01。TFO对胶质瘤细胞PDGF-B、VEGF和PCNA表达有明显的抑制作用;TFO能使胶质瘤细胞凋亡增加。联合应用TFO和AON能更好地抑制PDGF-B、VEGF和PC-NA的表达,使胶质瘤细胞增殖能力进一步降低,细胞凋亡进一步增加。结论联合应用TFO和AON能更有效地抑制肿瘤生长和细胞增殖,促进胶质瘤细胞凋亡。     

不稳定性心绞痛患者血清hs-CRP、TnI、CK-MB的研究

目的探讨不稳定性心绞痛患者血清hs—CRP、TnI、CK—MB变化及测定的临床意义。方法利用乳胶增强免疫比浊法和电化学发光法，对154例健康人群、112例uA患者、68例SA患者检测其血清hs—CRP、TnI和CK—MB的水平。结果UA组hs-CRP、TnI、CK—MB水平明显高于SA组（P〈0．01），更远远高于健康组（P〈O．01），并且sA组此三项检测也明显高于健康组（P〈0．05），UA组和SA组及健康组存在显著差异。结论如果将hs—CRP、TnI、CK—MB联合检测，对冠心病的早期诊断，尤其是对不稳定性心绞痛的早期发现及危险性预测，具有重大的现实意义。     

Clastogenic and aneugenic effects of tamoxifen and some of its analogues in hepatocytes from dosed rats and in human lymphoblastoid cells transfected with human P450 cDNAs (MCL-5 cells)

Tamoxifen and its analogues 4-hydroxytamoxifen, toremifene, 4- hydroxytoremifene, clomifene and droloxifene were tested for clastogenic effects in a human lymphoblastoid cell line (MCL-5) expressing elevated native CYP1A1 and containing transfected CYP1A2, CYP2A6, CYP2E1 and CYP3A4 and epoxide hydrolase and in a cell line containing only the viral vector (Ho1). MCL-5 or Ho1 cells were incubated with 4-hydroxytamoxifen, 4-hydroxytoremifene, clomifene or droloxifene and the incidence of micronuclei estimated. With MCL-5 cells there was an increase in micronuclei with 4-hydroxytamoxifen, 4- hydroxytoremifene and clomifene but not with droloxifene. With Ho1 cells only 4-hydroxytamoxifen and 4-hydroxytoremifene caused an increase in micronuclei. MCL-5 cells were incubated with tamoxifen, 4- hydroxytamoxifen, toremifene, droloxifene, clomifene or diethylstilbestrol (0.25-10 microg/ml) for 48 h and subjected to 3 h treatment with vinblastine (0.25 microg/ml) to arrest cells in metaphase. The incidence of cells with chromosomal numerical aberrations (aneuploidy) was increased in cells treated with tamoxifen, 4-hydroxytamoxifen, toremifene, clomifene and diethylstilbestrol but not droloxifene. The frequency of cells with structural abnormalities (excluding gaps) was increased in cells treated with tamoxifen and toremifene but not 4-hydroxytamoxifen, clomifene, droloxifene or diethylstilbestrol. The clastogenic activities of tamoxifen (35 mg/kg), toremifene (36.3 mg/kg), droloxifene (35.2 mg/kg) and diethylstilbestrol (25 mg/kg) were compared in groups of four female Wistar rats. Each chemical was dissolved in glycerol formal, administered as a single dose by gavage and hepatocytes isolated by collagenase perfusion 24 h later. The cells were cultured in the presence of epidermal growth factor (40 ng/ml) for 48 h, colchicine (10 microg/ml) being added for the final 3 h of incubation. At least 100 chromosomal spreads were examined from each animal for the presence of numerical and structural abnormalities. The incidences of aneuploidy following treatment were: tamoxifen 81%, toremifene 46%, droloxifene 9.6%, diethylstilbestrol 45.7%, vehicle control 5.3%. The incidences of chromosomal structural abnormalities excluding gaps were: tamoxifen 4.3%, toremifene 0.8%, droloxifene 0.5%, diethylstilbestrol 0.8%, control 0.5%. The incidence of chromosomal structural aberrations excluding gaps in the treated animals was not statistically significantly different from controls except in the tamoxifen-treated group. Tamoxifen (35 mg/kg per os) and toremifene (36.3 mg/kg per os) were dosed to rats for 4 weeks and chromosomal spreads made from hepatocytes. The incidences of aneuploidy were: tamoxifen 94%, toremifene 57%, control 6.5%. The incidences of chromosomal aberrations excluding gaps were: tamoxifen 12%, toremifene 1%, control 0.5%. The incidence of tamoxifen-induced chromosomal structural abnormalities was significantly elevated compared with control levels. The results demonstrate that tamoxifen and toremifene are the only two drugs tested in the study that cause chromosomal structural and numerical aberrations in vitro and tamoxifen is the only drug that induces both these effects in rat liver cells stimulated to divide in culture following oral dosing. Since chromosomal mutations require cell division for their manifestation and tamoxifen is the only compound of those tested that causes hyperplasia in the rat liver, chromosomal aberrations and aneuploidy in the rat liver would only be expected to occur following treatment with tamoxifen alone, although aneuploidy could be induced by toremifene in conjunction with a promoter such as phenobarbitone.      

Anterior shoulder dislocation: an unusual complication

A case of transection of anterior circumference humeral artery, a branch of the 3rd part of the axillary artery is reported, after a simple anterior shoulder dislocation. This complication though rare could potentially result in catastrophic consequences for the patient. It should therefore be recognised early and a coordinated prompt vascular and orthopaedic surgical treatment given for better upper limb functional outcome.     

老年缺血性脑血管病血瘀证患者的红细胞变形性及一氧化氮水平的检测及其意义

目的 :探讨老年缺血性脑血管病血瘀证患者的红细胞变形性及一氧化氮 ( NO)水平的变化。方法 :检测 5 5例老年缺血性脑血管病血瘀证患者的红细胞变形指数和 NO的水平。其中短暂性脑缺血发作 ( TIA) 2 5例 ,脑梗死 3 0例 ;另设 2 6例正常对照组作对比观察。结果 :血瘀证 TIA患者红细胞变形指数 ( 0 .4 67± 0 .14 5 )显著低于正常对照组 ( 0 .5 0 8± 0 .14 1) ,P<0 .0 5 ,脑梗死患者红细胞变形指数 ( 0 .4 43± 0 .15 6)降低更为明显( P<0 .0 1) ;NO水平 ,TIA患者与正常对照组比较无显著性差异 ( 79.10± 15 .3 7比 76.70± 17.10 ) ,而脑梗死患者 ( 88.5 0± 13 .68)显著升高。结论 :红细胞变形性改变及 NO水平升高在一定程度上均参与了老年缺血性脑血管病血瘀证的发生发展     

Therapeutic potential of fish oil in the treatment of ulcerative colitis

In a pilot study six patients with active ulcerative colitis and six healthy controls were given fish oil (MaxEPA) containing 3-4 g of eicosapentaenoic acid daily for a period of 12 weeks. There was a significant improvement in the patients' symptoms and histological appearance of the rectal mucosa by the end of the treatment period. There was significant fall in neutrophil chemiluminescence during treatment in patients, whereas no change was observed in the control group. Neutrophil leukotriene B4 levels fell significantly during treatment. Serum from patients receiving fish oil was significantly less chemotactic for neutrophils compared with control serum. Eicosapentaenoic acid inhibited neutrophil chemotaxis and chemiluminescence in vitro. The omega-3 fatty acids, which occur naturally in fish oils, may exert a beneficial effect by decreasing the production of inflammatory mediators.     

Cutaneous calcinosis in erythromelanosis follicularis faciei et colli

A case of erythromelanosis follicularis faciei et colli is described which showed deposition of calcium in the lesional skin on the face.     

Improved Short-Term Outcomes of Primary Coronary Stenting Compared to Primary Balloon Angioplasty in Acute Myocardial Infarction at Experienced Centers: The PAMI Study Group Experience

To study the additive benefits of routine stent implantation in patients undergoing primary percutaneous transluminal coronary angioplasty (PTCA) at experienced centers, we compared the outcomes of the 982 patients undergoing PTCA for acute myocardial infarction (AMI) in the Primary Angioplasty in Myocardial Infarction-2 (PAMI-2) trial (only 1% of whom were stented) to the 312 patients in the PAMI Stent Pilot Trial (236 [76%] of whom were stented). The inclusion and exclusion criteria, PTCA methodology, and definitions used were prespecified to be identical between the two trials. Compared to the primary PTCA approach in PAMI-2, the strategy of stenting all eligible lesions in the PAMI Stent Pilot Trial was associated with reduced rates of in-hospital death (0.6% vs 2.7%, P = 0.03), reinfarction (1.3% vs 4.6%, P = 0.008), recurrent ischemia (3.5% vs 11.6%, P < 0.0001), target vessel revascularization (7.3% vs 11.4%, P = 0.04), and a shorter hospital stay (6.4 ± 4.4 vs 7.1 ± 6.2 days, P = 0.01). By multiple logistic regression analysis in 1,294 patients, stent implantation versus PTCA only was the strongest predictor of freedom from the composite in-hospital end point of death, reinfarction, or target vessel revascularization (TVR) (8.3% vs 15.0%, multivariate odds ratio = 0.4, P < 0.0001). These data strongly suggest that despite the excellent results achieved when primary PTCA is performed by experienced operators, the short-term outcomes of mechanical reperfusion can be further improved by a primary stent strategy.