乳腺癌患者保乳术联合腔镜腋窝淋巴结清扫术的临床研究

目的 探讨保乳手术联合腔镜腋窝淋巴结清扫术(MALND)对乳腺癌患者上肢功能、应激反应及血管细胞黏附分子-1 (VCAM-1)、细胞间黏附分子-1(ICAM-1)水平的影响。方法 回顾性分析98例乳腺癌患者的临床资料,依据手术方式的不同分为研究组53例和对照组45例。对照组行保乳手术联合传统腋窝淋巴结清扫术(CALND),研究组行保乳手术联合MALND。比较2组术前、术后6个月上肢功能;收集2组患者术前、术后12 h焦虑自评量表(SAS)、抑郁自评量表(SDS)评分以及心率(HR)、平均动脉压(MAP)水平,并对比2组应激反应程度;比较2组患者术前、术后5 d VCAM-1、ICAM-1水平。结果 术后6个月,研究组前屈、后伸、内收、外展、内旋、外旋活动角度大于对照组,差异有统计学意义(P<0.05);术后12 h,研究组SAS、SDS评分及HR、MAP水平低于对照组,差异有统计学意义(P<0.05);术后5 d,研究组VCAM-1、ICAM-1水平低于对照组,差异有统计学意义(P<0.05)。结论 保乳手术联合MALND对乳腺癌患者上肢功能影响小,术后应激反应程度轻...     

Identification of 19 protein S gene mutations in patients with phenotypic protein S deficiency and thrombosis. Protein S Study Group

Protein S is a protein C-dependent and independent inhibitor of the coagulation cascade. Deficiency of protein S is an established risk factor for venous thromboembolism. We have used a strategy of specific amplification of the coding regions and intron/exon boundaries of the active protein S gene (PROS1) and direct single-strand solid phase sequencing, to seek mutations in 35 individuals with phenotypic protein S deficiency. Nineteen point mutations (16 novel) in 19 probands (or relatives of probands) with venous thromboembolism are reported here. Fifteen of the 19 mutations were expected to be causal and included 10 missense mutations (Lys9Glu, Glu26Ala, Gly54Glu, Cys145Tyr, Cys200Ser, Ser283Pro, Gly340Asp, Cys408Ser, Ser460Pro, and Cys625Arg). Three of the 15 mutations resulted in premature stop codons (delete T 635 producing a stop codon at position 126, Lys368stop and Tyr595stop) and two were at intron/exon boundaries (+1 G to A in intron d and +3 A to C in intron j). Of the remaining four mutations, three were within intronic sequence and one was a silent mutation within the coding region and did not alter amino acid composition. In two of the 10 missense mutations, reduced plasma protein S activity compared with antigen level suggested the presence of variant (type II) protein S.     

Naratriptan: biological profile in animal models relevant to migraine

The biological profile of naratriptan (N-methyl-3-(1-methyl-4-piperidinyl)-1H-indole-5-ethane-sulphona-mide), a novel 5HT_1B/1D receptor agonist, was investigated in a variety of experimental models of relevance to migraine. Naratriptan has high affinity for human recombinant 5HT_1B and 5HT_1D receptors (pKi = 8.70.03 and 8.30.1, respectively) and causes contractions of dog isolated basilar and middle cerebral artery (EC₅₀ values of 0.11 and 0.07 M, respectively). Naratriptan causes small contractions of human isolated coronary arteries (EC₅₀ value of 0.17 M; maximum contraction equivalent to 33% of 5HT maximum). In anaesthetized dogs, naratriptan causes selective vasoconstriction of the carotid arterial bed (CD₅₀ dose = 193 g kg⁻¹) and, in anaesthetized rats, naratriptan selectively inhibits neurogenic plasma protein extravasation in the dura (ID₅₀ = 4.1 g kg⁻¹). In a variety of antinociceptive tests, naratriptan has no effect even at high doses. In conscious rats and dogs, naratriptan has high oral bioavailability (71% and 95%, respectively). The data show that naratriptan is a selective agonist at 5HT_1B/1D receptors, with a pharmacological profile very similar to that of sumatriptan, albeit 2-3 fold more potent. These observations, coupled with high oral bioavailability in animals, suggest that naratriptan has the profile of an orally effective anti-migraine drug.     

化瘀通络方对局灶性脑缺血大鼠再灌注(MCAO)后脑组织氧自由基和NOS表达的影响

目的:观察化瘀通络方治疗大鼠局灶性脑缺血-再灌注损伤对脑组织自由基及一氧化氮合成酶(NOS)和iNOS变化的影响。方法:制备大鼠局灶性脑缺血再灌注损伤模型,给予化瘀通络方治疗后观察丙二醛(MDA)、超氧化物歧化酶(SOD)及一氧化氮合成酶(NOS)和诱导型一氧化氮合成酶(iNOS)的变化。结果:化瘀通络方可显著降低MDA含量以及iNOS和NOS活性,SOD含量升高。结论:在脑缺血再灌注损伤后,化瘀通络方能抑制脑缺血再灌注后脂质过氧化反应,促进自由基清除,对抗自由基损伤,提高脑组织自身抗氧化能力,降低NOS和iNOS介导脑缺血-再灌注时的神经损伤,保护脑细胞。     

槲皮素诱导人肝癌SMMC-7721细胞凋亡的研究

目的:观察槲皮素(quercetin)体外对肝癌SMMC-7721细胞的生长抑制和诱导凋亡作用,并探讨线粒体在诱导凋亡机制中的作用。方法:以10、30、60和100μmol/L槲皮素作用于体外培养的SMMC-7721细胞,MTT法检测细胞生长抑制率;Annexi-V/PI双染流式细胞仪检测细胞凋亡情况;吖啶橙(acridine or-ange,AO)染色法观察细胞凋亡时形态变化;JC-1染色法检测细胞线粒体膜电位(mitochondrial membrane potential)变化。结果:槲皮素体外能抑制肝癌SMMC-7721细胞的生长(P<0.01),诱导细胞发生凋亡,并呈现量效和时效关系。10、30、60和100μmol/L槲皮素作用72h引起的细胞抑制率(F=343.71,P<0.01)和凋亡率(F=234.17,P<0.01)明显高于对照组。槲皮素作用48h后,AO染色图片可见细胞膜呈泡状膨出和凋亡小体等。凋亡过程中线粒体膜电位下降。结论:槲皮素体外能抑制肝癌SMMC-7721细胞生长,诱导细胞凋亡发生,线粒体膜电位下降在细胞凋亡过程中可能起到重要作用。     

Usefulness of muscle denervation as an MRI sign of peripheral nerve pathology

Peripheral nerve disorders may be classified into compressive or entrapment neuropathies and non‐compressive neuropathies. Muscle denervation recognized on MRI may be a useful sign in the diagnosis of peripheral nerve disorders. Acute or subacute denervation results in prolonged T2 relaxation time, producing increased signal in skeletal muscle on short tau inversion‐recovery and fat‐suppressed T2‐weighted images. Chronic denervation produces fatty atrophy of skeletal muscles, resulting in increased muscle signal on T1‐weighted images. This review will outline and illustrate the various ways that muscle denervation as seen on MRI may assist in the diagnosis and localization of peripheral nerve disorders.     

语义网络技术在电子病历中的应用探讨

以肺癌病理案例和语义网络技术为基础,结合了统一医学语言系统(UMLS),研究探讨了语义网络技术在电子病历中的实际应用,并最终实现了加入时序性特征的病理案例语义网络的表示。     

248例儿童颅内肿瘤的临床特点

目的探讨儿童颅内肿瘤的临床特点。方法对云南省肿瘤医院及第三军医大学新桥医院2001～2006年间的248例经组织病理学诊断的儿童颅内肿瘤进行回顾性分析。结果幕上肿瘤156例，幕下肿瘤92例。常见的四类肿瘤为：星形细胞瘤（82／248，33．1％）、颅咽管瘤（58／248，23．5％）、髓母细胞瘤（44／248，17．1％）、室管膜瘤（25／248，10．1％），误诊31例，占12．4％。结论儿童颅内肿瘤部位上以幕上为主，病理以星形细胞瘤最常见，误诊率较高。     

拉萨S0S儿童村家庭膳食的调查与评价

[目的]了解中国拉萨SOS儿童村儿童的膳食结构及营养状况,并根据膳食调查结果和存在的问题,提出合理膳食建议。[方法]2005年12月采用食物称重法,对中国拉萨SOS儿童村负责供养168名4～16岁儿童的17户家庭进行了为期5 d的膳食调查。[结果]17户家庭中绝大部分家庭膳食模式不尽合理,油脂摄入过多,大部分家庭脂肪供热百分比﹥30%;动物性食品摄入量及品种偏少,致使所有家庭的钙摄入量普遍不足,70%左右家庭的核黄素、40%左右家庭的蛋白质摄入量不足;多数家庭维生素A和铁虽然超出供给量标准,但是来源于动物性食品的比例很低。[结论]膳食模式的不合理性,势必影响儿童的正常发育和身心健康。因此,进一步加强营养知识的传授显得极为迫切和必要。