腹腔液中Ⅳ型胶原含量与胃癌病理及腹膜转移相关因素的关系

探讨胃癌腹腔液中Ⅳ型胶原含量与其生物学行为及腹膜转移相关因素的关系。方法:术中收集50例胃癌和10例胃良性病变的腹水或腹腔冲洗液,采用放射免疫技术检测上清液中Ⅳ型胶原、CEA蛋白(p-CEA)含量,同时进行腹腔冲洗细胞学(peritoneallavagecytology,PLC)和病理学检查。结果:Ⅳ型胶原含量与胃癌组织学类型、生长方式、浸润深度、淋巴结转移及浆膜类型呈正相关。PLC、p-CEA阳性组Ⅳ型胶原含量均高于阴性组(P<0.05);肉眼腹膜转移的10例中Ⅳ型胶原均显著升高。全组Ⅳ型胶原含量升高者占68.0%,明显高于p-CEA(44.0%)和PLC(34.0%)的阳性率(P<0.05)。结论:腹腔液中的Ⅳ型胶原是反映胃癌生物学行为的分子标志物,与胃癌腹膜转移密切相关,其预测腹膜亚临床转移的灵敏性优于p-CEA和PLC。     

海南省黎族中学生艾滋病知识干预效果分析

目的：通过干预提高黎族中学生的艾滋病知识水平，降低黎族人群感染艾滋病的危险。方法：采用集中授课、播发VCD等方式进行干预，利用自行设计的调查表对干预对象进行相关知识调查。结果：干预后中学生对艾滋病相关知识的认识均有不同程序的提高，最高提高22．90个百分点，最低提高6．50个百分点，平均提高15．46个百分点；艾兹病知识主要来源于电视广播和医生，分别占58．00％和22．00％。结论：在黎族中学生中开展艾滋病健康教育是完全可行且是十分必要的，应该引起重视。     

Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation in a diabetic patient with end-stage liver disease]

OBJECTIVE: To study the effect of combined transplantation of the liver and the pancreas in diabetic patients with end-stage liver disease, and explore the optimal surgical procedure. METHODS: Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations were performed in a patient diagnosed as having chronic hepatitis B, hepatocirrhosis, hepatic cellular cancer, and insulin-dependent diabetes. Immunosuppression therapy utilized prednisone, tacrolimus (FK506), mycophenolate mofetil (MMF), and simulect. The function of the liver graft, serum amylase and lipase, blood glucose, and C-peptide were monitored after transplantation. RESULTS: Insulin was withdrawn at the 6th day after operation, good liver allograft functional recovery was achieved, without such complications as pancreatitis, thrombosis, and localized infections. CONCLUSION: End-stage liver disease with concomitant insulin-dependent diabetes is the indication for combined liver-pancreas transplantations, for which simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations may constitute the optimal surgical approaches as the primary choice.     

睾丸网注射法建立转基因小鼠

目的 为了研究睾丸网注射法建立转基因小鼠的可行性。方法 本试验应用显微注射仪将脂质体包裹的质粒pEGFP—N1通过睾丸网注射到4周龄昆明（KM）小白鼠睾丸生精小管内。注射后6周，与自然发情雌鼠交配，用PCR法检测仔鼠基因组中的外源DNA。结果 共注射4只雄性小鼠，3只存活，并且具有交配，受精能力，共获仔鼠63只，其中2只为PCR阳性仔鼠。结论 用睾丸网注射法制备转基因动物是可行的。     

中药生精冲剂对精索静脉曲张大鼠的治疗

目的：研究中药生精冲剂对大鼠精索静脉曲张的影响及疗效。方法：从80只SD雄性大鼠中随机抽出20只作为假手术组，余60只均建立精索静脉曲张病理模型后随机均分为模型组、生精冲剂组和克罗米芬组。造模后15d生精冲剂组和克罗米酚组分别给予生精冲剂4g/（kg·d）和克罗米芬20mg/（kg·d）灌胃，模型组和假手术组正常喂食。造模后45d放免法测定血清性激素（FSH、LH和T）及观察各组大鼠睾丸组织结构。结果：生精冲剂组大鼠光镜下睾丸组织结构优于模型组和克罗米芬组；血清FSH、LH生精冲剂组显著低于模型组和克罗米芬组（P〈0.05），而克罗米芬组显著高于其他3组。T在生精冲剂组、克罗米芬组和假手术组之间无显著差异，但均显著高于模型组（P〈0.05）。结论：中药生精冲剂对精索静脉曲张引起的睾丸损害有保护及修复作用，且可能优于克罗米芬。     

鼻咽癌放疗后咽部菌群的变化

目的:了解鼻咽癌放疗后患者咽部菌群的变化,为临床防治继发感染提供实验依据。方法:32例鼻咽癌放疗患者,于放疗前后分别在照射区域粘膜采集唾液标本,进行细菌的分离培养鉴定,测量可培养细菌的检出率、检出量和构成比。结果:与放疗前相比,放疗后照射区域的链球菌属、葡萄球菌属、白色念珠菌和绿脓杆菌检出增加;而放线菌属和奈瑟菌属检出减少(P<0.05)。结论:鼻咽癌放疗可影响咽部的微生态平衡,是导致鼻咽癌放疗后患者发生感染的重要原因之一。     

基于RFID的病人用药安全管理新技术探讨

目前,我国在病人用药安全方面存在的主要问题是：病人本人用药安全意识淡漠、政府和卫生机构管理乏力、医院内部管理不规范、缺乏合适且有效的高新技术的支持。针对这些问题,提出基于先进的RFID技术的病人用药安全管理的新技术和解决方案,从而提高病患在用药过程中的安全系数,辅助相关医疗管理人员对药物进行准确有效的使用,防止用药安全事故的发生。     

Neuroprotective effect of estrogen after chronic spinal cord injury in ovariectomized rats

BACKGROUND: At present, there is still lack of effective drugs for chronic spinal cord injury, whereas it is found recently that estrogen has a neuroprotective effect on brain and spinal cord injuries. OBJECTIVE: To observe the effect of estrogen on the apoptosis of nerve cells after gradual chronic spinal cord injury in ovariectomized rats. DESIGN: A randomized controlled animal trial. SETTING: Institute of Orthopaedics, the Second Hospital of Lanzhou University. MATERIALS: Sixty-five female Wistar rats of common degree, weighing 220–250 g, were provided by the experimental animal center of Lanzhou University. The rats were randomly divided into sham-operated group (n =5), estrogen-treated group (n =30) and saline control group (n =30), and the latter two groups were observed at 1, 3, 7, 14, 28 and 60 days respectively, and 5 rats for each time point. METHODS: All the rats were treated with bilateral oophorectomy 2 weeks before the experiment. T10 vertebral lamina was revolved into using plastic screw. The spinal canal impingement was not induced initially. After that, the original incision was opened to expose the screw every 7–10 days. MAIN OUTCOME MEASURES: The apoptosis and Caspase-3 positive cells in the damaged spinal cord were detected using terminal deoxynucleotidal transferase-mediated dUTP-biotin nick end labeling (TUNEL) method and Caspase-3 immunohistochemical staining at 1, 3, 7, 14, 28 and 60 days after chronic spinal cord injury respectively. RESULTS: Totally 65 rats were used, and the deleted ones during the experiment were supplemented by others. Changes of Caspase-3 expression after spinal cord injury: In the sham-operated group, only a small amount of Caspase-3 proteins were observed in the rat spinal cord, mainly located in motor neurons of spinal cord anterior horn. In the estrogen-treated group and saline control group, positive cells expressed occasionally at 1 day postoperatively, began to increase obviously at 7 days after injury, strongly expressed at 14 and 28 days, but decreased at 60 days, mainly located in the neurons of spinal cord gray matter anterior horn, and they expressed fewer in the motor neurons and white matter of ventral horn, and there were obvious differences between the estrogen-treated group and saline control group at 7, 14, 28 and 60 days (P < 0.05). CONCLUSION: Estrogen can reduce the apoptosis of nerve cells and promote the recovery of neurological function following gradual chronic spinal cord injury.     

经尿道前列腺汽化电切术后后尿道狭窄的防治(附19例报告)

目的探讨经尿道前列腺汽化电切(TVP)术后后尿道狭窄的防治。方法结合文献,回顾分析19例TVP术后并发后尿道狭窄患者诊治经过。结果19例患者中13例经尿道扩张术治愈,5例行冷刀内切开术 电切术治愈,1例腔内手术失败改开放手术治愈。结论后尿道狭窄为TVP术后常见并发症,多数可用尿道扩张术治愈,对尿道扩张失败者应进行冷刀内切开术 电切术,早期及时处理效果好。     

上尿路梗阻性急性肾功能不全内、外引流的选择

目的探讨内、外引流在上尿路梗阻急性肾功能不全时的选择和效果。方法25例各种原因引起的上尿路梗阻（15例肿瘤性梗阻,10例非肿瘤性梗阻）合并急性肾功能不全,分别或先后对12例行输尿管内置双J管（doub le J,D J）内引流15次,对19例行经皮肾穿刺造瘘（percutaneous nephrectomy,PCN）外引流23次。结果引流成功23例,PCN外引流成功率86.9%（20/23）,双J管内引流成功率60.0%（9/15）,PCN术后继发出血1例。结论对于盆腹腔进展期或广泛转移肿瘤导致的梗阻,PCN解除梗阻优于输尿管支架内引流;非肿瘤性梗阻宜先尝试D J内引流。