肝细胞生长因子在左肾动脉狭窄大鼠心血管中的表达及干预研究

目的　观察左肾动脉狭窄肾性高血压大鼠模型心肌和血管中肝细胞生长因子 (HGF)的表达 ,并观察缬沙坦和螺内酯对其表达的影响。方法　选用 6周龄SD大鼠 2 4只 ,制备左肾动脉狭窄肾性高血压模型 ,分为 4组 ,分别为手术组、假手术组、缬沙坦组、螺内酯组。治疗组分别用缬沙坦 3 0mg/kg·d-1、螺内酯 2 0mg/kg·d-1溶于饮水灌胃 ,1次 /d ,连续治疗 17周。用逆转录 聚合酶链反应 (RT PCR)法检测大鼠心肌和血管HGFmRNA水平。结果　 17周后 ,缬沙坦组和螺内酯组的心肌HGFmRNA/ β actinmRNA(1.17± 0 .0 8/ 0 .85± 0 .0 8)高于手术组 (0 .5 7± 0 .0 7) (P <0 .0 1) ,但低于假手术组 (1.3 5± 0 .0 9) (P均 <0 .0 1)。两治疗组肠系膜动脉HGFmRNA水平高于手术组 (P <0 .0 1) ,但低于假手术组 (P均 <0 .0 1)。结论　缬沙坦和螺内酯均能使左肾动脉狭窄肾性高血压大鼠心肌和血管中的HGF升高 ,同时伴有心肌和血管重塑的改善 ,说明HGF在左肾动脉狭窄肾性高血压大鼠的靶器官保护中起着重要作用     

中西医结合要为妇女生殖健康创新页

45年来,复旦大学妇产科医院在中西医结合临床及科研方面取得了可喜的成就.针刺促排卵的研究,通过观察血雌激素和中枢β-内啡肽(β-EP)的关系,提出了针刺通过耗竭中枢β-EP而促排卵的新认识,认为针刺促排卵的主要适应症是青春期月经失调,并将针刺成功地应用于治疗神经性厌食;补肾化痰的俞氏温补方治疗多囊卵巢综合征(polycystic ovary syndrome, PCOS)被证实是通过提高血促卵泡激素(follicle stimulating hormone, FSH)并诱发排卵而起作用;益肾化瘀的天癸方是通过降低患者及动物模型的雄激素和胰岛素,引起以中枢阿片促黑激素皮质素原、神经肽Y和瘦素受体为主的神经-内分泌-代谢网络调节而发挥促排卵和减肥作用,对高胰岛素型PCOS有良效,并在研究中提出了对PCOS分类的新设想;益肾清火的更年春通过提高中枢与周围组织的雌激素受体及其mRNA表达来调节围绝经期妇女的神经-内分泌-免疫-代谢网络而获优越疗效.这些研究表明,疾病是外环境影响下患者生命网络的某些主脉失调所致,而且亚健康状态的妇女具有初步网络失控的现象,中西医结合将为女性生殖医学研究找到捷径,调控生命网络是防病治病的主要思路.     

夜来香根茎水提取液局部麻醉作用的研究

目的：研究夜来香(CN)根茎水提取液的局部麻醉作用及其作用机制。方法：采用蟾蜍离体坐骨神经动作电位法、豚鼠皮丘法、椎管麻醉法、表面麻醉法。结果：20％的CN水提取液对蟾蜍离体坐骨神经动作电位可完全消失，但较1％的普鲁卡因稍弱。豚鼠皮丘实验表明，20％CN提取液有浸润麻醉作用，其浸润麻醉效果与1％的普鲁卡因相似，而且盐酸肾上腺素可增强其麻醉强度和明显延长局麻作用时间；家兔椎管麻醉实验表明CN提取液有明显的椎管麻醉作用；CN提取液对家兔角膜也有一定的表麻作用，只是作用强度及持续时间比1％的普鲁卡因稍弱或稍短。结论：CN提取液有明显的局部麻醉作用。     

原发性肝癌患者肝切除术前、后免疫细胞表型分析

目的研究原发性肝癌(PrimaryLiverCarcinoma,PLC)患者肝切除术前、后免疫细胞表型的变化。方法采用直接免疫荧光标记,流量血细胞计数法(FlowCytometry,FCM)检测方法,动态观察120例PLC患者肝切除术前后外周血T淋巴细胞亚群、NK细胞和HLA鄄DR含量变化。结果肝切除术前肝功能Child鄄PughB级、OGTTL型和术前施行肝动脉栓塞化疗患者外周血CD8+T细胞含量明显低于正常人组,CD4+/CD8+比值则较高(P<0郾05)。全部肝癌患者肝切除术前、后CD3+CD4+T细胞和NK细胞(CD3-CD16+CD56+)含量无明显差异。术后第1天、第3天、第7天和第2周外周血淋巴细胞CD3+CD8+含量明显低于肝切除术前和术后第3周(P<0.01);而CD4+/CD8+比值则显著高于肝切除术前和术后第3周(P<0郾01)。结论PLC合并肝硬变肝储备功能不足、术前肝动脉栓塞化疗和肝切除术可导致机体细胞免疫功能低下,PLC患者肝切除术前行肝动脉栓塞化疗的价值有待深入研究。     

Management of congenital tracheal stenosis

Objectives: Congenital tracheal stenosis is a rare disease. Various methods for treatment exist but there is still much debate as to the appropriate surgical procedure. We present our surgical experiences of patch tracheoplasty and slide tracheoplasty as viable methods for the treatment of congenital tracheal stenosis. Methods: From 1994 to 2002, 13 patients were diagnosed with congenital tracheal stenosis. Eight patients (7 symptomatic and 1 asymptomatic) had their stenosis corrected, three by means of pericardial patch tracheoplasty, four by slide tracheoplasty, and one by resection and anastomosis. Concomitant operations were performed on six patients to treat congenital cardiovascular disease. Five patients showing no significant symptoms did not undergo tracheal surgery and received only cardiac procedures. A retrospective review of the hospital course, complications, and long-term results was conducted. Results: Among the patch tracheoplasty group, every patient suffered from granulation tissue formation. One patient died of respiratory acidosis and one was hospitalized due to recurrent granulation tissue, which required frequent bronchoscopy. The third patient from this group is free of all symptoms. Among the slide tracheoplasty group, one patient died of anastomosis disruption. The three remaining patients are alive and well. The one patient who received resection and anastomosis is alive without symptoms. Conclusions: Surgical repair of long-segment congenital tracheal stenosis exhibited high mortality and morbidity rates. Every patient that underwent pericardial patch tracheoplasty suffered from troublesome granulation tissue. As slide tracheoplasty provided relatively good results in the short and mid-term follow-up periods, it seems to be a preferred method for the treatment of long-segment congenital tracheal stenosis.     

神经生长因子基因转染联合强化铁营养防治豚鼠爆震性聋的实验研究

Objective To study the protective effects of adenovirus-mediated human beta-nerve growth factor gene (hNGFβ) transfer combined with iron fortified nutrition on blast hearing damage in guinea pigs. Methods Deafness was induced by blast (172dB SPL) in 35 healthy guinea pigs. Seven days after noise exposure, 10 guinea pigs were inoculated with adenovirus-mediated hNGFβ (Ad-hNGFβ) into the perilymphatic space (the gene group), another 10 guinea pigs were given hNGFβ combined with iron fortified nutritional diet (the combination group), still another 10 guinea pigs were inoculated with artificial perilymphatic fluid (APF), and 5 guinea pigs served as control, given neither medicine nor noise exposure. Auditory brainstem response (ABR) threshold shifts were monitored in the guinea pigs before blast exposure and after gene transfer. Changes in cochlear morphology were examined with immunohistochemical and HE staining. Results One week after successful inoculation of hNGFβ, it was noted that Ad-hNGFβ protein was expressed in each turn of the cochlea, and its intensity was almost equal. After gene transfer in the combination group and the gene group, ABR threshold shifts at week 1 and 4 were significantly smaller than those of the APF group. HE staining showed that the number of the spiral ganglion cells in the combination group and the Ad-hNGFβ group was significantly higher than that of the control group after 4 weeks (P<0.01). Conclusions Ad-hNGFβ combined with iron fortified nutritional diet was effective in the prevention and treatment of blast hearing damage of cochlear hair cells.     

Factors Affecting Cardiac Catheterization Rates in Elders with Acute Coronary Syndromes

Background: Elder patients with acute coronary syndromes (ACS) are less likely to receive cardiac catheterization. The reasons for this are unclear.
Objectives: To assess whether elder patients who had a documented history of dementia, lived in extended care facilities, or had do not intubate–do not resuscitate (DNR-DNI) advance directives were less likely to receive cardiac catheterization, despite having ACS with high-risk features.
Methods: This was a medical record review conducted at an urban teaching hospital. DNR-DNI status before hospitalization, extended care facility (nursing home or assisted living) residence, and a previous diagnosis of dementia were obtained from the medical record. Patients 65 years and older who presented to the emergency department with acute myocardial infarction or with unstable angina with ST segment deviation were included. Univariate and multivariate logistic regression were performed, and odds ratios (ORs) were reported with their 95% confidence intervals (CIs).
Results: Of the 201 eligible patients, 66 (32.8%) patients did not undergo cardiac catheterization. In the univariate analysis, patients who had dementia, resided in extended care facilities, or were DNR-DNI were less likely to receive cardiac catheterization. Only extended care facility residence (OR, 0.18; 95% CI = 0.04 to 0.83) and DNR-DNI status (OR, 0.19; 95% CI = 0.04 to 0.92) remained significantly associated with decreased cardiac catheterization in the multivariate analysis.
Conclusions: Elder patients with ACS residing in extended care facilities or who are DNR-DNI are less likely to receive cardiac catheterization. Future studies concerning the quality of ACS care for elders should take these variables into account.     

输卵管积液影响体外培养胚胎质量的实验研究

目的：分析输卵管积液的形成及其化学成分，探讨输卵管积液对体外培养胚胎生长发育的影响及其机制。方法：建立输卵管积液动物模型，测定其成分；用不同浓度输卵管积液培养小鼠2-细胞胚胎，观察胚胎形态。结果：输卵管积认中K^ 、HCO3^-和表皮生长因子（EGF）含量明显低于输卵管液；pH值明显增高。输卵管积液组囊胚形成率和胚胎孵化率均明显低于输卵管液。结论：结扎兔输管两端能诱导输卵管积液形成；机械诱导的输卵管积液成分改变能影响早期胚胎的质量。