TRH、EGF及地塞米松促进未成熟胎肺组织分化及表面活性物质合成的研究

目的 比较TRH、EGF与地塞米松对未成熟胎肺形态发育及表面活性物质水平的影响。方法 在兔妊娠第22－24d或第24－26d分别用TRH、EGF或地塞米松母体静脉注射治病，通过光镜、图像分析及电镜等技术观察胎肺的形态结构，并检测胎肺的磷脂水平。结果 光镜下，TRH、EGF与地塞米松治疗组第25d及27d胎肺肺泡腔、肺泡间隔发育均明显好于对照组；EGF、TRH与地塞米松治疗组第27d胎肺的肺泡腔与肺泡间隔的面积比无明显差异。但EGF和TRH治疗组第25d胎肺的肺泡腔与肺泡间隔之比明显小于地塞米松治疗组。电镜下，三个治疗组第27d胎肺内含有板层体的Ⅱ型上皮细胞数量明显多于对照组，但各治疗组及对照组第25d的胎肺Ⅱ型上皮细胞胞浆内几乎未见明显板层体，相反胞浆内糖原含量却非常丰富。此外，三个治疗组27d胎肺的磷脂水平均明显高于对照组。结论 EGF、TRH及地塞米松在兔妊娠第24－26d母体治疗均能促进胎肺的形态发育和表面活性物质的合成，三种治疗方法对胎肺的影响程序无明显不同；在妊娠第22－24d治疗，地塞米松对胎肺形态结构的促进作用较EGF和TRH更明显，但三者对Ⅱ型上皮细胞分化及表面活性物质的合成均无明显影响。     

Therapy of human cervical carcinoma with monoclonal antibody-Pseudomonas exotoxin conjugates.

Pseudomonas exotoxin A (PE) linked to the F(ab')2 fragment of 1H10, a murine monoclonal antibody recognizing a carbohydrate epitope of a glycoconjugate expressed on the surface of human cervical carcinoma tumor cells, was evaluated for in vitro and in vivo activity. PE can kill cells by ADP-ribosylating elongation factor 2 thus inhibiting protein synthesis. Disulfide- as well as thioether-linked immunotoxins (1H10-PE) killed cervical carcinoma cells in vitro and were 20-160 times more inhibitory to target than to control cells. Cell killing was antibody mediated as demonstrated by the reduction of 1H10-PE growth inhibition to target CaSki cells by free 1H10 F(ab')2. In addition, a control antibody immunotoxin was nontoxic to CaSki cells. Thioether-linked 1H10-PE administered either i.v. or i.p. suppressed the growth of established solid s.c. cervical carcinoma tumors xenografted in nude mice for over 30 days. Treatment with antibody alone or a control immunotoxin had no significant effect on tumor growth. Administration of immunotoxin i.p. was associated with less toxicity than administration i.v., but i.v. injections were more effective at suppressing the growth of established solid tumors.     

人肿瘤特异抗原MAGE-3基因疫苗的构建和表达

目的：克隆肿瘤特异性共享抗原mage-3基因，制备基于α－病毒复制酶的高效黑色素瘤特异性基因疫苗。方法：用RT-PCR方法从黑色素瘤细胞系LB373中制备mage-3基因，以含α－病毒复制酶的哺乳细胞高效表达质粒pSMART2a为载体，构建重组DNA疫苗。重组子用载体中的T7和T3启动子序列为测序引物进行自动测序。再将鉴定过的重组质粒用脂质体法转化293细胞，用免疫印迹法和免疫组化法鉴定转化细胞中mage-3蛋白的表达。结果：正确构建了mage-3/pSMART2a重组质粒，并且在转化此质粒的293细胞中检测出了mage-3蛋白的表达。结论：此重组mage-3/pSMART2a质粒可以作为肿瘤特异的DNA疫苗，可进行下一步的肿瘤动物模型的疫苗接种及相关免疫学效应研究。     

后SARS时期对公共卫生与健康的再思考

在人们印象中“公共卫生”是一个很模糊的领域，它比较形象的载体可能就是爱国卫生运动或预防接种。美国1932年提出的公共卫生的定义，对现在依然有指导意义：公共卫生就是预防疾病，延长寿命，通过有组织的社会共同努力来改变环境卫生，从而促进身体的健康，提高工作效率，控制社区传染病的流行，教育个人形成良好的卫生习惯，组织医护人员对疾病进行早期的诊断和预防性治疗。简而言之，“公共卫生”就是关注公众健康的科学。公共卫生学不能脱离临床医学，后是对某种疾病的个体的治疗，而前则着眼对某种疾病做群体防护。     

认识生物的运动规律,须有正确的认识途径

要认识生物的变化规律，须有正确的认识途径与着眼点。这着眼点就是着眼于活的生物个体。这认识的深入途径就是向三个方向(方面)深入，且三个方面必须有机结合：(1)“横向”的深入，就是从个体一群体一整个生物界，在这个面上观察研究生物的共性(共有规律)与个性。(2)“竖向”的深入，是研究生物随时间的推移而有的变化，即研究从古生物到现今生物的变化。(3)“纵深向”的研究，是向生物个体内部物质的深入研究，这内部物质的变化，是生物在横向与竖向上发生变化的内部原因，由于横、竖向上的变化不能在纵深向上直接看到，所以须三向有机结合，由此才能全面立体地认识生物的变化规律与本质。     

载瘤动脉闭塞术治疗颅内巨大动脉瘤的探讨

目的总结和探讨脑血管造影和载瘤动脉闭塞在治疗颅内巨大动脉瘤上的作用及特点。方法60例颅内巨大动脉瘤患者,根据其脑血管造影的特点采取血管内介入方法[可脱式球囊和(或)弹簧圈]闭塞载瘤动脉近端53例、闭塞载瘤动脉两端后孤立动脉瘤7例;其中23例闭塞前先行颅内-外血管搭桥术。结果出院时Rankin评分分级:单纯血管内介入治疗组37例中轻残3例,合并颅内-外血管搭桥术组23例中死亡1例、重残2例。1-6年的影像学随访动脉瘤无复发。结论血管内介入结合颅内-外血管搭桥术闭塞载瘤动脉是治疗颅内巨大动脉瘤的方法之一。     

腰椎节段形态对峡部、小关节应力及小关节接触力影响的有限元分析

目的:探讨腰椎形态结构变化对峡部裂性滑脱及小关节退变的作用和意义。方法:采用改良的“非种子区域分割方法”及非平行“最佳切割平面”等一系列新型计算机辅助设计(CAD)方法精确建立包括椎间盘高度、腰椎小关节角、椎间盘前凸角改变的L4~L5活动节段有限元模型;在2700N轴向压缩载荷条件下,分别对各有限元模型的峡部、小关节应力、小关节接触力以及椎间盘负载进行测试。结果:压缩载荷下,腰椎活动节段峡部、小关节等效应力及小关节接触力随椎间盘高度的减小而减小,随小关节角的增大而增加,随椎间盘前凸角的增加而减小。结论:椎间盘高度、腰椎小关节角、椎间盘前凸角等形态结构变化对腰椎节段有限元模型的峡部、小关节应力及小关节接触力有明显的影响。提示腰椎峡部应力性骨折及小关节退变的发生与椎间盘高度、腰椎小关节角、椎间盘前凸角等解剖形态因素有关。     

In vivo PET imaging of cardiac presynaptic sympathoneuronal mechanisms in the rat.

The sympathetic nervous system of the heart plays a key role in the pathophysiology of various cardiac diseases. Small-animal models are valuable for obtaining further insight into mechanisms of cardiac disease and therapy. To determine the translational potential of cardiac neuronal imaging from rodents to humans, we characterized the rat sympathetic nervous system using 3 radiotracers that reflect different subcellular mechanisms: (11)C-meta-hydroxyephedrine (HED), a tracer of neuronal transport showing stable uptake and no washout in healthy humans; (11)C-phenylephrine (PHEN), a tracer of vesicular leakage and intraneuronal metabolic degradation with initial uptake and subsequent washout in humans; and (11)C-epinephrine (EPI), a tracer of vesicular storage with stable uptake and no washout in humans. METHODS: We used a small-animal PET system to study healthy male Wistar rats at baseline, after desipramine (DMI) pretreatment (DMI block), and with DMI injection 15 min after tracer delivery (DMI chase). The rats were kept under general isoflurane anesthesia while dynamic emission scans of the heart were recorded for 60 min after radiotracer injection. A myocardial retention index was determined by normalizing uptake at 40 min to the integral under the arterial input curve. Washout rates were determined by monoexponential fitting of myocardial time-activity curves. RESULTS: At baseline, HED showed high myocardial uptake and sustained retention, EPI showed moderate uptake and significant biphasic washout, and PHEN showed moderate uptake and monoexponential washout. The average (+/- SD) left ventricular retention index for HED, PHEN, and EPI was 7.38% +/- 0.82%/min, 3.43% +/- 0.45%/min, and 4.24% +/- 0.59%/min, respectively; the washout rate for HED, PHEN, and EPI was 0.13% +/- 0.23%/min, 1.13% +/- 0.35%/min, and 0.50% +/- 0.24%/min, respectively. The DMI chase resulted in increased washout only for HED. DMI block decreased myocardial uptake of all tracers by less than 90%. CONCLUSION: Kinetic profiles of HED in the rat myocardium were similar to those of HED in humans, suggesting comparable neuronal transport density. Unlike in humans, however, significant washout of EPI and faster washout of PHEN were encountered, consistent with high intraneuronal metabolic activity, high catecholamine turnover, and reduced vesicular storage. This evidence of increased neuronal activity in rodents has implications for translational studies of cardiac neuronal biology in humans.     

中西医结合治疗急性冠脉综合征临床疗效观察

目的观察中西医结合治疗急性冠脉综合征（ACS）的临床疗效。方法将60例ACS患者随机分为两组。治疗组在抗血小板、抗凝、降脂、扩张冠状动脉、降压、保护血管内皮功能等常规治疗基础上服用中药复方苏欣康颗粒；对照组在常规治疗基础上加用复方丹参滴丸。2周为1个疗程，1个疗程结束后观察治疗前后临床症状、心电图、24h动态心电图变化，并判定疗效。结果经2周治疗后，治疗组总有效率（90．O％，27／30）显著高于对照组（83．3％，25／30），差异有统计学意义（P〈0．05）。治疗组临床症状的改善程度高于对照组，其中以对心悸、自汗及心肾阳虚的改善最显著（P均〈0．05）。治疗组心律失常发生率（36．7％）低于对照组（50．0％），但差异无统计学意义（P〉O．05）。结论中药复方苏欣康结合常规手段治疗ACS疗效确切，可作为治疗ACS的有效方剂。     

Onyx液态栓塞剂栓塞颅内动静脉畸形的技术要点解析

自2003年Onyx液态栓塞剂进入中国以来，得到了神经介入医师的广泛关注。尤其在颅内动静脉畸形和硬脑膜动静脉瘘的治疗中发挥了越来越大的作用。但是，各地治疗的病例数差别较大，经验和疗效也有不同；更有一些医师出于对并发症的担忧而拒绝使用；使得Onyx在临床实践应用中仍有很多的争议。笔者作为中国取得Onyx栓塞技术许可证的第一人，近年来致力于在国内外推广Onyx的栓塞技术，现将其技术要点讲述如下。