1405例冠状动脉旁路移植、激光心肌血运重建术的临床分析

目的总结冠心病患者行冠状动脉旁路移植术(CABG)和激光心肌血运重建术(TMLR)中的治疗难点、围术期处理要点,以提高冠心病患者的外科治疗效果。方法1997年5月~2006年1月,1405例冠心病患者中在体外循环下行CABG825例,其中单纯CABG666例,CABG+心瓣膜手术98例,CABG+室壁瘤手术55例,CABG+左心房粘液瘤摘除术2例,CABG+室间隔穿孔修补术2例,CABG+升主动脉成形术1例,CABG+纵隔内肿瘤切除术1例;非体外循环下CABG(OPCAB)500例;单纯TMLR30例,CABG+TMLR50例。结果每例移植旁路血管2.9±1.0支。住院死亡42例(3.0%),死亡原因包括出血、心肌梗死、低心排血量综合征、肾功能衰竭、多器官功能衰竭等。术后发生并发症70例,包括出血、低心排血量综合征、心肌梗死、肾功能不全等,均经积极的对症处理后治愈或好转。术前心绞痛(CCS)为~级的1177例患者中,术后1154例(98.0%)改善为0~级。术后随访857例(62.9%),随访时间8.3±2.9个月。随访6个月时788例(91.9%)无心绞痛发作,复查超声心动图提示:左心室射血分数0.66±0.10,较术前提高7.9%,生活质量较术前大为提高。结论CABG已成为治疗冠心病最有效的常规手术,只要能正确掌握适应证,有效地加强围术期管理,便可以扩大手术适应证范围,降低手术死亡率和并发症发生率,提高手术疗效。     

Venous Lake of the Lip Treated With a Sclerosing Agent: Report of Two Cases

BACKGROUND: A venous lake is a venous ectasia that appears mostly on the lower lip and other sun-exposed areas of an older person. Treatment of lip venous lake includes surgical excision, laser therapy, infrared coagulation, and cryotherapy. Although the use of sclerotherapy on varicose veins, leg telangiectasia, hemorrhoids, and hemangiomas is well established, the use of sclerotherapy for lip venous lake has not been reported. OBJECTIVE: We present two cases of lip venous lake treated with intralesional injection of 1% polidocanol. METHOD: Two cases are reported, and literature is reviewed. RESULT: The lesions virtually disappeared, leaving an inconspicuous scar, with two sessions of sclerotherapy. Side effects were not observed. CONCLUSION: Sclerotherapy with polidocanol is effective in the treatment of lip venous lake and offers an alternative to conventional methods.     

颞叶癫痫大鼠海马CA1区Sema3C、Np1的表达变化研究

目的探讨颞叶癫痫的发病机制。方法取健康雄性SD大鼠制成颞叶癫痫模型，用免疫组织化学和原位杂交技术对匹罗卡品致痫后不同时间点CA1区的Sema3C mRNA、Np1 mRNA和蛋白表达进行分析。结果在匹罗卡品致痫后7d，实验组CA1区Sema3C、Np1的表达明显低于对照组（P〈0．01）。结论CA1区Sema3C、Np1的表达下凋可能参与了海马CA1区内的轴突出芽机制。     

纳洛酮与山莨菪碱、躯体刺激对内毒素休克狗血流动力学影响的比较

静脉给予纳洛酮2mg/kg期间可使内毒素休克狗的平均动脉压(MAP)、左心室收缩压(LVSP)及其一阶导数(±dp/dt max)和心力环面积(CFU)增加,但对肾血流量(RBF)、尿量及20h的存活率无明显影响。将本实验结果与山莨菪碱、躯体刺激效应进行比较,表明三者中山莨菪碱对休克动物的循环改善作用最明显。     

乏氧诱导因子-1α在非小细胞肺癌中的表达研究

Objective: To explore the expression level and its clinical significance of hypoxia inducible factor 1α (HIF-1α) in non-small lung cancer. Methods: The expression of HIF-1α was detected in 68 human non-small lung cancer samples by immunohistochemistry. Results: (1) Thirty-nine (57.35%) out of the 68 human non-small lung cancer samples was positive for HIF-1α; (2) The positive rate of HIF-1α in adenocarcinoma and squamous carcinoma was 54.76% (23/42) and 61.54% (16/26) respectively. No significant difference was found between adenocarcinoma and squamous carcinoma of non-small lung cancer in the expression of HIF-1α (P>0.05). The positive rate of HIF-1α in middle-high differentiation was 74.28% (26/35), significantly higher than in low differentiation (39.39%, 13/33) (P<0.05); (3) The positive expression of HIF-1α was not correlated to the sexes, ages, tumor stage and lymph node status. Conclusion: The expression of HIF-1α is higher in non-small lung cancer and is correlated to differentiation.     

子宫内膜异位症患者血清中靶抗体的检测和应用

目的 :建立一种ELISA方法 ,以检测子宫内膜异位症患者血清中抗转铁蛋白抗体。　方法 :用转铁蛋白包被的间接ELISA方法检测血清中的抗转铁蛋白抗体。血清标本来自 96例正常体检女性 ,6 4例妊娠妇女 ,72例儿科女童 ,以及 2 4例子宫内膜异位症患者。　结果 :子宫内膜异位症患者血清中的抗转铁蛋白抗体阳性率远远高于对照组 ,特异性为 99.0 % ,敏感度为 95 .8% ,准确性为 99.2 %。　结论 :子宫内膜异位症患者血清抗转铁蛋白抗体阳性率明显高于对照组 ,抗转铁蛋白抗体检测可作为子宫内膜异位症的非创伤性诊断方法     

抑郁症焦虑症状和焦虑症的抑郁症状

目的　探讨抑郁症和焦虑症的抑郁和焦虑症状的差异 ,为鉴别诊断提供依据。方法　使用HAMD和HAMA对5 5例抑郁症患者和 2 0例焦虑症患者进行评定。结果　 (1)抑郁症组绝大部分为中、重度抑郁 (92 .7% ) ,焦虑症组无一例为重度抑郁 ;(2 )抑郁症组的HAMD总分和除焦虑 /躯体化以外的因子分均显著高于焦虑症组 (P <0 .0 5或P <0 .0 1) ,(3)抑郁症患者和焦虑症患者的HAMD和HAMA评分均呈显著性正相关 (P <0 .0 0 1)。结论　HAMD总分有助于鉴别抑郁症和焦虑症。     

Sympathoadrenal excitation and inhibition by lower brainstem stimulation in cats

Effects of stimulation of brainstem sites on hemodynamics and plasma catecholamine levels were assessed in cats under chloralose-urethane anesthesia. Pressor areas of the dorsal medulla (DM) and ventrolateral medulla (VLM) and the depressor area of the paramedian reticular nucleus (PRN) were stimulated electrically using a monopolar electrode, or chemically using sodium glutamate microinjection. Plasma levels of norepinephrine (NE) and epinephrine (EPI) were measured in caval blood above the adrenal veins. Electrical stimulation of the DM and VLM produced increases in blood pressure and in plasma NE and EPI levels that were enhanced after acute vagotomies. The NE and EPI responses were attenuated after acute, bilateral adrenalectomies, confirming augmented adrenomedullary secretion, whereas the pressor responses were intact. Injection of sodium glutamate into the same pressor regions of the DM or VLM also produced pressor responses and elevated plasma catecholamine levels, indicating that the responses resulted from activation of neuronal perikarya. Stimulation of the PRN attenuated pressor and catecholamine responses during stimulation of the DM and VLM. The results indicate that pressor responses during stimulation of the DM and VLM are due at least partly to activation of perikarya in these regions, are associated with but not dependent on adrenomedullary activation, and are enhanced after vagotomy; and that neurons of the PRN exert inhibitory modulation of the pressor and adrenomedullary responses during stimulation of VLM and DM.     

术前动脉灌注化疗加乳腺区段切除治疗乳腺癌的探讨

目的　探索早期乳腺癌保留乳房治疗的新途径。方法　 1995 - 1997年采用术前动脉插管化疗加乳腺区段切除治疗Ⅰ、Ⅱ期乳腺癌共 2 6例 ,并随访 5年以上。结果　 2 6例中 1例术后 2年 4个月死于肺转移 ,另 1例术后 4年死于其他疾病。 1例术后 1年复发 ,行全乳房切除后至今无瘤生存 6年。本组 3年生存率 (OS) 96 .15 % ,3年无瘤生存率 (DFS) 92 .3% ;5年OS 88.4 6 % ,5年DFS 88.4 6 %。结论　术前动脉插管化疗能提高肿瘤区域的药物浓度 ,杀灭部分癌细胞 ,减少术后复发。该疗法对部分Ⅰ、Ⅱ期乳腺癌病例是可行的。