喀麦隆针灸治疗面瘫20例临床分析

笔者2004年7月赴喀麦隆吉德市执行援外医疗任务，于当年7月～10月治疗面瘫（周围性面神经麻痹）20例，疗效满意.当地有两个季节（旱季7个月，雨季5个月），此段时间，面瘫发病率很高，并有一定的规律，均属突发病证，男性多于女性10月之后，无面瘫病患就诊一追述历届医疗队也存在同样情况.现报道如下.     

人胎视网膜发生的光镜和电镜观察

本文在光镜下观察40例人胎视网膜的发生,在电镜下观察15例人胎视网膜视细胞、双极细胞、节细胞的发育。结果表明:胚胎第9周时神经上皮可分内、外成神经细胞层。第10周时内、外成神经细胞层之间的Chievitz带消失;第11周时节细胞从内成神经细胞层内迁;第13周节细胞与内成神经细胞之间出现内网层;第16周始双极细胞从外成神经细胞层中内迁形成外网层和内核层。第20周后视网膜各层形成。而视细胞、双极细胞、节细胞的超微结构于胎儿8个月后才发育完善。其结构与成人基本相同。     

Expression of Anion Exchanger 1 Sequestrates p16 in the Cytoplasm in Gastric and Colonic Adenocarcinoma

p16^INK4A (p16) binds to cyclin-dependent kinase 4/6 and negatively regulates cell growth. Recent studies have led to an understanding of additional biologic functions for p16; however, the detailed mechanisms involved are still elusive. In this article, we show an unexpected expression of anion exchanger 1 (AE1) in the cytoplasm in poorly and moderately differentiated gastric and colonic adenocarcinoma cells and in its interaction with p16, thereby sequestrating the protein in the cytoplasm. Genetic alterations of p16 and AE1 were not detectable. Forced expression of AE1 in these cells sequestrated more p16 in the cytoplasm, whereas small interfering RNA-mediated silencing of AE1 in the cells induced the release of p16 from the cytoplasm to the nucleus, leading to cell death and growth inhibition of tumor cells. By analyzing tissue samples obtained from patients with gastric and colonic cancers, we found that 83.33% of gastric cancers and 56.52% of colonic cancers coexpressed AE1 and p16 in the cytoplasm. We conclude that AE1 plays a crucial role in the pathogenesis of gastric and colonic adenocarcinoma and that p16 dysfunction is a novel pathway of carcinogenesis.     

用逆转录—聚合酶链反应法对类胰岛素生长因子cDNA的扩增

逆转录-聚合酶链反应(RT-PCR)法是将PCR方法与逆转录法结合应用,可快速高效地扩增某一基因的全cDNA。类胰岛素生长因子-I(IGF-I)在人染色体中只有一个基因,全长超过45kb,并有内含子,其cDNA却只有几百个bp,为了表达得到IGF-I,本文利用RT-PCR方法,从胎肝提出的混合mRNA中,筛选并扩增了IGF-I的cDNA。经过分子克隆与测序,证明不需制备胎肝cDNA库,即可快速获得IGF-I的cDNA。     

青年人原发性肝癌的治疗与预后分析

目的:探讨青年人原发性肝癌手术切除率低及术后复发率较高的原因.方法:将1985年1月～2000年1月收治的原发性肝癌173例患者分为青年组(≤35岁)83例和中老年组(≥36岁)90例,对其临床资料、手术切除率、术后复发率及生存率等进行比较分析.结果:青年组原发性肝癌手术切除率、术后1年复发率分别为26.51%(22/83)和68.18%(15/22),术后1、3、5年生存率分别为59.09%(13/22)、22.73%(5/22)和9.09%(2/22).中老年组原发性肝癌手术切除率、术后1年复发率分别为53.33%(48/90)和37.50%(18/48),术后1、3、5年生存率分别为81.25%(39/48)、47.92%(23/48)和39.58%(19/48).青年组各项生存率指标均较中老年组低(P＜0.01).结论:青年组原发性肝癌具有肿瘤生长迅速、侵袭力强、门静脉癌栓发生率高、多表现为巨块型及弥漫型等特点,导致手术切除率较低及术后复发率较高.     

Electrophysiological evaluation in 4 patients with diabetic pseudotabes

BACKGROUND: Researches on diabetic nervous system lesion are mainly focus on peripheral nerve and vegetative nerve, so there are few investigations on diabetic pseudotabes. OBJECTIVE: To investigate the electrophysiological examinations on the diagnosis of diabetic pseudotabes. DESIGN: Case study. SETTING: Department of Electrophysiology and Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University. PARTICIPANTS: A total of 4 patients with type 2 diabetes mellitus, including 3 males and 1 female aged from 50 to 72 years, were selected from Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University from March 2002 to February 2005. All accepted subjects met the modified diagnostic criteria of diabetes mellitus, which was set by American Diabetes Mellitus Association (ADA) in 1997. Otherwise, the subjects had typical symptoms and physical signs of spinal posterior funiculus damage. However, patients with spinal cord lesion which was caused by other factors were excluded. All accepted subjects provided the confirmed consent. METHODS: Nicolet NT electromyography (EMG)/evoked potential meter (made in the USA) was used to detect spinal cord conduction velocity (SCCV), somatosensory evoked potential (SEP) of lower limbs, motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of extremities. Determining criteria: Measurements were performed based on the laboratory standards. SCCV, which was less than lower limit of normal value (T2–12: 40–55 m/s, T12–L4: 20–41 m/s, T2–L4: 36–45 m/s), was regarded as abnormal. SEP value of lower limbs: P40, P60 and PF, which were more than standard deviation of normal value (x(—)+2.5), were regarded as the abnormality. Normal value of P40, P60 and PF latencies (x(—)±s) in this study: P40, P60 and PF in males were (37.6±1.9) ms, (59.8±3.9) ms and (7.6±0.9) ms, respectively; meanwhile, those in females were (35.5±1.7) ms, (55.2±2.7) ms and (6.3±0.7) ms, respectively. MNCV and SNCV, which were less than 50 m/s in upper limbs and 40 m/s in lower limbs, were regarded as the abnormality. MAIN OUTCOME MEASURES: Electrophysiological examinations. RESULTS: All 4 patients with type 2 diabetes mellitus were involved in the final analysis. ① SCCV: Among 4 patients, SCCV of three patients was decreased in T2–12, T12–L4 and T2–L4, and that of the other one was decreased in T2–12 and T2–L4; however, SCCV in T12–L4 was normal. There was significant difference as compared with normal value (P < 0.01). ② SEP of lower limbs: SEP values of lower limbs were abnormal in all 4 patients. Among them, P40, P60 and PF latencies of two patients were delayed; P40 of one patient was delayed and PF was not drained out; P40 and P60 of the last one were delayed and PF was normal. ③ MNCV and SNCV: The MNCV and SNCV were normal in one patient and abnormal in three patients. The results demonstrated that MNCV and SNCV of extremities decreased; especially, sensory nerve action potential (SNAP) of both lower extremities of one patient were not drained out. CONCLUSION: Detections of SCCV, SEP of lower limbs, MNCV and SNCV of extremities are helpful to investigate whether peripheral nerve and deep sensory passage are damaged or not and determine whether deep sensory damage is caused by peripheral nerve and spinal posterior funiculus.     

柴胡疏肝散、四君子汤对肝郁、脾虚大鼠Th细胞蛋白激酶C表达的影响

目的研究柴胡疏肝散、四君子汤对肝郁、脾虚大鼠Th细胞蛋白激酶C(PKC)表达的影响及其意义。方法应用RT—PCR法研究柴胡疏肝散、四君子汤对Th细胞PKCmRNA表达的影响。结果脾虚时PKCmRNA表达水平明显低于正常对照组 (P <0 .0 5 ) ,四君子汤治疗后恢复正常 (P <0 .0 5 ) ,柴胡疏肝散治疗后仍明显低于正常对照组 ;肝郁时PKCmRNA表达水平明显高于正常对照组 (P <0 .0 5 ) ,柴胡疏肝散治疗后恢复正常 (P <0 .0 5 ) ,但四君子汤治疗效应不明显。结论肝脾两脏在T细胞尤其是Th0的活化中具有相关性 ;PKC参与了肝脾这种相关的发生。     

日本血吸虫酚氧化酶的组化定位研究

目的观察酚氧化酶(phenol oxidase,PO)在日本血吸虫成虫的组织学分布.方法酚氧化酶组化方法:将42 d虫龄的日本血吸虫活成虫置含25 mmol/L邻苯二酚的磷酸盐缓冲液(pH 6.8)中,37℃孵育30 min后,转移虫体至载玻片上,吸去虫体表面液体,将其中一部分虫体置Olym-pus显微镜下观察酚氧化酶在虫体的组织学分布.荧光组织化学方法:经上述过程处理后,在另一部分虫体上滴加2滴含0.05%戊巴比妥钠的PBS溶液,然后置Leica荧光显微镜下观察酚氧化酶在虫体的组织学分布.结果酶组织化学方法显示,日本血吸虫酚氧化酶仅分布于雌虫卵黄腺及子宫内虫卵卵壳表面,呈现棕褐色显色反应;雌虫卵巢和雄虫均未发现酚氧化酶活性.然而,荧光组织化学方法显示,酚氧化酶除主要分布于雌虫卵黄腺及子宫内虫卵卵壳表面,呈现强荧光外,还少量分布于雄虫体壁表层,呈现弱荧光反应.结论不仅日本血吸虫雌虫含有酚氧化酶活性,而且雄虫也含酚氧化酶活性,只不过其含量少、活性低.荧光组织化学方法能更灵敏地显示日本血吸虫酚氧化酶活性,更适用于日本血吸虫酚氧化酶的组织学定位.     

无精子及严重少精子症的遗传学缺陷分析

目的 探讨遗传缺陷在无精子、严重少精子症中的检测意义。方法 采用细胞遗传学技术及多重聚合酶链反应(PCR)技术对65例无精子及严重少精子症患者进行染色体核型分析、Y染色体无精子因子(AZF)检测，同时行精索输精管诊察，阴性者行精液果糖定量实验。结果 染色体核型异常8例(12．3％)，AZF因子缺失7例(10．8％)，输精管缺如2例(3.1％)。结论 遗传学检测在男性无精子、严重少精子症有重要意义。     

肾上腺区神经节细胞瘤(附18例报告)

目的较全面的了解神经节细胞瘤的临床特点及治疗方法。方法回顾性分析18例病理确诊的神经节细胞瘤患者临床表现、实验室检查、影像学检查和治疗效果。结果15例是无临床症状的影像学偶然发现病例,内分泌检查均在正常范围;另外3例以阵发性高血压为主要临床表现,其中1例尿儿茶酚胺升高,肾上腺髄质显像(MIBG)阳性。18例B型超声检查均为低回声;13例CT平扫见散在点状高密度影,12例CT增强扫描肿瘤周边强化明显。手术前诊断为嗜铬细胞瘤12例,神经节细胞瘤4例,肾上腺无功能腺瘤2例。18例行肿瘤切除,随访6个月~7年,高血压症状消失,2例肿瘤复发。结论肾上腺区神经节细胞瘤与肾上腺髄质肿瘤难以鉴别,综合各项影像学检查对诊断有较高的参考价值。手术治疗是唯一的有效方法。