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。     

The use of muscle autograft denatured by microwave for repair of gaps in removal of facial neuromas]

OBJECTIVE: To study the clinical value of muscle autograft denatured by microwave for repair of gaps in removal of facial neuromas. METHODS: Two cases of patients with facial nerve Schwann cell neuromas were reported. The operations for removal of facial neuromas were completed, and the gaps of the nerves were repaired with muscle autograft denatured by microwave of 250 W for 120 sec. RESULTS: The patients were followed up for two years, and the recovery of facial function on the affected sides were satisfactory. CONCLUSION: Muscle autograft denatured by microwave technique is convenient, highly efficient for repairing facial nerve gap after removal of facial neuroma.     

神经外科麻醉对体感诱发电位的影响

目的探讨神经外科手术麻醉对体感诱发电位（SEP）的影响,以期为麻醉和手术处理提供依据。方法随机抽取我科17例全麻手术病人,分成颅内疾病手术组（A组）与脊柱、脊髓疾病手术组（B组）,于术前、麻醉（诱导完成）、术始、术中、术毕和术后6个时程连续监测SEP的潜伏期、波幅及波形并记录。结果麻醉后SEP潜伏期延长5.96%,波幅下降24.00%,未出现波形消失的情况。结论麻醉抑制SEP,表现为潜伏期延长和波幅下降,但未出现波形消失的情况。     

齿槽裂修复方法的研究进展

目的 探讨齿槽裂修复治疗的目的、方法以及治疗时机的选择。方法 查阅1950年至2006年有关齿槽裂修复的文献，归纳文献中报道的不同方法，并评价其各自的优缺点。结果 齿槽裂修复的主要目的：关闭口鼻瘘；建立稳定、连续的上颌骨牙弓；为牙齿萌出提供基础；为上唇和鼻底提供稳定支架。主要治疗方法：植骨术；牵引成骨技术；组织工程骨和生长因子应用；引导骨再生技术。患者最佳的手术治疗时机是9～11岁时混合牙列期。结论 在9～11岁混合牙列期手术，以髂骨松质骨为移植材料被认为是修复齿槽裂的主要手段。牵引成骨技术、组织工程技术和引导骨再生技术，将是齿槽裂修复的新方向。     

肩胛皮瓣在修复皮肤软组织缺损中的应用

目的探讨应用肩胛皮瓣修复不同部位皮肤软组织缺损的方法.方法设计以旋肩胛动脉及其皮支为供血系统的肩胛皮瓣,采用岛状皮瓣、吻合的游离皮瓣及借助知名动脉吻合携带的皮瓣修复头面、腋胸部及四肢皮肤软组织缺损创面.结果临床应用10例患者,皮瓣完全成活,患者局部外形及功能均比较满意.结论肩胛皮瓣的供瓣区较大,血供稳定充足,具有多种形式皮瓣移植的优点,是一种有效的修复皮肤软组织缺损的供瓣区.     

放射线联合p53基因及内皮抑素治疗小鼠前列腺癌皮下移植瘤

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.     

RNA干扰基因敲除MAGE-1在恶性胶质瘤U87细胞中的初步研究

目的：通过构建抑制MAGE-1的短片段双链核糖核酸（siRNA）表达载体，鉴定其在人恶性胶质瘤细胞系U87细胞中对MAGE．1基因表达的干涉作用。方法：化学合成2对编码短发夹RNA序列的靶向MAGE—1基因寡核苷酸链，克隆至经BglⅡ、HindⅢ双酶切的pSUPER载体上，重组构建核糖核酸干扰（RNAi）质粒载体。利用RT-PCR、流式细胞术和荧光显微镜，检测经稳定转染后胶质瘤U87细胞中MAGE-1的表达，以了解siRNA的干涉效果。结果：重组构建的pSUPER—MAGE—1载体经双酶切、电泳及插入基因片段序列分析，表明寡核苷酸链成功地插入至预计位点，且序列与预期完全一致。稳定转染后G418筛选出的U87多克隆细胞MAGE-1的表达经RT—PCR、流式细胞术和荧光显微镜检测，2对siRNA均有较明显的干扰作用。结论：载体的成功构建并能对U87细胞中的MAGE—1分子进行RNAi，为进一步研究MAGE—1在肿瘤中的作用，分析基因功能，展开肿瘤基因治疗奠定了基础。     

Laparoscopic Local Resection Based on Sentinel Node Evaluation for Early Gastric Cancer: A Preliminary Report

We previously reported that lymphatic mapping using isosulfan blue can be used to identify sentinel nodes (SNs). This study was undertaken to evaluate the feasibility of using the SN technique in treating early gastric cancer and to explore its usefulness for minimal invasive surgery. Twenty-three patients with early gastric cancer who underwent SN biopsy were retrospectively evaluated. Based on SN evaluation, individualized surgery was performed in five patients with T1N0M0 gastric cancer. When pathological examination of frozen sections revealed metastasis in SNs, we performed a standard D2 gastrectomy. Laparoscopic local resection was applied when the SN biopsy was negative. Our results showed that the success rate with SN biopsy in early gastric cancer was 100%, as were the accuracy, sensitivity, and specificity. All five patients with early gastric cancer had SNs negative for metastases both by frozen section and by postoperative pathology. Thus, all these patients underwent laparoscopic local resection without extended lymphadenectomy. We conclude that SN biopsy is a useful tool to individualize the operative procedure, and laparoscopic local resection can be safely performed using SN guidance in selected patients with early gastric cancer.     

端粒酶逆转录酶、环氧化酶-2在乳腺癌中的表达及其意义

目的 探讨端粒酶逆转录酶(hTERT)和环氧化酶(cox)-2在乳腺浸润性导管癌中的表达及其临床意义.方法 使用免疫组织化学法分别检测45例乳腺浸润性导管癌和22例乳腺良性病变标本的hTERT和COX-2蛋白表达情况.结果 hTERT在乳腺浸润性导管癌中阳性表达率fig71.11%,明显高于乳腺良性病变9.09%,两者比较差异有统计学意义(P<0.05).hTERT阳性表达与乳腺浸润性导管癌患者的年龄、肿瘤大小、腋窝淋巴结转移情况及雌、孕激素表达水平无相关性(P>0.05),与Her-2表达存在显著相关性(P<0.05).COX-2在乳腺浸润性导管癌中的阳性表达率为82.22%,明显高于乳腺良性病变50.00%,两者比较差异有统计学意义(P<0.05).COX-2阳性表达与乳腺浸润性导管癌患者腋窝淋巴结转移情况、Her-2、ER阳性表达有关(P<0.05).在乳腺浸润性导管癌中hTERT阳性表达与COX-2阳性表达呈正相关(r=0.557,P<0.01).结论 hTERT与COX-2在乳腺浸润性导管癌中的表达显著高于在乳腺良性病变中的表达,hTERT与COX-2在乳腺癌的发生、发展中起重要作用.hTERT表达与COX-2表达存在显著相关性,COX-2的过度表达可能是端粒酶激活和调节的机制之一.     

外科交接班存在的问题及对策

对于新病人。护理人员可为病人拟订护理计划并自己执行护理活动。但多数时间。护理人员是连续其他护理人员已执行的护理活动，因此交接班的好坏对护理质量有极大的影响。做好充分的交接班准备和一个能把握住重点的报告，可以得到真实完整的资料，使护理活动一开始就进入良好状况，保证原来护理工作的连续进行，提高护理质量。为此，2004年5月-2006年5月我科开始规范临床护理交接班工作，收到较好的效果。现将工作中存在问题进行分析并提出对策。