甲状腺机能亢进危象：附14例临床分析

本文报道14例甲亢危象,其发病率为4.5％,其发病与感染、劳累、情绪激动及同位素治疗有关。指出同位素治疗甲亢初期应服用抗甲状腺药物,讨论了淡漠型危象的有关问题。     

Prof. Ye Chuanhui''s Experience in Treating Nephritic Proteinuria

In the occurrence and development of glomerulonephritis, proteinuria is themain manifestation, which is easily recurrent but not easily got rid of in a short period of time. It may remain even after disappearance of the general symptoms. In some patients, there are no symptoms and signs at all in the initial stage, except proteinuria, the only distinct manifestation. Prof. Ye Chuanhui, from Chengdu University of Traditional Chinese Medicine, has accumulated rich experience for treating this disorder, which is introduced in the following.     

大肠肿瘤组织中EB病毒的原位杂交检测

目的：探讨EB病毒感染与人大肠癌发生的关系。方法：用原位分子杂交法对130例人大肠癌标本中EB病毒小分子RNA片段进行检测。结果：130例标本中有6例（4.48％）癌组织呈阳性反应，其中4例为男性，4例有明显淋巴细胞浸润。结论：EB病毒感染可能与我国部分大肠腺癌的发生有关，肿瘤细胞间质中大量淋巴细胞浸润可能是EB病毒感染的重要病理学特征。     

选择性环氧化酶—2抑制剂的研究现状及应用评价

选择性环氧化酶（COX）-2抑制剂可有效地治疗炎症，同时避免或减轻由于抑制COX-1而导致的毒副作用。有乐观的临床应用前景，但其不良反应亦不容忽视，寻找临床评价好的选择性COX-2抑制剂是当前非甾体类抗类药物研究的重点。     

PRK术后转化生长因子β1mRNA表达的实验研究

目的：探讨准分子激光角膜切削术（PRK）后转化生长因子β1（TGF－β1）在角膜伤口愈合和解膜雾状混浊发病机制中的作用。方法：将24只新西兰大白兔（24只眼）随机分为正常组（n＝4）和手术组(n=20)。手术组每只左眼行PRK术，术中采用准分子激光器，角膜中央激光去上皮，然后按－10.00D近视进行切削，分别于术后第7d,14d,28d和3月于裂隙灯下观察记录角膜haze的变化并处死动物，将角膜组织制成石蜡切片，应用原位杂交技术检测角膜缲TGF－β1mRNA的表达。结果：①从术后第7d开始，术眼均不同程度地发生了角膜haze，严重者可达3级，haze高峰约在术后第28d。②正常角膜上皮中TGF－β1mRNA有低水平表达，PRK术后第7d,14d和28d，角膜上皮TGF－β1mRNA表达明显增高。术后3月已开始降低；正常组角膜基质中未检测出TGF－β1mRNA，术后第7d,14,和28d，角膜基质中TGF－β1mRNA表达明显增高，术后3月已开始降低。结论：TGF－β1可能参与了PRK术后的伤口愈合，它可能通过促进角膜基质细胞的增殖和细胞外基质的合成而促进角膜haze的发生。     

No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk.

BACKGROUND: Gastric cancer (GC) is the leading cause of cancer deaths in China. Our study prospectively evaluated the impact of repeated endoscopic screens on GC mortality in a high-risk population in China. METHODS: Between 1989 and 1999, a population-based gastroscopic screening was conducted in 4,394 residents of Linqu County, China, a region with the highest rates of GC worldwide. Residents ages 35 to 64 years received initial gastroscopies with biopsies in 1989. Repeated endoscopies were performed in 1994 and 1999. Cancer occurrences and deaths were actively monitored throughout the entire period until July 2000. Mortality from GC was compared with expected values based on mortality rates obtained for Linqu in the 1990-1992 Chinese Cancer Mortality Survey. RESULTS: Between March 1989 and July 2000, 39,303 person-years were accumulated; 85 new GCs occurred, 29 (34.5%) were in early stage. Fifty-eight cases (68%) were identified at one of the screens. The number of observed deaths from GC (37) was close to the expected (36.8). The standardized mortality ratio was 1.01 (95% CI 0.72-1.37) for the entire cohort, 1.13 (95% CI 0.77-1.57) for males, and 0.65 (95% CI 0.26-1.32) for females. CONCLUSIONS: Despite high population coverage with repeated screens, no reduction in GC mortality was observed in this high-risk population in China.     

The effect of pressurized carbon dioxide as a temporary plasticizer and foaming agent on the hot stage extrusion process and extrudate properties of solid dispersions of itraconazole with PVP-VA 64.

The aim of the current research project was to explore the possibilities of combining pressurized carbon dioxide with hot stage extrusion during manufacturing of solid dispersions of itraconazole and polyvinylpyrrolidone-co-vinyl acetate 64 (PVP-VA 64) and to evaluate the ability of the pressurized gas to act as a temporary plasticizer as well as to produce a foamed extrudate. Pressurized carbon dioxide was injected into a Leistritz Micro 18 intermeshing co-rotating twin-screw melt extruder using an ISCO 260D syringe pump. The physicochemical characteristics of the extrudates with and without injection of carbon dioxide were evaluated with reference to the morphology of the solid dispersion and dissolution behaviour and particle properties. Carbon dioxide acted as plasticizer for itraconazole/PVP-VA 64, reducing the processing temperature during the hot stage extrusion process. Amorphous dispersions were obtained and the solid dispersion was not influenced by the carbon dioxide. Release of itraconazole from the solid dispersion could be controlled as a function of processing temperature and pressure. The macroscopic morphology changed to a foam-like structure due to expansion of the carbon dioxide at the extrusion die. This resulted in increased specific surface area, porosity, hygroscopicity and improved milling efficiency.     

Calcium-activated proteolysis of intracellular domains in the cell adhesion molecules NCAM and N-cadherin.

One of the consequences of increased intracellular calcium in response to a variety of physiological stimuli is the calcium activation of cytosolic proteases. Unlike lysosomal proteases with broad specificity, these calcium-activated neutral proteases show limited proteolysis of a restricted set of substrate proteins suggesting they may play a regulatory role in cellular physiology. In this study we show that the neural cell adhesion molecules NCAM-180 and N-cadherin are substrates for such endogenous calcium-activated neutral proteases. In contrast, a third neural cell adhesion molecule G4/L1 was not susceptible to calcium-activated proteolysis. The threshold for activation of NCAM and N-cadherin proteolysis is in the micromolar range of calcium suggesting that NCAM and N-cadherin are substrates for a mu-type calpain (calpain I). The site recognized by this protease is within intracellular domains of NCAM-180 and N-cadherin which are important for their interaction with cytoskeletal components. These results suggest that calcium-activated proteolysis at these sites in vivo could disrupt the linkage between extracellular ligand binding to these adhesion molecules and the normal intracellular effectors of such extracellular binding events.     

后囊连续环形撕囊在儿童人工晶体植入术的应用

后发障是儿童白内障最常见的并发症，是导致术后视力下降的主要原因，故降低后发障的发生率对提高术后视力及减少弱视的发生非常重要，以往文献报道大多是术后行ND-YAG激光后囊切开术来治疗后发障。笔者近年对儿童白内障采用白内障摘除人工晶体植入联合后囊连续环形撕囊术预防人工晶体术后后囊混浊，效果肯定，报告如下。