麦考酚酸联合迪银片治疗寻常型银屑病的近期临床疗效观察

目的研究麦考酚酸(MMF)联合迪银片治疗寻常型银屑病的使用方法、近期临床疗效及其副作用。方法46例患者随机分为治疗组和对照组。治疗组23例,MMF1.5 g/d分3次口服,1月后,减为1.0 g 2次/d,共4周,同时服用迪银片5片,3次/d共8周;对照组32例,服用迪银片和火把花根各5片,均3次/d,共8周。结果治疗组基本痊愈14例,显效5例,进步2例,无效2例,有效率91.30%;对照组基本痊愈16例,显效8例,进步2例,无效6例,有效率81.25%。两组疗效差异无显著性(P>0.05)。结论MMF联合迪银片治疗寻常型银屑病疗效与迪银片联合火把花根片相当,有较好的疗效。但因其价格昂贵,可作为二线银屑病治疗药物。     

A case of juvenile chronic myeloid leukemia with XX/XXX mosaicism.

Cytogenetic abnormalities are rarely found in patients with juvenile chronic myelogenous leukemia (JCML). In patients with chromosomal abnormalities, chromosomes 7 and 8 are usually involved. A case of JCML with 47 XXX and a 46 XX karyotype is described and the literature is reviewed. To our knowledge, this is the first case ever to have been reported.     

旁道位置与室上性心动过速首次发作时年龄及性别的关系探讨

目的为了解旁道位置与室上性心动过速初次发作时年龄及性别的关系.方法对128例已进行过射频消融的患者进行了回顾性分析.结果男性左侧旁道发病时平均年龄大于右侧及中隔旁道平均为14岁和9岁;大于女性左侧旁道7岁,男性显性旁道发病时平均年龄小于隐匿性旁道7岁.而女性显性旁道与隐匿性旁道、左侧旁道与右侧旁道发病时平均年龄无显著性差异.结论旁道位置与室上速初次发作时年龄及性别有关.     

一氧化氮与肺缺血再灌注损伤的研究进展

一氧化氮（nitricoxide，NO）是一种活性很强的自由基，具有广泛的生物学活性。多项研究提示NO在急性肺缺血／再灌注（ischemia／reperfusion，I／R）损伤中具有重要作用。本文重点描述有关一氧化氮在肺I／R损伤中作用的研究进展。     

超声洁治和局部用甲硝唑治疗轻、中度种植体周围炎

目的：评价用碳纤维工作头的超声洁牙机和25％甲硝唑凝胶治疗种植体周围炎的疗效。方法：将27颗患轻中度种植体周围炎的种植牙随机分为洁牙机治疗组和甲硝唑治疗组，在基线、1、2、6和12周时检查种植体的临床和生物学指标。结果： 两种治疗方法均可使菌斑指数、龈沟出血指数、龋下微生物的酶活性检查等指标改善。治疗期间未发现任何不良反应。结论；碳纤维头超声洁治和局部用25％甲硝唑凝胶是治疗牙种植体周围炎的安全有效的方法。     

粉防己碱舒张离体新西兰白兔阴茎海绵体平滑肌的机制研究

目的观察粉防己碱(tetrandrine,Tet)对阴茎海绵体平滑肌胞内钙释放和胞外钙内流的影响,初步探讨其舒张作用的机制。方法采用离体阴茎海绵体平滑肌肌条张力记录法,观察Tet对去氧肾上腺素(phenylephrine,PE)和氯化钾(KCI)诱导收缩的肌条的影响；采用无Ca~(2 )-复Ca~(2 )实验法,观察Tet对PE诱导的依赖细胞内钙和细胞外钙的肌条收缩反应的影响。结果Tet对PE或kcl诱导的肌条收缩均具有浓度依赖性的抑制作用。100μmol/L Tet可抑制20μmol/L PE引起的依赖细胞内钙和细胞外钙的肌条收缩(P＜0．05)；结论Tet可通过阻滞电压依赖性钙通道、受体依赖性钙通道和抑制细胞内钙库释放,从而介导其对海绵体平滑肌的舒张作用。     

Polymorphism in the promoter region of the apolipoprotein AI gene associated with differences in apolipoprotein AI levels: The European Atherosclerosis Research Study

The effect associated with the substitution of adenine (A) for guanidine (G) in the promoter region of the apolipoprotein AI gene (?75 bp) with plasma apo AI and high-density lipoprotein (HDL) levels was investigated in the European Atherosclerosis Research Study (EARS). This is a study of healthy offspring (cases) of fathers who had suffered premature myocardial infarction (MI) before age 55 years (n = 565) and age- and sex-matched controls (n = 1,078) from 12 European countries, divided into 5 regions based on geography and language. The frequency of the polymorphism was not significantly different among the regions and the relative frequency of the rare A allele was similar in cases and controls (0.159 vs. 0.142) combining data from all regions. Individuals with one or more A allele had significantly higher plasma apo AI levels (P < 0.05) than individuals homozygous for the G allele. This effect was consistent in all regions. The data were analyzed separately in males and females. In females, those with one or more A allele had significantly higher apo AI levels (P = 0.05) than individuals homozygous for the G allele, and this raising effect of the A allele was greater in cases than controls for both apo AI (5.23% vs. 1.56%) and HDL (4.48% vs. 1.89%). In males, the A allele was associated with higher levels of apo AI and HDL, but the effect was much smaller and the differences did not reach statistical significance. In the females, where the effect of the A allele was strongest, the effect on apo AI associated with genotype was evident in non-smokers, and individuals with one or two A alleles had 3.6% higher apo AI and 3.14% higher HDL levels than individuals homozygous for the G allele. However, in the female smokers the raising effect of the A allele was greatly reduced (0.56%). Thus genetic variation in the promoter region of the apo AI gene is associated with differences in apo AI and HDL levels in healthy individuals throughout Europe, but the effect is modulated by gender, environmental factors such as smoking, and a family history of MI.     

The use of tissue expanders in syndactyly repair

The syndactyly repairs of 11 hands in seven patients (average age 20.4) who had simple complete syndactyly between the third and fourth fingers were done by the use of tissue expanders in order to obtain adequate skin closure. At the first stage, a wedge type, 7 cc tissue expander was placed beneath the dorsal skin of the syndactylous digits via a vertical dorsal hand incision under local anesthesia. Inflation was begun on the 15th postoperative day. After the inflation period (average 32 days), syndactyly repair similar to the Littler technique was performed using axillary block anesthesia. During the expansion period one tissue expander became exposed and this hand was repaired by the classical skin grafting technique. In the remaining ten hands the expanded dorsal skin ensured skin closure of the digits and web reconstruction without any need for skin grafting. No complications were encountered during the postoperative period. Active and passive abduction angles, tip-to-tip length, active range of motion of the digits, and two point discrimination tests were done at follow-up (average six months). The web appearances were normal in all patients. Active abduction angles and active range of motion of the digits was always normal at the third postoperative month. Two point discrimination was 8.7 mm on the interdigital sides of the digits and there was no tip-to-tip length differences of the digits. No contractures were seen.Presented at the International Congress of Surgery of the Hand and Upper Extremity, Izmir, Turkey, September 25, 1994.     

上海市闵行区流动人口中的孕产妇保健状况

通过对上海市闵行区580名外来孕产妇及580名作为对照的本地孕产妇的孕产期保健现况调查分析,表明外来孕产妇缺乏必要的孕产期保健措施,有47.6％的外来孕产妇从未做产前检查,产后保健则完全没有,并由此而造成外来产妇在急产、死产、甚至孕产妇死亡等方面令人忧虑的现状。为适应和促进当前经济发展的新形势,改善流动人口的孕产妇保健状况,应对流动人口中孕产妇保健状况深入研究,并采取相应的措施。     

Comparison of indium-111 octreotide and thallium-201 scintigraphy in patients mammographically suspected of having breast cancer: Preliminary results

Indium-111 octreotide and thallium-201 scintigraphic studies were compared in 21 patients (16 with palpable and five with non-palpable lesions) suspected of having breast malignancies on the basis of mammography. Early (15 min) and late (3 h)²⁰¹Tl (111 MBq) and 4-h and 24-h¹¹¹In-octreotide (111–148 MBq) static planar anterior images (matrix 256×256) were obtained on separate days. Images were evaluated both visually and quantitatively. Biopsy was performed following the imaging studies. Histopathology revealed 17 breast carcinomas (15 cases of invasive ductal carcinoma, one mucinous adenocarcinoma and one intraductal carcinoma) and four benign breast lesions (two fibroadenomas, one abscess and one case of fat necrosis). The means histopathologcial tumour size (mean largest diameter) was 3.38±1.9 cm.¹¹¹In-octreotide detected 16 of the 17 breast cancers (94%) while²⁰¹Tl detected 13 of them (76%). Both¹¹¹In-octreotide and²⁰¹Tl missed one nonpalpable carcinoma showing only an isolated cluster of microcalcifications on mammography. The smallest tumour size detected by both agents 1.5×1.5 cm. Of the four benign lesions, only the breast abscess revealed both²⁰¹Tl and¹¹¹In-octreotide uptake.¹¹¹In-octreotide scan also showed tracer uptake in five of the six patients with histologically proven axillary metastases, while four of these six patients showed²⁰¹Tl uptake. The tumour/background (T/B) ratios of late¹¹¹In-octreotide and²⁰¹Tl images were 1.71±0.38 and 1.46±0.30 respectively (P=0.039). In this preliminary study,¹¹¹In-octreotide yielded more favourable results than²⁰¹Tl in the detection of breast carcinomas. However, the diagnostic efficacy of¹¹¹In-octreotide imaging needs to be investigated in larger patient series.