矢状缝早闭(舟状头)全颅成形术

目的探讨治疗矢状缝早闭(舟状头)畸形的手术方法。方法采用David“‖”形颅缝重建法(6例)、旋转骨瓣截骨法(2例)、梅花颅骨瓣头颅盖成型法(3例)等术式对舟状头进行矫治。结果11例患儿均治愈,外形满意。结论1~3个月舟状头宜采用简单的David“‖”形颅缝重建法进行治疗,3个月以上的患儿可选用浮动颅骨瓣头颅成型术、梅花瓣法颅骨瓣头颅盖成型术等方法进行治疗。     

嗜铬细胞瘤患者围手术期处理的改进

目的：探讨提高嗜铬细胞瘤患者围手术期安全性的措施。方法：对15例嗜铬细胞瘤患者、术前采用选择性α1受体阻滞剂多沙唑嗪控释片(可多华)控制高血压；11例患者采用3D DCEMRA进行肿瘤定位；术中均采用联合高容量血液稀释(AHH)和术中患者自体血回输纠正血容量。结果：除1例持续性高血压患者需联合钙离子拮抗剂和ACEI药物降压外．其余患者血压控制均为满意；根据3D DCEMRA定位选择手术径路者均顺利完成手术；AHH联合术中自体血回输使14例患者避免了异体输血。结论：本文围手术期处理改进．可多华可明显减少药物的不良反应；采用3D DCEMRA进行肿瘤定位，可增加手术安全性；AHH联合术中自体血回输可减少医疗成本和异体输血，以及由此而引起的并发症。     

Evaluation of trophoblast HLA-G antigen with a specific monoclonal antibody

A monoclonal antibody to HLA-G has been generated by immunizing HLA-A2.1/human β²-microglobulin (β²m) double transgenic mice with murine L cells transfected with both human β²m and HLA-G. This monoclonal antibody, designated as G233, has been found not to cross-react with other HLA class I antigens when tested on numerous cell lines by flow cytometry. With immunohistology, all populations of extravillous trophoblast (cell columns, interstitial trophoblast, endovascular trophoblast, placental bed giant cells) were stained. An extensive range of adult and fetal tissues was also tested but none reacted with monoclonal antibody G233, including those previously reported to express HLA-G mRNA, indicating that the protein has a highly restricted distribution. Failure to detect HLA-G in the fetal thymus raises the question as to how T-cell tolerance to this antigen is induced. Immunoprecipitation of trophoblast surface proteins with monoclonal antibody G233 revealed a heavy chain of 39 kDa and a light chain of 12 kDa, indicating that HLA-G expressed on the surface of trophoblast is complexed with p2m. However, sequential immunoprecipitation with monoclonal antibody W6/32 followed by monoclonal antibody G233 continued to detect a residual band of 39 kDa, suggesting that trophoblast surface HLA-G may also occur as free heavy chains not associated with p2m. Immunoprecipitation followed by two dimensional gel electrophoresis showed that monoclonal antibody G233 recognizes several iso-forms of HLA-G from trophoblast similar to the characteristic spot array previously described for HLA-G. This monoclonal antibody G233 will be highly useful in future experiments to elucidate the function of HLA-G.     

阻塞性黄疸:PTC下胆管钳夹活检的技术方法学研究

目的探索切实可行的胆管病理学检查新途径.资料与方法连续92例阻塞性黄疸患者接受经皮肝穿刺胆管造影(PTC)和经皮肝穿胆管引流(PTCD)治疗.PTCD过程中,影像监测下经皮经肝胆管穿刺,向胆管内引入活检钳对梗阻段钳夹活检,行组织病理学检查.统计学分析用χ2检验或Fisher确切概率计算法,以α=0.05作为检验水准.结果 92例钳夹活检患者90例成功获得组织块,技术成功率97.83%(90/92).钳夹活检敏感性为88.04%,63例胆管癌性恶性肿瘤钳夹活检敏感性较25例非胆管癌性恶性肿瘤高(93.65%比72.00%,P＜0.05).结论PTC下胆管钳夹活检操作简单,创伤小,敏感性高,是一种值得推广的胆管病理学诊断新途径.     

老年2型糖尿病患者胰岛素抵抗相关指标的检测和意义

目的:探讨老年2型糖尿病胰岛素抵抗(IR)及其相关性,为老年2型糖尿病的合理防治提供临床依据。方法:选择120例老年2型糖尿病患者,按胰岛素敏感指数(HOMA)胰岛素抵抗(HOMA-IR)50百分位点将患者分为两组:胰岛素相对敏感组(HOMA-IR<3.56)和胰岛素相对抵抗组(HOMA-IR≥3.56),比较体重指数(BMI)、腰/臀比(WHR)、血压、血生化学检查等指标。用年龄>40岁,<60岁的2型糖尿病患者做对照组。结果:两组老年患者在年龄、性别、舒张压、空腹血糖、胆固醇、高密度脂蛋白、糖化血红蛋白、HOMA胰岛β细胞功能方面无差异;但BMI、WHR、收缩压、甘油三脂、空腹胰岛素、HOMA-IR差异具有显著性。多线性回归分析后,只有腰/臀比、收缩压、甘油三脂、HOMA-IR存在统计学差异。老年患者与对照组相比,IR发生率明显增加,且两者腰/臀比、收缩压、甘油三脂方面也差异显著。结论:IR与老年2型糖尿病密切相关,是临床防治糖尿病的重要靶点。     

hCG/ATP-induced Leydig cell calcium channel reaction at different extracellular calcium ion concentration

Objective: To study the calcium channel reaction of human Leydig cells induced by hCG/ATP at different extracellular calcium ion concentrations. Methods: The Leydig cell calcium ion concentration was examined with laser confocal microscope, when the cells were stimulated with hCG/ATP at different extracellular calcium contrations. Results: With calcium-containing extracellular fluid, the Leydig cells were sensitive to hCG stimulation and when the extracellular fluid was calcium-free, the Leydig cells did not respond to the stimulation. However, the Leydig cells did respond to ATP stimulation no matter the extracellular fluid contained calcium or not. Conclusion: In human Leydig cells, there are calcium channels sensitive to hCG and ATP. The extracellular calcium ion concentration plays an important role in the regulation of Leydig cell metabolism by hCG/ATP.     

Modulation of high-dose methotrexate toxicity by a non-toxic level of 5-fluorouracil

High-dose methotrexate (MTX) toxicity is reduced by a non-toxic dose of 5-fluorouracil (FU) when these agents are used in combination. Changes in the hematopoietic system (platelets, erythrocytes, leukocytes, hemoglobin, and hematocrit), ileal tissue, body weight, and mean survival were used as parameters to assess toxicity. For all parameters studied, there were no significant differences between the scheduling of MTX (245 mg/kg) after a priming dose of FU (25 mg/kg), simultaneous MTX and FU, FU alone, and control. However, sequential treatment with MTX followed by FU, and MTX alone resulted in: a marked decrease in the hematopoietic parameters; significant morphological changes in ileal tissue; a reduction of body weight; and increased mortality of animals. Hence, this study suggests that FU, a cytotoxic agent, may protect against MTX toxicity and improve its therapeutic index when FU administration precedes MTX or when these agents are given simultaneously.     

IL-2-PE40体外抑制γ-干扰素诱导的角膜内皮细胞MHC抗原表达的研究

目的了解正常大鼠角膜内皮细胞在体外经γ-干扰素诱导后，主要组织相容性复合体（major histoeompatibility complex，MHC）-Ⅰ、Ⅱ类抗原异常表达的情况。并观察比较白细胞介素-2-绿脓杆菌外毒素（interleukin-2-pseudomonas exotoxin40。IL-2-PE40）、环胞霉素A（cyclosporine A，CsA）对角膜内皮细胞MHC-Ⅰ、Ⅱ类抗原异常表达的免疫抑制作用。方法采用ACAS-570黏附式细胞分析仪和免疫荧光技术，对体外原代培养经γ-干扰素诱导后的正常大鼠角膜内皮细胞分成A、B2组进行MHC-Ⅰ、Ⅱ类抗原表达的相对量测定，并在培养液中加入新型免疫抑制剂IL-2-PE40和CsA，进一步测定角膜内皮细胞MHC-Ⅰ、Ⅱ类抗原的表达量。结果未加入γ-干扰素前，MHC-Ⅰ类抗原的表达量为97．8±8．1，MHC-Ⅱ类抗原无表达；经γ-干扰素诱导后，MHC—Ⅰ类抗原的表达量为1006．3±13．2，MHC-Ⅱ类抗原表达量为406．5±10．5，γ-干扰素加入前后MHC-Ⅰ、Ⅱ类抗原比较均有统计学意义（P〈0．05）。IL-2．PE40组MHC-Ⅰ类抗原的表达量为618．2±13．5，MHC-Ⅱ类抗原表达量为204．5±7．8，CsA组MHC-Ⅰ类抗原的表达量为609．5±12．9，MHC-Ⅱ类抗原表达量为198．5±6．9，IL-2．PE40组、CsA组分别与注射用水比较，MHC—Ⅰ、Ⅱ类抗原间均有统计学意义（P〈0．05）。IL-2．PE40组与CsA组比较．MHC—Ⅰ、Ⅱ类抗原间差异无统计学意义（P〉0．05）。结论在体外，γ-干扰素可诱导角膜内皮细胞MHC-Ⅰ、Ⅱ类抗原异常表达；IL-2-PE40及CsA均能不同程度的抑制这种表达。[眼科新进展20ff7；27（3）：170．172]     

99m TC-MIBI动态显像对非小细胞肺癌化疗疗效的预测价值初探

目的 探讨^99mTC-MIBI动态显像对非小细胞肺癌化疗疗效的预测价值。方法 对确诊为不能手术的非小细胞肺癌患者化疗前,静脉注射740mbq ^99mTC-MIBI后分别于30min,2h行SPECT动态扫描,计算早期/晚期肿瘤组织与对侧正常肺组织的放射活性比（T/Ne,T/Nd）,全身采用卡铂/顺铂＋VP16化疗3周期,随后复查胸部CT,评判化疗疗效及其与^99mTC-MIBI动态显像的关系。结果 78例NSCLC符合入选标准,并完成化疗方案,66例呈阳性显像,12例阴性显像,66例阳性显像中化疗有效率为90.7%,阴性显像12例中化疗全部进展,两者比较差异有显著性（P〈0.01）。结论 ^99mTC-MIBI动态显像的放射活性越高,化疗效果越好,对非小细胞肺癌化疗疗效有预测价值,可为合理制定治疗方案提供重要依据。     

Terminal coma affects messenger RNA detection in post mortem human temporal cortex.

In situ hybridization histochemistry has been used to study the amount of M1 muscarinic receptor mRNA in temporal cortex from subjects with Alzheimer's disease and other neurodegenerative disorders, where the duration of terminal coma was known. Total polyadenylated mRNA and glutamate decarboxylase activity were also measured. Both muscarinic receptor mRNA and enzyme activity showed a significant decline with increasing duration of terminal coma, but were not related to diagnosis. Polyadenylated mRNA signal did not show an association with coma. These data indicate the need to consider the nature of the terminal illness in post mortem studies of mRNA as well as for neurochemical research.