Implantation of Active Can Implantable Defibrillators in the right Pectoral Region

Routinely the active can ICD is placed in the left side pectoral position, which theoretically gives optimal conditions for a low defibrillation threshold. Some patients, bowever, demand a right pectoral position, which possibly could result in a bigger defibrillation threshold. A right pectoral position was used in 3 of 85 active can ICDs implanted in our institution from 1994. the DFT was 12 J in two and 18 f in one patient. Thus, right pectoral implantation is feasible and offers an alternative approach in selected patients.     

功能性内镜鼻窦手术的核心技术

自Messerldinger 1972年开始采用鼻内镜手术治疗慢性鼻窦炎至今已近40年[1],在我国也已经有20年的历史.1995年Kennedy将其命名为功能性内镜鼻窦手术(functional endoscopic sinus surgery,FESS)[2].时至今日,FESS仍然是慢性鼻窦炎最重要的治疗手段之一.     

1,25-Dihydroxyvitamin D3 Exerts Opposing Effects to IL-4 on MHC Class-II Antigen Expression,Accessory Activity,and Phagocytosis of Human Monocytes

To investigate the differentiation and activation of monocytes, the combined effects of 1,25-dihydroxyvitamin D3 (D3) and IL-4 on human blood monocytes were examined with respect to expression of MHC class-II antigens, accessory activity, and phagocytic capacity. IL-4 was reported lo upregulate the expression of MHC class-II antigens and accessory activity of monocytes. The experiments described here demonstrate that D3 inhibits the expression of all three subtypes of MHC class-II antigens (HLA-DR, -DP and -DQ) as well as the accessory activity of monocytes. both in a dose- and time-dependent manner. However, D3 enhances the immunoglobulin- and complement-dependent phagocytosis by monocytes in a dose- and time-dependent manner. When monocytes are treated with both IL-4 and D3, the effects of D3 are reverted by IL-4. suggesting that IL-4 induces the development of monocytes into accessory cells, whereas D3 stimulates differentiation of monocytes into classical macrophages. These findings provide further evidence for the contention that, depending on defined stimuli, monocytes may develop either into accessory cells or into classical macrophages.     

肝脏血管瘤的手术指征和手术方法选择（附46例报告）

目的 探讨肝脏血管瘤的手术指征和手术方法。方法 回顾性分析采用手术治疗46例肝脏血管瘤病人资料，判断其手术指征，评价不同手术方法的治疗效果厦其手术并发症发生情况。结果 46例病人中，19例采用肝叶或肝段切除术，17例出现并发症，以胸腔积液和膈下积液多见，采用血管瘤摘除术的27例病人无并发症。结论 对肝脏血管瘤直径大于5cm并有明显临床症状，或不能除外恶性肿瘤的病人可以采用手术治疗。血管瘤摘除术是安全有效、并发症少的手术方法。     

腓浅神经痛诊治的解剖学基础(系列介绍之十五)

目的 介绍腓浅神经痛的诊断与局部注射的治疗方法。方法 选择门诊确诊为腓浅神经痛的患者18例，采用强的松龙混悬液加麻药局部注射神经穿出小腿深筋膜的部分的治疗方法。结果 所有病例皆在注射后短时完全止痛，多数病例一周后痊愈，少数病例经1～3次注射后痊愈。结论 对诊断明确的病例，采取强的松龙局部注射法，可以获得满意的疗效。     

腹膜透析治疗老年慢性肾功能衰竭的临床分析

目的 分析持续性腹膜透析(PD)治疗老年慢性肾功能衰竭(CRF)患者的临床效果,探讨PD在老年CRF患者中的应用经验.方法 回顾性分析89例老年CRF患者接受PD(简称老年PD组)治疗后的临床表现和生化指标、主要并发症、存活率、死亡原因等,并与53例非老年PD组相比较.结果 老年PD组的原发疾病以糖尿病(37.08%)、原发性高血压(30.34%)为主,而非老年PD组则以肾小球肾炎(54.72%)为主.两组患者的1年与3年存活率差异无统计学意义,腹膜炎仍是两组患者退出PD的主要原因.老年组的病死率明显高于非老年组,感染与心脑血管病是两组患者的主要并发症和死亡原因.低钾血症在老年PD患者中非常普遍.结论 腹膜透析在老年CRF患者的治疗中有效,但长期存活仍受腹膜炎、心脑血管病并发症的影响,老年PD患者的低钾血症应引起足够的重视.     

肿瘤光动力治疗中组织氧含量的动态模型研究

目的：分析肿瘤光动力治疗中的组织氧含量的变化规律，研究影响肿瘤光动力治疗效果的与氧相关的因素,探讨改进光动力治疗的途径。方法：建立肿瘤光动力治疗中氧含量的动态模型，并采用Crank—Nicolson离散方法解析该模型，在时间域和空间域上，分析光动力过程中肿瘤氧含量的动态变化过程，研究光照的光功率密度、肿瘤初始氧含量等因素对光动力疗效的影响，并比较间断光照和连续光照两种方式的不同疗效。结果：肿瘤氧含量随着治疗时间和离血管的距离呈衰减趋势，光动力反应只发生在血管附近的有限区域，且区域大小与初始氧含量密切相关．在较高的初始氧含量下，更大区域的氧含量因为处于阈值Cth以上，所以能发生光动力反应。当采用较低的光功率密度光照治疗时,肿瘤氧含量衰减比高功率密度下慢；当采用间断光照进行光动力治疗时，在治疗黑暗期肿瘤氧含量能得到回升．有利于光照期的治疗。结论：初始氧含量较高的情况下治疗效果更好；在较低的光功率密度下，光动力反应较难进行，但是有利于保护肿瘤供氧源的工作。在较低的初始氧含量下，间断光照方式的疗效要比连续光照要好。     

EB病毒LMP2A特异性CTL的体外诱导及分析

用EBV LMP2A重组痘苗病毒 (rVV LMP2A )转染人树突状细胞 (DC ) ,转染后的DC分别在第 1、 7、 14天刺激相同MHC背景的T细胞 ,在IL 2作用下诱导LMP2A特异性CTL。用LDH释放法检测CTL杀伤活性 ;流式细胞术 (FACS )检测CTL诱导分化过程中CD3+ 、CD4 + 、CD8+ 、CD5 6 + 等细胞的分群变化 ;RT PCR检测细胞分化过程中FasLmRNA表达 ;生物活性法检测功能性细胞因子IFN γ的分泌。结果显示本法诱导的CTL对靶细胞有特异性杀伤活性 ,第 2次和第 3次DC刺激后杀伤活性有所上升 ;在CTL诱导分化的第 7、 14、 2 1天细胞分群以CD4 + 、CD8+ 细胞为主 ;RT PCR证实所诱导的细胞内有FasLmRNA的表达 ;随细胞培养天数的增加IFN γ分泌增加 ,在第 14天达到较高水平。研究表明重组痘苗病毒载体rVV LMP2A转染的DC刺激T细胞可诱导出EBV LMP2A特异性CTL。     

CD44+/CD24-细胞在乳腺癌组织及细胞系中的数量与分布

Objective To study the distribution and quantity of CD44VCD24- cells in breast cancer tissue and the cell lines,and as well as its correlation with the expression of various breast cancer markers and molecular subtyping of breast carcinoma.Methods The expression of CD44 / CD24,estrogen receptor,progesterone receptor,HER2,human estrogen-induced protein PS2,bcl-2 and nm23 in 60 cases of invasive ductal carcinoma of breast were studied by either single or double immunohistochemical staining.The co-expression of CD44 and CD24 in 3 breast cancer cell lines (MCF-7,MDA-MB-468,and MDA-MB- 231) was also examined.Results The quantity and distribution of CD44 + /CD24- cells varied greatly and no specific patterns were identified.The percentage of CD44 + /CD24- in breast cancer was 65%.The amount of CD44+/CD24- cells did not correlate with the age of patients,lymph node metastasis,tumor　 size,molecular subtypes and expression of various breast cancer markers in breast carcinoma.The proportion of CD44+/CD24- cells in MCF-7,MDA-MB-468,and MDA-MB-231 cell lines was < 1%,5% and > 80% ,respectively.Conclusions CD44+ /CD24- cells are demonstrated in certain breast cancer tissues and cell lines.However,there is no relationship obtained between the quantity or the distribution of these cells and the molecular subtyping or the clinicopathologic parameters in breast cancer.     

Analysis of 8-hydroxydeoxyguanosine 5'-monophosphate (8-OH-dGMP) as a reliable marker of cellular oxidative DNA damage after gamma-irradiation

In order to improve 8-hydroxyguanine (8-OH-Gua) detection in DNA, we digested isolated DNA with nuclease P1 and analyzed for 8-hydroxydeoxyguanosine 5'-monophosphate (8-OH-dGMP) using a high-performance liquid chromatography system equipped with an electrochemical detector (HPLC-ECD). The amount of 8-OH-Gua in the DNA was expressed as the ratio of 8-OH-dGMP to deoxycytidine monophosphate (dCMP). Using this analysis, the background level of 8-OH-Gua in DNA from human lung carcinoma cells (A549) was several-fold lower than that obtained by a previous method. A549 cells were exposed to 20-60 Gy of gamma-radiation and an increase in 8-OH-Gua concentration was observed with increasing gamma-ray dose (0.3 residues per 10(7) dCMP per Gy). Moreover, by an immunohistochemical procedure using a commercial FITC-kit, 8-OH-Gua was clearly detected in A549 cells and the fluorescence intensity of cells with oxidative DNA damage increased with the doses of gamma-irradiation. Using an endonuclease nicking assay, we also found that gamma-rays decreased 8-OH-Gua repair activity. The results indicate that 8-OH-dGMP is a useful and sensitive marker for estimating oxidative damage in DNA.