中耳粘连手术治疗的疗效观察

中耳粘连是耳外科治疗的难题之一.为总结20年来手术治疗的体会和教训,对105例(129耳)的治疗情况进行了回顾性分析.对中耳粘连进行了分类,表明选择正确的手术方式有助于听力的改善;亦表明异物作为隔离物是不可取的;要进一步提高手术疗效尚有待进一步的探讨.     

筛窦开放后鼻甲外移开窗的临床及CT观察

OBJECTIVE: To assess the effect of middle turbinate (MT) and ethmoidal internal wall(EIW) moved externally after microsurgery. METHODS: Twenty-four cases (45 sides) were followed-up endoscopically for (16.3 +/- 9.3) months. Thirteen cases (24 sides) were observed by CT scans. Three cadaver heads were measured for anatomical analysis. RESULTS: Forty-one (91%) of 45 sides obtained better olfactory function after operation. Twenty-two (91%) of 24 sides were found to have better CT changes in sinus ventilation as compared with preoperative CT scans. The gap between the MT and EIW to the orbital wall was (12.0 +/- 1.0) mm, while that between the ethmoidal bulla and processus uncinatus was only (2.3 +/- 0.6) mm as revealed in the autopsy. CONCLUSION: MT and EIW moderately moved suitably to externally had no bad effect on sinus ventilation, and it improved olfaction.     

VEGF受体flk-1的表达与喉粘膜上皮癌变发生和转移的关系

 目的:观察血管内皮生长因子(VEGF)受体flk－1在不典型增生及鳞癌中的表达,用图象分析系统定量的方法观察flk-1与喉癌的生长、浸润及转移的关系。方法:用抗flk－1抗体,在经过微波处理组织暴露抗原后,进行标准化的EliteABC染色,并通过图象分析系统确定flk-1在不典型增生、鳞癌中的表达。结果:在不典型增生及鳞癌中flk－1均有表达。在组织中,flk－1不仅在血管内皮细胞中、在部分浆细胞和巨噬细胞中也呈阳性反应。鳞癌组中的flk－1的表达明显高于不典型增生组(P<0.05)。在鳞癌中,随着分化程度的下降,flk-1表达有逐渐递增的趋势。在鳞癌组中发生转移的病变flk-1的表达明显高于未转移组(P<0.05)。相关分析显示flk－1的表达与肿瘤的临床分期密切相关。结论:VEGF通过自分泌和旁分泌的途径影响肿瘤细胞生长及间质中新生血管的形成,肿瘤细胞的生长与血管的发生相互依赖。flk-1与喉癌的生长、浸润及转移密切相关,flk-1可能作为一个判断预后的重要指标。     

盐酸恩丹西酮预防化疗所致呕吐Ⅱ期临床研究

观察国产５－ＨＴ３阻滞剂－盐酸恩丹西酮预防化疗所致呕吐的临床疗效。方法：采用随机自身交替对照方法分为两组观察，接受顺铂联合化疗组及非顺铂联合化疗组各２５例。盐酸恩丹西酮８ｍｇ，化疗前１５分钟静注，恩丹西酮８ｍｇ，化疗后８小时口吸口服。对照组：胃复安２０ｍｇ，化疗前１５分钟肌注，胃复安８ｍｇ化疗后８小时口服。     

P38蛋白在大肠癌中的表达及其临床意义

目的:探讨人大肠癌中有丝分裂原激活蛋白激酶P38的表达及其临床意义.方法:应用免疫组织化学SABC法检测46例大肠癌组织及其癌旁正常粘膜中P38蛋白表达情况.结果:P38蛋白的表达定位于胞质中,胞核中无表达.P38在大肠癌中的阳性表达率为95.65%,在癌旁组织中阳性表达率为33.13%.P38在大肠癌中的表达明显高于癌旁组织,有显著的统计学差异(P＜0.01).P38的表达与年龄、性别、肿瘤大小、肿瘤位置无明显相关(P＞0.05).P38的表达与Dukes分级,组织分化程度及有无淋巴结转移有显著差异(P＜0.01).结论:大肠癌组织中P38蛋白处于过度表达状态,与大肠癌的发生,发展和转移密切相关.     

A comparative study on potential cytogenetic fingerprints for radiation LET in human lymphocytes

PURPOSE: To carry out a comparative study on potential cytogenetic fingerprints for radiation LET in human metaphase lymphocytes. MATERIALS AND METHOD: Human lymphocytes were irradiated in vitro with 3.0 Gy 60Co gamma-rays, 0.9 Gy 3H beta-rays or 0.2 Gy 2.7 Mev neutrons. Detailed chromosome aberrations were analysed by combined FISH with pan-telomere staining and specific whole-chromosome painting (1, 2 and 4). Total chromosome translocations and insertions were also analysed by multicolour whole-chromosome painting (chromosomes 1, 2 and 4 orange, chromosomes 3, 5 and 6 green). RESULTS: Among the six proposed radiation cytogenetic fingerprints, the ratio of total simple translocations to insertions (I-ratio), showed the largest difference between low-LET 60Co gamma-ray and high-LET neutron radiation. The ratios of complete exchanges to incomplete rejoinings [S(I)-ratio] and dicentrics to interstitial deletions (H-ratio), showed a similar significant difference between low- and high-LET radiation. The ratios of centric rings to interstitial deletion (G-ratio) showed a trend of LET-related difference, but the difference was not significant in this data set. The ratios of dicentrics to centric rings (F-ratio) and apparent complete exchanges to hidden complete exchanges [S(II)-ratio], showed no difference between low- and high-LET radiation. In the 1426 radiation-induced chromosome aberrations observed after 52 h culture, evidence for sister-chromatid fusion but not telomere addition was found. CONCLUSION: Pan-telomere staining plus specific whole chromosome painting allows simultaneous and objective detection of complete or incomplete chromosome exchanges and interstitial or terminal deletions in human peripheral lymphocytes. Of the six proposed cytogenetic ratios, the I-ratio is the most effective cytogenetic fingerprint for distinguishing low-LET from high-LET radiation in human metaphase human lymphocytes.     

金黄色葡萄球菌NorA蛋白免疫检测方法的建立

目的建立金黄色葡萄球菌耐药转运蛋白NorA免疫检测方法。方法利用琼脂稀释法测定诺氟沙星（NFLX）对临床分离的6株金葡菌和标准菌株ATCC25923的MIC。对norA基因进行克隆、表达，提取表达产物包涵体，并进行了纯化。将纯化的表达蛋白作为免疫原免疫家兔，获取NorA蛋白的抗体血清。利用制得的抗体通过Western blotting检测临床分离的6株金葡菌的NorA蛋白表达水平。结果氟喹诺酮类药物耐药水平较高的临床分离金葡菌菌株的NorA蛋白表达水平一般较高，敏感菌株的耐药水平较低且接近。结论免疫检测方法可用于检测金葡萄菌耐药转运蛋白NorA的表达水平。     

煤工尘肺患者下呼吸道产金属内酰胺酶铜绿假单胞菌感染状况

目的了解煤工尘肺患者下呼吸道产金属内酰胺酶的铜绿假单胞菌(PA)的感染状况及其耐药特性。方法分离下呼吸道感染的煤工尘肺患者痰液标本中的PA，根据药敏试验，筛选可疑产金属内酰胺酶PA，最后依据2-巯基丙酸双纸片法鉴定产金属内酰胺酶PA。结果40株PA中共筛选出10株可疑PA，最终确定产金属内酰胺酶PA6株。这些菌株均有很强的耐药性，对亚胺培南、头孢菌素、含酶抑制剂类抗菌药物全部耐药；对阿米卡星、环丙沙星、左氧氟沙星、庆大霉素等药物部分耐药。产金属内酰胺酶PA的耐药性远强于不产金属内酰胺酶的PA。结论产金属内酰胺酶PA的耐药性很强，应加强煤工尘肺患者产金属内酰胺酶PA的检测，以利于指导治疗和控制感染。