p53、C-erbB-2癌基因蛋白在涎腺粘液表皮样癌中的表达及其临床病理学意义

目的探讨癌基因蛋白p53、C-erbB-2（p185）过度表达与粘液表皮样癌生物学行为的关系。方法利用微波免疫组织化学方法对32例人粘液表皮样癌的癌基因蛋白p53、C-erbB-2进行检测。结果正常诞腺组织p53、C-erbB-2均为阴性反应。癌旁导管上皮细胞两者阳性率分别为10.0％及15.0％,但腺泡细胞阴性。粘波表皮样癌组织中p53、C-erbB-2阳性率分别为40.6％及46.9％。p53、C-erbB-2在粘液细胞、表皮样细胞及中间细胞内均有表达。p53、C-erbB-2的表达与粘液表皮样癌肿瘤组织学类型、分化程度及肿瘤复发等肿瘤生物学行为密切相关（P＜0.01）。结论p53、C-erbB-2可作为粘液表皮样癌的分化性标志物,用于监测病情、判断预后等。     

氨溴特罗口服液治疗支气管炎患儿的效果

目的：观察氨溴特罗口服液治疗支气管炎患儿的效果。方法选取承德市中医院2013年7月~2014年7月收治的支气管炎患儿100例,将其随机分为A、B两组。两组患儿均在常规治疗基础上分别给予氨溴特罗口服液及盐酸氨溴索糖浆进行治疗。比较两组患儿不同药物治疗后症状控制情况及治疗总有效率等指标。结果 A组患儿咳嗽、咳痰、喘息、肺部啰音、憋闷缓解时间及住院时间分别为(7.4±1.2)、(6.1±1.1)、(6.0±1.2)、(4.7±1.5)、(3.7±1.1)、(9.1±1.4)d,均显著短于B组[(10.3±2.1)、(8.4±1.2)、(7.5±1.4)、(5.2±1.3)、(4.3±1.4)、(13.7±1.5)d],差异有统计学意义(P约0.05)。A组患儿治疗后显效29例(58.0%),有效21例(42.0%),总有效率(100.0%)显著优于B组患儿[显效17例(34.0%),有效20例(40.0%),总有效率(74.0%)],两组总有效率比较,差异有统计学意义(P约0.05)。治疗后A组患儿咳嗽症状、咳痰量、痰液黏稠程度评分均较治疗前及B组患儿明显改善,差异有统计学意义(P约0.05)。结论临床应用氨溴特罗口服液可在短时间内缓解患儿咳嗽、发热等不适症状并缓解支气管痉挛。服药后起效速度快,且药效发挥时间长,有助于痰液排出并有效抑制炎性物质释放。服药后患儿不良反应较少,治疗安全性高,对加快疾病治疗速度、改善患儿预后情况并提高其生活质量具有重要意义。     

人sTRAIL基因的克隆、表达纯化及对人A549细胞的抗肿瘤活性作用

目的人TRAIL基因胞外区片段(114-281氨基酸残基,sTRAIL)的克隆、表达、纯化及对人肺腺癌A549细胞的抗肿瘤活性研究。方法采用PCR技术从人胎盘和肺cD-NA文库中扩增出全长人TRAIL基因,克隆到pUC19质粒载体上进行测序。然后再采用PCR技术,以全长人TRAIL基因为模板,扩增出sTRAIL基因片段并定向克隆到pET-11 a表达载体中,转化大肠杆菌BL21进行表达。表达后的产物经变性、复性和分离纯化,纯化后的sTRAIL用结晶紫染色法和流式细胞仪法测定其对人肺癌细胞A549的细胞毒性作用。结果从人胎盘和肺cDNA文库中都能扩增出全长人TRAIL基因,经测序表明与已发表的人TRAIL基因序列一致。扩增出的人sTRAIL基因克隆到表达质粒载体pET-11a,经IPTG诱导表达,表达量占细菌全菌蛋白的50%,纯化后的sTRAIL纯度大于98%,结晶紫法测定对人A549肺癌细胞的细胞毒性作用的IC50为(24±5.2)μg.L-1,流式细胞仪法测定对人A549肺癌细胞的细胞毒性具有明显的效应-时间依赖关系。结论本实验成功地克隆了人sTRAIL基因并实现其高表达,摸索出包涵体sTRAIL的变性、复性及其纯化方法,纯化后的sTRAIL蛋白对人A549肺癌细胞具有明显的细胞毒性作用,为进一步研究其功能与临床应用奠定了基础。     

Induction of human platelet fibrinogen receptors by epinephrine in the absence of released ADP

The ability of epinephrine to expose platelet fibrinogen receptors independent of released ADP was assessed using aspirin-treated, gel- filtered platelets. Similar to ADP-induced aggregation, platelet aggregation in response to epinephrine was accompanied by fibrinogen binding. Ten micromolar epinephrine induced a maximum number of platelet fibrinogen receptors in the absence of significant 14C- serotonin release. As indicated by Scatchard analysis, receptors exposed by both epinephrine and ADP had similar affinities for fibrinogen, but epinephrine induced approximately 30% fewer receptors than did ADP. This appears to correlate with the lesser degree of primary aggregation observed with this agent. Studies using phentolamine, a specific alpha-adrenergic antagonist, apyrase, or creatine phosphate/creatine kinase indicate that the exposure of platelet fibrinogen receptors by epinephrine was specific for platelet alpha-adrenergic receptor stimulation and was not the result of released ADP.     

B 超诊断前置胎盘分型的再探讨

目的 对Ｂ超诊断前置胎盘分型的改进探讨。方法 对３６例前置胎盘患者进行Ｂ超探查。观察胎盘下缘与子宫内口的关系。结果 前置胎盘的Ｂ超声像图可分四类：①胎盘中央部位于宫内口。②胎盘边缘部完全覆盖宫内口。③胎盘下缘至宫内口边缘,未覆盖宫内口。④盈盘位于子宫下截,未达到宫内口。结论 部分性前置胎盘的超声诊断分型担法不确切可予取消。将中央性前置胎盘诊断分两个亚型：中央型、边缘型。     

应用螺旋CT技术重建桩核体三维数字模型的可行性研究

目的构建桩核体的三维数字模型(库),为个体化桩核的设计、制作提供基础条件。方法在标准模型上制备桩核体的模板,采用螺旋CT扫描对其进行测量,应用Mimics软件和Geomagic 9.0软件实现桩核体的三维实体化重建,对桩核体模板表面标志点间距离进行相应的软件测量,并进行统计学分析。结果用螺旋CT扫描数据对桩核体的模板实现了三维实体化重建,获得桩核体的三维数字模型(库)。螺旋CT扫描数据所建立的桩核体三维数字模型,边缘轮廓连续、平滑,肩台清晰可辨。软件测量组和实体测量组桩核体模板表面标志点间距离的差异无统计学意义(t=0.158,P=0.876)。结论应用螺旋CT扫描数据,能够准确、快速建立桩核体的三维数字模型(库),软件测量与实体模型的测量值高度相关,系统与常用的测量手段间具有较好的一致性,该数字模型(库)能直接用来进行桩核的计算机辅助设计。     

糖耐量及胰岛素水平测定在多囊卵巢综合征中的临床应用

目的探讨多囊卵巢综合征患者（PCOS）糖代谢和胰岛素水平的改变。方法 173例PCOS患者按体质量指数（BMI）分为PCOS非肥胖组（BMI〈25kg/m2）、PCOS肥胖组（BMI≥25kg/m2）和42例正常对照组,各组均做口服糖耐量和胰岛素释放试验。结果与对照组相比,PCOS非肥胖组的空腹和口服葡萄糖后,1、2和3h的血糖差异均无统计学意义（P〉0.05）,胰岛素水平均有显著升高（P〈0.05）。PCOS肥胖组的空腹及口服葡萄糖后,1、2和3h的血糖和胰岛素水平均显著高于对照组和PCOS非肥胖组（P〈0.05）,差异具有统计学意义。结论 PCOS患者存在糖代谢异常和高胰岛素血症,口服糖耐量试验是用于监测育龄妇女PCOS患者糖代谢的较好指标。     

Adjuncts to case assessment of vaginal discharge syndrome in pregnant women

ObjectiveTo investigate the aetiology of abnormal vaginal discharge, using a non-culture based method, among pregnant women presenting at the University of Calabar Teaching Hospital, Calabar, Nigeria.MethodsTwo hundred consecutive antenatal patients, aged 18 to 38 years, with complaints of abnormal vaginal discharge between 1st April and 31st July 2004 were investigated clinically for the characteristics of the vaginal discharge. High vaginal swabs taken from the vaginal fornices were examined using a non-culture based method to determine the possible aetiology of the discharge. The possibility of integrating non-culture based laboratory methods in the syndromic case management of abnormal vaginal discharge in an antenatal clinic setting is discussed.ResultsThe commonest form of abnormal discharge was curdy white in 66% of cases. Ten (5%) women had malodourous vaginal discharged, 92% had vulval itching; and superficial dyspareunia was seen in 29% of cases. Microscopic studies of vaginal discharge revealed the following findings: lactobacilli (96%), polymorphs (96%), 'clue' cells (4%); positive Whiff test (5%), and pH > 4.5 (7%). The clinical and laboratory assessment of each patient lasted between 35 and 45 minutes. The procedures used were acceptable to 78% of women.ConclusionThe use of non-culture based laboratory methods in the initial assessment of abnormal vaginal discharge can be a useful adjunct in the syndromic case management of abnormal vaginal discharge in pregnant women.     

Endoscopic Mucosal Resection for Esophageal Cancer: EMR‐C Procedure

As a therapeutic modality for superficial esophageal cancer, endoscopic mucosal resection (EMR) is now thoroughly established. We routinely perform EMR using a cap (EMR‐C) procedure as a developer. In EMR‐C procedure, injection of a large volume of saline and a certain prelooping along the inner rim of the cap are vital issues for safe and reliable resection. In multi‐sessions of EMR, submucosal injection of saline prior to every session is essential, in order to avoid perforation. In such a manner, total circumferential EMR can be performed safely and easily by the EMR‐C procedure.