肠易激综合征患者胆囊运动功能的研究

目的 了解肠易激综合征患者的胆囊运动功能情况,协助肠易激综合征的治疗。方法 我们通过对健康志愿者(对照组)和肠易激综合征患者(IBS组)用核素显相测定胆囊排空功能。结果 IBS组23例中有13例(56.5％13／23),对照组16例中有4例(25％4／16),餐后1小时胆囊排空指数(GBEF)降低,两组比较差异有显著性(P<0.01)。餐后30、40、50和60minGBEF IBS组均低于对照组,差异有非常显著性(P<0.01)。结论 IBS组胆囊排空率下降,排空功能不良。在治疗肠易激综合征同时予利胆促动力剂治疗。     

胃癌及癌前期病变粘膜芳香基酰胺酶同工酶的表达意义

目的探讨胃癌及癌前期病变粘膜芳香基酰胺酶（ＡＡＤ）同工酶的表达规律，寻找癌前期病变及早期癌的标志物．方法采用本室建立的圆盘等电聚焦电泳（ＣＩＥＦ）分离１２２例各种胃病粘膜（胃癌４１例，浅表性胃炎４８例，萎缩性胃炎３０例，胃溃疡８例，其中伴肠化１９例，异型增生８例）中ＡＡＤ同工酶．以６０ｇ／Ｌ丙烯酰胺作支持递质，ｐＨ３５～５０和ｐＨ３５～１００两种载体两性电解质建立ｐＨ梯度，加匀浆液５０μｌ，阴极及阳极电极液分别用０２ｍｏｌ／ＬＮａＯＨ和０５ｍｏｌ／ＬＨ３ＰＯ４，恒压电泳（１０℃）１８ｈ后以亮氨酰β萘胺作为基质呈色．结果ＡＡＤ分为８条区带，从阳极到阴极依次命名为ＡＡＤⅠ～ＡＡＤⅧ，其中ＡＡＤⅣ主要见于胃癌（９０２％），不完全大肠型肠化（８６７％）和异型增生（７５０％）；而不伴有肠化或异型增生的良性胃病和正常胃中则未发现．ＡＡＤⅣ的阳性率与胃癌病理类型、细胞分化程度及临床分期无相关，且ＡＡＤⅣ等电点和胎盘型ＡＡＤ等电点相当．结论ＡＡＤⅣ是一种癌胚蛋白，即胃癌组织特异性同工酶，是癌前期病变及早期癌的标志物．     

Hostility, social support, and carotid artery atherosclerosis in the National Heart, Lung, and Blood Institute Family Heart Study

This cross-sectional study investigates the association of hostility and social support (measured by standardized instruments) to carotid artery atherosclerosis in men and women with a high familial risk for coronary heart disease (CHD) and those with low to medium risk. The hypothesis was that high hostility and low social support would have a stronger association in subjects with a familial predisposition to CHD. There were 535 low- to medium-risk women, 491 low- to medium-risk men, 1,950 high-risk women, and 1,667 high-risk men in the study. The extent of carotid artery atherosclerosis was assessed by B-mode ultrasound imaging. A lesion was defined as an intimal-medial far wall thickness of 1 mm in the common, internal, or carotid bifurcation, or identification of plaque at any site. Odds ratios and their 95% confidence intervals were calculated using generalized estimating equations (GEE) for logistic regression. Family was specified as the clustering variable, and robust SEEs were obtained that account for dependence of the data within families. After controlling for age, education, body mass index, ever having smoked, ever drinking > 5 drinks a day, and metabolic index, hostility was significantly associated with increased odds of carotid lesions in only high-risk women. High-risk women showed a significantly reduced odds of carotid lesions with high social support, but the extent of this protection was reduced when age and education were included in the equation. A combination of high hostility and low social support was associated with higher odds than hostility alone in both high-risk men and women. These results suggest that women with a high familial predisposition for CHD may be more vulnerable to cardiovascular influences from hostility and social support than high-risk men or men and women with low to medium risk.     

通冠胶囊对冠心病介入治疗病人作用机制探讨

通冠胶囊具有活血化瘀的功效，可以改善冠心病病人的临床疗效，其机制主要表现在对凝血系统、血脂、血小板及血液流变学等方面的干预作用。     

A family study of the variability of pulmonary function in alpha 1-antitrypsin deficiency. Quantitative phenotypes

A group of 52 alpha 1-antitrypsin-deficient individuals of phenotype Pi Z and 117 of their relatives underwent a protocol including pulmonary function testing, completion of a questionnaire, and blood donation. Our population permitted a minimum frequency estimate (7 x 10(-4)) for Pi null alleles. Five quantitative phenotypes were measured, including FEV1, FEF25-75, total serum alpha 1AT, oxidized serum alpha 1AT, and total serum IgE. We found that (1) total alpha 1AT levels were higher in Pi Z subjects with lung function impairment (FEV1 less than or equal to 65% of predicted) than in Pi Z subjects who were not impaired; (2) Pi Z subjects with lung function impairment had elevated serum levels of oxidized alpha 1AT; and (3) IgE levels were relatively elevated in first-degree Pi MZ relatives of impaired Pi Z subjects. Moreover, FEV1 tended to be relatively reduced in heterozygous parents of impaired Pi Z subjects, suggesting that a subset of Pi MZ individuals are at risk for development of lung disease because of familial factors. These results represent an initial step toward the development of intermediate phenotypes that will be predictive of a severe course in alpha 1AT deficiency; they suggest that, in addition to cigarette smoking, atopic predisposition and undetermined familial factors may be important codeterminants of lung disease progression.     

湖南省丝虫病防治后期监测及流行病学动态分析

湖南省基本消灭丝虫病后１９８７～１９９１年横向监测４６个县（市）的４０８个村，血检２８７８６４人，查出微丝蚴血症者４人，平均微丝蚴率为０．００１％，各年微丝蚴率依次为０．００４％、０．００３％、０、０．００２％和０．００１％。解剖致倦库蚊２６８５２只，仅１９８８年发现阳性蚊１３只；解剖中华按蚊５７７１只，未发现幼丝虫。血清学监测流行区人群平均抗体阳性率为３．７６％，与非流行区抗体水平相近。４个纵向监测点的观察结果表明，低密度微丝蚴血症者能自然转阴。６个县（市）的晚期丝虫病患病率调查结果显示，基本消灭丝虫病后不再出现新的象皮肿病人，鞘膜积液的新发病例显著减少，但仍继续出现新的乳糜尿病人。     

急性心肌梗塞时静脉输注硫酸镁对室性心律失常的影响

32名急性心肌梗塞患者(镁盐组)住院头三天每日静脉输注硫酸镁2.0g。结果表明:镁盐组和对照组心律失常发生率分别为22%(7/32)和63%(19/30)(P<0.01)。说明急性心肌梗塞早期补镁可能有助于减少心律失常发生。     

胃癌及癌前病变胃粘膜的粘液组织化学研究

本文应用粘液组织化学方法对168例肠化生、96例异型增生和89例胃癌胃粘膜活检标本进行观察,发现87.6％的胃癌和40.6％的异型增生组织有异常粘液分泌;不全结肠型肠化生和硫酸粘液阳性肠化生在癌旁和异型增生的检出率显著地高于萎缩性胃炎组(P<0.05);伴不全结肠型肠化生和伴其它型肠化生的胃癌患者平均年龄分别为59.5岁和54.4岁、男女比为6∶1和2.25∶1.结果提示有异常粘液分泌的异型增生、伴不全结肠型化生的异型增生、不全结肠型化生的高龄男性、伴不全结肠型化生的胃良性疾病和硫酸粘液阳性肠化生宜被看作是胃癌的癌前病变,其中前三组的癌变趋向性更大.     

长江集城垸平垸行洪后血吸虫病疫情变化及防制对策研究

目的：探讨平垸行洪后血吸虫病疫情变化规律及防制对策。方法：前瞻性纵向观察血吸虫病疫情变化以及引洪促淤，种植意扬，改变钉螺孳生环境等防制措施的效果。结果：废垸内活螺密度呈下降趋势且未发现感染性钉螺；废垸外活螺密度变化不大且每年都出现感染性螺；滞卵在废弃垸内从事生产活动的人群血吸虫感染率较原居民上升；尽管废弃垸耕牛大幅度减少，但菜牛和羊明显增加，且3年平均感染率分别高达18．18％、13．33％；进入试区活动的人群70％以上是外迁返回居民，余为渔民、船民、鸭民及其他人员，粪检阳性率3年平均高达24．69％；洲滩污染以人、牛粪为主。结论：平垸行洪后尽管采取一些防制对策，降低了活螺密度，但外来人群的感染率和牛、羊的感染率都明显上升，废弃垸有可能形成严重的易感地带。     

miRNA与食管癌

动植物中广泛存在着一大类小的非编码蛋白质的RNA,21-25个核苷酸长度,被命名为microRNA(miRNA). miRNA在物种进化中相当保守,其表达有组织特异性和时序特异性. 其功能为负调控基因表达,进而调节细胞的代谢,增殖,分化和凋亡等基本的生理过程. 因此,miRNA的改变必会导致一些严重的病理过程. 研究已证实miRNA在肿瘤的发生和发展起着癌基因或抑癌基因的作用,miRNA的表达谱可用于某些肿瘤的诊断、分期和判断预后,并且在肿瘤分类方面较mRNA有更大地优越性. 本文着重介绍miRNA的产生,作用机制,与肿瘤的关系,检测方法及其在食管癌的诊断、分期和生物治疗方面的潜在作用.