中国非综合征遗传性聋人群GJB6基因突变分析

目的：研究GJB6基因[连接蛋白30（Cx30）-]在中国非综合征遗传性聋人群中的突变情况。方法：用特定引物对372例非综合征遗传性聋患者（其中295例分子病因不明，77例携带GJB2病理性单等位基因突变）和182例正常对照者进行聚合酶链反应，检测GJB6基因的342kb大片段缺失del（GJB6〉D13S1830），并进行GJB6基因编码区扩增，以产物直接测序方法进行突变检测及鉴定。结果：372例耳聋患者中未发现GJB6 del（GJB6〉D13S1830），其中1例发现携带GJB6基因点突变404C〉A，导致了氨基酸的错义改变T135K，多物种Cx30氨基酸序列进化分析证实该点位于Cx30高度保守的第3跨膜区。对照组中未发现同样突变。结论：GJB6基因突变在中国耳聋人群中整体发生频率较低，GJB6基因可暂不列为第一线耳聋基因检测项目。     

冰艾油治疗化脓性中耳炎876例

笔者于1995年实习期间偶得一秘方,自命名为“冰艾油”,经过10多年临床验证,治疗急慢性化脓性中耳炎确有奇效,现将其整理总结如下。     

c-Met及HGF在胃癌及其肝转移灶中的表达

目的:探讨胃癌肝细胞生长因子受体(c-Met)及肝细胞生长因子(HGF)表达与胃癌肝转移间的相关性。方法:晚期胃癌标本59例,其中11例同时有取自左肝外叶的肝转移标本,应用免疫组化方法对上述组织石蜡标本进行检测。结果:59例胃癌中,c-Met阳性率55.8%(33/59),HGF阳性率28.8%(17/59);在29例发生了同时或异时性肝转移的胃癌标本中,c-Met表达率为75.9%(22/29),HGF阳性率为37.9%(11/29),其中c-Met表达率在有和无肝转移组间有显著差异(P<0.05);在11例胃癌肝转移灶中,9例c-Met阳性表达率为81.8%,3例HGF阳性表达率为27.3%。结论:胃癌组织c-Met表达可能与胃癌肝转移行为相关。     

双侧唇裂继发鼻畸形的矫正

目的通过对双侧唇裂继发鼻畸形进行细致的病理解剖学分析，制定出具体的治疗目标，探讨矫正的有效手术方法。方法以双侧唇裂继发鼻畸形的病理解剖学为基础，将手术程序分为鼻小柱及鼻尖整形、鼻翼软骨的整形、鼻底的整形3个连续的步骤。结果自2000年以来应用上述方法手术矫正36例，其中畸形严重的双侧完全性唇裂术后患者22例，占61．6％。所有病例术后伤口均Ⅰ期愈合，鼻外形明显改善，无感染及皮瓣坏死等并发症发生。术后随访10～24个月，平均17个月，满意率高达100％。结论双侧唇裂继发鼻畸形具有其特有的病理解剖学特征，以解剖学特征基础制定具体手术方案，确保了最终疗效的满意率。     

High abundances of neurotrophin 3 in atopic dermatitis mast cell

Background  

Neurotrophin 3 (NT-3) is a member of the neurotrophin family, a group of related proteins that are known to regulate neuro-immune interactions in allergic diseases. Their cellular sources and role in the recruitment of mast cell precursors in atopic dermatitis have not been characterized in detail so far.     

固体硅胶隆鼻术后感染排异的原因与预防探讨

感染及排异是固体硅胶隆鼻术较为严重的并发症。其发生原因主要在于手术适应证掌握不当；硅胶假体的质量不过关，假体的修雕成形不佳，假体消毒处理不严；手术操作及术后处理欠妥等。提出了加强术前体检及适应证的掌握，选择质量过关的硅胶假体，努力提高术者的审美及专业技术水平，设计修雕成形出恰当的假体，并注意规范假体的消毒处理，这都可有效减少感染及排异并发症的发生。强调手术操作时尽量减少局部组织的损伤，勿剥破鼻部的皮肤及粘膜，并做好术后的处理及护理，这同样也是减少感染排异并发症的关键。     

Doppler ultrasonic diagnosis for deep venous thrombosis of lower limbs.

Seventy-one patients with 80 lower limbs clinically suspected of deep venous thrombosis (DVT) were investigated by both Doppler ultrasound and venography. Sixty-seven lower limbs demonstrated by venography to have DVT, in 5 the thrombus was confined to the calf, and all were detected by the Doppler ultrasound. In 62 limbs thrombus extended into the popliteal and more proximal veins, the Doppler ultrasound detected 61 of them, a sensitivity of 98%. Venography showed a deep venous system without any evidence of thrombosis in 13, the Doppler findings were normal in all of the 13 lower limbs, a specificity of 100%. We found that the examination of the popliteal vein with patient in a semi-lateral prone position was important in detecting the presence of thrombosis in popliteal and more proximal vein.

     

经皮冠状动脉腔内成形术对急性心肌梗塞行早期血运重建

１２例急性心肌梗塞患者应用经皮冠状动脉腔内成形术进行早期血运重建，１１例梗塞相关血管再灌注血流为ＴＩＭＩ３级，残留狭窄１５．５±８．８％，１例并发血管内膜夹层形成行紧急冠状动脉旁路移植术，术后死亡。结果认为急性心肌梗塞早期直接进行经皮冠状动脉腔内成形术可实现稳定有效的血运重建，有利于减少心肌梗塞面积及心脏泵功能损害、降低再梗塞率和病死率。     

Synthetic Colloids Attenuate Leukocyte-Endothelial Interactions by Inhibition of Integrin Function

Background: It has been suspected that synthetic colloids may interfere with leukocyte adhesion by down-regulation of endothelial cell adhesion molecules. Although inhibition of endothelial inflammation might reduce leukocyte-related tissue injury, the same mechanism may be detrimental for host defense during severe infection. Regarding the widespread use of colloids, the authors performed a laboratory investigation to determine the mechanisms by which synthetic colloids interfere with leukocyte-endothelial interactions.

Methods: Adhesion molecule expression on native and cytokine-activated endothelium from umbilical veins was measured after pretreatment with gelatin and various preparations of dextran or hydroxyethyl starch. Inhibition of neutrophil adhesion to activated endothelium was examined in a flow chamber by perfusion of untreated and colloid-treated neutrophils over colloid-pretreated endothelium at 2 dyn/cm2. Comparisons were made between untreated controls, colloid-pretreated endothelium, and colloid-cotreated neutrophils.

Results: Intercellular adhesion molecule 1, vascular cell adhesion molecule 1, E-selectin, and P-selectin were not attenuated by any colloid. Accordingly, colloid pretreatment of endothelium alone did not reduce neutrophil adhesion. In contrast, when neutrophils were cotreated by addition of colloids to the perfusate immediately before perfusion, adhesion decreased by 31-51% (P < 0.05) regardless of the colloid type. As indicated by the twofold increased rolling fractions, this reduction was due to an inhibition of neutrophil integrins.     

胆汁返流性胃炎胃粘膜超微结构研究

为探讨胆汁返流性胃炎的发病机理和应用中药治疗此病的效果，作者进行了胃粘膜超微结构观察。在治疗前、后取胃粘膜做光、电镜检查，发现本病胃粘膜变化突出的特点是淋巴细胞侵入腺细胞内，溶解腺细胞，破坏细胞间联接装置，使腺腔破溃，腺管萎缩。以上变化可占全部病例的８７．５％。另一特点是腺细胞内出现微囊（８例中有４例），这在慢性胃炎尚未见有电镜观察报道。作者认为胆汁返流性胃炎可以是慢性萎缩性胃炎的前驱，而腺体萎缩的原因是由于淋巴细胞的浸润破坏；这为由细胞介导引起的胃腺细胞损伤提供了形态学依据。