改善胰岛素敏感性对血压影响的相关研究

目的 :观察胰岛素增敏剂二甲双胍改善 2型糖尿病胰岛素敏感性后对血压的影响。方法 :71例 2型糖尿病人口服二甲双胍 (格华止 ) 85 0 mg,qd-bid。治疗前后测定 BMI、血压、FBG、PBG、FINS、PINS,并按 HOMA模型计算胰岛素抵抗指数和胰岛素分泌指数。结果 :( 1)二甲双胍治疗 8周后 ,BMI治疗前后无显著性差异 ;血压治疗后明显下降 ,降压幅度达 ( 13.1± 4.97) /( 4 .2 2± 9.93) mm Hg,血压治疗前后有显著性差异。 ( 2 )治疗后 F BG、 PBG、 FINS均明显下降 ,治疗前后有显著性差异。 ( 3)治疗后 HOMA-IR下降 ,IAI升高 ,治疗前后有显著性差异 ,但 HOMA-IS、 FINS/FBG无显著性差异。结论 :二甲双胍治疗 2型糖尿病 ,在降低血糖、改善 IR的同时 ,伴有血压的明显下降     

ELISA法检测可溶性人类白细胞抗原—I及广东人参考值的测定

OBJECTIVE: To explore a method for quantitative detection of soluble human leukocyte antigen class I(HLA-I) antigens, with the assistance of which we attempt to define the reference value of the antigen in the population of Guangdong Province. METHODS: Sandwich enzyme-linked immunosorbent assay (ELISA) was employed with W6/32 monoclonal antibody serving as the solid phase antibody and beta2 microglobulin antibody as the first antibody. HRP-labeled second antibody and the substrate were added for enzyme-catalyzed coloring. On the basis of the standard curve obtained by sHLA-I standard reagent in serial dilution, the concentration of sHLA-I antigens in the samples of 60 normal subjects from the population of Guangdong province was detected. RESULTS: The sensitivity of this assay was 2.84 ng/ml with variation coefficients of 5.80% within the same batch and 9.00% between batches. The recovery rate ranged from 98.57% to 100.15%. The level of sHLA-I antigens in normal individuals was 699.54+/-360.10 ng/ml. CONCLUSION: Sandwich ELISA is sensitive, specific and stable in the detection of sHLA-I.     

PRK术后转化生长因子β1mRNA表达的实验研究

目的：探讨准分子激光角膜切削术（PRK）后转化生长因子β1（TGF－β1）在角膜伤口愈合和解膜雾状混浊发病机制中的作用。方法：将24只新西兰大白兔（24只眼）随机分为正常组（n＝4）和手术组(n=20)。手术组每只左眼行PRK术，术中采用准分子激光器，角膜中央激光去上皮，然后按－10.00D近视进行切削，分别于术后第7d,14d,28d和3月于裂隙灯下观察记录角膜haze的变化并处死动物，将角膜组织制成石蜡切片，应用原位杂交技术检测角膜缲TGF－β1mRNA的表达。结果：①从术后第7d开始，术眼均不同程度地发生了角膜haze，严重者可达3级，haze高峰约在术后第28d。②正常角膜上皮中TGF－β1mRNA有低水平表达，PRK术后第7d,14d和28d，角膜上皮TGF－β1mRNA表达明显增高。术后3月已开始降低；正常组角膜基质中未检测出TGF－β1mRNA，术后第7d,14,和28d，角膜基质中TGF－β1mRNA表达明显增高，术后3月已开始降低。结论：TGF－β1可能参与了PRK术后的伤口愈合，它可能通过促进角膜基质细胞的增殖和细胞外基质的合成而促进角膜haze的发生。     

中南邵阳、华东南京、西南成都组织胞浆菌感染流行病学调查

目的 :组织胞浆菌是一种真菌 ,由家禽及鸟类传播 ,可引起人的深部真菌病。我们进行的流调工作 ,对掌握疾病流行情况、制定防治措施及对结核病的防治工作具有重要意义。方法 :调查对象是健康人、住院的肺结核病人、住院的非结核性肺疾患病人。使用的方法是在前臂内侧皮内注射酵母相组织胞浆菌素 (Histolyn -CYL)。同时在另一前臂做PPD皮试 (1∶1万 )。结果 :中南邵阳地区健康人组织胞浆菌素皮试阳性率2 2 .4 0 %。肺结核病人阳性率 31.6 0 %。非结核病肺部疾病阳性率 15 .85 %。华东南京地区健康人阳性率15 .10 %。肺结核病等阳性率 17.74 %。西南成都地区健康人阳性率 2 1.77%。肺结核病人阳性率 5 4 .4 4 %。结论 :组织胞浆菌感染率很高 ,与人文地理条件密切相关 ,差异很大。因此制订防治措施也应有所不同 ,应结合当地具体情况。     

膳食黑米皮抑制高脂诱导的家兔动脉粥样硬化形成及其机制的初步探讨

目的 探讨膳食黑米皮对高脂诱导的家兔动脉粥样硬化形成的影响及其作用机制。方法 24只雄性新西兰大耳白家兔,按体重随机分为3组,分别饲以正常基础饲料、高脂饲料(含96％基础饲料、0.5％胆固醇、3.5％猪油)、黑米皮饲料(含 91％基础饲料、0.5％胆固醇、3.5％猪油、5％黑米皮),实验期为 60d。用图像分析法测定各组家兔主动脉脂质斑块面积,并分析家兔氧化与抗氧化状态。结果 黑米皮实验家兔的主动脉壁斑块面积较高脂组低66%(P<0.001);黑米皮组实验家兔的主动脉壁8-ohdG含量和血清及主动脉壁中MDA水平也低于高脂组(P<0.05 );而红细胞及主动脉壁中SOD水平和血清α-生育酚含量在两个处理组之间差异无显著性。结论 膳食黑米皮可以抑制高脂诱导的家兔动脉粥样硬化形成,其机制可能与之降低机体氧化应激水平及过氧化脂质生成有关。     

On the Role of Proteasomes in Cell Biology and Proteasome Inhibition as a Novel Frontier in the Development of Immunosuppressants

The proteasome, a large protease complex in cells, is the major machinery for protein degradation. It was previously considered a humble garbage collector, performing housekeeping duties to remove misfolded or spent proteins. Until recently, the interests of immunologists in proteasomes were focused largely on its role in antigen processing. Its real importance in cell biology has only been revealed contemporarily due to the availability of relatively specific inhibitors. It has now become increasingly clear that many aspects of immune responses highly depend on proper proteasome activity. Recently, a proteasome inhibitor has been successfully used to prevent acute as well as ongoing heart allograft rejection in mice. Such inhibitors are also efficacious in treating several autoimmune diseases, such as arthritis, psoriasis, and probably type I diabetes, in animal models. Phase II and III clinical trials of proteasome inhibitors in treating various tumors have shown promising results, and the side-effects of these drugs are tolerable. Therefore, proteasome inhibition represents a new and promising frontier in immunosuppressant development.     

218例乳腺癌术后十年随访观察

对218例女性乳癌术后进行了十年以上的随访观察。随访率为95.87％。术后总的十年生存率为54.87％。Ⅰ期为85.71％,Ⅱ期为53.09％。Ⅲ期为30.76％。阐明了术后疗效与妊娠哺乳,肿瘤部位,肿瘤大小,临床期别,淋巴结转移情况及病理类型有明显关系。讨论了手术方式对术后的影响,提示扩大根治术对Ⅰ、Ⅱ期乳癌并无明显优越性。     

保留肾单位手术治疗早期小肾癌21例临床分析

OBJECTIVE: To evaluate the clinical effects of nephron-sparing surgery in patients with early-stage small renal cell carcinoma. METHODS: Nephron-sparing surgery was performed in 21 patients with renal cell carcinoma including 1 with solitary kidney, 3 with unilateral tumor and contralateral renal compromise, and 17 with unilateral tumor and normal contralateral kidney. The diameter of the tumors ranged from 1.5 to 6.0 cm, with a mean of 2.8 cm. The tumor diameter in 17 patients with normal contralateral kidney was less than 4 cm (mean 2.5 cm) and the average diameter in 4 patients with contralateral renal compromise was 4.2 cm. Sixteen cases were in stage T(1), 4 in stage T(2), and 1 in stage T(3). Of the 21 patients, 4 underwent tumor enucleation, 10 polar nephrectomy and 7 wedge resection. RESULTS: All patients were followed up for an average of 40.8 months (7 to 66 months). One patient suffered a right lung and mediastinum metastasis 3 years after the surgery later and 1 with chronic glomerulonephritis required dialysis 27 months after the operation. No surgical complication or local recurrence were found in other patients. CONCLUSION: As a safe and effective therapy for early-stage small renal cell carcinoma, nephron-sparing surgery can be considered as the gold-standard therapy for patients with lesions less than 4 cm in T(1) and T(2) stages of localized unilateral tumor with normal contralateral kidney.     

下腹部Joel—Cohen切口术后切口愈合临床观察

目的探讨肥胖患者下腹部手术采用Joel—Cohen切口对预防非感染性切口裂开的临床效果。方法选择切口部位皮下脂肪层厚达4—5cm的妇产科手术患者90例，随机分为观察组44例，采用Joel—Cohen切口；对照组46例，采用下腹正中直切口。观察切口愈合和脂肪液化情况。结果观察组切口甲级愈合率显著高于对照组（P〈0．01）；脂肪液化切口裂开率显著低于对照组（P〈0．05）。结论脂肪组织厚达4—5cm以上下腹部手术切口，采用Joel—Cohen切口可以减少脂肪液化，切口愈合显著优于下腹直切口，值得临床推广应用。     

外伤性延迟性脾破裂的诊断和治疗（附21例报告）

目的探讨外伤性延迟性脾破裂的发病规律、临床特点、诊断和治疗方法。方法结合国内外资料及本组病例进行回顾性分析。结果明确诊断16例，误诊为肝破裂2例，宫外孕破裂2例，脾肿瘤1例。21例均手术治疗，行脾切除14例，其中保留副脾2例；脾切除加自体脾组织网膜内移植术3例；脾缝合修补术3例；脾部分切除术1例。死亡1例，原因有就诊晚、失血性休克。结论本病由于腹腔内出血与受伤时间间隔长，容易误诊。诊断除依靠病史、临床表现外，应及时进行腹腔穿刺、B超及CT检查。治疗以脾切除为主，可根据病情、脾破裂的程度以及是否有合并伤等情况采取保脾手术。