经迷路进路听神经瘤术后脑脊液漏的预防及处理

目的　探讨经迷路进路听神经瘤切除术后脑脊液漏发生的影响因素及处理方法。方法1999年以来采用迷路进路或扩大迷路进路听神经瘤切除术 85例 ,前 4 1例采用传统关闭术腔技术 ,后4 4例对关闭技术进行改良 ,分析其脑脊液漏的发生率。发生脑脊液漏者行保守或手术治疗。结果传统关闭技术组中脑脊液漏的发生率为 19 5 % ( 8 4 1) ,改良关闭技术组中脑脊液漏的发生率为 2 3%( 1 4 4 ) ,两组差异有显著性意义 (P =0 0 13)。传统关闭技术组中脑脊液漏多数发生在大型听神经瘤中 ,其发生率随肿瘤增大有上升的趋势。 9例脑脊液漏的患者中 ,3例经保守治疗 ;6例经手术修补成功 ,其中 5例 1次修补成功。结论　改良关闭术腔技术可显著降低经迷路进路听神经瘤切除术后脑脊液漏的发生率 ,手术修补为终止脑脊液漏的有效措施     

听觉器官线粒体DNA缺失在老年聋发病中的意义

目的 探讨听觉器官中线粒体DNA缺失在老年聋发病中的意义。方法:饲养不同年龄组的大鼠,测试ABR阈值,PCR检测其耳蜗、蜗核、大脑、颞肌和外周血中是否存在mtDNA~(4834)缺失,对存在的缺失进行定量分析;PCR产物进行克隆、测序。结果:老年组大鼠的ABR平均阈值为92.22±10.60dBSPL(n=20),中年组为42.75±5.73dBSPL(n=24),青年组为30.50±1.54dBSPL(n:24),老年组大鼠的ABR阈值明显高于中年组和青年组,其差别具有非常显著性的意义(方差分析,P<0.01);(2)所有老年大鼠的听觉器官和颞肌中均存在mtD-NA~(4834)缺失,其缺失发生率高于中年组,青年组mtDNA~(4834)缺失发生率最低;(3)定量分析显示不同年龄大鼠听觉器官中mtDNA~(4834)缺失占总mtDNA的百分比不同,老年组mtDNA~(4834)缺失占总mtDNA的百分比高于中年组。结论:老年大鼠的ABR阈值明显升高,其包括耳蜗、蜗核在内的多种组织中普遍存在的mtDNA~(4834)缺失,提示mtDNA缺失在老化和老年聋的发生中具有重要意义。     

Caspase-3 持续激活时程与新生大鼠缺氧缺血性脑损伤

目的　探讨Caspase 3在新生大鼠缺氧缺血性脑损伤后期的表达情况及其与神经元凋亡的关系。　方法　新生大鼠缺氧缺血性脑损伤模型 ,在损伤后不同时间 (2、3和 4周 )随机分为 3组 ,每组每个时间点各 5只鼠。用半定量RT PCR观察新生大鼠缺氧缺血性脑损伤后期Caspase 3mRNA表达及用免疫组化方法观察Caspase 3蛋白表达情况 ;用TUNEL方法检测不同时程细胞凋亡情况。　结果　缺氧缺血后 3周时Caspase 3mRNA水平为 (0 .771± 0 .0 74 ) ,仍高于对照组的(0 .6 2 0± 0 .0 38,P <0 .0 1) ,Caspase 3蛋白表达 (平均吸光度A值 0 .375± 0 .0 38) ,亦强于对照组(0 .35 6± 0 .0 2 0 ) (P <0 .0 5 )。缺氧缺血后 4周时 ,缺氧缺血性脑损伤组与对照组比较 ,Caspase 3mR NA表达及其蛋白表达差异均无显著性 (P >0 .0 5 )。HI后 3周时左脑凋亡细胞数为 (8.0 0± 1.0 0 )个 ,与正常组 (4 .2 0± 1.30 )个比较 ,差异有显著性 (t=5 .17,P <0 .0 1) ;在HI后 4周时左脑凋亡细胞数 (4 .0 0± 1.0 0 )个 ,与对照组比较差异无显著性 (t=0 .2 7,P >0 .0 5 )。HI后 3周时脑组织DNA断裂百分率为 (8.19± 2 .4 9) % ,与正常组 (3.0 4± 0 .12 ) %比较 ,DNA断裂百分率之间差异有显著性 (t =4 .6 2 ,P <0 .0 5 ) ,而HI后 4周时则差异无显     

小鼠胚泡着床相关基因的差减筛选

目的:筛选新的小鼠胚泡着床相关基因。方法:对孕4.5 d小鼠着床和非着床位点的子宫内膜组织进行PCR差减。获得了2个新的在小鼠胚泡着床位点高表达的EST(EST8和EST81)。结果:EST8在孕4.5 d小鼠着床位点、肝脏中表达较高,在非着床位点和卵巢中亦有微量表达。EST81主要在孕4.5 d小鼠子宫着床组织和卵巢中表达,其它各种组织中也有微量表达。用PCR方法获得了相应的全长。cDNA,长度分别为1665bp和1364bp。结论:用差减筛选获得的两种cDNA是孕小鼠着床相关基因,其功能有待进一步研究。     

避孕药物醋酸烯诺孕酮的研究进展

哺乳期妇女出于对婴儿安全的考虑 ,对于避孕药物的选择十分谨慎。醋酸烯诺孕酮的激素特性和药代动力学特点使其在临床试验中避孕率高 ,副作用小 ,尤其对婴儿无影响 ,其皮下埋植剂有希望成为哺乳期妇女避孕的首选药物。本文就醋酸烯诺孕酮的化学结构、激素活性、药代动力学特性、临床有效率、副作用、药物作用机制以及阴道环剂型等方面作一综述。     

TNF-α和IL-6对绒毛膜11β-羟基类固醇脱氢酶I型和前列腺素合成酶II型的调节

目的 :研究肿瘤坏死因子 (TNF α)、白细胞介素 6(IL 6)对胎膜糖皮质激素代谢酶 11β 羟基类固醇脱氢酶I型 (11β HSD1)和前列腺素合成酶II型 (PGHS 2 )的影响 ,以探讨细胞因子导致分娩启动的机制。方法 :利用薄层层析法 (TLC)和Westernblot杂交法分别从酶活性、蛋白表达水平 ,研究IL 6、TNF α对原代培养的人类绒毛膜细胞 11β HSD1及PGHS 2水平的影响。结果 :TNF α和IL 6对绒毛膜滋养层细胞 11β HSD1还原酶活性有促进作用 ,对绒毛膜细胞 11β HSD1和PGHS 2的蛋白表达均有上调作用。 结论 :IL 6、TNF α对胎膜 11β HSD1及PGHS 2的诱导作用可能是其导致分娩启动的机制之一     

不同剂量HCG对体外受精-胚胎移植的影响

目的 :比较使用不同剂量人绒毛膜促性腺激素 (HCG)对体外受精 /胞浆内单精子注射 (IVF/ICSI)的结局及对卵巢过度刺激综合征 (OHSS)发病率的影响。方法 :对在本所接受IVF/ICSI辅助生育的 2 6 2例采用GnRH a长方案促排卵的患者进行回顾性分析 ,按HCG用量分为A组 (HCG 5 0 0 0～ 6 0 0 0U)、B组 (HCG 80 0 0～ 10 0 0 0U)。结果 :两组临床妊娠率分别为 35 .94 %和 38.0 5 % (P >0 .0 5 ) ,OHSS发生率分别为 2 .34%和 4 .4 8% (P >0 .0 5 )。结论 :减少HCG用量后对IVF/ICSI的临床妊娠率无明显影响 ,且可以减少OHSS的发生。     

胃癌患者血清肝细胞生长因子的检测及意义

Objective To explore the clinical significance of serum HGF level changes in gastric cancer pa-tients. Methods 60 cases of patients who operatied and clinicopathological confirmed gastric cancer, were detected serum HGF level by enzyme linked immunosorbent assay(ELISA) .40 cases were administered radical gastrectomy,20 cases of patients who had distant metastasis and loss operative chance were detected 7 days and 3 months preopera-tive,postoperative serum HGF level respectively. At the same time 40 cases of chronic gastritis patients and 40 cases of healthy examination people were selected as control group. Results Serum HGF level in patients with gastric canc-er was significantly higher than that of chronic gastritis and normal controls(P <0. 01). The serum HGF level of pa-tients with tumor vascular invasion significantly increased(P <0. 05). The patients with lymph node metastasis,serum HGF level was significantly higher than that patients with no lymph node metastasis(P <0. 05). The serum HGF level of patients with liver metastasis was significantly higher than that patients with no liver metastasis(P <0. 05). The se-rum HGF level of gastric cancer patients whose maximum diameter of the tumor ≥3cm were significantly higher than that maximum diameter of the tumor <3cm(P<0. 05). According to TNM staging of gastric cancer,the serum HGF level of Ⅰ phase and Ⅱ phase patients were significantly lower than that Ⅲ phase and Ⅳ phase patients(P <0.05).The serum HGF level of gastric cancer patients had no significant correlation with sex ,age and histological type(P <0.05). The serum HGF level of 40 cases of patients who were 1 week after surgery were significantly decreased,the patients who were 3 months after surgery were more obvious(P <0. 05 and P <0. 001). Conclusion HGF may play an important role in gastric cancer occurrence and development. The detection of serum HGF level can become an im-portant index for monitoring the degree of gastric cancer and prognosis of patients.     

73例70岁以上妇女妇科恶性肿瘤手术分析

[目的]探讨70岁以上妇科恶性肿瘤患者手术的耐受情况。[方法]收集浙江省肿瘤医院自1996年1月到2001年12月间,70岁以上妇科恶性肿瘤患者接受盆腔姑息性和根治性手术治疗73例,分析不同年龄及手术范围对术后恢复的影响。[结果]73例患者66例选择了根治性手术,7例接受姑息性手术。术后70~75岁组和>75岁组,其手术方式、平均住院时间、术前术后并发症等无明显差别。术中出血量、手术时间及并发症发生率均明显较姑息性手术组增加,12例严重并发症中,11例发生在根治性手术组。[结论]经过严密的术前准备、术后处理,70岁以上的老年妇女能够耐受根治性手术治疗。     

EXPRESSION OF p16,CYCLIN D1 AND RB PROTEIN IN GASTRIC CARCINOMA AND PREMALIGNANT LESIONS

Gastric carcinoma is one of the most serious diseases in mankind. Its pathogenesis has not been understood very clearly. Recent researches suggested that oncogenes (such as cyclin D1), antioncogenes (ie., p16, Rb) and cell cycle played an important role in the pathogenesis of gastric carcinoma. But there are few reports about the relationship between these genes in gastric carcinoma and gastric premalignant lesions. In this study, we will discuss these problems. MATERIALS AND METHO…