人子宫内膜细胞共培养体系对早期鼠胚体外发育的影响

目的:研究人子宫内膜共培养体系对早期鼠胚体外发育的影响及移植后的妊娠情况。方法:将2-细胞小鼠胚胎与人子宫内膜细胞进行体外共培养,对照组为无营养细胞的单纯培养液,每日在显微镜下观察胚胎的发育情况。将培养到囊胚期的胚胎移植回小鼠的子宫腔,观察着床情况。结果:共培养体系中68.3％的2-细胞胚胎发育至桑椹胚期,50.8％发育至囊胚期,囊胚的孵化率为36.7％,胚胎的着床率为25.0％。而对照组只有24.8％的2-细胞胚胎发育至桑椹胚期,11.4％到达囊胚期,且其中大部分为早期囊胚即停止发育。另外对照组细胞碎片出现早且多,卵裂球不均匀,胚形态差,移植后胚胎的着床率仅为3.1％。结论:人子宫内膜细胞共培养体系可以促进小鼠胚胎的体外发育,改善胚胎的质量,提高着床率。     

Development of multifocal duodenal erosions after anti-Helicobacter pylori triple therapy.

BACKGROUND AND PURPOSE: Anti-Helicobacter pylori triple therapy is effective for healing duodenal ulcer (DU) diseases and reducing disease recurrence. However, multifocal duodenal erosions or shallow ulcers may develop after triple therapy. The purpose of this study was to investigate the incidence and outcome of duodenal erosions that developed after triple therapy. METHODS: A total of 106 Taiwanese with active DU and with H. pylori infection were enrolled in this study. All patients received anti-H. pylori triple therapy (i.e., 2 weeks of antimicrobial agents combined with treatment for 4 to 6 weeks with acid suppression agents). Follow-up endoscopy was performed immediately after stopping treatment. The incidence of multifocal erosions or shallow ulcers over the bulb and/or second portion of the duodenum was studied. Additional acid suppression agent was given for 4 weeks whenever duodenal erosions or shallow ulcers were found. RESULTS: Out of 106 patients, 11 (10.4%) were found to have multifocal duodenal erosions and/or shallow ulcers on the duodenal bulb and/or second portion of the duodenum at the end of treatment. Ten of the 11 patients with newly developed erosions had healed DU in the S1 or S2 stage, and all 11 had successful H. pylori eradication. The duodenal erosions and/or shallow ulcers of these 11 patients were healed after an additional 4 weeks of histamine-2-receptor antagonist therapy. CONCLUSIONS: Multifocal duodenal erosions and/or shallow ulcers were noted in around 10% of Taiwanese DU patients who received anti-H. pylori triple therapy. An additional 4 weeks therapy with acid suppression agents healed these lesions.     

细胞周期素D1与p53蛋白在卵巢上皮性肿瘤的表达及意义

目的　探讨细胞周期素D1(CyclinD1)与 p5 3蛋白在卵巢上皮性肿瘤的表达及意义。 方法　 1990～1995年应用免疫组化法对 4 0例恶性卵巢上皮性肿瘤及 2 0例良性卵巢上皮性肿瘤组织进行CyclinD1与 p5 3蛋白检测。结果　良性卵巢上皮性肿瘤CyclinD1阳性表达为 10 0 % ,而恶性卵巢上皮性肿瘤CyclinD1阳性表达为37 5 %。良性卵巢上皮性肿瘤p5 3阳性表达为 15 0 % ,恶性卵巢上皮肿瘤 p5 3阳性表达为 4 7 5 %。CyclinD1在卵巢上皮癌G1与G2 、G3 中的阳性表达统计学差异有显著性 (P <0 0 5 ) ,p5 3蛋白在早期卵巢上皮癌与晚期卵巢上皮癌组织中的阳性表达 ,统计学差异有显著性 (P <0 0 5 ) ,p5 3蛋白的阳性表达在卵巢癌G1与G2 、G3 比较差异有显著性 (P <0 0 5 )。CyclinD1过表达的细胞同时也有 p5 3的过表达。 结论　CyclinD1与 p5 3蛋白在卵巢上皮性肿瘤的共同表达可能是促进卵巢上皮性肿瘤发展的因素。     

Clinical characteristics of patients with thyrotropin-secreting pituitary adenoma.

BACKGROUND AND PURPOSE: Thyroid-stimulating hormone (thyrotropin, TSH)-secreting pituitary adenoma is a very rare cause of hyperthyroidism. Diagnosis of this condition is often delayed due to lack of availability of TSH radioimmunoassay (RIA), the failure to recognize the utility of RIA and the incorrect attribution of the condition to other causes of thyrotoxicosis. This retrospective study analyzed the clinical characteristics of patients with this disorder treated from 1991 to 2002. METHODS: Seven patients (6 females, 1 male; mean age, 48 years; range, 33 to 72 years) with a diagnosis of TSHsecreting pituitary adenoma based on detectable TSH levels with high serum free thyroid hormone or triiodothyronine concentrations and pituitary lesions found on neuroimaging were included in this study. Patient records including clinical features, endocrine studies, immunohistochemistry studies, and response to treatment were reviewed. RESULTS: All 7 patients had hyperthyroidism, elevated free thyroxine or triiodothyronine levels, and unsuppressed levels of TSH. Imaging studies demonstrated a pituitary mass or lesion in all patients. Six patients had macroadenomas and 1 patient had a microadenoma. One of the patients had coexisting acromegalic features and hypersecretion of growth hormone was diagnosed. All of the patients had been treated with thionamides or thyroidectomy for presumed primary hyperthyroidism. Serum alpha-subunit level was uncharacteristically normal in 2 patients and elevated in 1 patient. Alpha-subunit/TSH molar ratios were elevated in 3 patients. Five patients underwent transsphenoidal adenomectomy but only one of them remained well-controlled at follow-up. Three patients received administration of somatostatin analogs and they achieved normalization of serum TSH and free thyroid hormones during the period of therapy. CONCLUSIONS: TSH immunoassay has an important role in the evaluation of hyperthyroid patients to determine the presence of inappropriate secretion. TSH-secreting pituitary adenoma exhibits heterogeneity in clinical presentation, hormonal expression and therapeutic response.     

2001年—2003年第1季度北京地区门诊患者降血糖用药动态分析

目的 :了解北京地区糖尿病患者的用药需求 ,并对降血糖药物进行分析。方法 :采用《医院处方分析》课题 (北京地区 )2 0 0 1年～ 2 0 0 3年每年第 1季度门诊降血糖用药的处方数据进行比较。结果与结论 :通过统计 ,北京地区糖尿病患者人数不断增多 ,且人们更多选用了新型降糖药。在临床应用中 ,口服制剂以磺酰脲类用量居主导地位 ,而α-葡萄糖苷酶抑制剂用量逐年上升 ;使用基因合成人胰岛素较动物胰岛素的用量逐年增多 ,为控制糖尿病用药及合理应用提供了依据     

Metabolism of (R)-(+)-menthofuran in Fischer-344 rats: identification of sulfonic acid metabolites.

(R)-(+)-Menthofuran is a metabolite of (R)-(+)-pulegone, the chief constituent of pennyroyal oil. Menthofuran has been shown to account for a significant percentage of pulegone toxicity through further metabolism to a reactive intermediate, an enonal (2-Z-(2'-keto-4'-methylcyclohexylidene)propanal). Hydration of the enonal followed by a 1,4-dehydration and rearrangement gives rise to diastereomeric (-)-mintlactone and (+)-isomintlactone (mintlactones). We have conducted disposition studies on pulegone as part of the National Toxicology Program initiative in herbal medicines and dietary supplements, and have reported previously unknown urinary metabolites of pulegone. Comparative metabolism studies of 14C-labeled menthofuran in Fischer-344 (F344) rats were carried out to determine urinary metabolites of pulegone that are derived from the menthofuran pathway. Three sulfonic acid metabolites, namely, hexahydro-3,6-dimethyl-1-(2-sulfoethyl)-2H-indol-2-one, hexahydro-3,6-dimethyl-7a-sulfo-2(3H)-benzofuranone, and 2-sulfomenthofuran, were identified in urine of treated rats. Formation of these metabolites may be derived from reactions of the enonal with taurine or glutathione (GSH) (or sulfite ion). Other identified urinary metabolites of menthofuran could be attributed to further metabolism of mintlactones. Further hydroxylation of mintlactones could give 7a-hydroxymintlactone and 6,7a-dihydroxymintlactone. Glucuronidation or reduction of 7a-hydroxymintlactone could give rise to the major metabolites 7a-hydroxymintlactone glucuronide and 2-[2'-keto-4'-methylcyclohexyl]propionic acids. Glucuronidation or repeated hydroxylation/dehydration of 2-[2'-keto-4'-methylcyclohexyl]propionic acids could result in formation of hexahydro-3,6-dimethyl-7a-hydroxy-2(3H)-benzofuranone glucuronide and 2-(2'-hydroxy-4'-methylphenyl)propionic acid. 2-(Glutathion-S-yl)menthofuran, a GSH conjugate of the enonal that has been partially characterized in bile of rats dosed with pulegone, is at most a minor biliary metabolite of menthofuran in rats.     

张家维教授针灸治疗小儿多动症380例临床研究

目的　探讨针灸治疗小儿多动症的临床疗效、对异常脑电图的改变情况、疗效与证型的关系、疗效与年龄的关系等。方法　将 5 92例患者分为针灸组及中药组。结果　针灸组总有效率为 84 .4 % ,中药组为 78.77% ,前者疗效优于后者 (P<0 .0 5 ) ;针灸组对异常脑电图的改变率优于中药组 (P<0 .0 5 ) ;针灸组中肝肾不足型、肝郁气滞型两型间的疗效有显著性差异(P<0 .0 1) ;肝郁气滞型较佳。疗效与年龄之间有非常显著性关系 (P<0 .0 1) ,年龄小者针刺疗效较佳。结论　针灸治疗小儿多动症可取得较好疗效 ,其总有效率及对异常脑电图的改善优于内服中药 ,肝郁气滞型及年龄小者疗效较好     

末治脾肾,能起沉疴--单纯中药治疗乙肝相关性肝癌1例

探讨中药审因论治对乙肝相关性肝癌的治疗作用。应用调补脾肾、搜邪泄浊法 ,对一例乙肝相关性肝癌患者进行单纯中药治疗。结果 :经过 12个月治疗 ,AFP由最高 10 0 0 0 μg/L降至正常 (<2 0 μg/L) ,AFP异质体同步转阴 ,B超、MRI显示肝部实质性肿块消散 ,肝功能好转。提示本治法对肝癌具有较好的治疗作用。     

Rare complication of massive hemorrhage in neurofibromatosis with arteriovenous malformation

Neurofibromatosis is rare in the general population. Its clinical manifestations are systemic and variable. The clinical presentation of cutaneous lesions is even more variable. Some patients have giant tumors in the trunk or limbs (so-called "elephant neurofibromatosis"). The pathological findings are diffuse neurofibromatosis of the nerve trunk associated with overgrowth of subcutaneous tissue and skin. The associated vascular malformations make most surgeons hesitant to address them because bleeding to death is possible if the bleeding is not well controlled. According to the authors' experience in treating this complication of neurofibromatosis, they noted that there are three key points to reducing the amount of hemorrhage to a minimal level: (1) hypotensive anesthesia, (2) preliminary sutures around the lesion, (3) ligation of the limited numbers of feeding vessels in the vascular malformation of the neurofibroma. Ligating these pedicles can decrease bleeding during resection of the neurofibroma, as demonstrated in their patient.     

Potassium increases intracellular calcium simulating progesterone action in human sperm

Progesterone (P) and zona pellucida are known to induce acrosome reaction in human sperm by increasing cytosolic calcium. High concentrations of potassium ions (K+) improve the rate of acrosome reaction in human sperm in vitro. This article determined whether the effect of K+ on the acrosome in human sperm is mediated by increasing intracellular calcium ([Ca2+]i). The effect of K+ on [Ca2+]i was examined by using Fura 2 as the fluorescent indicator. The effect of K+ and P on [Ca2+]i in sperm and the involvement of ion channels was compared. Motile sperm were collected by the swim-up method from semen of healthy volunteers and capacitated overnight in BWW containing 0.5% BSA. Incubation of capacitated sperm with different concentrations of potassium chloride (1.25-20 mM) resulted in dose-dependent increase in [Ca2+]i similar to that observed with P. The increase in [Ca2+]i by K+ and P was blocked by the addition of EGTA, a Ca2+ chelator. K+-induced change in [Ca2+] was not altered by the addition of dihydropyridine derivatives. The combined treatment of K+ (20 mM) and P (0.75 microg/mL) caused an additive effect on the increase in [Ca2+]i. It would appear that human sperm plasma membrane possess different Ca2+ channels responsive to P and K+.