腹腔镜手术治疗小儿卵巢肿瘤26例

目的探讨腹腔镜手术治疗小儿卵巢肿瘤的效果及安全性。方法2000年1月~2005年3月,我们对26例小儿卵巢肿瘤行腹腔镜手术。气管插管全麻或静脉复合麻醉,行卵巢肿瘤剥除术或一侧附件切除术。对直径<5 cm的肿瘤,在肿瘤的外侧缘线形电凝囊肿包膜;直径>5 cm的肿瘤,在其中部或距基底部3 cm处环形电凝囊肿包膜,钝性分离肿瘤与囊壁,完整剥出肿瘤,残余囊壁创面彻底电凝止血,不缝合。卵巢冠囊肿切除。影响术野的大卵巢囊肿,先穿刺吸净囊液,帽状电凝卵巢囊肿包膜一周,再剥出肿瘤。结果所有患儿卵巢肿瘤手术都在腹腔镜下完成,肿瘤剥除术24例,一侧附件切除2例。手术时间(50±20)m in,术中出血量(30±10)m l,术后住院2~4 d,无手术并发症,无伤口感染。24例随访1年,未见复发。结论腹腔镜手术治疗小儿卵巢肿瘤是一种安全、有效的手术方法。     

车前子对高脂血症大鼠脂质过氧化的影响

目的 :　探讨车前子对高脂血症大鼠脂质过氧化的影响。方法 :　采用大鼠血清及多脏器组织 ,观察车前子对高脂血症大鼠脂质过氧化的影响。结果 :　高脂对照组血清和心肌超氧化物歧化酶 ( SOD)活性显著降低 ,而脂质过氧化物 ( LPO)含量明显升高 ,血清和肝脏的过氧化氢酶( CAT)、谷胱苷肽过氧化物酶 ( GSH-Px)活性明显降低。补充车前子后显著升高血清及心肌组织SOD活性 2 2 %和 2 8% ,以及肝脏 GSH-Px活性 2 2 %。而使血清及心肌的 LPO含量分别下降 3 2 %和 1 7%。结论 :　 1 5 g/kg车前子可提高高脂血症大鼠体内抗氧化能力并免受自由基损伤     

聚偏氟乙烯支撑液膜萃取乳酸

采用聚偏氟乙烯固体微孔膜,与溶解在煤油中的三烷基氧磷组成支撑液膜(SLM),分离稀水溶液中的乳酸。考察了pH值、料液浓度、载体浓度、温度、料液及解析液流量对传质速率的影响。同时进行了膜稳定性的定性研究。发现乳酸以分子形式通过SLM;载体浓度为40%时传质速率最大;SLM对乳酸的通量与稀水溶液中乳酸浓度成正比。料液和解析液预先用有机相饱和时,膜的稳定性可大大改善。     

营养性驱铅饮料的研究

本文研究营养性驱铅饮料的动物和人群试验。饮料与铅料动物组间比较,饮料组动物的尿、粪排铅量高,分别是对照组的1.5倍和1.1倍;血、肝、肾中含量低;体内 Zn、Cu、Fe 等微量元素基本稳定。其体重增长与对照组相一致。人群试验:试验组尿铅排出明显,试验末(2月后)仅为试验初的21.7%;血铅平均减少0.39μmol/l;血中 Hb、δ-ALAD 和尿中δ-ALA 等均恢复良好;不影响体内Zn、Cu 等微量元素,无不良反应。     

增殖细胞核抗原在鼻咽癌组织中的表达及其临床意义

目的：探讨鼻咽癌（ＮＰＣ）组织ＰＣＮＡ的表达与其临床进展、病理组织分裂的相互关系。方法：用免疫组化Ｓ－Ｐ法检测１１３例ＮＰＣ和２５例鼻咽慢性炎的ＰＣＮＡ表达。结果：１０３例ＮＰＣ和３例鼻咽慢性炎呈ＰＣＮＡ阳性。ＮＰＣ呈ＰＣＮＡ低增殖频率者，倾向于Ｉ、Ⅱ期临床分期（８７．１％）及无淋巴结转移（７０．９６％）。高增殖频率者，倾向于Ⅲ、Ⅳ期临床分期（８２．１％）及有淋巴结转移（７９．４９％）。增殖频率与     

GASTRIC CANCERS IN SINGAPORE: POOR PROGNOSIS ARISING FROM LATE PRESENTATION

Background : Mortality rates from gastric cancer, apart from those derived from Japanese series, remain poor. This paper sought to determine the present outcome of gastric carcinoma in a predominantly Chinese population in Singapore. Prognostic factors useful in predicting survival were also evaluated in this population. Method : All cases of histologically confirmed gastric adenocarcinoma presenting in 1992 were entered into a prospective database. Prognostic factors related to age, sex, site of disease, depth of invasion, histological grade, nodal status and stage of disease were evaluated in patients with resectable disease to determine their utility in predicting survival. Results : Of 1310 consecutive patients with histologically proven adenocarcinomas, 37% had distant metastases at presentation predominantly in the liver (21%) and peritoneal cavity (20%). Sixty-four per cent of patients underwent surgery and in only 51% of these patients was resection of the turnour possible. Stages 111 and IV (T4N2) locally advanced disease were present in 38% of patients. Thus the majority of patients presented with late or metastatic disease (75%, stages 111 and IV). Sixty per cent of patients were alive at I year and 40% at 2 years after resection of the tumour (Kaplan-Meier survival plots). In contrast, no patient survived longer than a year if the tumour was not resectable (P < 0.001, log-rank test). Median survival of patients without surgery was 12 weeks. Median survival for patients with resected stage IV disease was 23 weeks, compared to 18 weeks after surgical bypass. Age, sex, site, depth of invasion and histological grade did not significantly predict survival. Patients with node-negative disease survived longer (2 year, 70%) than those with nodal involvement (2 years, 44%; P = 0.06, log-rank test). Pathologic staging with the TNM system was useful in predicting survival (P < 0.001). Sixty per cent of patients with stage I and II disease were alive at 2 years compared to 54% with stage III disease and 0% with stage IV disease. Conclusion : The prognosis of stomach cancer remains poor, due predominantly to late presentation. Pathologic TNM staging and nodal status were useful in predicting survival outcome after resection. If the tumour were resectable, survival was appreciable even in patients with advanced stage III (2 years, 54%) and stage IV (1 year, 40%) disease. Strategies to improve outcome should focus on early detection of gastric carcinomas.     

Iontophoresis of polypeptides: effect of ethanol pretreatment of human skin

This paper explores the possibility of iontophoretically enhancing the in vitro transdermal flux of two polypeptides: leuprolide (a LHRH analogue; MW = 1209.4) and a cholecystokinin-8 analogue (CCK-8; MW = 1150.17). Control experiments at an applied voltage of 0.5 V across full-thickness human skin did not yield measurable fluxes of either polypeptide, suggesting that despite the expected iontophoretic flux enhancements, the intrinsic permeability of these polypeptides through skin may be too low to allow significant amounts of the drug to permeate. Therefore, pretreatment with ethanol (to simulate the effect of a chemical permeation enhancer) followed by iontophoresis was investigated with the aim of evaluating the potential of the enhancer plus ionophoresis as a means for controlled transdermal delivery of these polypeptides. The ethanol pretreatment dramatically increased the passive fluxes of both polypeptides, and iontophoresis produced further enhancements in their fluxes. Also, the experimental enhancement factors for leuprolide as a function of the applied voltage appeared to be generally lower than the predictions of the constant field theory. A synergism of iontophoresis with a chemical permeation enhancer may be a potential route for controlled transdermal delivery of these and other high molecular weight polypeptides.     

高原地区人胎儿脊柱的生长发育

本文用X线摄片的方法,对西宁地区胎龄为17—36周的60例胎儿脊柱的骨化及生长动态进行了研究。结果:1、提供了高原地区人胎儿脊柱长轴生长发育的资料。脊柱各段以胸段为最长,其次为腰、颈、骶段。2、计算出胎龄与脊柱各段长度间的回归方程,据此可以胎龄推算脊柱的长度,反之亦可以脊柱的长度估计胎龄。3、报道了颈、骶、尾段亿发骨化点出现顺序的规律。     

HLA-DR 52- and 51-associated DRB1 alleles in Kenya, East Africa

The genes of the major histocompatibility complex (MHC) are amongst the most polymorphic loci known in the human population. The population genetics of the MHC encoded HLA loci of sub-Saharan Africa are of major interest because of their particular genetic diversity. Here we report on the HLA-DR 52- and 51-associated determinants of the DRB1 loci observed in 165 East African individuals studied in Nairobi, Kenya. The HLA-DR typing was done by serologic and by molecular DNA techniques (PCR-SSOP). The most frequent allele identified was DRB1*1101, followed by DRB1*1503 and DRB1*1302. Some unexpected alleles were repeatedly identified: DRB1*1108, DRB1*1316 and DRB1*1421. Most oftheDR 52-and 51-associated DRB1 alleles were correctly identified by serology as part of the DR3, DR5, DR6 and DR2 groups respectively. The HLA-DRB1 profile reported here corroborates previous genetic and linguistic data supporting the concept that the Eastern African Black population is genetically distinct from other African Black populations. This has important implications in public health issues related to the genetic profile of a population (transplantation, vaccine design for example).     

偏心圆剥离法在隆乳术中的应用

以往以乳头为圆心的同心圆剥离法常形成假体的移位，使假体的体表轮廓与前方的自然乳房分离，产生“双重乳房”现象。在研究了女性不同体位下不同的乳房形态及总结了以前的经验后，提出了偏心圆剥离的概念。偏心圆手术设计方法：以乳头为圆心，按其内侧、下侧为直径３／５的比例，以外侧、上侧为直径２／５的比例，形成一偏心圆的剥离范围。偏心圆的直径因考虑到假体的不同形态、大小及底面直径，以经中心假体纵截面的周长的１／２再放大２ｃｍ，作为剥离范围的直径。自１９９１年１０月以来已应用了１７６例，无一术后移位现象，也没有固较多地剥离胸大肌内、下侧止点纤维而影响上肢活动。自然乳房并不是静态的圆锥形或半球形，它具有伸缩的组织学特点，又有随体位变动而变化的特点。用偏心圆法剥离，可使置入的假体与前方的自然乳房融为一体，消除“双重乳房”现象，而成为“真实”的乳房。同时也应积极寻找一种与身体组织相容性好的，弹性、比重与女性乳腺较为一致的，假体容量相对恒定的生物性材料。这样隆乳术才可以更广泛地开展。