漂浮导管技术在监测指导急性心力衰竭患者临床治疗的价值

目的评估漂浮导管技术在监测指导急性心力衰竭（HF）患者临床治疗的价值。方法以48例经常规处理效果不佳的急诊心力衰竭患者为研究对象,尽早留置漂浮导管,留置漂浮导管后0．5h和48h,记录心率（HR）、中心静脉乐（CVP）、肺毛细血管楔压（PCWP）、心排血量（CO）,并计算心脏指数（CI）、左心室每搏做功指数（LVSWI）、右心室每搏做功指数（RVSWI）、体循环阻力（SVR）、肺循环阻力（PVR）,然后根据情况选用各种药物治疗。HF患者根据出院时预后分为病情好转组和病情恶化组,对两组患者留置漂浮导管后0．5h和48hHR、CVP、PCWP、CO、CI、LVSWI、RVSWI、SVR、PVR变化进行比较。结果33例病情好转患者应用监测漂浮导管治疗后与治疗前比较,心率、PCWP、CVP明显下降（均P〈0．01）,SVR、PVR明显下降（P〈0．05）,CO、CI、RVSWI明显升高（均P〈0．05）,LVSWI明显升高（P〈0．01）;与治疗前比较,15例病情恶化患者应用监测漂浮导管治疗后HR、CVP、PCWP、CO、CI、LVSWI、RVSWI、SVR、PVR均无明显改变（均P〉0．05）。结论漂浮导管技术在血流动力学不稳定的急性心力衰竭患者的评估病情、指导临床治疗和预后评估中有再要的价值。     

果糖氯化钠注射液在急危重病救治中的临床研究

目的观察果糖氯化钠注射液在急危重病救治中对机体内环境的影响。方法将120例急危重病患者随机分为试验组（60例）和对照组（60例）,开放静脉通道的第一瓶液体分别使用果糖氯化钠注射液250ml及0．9％氯化钠注射液250ml,输液速度均为10ml／min。观察两组患者治疗前后的血钾、血钠、血氯、血糖水平变化。结果试验组治疗前后血钾、血钠、血氯、血糖水平变化绝对值分别为（0．26±0．25）mmol/L、（1．7±1．7）mmol／L、（1．5±1．3）mmol／L和（0．7±0．5）mmoL／L,对照组分别为（0．32±0．40）mmol／L、（2．7±3．1）mmol／L、（2．4±2．8）mmol／L和（0．7±0．5）mmol／L,两组患者治疗前后血钠、血氯水平变化绝对值间差异有统计学意义（P〈0．05）,而血钾、血糖水平变化绝对值间差异无统计学意义（P〉0．05）。结论果糖氯化钠注射液可以保持血钾及血糖水平稳定,且血钠、血氯变化值小于0．9％氯化钠注射液,可为急危重患者提供能量而不引起血糖、血钾升高,是一种安全、合适的注射液。     

麦制面粉添加剂对糖尿病的动物实验与临床研究

用含水溶性纤维素、铬和锌的麦制面粉添加剂进行动物实验和临床治疗观察。结果表明，该添加剂可明显地降低血糖、改善血脂异常和糖尿病的一般情况，不引起高胰岛素血症，无明显副作用，容易为患者长期接受。     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Mutation rate at the hprt locus in human cancer cell lines with specific mismatch repair-gene defects

Spontaneous mutation rates at the hypoxanthine-guanine phosphoribosyl transferase (hprt) locus were measured in human cancer cell lines defective in the mismatch repair (MMR) genes hMLH1, hPMS2, or GTBP, as well as in a cell line carrying mutations in both hMLH1 and hPMS2. The mutation rate was determined by quantitating mutant frequency increases within a single culture as a function of cell division. These MMR- deficient cell lines exhibited a 50- to 750-fold increase in mutation rate relative to a MMR-proficient cancer cell line. From lowest to highest, the spontaneous mutation rates relative to the MMR-gene defects studied here are as follows: hMLH1- < GTBP- < hPMS2- < hMLH1- / hPMS2-. In addition, a cell line in which MMR was restored by chromosome transfer exhibited a mutation rate 12-fold below the MMR- deficient parental cell line. These data support the notion that MMR plays an important role in controlling the rate of spontaneous mutation and suggest that different MMR-gene defects may vary in their ability to repair different types of DNA mismatches, thus leading to measurable quantitative differences in spontaneous mutagenesis. Furthermore, a difference in mutation rates was observed between a hPMS2-defective cell line (3.1 x 10(-5) mutations/cell/generation) and two hMLH1- defective cell lines (4.0 x 10(-6) and 7.3 x 10(-6) mutations/cell/generation). Assuming the hPMS2- and hMLH1-gene products only function in the proposed hMutL alpha heterodimer, then defects in either gene should yield comparable mutation rates. These data suggest that hPMS2 plays a critical role in MMR, while additional hMLH1 homologues or hPMS2 alone may function to partially complement defects in hMLH1.      

Human chorionic gonadotrophin-beta gene sequences in women with disorders of HCG production

Women with recurrent abortion, primary unexplained infertility, and gestational trophoblastic neoplasia (GTN) manifest disordered human chorionic gonadotrophin (HCG) secretion. Mutations in the HCG beta/luteinizing hormone (LH) beta gene complex could cause aberrant HCG production in these disorders. The purpose of this study was to determine whether HCG beta gene deletions occur in women with recurrent abortion or primary unexplained infertility, and whether HCG beta gene duplications are present in women with GTN. DNA was extracted from 10 patients with unexplained recurrent abortion, 10 patients with unexplained primary infertility, 12 patients with GTN, three partners of women with GTN, and 30 controls. Southern blots were constructed and hybridized with DNA probes for HCG beta-5 and the LH beta gene. No gene deletions were identified in patients with recurrent abortion or primary unexplained infertility. Likewise, no gene duplications were identified in women with GTN. A previously described Mbol restriction fragment length polymorphism (RFLP) was identified in both patients and controls. A new Pstl RFLP was also characterized, but was present in patients and controls. Deletion/duplication mutations in the HCG beta/LH beta gene complex do not appear to be common causes of aberrant HCG production in humans with these disorders.      

The molecular mechanisms of oocyte maturation and early embryonic development are unveiling new insights into reproductive medicine

The purpose of the present review is to outline the current understanding on the molecular mechanisms governing various stages of oocyte maturation, transition from maternal to embryonic control and the initial steps of pre-embryo development. The cytoplasmic and nuclear maturation of the oocyte during pre-ovulatory development can be viewed as separate entities. Cytoplasmic maturation and the acquisition of stores of RNA and protein dominates oocyte development between the premordial and pre-ovulatory stages of development. Initiation of nuclear maturation is marked by the breakdown of the nuclear envelope, or germinal vesicle and is triggered by the midcycle luteinizing hormone peak. In vitro, this is associated with a decrease in the intracellular concentrations of cAMP. This and several subsequent steps of meiosis are controlled by the M-phase promoting factor (MPF). While the constituents of MPF, p34cdc2 kinase and B-type cyclin, are also present in mitotically dividing cells, in meiotically dividing oocytes the regulation of MPF activity differs. An oocyte- specific protein kinase, c-mos, plays an important role in up- regulating the activity of MPF at various stages of final oocyte maturation. Several lines of evidence suggest that the proper function of the c-mos-MPF system is associated with important features of the last stages of oocyte maturation such as the resumption of meiotic maturation, inhibition of DNA replication between meiosis I and II, and the maintenance of the oocyte at metaphase II arrest until it is fertilized. Eventually the destruction of c-mos and active MPF following fertilization allows the initiation of mitotic cell division in the pre-embryo. The very first cell divisions of the human pre- embryo are still under the control of maternally inherited mRNA and protein. Several lines of evidence suggest that in humans, zygotic gene expression is initiated between the 4- and 8-cell stages, after which the pre-embryo begins to utilize its own genes. Some of the first genes to be expressed in the human pre-embryo encode proteins that are associated with cell division, extracellular growth modulatory signals as well as factors associated with implantation. We acknowledge that most of the data presented comes from species other than human, therefore at present the full biological role of the proposed regulatory pathways and control mechanisms for human biology remains speculative.      

超声血管造影在肝癌介入治疗前后的应用价值

目的探讨超声血管造影对原发性肝癌（ＨＣＣ）在经皮肤动脉栓塞术（ＴＡＥ）治疗前后的应用价值。方法采用超声造影剂Ｌｅｖｏｖｉｓｔ经肘静脉注入的方法,检查１２例ＨＣＣ患者在ＴＡＥ治疗前后血供的变化情况。要用彩色多普勒血流显像（ＣＤＦＩ）的半定量测量方法,判定栓塞前后肿瘤血供的丰富程度,并与Ｘ线数字减影血管造影（ＤＳＡ）进行对比分析。结果超声血管造影与ＤＳＡ在探查肝癌ＴＡＥ治疗前后肿瘤血供方面无差异（Ｐ〉