放射状角膜切开的实验病理与临床应用

以１４只兔及２只猴为动物模型，对放射状角膜切开术（ＲＫ）进行了２￣３个月观察，发现：ＲＫ切口内的上皮塞子持续２个月以上才逐渐消退。术后一个月内上皮下基底膜形成，后逐渐变薄，切口内的成纤维细胞分裂增殖较慢，开始走行与切口平行，１５天后可见横过切口，２月后实质表层成纤维细胞排列变得整齐，但深层仍较紊乱，胞核多深染。术中切穿角膜的实验兔，术后２个月病理切片可见：切口附近内皮细胞丢失，内弹力膜断裂，切口内     

致倦库蚊有机磷抗性相关扩增酯酶B基因的多样性

本实验从佛山和成都两地的致倦库蚊群体中筛选出３个酯酶类型不同的有机磷（ＯＰ）抗性品系，ＦＳ－１、ＦＳ－２和ＣＤ－１品系。各品系的酯酶基因Ｂ扩增水平、酯酶活性和ＯＰ抗性水平三者一致。各品系酯酶Ｂ基因限制性酶切片段比较分析表明，我国的ＯＰ抗生库蚊群体中不仅有世界性分布的酯酶Ｂ１和Ｂ２，而且在佛山和成都地区各有一个新的独立扩增的酯酶Ｂ，分别命名为Ｂ６和Ｂ７。     

胸水军团菌抗体检测的探讨—附军团菌肺炎合并胸水一例报告

我们应用试管凝集法及酶联免疫吸附试验方法检测了５０例非军团菌感染病人胸水中嗜肺军团菌１、６型抗体及病人血清中相应抗体。发现在这些普通病人胸水中也存在一定的嗜肺军团菌抗体滴度，并计算出这些抗体的９９％上限滴度（Ｘ＋２．３２６Ｓ）。为今后检测嗜肺军团菌感染病人的胸水提供了一个参比对照指标。实验后期，我们检测了一例军团菌肺炎病人，其胸水中Ｌｐ１型抗体滴度远远超过了该上限值，并高于其自身血清中相应抗体。     

人脑胶质瘤逃避免疫监视机制的研究

为研究胶质瘤逃避免疫监视的机制，检测了胶质瘤体外细胞系培养上清（SN）抗PHA－P刺激正常人及胶质瘤患者外周血淋巴细胞增殖的作用。证实了胶质瘤可自分泌免疫抑制因子。经抗TGFβ2单抗中和SN试验，TGFβ2免疫组化染色及Northern杂交进一步表明该因子主要成分为TGFβ2并对胶质瘤患者血浆皮质醇，生长激素及儿茶酚胺含量及细胞免疫功能进行检测，发现血浆去甲肾上腺素显著降低，其水平与CD8亚群％呈负相关，与CD4／CD8比值及淋巴细胞增殖率呈正相关。初步提示存在胶质瘤的情况下，神经－免疫调控紊乱，可能起着抑制性调节作用。     

78例胃窦癌的治疗分析

自１９８８年２月至１９９２年８月期间手术治疗的７８例胃窦癌患者进行了回顾性分析，手术后肿瘤复发的情况，与十二指肠断端有无癌细胞残存密切相关，并发现于幽门环下切断十二指肠少于３ｃｍ者有癌细胞残存达３４％，切除十二指肠达３ｃｍ者，无论肿瘤分化程度如何，恶性程度高低，切除断端均无癌细胞残存，手术后辅以化疗，对于病人的预后有一定提高。本组随访到的５９例病人中，接受化疗的３３例，在２年３个月至６年１个月内死亡７例（２１．２％），未接受化疗的２６例，在５个月至３年８个月内死亡的２６例，在５个月至３年８个月内死亡９例（３５％）。     

不同类型高危儿早期干预的临床研究

目的 探索早期干预对窒息、高胆、早产三类高危儿智力发育改善的效果，寻找更合适的早期干预措施。方法 将三类高危儿分为干预组及对照组，同时随机选取正常对照组进行随访。干预组采用鲍秀兰教授“0～3岁”早期干预方案训练，各组均在6个月、1岁时分别采用婴幼儿智能发育量表(CDCC)进行智力发育测评，结果用MDI、PDI表示。结果 (1)6个月龄时MDI各干预组与对照组间有显著性差异，窒息组、早产组与正常组间亦有显著性差异；高胆组与正常组间无差异；PDI窒息组中干预组与对照组之间有显著差异(P＜0．01)，高胆组、早产组均无差异(P＞0．05)。(2)1岁时MDI和PDI结果一致，干预组与对照组间比较窒息组、高胆组有显著差异，早产组无差异；窒息组、高胆组干预组与正常组比较无差异，对照组和早产组与正常组比较均有显著差异(P＜0．01)。(3)所有干预组测评分值均高于对照组，6个月与1岁之间比较有显著差异，各观察组间比较有显著性差异(P＜0．01)。结论 三类高危儿早期干预效果差异较大，干预组均较对照组分值高，早期干预有改善智力发育的作用；三类高危儿中，窒息组、高胆组效果最好，均达到或超过正常水平。所有未干预组均不及正常水平；早期干预对足月高危儿效果显著，对早产儿欠佳，远期效果尚需进一步随访观察。     

前路减压Z-plate内固定治疗胸腰段爆裂性骨折伴不全性截瘫

目的 探讨胸腰段爆裂性骨折伴不全瘫前路减压内固定优越性以及Z-plate系统的优点。方法 采用前路减压Z-plate内固定治疗胸腰段爆裂性骨折伴不全瘫25例。结果 全部病例均获随访，随访时间6～24个月，平均17个月。按Frankel分级评定有1～3级恢复，随访期间无后凸加重及内固定松动，植骨融合。结论 前路减压Z-plate内固定是治疗胸腰段爆裂性骨折的较好方法。     

Ancillary Community Pharmacy Services Provided to Older People in A Largely Rural and Ethnically Diverse Region: A Survey of Consumers in West Texas

Little is known about the quality of pharmacy services provided to the rural elderly population. This exploratory study examines rural/urban and ethnic differences in perceived access to ancillary pharmacy services among elderly people. Two telephone surveys were conducted using directory listings in West Texas to generate a longitudinal sample. Persons aged 65 years and older who were not cognitively impaired were asked to complete the survey. The number of participants in both rounds of the survey was 3,689. Seven ancillary pharmacy services were examined: delivery of medications, medication counseling, written medication information, blood pressure monitoring, blood glucose monitoring, osteoporosis screening, and immunization. The sample was stratified by county of residence (urban, rural, or frontier) and racial/ethnic background. Chi-square tests were performed to detect rural/urban and racial/ethnic differences in access to the seven ancillary services. The association between proficiency in English and access to the services was also examined. Rural residents were more likely than urban residents to report that their pharmacies provide delivery of medications, medication counseling, and immunization services, but they were less likely than their urban counterparts to report that their pharmacies provide blood pressure monitoring. Access to ancillary pharmacy services was reported as poorer by older Hispanic people compared with non-Hispanics. Deficiency in English was significantly related to inequality in reported access to ancillary pharmacy services. It is essential to consider the special needs of rural and Hispanic elderly people to ensure equitable access to ancillary pharmacy services.     

Differentiation plasticity of human fetal articular chondrocytes.

OBJECTIVE: To test chondrogenic differentiation potential, we examined the differentiation plasticity of isolated human fetal articular chondrocytes (HFACs). STUDY AND DESIGN SETTING: Culture-expanded human fetal articular chondrocytes (HFACs) were analyzed for chondrogenic, adipogenic, osteogenic capacity and neural differentiation ability in defined in vitro culture systems. RESULTS: The different assays demonstrated that culture-expanded HFACs have potential to form cartilage in pellet mass culture, to form adipose cells, osteogenic cells, and neural cells in monolayer culture. CONCLUSIONS: These results suggest that within human fetal articular cartilages there are MSC-like cells that exhibit differentiation plasticity that is comparable with that of BM-MSCs and they may be a new kind of seeding cells for head and neck cartilage reconstruction.