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目的探讨介入治疗在肝胆管结石术前、术后的应用及疗效。方法对20例多发肝内外胆管结石病人于手术前后进行介入治疗操作，包括经皮引流术、扩张术、胆道内支架留置术、动脉栓塞术等多种方法。结果通过进行介入治疗可达到不同程度的症状缓解或痊愈，未出现新的并发症。结论介入治疗在肝胆管结石外科手术前后的合理应用，可以大大降低手术危险性，并能对部分术后并发症的治疗提供帮助；胆系介入治疗是一种安全有效的技术，在肝胆管结石的治疗中如能综合灵活应用，可以作为胆道外科手术的辅助治疗方法。     

二步冷冻保存同种异体骨-ACL-骨移植后排斥反应的影响

目的 :探讨新鲜异体和二步冷冻保存同种异体骨 前交叉韧带 (ACL) 骨移植后排斥反应的差异。方法 :将 6 0只新西兰兔和 6 0只日本大耳兔分别随机分成自体骨 ACL 骨移植组、新鲜异体骨 ACL 骨移植组和二步冷冻保存同种异体骨 ACL 骨移植组 ,分别于术前及术后 1周、2周、3周、4周各采血 2ml测定血清中白细胞介素 2 (IL 2 )水平 ,术后 4周、12周切取移植关节 ,作苏木精 -伊红染色。结果 :光镜下检查显示 ,自体移植组和二步冷冻保存移植组均未见明显炎性细胞浸润 ,胶原排列规则 ,分化成熟。新鲜异体移植组有大量淋巴细胞浸润 ,其IL 2水平明显高于自体移植组和二步冷冻保存同种异体移植组且高于术前水平 (P <0 .0 1)。结论 :二步冷冻减轻了同种异体骨 ACL 骨移植后排斥反应 ,移植后其组织学改变同自体移植相似     

激光光凝联合玻璃体腔注气治疗玻璃体切割术后再发黄斑孔

目的 探讨激光光凝联合玻璃体腔注气治疗玻璃体切割术后再发与未愈黄斑孔的疗效。方法 应用COHERENT Omni多波长激光光凝黄斑裂孔底部的视网膜色素上皮层。随后眼内注入20％C3F80．5～0．8ml并置换出玻璃体腔液体。治疗后每天坚持俯卧位。结果 19只眼中16只眼黄斑孔愈合，成功率为84．2％，视力提高15只眼，占78．9％，未出现严重的并发症。结论 应用激光光凝联合眼内注气治疗玻璃体切割术后再发与未愈黄斑孔具有方法简单、费用低、疗效确定、大部分患者无须住院等优点。     

劳动复合方案对小鼠血浆心钠素和耐力的实验研究

昆明种小鼠56只，在两个海拔高度上（300m和5000m）各分为两个组（对照组和复合组），分别给予相应的处理因素后，检测其血浆ANP水平和游泳时间。结果表明，小鼠在海拔5000m生活48h后，其血浆ANP较海拔300m小鼠降低52．87％，而其游泳时间则增长91．59％；在两个海拔高度上，复合组血浆ANP都较对照组降低，而游泳时间都长于对照组．提示复合方案提高高原劳动能力的机理，可能与降低体内血浆ANP水平有关。     

临床科室主任到医疗职能部门脱产挂职培训制度的实践体会

介绍了中国医科大学附属盛京医院实施临床科室主任到医疗职能部门脱产挂职培训制度的具体方法、成效和体会,实施结果表明,挂职锻炼的科室主任对医疗管理工作有了客观全面的认识,医疗管理能力和水平得到迅速提高,医疗安全的警惕性有所提高,处理医疗纠纷的能力增强,有利于提高医疗管理的执行力度.     

Similarities and differences in mechanisms of cardiotoxins, melittin and other myotoxins

Myonecrosis induced in vivo by cardiotoxin, melittin, and Asp49 and Lys49 phospholipase A₂ (PLA₂) myotoxins involves rapid lysis of the sarcolemma, myofibril clumping, and hypercontraction of sarcomeres. In contrast, skeletal muscle necrosis induced by crotamine and myotoxin a is much slower, consisting of mitochondrial and sarcoplasmic reticulum swelling, myofibril degeneration, and lack of sarcolemma or transverse tubule damage. The mechanisms contributing to the myonecrosis induced by these peptides were evaluated. Two cardiotoxins and two Lys49 PLA₂ myotoxins lysed primary cultures of human skeletal muscle within 24 hr at a concentration of 0.25 μM, while melittin, crotamine, and myotoxin a, and an Asp49 PLA₂ myotoxin were non-cytolytic at concentrations up to 5.0 μM, suggesting that cytolysis is not a good measure of myotoxicity. Crotamine and the Lys49 PLA₂ myotoxin altered Ca²⁺ ion flux in human heavy sarcoplasmic reticulum by opening the ryanodine receptor. Whole-cell patch-clamp studies demonstrated that administrating crotamine intracellularly increased Na⁺ currents. Free fatty acids, liberated by activation of tissue phospholipase C or by the PLA₂ activity of the myotoxins, were monitored for crotamine, myotoxin a and a Lys49 PLA₂ myotoxin in cell cultures in which the lipids had been radiolabeled. Only the Lys49 myotoxin produced significant amounts of fatty acid in cell cultures, supporting a potential role for fatty acid production only in the mechanism of sarcolemma-destroying myotoxins. These findings, coupled with those in the literature, support a hypothesis in which the myotoxins and/or products of lipase activity (e.g. fatty acids) are acting at a site existing on both the Na⁺ channel and a protein involved in Ca²⁺ release and probably serving a modulatory function for ion regulation. Based on the similarities in mechanisms between the toxins and fatty acids, the most likely site would be a fatty acid binding site on the protein (either similar to that on fatty acid binding proteins, or an acylated cysteine residue) or in the membrane.     

Proteolytic Processing Mechanisms in the Biosynthesis of Neuroendocrine Peptides: The Subtilisin-like Proprotein Convertases

The recent discovery of a novel family of precursor processing endoproteases has greatly accelerated progress in understanding the complex mechanisms underlying the maturation of prohormones, neuropeptides, and many other precursor-derived proteins. At least six members of this family have been found thus far in mammalian species, several having alternatively spliced isoforms, and related enzymes have been identified in many invertebrates, including molluscs, insects, nematodes, and coelenterates. The proprotein convertases are all dependent on calcium for activity and all possess highly conserved subtilisin-like domains with the characteristic catalytic triad of this serine protease (ordered Asp, His, and Ser along the polypeptide chain). Two members of this family, PC2(SPC2) and PC1/PC3(SPC3), appear to play a preeminent role in neuroendocrine precursor processing. Both convertases are expressed only in the brain and in the extended neuroendocrine system, while another important family member—furin/PACE (SPC1)—is expressed more ubiquitously, in almost all tissues, and at high levels in liver. SPC2 and SPC3 exhibit acidic pH optima and other properties which enhance their activity in the acidic, calcium-enriched environment of the dense-core secretory granules of the regulated pathway in neuroendocrine cells, while furin has a neutral pH optimum and is localized predominantly to the trans Golgi network where it is retained by a C-terminal transmembrane domain. Furin processes a wide variety of precursors in the constitutive pathway, such as those of growth factors, receptors, coagulation factors, and viral glycoproteins. Recent findings on the processing of proopiomelanocortin, proinsulin, proglucagon, and several other neuroendocrine precursors by SPC2 and SPC3 are discussed, along with information on the structure, properties, evolution, developmental expression, and regulation or the convertases. An inherited defect in the fat/fat mouse which affects the processing of proinsulin, and probably also many other prohormones, due to a point mutation in carboxypeptidase E has recently been identified and has begun to provide new insights into the functional integration of the individual processing steps.     

特发性肌炎免疫机制研究及临床意义

目的探讨多发性肌炎（PM）和皮肌炎（DM）患者骨胳肌组织损伤的免疫机制及临床意义。方法应用免疫荧光一步法和免疫组化SP法分析25例PM／DM肌组织中免疫球蛋白IgG、IgM、补体C3和浸润肌组织单核细胞的分布与定位。结果PM和DM肌组织中IgG、IgM、C3的阳性率分别为60％、33．3％、20％和70％、40％、50％，以IgG为主（P＜0．05），分布于肌组织血管壁、肌膜和肌浆中，补体C3在DM血管壁的分布有统计学意义（P＜0．05）；80％PM和7O％DM肌组织有单核细胞浸润，PM以T淋巴细胞为主，Ia＋活化TS细胞占多数，主要分布于肌内衣，DM以B淋巴细胞为主，多分布在肌柬衣血管周围。结论免疫反应在PM和DM发病机理中占重要地位，PM以T细胞介导的细胞毒作用为主，DM以体液免疫特别是补体介导的血管损害为主。     

心包肽类激素免疫组织化学及免疫电镜的研究

采用免疫组织化学、免疫电子显微镜及高效液相结合放射免疫学方法,研究人和 Wistar 大鼠心包,结果表明:心包组织中存在 ANF 和 AngⅡ样物质。在采用兔抗 ANF 为抗体时,心包组织的间皮细胞存在明显的金粒子标记颗粒,间皮细胞是主要的内分泌细胞。心包组织存在 Ang Ⅱ和3种分子形式ANF.本研究提示.心包除已知功能外,尚存在重要的内分泌功能.