武汉市前列腺癌的流行病学研究

前列腺癌是欧美国家男性的主要死亡原因，我国还没有全面的发病率和死亡统计资料。为了解我国前列腺癌的流行情况，在武汉市１９９０～１９９２年前列腺癌的发病及死亡报告的基础上，收集了１９９０～１９９５年住院治疗的１０２例前列腺癌现患病例进行了１１配比的病例对照研究。结果显示：武汉市前列腺癌的发病率和死亡率分别为１．３７／１０万和０．７５／１０万，世界人口年平均标化发病率和死亡率分别为１．１０／１０万和０．６６／１０万。泌尿系统病史〔ＯＲ＝５．４２，９５％可信区间（ＣＩ）＝１．５６～１８．８３〕、子女数超过３个（ＯＲ＝２．４３，９５％ＣＩ＝１．１７～５．０２）、青壮年期每周性交超过３次（ＯＲ＝３．３８，９５％ＣＩ＝１．５１～７．５８）、滥用药物（ＯＲ＝４．１１，９５％ＣＩ＝１．６５～１０．２５）、体质指数高（ＯＲ＝２．５８，９５％ＣＩ＝１．３０～５．１１）等是前列腺癌的危险因素，而体力劳动（ＯＲ＝０．３５，９５％ＣＩ＝０．１７～０．７１）、初次遗精年龄晚于１８岁（ＯＲ＝０．２０，９５％ＣＩ＝０．０８～０．５２）等是其保护性因素。     

宁国贝母生物碱的分离和结构鉴定

从贝母新种——宁国贝母(Fritillaria ningguoensis S. C. Chen et S. F. Yin)鳞茎中分离出五个生物碱,其中碱V是一种新的生物碱,命名为宁贝新(ningpeisine),根据理化常数和光谱解析以及衍生物制备,测定其结构为N-methyl-3β-hydroxy-5α-veratranine-6-one。其余四种生物碱鉴定为浙贝甲素(peimine,verticine,Ⅰ),浙贝乙素(peiminine,verticinone,Ⅱ),异浙贝甲素(isoverticine,Ⅲ)和贝母辛(peimisine,Ⅳ)。     

Clonidine attenuates morphine withdrawal and subsequent drug sensitization in rhesus monkeys

AIM: Clonidine is an alpha2 adrenoceptor agonist that is frequently used to reduce withdrawal symptoms during opioid detoxification in humans. The long-term effects of clonidine on withdrawal symptoms and its effects on subsequent drug exposure have not been thoroughly documented. The aim of the study was to determine if clonidine administered during morphine withdrawal in rhesus monkeys produces long-lasting effects on withdrawal symptoms and alters the effects of subsequently taken drugs of abuse. METHODS: Adult male rhesus monkeys were treated with increasing doses of morphine for 90 d to induce opiate (narcotic) dependence. The immediate and long-lasting effects of 1 week's administration of clonidine were measured via the recording of morphine withdrawal signs and the subsequent effects of challenge injections of morphine or cocaine. RESULTS: Monkeys chronically treated with morphine displayed withdrawal signs that lasted 2 weeks after cessation of morphine administration and displayed sensitized responses to subsequent morphine and cocaine injections. Clonidine significantly reduced certain morphine withdrawal signs and overall withdrawal score, but these effects did not persist upon cessation of clonidine treatment. Sensitization to the effects of morphine and cocaine were significantly reduced in monkeys previously treated with clonidine. CONCLUSION: Our results suggest that in addition to its short-term alleviating effect on morphine withdrawal signs, clonidine may reduce subsequent effects of drugs of abuse after prolonged abstinence.     

Association of genetic variants at MYP10 and MYP15 with high myopia in a Han Chinese population

Background: Previous genome-wide association study (GWAS) has revealed the association between MYP10 at 8p23 and MYP15 at 10q21.1 and high myopia (HM) in a French population. This study is managed to discover the connection between some single nucleotide polymorphism (located at MYP10 and MYP15) and Han Chinese HM.

Methods and Results: This case-control association study contained 1673 samples, including 869 ophthalmic patients and 804 controls. Twelve tag SNPs have been selected from the MYP10 and MYP15 loci and genotyped by SNaPshot method. Among 12 SNPs, rs4840437 and rs6989782 in TNKS gene were found significant association with HM. Carriers of rs4840437G allele and rs4840437GG genotype created a low risk of high myopia (P = .036, OR = 0.81, 95%CI = 0.71–0.93; P = .016, OR = 0.73, 95%CI = 0.56–0.96; respectively). Carriers of rs6989782T allele and rs6989782TT+CT genotype also had a decreased risk of high myopia (P = .048, OR = 0.82, 95%CI = 0.71–0.94; P = .006, OR = 0.74, 95%CI = 0.59–0.92; respectively). Other 10 SNPs displaced nonsignificant association with HM. Additionally, the risk haplotype AC and the protective haplotype GT, generated by two SNPs in TNKS, were considerably more likely to be association with HM (for AC, P = .002 and OR = 1.26; for GT, P = .027 and OR = 0.84).

Conclusions: Our results demonstrated that some heritable variants in the TNKS gene are associated with HM in the Han population. The possible functions of TNKS in the development and pathogenesis of hereditary high myopia still require further researches to identify.     

血管紧张素Ⅱ受体拮抗剂的不良反应文献综述与评价

目的分析血管紧张素Ⅱ受体拮抗剂在临床使用中出现的不良反应,为临床安全用药提供参考。方法检索中国医院数字图书馆数据库中2000～2007年关于血管紧张素Ⅱ受体拮抗剂安全性的文献,并参考其他国内外资料进行综述。结果血管紧张素Ⅱ受体拮抗剂的不良反应主要有头晕、头痛、刺激性干咳与血管神经性水肿、消化系统反应、血液系统反应与神经精神系统反应、泌尿系统反应、心血管反应等,多数症状较轻,但也有严重病例报道,发生与否同用药者个体差异有关。结论血管紧张素Ⅱ受体拮抗剂的不良反应值得临床医生关注。     

安徽省43771例围产儿出生缺陷流行病学监测

本文报道安徽省1986年10月1日～1987年9月30日期间我省29所医院围产儿出生缺陷监测结果。43771名围产儿中,出生缺陷467例,发生率10.67‰;围产儿死亡1600例,死亡率36.55‰。两组性别间均无显著性差异(P>0.05)。81种畸形前五位依次为脑积水、无脑儿、唇腭裂、多指(趾)与足内(外)翻。农村出生缺陷发生率(16.35‰)高于城市(7.37‰),两者有显著性差异(P<0.01)。皖北地区神经管畸形居首位;皖南、皖中则以肢体畸形多见。木文初步探讨了出生缺陷与父母血缘、母亲文化程度低、年龄<20或>35岁、多孕次、产次、双胎等因素的关系。     

对维生素D缺乏性佝偻病不合理治疗的干预效果评价

目的 对有不合理治疗病史的维生素D缺乏性佝偻病患儿进行干预治疗并进行效果评价。方法 对147名有不合理治疗病史的维生素D缺乏性佝偻病患儿进行合理治疗，对其家长和保育员进行卫生宣教。结果 合理治疗后患儿的治愈率增加，临床症状显著减少；卫生宣教后家长的问卷及格率显著提高。结论 积极的卫生宣教和合理的治疗对于减少维生素D缺乏性佝偻病的发病、提高治愈率很有价值。     

Overexpression/amplification of HER-2/neu is uncommon in hepatocellular carcinoma

BACKGROUND： Hepatocellular carcinoma （HCC） is one of the most prevalent fatal cancers in the world. Despite advances in early diagnosis and improvements in surgical techniques, the survival of patients with HCC even after resection is poor because of the high incidence of recurrences. Therefore, the identification of prognostic factors may be helpful in the development of new treatment protocols. AIMS： To investigate HER-2/neu status in HCC by immunohistochemistry （IHC） and fluorescence in situ hybridisation （FISH）, and to explore the possibility of using trastuzumab in the treatment of HCC. METH ODS： Eight hundred and sixty eight surgical samples from patients with primary HCC were examined for their HER-2/neu status. IHC for HER-2/neu was performed with the HercepTest kit; FISH analysis was performed with the PathVysion HER-2 DNA probe kit. The correlations between HER-2/neu overexpression and clinicopathological characteristics were analysed statistically. RESULTS： HER-2/neu overexpression was detected in 21 （2.42%） of the 868 primary HCCs. Only one specimen showed HER-2/neu gene amplification by FISH. No significant associations were found between HER-2/neu overexpression and the clinicopathological parameters. CONCLUSIONS： There is a low frequency of HER-2/neu overexpression/amplification in HCC. There appears to be no role for HER-2/neu as a prognostic marker and no benefit of anti-HER-2/neu trastuzumab treatment in patients with HCC.     

腹腔镜下子宫肌瘤摘除术68例分析

目的:探讨腹腔镜子宫肌瘤摘除术的方法。方法:选择68例子宫肌瘤患者进行腹腔镜下手术,依肌瘤的类型、大小及个数以不同的方法作肌瘤摘除术。结果:本组病例术后6h恢复正常饮食,起床活动,3d伤口折线。术后无出血、感染,手术无中转开腹。结论:腹腔镜下子宫肌瘤摘除术具有创伤小,痛苦少,恢复快,住院日短,术后并发症少等优点,并能保留子宫,维持正常月经和生育功能。本文还对病例的选择、预防和减少术中出血等问题进行讨论。     

加强实验室建设和管理培养实用型人才

从实验教学管理、实验队伍建设、实验室建设等方面论述医学专科学校如何建立具有专科特色的实验室管理模式和运行机制,为培养高质量的实用型技术人才发挥重要作用。