慢性冠状动脉完全闭塞患者行PTCA术后血管造影随访情况

据《American Heart Journal》1994年127卷第1期报道 作者对110例慢性冠状动脉闭塞患者行经皮腔内冠状动脉成形术(PTCA),其中69例获得成功。首次PTCA术是否成功与冠状动脉病变的程度、堵塞部位邻近表面形态学以及临床堵塞持续时间有关。首次PTCA术成功的患者中,62例再次血管造影证实,有34例(55％)再次出现狭窄,其中11例为完全性闭塞。30例再次行PTCA术,80％获得成功。所有第二次PTCA术成功的患者血管造影随访证实,有7例又一次出现狭窄。在该项研究中,111根动脉完全闭塞,其中28根血管一次行PTCA术获得成功,另有17例在第二次PTCA术后血管造影随访时没有发现再次狭窄。     

骨转移癌放射治疗的止痛效果

1资料与方法1.1病例资料本组128例,男77例,女51例。年龄37～83岁,平均58.5岁。其中肺癌37例,乳腺癌33例,肝癌26例,前列腺癌15例,肾癌8例,直肠癌4例,甲状腺癌2例,原位不明癌3。转移灶:单发73例,占57.03%;多发55例,占42.97%。转移部位:以胸腰椎居多共62例,占48.44%;骨盆25例,占19.53%;髋关节16例,占12.50%;股骨和肋骨各10例,共占15.63%;颅骨等共5例,占3.90%。所有骨转移瘤均经X线或CT、MRI明确诊断。1.2治疗方法根据患者情况,针对转移灶的多少和症状轻重缓急,选取1个或3个骨转移灶,利用直线加速器4MVX线外照射治疗,40～60Gy/4～6周,或4～6…     

精神分裂症脑结构异常与临床

半个多世纪以来，医学界对精神分裂症脑部形态结构的研究，一直受到各国学者的关注，但由于研究方法和使用标准不一，其研究结果不尽一致。近20年来，随着新技术的应用，如电子计算机断层扫描(CT)及MRI等，为研究精神分裂症脑部形态学改变与临床之间的关系，提供了良好的机会。国内外学者在这方面做了大量工作，现将有关资料综述如下：     

40例无变应性结核病抗结核治疗前后细胞免疫功能状态分析

目的：了解无变应性结核病细胞免疫功能状态，以期为临床治疗提供帮助。方法：对40例无变应性结核病患者行规律标准抗结核＋免疫调节剂治疗前后进行T细胞亚群数值测定。结果：40例无变应性结核病患者均存在不同程度的免疫功能低下，抗结核＋免疫调节治疗前后T细胞亚群数值有明显升高（P〈0．01），PPD试验转阳。结论：变应性结核病抗结核治疗前后细胞免疫功能变化较多。     

胃良性和恶性病变组织中β-半乳糖凝集素3和接骨木凝集素的表达及其临床病理意义

Objective To study the expressive levels of galectin-3(gal-3) and sambucus nigra agglutinin (SNA) and their clinicopathological significance in the benign and malignant lesions of stomach. Methods EnVisonTM immunohistochemistry for assaying gal-3 expressive level and ABC cytochemistry for determining SNA expressive level were used in conventional paraffin-embedded sections from specimens of gastric cancer(n=49), peritumoral tissues(n=20), metastastic foci of lymph nodes(n=36), and different types of benign lesions(n=80). Results The positive rates of gal-3 and SNA were significantly higher in gastric cancer tissues than those in peritumoral tissues and different types of benign lesions (P<0.05, P<0.01). The positive cases of gal-3 and/or SNA in peritumoral tissues and benign lesions showed mild- to severe-atypical hyperplasia of mucous epithelial cells. No difference was found between the primary foci and metastatic foci in gal-3 and SNA expressions (P>0.05). The positive rates of gal-3 and SNA were significantly lower in histologic grade Ⅱ, infitrating depth T1,T2 and no-metastasis of regional lymph node than those in histologic grade Ⅲ, Ⅳ, infitrating depth T3,T4 and metastasis of lymph node in gastric cancer(P<0.05). The positive rates of gal-3 and SNA were higher in lymphnede metastatic site N1 and no-metastasis of distant organs than those in lymphnede metastatic site N2, N3 and metastasis of distant organs, but no significant difference was found (P>0.05). The consistence was found between the expression of gal-3 and SNA in gastric cancer tissues (χ2=6.59,P<0.05). Conclusions The expressive levels of gal-3 and SNA may be important molecular markers of lectins for reflecting the carcinogenesis, progression and biological behaviors in gastric cancer.     

新辅助化疗对结直肠癌的作用

目的探讨短程5-FU/CF方案新辅助化疗对结直肠癌细胞凋亡、增殖和p53表达以及术后并发症和预后的影响。方法分别采用脱氧核糖核苷酸末端转移酶介导的缺口末端标记法（TUNEL）和免疫组化SP法检测68例患者结直肠癌组织的细胞凋亡指数（AI）和ki-67增殖指数（PI）及凋亡相关基因p53的表达,并比较新辅助化疗组和对照组患者术后并发症的发生情况和预后情况。结果新辅助化疗组肿瘤细胞的AI均数为3.56%,明高于对照组的2.29%（P〈0.01）,PI均数为22.60%明显低于对照组的33.60%（P〈0.01）,p53阳性表达率为28.9%（11/38）明显低于对照组的56.7%（17/30）（P〈0.05）。两组中大肠癌细胞的AI与PI均呈负相关（r=-0.790,r=-0.663）（P〈0.01）。两组术后并发症的发生差异无显著性（P〈0.05）。两组的复发转移率和复发转移平均时间差异有显著性（P〈0.05）。结论短程5-FU/CF方案新辅助化疗可以显著诱导结直肠癌细胞凋亡,并抑制其增殖;降低结直肠癌组织p53的阳性表达率,而不增加术后并发症的发生,能延缓和减少结直肠癌术后的复发转移。     

胃良性和恶性病变组织中β-半乳糖凝集素3和接骨木凝集素的表达及其临床病理意义

Objective To study the expressive levels of galectin-3(gal-3) and sambucus nigra agglutinin (SNA) and their clinicopathological significance in the benign and malignant lesions of stomach. Methods EnVisonTM immunohistochemistry for assaying gal-3 expressive level and ABC cytochemistry for determining SNA expressive level were used in conventional paraffin-embedded sections from specimens of gastric cancer(n=49), peritumoral tissues(n=20), metastastic foci of lymph nodes(n=36), and different types of benign lesions(n=80). Results The positive rates of gal-3 and SNA were significantly higher in gastric cancer tissues than those in peritumoral tissues and different types of benign lesions (P<0.05, P<0.01). The positive cases of gal-3 and/or SNA in peritumoral tissues and benign lesions showed mild- to severe-atypical hyperplasia of mucous epithelial cells. No difference was found between the primary foci and metastatic foci in gal-3 and SNA expressions (P>0.05). The positive rates of gal-3 and SNA were significantly lower in histologic grade Ⅱ, infitrating depth T1,T2 and no-metastasis of regional lymph node than those in histologic grade Ⅲ, Ⅳ, infitrating depth T3,T4 and metastasis of lymph node in gastric cancer(P<0.05). The positive rates of gal-3 and SNA were higher in lymphnede metastatic site N1 and no-metastasis of distant organs than those in lymphnede metastatic site N2, N3 and metastasis of distant organs, but no significant difference was found (P>0.05). The consistence was found between the expression of gal-3 and SNA in gastric cancer tissues (χ2=6.59,P<0.05). Conclusions The expressive levels of gal-3 and SNA may be important molecular markers of lectins for reflecting the carcinogenesis, progression and biological behaviors in gastric cancer.     

浅论医院人事与分配制度改革的必要性及措施

1　深化改革 ,势在必行1 1　长期以来 ,医院主要靠政府投入 ,计划经济带来的吃大锅饭、分配不公、人浮于事的现状严重制约着医院发展 ,用人缺乏自主 ,定职、任免、调配等完全由上级有关部门操作 ,导致了有些专业技术人员甘居中游 ,不思进取 ;还有相当一部分人凭关系通过各种途径进入医院 ,业务能力低下 ,干好干坏 ,待遇均等 ,挫伤了部分工作人员的积极性。1 2　服务理念和经营意识有待改变 ,尽管经过多年的纠风工作 ,但服务质量仍不尽人意 ,冷、硬、顶、推、拖现象时有发生。1 3　为寻求一条适应市场经济发展的出路 ,改变全体职工的思想观念…     

大学生篮球运动员集训期间部分淋巴细胞亚群和Th1/Th2细胞因子mRNA表达变化分析

目的:探讨大负荷体能训练对大学生篮球运动员细胞免疫功能的影响。方法:14名男子大学生篮球运动员进行为期16周的集训,在训练期间分次对运动员外周血淋巴细胞亚群(CD3+、CD4+/CD8+淋巴细胞比值、NK细胞比例)和Th1/Th2细胞因子 mRNA表达进行检测。结果:在两次分别持续了6周的训练期后,运动员外周血CD3+淋巴细胞数于增加后出现显著下降,从第7周的峰值(59.74±7.18)下降至第16周的最低值(52.02±7.92)(P<0.001);CD8+细胞数第16周(31.15±6.25)与第3周(37.98±7.05)相比显著下降(P<0.05);NK细胞数从第7周的最高值(19.62±5.21)下降至第14周的最低值(14.41±7.93)(P<0.05);IL-4 mRNA表达训练后与基础值(6.56±0.71)相比显著增加,从第7周的7.04±0.35和第14周的7.30±0.25,直至第16周达到最大值7.36±0.45(P<0.05),其他指标的变化不具有统计学意义。结果提示,大负荷训练使运动员细胞免疫功能削弱,Th1/Th2平衡向Th2方向漂移。     

新一代国产吻合器在中低位直肠癌手术中的应用

进口双吻合器价格昂贵．在目前条件下很难在我国广大地区普及使用。我院2001年1月至2005年8月对75例中低位直肠癌患者，使用国产荷包缝合器和吻合器行中低位直肠癌前切除术，效果良好。